Postoperative thrombocytopenia in patients with acute type A aortic dissection (AAD) necessitates platelet transfusions and is associated with higher morbidity and mortality. This retrospective study aimed to evaluate the effects of recombinant human thrombopoietin (rhTPO) on AAD patients who experienced severe postoperative thrombocytopenia (platelet count nadir <20 × 109/L). We retrospectively evaluated 43 AAD patients who underwent open aortic repair surgery with subsequent severe thrombocytopenia at the Second Hospital of Shandong University between June 2019 and June 2022. We compared patient outcomes between rhTPO-treated patients (n = 20) with nontreated patients (n = 23). The primary outcome was to evaluate the association of the rhTPO treatment with postoperative platelet count response. The secondary outcomes included transfusions of blood components and length of hospital stay. Compared with nontreated controls, significantly higher levels of platelet count were observed in rhTPO-treated patients on POD7 (110.1 ± 18.1 vs 83.6 ± 19.1 [×109/L]; P < 0.001). The time required for the platelet count to increase to >100 × 109/L was significantly less in rhTPO-treated patients compared with controls (6.8 ± 0.85 vs 8.5 ± 1.5 days; P < 0.001). The rhTPO treatment was significantly correlated with the reductions in perioperative plasma transfusion (1435 ± 114 vs 1743 ± 206 mL; P < 0.001) and days of hospital stay (P = 0.003). We concluded that rhTPO treatment was significantly associated with increased platelet count recovery in postcardiac surgery AAD patients suffering from severe thrombocytopenia. Besides, the rhTPO therapy appeared to be correlated with reduced blood transfusions and length of hospital stay.

Hematologic indices in pediatric sleep-disordered breathing: a retrospective case-control study.

Risk factors, clinical outcomes of patients with Ceftazidime/Avibactam-resistant carbapenem-Resistant Klebsiella pneumoniae infection and its potential resistant mechanisms.

Frequency of Entamoeba gingivalis and trichomonas tenax with hematological and immunological changes among human.

Acute myocardial infarction following allogeneic hematopoietic stem cell transplantation: A national cohort study.

Thrombotic thrombocytopenic purpura (TTP) is rare, life-threatening autoimmune disorder characterized by microvascular thrombosis, severe thrombocytopenia, and hemolytic anemia. It can lead to organ ischemia and increase the risk of thromboembolic events, including acute ischemic stroke (AIS). Caplacizumab, an essential adjunct in TTP management, rapidly inhibits platelet aggregation and prevents disease progression. We present 3 cases of TTP diagnosed in patients with AIS. Treatment included plasma exchange (PLEX), corticosteroids, and caplacizumab. All 3 patients exhibited acute neurologic deficits, with brain MRI confirming AIS. Laboratory tests revealed thrombocytopenia, hemolytic anemia, and ADAMTS-13 activity <1%, confirming TTP. Two patients initially treated only with PLEX and corticosteroids experienced thrombocytopenia exacerbation, requiring caplacizumab for stabilization. The third patient, treated with caplacizumab from stroke onset, maintained stable platelet counts without exacerbation. No adverse events or deaths occurred, emphasizing caplacizumab's role in sustained hematologic recovery. This case series underscores caplacizumab's potential role in stabilizing platelet counts, reducing exacerbation rates, and improving clinical outcomes in TTP-associated AIS. Although all patients experienced favorable neurologic outcomes, a faster recovery cannot be directly attributed to caplacizumab given the multimodal treatment approach. These findings are suggestive of its early use as first-line adjunct, potentially optimizing treatment strategies and improving prognosis.

Clinical study of recombinant human thrombopoietin in platelet engraftment following autologous hematopoietic stem cell transplantation.

Routine preprocedural pathology testing is no longer recommended for minor and intermediate-risk elective procedures. British Thoracic Society guidelines advise hemoglobin, platelet count, and coagulation studies only in patients with risk factors for bleeding. Despite this, such tests are commonly ordered without a clear clinical indication before bronchoscopic procedures, incurring unnecessary financial and environmental costs. We conducted a retrospective review of outpatient bronchoscopic procedures over a 12-month period at an Australian tertiary hospital. Preprocedural pathology testing was defined as any test ordered at bronchoscopy referral or repeated within 6 weeks before the procedure. We evaluated the impact on clinical management and complication rate. Financial cost was estimated using Australian Medical Benefits Schedule (MBS) prices, and environmental impact via carbon dioxide equivalent (CO2e) emissions. A total of 436 bronchoscopic procedures were performed, with all with preprocedural pathology testing. Abnormal results occurred in 8.3% of cases, but only 4.0% led to clinical intervention-all in patients with established risk factors. No interventions were required for patients without risk factors, and no procedures were delayed or cancelled. There was no correlation between abnormal blood test results and adverse outcomes. Routine testing cost AUD 30,441.20 (19,548.12 USD) and produced an estimated carbon footprint of 103.2kg CO2e. Routine pathology testing before bronchoscopic procedures offers limited value, with most results not influencing management. Clinically significant abnormalities occurred only in patients with established risk factors, supporting a targeted approach. Given the significant financial and environmental costs, transitioning to selective, evidence-based testing is essential to optimize resource use and improve sustainability.

Introduction: Protein-Energy Malnutrition (PEM) remains a significant contributor to childhood morbidity and mortality worldwide, with anaemia being one of its most common and serious complications. Understanding the haematological profile of malnourished children is essential for early diagnosis and effective management. Aim: To assess the prevalence of anaemia and evaluate haematological profiles among children with Moderate Acute Malnutrition (MAM) and Severe Acute Malnutrition (SAM). Materials and Methods: A cross-sectional study was conducted at the Department of Paediatrics at Karwar Institute of Medical Sciences, Karwar, Karnataka, India, over six months from January 2025 to June 2025. A total of children aged 6 months to 5 years, diagnosed with MAM or SAM according to World Health Organisation (WHO) criteria, were enrolled. Children with primary haematological disorders, critical illness, or those outside the age criteria were excluded. Demographic details, anthropometric measurements, and haematological parameters including complete blood count, peripheral smear and serum ferritin were assessed. Data were analysed using descriptive statistics, the Chi-square test, and the Student’s t-test. Results: Of the 81 children, 59 (72.8%) had MAM and 22 (27.2%) had SAM. There were no significant differences between the groups in age, gender, or socio-economic status. However, children with SAM demonstrated significantly lower Body Mass Index (BMI), Haemoglobin (Hb), Packed Cell Volume (PCV), Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin Concentration (MCHC), platelet count, and serum ferritin levels than children with MAM (p-value &lt;0.05). Pneumonia (32.9%) was the most common associated diagnosis. Peripheral smear examination revealed a predominance of microcytic hypochromic anaemia, with a significant difference between the groups (p-value=0.0093). Overall, the prevalence of anaemia was high and its severity correlated strongly with the degree of malnutrition (p-value=0.0001). Conclusion: Anaemia was highly prevalent among children with PEM and was more severe in those with SAM. Routine haematological screening and early nutritional intervention are vital to improving clinical outcomes.

Risk factors for sputum smear-positive in COPD patients first diagnosed with active tuberculosis.

Parasites in the bloodstream: Unraveling hematological chaos and clinical implications.

Predictors of symptomatic intracranial hemorrhage after endovascular thrombectomy in acute ischemic stroke: A retrospective study.

Double-negative T cells (DNTs) are significantly elevated in autoimmune diseases and are thought to play an important role in inflammation. The purpose of this study was to explore their role in childhood-onset systemic lupus erythematosus (cSLE). DNTs, as well as T and B cell subsets in peripheral blood, were detected by flow cytometry in 78 patients, including 34 cSLE. Clinical and laboratory data of cSLE patients were collected to analyze the correlation between DNTs and these indices, including demographics: proportion of female patients and mean age (± SD); Organ involvement: presence of lupus nephritis, neuropsychiatric manifestations, and pulmonary involvement; Hematologic parameters: leukopenia, anemia, and thrombocytopenia (WBC, Hb, and PLT counts); Autoantibody profiles: ANA, anti-dsDNA, and anti-Sm antibodies. The changes in DNT levels after glucocorticoid treatment were observed, and the effects of different doses of glucocorticoids on DNTs were analyzed. DNT levels were significantly increased in the peripheral blood of cSLE patients. DNTs were correlated with SLE disease activity, organ involvement, the production of autoantibodies, naive B cells, and plasmablasts. DNT levels increased after low-dose glucocorticoid treatment (9.12 ± 1.43 vs 14.24 ± 1.36, p < 0.01) but gradually decreased with increasing glucocorticoid doses (14.24 ± 1.36 vs 13.45 ± 1.51 vs 7.45 ± 1.01 vs 4.72 ± 1.20, p < 0.05). DNT levels significantly decreased from the fourth day of glucocorticoid pulse therapy. DNT levels were positively correlated with disease activity in cSLE patients, and the effect of glucocorticoid dose on DNT levels varied. Key Points • DNT cells are significantly elevated in cSLE patients and correlate with disease activity, organ involvement, and autoantibody profiles. Low-dose glucocorticoids transiently increase circulating DNT levels, while higher doses progressively reduce DNT frequencies. DNT levels positively correlate with B-cell subsets, suggesting a potential role in autoantibody production in pediatric SLE. • Dynamic changes in DNTs may be influenced by glucocorticoid treatment.

Sustainable plateletapheresis in a LMIC blood service: Namibia's five-year experience with the Trima Accel™ Automated Blood Collection System.

To evaluate the predictive value of pan-immune-inflammation value (PIV) in the diagnosis of proliferative diabetic retinopathy (PDR) and its association with the stage of PDR. This observational case-control study included participants who underwent routine complete blood count testing. Inflammation-related indices, including neutrophil-to-lymphocyte ratio, systemic immune-inflammation index (SII), and PIV, were derived and analyzed. Receiver operating characteristic curve (ROC) analysis was applied to assess the diagnostic performance of these indices in distinguishing patients with PDR, with sensitivity, specificity, area under ROC, and optimal threshold values calculated. In addition, binary logistic regression analysis was performed to evaluate the association between inflammatory indices and PDR stage. This study included 205 patients: 60 with diabetes without retinopathy (mean age: 61.81±10.76y), 80 with PDR (mean age: 61.63±10.03y) and 65 healthy controls (mean age: 59.52±5.88y). The PDR group had significantly higher white blood cell (WBC, P<0.001), monocyte (MONO, P=0.009) and neutrophil (NEU) counts (P<0.001). SII and PIV had the highest sensitivity and area under ROC for predicting patients with PDR (0.822, 0.846, respectively). The optimal cut-off values for discriminating patients with PDR were determined to be >527.12 and >299.08 for SII and PIV, respectively. The logistic regression analysis demonstrated that a decrease in lymphocyte (LYM) count and an increase in platelet count (PLT), glycated haemoglobin (HbA1c), SII, and PIV were all significantly associated with the development of high-risk PDR (all P<0.05). PIV was more stable than independent MONO, LYM, PLT and NEU levels in predicting both the diagnosis and stage of PDR. The optimal cut-off value for PIV to discriminate patients with high-risk PDR was found to be >345.87 area under ROC=0.871, with sensitivity of 0.827 and specificity of 0.812. PIV is a reliable, valuable, and inexpensive blood index that can be used for early detection and staging of PDR. PIV may therefore be essential to be used for the follow-up of diabetic patients.

BACKGROUND Circulating tumor cells (CTCs) are promising minimally invasive biomarkers for tumor biology and metastasis. Although their clinical value has been established in several cancers, the evidence supporting their role in gastric cancer remains inconsistent and warrants further validation. AIM To investigate the prognostic value of preoperative CTCs detection in patients with gastric cancer. METHODS A retrospective analysis of patients with pathologically confirmed gastric adenocarcinoma who underwent preoperative testing of peripheral blood CTCs at the Department of Gastric and Small Intestinal Surgery, Zhangzhou Hospital, Fujian Province between June 2020 and March 2021 was performed. Correlations between preoperative CTCs status and clinicopathological characteristics as well as prognosis were evaluated. RESULTS Among the 115 patients newly diagnosed with gastric cancer, 61 (53.04%) were CTCs-positive and 54 (46.96%) were CTCs-negative. Significant differences were observed between the CTCs-positive and CTCs-negative groups in terms of tumor differentiation, lymph node metastasis, distant metastasis, pathologic tumour, node, and metastasis stage, and coagulation parameters (activated partial thromboplastin time, thrombin time, D-dimer level, and platelet count) (all P &lt; 0.05). However, no significant differences were found in age, sex, body mass index, tumor size, tumor location, depth of invasion, neural invasion, vascular invasion, or other coagulation markers (prothrombin time and fibrinogen) (all P &gt; 0.05). Univariate Cox regression analysis identified tumor size, depth of invasion, lymph node and distant metastases, tumor stage, neural invasion, vascular invasion, and CTCs positivity as risk factors for poor prognosis in patients with gastric cancer. At the follow-up cutoff date, recurrence or metastasis had occurred in 28 CTCs-positive patients (45.90%) and 15 CTCs-negative patients (27.78%). The CTCs-positive group exhibited higher rates of distant metastasis (78.57% vs 66.67%, P = 0.394) and peritoneal metastasis (64.29% vs 46.67%, P = 0.264) than the CTCs-negative group. Additionally, the CTCs-positive group had significantly shorter progression-free survival (PFS) (32.72 months vs 39.96 months, P = 0.036) and a trend toward reduced overall survival (38.62 months vs 41.11 months, P = 0.411). CONCLUSION Preoperative CTCs detection is associated with aggressive biological behavior in gastric cancer and has predictive value for PFS. Based on these findings, we recommend integrating preoperative CTCs testing into the clinical management of patients to improve risk stratification and guide personalized treatment strategies. Further prospective studies are warranted to validate the utility of optimizing surveillance protocols and therapeutic decisions.

To evaluate the relationship between systemic inflammatory indices and the severity of hyperemesis gravidarum (HG) using the Pregnancy-Unique Quantification of Emesis (PUQE) score, and to assess their predictive value for hospitalization. This prospective case-control study included 80 first-trimester pregnant women: 40 with HG and 40 healthy controls. Demographic, hematological, and biochemical data were analyzed. Systemic inflammatory indices-neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII)-were calculated from complete blood counts. Correlations between PUQE score, urinary ketone levels, and these indices were assessed using Spearman's test, and ROC analysis was used to determine predictive performance for hospitalization. Compared with controls, HG patients had significantly higher PUQE scores, white blood cell, neutrophil, monocyte, and platelet counts, and lower hemoglobin and sodium levels (all p < 0.05). NLR, MLR, PLR, and SII were markedly elevated in HG (all p < 0.001). PUQE and urinary ketone levels correlated positively with NLR (r = 0.703 and 0.786), MLR (r = 0.415 and 0.503), PLR (r = 0.469 and 0.563), and SII (r = 0.746 and 0.832) (all p < 0.001). SII showed the highest diagnostic accuracy for hospitalization (AUC = 0.973, 95% CI: 0.924-1.000). Systemic inflammatory indices, particularly SII and NLR, are significantly associated with the clinical severity of hyperemesis gravidarum and may serve as supportive markers for identifying patients at increased risk of hospitalization. These easily obtainable and inexpensive hematological markers may aid in identifying patients at higher risk who require inpatient management.

Prophylactic rhTPO Prevents Cancer Therapy-Induced Thrombocytopenia During Concurrent Chemoradiotherapy in Limited-Stage SCLC:A Prospective, Multicenter, Phase II Clinical Trial.

Introduction: Dengue hemorrhagic fever (DHF) remains a major public health concern in endemic regions, with plasma leakage being the pathognomonic feature determining disease severity. Despite widespread clinical use of platelet count and hematocrit as monitoring parameters, their predictive value for plasma leakage remains debated. This systematic review aims to comprehensively evaluate the evidence for platelet count and hematocrit as predictors of plasma leakage in DHF patients. Methods: A systematic review of 34 sources including primary observational studies, systematic reviews, meta-analyses, and randomized controlled trials was conducted. Studies were screened based on predefined criteria including DHF population according to WHO criteria, plasma leakage assessment through clinical signs or imaging, reporting of platelet count and/or hematocrit as predictors, and adequate statistical information. Data extraction encompassed study characteristics, platelet and hematocrit measurements, statistical findings, and confounding factors. Results: Low platelet count demonstrated consistent association with plasma leakage across multiple meta-analyses, with pooled odds ratios ranging from 2.01 (95% CI: 1.70-2.38) to 3.21 (95% CI: 1.81-5.69). A dose-response relationship showed 33% increase in logOR per 10,000-cell decrement. Platelet count below 50,000/mm³ was identified as a significant threshold for dengue shock syndrome (OR=2.85; 95% CI: 1.25-6.47). Hematocrit showed variable predictive utility depending on measurement timing; significant during critical phase (days 4-7) but not during early febrile phase. Combined assessment of rising hematocrit with declining platelet count yielded the strongest predictive signal (OR range: 5.13-43.17). Discussion: The apparent contradiction regarding hematocrit's predictive value is explained by temporal discordance in measurement timing. Platelet count emerges as a more reliable early predictor, with reductions detectable during febrile phase before hemoconcentration manifests. Population-specific factors, particularly age, significantly modulate predictive accuracy. The combined parameter approach captures mechanistically linked processes of capillary permeability and platelet consumption. Conclusion: Platelet count below 50,000/mm³ and rising hematocrit (particularly &gt;20% above baseline) are consistent predictors of plasma leakage, with combined assessment providing optimal predictive utility. Serial monitoring rather than single-point measurements is essential. Future research should focus on developing integrated predictive models incorporating clinical, laboratory, and sonographic parameters.

Reactive thrombocytosis is defined as an increase in megakaryocyte count and production secondary to inflammation, malignancy, or anemia. Although cases of reactive thrombocytosis are frequently encountered in newborns admitted to the neonatal intensive care unit (NICU), neonatal thrombocytosis has not yet been fully elucidated. This study aimed to evaluate the maternal and neonatal medical characteristics of neonates diagnosed with reactive thrombocytosis in the NICU. This retrospective, cross-sectional study included neonates with thrombocytosis (platelet count >450 × 109/L) who were admitted to our institution's NICU between January 1, 2021, and December 31, 2022. Children with suspected primary thrombocytosis were excluded from the study. Maternal and neonatal medical data were retrospectively analyzed using patient files. The cases were divided into 3 groups: platelet counts >450 and <700 × 109/L, 700 and <900 × 109/L, and 900 and <1000 × 109/L; gestational age was divided into 2 groups: <37 gestational weeks (GH) (preterm) and ≥37 to 42 GH (term); maternal age was divided into 3 groups: 20 years or younger, 20 to 34 years old, and 35 years or older; and birth weight was divided into 3 groups: <2500g, 2500 to 3999g, and ≥4000g. The groups were then compared. Statistical significance was set at P<0.05. A negative correlation was observed between mean platelet volume (MPV) and hemoglobin (Hb) levels at admission, as well as between MPV and platelet counts. The mean platelet count at the time of thrombocytosis was significantly higher in term cases than in preterm cases. Platelet counts were higher in the macrosomic group than in the nonmacrosomic group. Decreased Hb levels and increased C-reactive protein (CRP) levels were associated with severe thrombocytosis. Reactive thrombocytosis resolved spontaneously without complications and did not require any clinical intervention.