Normal Blood Levels Research Articles

J-131 therapy in patients with autonomously functioning thyroid nodules and normal FT4 blood level

J-131 therapy in patients with autonomously functioning thyroid nodules and normal FT4 blood level

Serum 25(OH)D Levels and Mitral Valve Calcification in Patients with Severe Rheumatic Mitral Stenosis

Background: Rheumatic heart disease (RHD) imposes a significant burden on patients and the health system, especially in the developing countries. Recently, the role of vitamin D deficiency in increasing the severity of valve involvement and calcification in patients with RHD has been suggested. However, its role in the severe stenosis of the mitral valve is unknown. The aim of this study was to determine the relationship between serum levels of 25(OH)D and mitral involvement severity scores in patients with severe mitral stenosis (MS). Materials and Methods: In this cross-sectional study conducted in Shahid Madani Heart Center, Tabriz, Iran, 104 patients with severe rheumatic MS were reviewed, in the absence of other underlying diseases. Trans-esophageal Echocardiography was performed for all patients, and mitral valve Wilkins score and mitral valve area were calculated. Blood samples were taken from patients and levels of 25(OH)D, total calcium, phosphorus, and i-PTH were measured. Results: Eighty eight cases were female and 16 were male. Eighty-one patients had mild to moderate mitral calcification and in 23 patients with mitral valve was severely calcified. Furthermore, 54 were vitamin D deficient, while 35 had insufficient vitamin D levels, and only 15 had normal blood levels of vitamin D. In addition high serum iPTH levels were present in 83 patients (80%). The levels of 25(OH)D, calcium, phosphorous, and iPTH with total Wilkins score, calcification score and mitral valve area were not significantly correlated (p>0.05 for all above). Conclusions: Although no correlation was found between the severity of mitral valve involvement, and vitamin D and iPTH levels, vitamin D deficiency and secondary hyperparathyroidism tend to be common among patients with severe rheumatic MS, which may play a role in the progression of the disease.

Gender Disparities in Health Biomarkers, Lifestyle Patterns, and Nutritional Status among Bank Staff: A Cross-Sectional Study.

Background and Objectives: Despite the importance of nutritional status and a healthy lifestyle in shaping overall well-being, little is known about examining gender-specific differences and trends in health, lifestyle, and nutritional status. The present study aimed to evaluate blood levels of micronutrients, homocysteine, and CoQ10, as well as physical activity (PA) levels and sedentary behavior, among a cohort of Austrian bank staff, with a particular focus on identifying gender differences as well as gender-specific nutritional deficiencies compared to the reference ranges. Materials and Methods: Following a cross-sectional study design, 123 Austrian bank staff (mean age: 43 years; 51% females) participated in this study. Blood samples were collected to evaluate participants' micronutrient status and serum levels of homocysteine and CoQ10. Whole-blood values of macronutrients were compared to gender-specific reference ranges and categorized into three groups: below, within, or over the range. The WHO's Global Physical Activity Questionnaire was used to assess PA levels and sedentary behaviors. Results: No significant difference between males and females was found for diet types, PA levels, sedentary time, homocysteine levels, or CoQ10 values (p > 0.05). A high PA level was reported by 64% of males and 58% of females. 71% of females and 56% of males were found to have a vitamin D deficiency. 63-98% of females and 72-97% of males showed normal blood levels for the remaining micronutrients, including potassium, calcium, magnesium, copper, iron, zinc, selenium, manganese, molybdenum, B6, B9, and B12. Conclusions: The findings highlight the necessity of implementing tailored strategies to foster healthy lifestyle behaviors, thereby enhancing the overall state of health, particularly in the context of occupational health.

ALDH18A1‐related hereditary spastic paraplegia and developmental and epileptic encephalopathy with spike‐wave activation in sleep: Expanding the clinical phenotype

AbstractObjectiveWe present the cases of two sisters, both harboring the same ALDH18A1 gene mutations, who presented with a complex clinical phenotype characterized by spastic paraparesis with ataxia, epileptic encephalopathy, severe psychomotor deficits, and behavioral abnormalities.MethodsCase description of two sisters with ALDH18A1 gene mutations.ResultsThe older patient, a 12‐year‐old girl, exhibited spastic paraparesis with ataxia, microcephaly, facial dysmorphisms, and severe intellectual disability, with an absence of verbal language. An electroencephalogram (EEG) revealed marked spike‐and‐wave activation during sleep (SWAS), although no clinically documented seizures were observed. The younger sister, who was 9 years old, displayed a similar clinical presentation, including spastic paraparesis with ataxia, microcephaly, dysmorphisms, however, she displayed slightly more severe intellectual deficits and polymorphic seizures. EEG revealed a SWAS pattern in this case. Magnetic resonance imaging scans in both cases showed only a thin corpus callosum. Whole exome sequencing unveiled the presence of two likely pathogenic variants in compound heterozygosity within the ALDH18A1 gene. Specifically, these variants included the splice site variant c.88 + 1c.88+1G>A of paternal origin and the variant c.1364c.1364T>C (p.Leu455Ser) of maternal origin. Both sisters displayed normal blood levels of ammonia, ornithine, citrulline, arginine, and other amino acids.InterpretationThese findings were compatible with ALDH18A1‐related HSP complicated with a clinical and EEG pattern reminiscent of DEE‐SWAS. We present the first report of DEE‐SWAS in ALDH18A1‐related HSP, expanding the clinical manifestations of this complex neurodevelopmental condition.

Analysis of published and clinical sample data to develop new ranges of liver and blood concentrations of vitamin A for diagnosis of vitamin A deficiency in cattle

In cattle, liver stores of vitamin A (VA) maintain blood VA concentrations until liver supplies are nearly exhausted, pro­viding VA to tissues during insufficient dietary intake. There­fore, normal blood levels do not indicate adequate VA, but low blood levels indicate a deficiency. We hypothesized that previous diagnostic criteria for VA deficiency needed updating and that blood levels of VA could be used as indicators of liver VA deficiency. We performed multiple regressions of paired blood and liver sample data from published experimental and field case reports of VA deficiency in cattle to demonstrate this. We fitted various models using data from unpaired clini­cal samples submitted to the Iowa State University Diagnostic Laboratory by comparing fractiles of liver and plasma/serum samples. Using these relationships, we propose new ranges for severely deficient, deficient, marginal and adequate, and we also propose that blood samples alone can be used to di­agnose deficiency in the presence of clinical signs of VA defi­ciency. Veterinary diagnostic laboratories can use this infor­mation to better estimate serum and liver VA concentrations for unpaired data and recommend to cattle practitioners the status of VA in their herds.

Risk factors of hyperammonemia in epilepsy patients with valproic acid therapy

BackgroundHyperammonemia can occur after acute overdose or chronic use of valproic acid (VPA). Although VPA-related hyperammonemic encephalopathy (VHE) is a rare complication of VPA therapy, early recognition of VHE and identifying its risk factors are important because VHE can lead to loss of consciousness and increased seizure frequency. PurposeThe purpose of our study is to evaluate the risk factors of hyperammonemia in epilepsy patients during treatment with VPA therapy. MethodsWe reviewed the medical records of 1084 adult patients with epilepsy and enrolled 116 patients with VPA therapy who had results of blood levels of ammonia over a 3-year period. Hyperammonemia was defined as a blood ammonia level exceeding 80 µg/dL. Correlations of blood levels of ammonia with dosages and blood levels of VPA were evaluated. We further performed univariate and multivariate linear regression analyses to identify risk factors for hyperammonemia in epilepsy patients treated with VPA therapy. ResultsBlood levels of ammonia were well correlated with dosages of VPA (p = 0.036), but not with blood levels of VPA (p = 0.463). Hyperammonemia was more common in patients with higher VPA dosage and higher total drug loads of concurrent antiseizure medications (ASMs). Hyperammonemia was also associated with the use of topiramate and phenobarbital. In multivariate analysis, we identified total drug load of ASMs (p = 0.003) and use of topiramate (p = 0.007) as independent predictors of hyperammonemia. Four patients (4/116, 3.4 %) had clinical symptoms of VHE. Three of them had hyperammonemia while the other patient had normal blood level of ammonia with a high blood level of VPA. ConclusionOur study shows that higher total drug loads of concurrent ASMs and use of topiramate were independent risk factors of hyperammonemia in epilepsy patients with VPA therapy. Although the incidence of VHE was not high in our study, clinicians should be aware of this potential adverse effect of VPA therapy, especially in patients with polytherapy of ASMs including topiramate.

Individualized approach to the patients with autonomously functioning thyroid nodules and normal TSH blood level

Individualized approach to the patients with autonomously functioning thyroid nodules and normal TSH blood level

Correlation of Serum Uric Acid Levels with Coronary Flow in Patients with STsegment Elevation Myocardial Infarction Undergoing Primary Coronary Intervention

Abstract Background Worldwide, ischemic heart disease is the single most common cause of death and its frequency is increasing. STEMI is a significant cause of morbidity and mortality in patients with coronary heart disease. Aim of the Work Our study aimed to assess the impact of Uric acid level prior to primary PCI in patients presenting with acute STEMI on myocardial perfusion. Patients and Methods This is an interventional randomized controlled clinical trial conducted the coronary care units and coronary catheterization lab unit of the cardiology department and ER in Ain Shams University Hospitals between January 2021 and June 2021. The study was conducted in Ain Shams University hospitals on 80 patients presented from 2020 till the end of June 2021 with ST segment elevation myocardial infarction and underwent primary PCI. They were divided into two groups. The first group was hyperuricemic while the second group had normal uric acid blood level. Both groups received the standard care for acute STEMI patients which is the primary percutaneous intervention in addition to medications. Results Results for age, gender, hypertension, smoking, family history dyslipidemia, and diabetes did not show any statistical significance of value between the cases and control groups. In the control group, there were 19 patients with TIMI flow less than III and MBG less than III. Meanwhile, in the cases group, there were 8 patients with TIMI flow less than III and 7 patients MBG less than III. This difference was statistically significant with a P-value of 0.010 regarding TIMI flow score while a highly significant statistical difference of P-value 0.003 regarding MBG. Conclusion Our study concluded that normal uric acid level before primary PCI is associated with improved post-procedural TIMI flow and MBG.

Association between 25(OH)D3 Levels and the Presence of COVID-19 Symptoms

Background: Recently, there have been studies reporting a relationship between vitamin D levels in the blood and the immune system. This study aimed to analyze the association between vitamin D levels and symptoms of coronavirus disease 2019 (COVID-19).Materials and methods: This study was an analytical survey study with a cross-sectional approach, with lecturers at Universitas Malahayati that have been infected with COVID-19 in 2022 as subjects. Total 47 subjects were included. Subjects were fasted overnight, then blood samples were taken from subjects in the next morning. The blood was centrifuged, then the serum was separated for examination by the direct competitive chemiluminescence immunoassay (CLIA) method using Architect 25-OH Vitamin D Reagent. Data was analyzed using logistic regression.Results: None of the subjects had normal blood levels of 25(OH)D3 and almost half (48.9%) of the subjects had symptoms when infected with COVID-19. There was a significant relationship between the level of 25(OH)D3 (p=0.001) and the status of the COVID-19 vaccine (p=0.013) with the presence of symptoms in COVID-19 patients.Conclusion: The lower the level of 25(OH)D3 in the blood and the more incomplete the COVID-19 vaccine, the greater the onset potential of COVID-19 symptoms. It is necessary to maintain vitamin D intake and increase the coverage of the COVID-19 vaccine, especially at booster doses.Keywords: vitamin D, COVID-19, vaccination, health protocol

A Study on CBC (Complete Blood Count) findings with COVID-19 Virus Infection

Purpose: To observe the blood picture of patients with COVID 19 infections and to formulate future guidelines for management. Methods: This cross-sectional descriptive study was carried out among patients with COVID 19 infections who were admitted to one of the Covid-dedicated hospitals in Bangladesh from March-2020 to May-2020. Results: A total of 92 patients were included in this study. 53.3% were male and 46.7% were female. Most of the patient’s haemoglobin percentage was found below normal (53.3%), however, the total count of RBC, WBC and Platelet was found within the normal limits in most of the cases (64.1%,80.4% and 87% cases respectively). 75% of patients had high ESR levels. 50% of cases showed Neutrophilia and Lymphocytopenia in 43.5% cases. Although some cases show changes in Monocyte, Eosinophil and Basophil count they were not significant in number. Conclusions: A significant number of patient’s neutrophilia and lymphocytopenia. Blood parameter is an important tool for managing the COVID-19 patients. With or without co-morbidities maintaining normal blood levels is essential in COVID-19 patient management.

Assessment of the phenotypic composition of lymphocytes, immunoglobulins and their relationships in patients with chronic rinosinusitis

The study of the population and subpopulation content of lymphocytes and immunoglobulins and their associations in IgE-mediated CRS relative to other CRS and the control group. 23 patients with IgE-mediated chronic rhinusinusitis and 67 patients with normal IgE blood levels were examined. For analysis, flow cytometry (Cytomics FC500, Beckman Coulter, USA), using monoclonal antibodies CD3+, CD4+, CD8+, CD16+, CD19+ and enzyme immunoassay (Thermo Scientific Multiskan FC, Thermo Fisher Scientific, USA), using IgA, IgM, IgE and IgG in serum, statistical processing was performed using Statistica 7.0. In patients with CRS and IgE-mediated CRS, hyperactivation was revealed in both T- and B-cell immunity, manifested by an increase in the level of T-lymphocytes, NK-lymphocytes and B-lymphocytes. More pronounced disorders in the immune status are detected in patients with IgE - mediated CRS, there is a more pronounced activation of the T-cell immune link due to an increase in T-helper cells, T-killer/suppressor cells, an imbalance in their number is accompanied by a decrease in their ratio in the immunoregulatory index. Activation of the immune system in patients with CRS is also associated with an increase in the content of mature B-lymphocytes (CD19+), while only in patients with IgE-mediated CRS, hypergammaglobulinemia of classes A and M was detected. Changes in the immune status indicate a violation of immune regulation, confirmed by the revealed correlations between the subpopulations of lymphocytes and immunoglobulins that implement the immune response in this condition. The greatest number of violations in the regulation is associated with mature T-lymphocytes in both CRS and IgE-mediated CRS, while only IgA fully retains its function.

Piège diagnostique : neurotoxicité au lithium avec lithémie normale

We describe here the case of a 54-year-old bipolar woman, followed in psychiatry and treated with lithium and a selective serotonin reuptake inhibitor (escitalopram) and lamotrigine, presenting a lithium poisoning with an altered state of consciousness caused by a supposed mismanagement of her treatment. Lithium poisoning was suggested based on neurological clinical features, but the blood test brought out a lithium concentration within the therapeutic values at 1,2 mmol/L (N: 0,6–1,2 mmol/L). The classic biological complications related to lithium poisoning (hypercalcemia, diabetes insipidus) confirmed the diagnosis. The patient has been transferred to our nephrology department where she got two hemodialysis sessions conducting to clinical and biological improvement, confirming the diagnosis of lithium poisoning despite the normal blood levels. Later, she was transferred to the psychiatry department for follow-up and for treatment adjustment.

I-131 treatment of patients with autonomously functioning thyroid nodules and normal TSH blood level

I-131 treatment of patients with autonomously functioning thyroid nodules and normal TSH blood level

Glucose-responsive biomimetic nanoreactor in bacterial cellulose hydrogel for antibacterial and hemostatic therapies

Anti-infections therapy accompanied with effective hemorrhage control is highly urgent in clinics. Herein, a biomimetic nanoreactor encapsulated self-healing hydrogel with glucose-responsive catalytic activity was constructed for synergetic antibacterial defense and hemostasis. A metal-organic frameworks (MOF)-based nanocatalyst loaded with glucose oxidase (GOx) was fabricated and encapsulated in the bacterial cellulose (BC) reinforced hydrogel, while the sustained release of GOx could catalyze the decomposition of glucose for triggering the MOF-mediated catalytic activity to in situ generate OH for bacteria killing. Importantly, this nanozyme-based hydrogel exhibited excellent hemostatic property owing to the enhanced absorption capacity, which provides the essential glucose from blood for triggering the glucose-responsive antibacterial activity simultaneously. Antibacterial tests revealed that the hydrogel exhibited significant antibacterial efficacy and biofilm inhibition ability in the presence of normal blood level of glucose. Such design of biocatalytic hydrogel for synergistic hemostatic and antibacterial application brings new insight for nanozyme-based biomedical therapies.

COVID-19 and Serum Amylase and Lipase Levels.

Blood levels of amylase and lipase are the result of a balance between production and clearance of these enzymes. Normal blood level of amylase and lipase is 0–90 U/L and 0–70 U/L, respectively. Rise in blood levels of lipase and amylase was observed in pancreatic injury. This is an observational, cross-sectional study involving 279 patients [176 COVID-positive and 103 COVID-negative] admitted at a tertiary care hospital in Mumbai during COVID pandemic.The mean age was 45 years with SD of 15 years with men:women ratio of 2.7:1. Serum lipase and amylase were raised in 101 cases (57.4%) and 57 patients (32.4%), respectively. Out of the 101 patients with raised lipase levels, 44 (25%) patients showed a severe rise (> 3 times the normal), and out of 57 patients with raised amylase levels, 12 patients (6.8%) showed a severe rise (> 3 times the normal). From this study, it can be concluded that the prevalence of hyperamylasemia was 32.4% and that of hyperlipasemia was 57.4% in the involved study population with COVID-positive status.

A Case of Parkinsonism and Encephalopathy with Combined Lithium-Risperidone Therapy: Treatment with Pramipexole

Lithium is a drug that has been used in the treatment of bipolar disorder for many years. Due to its narrow therapeutic range, systemic side effects can be seen frequently. Serious side effects can occur even in non-toxic doses. We present a case of parkinsonism and encephalopathy developed in a patient with normal lithium blood level who used lithium and risperidone combination therapy for bipolar disease.

Evaluation of Serum Biochemical Profile in Heifer and Adult Sahiwal Cows Reared in Maharashtra

Background: The Sahiwal cattle, one of the best dairy breeds of Zebu cattle in India and Pakistan, originated from the Montgomery district of Pakistan. The performance of this breed in the tropical environment is also better than other cattle breeds. Now a day Sahiwal is choice of farmers in Maharashtra as it is a milch type breed mostly preferred for Deshi cow milk production and for organic farming. Blood profile of an individual is an important indicator of an individual’s well-being. Normal blood levels of various biochemical components are essential for normal function of various systems in the body including reproductive system. Hence, the current study was aimed to evaluate of serum biochemical profile of Sahiwal cows reared in Pune district of Maharashtra. Pune district of Maharashtra comes under western Maharashtra plain zone with Grayish black soils. The annual rainfall ranges from 150 to 700 mm. Soils formed from trap rock are grayish black in colour and varying texture. The natural vegetation is of shrub. The area mostly grows paddy, sugarcane, pearl millet, sorghum and groundnut. Methods: Serum biochemical profile of Sahiwal heifers and cows were evaluated at different stages i.e. below 1 year heifer, above 1 year heifer, early lactating cow, mid lactating cow, late lactating cow, dry pregnant cow and dry non pregnant cows. Total seventy (70) animals was selected i.e. ten (10) animals from each group stage. All animals were maintained under standard feeding and management conditions. The blood samples of selected cows were collected by puncturing in jugular vein in heparinized vacationer tubes. Analysis of serum profile of 70 blood samples were carried out by using automatic blood analyzer machine (Miura 200 I.S.E. group, Italy). Result: The concentrations of serum cholesterol, glucose, triglyceride, uric acid, calcium, phosphorus, copper, zinc, total protein, globulin, A: G ratio ALP, ALT and AST were significant in different stages of Sahiwal cows. The non-significant difference was observed in different stages of Sahiwal cows in regards to serum concentration of amylase, bilirubin direct, bilirubin total, creatinine, urea, albumin, magnesium, iron and GGT.

SYNGAP1 and Methylenetetrahydrofolate in Cerebrospinal Fluid: Cognitive Development after Oral Folate (5-Methyltetrahydrofolate) Supplementation in a 5-Year-Old Girl

AbstractSynaptic Ras GTPase-activating protein 1 (SYNGAP1), also called Ras-GAP 1 or RASA5, is a cerebral protein with a role in brain synaptic function. Its expression affects the development, structure, function, and plasticity of neurons. Mutations in the gene cause a neurodevelopment disorder termed mental retardation-type 5, also called SYNGAP1 syndrome. This syndrome can cause many neurological symptoms including pharmaco-resistant epilepsy, intellectual disability, language delay, and autism spectrum disorder. The syndrome naturally evolves as epileptic encephalopathy with handicap and low intellectual level. A treatment to control epilepsy, limit any decrease in social capacities, and improve intellectual development is really a challenging goal for these patients. The etiologic investigation performed in a 5-year-old girl with early epileptic absence seizures (onset at 6 months) and psychomotor delay (language) revealed a low methylenetetrahydrofolate level in cerebrospinal fluid in a lumbar puncture, confirmed by a second one (35 nmol/L and 50 nmol/L vs. 60–100 nmol/L normal), associated with normal blood and erythrocyte folate levels. Hyperhomocysteinemia, de vivo disease, and other metabolic syndromes were excluded by metabolic analysis. No genetic disorders (like methylenetetrahydrofolate reductase and methenyltetrahydrofolate synthetase) with folate metabolism were found. The physical examination showed only a minor kinetic ataxia. An oral folate (5-methyltetrahydrofolate) supplementation was started with oral vitamin therapy. The child showed good progress in language with this new treatment; epilepsy was well balanced with only one antiepileptic drug. The SYNGAP1 mutation was identified in this patient's genetic analysis. Since the start of folate supplementation/vitamin therapy, the patient's neurologic development has improved. To our knowledge, no association between these two pathologies has been linked and no patient with this SYNGAP1 mutation has ever showed much intellectual progress. Low cerebral methylenetetrahydrofolate levels could be associated with SYNGAP1 mutations. One of the hypotheses is the link of folate metabolism with epigenetic changes including methylation process. One inborn metabolic activity in folate metabolism may be associated with SYNGAP1 disease with epigenetic repercussions. Further studies should assess the link of SYNGAP1 and methyltetrahydrofolate and the evolution of SYNGAP1 patients with oral folate supplementation or vitamin therapy.

KORONER TROMBÜSÜN NEDEN OLDUĞU AKUT KORONER SENDROMLU ÜÇ OLGUNUN DEĞERLENDİRİLMESİ

Coronary thrombus causes reduced blood flow in patients with acute myocardial infarction. Our aim was to to contribute to the understanding of the mechanisms of coronary occlusion caused by thrombus, evaluating the histopathological characteristics of thrombi in three cases. Cases were diagnosed with ST elevation type of myocardial infarction by coronary angiography. Histopathological analysis of thrombi as well as immunohistochemical staining with PTX3 (pentraxin 3, an acute phase protein) and CD68 (a cytokine released from monocyte and macrophages) were performed. Blood levels of troponin and PTX3 were also evaluated. The PTX3 immunostaining score was high in all cases but it was not consistent with its blood level. The high PTX3 staining intensity in the case with normal PTX3 blood level may be the result of rapid local release of PTX3. Case with highest PTX3 blood level had another inflammatory disease that could have driven this increase. We suggest that PTX3 and CD68 immunostainings can be used as a marker in the histopathological evaluation of coronary thrombus.

Dynamics of changes in type 1 and 2 insulinlike growth factors in the blood of patients with oral squamous cell cancer after targeted therapy with cetuximab

Objective. Studying the blood levels of type 1 and 2 insulin-like growth factors in patients with squamous cell carcinoma of the tongue and mouth floor mucosa depending on the therapy effect.Materials and Methods. The study included data from 30 patients with squamous cell carcinoma of the tongue and mouth floor mucosa T3–4N0–1M0 who received chemotherapy cycles together with targeted therapy with cetuximab. Twenty non-cancer donors were examined as well. Depending on the therapy effect, patients were divided into two groups: sensitive and resistant ones.Results. Initial levels of IGF-1 and IGF-2 in the blood serum of patients prior to chemotherapy and targeted therapy with cetuximab were lower than the levels in donors by 53.5 % and 20.3 %, respectively. After chemotherapy and cetuximab therapy, patients with sensitivity to the treatment showed normalization of IGF-1 and its significant increase compared to the initial levels — by 87 %. Levels of IGF-2 were not statistically significantly different from the initial levels and were 32.5 % lower than in donors. The IGF-1 / IGF-2 coefficient was 58 % higher than the initial value.Conclusions. Chemotherapy and cetuximab therapy normalized levels of IGF-1 in patients with sensitivity to the treatment which was demonstrated by an increase in IGF-1 up to the normal blood levels in effective treatment.