Neutrophil-lymphocyte Rate Research Articles

Effect of fibromyalgia on demographic, biochemical, metabolic and inflammatory profiles: a single-centre retrospective study.

The objective of this study is to ascertain the disparities in demographic features and biochemical profiles between individuals diagnosed with fibromyalgia (FM) and a control group of healthy individuals. This retrospective, cross-sectional study compared the demographic, biochemical, metabolic, and inflammatory indexes and rates of 174 FM patients diagnosed using the American College of Rheumatology 2016 diagnostic criteria between January 2023 and January 2024, and 186 healthy control groups. There was no difference between the FM and control groups in terms of alcohol consumption, marital status, or diabetes mellitus. The smoking rate is higher, and the educational level was found to be lower for FM versus the control. There was no significant difference between FM and controls regarding waist-height ratio, triglyceride-glucose index, plasma atherogenic index, vitamin B12, and folate levels. Monocyte HDL ratio, cardiometabolic index, magnesium, HbA1c, and ferritin levels were significantly higher in the control than in FM (p<0.001, p=0.039, p=0.007, p<0.001, p<0.001, respectively). C-reactive protein, erythrocyte sedimentation rate, systemic immune-inflammatory index, neutrophil-lymphocyte rate, platelet lymphocyte rate, and vitamin D levels were found to be higher in FM compared to control (p=0.001, p=0.032, p=0.003, p=0.030, p=0.003, p<0.001, respectively). A weak positive correlation was observed between the fibromyalgia impact questionnaire (FIQ) score and disease duration, as well as between pain degree and ESR, and pain degree and CRP. The study revealed a weak inverse relationship between Widespread Pain Index (WPI) and waist circumference. This study highlights fthe association f ibromyalgia with elevated inflammatory markers, altered metabolic parameters, and specific demographic characteristics.

Methamphetamine Use Disorder and Inflammation: A Case-Control Study

Objective Methamphetamine use disorder (MUD) is a global health condition that impairs a person’s health which may result in morbidity and mortality. Inflammation is a crucial process playing a vital role in MUD. For this reason, it is necessary to examine biochemical parameters for follow-up and treatment alternatives.Methods We aimed to reveal the relationship between inflammatory response and MUD by evaluating peripheral hemogram parameters, leukocyte count, subtypes, and their ratios to each other, systemic immune inflammation index (SII), monocyte/high-density lipoprotein (HDL) ratio, and human C-reactive protein (CRP) in adult men with MUD. We included 76 adult male participants in the patient group and 70 adult male participants in the control group. We calculated the neutrophil/lymphocyte rate (NLR), monocyte/lymphocyte rate (MLR), platelet/lymphocyte rate (PLR), and basophil/lymphocyte rate (BLR). In addition, we obtained the SII and the monocyte/HDL rate.Results The patients’ leukocyte (p&lt;0.001), platelet (p&lt;0.001), plateletcrit (PCT) (p=0.002), neutrophil (p&lt;0.001), monocyte (p=0.002), CRP (p&lt;0.001), NLR (p=0.001), PLR (p=0.004), MLR (p=0.009), SII (p&lt;0.001) and monocyte/HDL ratio (p&lt;0.001) were higher than the control group. We observed a significant and positive relationship between the daily methamphetamine intake, and methamphetamine use duration (p=0.002), PCT (p=0.044), neutrophil (p=0.021), NLR (p=0.001), PLR (p=0.004), MLR (p=0.029), and SII (p&lt;0.001). Daily methamphetamine intake had a significant and positive effect on SII. A one-unit increase in daily methamphetamine intake elevated SII by 165.53 units.Conclusion The results confirm the presence of peripheral subclinical inflammation and systemic immune inflammation in adult men with MUD.

Macula, choroid and retinal nerve fiber layer optical coherence tomography biomarkers in liver dysfunction

Abstract Objectives We aimed on evaluating the effect of liver dysfunction on retinal nerve fiber layer (RNFL), GCL++ (ganglion cell layer + RNFL + inner plexiform layer), central macular thickness (CMT) and subfoveal choroidal thickness (CT) measurements. Methods Fifty two patients with primary biliary cirrhosis (PBC group) and 61 healthy individuals (control group) were included in our study. Blood alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase (GGT), alkaline phosphatase (ALP), total bilirubin, albumin, prothrombin time results as the international normalized ratio (INR), neutrophil (NEUT), lymphocyte (LYMP), neutrophil lymphocyte rate (NLR), platelet (PLT), mean platelet volume (MPV) levels were analyzed in both groups. RNFL, Inferior RNFL (IRNFL), Superior RNFL (SRNFL), GCL++, CMT and CT were measured by swept source optical coherence tomography (OCT). The choroidal vascular index (CVI) was also obtained. Results GGT (p=0.001), ALP (p&lt;0.001), albumin (p&lt;0.001), NEUT (p=0.046) and MPV (p&lt;0.001) values were higher in the PBC group. INR (p=0.017) and PLT (p=0.027) values were lower in the PBC group. CMT (p=0.015), CT (p=0.002), and GCL++ (p&lt;0.001) values were found lower in the PBC group. Conclusions OCT analyzes revealed thinning in CMT, CT and GCL++ in patients with liver dysfunction. OCT analyzes should be evaluated during periodic ocular examinations of PBC patients.

Prognostic importance of platelet/lymphocyte ratio and neutrophil/lymphocyte ratio in proteinuria associated with primary glomerular diseases

Objective: Proteinuria is associated with inflammation, endothelial dysfunction, platelet activation, and progression of kidney disease. The biological mechanisms by which platelet/lymphocyte rate (PLR) and neutrophil/lymphocyte rate (NLR) variables play a role in mediating protein excretion are not fully known. Here we aimed to compare NLR and PLR variables between patients with the primary glomerular disease (PPGD) with normal estimated glomerular filtration rate (eGFR) and healthy individuals (HIs). We divided the primary glomerular disease (PGD) participants into three sub-groups according to the level of proteinuria. In addition, a comparison was made between the sub-groups of patients with PGD in terms of these variables. Methods: This cross-sectional, double arm, single center retrospective study was performed between January 2019 and April 2020. Serum platelet, total, and differential leukocyte analyses were evaluated using an automated cell counter. Biochemical analysis and 24-hour urinalysis in order to measure protein excretion and creatinine (Cr) clearance were performed using a chemistry analyzer. Of 225 participants in the study, 111 were patients with PGD, and 114 were HIs. Results: A statistically significant difference was found when compared with PPGD and HI participants in terms of red blood cell (RBC), hemoglobin (HGB), white blood cell (WBC), platelet, neutrophil, NLR, and PLR variables. PPGDs revealed higher median C-reactive protein (CRP) and lower median albumin levels compared to HIs. Age, gender, urea, Cr, CRP, WBC, RBC, HGB, platelet, neutrophil, lymphocyte, NLR, and PLR variables between the sub-groups of patients with PGD were not statistically significant. But, there was only a difference between the sub-groups of patients with PGD in terms of albumin levels. Conclusions: Our data suggested that PLR and NLR can be used as predictors in PPGDs. Higher median CRP and lower median albumin levels were also associated with proteinuria in PPGDs.

Sensibilidad y especificidad del índice neutrófilo/linfocito en pacientes pediátricos con apendicitis aguda complicada.

Establish the sensibility and specificity of the neutrophil-lymphocyte rate (NLR) in pediatric patients with acute complicated appendicitis. Transversal, observational, descriptive, and retrospective study of pediatric patients between 4 to 16 years old with diagnosis of acute appendicitis, who had appendectomy, from December 2017 to January 2019. We calculated the NLR in every patient. To analyze the variables, we used the test of Mann-Whitney and we value the sensibility and specificity of the NLR. There were 245 patients, 81 with simple appendicitis and 144 with complicated appendicitis. Just 27 of them were laparoscopic appendectomy. The NLR had a media of 10.48 in simple appendicitis, and 13.03 in complicated ones, with a p value of 0.02. the area under the curve was 0.622. There was a rate of 8.2 in complicated appendicitis to the NLR. The NLR has been poorly studied in pediatric patients with acute appendicitis. In this study the NLR had a significant value in the patients with acute complicated appendicitis, with medium sensibility and a relatively low specificity.

The Incidence of Itching in Thoracic Epidural Morphine Applications: Can Laboratory Parameters Be Effective in Predicting Itching?

BackgroundEpidural morphine, a powerful analgesic, also causes significant itching in patients. This study aimed to determine the incidence of thoracic epidural morphine-induced pruritus (EMIP) after thoracotomy and to investigate preoperative laboratory parameters for predicting itching in patients who received thoracic epidural morphine (TEM).MethodsThe patients were divided into two groups. The itching (+) group consists of patients who developed itching (n=31). The no-itching (-) / control group (n=31) was selected among patients who did not develop itching after TEM. Preoperative hemogram values, neutrophil/lymphocyte rate (NLR), platelet/lymphocyte rate (PLR), lymphocyte/monocytes rate (LMR), preoperative and postoperative alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase (ALP), gamma-glutamyl transferase values, and whether there was itching in the first 48 hours after surgery were determined.ResultsThe incidence of thoracic EMIP after thoracotomy was 7.9%. While preoperative and postoperative ALP was found to be lower in patients with itching compared to those without itching. The cut-off value for preoperative/postoperative ALP was 84.5/53. Decreased white blood cell (WBC) could predict pruritus with a borderline statistical significance.ConclusionsThe incidence of EMIP after thoracotomy was lower compared to other literature data. Infusion of morphine only into the epidural area may cause a low incidence of EMIP. Laboratory parameters ALP and WBC can predict EMIP, but other hemogram parameters, NLR, LMR, and PLR cannot predict EMIP.

Neutrophil Lymphocyte Rate: A Marker of Mortality and Prognosis for Covid-19?

Objective: In recent years, the neutrophil-to-lymphocyte ratio (NLR) has become a parameter sought in the prediction of aggressive prognosis or mortality in many studies including sepsis, infectious diseases, and malignancies. There are publications studying the correlation between the high values of this parameter, which can be interpreted as an indirect indicator of the host’s immune response, in the COVID-19 infection with mortality. The primary objective of our study is to evaluate the correlation between the height of NLR values in the patients followed up in our intensive care units (ICU) with the final diagnosis of COVID-19 infection (PCR(+)), the continuation of such high values throughout the treatment and mortality, and finally obtain a cut-off value in predicting the prognosis. Method: The case files with final diagnosis of COVID-19 infection followed up and treated in our 3rd Level Intensive Care Unit from 21 March 2020 to 1 July 2020 were screened retrospectively and included in the study. These cases were examined in two groups: exitus (n=113) and survivors (n=70). The demographics of the cases such as age, gender, comorbid diseases as well as their vital signs and clinical and laboratory features were screened from the Hospital Operating System (HOS) and archive files, and recorded. The correlation among the data obtained as well as the correlation between such data and mortality were analyzed. Findings: In the study conducted on 183 cases, the ages, APACHE II scores, admission NLR values, study endpoint NLR values, neutrophil, procalcitonin, D-dimer, PT and INR levels, and MV (Mechanical Ventilation) durations of the exitus cases were found statistically significantly higher than the survivor cases. In the exitus cases, the cut-off point found for the admission NLR was &gt;7.82. During the course of treatment, the patients with high NLR level had poor prognosis. The patients’ NLR values at the study endpoint were analyzed. The conclusion is that &gt;6 as the cut-off point value is significant from the viewpoint of mortality. In addition, it was observed that a NLR level over 6 despite the treatment increased the mortality rate by 15.6 times. Conclusion: We have found out that old age, long MV duration, prolonged high levels of D-dimer, neutrophil, PT, INR and NLR levels increase the mortality rate. Being able to predict the course of prognosis and using early warning systems will increase the survival rate. In this regards, we consider closer monitoring of the patients with high NLR level, particularly in the intensive care units even if they do not have respiratory distress, will decrease mortality significantly. NLR can help identifying the COVID-19 patients with high risk level. High NLR level during the intensive care monitoring process may be regarded as insufficient immune response, and thus correlated with mortality and aggressive prognosis.

The prognostic evaluation of CA19-9, D-dimer and TNFAIP3/A20 in patients with pancreatic ductal adenocarcinoma.

This study aimed to explore the significance and prognostic value of serum tumor-associated carbohydrate antigen 19-9 (CA19-9), D-dimer, and tumor necrosis factor alpha-induced protein 3 (TNFAIP3/A20) in patients with pancreatic ductal adenocarcinoma (PDAC).Our study included 148 patients treated for PDAC at Northern Jiangsu People's Hospital Affiliated to Yangzhou University from January 2012 to December 2016. Cutoff prognostic values were predicted using the receiver operating characteristic (ROC) curve. The Kaplan-Meier method was used to assess the survival rates of patients. Univariate and multivariate COX regression analyses were used to evaluate the prognostic factors.The recommended cutoff values of neutrophil-lymphocyte rate (NLR), platelet-lymphocyte rate (PLR), CA19-9, and D-dimer were 2.04 (sensitivity, 0.59; specificity, 0.9; area under the ROC curve [AUC], 0.749; P < .001), 52.94 (sensitivity, 0.73; specificity, 0.95; AUC, 0.829; P < .001), 176.66 U/mL (sensitivity, 0.7; specificity, 0.9; AUC, 0.794; P < .001), and 1.18 mg/L (sensitivity, 0.82; specificity, 0.9; AUC, 0.845; P < .001), respectively. Positive TNFAIP3/A20 expression was considered as an inclusion criterion. Serum CA19-9 expression was related with lymph node metastasis (P = .010), tumor-lymph node-metastasis (TNM) stage (P < .001), and survival rate (P < .001). D-dimer was correlated with tumor differentiation grade (P = .014), tumor size (P = .045), TNM stage (P < .001), and survival rate (P < .001). TNFAIP3/A20 was correlated with tumor differentiation grade (P < .001), body mass index (BMI) (P < .001), TNM stage (P = .014), and survival rate (P < .001). Kaplan-Meier curves showed that PDAC patients had significant differences in CA19-9, D-dimer, and TNFAIP3/A20 expressions (P < .05). CA19-9, D-dimer, TNM stage, tumor differentiation grade, and TNFAIP3/A20 were independent prognostic markers for PDAC in univariate and multivariate COX analyses.CA19-9, D-dimer, and TNFAIP3/A20 were found to be independent prognostic markers for PDAC patients.

Evaluation of Inflammation in the Carpal Tunnel Syndrome by the Neutrophil-Lymphocyte Rate, Platelet- Lymphocyte Rate and Mena Platelet Volume

Amaç: Karpal tünel sendromu median sinirin karpal tünel seviyesinde sıkışmasından kaynaklanan ve en yaygın görülen mononöropati şeklidir. Büyük bir kısmı idiopatik olan bu tablonun fizyopatolojik mekanizması halen tam açıklanamamıştır. Biz bu çalışmada karpal tünel sendromun’da sistemik inflamasyonun olası rolünü nötrofil-lenfosit oranı, platelet-lenfosit oranı ve ortalama platelet hacmi değerleri ile incelemeyi amaçladık. &#x0D; &#x0D; Gereç ve Yöntemler: Çalışmaya yaşları 20 ve 60 arasında değişen, elektofizyoloji labaratuvarımıza refere edilen ve American Academy of Neurology kriterlerine göre karpal tünel sendromu tanısı konulan toplam 55 hasta ve sağlıklı 36 kişi dahil edildi. Hastalar elektrofizyolojik bulgulara göre hafif, orta ve şiddetli olmak üzere üç alt gruba ayrıldı. Hastaların klinik açıdan fonksiyonel durumları ve hastalık şiddetleri Boston Questionnaire ile değerlendirildi. &#x0D; &#x0D; Bulgular: Çalışmaya 71 kadın (%78,02) ve 20 erkek (%21,98) olmak üzere toplam 91 kişi alınmıştır. Hasta grubu yaş ortalaması 50,04±9,78 olan 43 kadın ve 12 erkekten oluşmaktadır. Kontrol grubu yaş ortalaması 49,92 ±7,59 olan 28 kadın ve 8 erkekten oluşmaktadır. Hasta ve kontrol grupları arasında karşılaştırıldığında nötrofil-lenfosit oranı, platelet-lenfosit oranı ve ortalama platelet hacmi değerleri arasında anlamlı fark saptanmadı. Ölçülen değerler hasta alt gruplarında karşılaştırıldığında hastalık şiddetiyle değerler arasında anlamlı fark saptanmamıştır.&#x0D; &#x0D; Sonuç: Karpal tünel sendromu fizyopatolojisinde sistemik inflamasyonun rolünün belirsiz olduğu, bazı mekanik ve lokal patolojilerin etyopatogenezi aydınlatmakta daha ön planda düşünülmesi gerektiği akla yatkın görünmektedir. Konu ile ilgili hasta sayısının artırıldığı çok merkezli ve uzunlamasına çalışmalara ihtiyaç olduğu kanaatindeyiz.

Safety and Clinical Impact of a Single Red Light Irradiation on Breast Tumor-Bearing Mice.

Low-level light therapy has been used in health care as a therapeutic strategy for different diseases. However, its effects on cancer are controversial. This work evaluated the effects of three energies on breast cancer-bearing mice after a single red light-emitting diode (LED) irradiation. 4T1 cells were inoculated into the mammary fat pad of female BALB/c mice. When tumor volume reached 100 mm3 , animals were irradiated by a LED irradiator (660±11nm) with energies of 1.2, 3.6, and 6.0J. Control without irradiation and healthy animals were also evaluated. Mice were monitored regarding tumor volume and total blood count. After euthanasia, their organs were examined. We observed that a single irradiation does not increase tumor volume. All irradiated groups exhibited better clinical conditions than control, which presented a significant decrease in platelet and red blood cell levels compared with healthy mice. The energy of 3.6J arrested neutrophil-lymphocyte rate besides promoting longer survival and a lower number of metastatic nodules in the lungs. These findings suggest that a single red LED irradiation causes no impact on the course of the disease. Besides, the intermediary dose-effect should be further investigated since it seems to promote better outcomes on breast cancer-bearing mice.

An evaluation of biomarkers indicating endothelial cell damage, inflammation and coagulation in children with Henoch-Schönlein purpura

Abstract Objective Henoch-Schönlein purpura (HSP) is characterized by generalized vasculitis. The etiopathogenesis of the disease is unknown, but inflammation and endothelial dysfunction have been held responsible. Therefore, herein we investigated serum levels of biomarkers indicating endothelial cell damage, inflammation and coagulation in children with HSP. Materials and methods Twenty six patients with HSP and 26 healthy children were included in the study. Routine biochemical tests and laboratory parameters showing inflammation, coagulation, and endothelial cell damage were examined in all subjects. Results White blood cell (WBC) number, C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), neutrophil/lymphocyte rate (NLR), triglyceride, immunoglobulin A (IgA), and C3 were significantly higher in children with HSP than the controls. HDL and albumin levels were lower in the patients with HSP. Endocan levels were not significantly different between the HSP and control groups (p = 0.884). Serum endocan levels in patients with HSP were inversely correlated only with activated partial thromboplastin time (APTT) (r = −0.485, p = 0.012). Conclusion Coagulation abnormalities and increased acute phase reactants were present in patients with HSP while no difference was determined in endocan levels.

Comparison of complete blood counts of stable COPD patients at two different altitude in Turkey.

Introduction: The aim of this study was to evaluate how altitude difference affects complete blood count (CBC) in patients with stable Chronic Obstructive Pulmonary Disease (COPD). Study Design: Cross-sectional study. Setting: Department of Pulmonology, Kars Harakani State Hospital (Group 1) and Samsun Chest Diseases and Thoracic Surgery Hospital (Group 2), Turkey. Period: Six months i.e. from March to September 2018. Material and Methods: A total of 400 patients (200 female, 200 male) with stable COPD were included. For each group, 100 female and 100 male patients were randomly selected from hospitals. Age, BMI (kg/m2), comorbidity, smoking status, CBC were evaluated. Hemoglobin, hematocrit, WBC, MPV, platelet, lymphocyte count and percentage, platelet/lymphocyte rate (PLR), neutrophil count and percentage, neutrophil /lymphocyte rate (NLR), eosinophil count and percentage, PDW, PCT were recorded. Results: Patients living at high altitude were significantly older, had lower weight and had lower FEV1 levels. COPD stages of Group 1 patients were more severe (p&lt;0.001). There were no moderate COPD patients in this group and the patients had fewer comorbidities (43%). Hemoglobin, hematocrit, MPV, WBC, neutrophil count and percentage, NLR and PLR were significantly higher in Group 1 (p&lt;0.001). PDW, PCT, lymphocyte count and percentage, eosinophil count and percentage were significantly higher in Group 2 patients (p&lt;0.001). Conclusion: Hemoglobin, hematocrit, MPV, WBC, neutrophil count and percentage, NLR and PLR were higher in patients living at high altitude. PDW, PCT, lymphocyte count and percentage, eosinophil count and percentage were significantly higher in patients living at low altitude.

Predictors of non-sentinel lymph node metastasis in clinical early stage (cT1-2N0) breast cancer patients with 1-2 metastatic sentinel lymph nodes

The purpose of this study was to determine the risk factors that caused non-sentinel lymph nodes (nonSLNs) metastasis by considering the clinicopathological characteristics of patients who have 1-2 sentinel lymph node (SLN) metastasis in the clinical early stage (T1-2, N0) breast cancer. The demographic and clinicopathological characteristics of the patients were recorded retrospectively. Among these, age, size of the primary breast tumor, tumor localization and multifocality/multicentricity status, preoperative serum Neutrophil/Lymphocyte rate (NLR), c-erbB2/HER2-neu status, Estrogen Receptor (ER) and Progesterone Receptor (PR) status, primary tumor proliferation index (Ki-67), histopathological grade, molecular subtypes, histopathological subtypes, nipple/areola infiltration, Lymphatic Invasion (LI), Vascular Invasion (VI), Perineural Invasion (PNI), number of metastatic SLN m(SLN), mSLN diameter, SLN Extranodal Extension (ENE) status, and number of metastatic nonSLNs were recorded. According to the univariate analysis, the HER2 positivity, Ki-67≥%20, mSLN diameter, LI, VI, PNI, ENE and molecular subtypes were found to be significant. However, the age, tumor localization, multifocality/multicentricity, T stage, ER and PR status, tumor size, histopathological grade and subtypes, nipple/areola infiltration and NLR were not found to be significant. In the multivariate analysis, significant independent predictors in nonSLN metastasis development were found to be HER2 positivity, PNI, mSLN diameter ≥10,5mm and ENE. The HER2 positivity, ENE, PNI and mSLN diameter ≥10,5 mm were found to be very strong predictors in nonSLN metastasis development. The findings of this study have the potential to be a guideline for surgeons and oncologists when determining their patients' treatment plan. These components are candidates for inclusion among the clinicopathological factors that may be used in the new nomograms due to their higher sensitivity and specificity.

Analysis of prognostic factors for hospitalized patients aged 95 years and over with community-acquired pneumonia

Objective To investigate clinical characteristics and prognostic factors for hospitalized patients aged 95 years and older with community-acquired pneumonia(CAP). Methods A retrospective study was conducted on CAP patients aged ≥95 years hospitalized in Jiangsu Province Hospital or Jiangsu Province Hospital of TCM between January 2014 and January 2018.Clinical characteristics were collected.The shock index(SI), Charlson comorbidity index(CCI), neutrophil/lymphocyte rate (NLR)and CURB-65 score were calculated.The predictive value of the related factors was evaluated by using the Logistic regression model and the subjects' receiver operating characteristic curve (ROC). Results A total of 205 cases were enrolled in this study.The hospital mortality rate was 36.1%(73/205). The heart rate, white blood cell count, mononuclear cell count, neutrophil count(N), NLR, fasting blood glucose, blood urea nitrogen(BUN)and D-dimer results revealed significant differences between the death group and the survival group(all P<0.05). Scores of CCI and CURB-65 were higher in the death group than in the survival group[(2.90±1.88)vs.(1.91 ±1.81), (2.34±0.69)vs.(1.76±0.69), both P<0.05]. Multivariate Logistic analysis showed that heart rate≥84.73 beat per minute(OR=2.452, 95%CI: 1.054~5.702), NLR≥11.43(OR=5.499, 95%CI: 2.132~14.180), BUN≥12.95 mmol/L(OR=2.546, 95%CI: 1.025~6.319), CCI≥3(OR=4.453, 95%CI: 1.191~10.113), CURB-65≥2 scores(OR=3.888, 95%CI: 1.288~11.735)and respiratory failure(OR=2.875, 95%CI: 1.204~6.806)were risk factors for death in hospitalized elderly aged 95 years and older with CAP.ROC analysis showed that CCI combined with the CURB-65 score or CCI combined with the CURB-65 score plus NLR could better predict the in-hospital mortality of elderly patients than CCI or the CURB-65 score used alone. Conclusions Hospitalized patients aged≥95 with CAP are prone to multiple complications and high mortality rates.Combined application of multiple evaluation systems and indicators can improve the prognosis of outcomes for patients in this age group. Key words: Pneumonia; Hospitalization

Neutrophil-lymphocyte and platelet-lymphocyte rate and their seasonal differences in ankylosing spondylitis and rheumatoid arthritis patients using anti-TNF medication.

In recent years, neutrophil-lymphocyte rate (NLR) and platelet-lymphocyte rate (PLR) are reported to be increasing in plenty of rheumatological diseases and the latter rates to be disease activity indicators. In our study, we aimed to search for the difference in NLR and PLR before and after the treatment, their relationship with the disease activity and their seasonal differences in patients using anti-TNF medication for rheumatoid arthritis (RA) and ankylosing spondylitis (AS) while. Sixty-eight RA and 203 AS patients using anti-TNF medication for at least 6 months were included in the study. Patients with acute infection, diabetes, hypertension, cancer, renal failure and liver failure were excluded from the study. NLR, PLR, seasonal differences and the disease activities of the patients were evaluated retrospectively. We determined that NLR and PLR are strongly correlated with disease activity, erythrocyte sedimentation rate (ESR) and c-reactive protein (CRP). In addition, we determined that disease activity, thrombocytes and PLR are increased in spring and winter, especially in patients with RA. NLR and PLR are simple, cheap, and easily accessible parameters which can be used to evaluate disease activity and treatment response before and after anti-TNF treatment. Further studies are needed to enlighten the effect of seasonal differences on disease activity (Tab. 2, Fig. 2, Ref. 43).

Can Neutrophil Lymphocyte Ratio Predict the Likelihood of Suicide in Patients with Major Depression?

BackgroundNeutrophil lymphocyte rate (NLR), platelet lymphocyte rate (PLR), and systemic immune inflammatory index (SIII) are rates obtained from hemogram parameters, and they are biomarkers used for the diagnoses of many diseases and their severity, and prediction of disease. In addition to the NLR, PLR, and SIII, platelets, plateletcrit (PCT), and platelet distribution width (PDW), which are platelet indices, are also investigated as biomarkers in many diseases. There are limited studies on the use of hemogram derivates (NLR, PLR, and SIII) in the diagnosis and severity determination of psychiatric disorders.ObjectivesIn this study, we aimed to investigate the effect of biomarkers and the proportions of NLR, PLR, and SIII, which are obtained from hemogram parameters, to distinguish or predict the patients with major depression who are likely to commit suicide.Materials and methodsIn this retrospective study, the files of patients referred to an educational research emergency and psychiatric outpatient clinic between June 2017 and December 2017 were evaluated. Patients who had been referred to the emergency polyclinic because of suicide attempts and those with major depression diagnosed at a psychiatric clinic were evaluated in this study. All hemogram evaluations were performed using the Sysmex XT-2000i Automated Hematology Analyzer (GMI, MN, USA).ResultsTwenty-seven suicide patients and 26 major depression groups meeting the study acceptance criteria were included in the evaluation. Of these patients, 40 were female and 13 were male. There was no difference between the groups in terms of age, body mass index, and complete blood count (CBC) parameters such as white blood cell (WBC), neutrophil count, lymphocyte count, eosinophil count, monocyte count, platelet indices, and NLR, PLR, SIII, which were obtained from the hemogram.ConclusionWe found that the neutrophil to lymphocyte ratio and other biomarkers obtained from hemograms were higher in patients with major depression than those who had suicide attempts, but we found that this was not statistically significant.

756P - Treatment patterns, clinical characteristics, and outcomes of patients (pts) with metastatic pancreatic cancer (MPC) treated with nab-paclitaxel (nab-P) plus gemcitabine (GEM) in real-life practice: ANICE-Pac trial

Background: Combined treatment of nab-P plus GEM increases survival in patients with MPC. However, treatment efficacy and safety need to be assessed in real-life practice, including pts irrespective of their clinical characteristics and number of dose administrated and treatment duration. Methods: Retrospective, multicenter study including pts with MPC who started first-line treatment with nab-P plus GEM between December 2013 and June 2015 according to routine clinical practice. Overall survival (OS) and progression-free survival (PFS) were assessed for the total sample and the exploratory subgroups based on treatment and clinical characteristics of pts. Results: 210 pts (60% males) were enrolled with a median age of 65 years (range 37 – 81); 25% were ≥ 70 years. MPC was de novo and recurrent in 78% and 22% of pts, respectively; 18% had a biliary stent. At baseline, 53% of pts had Neutrophil lymphocyte rate (NLR)> 3, 82% CA 19.9 > 35 U/mL, and 18% ECOG ≥ 2. Pts received a median of 4 cycles (1 – 21); 32% started treatment with a dose reduction and 17% received ≤ 30 days of treatment, mainly due to toxicity (33%) or progression (30%); 25% of pts achieved objective response, and median OS and PFS were 7.2 (95%CI 6.0 – 8.5) and 5.0 (4.3 – 5.9) months (mo), respectively. Compared with pts treated during > 30 days, those with ≤ 30 treatment had lower OS (8.6 [7.2 – 10.2] vs. 1.9 [0.8 – 2.3] mo; p < 0.001). OS was not influenced by age ≥ vs < 70 years (p = 0.205) and the presence of a biliary stent (p = 0.195), but it was significantly lower in pts with baseline NLR > 3 (p = 0.002), CA 19.9 > 35 U/mL (p = 0.002), and ECOG ≥ 2 (p = 0.018); 29% pts experienced at least one grade 3-4 adverse event, mostly neutropenia (14%). Conclusions: Our results revealed that real-life MPC pts tend to be older and have worse performance status (ECOG) than those included in clinical trials with restrictive selection criteria. In fact, many pts either did not complete 1 month of treatment or started treatment with a dose reduction. Despite these limitations, nab-P plus GEM remains effective in this clinical setting. ECOG ≥ 2, NLR > 3, and CA 19.9 > 35 U/mL are associated with lower OS. Clinical trial identification: GIT-ADE-2015-02 Legal entity responsible for the study: Galician Group for the Treatment of Digestive Tumors (GITuD) Funding: Galician Group for the Treatment of Digestive Tumors (GITuD) Disclosure: A. García: Received honoraria from Celgene. C. Guillén: Consultant/advisor board member for Celgene, and received remuneration for traveling and accomodations by Celgene. All other authors have declared no conflicts of interest.

The Predictive Value of Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratio for the Effusion Viscosity in Otitis Media With Chronic Effusion.

The objective of the authors' study was to investigate the predictive value of the neutrophil-lymphocyte rate (NLR) and platelet-lymphocyte rate (PLR) in otitis media with effusion and the correlation of the effusion type with these ratios. Retrospective case-control study. One hundred twenty-six pediatric patients diagnosed otitis media with chronic effusion and had ventilation tube inserted between October 2015 and July 2016 were included in the study group and 124 healthy children, who applied for the routine examination and had blood count analysis, were included in the control group. The patients in the study group were divided into 2 groups regarding the effusion viscosity, which was obtained from the patients' operation files. Seventy-one patients were included in the serous group and 55 patients in the mucous group. The NLR and PLR rates of the groups were compared and statistically evaluated. The average NLR and PLR rates were significantly higher in the study group than in the control group (P = 0.000, P = 0.004 respectively). Comparison of the serous and mucous groups with the control group revealed a significant difference between the control group and the serous group regarding the NLR and PLR (P = 0.000; P = 0.000 respectively), but not between the control group and mucous group (P = 0.694; P = 0.691 respectively). Neutrophil-lymphocyte rate and PLR had a predictive value for otitis media with effusion and additionally it was a laboratory indicator supporting the typing of the viscosity of the fluid accumulated in the middle ear.

切除不能進行・再発大腸癌における好中球/リンパ球比の意義について

切除不能進行・再発大腸癌における好中球/リンパ球比の意義について

Effects of isotretinoin on the inflammatory markers and the platelet counts in patients with acne vulgaris

Objective: Oral isotretinoin is an efficient treatment used commonly in treating the moderate and severe acne. It has various side effects that affect many systems in the body. In this study, we are planning to examine the possible effects of the oral isotretinoin on platelet density, mean platelet volume, neutrophil lymphocyte rate, platelet lymphocyte rate, and red-blood-cell distribution width level.Methods: Twenty-eight males and 84 females, 112 patients in total, diagnosed with acne vulgaris and receiving oral isotretinoin treatment were examined retrospectively. The full blood parameters of the patients before the treatment and in the third month of the treatment were recorded.Results: A statistically meaningful increase was observed in the platelet density, hemoglobin levels. And a statistically significant decrease has been determined in the red-blood-cell distribution width level while no meaningful differences were detected in the mean platelet volume, neutrophil lymphocyte rate, platelet lymphocyte rate, and white blood cell count.Conclusions: The oral isotretinoin treatment has been demonstrated as having increased the platelet density, hemoglobin levels and having decreased red-blood-cell distribution width level significantly.