Blood Markers Research Articles

Unravelling Faecal Microbiota Variations in Equine Atypical Myopathy: Correlation with Blood Markers and Contribution of Microbiome

Hypoglycin A and methylenecyclopropylglycine are protoxins responsible for atypical myopathy in equids. These protoxins are converted into toxins that inhibit fatty acid β-oxidation, leading to blood accumulation of acylcarnitines and toxin conjugates, such as methylenecyclopropylacetyl-carnitine. The enzymes involved in this activation are also present in some prokaryotic cells, raising questions about the potential role of intestinal microbiota in the development of intoxication. Differences have been noted between the faecal microbiota of cograzers and atypical myopathy-affected horses. However, recent blood acylcarnitines profiling revealed subclinical cases among cograzers, challenging their status as a control group. This study investigates the faecal microbiota of horses clinically affected by atypical myopathy, their cograzers, and a control group of toxin-free horses while analysing correlations between microbiota composition and blood parameters. Faecal samples were analysed using 16S amplicon sequencing, revealing significant differences in α-diversity, evenness, and β-diversity. Notable differences were found between several genera, especially Clostridia_ge, Bacteria_ge, Firmicutes_ge, Fibrobacter, and NK4A214_group. Blood levels of methylenecyclopropylacetyl-carnitine and C14:1 correlated with variations in faecal microbial composition. The theoretical presence of enzymes in bacterial populations was also investigated. These results underscore the critical need to investigate the potential role of intestinal microbiota in this poisoning and may provide insights for developing prevention and treatment strategies.

Preoperative diagnostic efficacy of novel blood markers white blood cell ratio and fibrinogen levels in periprosthetic joint infection

To investigate the clinical utility of novel of new hematological markers in the preoperative diagnosis of periprosthetic joint infection (PJI). A retrospective analysis was conducted on a total of 149 patients who underwent revision of total hip arthroplasty (THA) or total knee arthroplasty (TKA) at a single center between January 2016 and June 2022, including 63 males and 86 females, aged from 47 to 93 years old with an average of (69.5±11.8) years old. Of them, 46 were diagnosed as PJI(PJI group), including 22 males and 24 females. The mean age was (71.3±12.5) years old. The body mass index (BMI) was (26.4±3.1) kg·m-2. And 103 patients were diagnosed as aseptic prosthesis loosening (aseptic group), including 41 males and 62 females. The mean age was (68.7±11.4) years old. The BMI was (25.8±3.5) kg·m-2. Preoperatively analyzed clinical parameters included C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), albumin, globulin, albumin-to-globulin ratio (AGR), plasma D-dimer, and plasma fibrinogen. The receiver operating characteristic curve (ROC), sensitivity, and specificity analysis were employed to compare the diagnostic value of each blood marker in preoperative PJI diagnosis. In the PJI group, the levels of CRP were 16.6 (7.6, 4.5) mg·L-1, ESR was 17.0 (12.8, 35.5) mm·h-1, plasma D-dimer was 1.0 (0.5, 3.1) μg·L-1, and plasma fibrinogen was 4.2 (3.2, 3.1) mg·L-1;all of which were higher compared to the aseptic group with CRP at 4.2 (2.6, 7.8) mg·L-1, ESR at 12.0(8.0, 20.0 )mm·h-l, D-dimer at 0.4(0.2, 0.7)μg·L-1, and fibrinogen at 2.8(2.4, 3.3 ) g·L-1(P<0.05). However, the albumin level of 35.3 (32.3, 37.5) g·L-1 and the WBC ratio of 1.0(0.9, 1.1) in the PJI group were significantly lower compared to the aseptic group with levels of 39.8 (36.1, 41.8) g·L-1 and 1.4 (1.3, 1.5), respectively (P<0.05). Only the area under the curve (AUC) of AGR and plasma fibrinogen were greater than 0.8. The optimal predictive cut-1off, AUC, sensitivity and specificity were 3.4 g·L-1, 0.820, 69.57% and 84.47% for plasma fibrinogen; 1.18, 0.813, 82.61% and 78.64% for AGR, respectively. AGR and plasma fibrinogen are promising blood markers for improving the diagnosis of PJI.

Lifetime age-related changes in clinical laboratory results, aging clocks and mortality predictors in 2412 Golden Retrievers.

In this study, we investigated age-related changes in clinical laboratory data and their association with mortality in dogs from the Golden Retriever Lifetime Study. By analyzing complete blood count (CBC) and biochemistry data from 2'412 Golden Retrievers over 16,678 visits, we observed significant changes during the first 2 years of life and throughout aging. Based on these observations, we developed a biological aging clock using a LASSO model to predict age based on blood markers, achieving an accuracy of R = 0.78. Although the biological age clock and pace of aging did not significantly improve mortality prediction, a model incorporating all blood biomarkers showed better predictive power for lifetime (C-index = 0.763) and 1-year mortality (AUC = 0.817). Our findings underscore the importance of comprehensive blood analysis for aging and mortality prediction in dogs and open the door for the development of novel methods to investigate aging in companion animals.

Prognostic significance of peripheral blood biomarkers in patients with advanced renal cell carcinoma treated with nivolumab and ipilimumab—a polish multicenter, observational study

Immune checkpoint inhibitors have improved the treatment of metastatic renal cell carcinoma (RCC), with the combination of nivolumab (NIVO) and ipilimumab (IPI) showing promising results. However, not all patients benefit from these therapies, emphasizing the need for reliable, easily assessable biomarkers. This multicenter study involved 116 advanced RCC patients treated with NIVO + IPI across nine oncology centers in Poland. Blood markers such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR), eosinophils, and monocytes were assessed at baseline, after three months, and before disease progression (PD). The prognostic significance of these parameters was analyzed using linear regression, Kaplan–Meier survival analysis, and Cox regression models. After a median follow-up of 11.8 months, the progression-free survival (PFS) was 12.8 months (95% confidence interval [CI] 5.7–28.1), while the overall survival (OS) was 27.3 months (95% CI 16-not reached). Patients with an NLR increase of ≥ 25% had a PFS of 8.2 (3.1–24.7) months compared to 17.5 (8.6–28.1) months in those with a rise in < 25% (p = 0.015). Similarly, a ≥ 25% increase in PLR was linked to a PFS of 6.8 (2.8–8.3) months compared to 17.4 (8.4–28.1) months (p < 0.001). Multivariate analysis confirmed PLR as an independent predictor of PFS (HR 2.9, 95% CI 1.5–5.6, p = 0.001), while elevated eosinophil levels were associated with a reduced risk of death (HR 0.2, 95% CI 0.04–0.9, p = 0.05). No other analysis was statistically significant. NLR, PLR, and eosinophil levels may serve as valuable biomarkers for predicting treatment response in RCC patients receiving NIVO + IPI.

P0369 The use of exhaled volatile organic compounds for the non-invasive assessment of endoscopic inflammation in patients with ileal pouch anal anastomosis (IPAA)

Abstract Background The incidence of inflammatory conditions in patients with ileal pouch-anal anastomosis (IPAA) constructed for the treatment of refractory ulcerative colitis (UC) and its complications is increasing. Objective assessment of IPAA inflammation is limited to surrogate markers in blood and stool which lack sensitivity and specificity or invasive endoscopic evaluations. Measurement of exhaled breath volatile organic compounds (VOCs) in breath shows promise for the assessment of inflammation. Our study aims to evaluate the pattern of VOCs in the exhaled breath of patients with IPAA and assess whether exhaled breath analysis can effectively distinguish patients with endoscopically active IPAA inflammation from patients without IPAA inflammation. Methods We conducted a cross-sectional study of patients with IPAA created for the management of UC. Exhaled breath samples were obtained from patients presenting for endoscopic pouch evaluation. Samples were analyzed using selective ion flow tube mass spectrometry (SIFT-MS) to measure constituent VOCs. Patients were dichotomized into subjects with significant endoscopic pouch inflammation, endoscopic pouch disease activity index greater than or equal to 4 (ePDAI ≥ 4) or patients with minimal pouch inflammation (ePDAI ≤ 1) . Similar analyses were performed in subjects with a ePDAI greater than or equal to 5. Principle component analysis (PCA) was conducted to reveal the most important VOCs that differentiate two cohorts. Principle component regression (PCR) was performed to assess the prediction performance of exhaled breath VOC analysis in differentiating the groups. Results In the final analysis, 70 subjects presenting for pouch endoscopic evaluation were included in the study. 29 subjects had an ePDAI less than or equal to 1 and 41 subjects had and ePDAI greater than or equal to 4. Demographics are provided in table 1. Key VOCs—ethane, octanoic acid, and propylcyclohexane—were found to differ significantly between the two groups. Figure 1 shows the receiver operating curve (ROC) of the PCR model for the full mass scan, showing an area under the curve (AUC) of 0.77 (0.66-0.88). A similar analysis in patients with PDAI of greater than equal to 5, demonstrated and AUC of 0.83 (0.72-0.94). Conclusion Exhaled breath VOC analysis effectively differentiates between patients with significant pouch inflammation and those with minimal inflammation. This non-invasive method shows promise as a reliable tool for assessing ileal pouch inflammation, with high patient acceptance. Further research is warranted to validate these findings and explore the potential of VOC analysis in clinical practice.

P0558 An Integrative Blood-Based Risk Score Predicts Development of Crohn's Disease

Abstract Background Individual blood markers have been associated with future risk of Crohn's disease (CD). However, there is a need to understand which combination of biomarkers will be most predictive to facilitate CD prevention trial recruitment. We aimed to develop and validate a blood-based integrative risk score for CD development. Methods We analyzed data from 200 patients with CD and 100 age, sex, and race-matched healthy controls (HC) from PREDICTS, a nested case-control study of US active-component service members (ACSM). Longitudinal serum samples were collected at four time points up to 6+ years prior to diagnosis. Anti-microbial antibodies (Prometheus), proteomic markers (Olink inflammation panel), and anti-granulocyte macrophage-colony stimulating factor autoantibodies (anti-GM-CSF) were assayed in each sample. Participants were randomly divided into equal sized training and testing sets. Time-varying trajectories of marker abundance were estimated for each biomarker. Logistic regression modeled disease status as a function of each marker for different time points and multivariate modeling was performed via logistic lasso regression. A risk score to predict CD onset within 2 years was developed using penalized mixed-effects logistic regression. Prediction models were fit on the testing set and predictive performance evaluated via receiver operating characteristic (ROC) curves and area under the curve (AUC). Results The AUCs of individual markers were dynamic over time, with some having stable predictive capacity and others increasing or decreasing closer to time of diagnosis (Figure 1A). The AUCs for a model combining antibodies (Prometheus and anti-GM-CSF) and proteins were consistently above 0.8 starting 4 years prior to diagnosis, primarily driven by proteomic markers (Figure 1B). An integrative model predicting CD onset within 2 years incorporated 10 biomarkers and significantly associated with CD onset (Figure 1C). The model resulted in an AUC of 0.87 with a specificity of 99% and positive predictive value of 84% at a classification threshold of 0.7 (Figure 1D). Stratifying the integrative model scores into quartiles revealed a clear gradient in CD incidence within 2 years, increasing from 2% in the first quartile to 57.7% in the fourth quartile (Figure 1E). The relative risk (RR) for developing CD among ACSM in the top quartile, compared to the lower quartiles, was 10.4 (95% CI 6.9, 15.6). Conclusion An integrative blood-based model combining anti-microbial antibodies and proteins predicts onset of CD. Serologic and proteomic markers have dynamic changes years before diagnosis, highlighting the varying preclinical phases of CD and how leveraging biomarker dynamics can predict time to diagnosis. Figure 1

P0356 A case of pulmonary nodules in Ulcerative Colitis and primary sclerosing cholangitis: is it drug or disease?

Abstract Background Pulmonary manifestation of inflammatory bowel disease (IBD) is rare, with a broad range of lung diseases including airways, parenchymal, pleural, and pulmonary vascular disease. It is commonly associated with concurrent use of disease-modifying drugs. We present a case of a 26 year old man with ulcerative colitis and primary sclerosing cholangitis (PSC) who developed lung nodules. Methods Case summary: He was diagnosed with PSC in 2017 and ulcerative colitis in 2018. He had active colitis while on an escalated dose of adalimumab, therefore he was switched to vedolizumab. His faecal calprotectin improved but due to ongoing rectal bleeding, the dose of vedolizumab was escalated from 8 to 4 weekly. 5 months after starting vedolizumab he developed night sweats, dry cough, and breathlessness. He has no history of foreign travel, exposure to tuberculosis, industrial exposure, or bird keeping. Results His initial investigations showed a raised CRP and bilirubin. His CT chest showed numerous lung nodules in both lower lobes. His sputum culture, AFB, and fungal blood markers were negative. Samples were also sent from a bronchoalveolar lavage fluid including for pneumocystis jirovecii, which were negative. He was treated with antimicrobials and antifungal, without improvement. He subsequently underwent a lung biopsy, which showed inflammatory changes in an interstitial pattern, which could be related to the biologic therapy, or underlying disease. Staining for fungus, EBV, CMV, HSV were negative. He was treated as bronchiolitis obliterans organising pneumonitis induced by vedolizumab. Vedolizumab was stopped and prednisolone 40mg was started. His symptoms and inflammatory markers improved, and subsequent pulmonary imaging showed a reduction in the size of the lung nodules. Tapering the prednisolone dose to 10mg unfortunately caused a progression in the lung nodules, despite cessation of vedolizumab, which makes it less likely as the culprit drug. Prednisolone was then increased back up to 40mg, resulting in almost complete resolution of the lung nodules, with the plan for a much slower tapering. Despite the high doses of steroid his colitis is still moderately active on colonoscopy. However, further advanced therapy had to be put on hold while waiting for his lung nodules to resolve. Conclusion It remains difficult to determine whether his pulmonary disease is secondary to the biologic drugs, or the underlying disease process of ulcerative colitis. While pulmonary disease associated with IBD has been widely reported, there is currently unclear understanding of its pathophysiology and treatment. Clinicians need to be aware of this rare entity in IBD in order to improve patient outcomes.

P1313 Gut microbiota therapy improves outcomes in inflammatory bowel disease

Abstract Background Inflammatory bowel disease (IBD), which includes Crohn’s disease (CD) and ulcerative colitis (UC), is a long-term condition characterized by inflammation of the gut. Research has shown that disruption of the gut microbiota, known as dysbiosis, plays an important role in the disease. While current treatments focus on controlling inflammation, many patients continue to experience symptoms or side effects. This study explores the effectiveness of a new therapy aimed at restoring the balance of gut microbes and improving disease outcomes. Methods This study included 120 adults with IBD, randomly divided into two groups: one received standard care, and the other received a combination of prebiotics, probiotics, and dietary adjustments targeting gut bacteria. The trial lasted 12 weeks, with assessments at the start, 6 weeks, and 12 weeks. Prognosis was assessed through upper gastrointestinal endoscopy (including esophagogastroduodenoscopy) and colonoscopy to evaluate disease extent, detect complications, and monitor gastrointestinal changes. Postoperative complications, clinical symptoms, and routine lab tests (CRP and IL-6) were used to assess outcomes. Statistical tests compared clinical and endoscopic results between the groups. Results Patients who received the microbiota-targeted therapy showed significant improvement compared to the standard care group. Disease scores decreased notably (Harvey-Bradshaw Index reduced by 3.9 points and Mayo Score by 3.2 points, both p &amp;lt; 0.01). Blood markers of inflammation also dropped, with CRP levels falling by 42% and IL-6 by 38% (both p &amp;lt; 0.05).Additionally, upper gastrointestinal endoscopy (including esophagogastroduodenoscopy) and colonoscopy were used to assess the condition of the gastrointestinal tract and evaluate disease improvement. Postoperative complications, changes in clinical symptoms, and routine test results also helped in determining the treatment outcome. The therapy was well tolerated by patients, with no major side effects reported. Conclusion This study highlights the promising potential of gut microbiota therapy as a safe and effective approach for improving symptoms and reducing inflammation in IBD. By restoring balance to the gut microbiota, this therapy targets a critical factor in the disease process. The positive outcomes observed in this trial pave the way for future research into the integration of microbiota-based treatments as part of comprehensive IBD management strategies. Continued investigation in larger, long-term studies will be crucial to further validate these findings and explore the potential of microbiota-targeted therapies for achieving sustained remission and improving overall patient outcomes.

P0455 An eosinophilic endotype of ulcerative colitis is linked with a more complicated disease phenotype

Abstract Background The course, extent, and therapeutic response in ulcerative colitis (UC) are highly heterogeneous. The spatial and immunological variability of chronic inflammation in UC may explain the inconsistent responses to advanced therapies. Eosinophils are found in both inflamed and non-inflamed tissue at varying numbers, though their exact role in UC pathophysiology and clinical significance is still unclear, despite being part of the Geboes score criteria. We therefore aimed to systematically assess the clinical characteristics of UC patients with tissue eosinophilia as reported by pathology, hypothesizing that this group represents a molecularly distinct sub-entity of UC. Methods We screened all pathology reports from endoscopies performed on IBD patients at the University Hospital Schleswig-Holstein (UKSH, Kiel), between 2010 and 2022. Of 10,552 reports, we identified 179 cases with confirmed UC diagnosis, informed consent, and sufficient clinical and follow-up data. Clinical data extracted from electronic medical records included baseline demographics, histo-endoscopic disease activity, routine blood markers, and 24-month follow-up for UC-related hospitalization, surgery, and therapy escalation (with advanced therapies or systemic steroids). A molecular cross-sectional UC cohort (n=587) recruited at UKSH during the same period served as the control group. Early disease was defined as a disease duration of less than 24 months with no prior advanced therapies. Results Patients with tissue eosinophilia were younger (median age: 36 vs. 42 years, p=0.0095), had a lower BMI (25.20 vs. 33.90 kg/m², p&amp;lt;0.0001), higher blood eosinophil counts (0.20 vs. 0.09 /nL, p=0.0003), elevated CRP levels (3.88 vs. 2.47 mg/L, p=0.0342), and higher Endoscopic Mayo Scores (2 vs. 1, p=0.0003) compared to controls. However, the Nancy Histology Index (2 vs. 2, p&amp;gt;0.05) as well as the sex ratio (male sex: 56.42% vs. 57.99%; p&amp;gt;0.05) was similar between the groups. Within 24 months of follow-up, the tissue eosinophilia group had a higher likelihood of disease-related hospitalization (Log-rank test: p=0.0029) and UC-related surgery (p=0.0223). When stratified by disease phase, these findings were significant only in patients in the late disease phase (hospitalization: p=0.0345; surgery: p=0.0012). Conclusion Tissue eosinophilia in patients in the later stage of their disease is associated with worse long-term outcomes, such as UC-related hospitalization and surgery within 2 years. These findings hint towards the existence of a type-2 immunity-associated endotype of UC. Further studies on eosinophil count and their activation states are needed to define functional signatures of this novel group of patients that might benefit from therapies targeting type-2-cytokines. References This project has received funding from the DFG Cluster of Excellence 2167 “Precision medicine in chronic inflammation”, the BMBF (e:Med Network iTREAT 01ZX2202A), EKFS (2022_EKMS.23), the PATHWAYS Global Innovation Grant program (Sanofi &amp; Regeneron), and the Innovative Medicines Initiative 2 Joint Undertaking (JU) under grant agreement No 831434 (3TR) and No 853995 (ImmUniverse).The JU receives support from the European Union’s Horizon 2020 research and innovation programme and EFPIA. The content provided in this publication reflects the author’s views only. Neither the Innovative Medicines Initiative (IMI JU) nor the European Commission are responsible for any use that may be made of the information it contains.

Impact and Contributing Factors of Maternal Pyrexia Peaks During Labor on Maternal and Neonatal Outcomes.

This study aims to equip clinicians with the necessary insights for identifying and managing pregnant women experiencing elevated maternal pyrexia during labor. It examines maternal and neonatal outcomes along with the factors associated with varying peak temperatures. A retrospective analysis was conducted on 319 pregnant women presenting with maternal pyrexia during labor. Participants were categorized into two groups based on peak temperature: Group A (n = 180, temperature <38°C) and Group B (n = 139, temperature ≥38°C). Basic characteristics, blood markers, and maternal and neonatal outcomes were compared between the two groups. (1) Group B exhibited a higher percentage of neutrophilic granulocytes (NE%) and C-reactive protein to lymphocyte ratio (CLR) compared with Group A (p < 0.05). (2) The rates of meconium-stained amniotic fluid, histological chorioamnionitis, hospitalization of neonates, and infections in neonates were greater in Group B than in Group A (p < 0.05). (3) Logistic regression analysis identified elevated CLR levels as a risk factor for peak temperatures exceeding 38°C, indicating that CLR could serve as a reliable predictor of maternal pyrexia above 38°C during labor. Higher maternal pyrexia peaks may exacerbate adverse maternal and neonatal outcomes, emphasizing the importance of timely clinical intervention. NE% and CLR could serve as valuable indicators for identifying underlying causes and predicting peak maternal pyrexia during labor.

Excessive Weight Gain During Pregnancy Increased Ponoxarase 1 Level in Neonatal Cord Blood.

Maternal obesity is increasingly recognized as a risk factor for adverse fetal outcomes, primarily through its association with heightened oxidative stress. This study aimed to evaluate oxidative stress markers in umbilical cord blood of neonates born to obese mothers. Sixty-three pregnant women, who were of normal weight at the start of pregnancy but classified as obese at term, were included. Umbilical cord blood samples were collected immediately post-delivery and analyzed for serum oxidative stress markers (total oxidant status (TOS), total antioxidant status (TAS), paraoxanase (PON), aryl esterase, thiol, and catalase activities). Protein interaction networks were generated using Cytoscape (v3.10.3), and the overlapping proteins were further analyzed for functional annotations with ShinyGO (0.80). The top ten significantly enriched pathways were identified with a false discovery rate (FDR) threshold of <0.05. Significant associations were found between maternal BMI change and paraoxonase 1 (PON1) levels in umbilical cord blood, while no correlation was observed with other oxidative (total oxidant status) and antioxidant markers (total antioxidant status, aryl esterase, thiol, and catalase). Additionally, the correlation analysis showed a significant relationship between BMI change and fetal gestational age, but not with other demographic or clinical features. A total of 24 common protein interactors associated with PON1, obesity, and oxidative stress were identified. Functional annotation analysis revealed significant enrichment in antioxidant and oxidoreductase activities, along with pathways involved in insulin resistance, AGE-RAGE signaling, and atherosclerosis. Maternal obesity may specifically affect PON1 activity, potentially serving as a compensatory response to oxidative stress in neonates, suggesting PON1 as a possible biomarker for oxidative stress-related metabolic disturbances in neonates of obese mothers, with implications for monitoring and managing pregnancy outcomes in obese populations.

Predictive Role of Soluble B-Cell Maturation Antigen in Short-Term Monitoring of Differently Treated Multiple Myeloma Patients: A Prospective Study.

The management of multiple myeloma is challenging because the disease is incurable and unexpected relapses can threaten a patient's survival. Several assessment systems are currently available, but they often require invasive or costly procedures (e.g., instrumental bone marrow and whole-body examinations) or rely on non-specific markers in blood and urine that may not be sufficient to assess and monitor the disease. To address some of these limitations, the aim of this study was to evaluate the potential use of soluble B-Cell Maturation Antigen (BCMA), a promising new serum biomarker, as a toll for moniting multiple myeloma patients. An unselected cohort of 57 newly diagnosed or relapsed myeloma patients was followed up for 6 months after starting a new therapy. Soluble BCMA levels were measured in peripheral blood using a simple and inexpensive ELISA assay. Soluble BCMA was detectable in peripheral blood by a simple and inexpensive assay in all patients, even in non-secretory disease or during BCMA-targeted therapies, and significant changes in its levels were observed over time. The analysis showed that the decrease in sBCMA at 1 and 6 months reflects the quality of the clinical response to anti-myeloma regimens. The data provide interesting insights into the usefulness of sBCMA as a non-invasive toolfor early assessment of treatment efficacy. Its simple and cost-effective detection in peripheral blood could provide clinicians with an addiotional resource for monitoring disease progression and tailoring treatment strategies.

Identifying key blood markers for bacteremia in elderly patients: insights into bacterial pathogens

Identifying key blood markers for bacteremia in elderly patients: insights into bacterial pathogens

Clinical significance of the preoperative prognostic nutritional index in patients with resectable non-small cell lung cancer: a multicenter study.

To validate the clinical impacts of the prognostic nutritional index (PNI), an immune-nutritional blood marker, in patients with resectable non-small cell lung cancer (NSCLC) using multicenter cohort data. The subjects of this retrospective multicenter study, involving 11 hospitals, were patients who underwent curative lung resection for pathological stage IA-IIIA NSCLC. We analyzed the relationship between the preoperative PNI and postoperative outcomes. Patients were divided into a high PNI group and a low PNI group (cutoff: 45). We also performed exact matching and three propensity score-based methods to validate the results. Among the total 2,770 patients, 2,272 (82.0%) had a high PNI (>45) and 498 (18.0%) had a low PNI (≤45). A low preoperative PNI was a predictor of increased overall postoperative complications (relative risk 1.49; 95% confidence interval (CI) 1.31-1.69) and an independent adverse prognostic factor for overall survival (hazard ratio 1.77; 95% CI 1.45-2.17) and recurrence-free survival (1.34; 95% CI 1.14-1.59). All the methods we used (whole cohort, exact matching, and three propensity score methods) showed consistent results. The findings of this multicenter study suggest that immune-nutritional assessment using the PNI will provide useful prognostic information for patients with resectable NSCLC.

Quantification of Myocardial Biomarkers in Sudden Cardiac Deaths Using a Rapid Immunofluorescence Method for Simultaneous Biomarker Analysis.

Differential diagnosis of sudden cardiac death (SCD) remains challenging, particularly in cases lacking evident structural abnormalities. Cardiac markers have been proposed as useful tools for this differentiation in forensic contexts. However, key issues include the influence of postmortem interval (PMI) on marker stability and the limitations of traditional approaches that focus on pericardial fluid, which requires invasive sampling compared to peripheral blood. This study aimed to evaluate the potential of cardiac markers in peripheral blood for diagnosing SCD, addressing methodological concerns related to PMI, hemolysis, and sample handling. This study analyzed 5 cardiac markers (creatine kinase-MB [CK-MB], myoglobin, troponin I [TnI], BNP, and D-dimer) in peripheral blood samples from 42 autopsied cadavers, divided into an SCD group and a control group. Marker levels were quantified using immunofluorescence, with cases meticulously selected to exclude confounding factors such as chronic diseases, pulmonary thromboembolism, and drowning. The study also accounted for potential degradation due to PMI, and evaluated the accuracy of point-of-care testing (POCT) in forensic samples. The study identified statistically significant differences in myoglobin and TnI levels between the SCD group and the control group, though myoglobin's diagnostic reliability remains limited due to its lack of specificity for myocardial injury. TnI emerged as a more robust marker for SCD. Contrary to prior concerns, PMI showed no significant correlation with marker levels in samples handled without freeze-thaw cycles. Issues related to hemolysis were addressed, and no significant effects were observed from resuscitation maneuvers. This study supports the potential use of cardiac markers, particularly TnI, in peripheral blood for postmortem SCD diagnosis, emphasizing the importance of rapid and systematic analysis to minimize hemolysis-related variability. While further validation is needed to confirm these findings, this approach offers a less invasive, economical, and practical method for forensic investigations.

The Influence of Mat Pilates Training on Cardiometabolic Risk Factors in Postmenopausal Women with Single or Multiple Cardiometabolic Diseases.

This study compared the effects of Mat Pilates training on cardiovascular risk markers in postmenopausal women with single or multiple cardiometabolic conditions. Forty-four women were divided into single-condition (SINGLE; n = 20) and multiple-condition (MULTI; n = 24) groups. Both groups completed Mat Pilates three times per week for 12 weeks. Measurements of resting blood pressure, body composition, dietary intake, and blood markers were taken before and after the intervention. A Generalized Estimating Equation was used for hypothesis testing. MULTI presented higher body mass, BMI, fat mass, and waist circumference. Systolic blood pressure decreased more in SINGLE (-13 ± 15 mmHg) than in MULTI (-3 ± 16 mmHg, p interaction = 0.016 with diastolic reductions in both groups (SINGLE: -9 ± 12 mmHg; MULTI: -2 ± 11 mmHg, p interaction = 0.053). Triglycerides decreased only in SINGLE (-40 ± 98 mg/dL vs. +31 ± 70 mg/dL in MULTI, p interaction = 0.006), while no significant changes were observed in cholesterol levels. Adiponectin levels decreased in both groups (SINGLE: -1.5 ± 16.3; MULTI: -9.3 ± 12.4 vs. µg/dL, p time = 0.015). Glycated hemoglobin levels decreased over time in both groups (-0.3 ± 0.5% in SINGLE, -0.5 ± 0.6% in MULTI, p time < 0.001), with no significant changes in blood glucose. These findings suggest that Mat Pilates may be more effective in reducing cardiometabolic risk factors in women with a single condition compared to those with multiple conditions.

Primary T-Cell Lymphoma of the Prostate in a Dog – Case Report

The prostate gland is considered an accessory sexual organ of the male reproductive system which in dogs can vary in size influenced by age, weight and breed. The most frequent anomalies found in the canine prostate are due to Benign prostatic hyperplasia, prostatitis, abscesses, prostatic and paraprostatic cysts, squamous metaplasia and prostate neoplasia in adult and geriatric dogs. Prostate lymphoma, unlike some neoplasms, is not routinely seen. An abnormal prostate is presumptively diagnosed based on the patient’s history and clinical signs, blood markers and abnormal anatomical outline detected on palpation and imaging. The present report describes the case of a 13-year-old male, 26 kg, intact dog, referred to the Centro Universitário Barão de Mauá Veterinary Campus manifesting dysuria and diagnosed with primary prostatic lymphoma.

Kinetics of recovery and normalization of running biomechanics following aerobic-based exercise-induced muscle damage in recreational male runners.

The study aimed to examine the effects of exercise-induced muscle damage on running kinetics. Twenty-six adult recreational male runners performed 60 min of downhill running (-10 %) at 65 % of maximal heart rate. Running gait changes, systemic and localized muscle damage markers were assessed pre - and post-exercise induced muscle damage protocol. Running gait was analyzed using a 3D treadmill at baseline, immediately post, 24 h, and 48 h to determine changes in running pressure sway and vertical ground reaction forces. Blood markers, subjective pain perception, and magnetic resonance imaging utilizing T2 relaxation time of the thigh muscles assessed systemic and localized damage. Linear mixed-effects models examined changes over time. Significant decreases were found in the left leg's first (-454.0 to -396.1, P < 0.05) and second (-532.8 to -498.2, P < 0.05) VGRF peaks across all time points compared to baseline. The right leg showed reductions in the first vertical ground reaction forced peak at immediately post (-348.4, P = 0.036) and the second peak at immediately post and 24 h (-467.4 and -396.8, P < 0.05). Creatine kinase increased significantly (P < 0.001) at 24 h and 48 h compared to baseline. The anterior thigh muscle compartment showed significant (P < 0.05) increases in mean T2 values 1 h following exercise protocol remained elevated up to 48 h. Negative correlations were identified between running biomechanics to local and systemic muscle damage markers. Running biomechanics remained impaired for up to 48 h following exercise induced muscle damage and correlated with markers of muscle damage using magnetic resonance imaging.

Anaesthetic Management of Cardiac Myxoma Patient with Systemic Involvement: A Case Report

Although the metastatic involvement of heart is more common, the incidence of Primary Cardiac Tumour is very less (0.001- 0.03 percent of the population). Myxomas, the commonest Primary Cardiac Tumours, are usually benign. However, they can manifest symptoms of systemic involvement, depending upon their location. 75% of the myxomas are located in the left atria of the heart, although no chamber of the heart is immune. Commonly they have pedunculated morphology, with peduncle usually attached to the atrial inter-atrial septum. The symptoms of systemic involvement are common when the myxomas are located in left atria. Diagnosing these Cardiac myxomas can be challenging, especially when the presentation is diverse due to systemic involvement. Echocardiography is helpful in the diagnosis of these cases, although there are reports of various blood markers to be helpful. Once the diagnosis is made, tumour excision is to be undertaken in a timely manner. We present a case of patient left atrial myxoma that had signs of involvement of multiple organs- lungs, abdomen and nervous system. We will be discussing the manner in which we proceeded with the case, taking care of involved organs and optimization of their functions along with the literature review of such cases in this article.

Feasibility, safety and tolerability of estrogen and/or probiotics for improving vaginal health in Canadian African, Caribbean, and Black women: A pilot phase 1 clinical trial.

A dysbiotic vaginal microbiome (VMB) is associated with clinical conditions such as bacterial vaginosis (BV) and an increased risk of human immunodeficiency virus (HIV-1) infection. Considering the high prevalence of BV among African, Caribbean and Black (ACB) women, we conducted a prospective, randomized, open-label phase 1 clinical trial to determine the feasibility, safety and tolerability of administering low-dose estrogen, probiotics or both in combination to improve vaginal health and decrease HIV-1 susceptibility. ACB women aged 18-49 from the Greater Toronto Area (GTA) were randomized to one of four study arms: intravaginal estradiol (Estring©; 7.5mg/day); a vaginal probiotic (RepHresh™ Pro-B™) administered twice daily; a combination of Estring© and vaginal RepHresh™ Pro-B™ (twice daily); or the Estring© and oral RepHresh™ Pro-B™ (twice daily), for a duration of 30 days. Feasibility was evaluated through enrolment, retention, and adherence rates, while safety and tolerability were determined by a pre- and post-treatment blood panel and reported adverse events (AEs). Overall, 63 ACB women were screened, 50 were enrolled and received the intervention while 41 completed the study, resulting in 80% enrollment and 82% retention rates. Overall adherence to the study protocol was high at 93%, with an adherence of 92% for RepHresh™ Pro-B™ and 97% for Estring©. A total of 88 AEs were reported by 29 participants which were mild (66/88; 75%) and largely resolved (82/88;93%) by the end of the study, with no serious AEs (SAEs) noted. In addition, a panel of safety blood markers measured pre- and post-intervention confirmed no clinically significant changes in blood chemistry or blood cell count. Overall, the administration of intravaginal estrogen and/or probiotics in pre-menopausal ACB women is feasible, safe, and well tolerated. The trial was registered with Clinicaltrials.gov (NCT03837015) and CIHR HIV Clinical Trials (CTN308).