Complete Blood Count Measurements Research Articles

Role of neutrophil-lymphocyte ratio in predicting mortality in acute coronary syndrome patients

Abstract Funding Acknowledgements Type of funding sources: None. Background Inflammation is the basic mechanism of acute coronary syndrome (ACS). Among the various inflammatory markers related to ACS is the neutrophil-lymphocyte ratio (NLR). Neutrophils act as a mediator of inflammatory response to acute damage of myocardium, while lymphocytes decrease because of apoptosis caused by inflammation. Therefore, high NLR suggests further risk of infarction of the myocardium. Purpose This study determines the cut-off value and the role of NLR at admission in predicting in-hospital mortality of ACS patients. Methods A retrospective cohort study was conducted using data of patients admitted with ACS from the SCIENCE registry between February 2019 and November 2020. The inclusion criterion was complete blood count measurement at presentation. NLR was calculated from the absolute neutrophil and lymphocyte count. The optimal cut-off value of NLR was determined using receiver operating characteristic (ROC) curve and Youden index (J) analysis. Patients was divided into two groups based on the NLR cut-off value. In-hospital mortality between the two groups was compared using Chi-square test with a risk estimate to obtain the relative risk. Results A total of 1147 ACS patients aged 60,70 ± 10,951 years old were included in the study. Area under the ROC curve was 0,607 (95% CI: 0,559-0,655; p <0,001). The optimal cutoff value of NLR to predict mortality was 10,7566 (sensitivity: 39,8%, specificity: 79,5%, J: 0,193). In-hospital mortality occurred in 64 of 266 (24,1%) patients with NLR >10,7566 and in 97 of 881 (11%) patients with NLR <10,7566, with relative risk 2,185 (95% CI: 1,645-2,904; p <0,001). Conclusion In ACS patients with NLR >10,7566, there is an increased mortality risk 2,185 times higher compared to ACS patients with NLR <10,7566. Therefore, NLR can be used to predict in-hospital mortality in ACS patients. Mortality incidence between NLR groupsNLR >10.7566 (n= 266)NLR <10.7566 (n= 881)P-valueRelative risk95% CIMortality64 (24.1%)97 (11%)<0.0012.1851.645-2.904Non-mortality202 (75.9%)784 (89%)NLR neutrophil-lymphocyte ratio, CI: confidence interval, P-value considered significant if <0.005Abstract Figure. ROC curve of NLR

Effect of First Long-Term Training on Whole Blood Count and Blood Clotting Parameters in Thoroughbreds.

Training has a strong effect on the physiology of hematological parameters and blood coagulation, both in humans and in horses. Several blood changes have been reported after exercise in horses but available data differ. We aimed to investigate modifications in complete blood count and some hemostatic parameters induced by the first training period in young untrained Thoroughbred racehorses to detect a possible labile blood coagulability in racehorses. Twenty-nine untrained 2-year-old Thoroughbreds were followed during their incremental 4-month sprint exercise schedule. Blood collection was performed once a month, five times (T-30, T0, T30, T60 and T90), before and during the training period for measurement of complete blood count (CBC) and blood clotting parameters (prothrombin time-PT, activated partial prothrombin time-APTT, thrombin clotting time-TCT, fibrinogen-Fb, thrombin-antithrombin complex-TAT). Differences among the time points for each parameter were analyzed (ANOVA, Kruskal-Wallis one-way analysis of variance, p < 0.05). In Thoroughbreds, the first long-term exercise workout period was found to induce a statistical increase in red blood cell indexes and lymphocytes, eosinophils and platelet counts, as well as a hypercoagulability state evident at 30 days of training, which returned to basal levels after 90 days. Regular physical exercise seems to blunt the negative effects of acute efforts on hematological and clotting parameters, an effect that may be attributed to the training condition.

Risk factors for severity of thrombocytopenia in full term infants: a single center study

BackgroundNeonatal thrombocytopenia (NT) (platelet count < 150 × 109/L) is a common finding in the neonatal intensive care unit (NICU). The main aim of this study was to assess the prevalence, risk factors, and outcomes of severe NT in full term (FT) infants.MethodsDuring the study period, all FT infants who met the inclusion criteria for NT on two occasions were included. Maternal data, such as maternal age, weight, gestational age, mode of delivery, and history of systemic diseases, including diabetes mellitus, pre-eclampsia, systemic lupus erythematosus, and immune thrombocytopenic purpura, were recorded. Furthermore, neonatal data, such as gender, neonatal weight, causes/duration of admission, types of respiratory support used, complete blood count measurements, and outcomes for neonates admitted to the NICU, were recorded.ResultsIn total, 55 FT infants with NT met the inclusion criteria, and 29 (52.73%) cases had severe NT. The most common cause of NT was neonatal sepsis (20 cases, 36.35%), followed by a postoperative state (5 cases, 9.09%). Moreover, in cases of positive blood cultures, the most commonly isolated organism was Escherichia coli (6 cases, 10.90%), followed by Klebsiella (5 cases, 9.09%). Cases of severe NT needed more platelet transfusions (P = 0.001) and had higher rates of mortality (P = 0.001) when compared to cases of mild/moderate NT associated with signs of bleeding and pulmonary/intraventricular hemorrhage (IVH) (P = 0.001).ConclusionSevere NT compared to mild/moderate NT, associated with signs of bleeding and pulmonary/IVH, needed more platelet transfusions, and had increased mortality. Further research is needed to explain which of these complications related to severity of thrombocytopenia or were associated with original disease of the babies.

A cross-sectional, case-control study of intracranial arterial wall thickness and complete blood count measures in sickle cell disease.

In sickle cell disease (SCD), cerebral oxygen delivery is dependent on the cerebral vasculature's ability to increase blood flow and volume through relaxation of the smooth muscle that lines intracranial arteries. We hypothesised that anaemia extent and/or circulating markers of inflammation lead to concentric macrovascular arterial wall thickening, visible on intracranial vessel wall magnetic resonance imaging (VW-MRI). Adult and pediatric SCD (n = 69; age = 19.9 ± 8.6 years) participants and age- and sex-matched control participants (n = 38; age = 22.2 ± 8.9 years) underwent 3-Tesla VW-MRI; two raters measured basilar and bilateral supraclinoid internal carotid artery (ICA) wall thickness independently. Mean wall thickness was compared with demographic, cerebrovascular and haematological variables. Mean vessel wall thickness was elevated (P<0·001) in SCD (1·07±0·19mm) compared to controls (0·97±0·07mm) after controlling for age and sex. Vessel wall thickness was higher in participants on chronic transfusions (P=0·013). No significant relationship between vessel wall thickness and flow velocity, haematocrit, white blood cell count or platelet count was observed; however, trends (P<0·10) for wall thickness increasing with decreasing haematocrit and increasing white blood cell count were noted. Findings are discussed in the context of how anaemia and circulating inflammatory markers may impact arterial wall morphology.

39 Effects of increasing iron dextran dosage at birth on the hematological profile and growth performance of piglets during the lactation period

Abstract The objective of the experiment was to critically monitor the blood profile and growth performance of piglets during the lactation period after receiving various amounts of injectable iron at birth. A total of 70, newborn pigs (initial BW 1.51 ± 0.26 kg) from 7 litters were assigned to 1 of 5 iron dosage treatments on d 0. Injectable iron dosage treatments were 0, 50, 100, 200, and 300 mg iron from iron dextran. BW and blood samples were collected on d 0, 1, 2, 3, 4, 6, 8, 11, 14, 17, and 22 (weaning) and blood was analyzed for a complete blood count (CBC). Blood was only sampled from 50 of the 70 pigs as the pigs not sampled were used for tissue collection at weaning and postweaning. Data were analyzed as repeated measures using the individual pig as the experimental unit. As early as d 1 after the injection, hemoglobin concentration (Hb) improved (linear: P &amp;lt; 0.05). The Hb response was both linear (P &amp;lt; 0.001) and quadratic (P ≤ 0.01) from d 3 through weaning at d 22. For the 50 and 100 mg iron treatments, Hb peaked at d 6, whereas Hb for the 200 and 300 mg iron treatments peaked on d 17. Other CBC measures followed a similar pattern of improvement from d 2-3 through weaning as the iron dosage increased. Average daily gain was greater (linear: P = 0.04 and quadratic: P = 0.05) from d 0 to 22 which, in turn, led to a linear improvement (P ≤ 0.05) in weaning BW. Increasing iron injection dosage at birth leads to an improved blood profile and greater ADG during the nursing period (d 0-22). The dosage provided also affects the timing and magnitude of the peak Hb response.

PSVIII-12 Effects of increasing iron dextran dosage at birth on hematological profile, growth performance, and tissue mineral concentrations of pigs in the nursery

Abstract The objective of this experiment was to evaluate the blood profile, growth performance, and tissue mineral concentration during the nursery period in weanling pigs that received various dosages of iron at birth. A total of 70 crossbred pigs (weaning BW 6.36 ± 0.92) from 5 different injectable iron dosage treatments administered at birth (0, 50, 100, 200, and 300 mg iron from iron dextran) were used. Pigs were weighed at d 22 (weaning), 23, 24, 25, 29, 38, 44, and 52. Blood was collected from 10 pigs per treatment at the same times as above except for d 44 and analyzed for a complete blood count (CBC). A total of 3 pigs per treatment were euthanized on d 22, 38, and 52 to determine tissue mineral concentration. All pigs were fed a common nursery diet supplemented with 100 mg/kg Fe from ferrous sulfate. All data were subjected to ANOVA with the pig as the experimental unit. As injectable iron dosage at birth increased, hemoglobin concentration (Hb) increased at weaning (linear and quadratic: P &amp;lt; 0.05), to d 29 and then quadratically through (P &amp;lt; 0.05) d 38. Along with the other CBC measurements, Hb was similar between treatments at d 52. There was a quadratic response (P &amp;lt; 0.05) for ADG from d 22 to 52. Although by d 52, final BW peaked (quadratic: P &amp;lt; 0.05) for pigs receiving 100 mg iron. Iron concentration of the liver and spleen were greater (linear: P &amp;lt; 0.05) at weaning as iron injection dosage increased but was greater only in the liver at d 38 (P &amp;lt; 0.05) and the spleen at d 52 (P &amp;lt; 0.05). Results indicate that an iron injection administered shortly after birth is vital for proper growth and hematological functions during the nursery period.

Pharmacist Versus Physician Provider Management of Hydroxyurea Therapy for Polycythemia Vera (PERMANACE)

Background: Cytoreduction utilizing hydroxyurea to achieve a hematocrit (HCT) &amp;lt;45% has improved clinical outcomes for patients with Polycythemia Vera (PV). Pharmacists, through a collaborative practice agreement with hematologists, are uniquely posited to act as physician extenders and therapeutically dose adjust hydroxyurea (HU). Since 2013, HU therapeutic drug monitoring for PV patients has been transitioned to pharmacists in our oral chemotherapy clinic. We conducted a retrospective cohort cross-over study to evaluate pharmacist versus physician HU management to achieve a therapeutic HCT &amp;lt;45%. Methods: We retrospectively queried our institutional electronic medical record to identify patients diagnosed with PV with a documented ambulatory HU prescription. Additionally, patients' HU must have been managed by a physician (Phys) and subsequently crossed over to a pharmacist (PharmD) with at least two documented encounters by each clinician type. Hematological parameters for therapeutic drug monitoring are outlined in Table 1. Descriptive statistics were used for demographic information and a random effects model was used to evaluate HU management between Phys and PharmD. We fit a generalized linear regression model with random intercepts for each patient, using SAS's PROC GLIMMIX and Laplace approximation method t-test for a significant difference in probability of a therapeutic measurement between PharmD and Phys managed patients. Odd ratios were also calculated and adjusted for age and sex. Statistical analysis was performed using SAS (SAS9.4 SAS Institute, Cary, NC) and R software (The R Group, Vienna, Austria), with p&amp;lt;0.05 considered statistically significant. Results: Between 1/1/2003 and 1/20/2020, 104 patients meet the inclusion criteria. This cohort was primarily female (53%), white (97%), and aged 71 years during PharmD management vs 69 years during Phys management. The median time of a patient's HU management by PharmD was 2.4 years (IQR 1.2-3.8), Phys was 0.7 years (IQR 0.02-4.2), and overall was 3.6 years (IQR 2-6.6). 3154 complete blood count measurements were collected in the PharmD cohort and 2007 were collected in the Phys cohort. HU management by PharmD vs Phys resulted in statistically significant increases of therapeutic HCT measurements (p&amp;lt;0.0001) and platelet (PLT) measurements (p&amp;lt;0.0001) as shown in Figure 1. These outcomes remained significant when adjusted for both age and sex: HCT 87.8% vs 74.7% (p&amp;lt;0.0001) and PLT 78.4% vs 70.1% (p=0.0001). There was no difference white blood cell (WBC) therapeutic measurements between cohorts nor when adjusted for age and sex. Patients in the PharmD cohort had higher odds of achieving therapeutic HCT (OR 2.44; 95% CI [1.92 - 3.10], p&amp;lt;0.0001) and PLT (OR 1.55; 95% CI [1.25 - 1.92], p=0.0001) goals (Table 1). In terms of hematological safety parameters, there was no significant difference in neutropenia (OR 1.30; CI 95% [0.51-3.25]) with PharmD vs Phys HU management. All grade neutropenia occurred in 35 (1.1%) and 18 (0.9%) of patients between the PharmD vs Phys cohort, respectively. Grade 3 neutropenia occurred in 1.1% of patients in both cohorts with no instances of Grade 4 neutropenia. Conclusion: These findings support the efficacy of pharmacist therapeutic drug management of HU for patients with PV. Pharmacists managing HU achieve a target HCT and PLT count more often than physician management. By acting as a physician extender, pharmacist HU management for PV patients can help decrease the clinical burdens on physicians without compromising efficacy. Disclosures No relevant conflicts of interest to declare.

Association of proton pump inhibitor and histamine H2-receptor antagonists with restless legs syndrome.

Restless legs syndrome (RLS) is a common sensorimotor disorder, which can disrupt sleep and is thought to be caused in part by low cellular iron stores. Proton pump inhibitors (PPI) and histamine H2-receptor antagonists (H2A) are among the most commonly used drugs worldwide and show evidence of causing iron deficiency. We conducted a case/non-case observational study of blood donors in the United States (N = 13,403; REDS-III) and Denmark (N = 50,323; Danish Blood Donor Study, DBDS), both of which had complete blood count measures and a completed RLS assessment via the Cambridge–Hopkins RLS questionnaire. After adjusting for age, sex, race, BMI, blood donation frequency, smoking, hormone use, and iron supplement use, PPI/H2A use was associated with RLS (odds ratio [OR] = 1.41; 95% confidence interval [CI], 1.13–1.76; p = 0.002) in REDS-III for both PPI (OR = 1.43; CI, 1.03–1.95; p = 0.03) and H2A (OR = 1.56; CI, 1.10–2.16; p = 0.01). DBDS exhibited a similar association with PPIs/H2As (OR = 1.29; CI, 1.20–1.40; p < 0.001), and for PPIs alone (OR = 1.27; CI, 1.17–1.38; p < 0.001), but not H2As alone (OR = 1.18; CI, 0.92–1.53; p = 0.2). We found no evidence of blood iron stores mediating this association. The association of PPI, and possibly H2A, consumption with RLS independent of blood iron status and other factors which contribute to RLS risk suggest the need to re-evaluate use of PPI/H2A in populations at particular risk for RLS.

Assessment of Some Inflammatory Biomarkers in Children with Febrile Seizure and Bacterial Meningitis

Introduction: Bacterial meningitis (BM) is a serious infection characterized by inflammation of themeninges, causing a high rate of acute complications in children. This research aimed to explain the effect ofprocalcitonin (PCT) in BM and its correlation with the others some inflammatory biomarkers.Method: The case-control study included Fifty children who were diagnosed with suspected bacterialmeningitis associated with febrile seizure according to the clinical investigation by specialized pediatricianand analysis of CSF and Forty children were enrolled as healthy control. The inflammatory biomarkersprocalcitonin, Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) were estimated for eachparticipants in addition to measurement of CBC(complete blood count) by using an automated instrument.Results: Patients have significantly higher serum levels of PRO, CRP, ESR, total WBC count, ANC, andNLR than the control group. Elevating serum PRO and CRP levels in patients group were significantlyassociated with increased serum ANC levels. A significant relationship was also observed between PRO andNLR, indicating that the PRO, CRP and NLR had a suitable biomarkers in the diagnosis of BM.Conclusion: Serum procalcitonin is more specific and sensitive inflammatory biomarkers than the NLR andCRP for the evaluation of suspected bacterial meningitis, so the recommended to use PCT assays in the earlydiagnosis of children with BM.

Thromboelastometry and a hemostasis management system are most beneficial for guiding hemostatic therapy in cardiac surgery patients with a EuroSCORE II of ≥1.83%: a randomized controlled two-step trial.

We evaluated the efficacy of hemostatic therapy based on point-of-care (POC) testing in patients undergoing cardiac surgery. This was a single-institution, prospective, randomized, double-blinded study. In step 1, 90 patients scheduled for elective cardiac surgery underwent complete blood count and fibrinogen measurements at baseline, after cardiopulmonary bypass (CPB) initiation (CPB start), just after CPB end, and in the intensive care unit (ICU). In step 2, 72 patients scheduled for elective cardiac surgery underwent conventional laboratory coagulation tests (control group) or POC coagulation tests (POC group). Transfusions were prepared using the fibrinogen and platelet values at mainly "CPB start" for the control group, and using the ROTEM values at mainly "CPB end" for the POC group. Consequently, the step 2 patients were divided into high- and low-risk subgroups based on the EuroSCORE II by logistic regression analysis; transfusion data and bleeding volumes were compared between the control and POC groups within the high- and low-risk subgroups. In step 1, all blood components were significantly decreased at CPB start compared with baseline, and platelet and fibrinogen levels remained almost constant from CPB start to end. In step 2, the transfusion rates and perioperative bleeding volumes did not significantly differ between the control and POC groups. Subgroup analysis suggested that only the high-risk subgroup significantly differed regarding perioperative red blood cell transfusion and total bleeding volume in the ICU. POC testing is beneficial for cardiac surgery patients with a EuroSCORE II of ≥1.83%.

New Marker for Suspected Open Globe Injury (Perforation or Penetration): Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio

Purpose: To compare the strength of the relationship between the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio(PLR) results of patients with or without open globe injury (perforation and penetration) in the acute period of orbital trauma.&#x0D; Materials and Methods: Forty patients with open globe injuryand twenty-five patients without open globe injury in the acute period of orbital trauma were enrolled in this retrospective study. Complete blood count measurement results of all subjects were assessed.&#x0D; Results: There was a significant difference in neutrophil-to-lymphocyte ratio and the platelet-to-lymphocyte ratio between orbital trauma with open globe injury group and without open globe injury group (p=0.001, p=0.006).&#x0D; Conclusion: Our results of the blood count measurements suggest that the NLR and PLR at first three hours may predict ocular perforation/penetration and the clinicians have to alert are a risk factor of open globe injury.

Serum Inflammation Biomarkers in Patients with Keratoconus

ABSTRACT Purpose: To evaluate inflammation-sensitive parameters, namely the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), eosinophil count, erythrocyte distribution width (RDW), and CRP/albumin ratio in patients with keratoconus (KC). Methods: Thirty-five patients with KC and 30 healthy people (control group) were included in the study. Complete blood count measurements were performed in all subjects, and NLR, PLR and the CRP/albumin ratio were calculated. Results: NLR was determined as 2.01 ± 0.53 in patients with KC and 1.97 ± 0.41 in the control group. PLR was 146.20 ± 23.32 in the KC group and 121.45 ± 31.75 in the healthy group. The CRP/albumin ratio was determined as 0.33 ± 0.09 in the KC group and 0.29 ± 0.11 in the healthy group. Conclusion: Although no significant difference was found between the groups in terms of NLR, CRP/albumin ratio and RDW levels, PLR was significantly higher in the KC group.

Dietary ractopamine supplementation of pregnant sows: what are the impacts on the neonate?

The use of additives such as ractopamine (Rac) in pregnant sows during early-mid pregnancy is an alternative to increase foetal and progeny growth and development. However, Rac supplementation in finishing pigs can lead to behavioural and physiological changes similar to the typical stress responses. The objective of this study was to evaluate the effects of dietary supplementation with Rac in pregnant sows from day 25 to 50 of gestation (pre-hyperplastic stage) on piglet’s vitality, blood parameters, number, diameter and perimeter of muscle fibres in semitendinosus muscle and developmental characteristics of piglets at birth to weaning. Forty-one hybrid sows were divided into three dietary treatments: (1) control diet without Rac (control), (2) addition of 10 mg/kg of Rac (Rac10) and (3) addition of 20 mg/kg of Rac (Rac20). Higher numbers of low-vitality piglets (P<0.05) were observed in Rac-fed sows, regardless of dose, compared with the control group. Very low-density lipoprotein levels were lower in the Rac10 group when compared with the Rac20 group at day 21. Haematocrit was greater, and the mean corpuscular haemoglobin concentration was lower in piglets from Rac-fed sows. No significant statistical differences were detected regarding piglets body weight, average daily gain, blood gasometry, complete blood count and muscle fibre measurements in semitendinosus muscle. The use of Rac in pregnant sows reduced the vitality parameters of piglets but did not improve the performance from birth until weaning and did not negatively influence the haematological parameter and lipid metabolism.

Associations between Blood Cell Profiles and Primary Open-Angle Glaucoma: A Retrospective Case-Control Study

Purpose: We aimed to evaluate whether the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and systemic immune inflammation index (SII) were associated with primary open-angle glaucoma (POAG). Materials and Methods: This retrospective case-control study included 240 patients with POAG and 300 age- and sex-matched control subjects. Complete ophthalmological examination and blood count measurements were performed for all subjects. Results: The values of NLR, PLR, and SII in the POAG group were significantly increased compared with the control group (p < 0.001; p = 0.012; p < 0.001). However, the LMR value was lower in the POAG patients than in the control group (p < 0.001). When we divided the subjects into different age and gender subgroups, the NLR and SII values in the POAG patients were always higher than those in the control group. In the comparison of laboratory parameters in POAG subjects stratified according to severity, we also found that NLR and SII increased with the severity. The receiver operating characteristic (ROC) analysis revealed that the areas under the ROC curve of NLR, PLR, LMR, and SII to predict patients with POAG were found to be 0.627, 0.569, 0.382, and 0.986, respectively. The best cutoff point of NLR was 1.998 with a sensitivity of 59.8% and a specificity of 63.0%, and the SII was 947.365 with a sensitivity of 95.4% and a specificity of 95.7%. Multivariable logistic regression analysis showed that NLR was positively associated with mean deviation; moreover, NLR and SII were independent indicators correlated with POAG (OR 1.502; 95% CI 1.227–1.839; p < 0.001; OR 1.02; 95% CI 1.009–1.021; p < 0.001). Conclusion: We speculated that elevated NLR and SII might serve as readily available inflammatory predictors in POAG patients.

Determination of echocardiographic parameters in spider monkey (Ateles spp.) collectives in captivity sedated with ketamine and midazolam

Nonhuman primates have long been studied and managed in research centers, zoos, and farms, but there is still a lack of information regarding their illnesses. The present study aimed to establish the echocardiographic parameters of normality among primates of the genus Ateles (spider monkey) that are housed at the Zoo of the City of Rio de Janeiro – RIOZOO Foundation. Nine specimens of the same species were used, 5 females and 4 males, that were clinically healthy, young adults, with an approximate captive age of 2 to 3 years, and an average weight of 8.5 kg. The animals were physically restrained with a net and soon after, chemical containment was carried out by means of an association of ketamine hydrochloride at a dose of 8 mg per kg and midazolam at 0.5 mg per kg, intramuscularly. The animals were submitted to chemical restraint to establish the clinical evaluation, blood collection for complete blood count and biochemical measurements, urine collection for urinalysis, chest X-ray in the ventro-dorsal and latero-lateral positions, and electrocardiographic exams, with all the parameters within the normal range, in addition to echocardiographic examination, which became the means by which the study parameters were acquired. During this examination, the following values were evaluated: cardiac output, ejection fraction, final cardiac volume, heart rate, left atrial diameter, aorta diameter, ratio between the diameters of the left atrium and aorta artery, thickness of the interventricular septum in diastole, diameter of the left ventricle in diastole, thickness of the free wall of the left ventricle in diastole, thickness of the interventricular septum in systole, diameter of the left ventricle in systole, thickness of the free wall of the left ventricle in the systole, left ventricular end systolic volume, left ventricular end diastolic volume, septum bending fraction, fraction of curving of the posterior wall, septal separation, and shortening fraction. With the data obtained, tables were drawn with the echocardiographic values of the species studied under sedation.

P5337Neutrophil-lymphocyte ratio and peripheral arterial disease in HIV infection

Abstract Background/Introduction While antiretroviral therapy has increased survival in HIV-infected patients, cardiovascular mortality is now their leading cause of death. Together with a high prevalence of traditional cardiovascular risk factors in HIV infection, chronic inflammation may be also responsible of an increased risk of cardiovascular diseases. Purpose To determine the association between a systemic inflammation-based biomarker, the neutrophil-lymphocyte ratio, and the occurrence of peripheral arterial disease in HIV infected patients. Methods In a case-control design, 41 patients with peripheral arterial disease and HIV infection were compared to 119 patients with HIV infection but no peripheral arterial disease. All patients were recruited at a Regional Hospital. The ankle-brachial index was measured in all subjects and peripheral arterial disease was defined as an ankle-brachial index &gt;0.9. The neutrophil-lymphocyte ratio was assessed using neutrophil and lymphocyte levels in the complete blood count measurement, from routine hemograms performed six to twelve months before measurement of the ankle-brachial index. The cut-off of neutrophil-lymphocyte ratio &gt;2 was used to categorize patients into low- and high- neutrophil-lymphocyte ratio groups. Odds ratios (OR) with 95% confidence intervals were used to estimate the strength of association. In order to control for potential confounders, a multiple logistic regression model was used. Results There was a significant association between elevated neutrophil-lymphocyte ratio and the presence of peripheral arterial disease (OR 7.25 [3.32–15.85], after adjustment for age (OR 1.07 [1.04–1.11]), smoking index (OR 1.12 [1.02–1.24]. Other considered variables did not contribute to the model (HDL-cholesterol, LDL-cholesterol, triglycerides, sex, diabetes, obesity and treatment). Conclusions The ankle-brachial index is a simple, cost-effective and validated method to assess peripheral arterial disease, which its presence increases the risk of cardiovascular disease morbidity and mortality. The neutrophil-lymphocyte ratio is a simple, rapid and novel inflammation parameter, that may help to identify HIV-infected patients with a higher risk of peripheral arterial disease.

90 Evaluation of transport duration on immune response and blood parameters in sedentary horses

Abstract Transport has cogent effects on the physiological and immunological welfare of horses, resulting in inevitable stressors regardless of adaptation or conditioning. We hypothesized transporting sedentary horses would yield allied results to studies using transport-conditioned horses. Mature stock-type horses (n = 4) were subjected to three transport durations (0.25, 3 and 6 hours) with 7–8 days between transport. All subjects were transported simultaneously for all durations of transport. Blood samples were collected before, post-transport and 24 hours post-transport and analyzed for complete blood count (CBC). Body weight (BW), rectal temperature (RT), blood glucose (GLU) and blood lactate (BLA) were recorded before and post-transport. All data (p&lt;0.05) were analyzed using PROC MIXED (SAS © 9.4). Transport duration did not influence CBC, BLA or other physical measurements. Resulting GLU increased after 3 (158.5±8.5 mg/ dL) and 6 (147.50±8.5 mg/dL) hours of transport compared to 0.25 hour of transport (117.8±7.2 mg/dL). Weights decreased after transport; however, this was likely due to eliminative behavior during transport. Total WBC tended (P = 0.06) to increase before transport (7.71±0.6 K/µL) than post (5.64±0.59 K/µL) and 24 hours post-transport (6.14±0.06 K/µL). Percent neutrophils (N) increased post-transport (66.8±2.5%) compared to before transport (55.7±2.6%) and 24 hours post-transport (57.2±2.5%). Neutrophil to lymphocyte ratio (N:L) tended (p= 0.07) to increase post-transport (66.7±2.7%) than before (55.7±2.7%) and 24 hours post-transport (57.3±2.6%) regardless of duration. Increases in N are consistent with previous research indicating a short-term stress response. Previous research measuring adrenocortical response reported elevated N:L ratios indicating stress; our results suggests transport, even minimal, may stimulate a stress response in rarely-transported horses. Elevated GLU after transport may further support an adrenocortical response as cortisol can influence blood glucose concentrations. Findings indicate even short-term transport elicits an immunological stress response and may be intensified in rarely transported horses compared to seasoned travelers.

Short-Term Stability of Hematologic Parameters in Frozen Whole Blood

Complete blood counts (CBCs) are commonly obtained in large multicenter studies. We assessed the stability of 10 parameters after short-term (up to 30 days) frozen storage. We compared CBC measurements from fresh samples (n = 53) with samples stored for up to 30 days at -70 °C. We calculated the CVs and intraclass correlation coefficients. Mean values of most parameters, with the exception of hemoglobin and platelet count, were significantly different by 15 days of storage. White blood cell count (CV, 38.3%; 95% CI, 31.3%-46.2%) and red cell distribution width (CV, 37.7%; 95% CI, 34.1%-41.3%) were the most variable. After 30 days, only hemoglobin remained stable and reliable (CV, 0.8%; 95% CI, 0.4%-1.3%). Hemoglobin remained stable in frozen blood samples stored for up to 30 days at -70 °C and may be reliably used in research studies using short-term frozen specimens. Other CBC parameters measured in stored blood are not sufficiently reliable for research or patient care.

Mean platelet volume, neutrophil- and platelet to lymphocyte ratios are elevated in vestibular neuritis

AimTo evaluate the alterations in inflammatory markers, NLR and PLR, as well as mean platelet volume (MPV) and the other parameters of complete blood counts (CBC) in adult patients with vestibular neuritis (VN). MethodDesigned as a case control study. The records of the patients, who were hospitalized due to an acute onset vertigo, and diagnosed as VN, were analysed retrospectively. The complete blood count (CBC) measures of the patients were statistically compared with the measures of healthy subjects. The correlations between the length of hospitalization and the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were also analysed. ResultsOne hundred four patients with VN and 138 healthy controls were included. MPV, white blood cell and neutrophil counts, NLR and PLR were significantly higher; while lymphocyte count was significantly lower in the VN group (p < 0.001). There were no correlations between the length of hospitalization and NLR or PLR. ConclusionThe elevations of NLR and PLR support the role of inflammation in VN. The high level of MPV indicates the possible role of the vascular thrombosis in the etiology of VN.

The Effect of Marked Nasal Septal Deviation on Left Ventricular Function and Blood Markers.

This study aimed to assess the effect of nasal septoplasty in patients with marked nasal septal deviation (MNSD) on subjective perception of nasal patency, echocardiography, and hematologic parameters. Seventy-nine consecutive patients (mean age, 29.9 ± 9.7 years; 57 men and 22 women) at least 18 years old were diagnosed as MNSD consistent with presenting symptom of chronic nasal obstruction lasting at least 3 months. Complete blood count measurement to assess mean platelet volume (MPV) and neutrophil to lymphocyte ratio (NLR), the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire, and echocardiography were performed for all patients just before and at postoperative third month of septoplasty. The MPV (0.021), NLR (<0.001), and NOSE (<0.001) were all significantly decreased, and global longitudinal strain (GLS) value (<0.001) were also significantly increased at postoperative third month. Correlation analysis also indicated that ΔNLR was positively correlated with ΔGLS (r = 0.385, P < 0.001), and ΔNOSE (r = 0.436, P < 0.001), and correlated negatively with the ΔMPV (r = -0.302, P = 0.024). ΔGLS was also positively correlated with the ΔNOSE (r = 0.769, P < 0.001). Septoplasty for MNSD could provide not only alleviation of otorhinolaryngologic symptoms but also improvement in subclinical left ventricular systolic dysfunction and decline in MPV and NLR levels.