Mean Values Of Albumin Research Articles

Influence of treatment to remove oral inflammation foci on the systemic malnutrition and inflammation markers of dialysis patients: A series of cases

Background and objectives: Studies report a more precarious oral health status, with a higher prevalence of periodontal disease, in hemodialysis patients. Also, oral inflammation foci, mainly periodontal disease, are related to systemic inflammation and malnutrition which have a negative impact on morbidity and mortality in these patients. The aim of this study is to observe the influence of dental on the general status of these patients. Material and Methods: The study is a series of cases and was conducted in two phases: data collection and treatment phase and monitoring phase. Dental treatment was performed on 13 patients, with ages between 43-69 years of age, diagnosed with moderate or severe periodontal disease. Oral status parameters (plaque and gingival bleeding index, pocket depth, attachment level, DMFT and CPITN index) and general parameters (C-reactive protein, albumin, hemoglobin, calcium phosphate product, calcium and phosphate levels, erythropoietic-stimulating agents) were registered and monitored. Conventional periodontal treatment, dental extractions, endodontic treatments were performed. Results: Oral assessment showed a statistically significant improvement of oral parameters, at both 1 month and 3 months post-treatment. Mean values for albumin, C-reactive protein, hemoglobin, calcium phosphate product and calcium levels had a slight improvement, but the difference was not statistically significant. Conclusion: The oral status, characterized by the measured periodontal parameters, improved visibly and statistically significant after the dental treatment. The parameters of the general status did not change significantly following the intervention.

Predictors of one-year mortality following hip fracture surgery in elderly.

Understanding mortality risk factors is critical to reducing mortality among elderly hip fracture patients. To investigate the effects of admission and post-operative levels of distribution width of red blood cells (RDW), albumin, and RDW/albumin (RA) ratio on predicting 1-year mortality following hip fracture surgery. A retrospective study was conducted on 275 elderly patients who underwent hip fracture surgery in a tertiary hospital between January 2018 and January 2022. Deaths within one year of hip fracture were defined as the deceased group. The survivors were defined as those who survived for at least one year. The relationship between admission and post-operative levels of RDW, albumin, RA, and mortality within one year after hip surgery was assessed statistically, including binary logistic regression analysis. The study also assessed other factors related to mortality. One-year mortality was 34.7%. There was a 3.03-year (95% CI [1.32-4.75]) difference between the deceased (79.55 ± 8.36 years) and survivors (82.58 ± 7.41 years) (p<0.001). In the deceased group, the mean hemoglobin (HGB) values at admission (p=0.022) and post-operative (p=0.04) were significantly lower. RDW values at admission (p=0.001) and post-op (p=0.001) were significantly lower in the survivor group. The mean albumin values at admission (p<0.001) and post-operative (p<0.001) in the survivor group were significantly higher than in the deceased group. A significant difference was found between the survivor group and the deceased group in terms of mean RA ratio at admission and post-operative (p<0.001). Based on binary logistic regression analysis, presence of chronic obstructive pulmonary disease (COPD) (OR 3.73, 95% CI [1.8-7.76]), RDW (OR 1.78, 95% CI [1.48-2.14]), and albumin (OR 0.81, 95% CI [0.75-0.87]), values at admission were found to be independent predictors of 1-year mortality in elderly patients with hip fracture. Based on this study, presence of COPD, higher RDW, and lower albumin levels at admission were independent predictors of 1-year mortality following hip fracture surgery in the elderly.

Prognostic Potential of Thrombocyte Indices, Acute Phase Proteins, Electrolytes and Acid-Base Markers in Canine Parvovirus Infected Dogs With Systemic Inflammatory Response Syndrome

Dogs with canine parvovirus enteritis (CPVE) that develop systemic inflammatory response syndrome (SIRS) frequently have a poor prognosis. The aim of the study was to assess the prognostic potential of thrombocyte indices, acute phase proteins, electrolytes, and acid-base markers in CPVE puppies with SIRS (CPVE-SIRS+) at admission. A case-controlled, prospective, and observational study was performed on 36 CPVE puppies. Mean concentrations of C-reactive protein (CRP), albumin, thrombocyte count, mean platelet volume (MPV), platelet distribution width (PDW), sodium (Na+), potassium (K+), chloride (Cl−) and ionized calcium (iCa) were measured and strong ion difference 3 (SID3), ATOT-albumin and ATOT-total protein were determined in CPVE-SIRS+ survivors and nonsurvivors. A prognostic cut-off value for predicting the disease outcome was determined by receiver operating characteristic (ROC) curve analysis. The mean values of MPV, PDW and CRP were significantly higher and the mean values of albumin, Cl− and ATOT-albumin were significantly lower in CPVE-SIRS+ nonsurvivor than CPVE-SIRS+ survivor puppies on the day of admission, but the thrombocyte count, Na+, K+, iCa, SID3 and ATOT- total protein values did not differ significantly. The positive predictive values (PPVs) for survival using cut-off value of MPV (≤15.08 fL), PDW (≤14.85%), CRP (≤180.7 mg/L), albumin (≥1.795 g/dL), Cl− (≥96.00 mmol/L), and ATOT-albumin (≥7.539) were determined as 100%, 100%, 100%, 80%, 100%, and 80%, respectively with better area under ROC curve and sensitivity. Based on sensitivity, specificity, and PPVs from ROC analysis, it is concluded that the determination of Cl− concentration and MPV at admission followed by CRP will serve as the most appropriate biomarkers in predicting the disease outcome of CPVE puppies that develop SIRS.

Characteristics and outcomes of elderly patients with Parkinson's disease hospitalized due to COVID‑19‑associated pneumonia.

Patients with Parkinson's disease (PD) and coronavirus disease 2019 (COVID-19)-associated pneumonia present, according to the literature, high mortality rates due to the nature of the disease, advanced age, and underlying diseases. Most available studies, however, refer to the first waves of the pandemic. The aim of the present study was to investigate the clinical characteristics and outcomes of elderly patients (≥65 years old) with PD hospitalized with COVID-19-associated pneumonia during the period of prevalence of various severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants, as well as to determine possible prognostic factors for poor outcomes. During the period from February 15, 2021, to July 15, 2022, 1,144 elderly patients with COVID-19 pneumonia were hospitalized. Age, sex, Charlson comorbidity index, vaccination status against SARS-CoV-2, and admission laboratory parameters were recorded for all patients. A total of 36 (3.1%) patients with PD were hospitalized due to COVID-19-associated pneumonia (18 males, 50%). The mean age of the patients was 82.72±8.18 years. In total, 8 patients (22.2%) were hospitalized during the period of alpha variant predominance, 3 patients (8.3%) during the period of delta variant predominance, and 25 patients (69.4%) during the omicron variant predominance period. Of note, 16 patients (44.4%) were vaccinated with at least two doses. In addition, 17 (47.2%) patients succumbed to the disease. Between the patients who survived and those who succumbed, a statistically significant difference was only found in the mean value of albumin (37.48±6.02 vs. 31.97±5.34 g/l, P=0.019). In particular, as shown by receiver operating characteristic curve analysis, albumin exhibited a satisfactory predictive ability for mortality (area under the curve, 0.780; P=0.013) with an albumin value ≤37.7 g/l being able to predict mortality with 85.7% sensitivity and 54.8% specificity. Overall, the findings of the present study indicate that mortality among elderly patients with PD hospitalized with COVID-19-associated pneumonia was high in all phases of the pandemic. A low albumin value, not only as an indicator of the immune status, but also of the nutritional status, is a predictor of adverse outcomes.

Haematological and serum biochemical indices of cocks drenched varying levels of clove powder (Syzygium aromaticum)

There is stimulated increased interest in the usage of consumer accepted natural alternatives such as phytogenic feed additive (PFAs) to improve livestock performance. Clove is a wonderful phytogenic feed additives with little information in its benefit in poultry production. This study was conducted to assess the effect of clove powder (Syzygium aromaticum) on haematological and serum - biochemical indices of cocks. Clove was obtained from a local market in Saki, Oyo State. Dried clove buds were cleaned and air dried for 24 hours prior to milling and stored in air-tight bags until the period of usage. Cocks (48 birds assigned into four treatments) were drenched at 0.0g (T1), 0.05g (T2), 1.00g (T3) and 1.5g (T4) after 2 weeks of acclimatization. Haematological parameters measured were: packed cell volume (PCV), red blood cell (RBC), white blood cell (WBC), haemoglobin (Hb), mean corpuscular volume (MCV), Mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC). While biochemical evaluated were total protein, albumin, globulin, uric acid, creatinine, cholesterol and glucose. Data obtained were subjected to one-way analysis of variance in a completely randomised design. RBC (3.64 – 3.76 X106/mL), Hb (3.64 – 12.86 g/dL), MCH (32.79 – 36.86 μμg) and MCHC (31.62 – 32.85%) showed significant difference (P&lt;0.05), while PCV (39.00 – 41.00%), WBC (18.66 – 19.10 X109/mL), MCV (103.74 – 112.23 μ3) shows no significant difference (p&gt;0.05). Total protein showed significant difference (P&lt;0.05) with values ranging between 4.46 and 5.40 g/dL There exists significant difference (P&lt;0.05) in the mean value of albumin, with highest value in 1.50g CP (5.40). Other biochemical parameters studied also showed significant differences (P&lt;0.05) with the highest value in 1.50g CP. Drenching cocks with clove powder up to 1.5g was discovered posing no harmful effect on cocks.

Impact of Lamda-Cyhalothrin on the Biochemical Parameters of Clarias gariepinus

Background: Widespread applications of pesticides such as Lambda cyhalothrin to boost crops production have frequently led to contamination of the fresh water ecosystem in Nigeria.&#x0D; Materials and Methods: In this study, Clarias gariepinus were exposed to sub-lethal concentrations of Lambda-cyhalothrin pesticide. The 96 h LC50 of lambda cyhalothrin to the fish was estimated at 3.98mgl-1. Mortality of 100% and 10% were observed in fish exposed to 12.00 mg l-1 and 1.25 mg l-1 of Lambda cyhalothrin respectively as compared to no mortality recorded in the control group. Varying degrees of abnormal behaviours like air gulping, hyperactivity, erratic movement, skin discoloration and jerky movements were observed during the 96 hrs exposure period of the fish to Lambda compared to the control. Exposure to sub-lethal concentrations of Lambda cyhalothrin at 0, 0.25, 0.50 and 1.00 mgl-1 and for 15 days at 5 days intervals that is 5, 10 and 15days led to changes in the biochemical parameters.&#x0D; Results: In the Biochemical parameters analysed, there was significant (P&lt;0.5) increase in the mean values of Albumin, Aspartate Amino Transfarase (AST), Alanine Amino Transaferase (ALT), Alkaline Phosphate (ALP) and Creatinine compares to the control group. There was no significant difference (p&gt;0.05) between the values of water quality assays in control and treated group.&#x0D; Conclusion: The biomarkers measured could be useful tools for monitoring effects of other pesticides on aquatic organisms. However, further studies could be done to investigate their mode of action to strike a balance between protection of aquatic biota and discharges of these pesticides and their metabolites to aquatic environments.

Comparison of mortality according to baseline, first year, and mean albumin levels in peritoneal dialysis: a retrospective study

Background The relationship between hypoalbuminemia in peritoneal dialysis (PD) and mortality, risk of peritonitis, and decreased residual renal function (RRF) is known. However, we have not encountered a comprehensive study on which of the mean albumin values, at the beginning of peritoneal dialysis, in the first year, and during the peritoneal dialysis period, provide more predictive predictions regarding mortality, peritonitis risk, and RRF reduction. Methods A total of 407 PD patients in whom PD was initiated and followed up and PD was terminated were included in the study. Albumin levels, peritonitis, and RRF at the beginning of PD and at 3-month periods during PD were recorded. Results In the evaluation of the patients, there was a significant relationship between mean, first-year albumin values in RRF loss (p = 0.001, p = 0.006, respectively) and peritonitis (p < 0.001), but no significant correlation was found with baseline albumin values (p = 0.213, p = 0.137, respectively). In the comparison of mortality ROC analysis of PD patients, a significant correlation was found with mortality at baseline, first year, and mean albumin values (p < 0.001). However, in the multivariate Cox regression analysis, it was determined that there was a more significant relationship between first-year albumin and mean albumin values compared to baseline albumin values (HR 0.918 [95% CI 0.302–0.528] (p < 0.001)), (HR 1.161 [95% CI 0.229–0.429] (p < 0.001)), (HR 0.081 [95% CI 0.718–1.184] (p = 0.525)). Conclusions In conclusion, mean and first-year mean albumin levels provide more determinative predictions for mortality, risk of peritonitis, and maintenance of residual renal functions in peritoneal dialysis patients compared to baseline albumin.

Effect of dietary phosphorus and restricted feeding on performance, egg quality and serum biochemical traits of laying hens at the second production phase

The effect of available phosphorus and restriction of feeding on the performance, egg quality, serum biochemical and yolk fatty acid profiles in laying hens at 40 to 60 weeks of age was studied. A total 540 laying hens (Lohmann Brown) aged at 40 weeks were randomly placed in a 2×3 factorial arrangement of dietary treatments including two levels of available phosphorus (AP, 0.32 and 0.45%) and three restricted feeding levels (RFL, 90, 95 and 100%) having 5 replicates in each treatment, and the experiment were conducted for twenty weeks. The results showed that dietary interaction between AP and RFL had significant effects on egg production percentage (P&lt;0.01), egg weight (P&lt;0.05), daily egg mass (P&lt;0.01) and feed conversion ratio (P&lt;0.01). Production performance was significantly (P&lt;0.01) affected by RFL; and both 95% and 100% RFL had showed similar mean value in egg production and egg weight. Egg quality traits: eggshell color and eggshell breaking strength were differed (P&lt;0.05) among the treatments. Moreover, albumen height, Haugh unit and eggshell breaking strength significantly (P&lt;0.05) increased in diet contained 0.45% AP. Dietary limitation of feed did not alter the egg quality except eggshell color. Serum albumin was influenced among the treatments and the mean value of albumin and total protein were same in sole effect of 95% and 100% RFL. Higher serum glucose was obtained in response to the primary effect of 0.32% AP. The total concentration of yolk fatty acid profiles was not assorted in the impacts of AP, RFL and in their interaction. Therefore, the results suggest that 95% feeding was sufficient to hens during second production period, for optimum production performance and egg quality as well as diet containing 0.45% inorganic phosphorus could have influenced positively on egg quality. Bangladesh J. Agri. 2022, 47(2): 119-132

Böbrek Nakli Yapılan Hastaların Ameliyat Öncesi ve Sonrası Laboratuvar Bulgularının Retrospektif Analizi

Objective: This study was conducted to review the sociodemographic characteristics of kidney transplant patients and the changes in preoperative and postoperative laboratory findings. Material and Methods: This is a retrospective study including 130 patients who underwent kidney transplantation between January 2015 and June 2019. This research was conducted at the Turgut Özal Medical Center Organ Transplant Hospital between August and December 2019 in the form of a four-month file archive review. File archive was used to access the data. The demographic characteristics of these patients, clinical and laboratory findings, donor characteristics, pre-transplant chronic diseases, pre-transplant dialysis duration and dialysis types were retrospectively analyzed to evaluate post-transplant infection and survival. Results: In the study, it was determined that patient survival rates were higher in transplants from a cadaver donor compared to transplants from a living donor. When the values before and after the transplantation were compared, it was found that the difference between the mean values of albumin, calcium, leukocytes, hemoglobin, hematocrit, platelets and international normalized ratio before and after transplantation was statistically significant. Conclusion: In this patient group, it may be suggested to carry out studies on nursing that provide sustainable, professional, holistic, evidence-based care and raise awareness, and to add the study findings to nursing practices in order to achieve the expected goals in improving the quality of life and survival.

Comparative Efficacy of Two Antibiotics for the Management of Secondary Bacterial Infection in Goats Clinically Affected by Peste des Petits Ruminants

Aims: Peste des petits Ruminants (PPR) is a major viral disease that poses a challenge to small ruminant farming. Its natural occurrence has been complicated by secondary bacterial infection which has led to an increase in morbidity and mortality rates. This study reports the management outcome of natural PPR-infected goats using two types of antibiotics in Nsukka metropolis of Enugu State Nigeria.&#x0D; Methodology: Goats (N=24) were confirmed to be suffering from PPR based on clinical signs and using polymerase chain reaction (PCR). The animals were divided into two groups. Group A was treated with 20% oxytetracycline (N= 10) and group B with procaine penicillin and streptomycin combination (penstrept) (N= 14) injection. Clinical signs, recovery and survivability, temperature, haematology [Packed cell volume (PCV); haemoglobin concentration (Hbconc); red blood cell (RBC) and white blood cell (WBC) counts] and some serum biochemical profiles [alanine aminotransferase (ALT); aspartate transaminase (AST); total protein (TP); Albumin; urea; creatinine; potassium and sodium] were used to assess the efficacy of the antibiotics using standard techniques.&#x0D; Results: The mean temperature, RBC, WBC and urea values of the PPR-infected goats were above their reference ranges, mean albumin values were below the reference range while mean Hbconc, PCV, AST, ALT, TP and creatinine values were within their reference range before the commencement of treatment. Following treatment, clinical signs cleared in 20% and 35.7% of the goats treated with oxytetracycline and penstrep respectively. Death was recorded in 20% and 15% of goats treated with oxytetracycline and penstrep respectively before the end of treatment. Penstrep-treated group showed improvement in their haematological profile.&#x0D; Conclusion: Based on our findings, the use of penstrep in the management of PPR-infected goats gave a better result.

Influence of age and sex on the blood biochemical constituent values of broiler breeders during the egg-laying stage.

This study aimed to evaluate the influence of age and sex on the blood biochemical constituents of broiler breeders during the egg production stage. The analysis was performed in an industrial broiler breeder farm, and blood samples were collected from males and females at five different ages. Biochemical elements analysed in each serum sample were total proteins, albumin, globulins, uric acid, total cholesterol and triglycerides, alanine aminotransferase (ALT) and aspartate aminotransferase (AST), gamma-glutamyltransferase (GGT), creatine kinase (CK), alkaline phosphatase (PAL), calcium and phosphorus, beside the glycaemic status. At most ages, females had higher values of total proteins, albumin, globulins, triglycerides, cholesterol, glucose, calcium, phosphorus, Ca/P (calcium and phosphorus) ratio and gamma-glutamyltransferase (GGT). The values of uric acid, aspartate aminotransferase (AST), creatine kinase (CK) and alkaline phosphatase (PAL) were higher in males. The lowest protein values were found at 28 and 60 weeks old. The mean albumin values were significantly higher at 44 and 52 weeks old in males and females. A trend of increasing globulin values with increasing age up to 52 weeks old was observed. Although calcium and phosphorus did not vary according to age, the Ca/P ratio was lowest at 36 weeks old. Comparing the means of both sexes, the AST and GGT values were significantly higher in 60-week-old birds. The highest serum levels of CK occurred at 28 and 52 weeks old. The physiological levels of serum biomarkers presented in this work are important for evaluating productivity performance, welfare and disease indication in breeding flocks.

Üçüncü Basamak Bir Yoğun Bakım Ünitesinde Bir Yıl Içinde Ölen Hastaların Klinik Özellikleri

Aim: The aim of this study was to find out the clinical characteristics of patients who died within a year in the intensive care unit (ICU) and to find out the association of ICU admission albumin, lactate levels and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores of these patients who died with ICU length of stay.Material and Method: The files of patients who died in the ICU (n:350) between January 2018 and December 2018 were examined retrospectively. The patients’ demographic data and their clinical characteristics, ICU admission types (surgery or medical medicine), the units they were admitted in, reasons for admission, comorbidities, admission albumin and lactate levels, APACHE II scores and ICU length of stay were recorded. The association of patients’ clinical characteristics with ICU length of stay and laboratory values was evaluated. Result: The patients’ mean age was 72.68±12.98 years, mean APACHE II score was 27.0±10.0, mean albumin value was 3.1±0.7 g/dL and mean lactate value was 4.1±3.3 mmol/L. It was found that albumin value was lower in patients admitted to ICU with mechanical ventilator (MV) need (p&amp;lt;0.001), and lactate value and APACHE II score were significantly higher in patients with post-cardiopulmonary resuscitation (p&amp;lt;0.001). Mean ICU length of stay was 28.24 ± 37.53 days. A weak positive correlation (r =0.172, p=0.001) was found between the patients’ length of stay and albumin, and a weak negative correlation was found with the lactat (r = 0.121, p=0.023) and APACHE II scores (r = 0.151, p=0.001). A weak negative correlation was found between the patients’ albumin and lactate (r =0.152, p=0.004), and APACHE II score (r =0.179, p=0.001), as well as a moderate positive correlation between lactate and APACHE II score.Conclusion: Significant association was found between hypoalbuminemia, hyperlactatemia and high APACHE II scores and ICU length of stay in patients who died in ICU. More comprehensive studies are needed to show the effects of this association on effective use of ICUs.

Serum markers for the early diagnosis of intestinal anastomotic leak after gyne-oncological operations.

To analyse the serum markers for the early diagnosis of intestinal anastomotic leak (AL) after the gyne-oncological operations. Between September 2017 and March 2021, patients with an intestinal anastomosis performed during the gyne-oncological surgeries were identified from a tertiary centre in Turkey. As the local guideline of the clinic, all these patients were followed by measuring serum samples including procalcitonin (PCT) and C-reactive protein (CRP) on postoperative day (POD) 1 through the day of discharge or the day of re-operation for AL. 12.5% (5/40) of the patients suffered an AL and 4 of them were re-operated. The mean albumin values on POD 3-4 and the mean platelet values on POD 1 were lower in the AL group (P < .05). Although it was not statistically significant (P > .05), median PCT values (ng/mL) on POD 8-10 were higher in the AL group compared with no leak group. The best cut-off point for PCT on POD 9 was determined to be 0.11ng/mL (AUC: 0.917, Sensitivity = 100.0%, specificity = 66.7%, positive predictive value = 66.7%, negative predictive value = 100.0%). Serum PCT and CRP concentrations were not found to be helpful for the early diagnosis of AL in patients operated for gyne-oncological malignancies. Low levels of albumin and platelets in the first days after the operation may be clue for a possible AL.

MO297MONOCLONAL GAMMOPATHY OF RENAL SIGNIFICANCE: A REPORT OF CASES FROM FOUR PORTUGUESE CENTERS

Abstract Background and Aims Monoclonal gammopathy of renal significance (MGRS) refers to any plasma cell or B cell clonal lymphoproliferation that has at least one kidney lesion related to the monoclonal immunoglobulin productions plus, the underlying clone is not responsible for tumour complications. Plus, does not meet any haematological criteria for specific treatment. Although considered a non-malignant or smouldering hematologic condition, its effects on the kidney are not benign since it frequently evolves to end-stage renal disease. There has been some reluctance in treating these patients but increasing evidence has shown that renal outcomes are closely associated with the haematological response to chemotherapy. We aimed to evaluate the incidence of MGRS in the North of Portugal and to assess patients’ characteristics, treatment and follow-up. Method We have, retrospectively, collected information of all patients with a biopsy proven MGRS diagnosis, from four Portuguese centers. Demographic, clinical, laboratorial data and treatment were analysed. Follow-up was made until dialysis start, death of until December 2020. Survival curves were analysed according to the treatment performed, the histological diagnosis, the type of chains, the estimated glomerular filtration rate (eGFR) and proteinuria at the time of diagnosis. Baseline characteristics were reported as mean ± standard deviation (SD) and median (min-max) for continuous variables or as number (percentage) for categorical variables. Survival curves were analysed using Kaplan–Meier method. Statistical calculations were performed using SPSS. Results Our study included 36 patients, with a mean age of 69 ± 11 years old and 52,8% were males. At baseline, the median value of serum creatinine (sCr) was 1,2 (0,4-6,3) mg/dL, which represented a mean eGFR of 55,4 ± 30,4 ml/min/1,73 m2 according to the CKD-EPI formula. The nephrotic syndrome was the most common (72%) renal presentation. The median proteinuria value was 8,0 (0,5-28) g per day and the mean albumin value was 2,7 ± 0,8 g/dL. The mean value of monoclonal protein was 5,5 ± 4,8 g/L with 62,5% of the patients having an abnormal serum free light chain ratio. Table 1 describes the type of gammopathy found, being the IgG/Kappa the most observed. The immunoglobulin light chain amyloidosis (AL amyloidosis) and the monoclonal immunoglobulin deposition disease (MIDD), mainly light chain deposition disease (LCDD) were the most frequent histological diagnosis (Table 2). Monoclonal gammopathy of undetermined significance (MGUS) was the most frequent haematological diagnosis (Table 3). Treatment was done in 75% of the cases and bortemozib-based regimens were the most used. Three patients (8,3%) received a bone marrow auto transplant. Approximately 40% of the patients had complete haematological and renal response. Treatment regimens and haematological and renal responses are summarized in Table 4 and 5. Survival curves (Figures 1–2) were significantly higher in younger patients (p=0,039) and both renal and global survival were better (p=0,023) in MIDD compared to AL amyloidosis. No statistically significant differences were detected when analysing according to treatment, type of chain, eGFR, proteinuria and serum albumin at admission. Conclusion The incidence of MGRS is probably underestimated and its treatment is yet far to be universal. In our series, 25% of the patients weren’t proposed to any treatment. MGRS approach requires a multidisciplinary team composed by Nephrologists, Pathologists, Onco-Haematologists and a Bone Marrow Transplantation department. Since not all hospitals meet these conditions, referral centers of greater expertise are required for a prompt diagnosis and to provide the most adequate treatment. We hope that in a near future more centres join this project and that this represents the first step towards the creation of a Portuguese group dedicated to the study and treatment of MGRS.

MO610NUTRITIONAL PARAMETERS OF PATIENTS WITH END-STAGE RENAL DISEASE IN THE GENERAL UNIVERSITY HOSPITAL AREA

Abstract Background Malnutrition is one of the problems that patients can develop during the later stages of kidney disease. These problems are derived from uraemia and acidosis that can present due to the decrease in glomerular filtration and added to an accumulation of urine levels. During the months of January 2019 and May 2020 were collected information of 564 patients about age, weight, height, BWI, glomerular filtration rate, use of oral nutrition supplements and albumin, protein, phosphorous and potassium biochemical levels. All of patients were had a GFR below 45 mL/min/1,73m2 and any of them have been started a renal replacement therapy when the data was collected. A descriptive and frequency analysis has been carried out with all the parameters obtained. The T of Student for a related sample test was used due to the normality of the data and the participants condition of intervention – control. Results The results indicate that the mean values for ESRD patients in our area are: age (75,3±12,5 years old), weight (74,7±15,6 kg), height (1,6±0,1 m), IMC (28,8±5,4 kg/m2), glomerular filtration rate (19,9±9,1 mL/min/1,73m2), albumin (3,7±0.5 g/dL), protein (6,8±0,7 g/dL), phosphorous (4,2±1,1 mg/dL) and potassium (4,6±0,5 mEq/L). 41 patients (7,3%) used oral nutrition supplements. We found statistical significance between the stages 4 and 5 of kidney disease and albumin (p-value 0.03 and 0.04) and potassium (p-value 0.04 and 0.04) levels. Only at stage 4 we found statistical significance between the levels of protein (p-value 0.04) and phosphorous (p-value 0.04). Also were found increased levels of albumin (3,73 vs 3,7 mg/dL), proteins (6,87 vs 6,8 mg/dL), phosphorous (4,4 vs 4,3 mg/dL) and potassium (4,8 vs 4,6 mg/dL) in the group who use oral nutrition supplements, however, we did not reach statistical significance between groups. About correlations, we found that the albumin levels have a statistical significance with age, protein, phosphorous and potassium levels, but not with BWI. Conclusion In the General University Hospital area, the patients in ESRD have a high BWI, which can impair the renal disease. Also, we found that BWI decrease in end stages of ESRD worsening the nutritional status before start the renal replacement therapy. About albumin, the worst levels were found at stage 4 of the kidney disease and older patients have more risk of present low albumin levels. The mean values of albumin show that most of our patients meet one of three conditions to diagnose PEW. The protein level was lower at the 5 stage of the disease, and as the albumin, the older patients show lower values of this parameter. Concerning phosphorous and potassium the patients at the end stage of renal disease present higher values of both of them due possibly to the impaired renal function. About the use of nutritional supplements, a low percentage of patients used this as nutritional therapy, but mean levels of biochemical parameters such as albumin, protein, phosphorous and potassium were higher than the patients who did not use them. However, we did not find statistical significance between the use of ONS and better status of biochemical parameters. We can say that older patients in end stage of renal disease have a higher risk of malnutrition in comparison with young patients due to a decrease in BWI, albumin and protein levels. To conclude, the nutritional treatment to these patients should consist, on the one hand, the decrease of the BWI to prevent a quickly loss of renal function and, on the other hand, prevent the malnutrition, especially in the older patients with lower BWI.

Effect of Azolla (pinnata) Supplementation on the Haematological and Blood Biochemical Parameters of Deccani Ram Lambs Reared under Grazing Based Production System

Background: Most of the shepherds in Telangana follow extensive rearing system, thereby intake of nutrients by the animal is minimal while grazing. In this context, Azolla, an unconventional feed with high protein and nutritive value may meet the nutritional demand of sheep and help in gaining optimum body weight at an early age in grazing system of management. Therefore, the present study was aimed to study the changes in haematological and blood biochemical parameters of lambs with azolla meal supplementation under grazing based production system.Methods: Eighteen weaner ram lambs were divided in to three experimental groups i.e., T1, T2 and T3 with six lambs in each group, such that average group weights were uniform. T1 group was control with no azolla supplementation while in T2 and T3, azolla was supplemented at the rate of 10 and 20% of dry matter intake, respectively. Duration of experimental feeding was 120 days. The mean haematological and blood biochemical studies were done by collecting the blood samples before the start, in the middle and at the end of the experiment.Result: The haematological parameters like PCV, Hb, RBC and WBC showed no significant difference between the groups. The mean total protein at the end of the experiment was significantly (p less than 0.01) higher in T3 group as compared to T2 and T1 groups. The mean albumin value in the middle and at the end of the experiment was non significantly higher in T3 group followed by T2 and T1 group. The mean BUN value at the end of the experiment was non significantly lower in T3 group followed by T2 and T1 group.

Results of treatment of drug-resistant tuberculosis of mycobacteria using bedaquiline and delamanid

The article presents the results of an analysis of the efficacy and safety of bedaquiline and delamanid in patients with multidrug-resistant tuberculosis (MDR-TB). We studied 73 patients with MDR-TB of the lungs who received treatment with bedaquiline and / or delamanid for&gt; 4 weeks in combination with a background regimen recommended by the WHO. For all patients, the treatment regimen was selected individually, according to the drug sensitivity test. The average age of patients was 49.1 ± 2.77 years, men were 46 (63.0%), women — 27 (37.0%). The patients were divided into 3 groups: Group I — 28 patients who were included in the treatment regimen with bedaquiline, Group II — 25 patients who were included in the treatment regimen with delamanid, Group III — 20 patients were treated with both drugs. A month after treatment, the amount of hemoglobin in comparison with the initial value in group I increased by an average of 29.5% (p &lt;0.05), in groups II and III by 31.9% (p &lt;0.05) and 31, 4% (p &lt;0.05), respectively. The mean albumin value increased by 13.2%, 14.7% and 20.3% in groups I, II and III, respectively. The concentration of ALT and AST in the blood after treatment decreased, respectively, by 24.0 and 28.2% in group I, by 29.8 and 36.5% (p &lt;0.05) in group II, by 32.0 (p &lt; 0.05) and 39.0% (p &lt;0.05) in group III. Samples of 49 (80.3%), 44 (71.5%) and 28 (45.9%) patients were resistant to ethambutol, pyrazinamide, and streptomycin, respectively. Resistant to kanamycin were 30.1% of the samples, to ofloxacin — 68.5%. in 58.9% of cases, sputum cultures were positive at the time of initiation of treatment with bedaquiline and / or delamanid. Of these, 39.7% have achieved culture conversion. Adverse reactions were observed in 43.8% of patients. The inclusion of bedaquiline and delamanid in the anti-tuberculosis therapy regimen promotes clinical improvement and a decrease in bacterial excretion in a fairly short time. Treatment of MDR-TB patients with bedaquiline and/or delamanid was effective and well tolerated.

Evaluation of the Role of Routine Laboratory Biomarkers in COVID-19 Patients: Perspective from a Tertiary Care Hospital in India.

To evaluate the role of routine laboratory biomarkers like C Reactive Protein (CRP), Lactate Dehydrogenase (LDH), Interleukin 6 (IL6), Ferritin, Creatinine, Procalcitonin (PCT), Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Serum Albumin, Total Bilirubin (T Bil), High Sensitive Troponin I (hs troponin I), N Terminal-pro B-type Natriuretic Peptide (NT proBNP), Blood Urea Nitrogen (BUN) and Blood Gases in COVID 19 patients who are admitted with SARS CoV-2 positive test results by real-time reverse transcriptase polymerase chain reaction (rRT PCR) in Kokilaben Dhirubhai Ambani Hospital & Medical Research Institute, Mumbai, India. 100 individuals detected with COVID-19 belonging to the age group 12–83 years (median age 62 years) within the period of 1st March 2020 to 10th July 2020 were studied. The case group consisted of 72 males and 28 females. 40 healthy adults without any history or clinical evidence suggestive of COVID-19 and without any comorbidities, like diabetes, hypertension chronic lung disease, cardiac disease, cancer, and immune-compromised individuals were considered as a control group for the study. Routine laboratory findings of these 100 patients were used to evaluate the abnormalities found in COVID-19 patients. Statistical analysis was carried out on the data after determining whether the data had a normal/log-normal distribution and their significance was determined by calculating the p-value. The percentage of patients showing a decrease or increase from the normal value was calculated. Trend analysis was carried out for the 100 patients considered in the case group. Among them, 6 patients were used as representatives to show the trend in these biomarkers during the course of hospital stay. These 5 severe cases consisted of 2 adult males, 2 adult females, and 1 adolescent girl. This selection is to demonstrate the representation of COVID-19 infection in adult males and females and pediatric multisystem inflammatory syndrome associated with COVID-19 in the younger age group. One mild case (adult male) was also selected in the case study. We found a significant increase in mean values of AST, ALT, Total Billirubin, Creatinine, CRP, PCT, LDH, IL6, Ferritin, Lactate, hsTroponin I, NT Pro BNP and decrease in mean values of Albumin, SO2, and PO2 in COVID 19 cases than control. We applied Receiver Operating Curve (ROC) curve to discriminate case population more precisely than the control population. Therefore, Routine laboratory biomarkers appear to play a significant role in COVID-19 patients.

ASSESSMENT OF CORRELATION OF LACTATE /ALBUMIN RATIO IN SEPSIS PATIENTS ADMITTED IN ICU

Sepsis is life-threatening organ dysfunction caused by dysregulated host responses to infection, and septic shock is a subset of sepsis in which underlying circulatory and cellular/metabolic abnormalities are sufficiently profound to substantially increase mortality. Patients with sepsis are usually treated in the intensive care unit (ICU). Hence; under the light of above-mentioned data, the present study was undertaken for determining the correlation of lactate /albumin ratio in outcome of patients of sepsis in ICU. The present study was undertaken for determining the correlation of lactate /albumin ratio in outcome of patients of sepsis in ICU. A total of 30 patients were enrolled. The resulting patients were subjected to detailed history and examination followed by investigations (CBC, ESR, CRP), Bacterial culture, liver function test, renal function test, arterial blood gas analysis for lactate, serum albumin level). Mean Lactate value was 4.59 while mean albumin value was 25.12. Mean lactate to albumin ratio was 0.18. While correlating lactate to albumin ratio with Serum Procalcitonin levels, significant results were obtained. While correlating lactate to albumin ratio, it was seen that higher lactate to albumin ratio was associated with higher mortality. Lactate/albumin ratio is an independent predictor for the mortality among sepsis patients admitted to ICU.

The role of the BUN/albumin ratio in predicting mortality in COVID-19 patients in the emergency department.

IntroductionDue to the high mortality and spread rates of coronavirus disease 2019 (COVID-19), there are currently serious challenges in emergency department management. As such, we investigated whether the blood urea nitrogen (BUN)/albumin ratio (BAR) predicts mortality in the COVID-19 patients in the emergency department.MethodsA total of 602 COVID-19 patients who were brought to the emergency department within the period from March to September 2020 were included in the study. The BUN level, albumin level, BAR, age, gender, and in-hospital mortality status of the patients were recorded. The patients were grouped by in-hospital mortality. Statistical comparison was conducted between the groups.ResultsOf the patients who were included in the study, 312(51.8%) were male, and their median age was 63 years (49–73). There was in-hospital mortality in 96(15.9%) patients. The median BUN and BAR values of the patients in the non-survivor group were significantly higher than those in the survivor group (BUN: 24.76 [17.38–38.31] and 14.43 [10.84–20.42], respectively [p < 0.001]; BAR: 6.7 [4.7–10.1] and 3.4 [2.5–5.2], respectively [p < 0.001]). The mean albumin value in the non-survivor group was significantly lower than that in the survivor group (3.60 ± 0.58 and 4.13 ± 0.51, respectively; p < 0.001). The area-under-the-curve (AUC) and odds ratio values obtained by BAR to predict in-hospital COVID-19 mortality were higher than the values obtained by BUN and albumin (AUC of BAR, BUN, and albumin: 0.809, 0.771, and 0.765, respectively; odds ratio of BAR>3.9, BUN>16.05, and albumin<4.01: 10.448, 7.048, and 6.482, respectively).ConclusionThe BUN, albumin, and BAR levels were found to be reliable predictors of in-hospital mortality in COVID-19 patients, but BAR was found to be a more reliable predictor than the BUN and albumin levels.