Platelet Count Research Articles

The Effect of Dengue Infection Severity on Blood Parameters

Objective: To evaluate the relationship between dengue infection severity, Alanine Aminotransferase levels, and platelet counts. Study Design: Cross-Sectional study. Place and Duration of Study: Akhtar Saeed Medical College-affiliated Farooq Hospital, Tehsil Murree, District Rawalpindi Pakistan, from Oct 2022 to Sep 2023. Methodology: Data from the medical records of individuals admitted to the dengue ward and diagnosed with confirmed dengue fever were evaluated. Demographic data, platelet counts on days 3, 4, and 5, Alanine Aminotransferase levels, and reports of Dengue Shock Syndrome and Dengue Hemorrhagic Fever. Results: Of the 69 participants, 76.8% were men, and most were aged 19–30 years. There was no significant difference in the mean Alanine Aminotransferase levels between the Dengue Hemorrhagic Fever positive and Dengue Hemorrhagic Fever negative patients (p=0.615). Patients with Dengue Shock Syndrome showed significantly different mean Alanine Aminotransferase levels (p=0.031). When comparing Dengue Shock Syndrome-positive individuals with Dengue Shock Syndrome -negative individuals, platelet counts were considerably lower (p=0.023). Conclusion: Thrombocytopenia is an important marker for severe dengue fever outcomes, particularly in Dengue Shock Syndrome patients. Although there was no significant difference in Alanine Aminotransferase levels between Dengue Hemorrhagic Fever cases and Dengue Shock Syndrome-positive cases, there was a discernible increase in Dengue Shock Syndrome-positive cases, suggesting that liver function tests may be helpful in anticipating shock.

Immuno-hematological parameters among adult HIV patients before and after initiation of Dolutegravir based antiretroviral therapy, Addis Ababa, Ethiopia.

Immuno-hematological abnormalities are common among HIV infected individuals as well as patients with highly active antiretroviral therapy (HAART). However, the immuno-hematological outcome of Dolutegravir based antiretroviral therapy (ART) usage is not well investigated. To assess hematological and immunological parameters among adult HIV patients before and after initiation of Dolutegravir based ART regimen at St. Peter Specialized Hospital, Addis Ababa, Ethiopia. A cross-sectional study was conducted from May to July 2021 at St. Peter Specialized Hospital among adult HIV patients. A total of 422 HIV patients on Dolutegravir based ART (combination of Dolutegravir/lamivudine/tenofovir disoproxil fumarate (DTG/3TC/TDF)) for a minimum of 3 months were selected using convenient sampling methods. Socio-demographic as well as clinical data of the participants was obtained using pre-tested structured questionnaires and a review of medical records. Hematological parameters such as CBC was obtained using Beckman coulter automated hematology analyzer and immunological parameters such as CD4 count were determined using BD FACS presto. Statistical analysis of the data was done using SPSS version 21. Paired t-test was used to compare dependent variables before and after initiation of the new HAART and binary logistic regression was used to determine predictors of immuno-hematological abnormalities. P-value < 0.05 was considered as statistically significant. Of 422 adult HIV patients, about 273(64.7%) were females. The mean age of study participants was 42.2 years (±10.4SD). The mean white blood cell (WBC) count, red blood cell (RBC) count, hemoglobin (Hb), platelet distribution width (PDW), CD4 count, as well as lymphocyte percentage, neutrophil percentage, and platelet counts (PLT) were increased significantly(P<0.05) after 3 months of the Dolutegravir based therapy. While, red cell distribution width (RDW) and mean cell hemoglobin (MCH) were decreased (P<0.05) after the treatment. Other hematological parameters such as mean cell volume (MCV), hematocrit (HCT), mean cell hemoglobin concentration (MCHC), mean platelet volume (MPV) and platelet distribution width (PDW) showed no significant change. On the other hand, the most common hematological abnormalities identified after the new HAART were anemia (12.1%); followed by Leucopenia (11.3%), neutropenia (6%), and thrombocytopenia (4%). Anemia was associated with female sex (AOR = 7.8, 95% CI: 1.9-32.2, P<0.005) and WHO clinical stage III/IV (AOR = 16, 95% CI: 10.63-66.46, P<0.01). There was a significant change in certain immuno-hematological parameters such as WBC count, RBC count, PLT count, Hb, PDW, CD4 count, lymphocyte and neutrophil percentage after initiation of the Dolutegravir based therapy. Anemia was the most common hematological abnormality. Further studies are required to fully comprehend the outcome of the new treatment regimen on immuno-hematological parameters.

Comparative Study of Inflammatory Markers in Schizophrenia, FirstEpisode Psychosis, and Bipolar Disorder

Objective: An elevated level of NLR level is defined as an indicator of systemic inflammation, and it is stated that it can be used as an effective tool in navigating psychosis. The aim of the present study is to explore the blood parameters such as neutrophil, lymphocyte, and monocyte and their ratios (NLR, MLR, PLR) in both affective and non-affective psychosis. Materials and Methods: This is a retrospective case-control study conducted on schizophrenia(Sch), first-episode psychosis(FEP), and bipolar disorder(BD). Digital medical records were retrospectively analyzed between 2016 to 2021. The total number of patients recruited for this study is 437. Patients were divided into 3 groups which are schizophrenia (n:199), FEP (n:127), and Bipolar Disorder (n:111). The healthy control (HC) group (n:200) was selected who had never been diagnosed with any psychiatric disorders. Results: In this study, no difference was found between the patient groups in terms of substance use (Chi-square= 5.008; p= 0.082), platelet count was lower in SCH patients and no difference was found between the other groups in terms of platelet count. There was no statistical difference between the study groups in terms of lymphocyte, neutrophil, and monocyte counts and their ratios (NLR, MLR, PLR) (p&amp;gt;0.05 for each). Conclusion: In contrast to the previous findings, we did not show any significant differences in NLR, MLR, and PLR levels in both affective and non-affective psychosis. To better understand the pathophysiology of psychosis, it might be more suitable to conduct a clinical trial with drug-naive FEP patients in a prospective manner.

Effects of Variable Doses of Neurokinin B on Hematological and Coagulation Parameters in Adult Male Rats

Objective: To evaluate the dose-dependent effects of Neurokinin B on hematological and coagulation parameters in adult male Sprague Dawley rats. Study Design: Laboratory-based experimental study Place and Duration of Study: Gomal University and KMU Institute of Medical Sciences from February 2019 to April 2021. Methodology: Adult male Sprague Dawley rats (n=5 per group) were administered intraperitoneally with Neurokinin B at doses of 1 µg, 1 ηg and 1 ρg for 12 days consecutively. Control rats received distilled water injections. After 12 days, rats were sacrificed, and blood samples were collected from the left ventricle for hematological and coagulation analysis. Results: Bleeding time was significantly prolonged in NKB-µg (114±17.10sec) and Neurokinin B -ηg (72±22.25sec) compared to control (33±12.55sec). Clotting time (CT) was also increased (NKB-µg: 111±17.10sec; NKB-ηg: 69±17.10sec, control: 42±12.55sec), as did prothrombin time (PT) [NKB-µg: 93.60±10.92sec; NKB-ηg: 63.40±12.66sec, control: 15±4.12sec] and activated partial thromboplastin time (APTT) [NKB-µg: 94.80±14.04sec; NKB-ηg:68.60±13.74sec, control: 19.40±2.97sec]. Additionally, mean platelet volume [NKB-µg:8.94±0.36fl, control: 8.04±0.48fl] and leukocyte count (×103/µl) [NKB-µg: 12.14±0.69, control: 8.87±1.32] were significantly increased in NKB-treated animals compared to control. There was a significant increase in international normalized ratio in NKB-µg (6.86±0.80) and NKB-ηg (4.65±0.93) compared to control group (1.10±0.30). Conversely, platelet count (×103/µl) was decreased significantly in NKB-µg group (787.80±48.51) compared to the control group (960.60±58.71). Conclusion: NKB administration led to leukocytosis, thromboctopenia, and affected coagulation pathways with prolonged BT, CT, PT, APTT and INR dose-dependently.

The effect of a new coronavirus infection on hemogram parameters in the early convalescence period of patients with coronary heart disease

Laboratory data, especially a general blood test, play an important role in the treatment of infectious diseases, including COVID-19. However, in patients with coronary heart disease (CHD) and COVID-19, a general blood test is rarely analyzed and is insufficient to fully assess an impact of the new coronavirus infection on patients with cardiac diseases. The aim of the study was to analyze a COVID-19 effect on hemogram parameters in the early recovery period of patients with coronary heart disease. The study was performed at the Kursk City Clinical Hospital for Emergency Medical Care in the years 2021–2022, which involved 58 mature-aged patients (45–59 years old) suffering from coronary heart disease who had a new coronavirus infection and 62 elderly patients suffering from coronary heart disease alone. Morning blood sampling was carried out from the forearm superficial veins into Vacutainer test tubes added with a coagulation activator. In elderly patients, 3–4 weeks after recovery, significant changes in red blood parameters persisted — a decline in the level of peripheral blood erythrocytes, hemoglobin and hematocrit. Elderly patients with coronary heart disease comorbid with a moderate new coronavirus infection, 3–4 weeks later had also higher count of leukocytes, neutrophils, segmented neutrophils and ESR level relative to comparison group. It should be noted that in the early convalescence period elderly patients with coronary heart disease and COVID-19 had significantly elevated ESR, which confirms ongoing sustained inflammatory process. After evaluating the information content according to the calculated Kullback informativeness assessment for analyzed general blood test parameters, it was found to peak for platelet and leukocyte counts as well as ESR level. Thus, among the analyzed indicators in the general blood test, it turned out that platelet and leukocyte count along with ESR level were most informative and of prognostic significance during early convalescent period of elderly patients with coronary heart disease comorbid with a new coronavirus infection, which are proposed to be used as biomarkers of early convalescent period.

Posthepatectomy Liver Failure in Patients with Splenomegaly Induced by Induction Chemotherapy for Colorectal Liver Metastases.

With advances in chemotherapy, conversion surgery is often performed for initially unresectable colorectal cancer liver metastasis (CLM). However, unexpected posthepatectomy liver failure (PHLF) is sometimes associated with chemotherapy-associated liver injuries following long-term chemotherapy. We aimed to identify predictive factors for PHLF after conversion surgery for initially unresectable CLM. We retrospectively identified 774 consecutive patients who underwent initial liver resections for histologically confirmed CLMs between 2010 and 2019 at our institute. We enrolled 107 patients with initially unresectable CLMs. Clinicopathological characteristics were evaluated to determine their association with PHLF. Logistic regression analysis was performed to analyze the predictors of PHLF. Among the 107 patients, PHLF occurred in 15 cases (14%). Multivariate analysis revealed that splenomegaly during preoperative chemotherapy (> 135%) was an independent risk factor for PHLF (P = 0.002; odds ratio 14.30; 95% confidence interval 2.69-76.08). In the analysis limited to the splenomegaly group, lower platelet counts, increased blood loss and operative times, and large liver resection areas (> 100 cm2) were significant risk factors for PHLF (P = 0.018, 0.043, 0.020, and 0.024, respectively). Among them, a liver resection area > 100 cm2 can be calculated preoperatively and correlate with a complex hepatectomy. These findings could help predict PHLF after conversion surgery and induction chemotherapy for initially unresectable CLMs. Careful decisions, including detailed procedures and timing of hepatectomy, should be made before conversion hepatectomy in patients who develop splenomegaly after induction chemotherapy and require complex hepatectomies with a large liver resection area.

Real-World Data on Effectiveness and Safety of First-Line Use of Caplacizumab in Italian Centers for the Treatment of Thrombotic Thrombocytopenic Purpura: The Roscapli Study

Background/Objectives: Immune thrombotic thrombocytopenic purpura (iTTP) is a thrombotic microangiopathy caused by the formation of anti-ADAMTS13 antibodies. Caplacizumab is approved for the treatment of acute episodes of iTTP in conjunction with plasma exchange (PEX) and immunosuppression. Real-world data for the use of caplacizumab in Italy have been recently published by a limited number of centers located in the northern and middle regions of the country only. Methods: A total of 38 patients with iTTP were enrolled in the study in six Italian centers spread over the entire territory of the country. The patients’ data were registered in eCRF. Results: All patients achieved normalization of platelet count (median 2.0 days, IQR: 2–4), within a time significantly shorter than in the absence of caplacizumab, as previously reported in other studies. As to the secondary aims, patients treated with caplacizumab had a few exacerbations (4/38 (10.5%)) and relapses (2/38, 5.3%). No deaths or refractoriness were observed in these patients. The total length of hospitalization was 12 days (IQR: 9–18) and only one patient required 2 days of stay in the intensive care unit. Interestingly, when caplacizumab was initiated within the first 3 days, the plasma exchange (PEX) duration was 9 days (IQR: 8–10), which was significantly lower than those reported in previous studies conducted in the absence of caplacizumab. No severe adverse event was described in the caplacizumab-treated patients. Conclusions: Caplacizumab reduced exacerbations and refractoriness compared with previously reported standard-of-care regimens. When administered in association with PEX and immunosuppressive therapy, caplacizumab provided rapid normalization of platelet count, which was responsible for lower overall hospitalization time, ICU stay, lower exacerbations and relapses compared to previously reported outcomes of studies carried out without caplacizumab.

Correlations between coagulation abnormalities and inflammatory markers in trauma-induced coagulopathy

IntroductionIn multiple trauma patients, the occurrence of trauma-induced coagulopathy (TIC) is closely associated with tissue damage and coagulation function abnormalities in the pathophysiological process.MethodsThis study established a multiple trauma and shock model in Sprague-Dawley (SD) rats and comprehensively utilized histological staining and radiographic imaging techniques to observe injuries in the intestine, liver, skeletal muscles, and bones. Monitoring activated partial thromboplastin time (APTT), platelet (PLT) count, respiratory rate, blood pressure, and other physiological indicators revealed time-dependent alterations in coagulation function and physiological indicators. Enzyme-linked immunosorbent assay (ELISA) measurements of inflammatory factors Tumor Necrosis Factor-alpha (TNF-α), Interleukin-6 (IL-6) and vascular endothelial injury marker (Syndecan-1) were also conducted.ResultsExperimental results demonstrated significant changes in tissue structure after multiple traumas, although widespread necrosis or hemorrhagic lesions were not observed. There were time-dependent alterations in coagulation function and physiological indicators. ELISA measurements showed a strong positive correlation between the significant decrease in PLT count and the increase in TNF-α and IL-6 concentrations.DiscussionThe study provides crucial information for the early diagnosis and treatment of TIC. The findings suggest that structured monitoring of coagulation and inflammatory indicators can help in understanding the pathophysiological changes and aid in the management of TIC in multiple trauma patients.

Comparison of Non-invasive Biochemical Fibrosis Markers According to Obesity-Based Metabolic Profile in Chronic Liver Disease with Chronic Hepatitis B Etiology

Aim: The aim of this study is to investigate the impact of obesity on fibrosis by comparing fibrosis markers between obese and non-obese patients with Chronic Hepatitis B (CHB). Material and Method: A total of 172 CHB (50.6±9.4 mean aged) patients were included in this retrospective study. The patients were divided into two groups: Obese (n=72) and Non-obese (n=100). Inclusion criteria were those diagnosed with chronic hepatitis B and ≤ 50 IU/mL or undetectable HBV-DNA, and exclusion criteria were other chronic diseases other than CHB and pregnancy. The height, body weight, and waist circumferences were measured. BMI ≥30 kg/m2 was classified as the obese group. Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST), Gamma-glutamyl transferase, albumin, bilirubin, and prothrombin time were analyzed. Fibrosis-4 score (FIB-4) was calculated with the formula Age x AST / platelet count x √(ALT), and AST-Platelet Ratio Index (APRI) was calculated with the formula [AST/AST (upper limit of normal)]/ platelet count. Results: AST levels were significantly higher in obese patients (p

Caloric Vestibular Stimulation Alleviates Cold Water Swimming Stress Induced Changes in BDNF and Haematological Parameters

Introduction: Stress is inevitable in daily life. Stress in long term has been implicated in the development of physical and neuronal disorders. Various studies have described the levels and role of BDNF in the brain following stress. Studies representing the changes in serum BDNF and wet weight of organs in stress are limited and controversial. Aim: The aim of the present study is to find the effect of stress on serum BDNF concentration, wet weight of selected organs, haematological parameters and to evaluate the effectiveness of caloric vestibular stimulation on stress-induced changes in these parameters. Methods and material: Male Wistar rats were exposed to cold water swimming stress for 14 days for a duration of 30 minutes per day. Serum corticosterone and serum BDNF were measured using the ELISA method. Weight of liver, spleen, thymus and lymph nodes were measured and their relation to body weight was calculated. Total RBC count, total WBC count, platelet count and haemoglobin concentration were analysed. Results: A statistically significant increase in serum corticosterone and BDNF was observed following stress. Liver weight, thymus weight and lymph nodes weight did not show any significant changes but spleen weight has reduced in the normal recovery group following stress. Total RBC count, total WBC count, platelet count and haemoglobin levels were significantly higher in the stress group. Caloric vestibular stimulation was effective in managing stress-induced changes in serum corticosterone, BDNF and spleen weight. Conclusion: Caloric vestibular stimulation is effective in restoring the stress-induced changes.

Development and validation of an early acute kidney injury risk prediction model for patients with sepsis in emergency departments

In this study, we aimed to develop and validate a nomogram to predicting the risk of sepsis-associated acute kidney injury (SA-AKI) in patients admitted to emergency departments (EDs). We randomly divided a retrospective dataset of 391 patients with sepsis into a 294-person training cohort and a 97-person validation cohort, and developed three predictive models using multivariate logistic regression analysis and clinical insight. No difference was observed between the three models using the DeLong test and Model 3 was selected as the risk prediction model based on the principle of least inclusion indicators. The use of vasopressor drugs, patient age, platelet count, procalcitonin, and D-dimer levels were included. The training and validation cohorts had a consistency index of 0.832 and 0.866, respectively, indicating high accuracy and stability in predicting SA-AKI risk. The area under the receiver operating characteristic curve was 0.832, showing excellent discrimination. The calibration curves for the training and validation cohorts showed excellent calibration. The decision curve and clinical impact curve analyses showed that the net clinical benefit of using the nomogram was greatest over a probability threshold of 0.05–0.90. In addition, the model showed moderate validity in predicting the 30-day survival and the incidence of major adverse renal events within 30 days. The nomogram developed for SA-AKI risk assessment in patients in EDs showed good discriminability and clinical utility. It can provide a theoretical basis for emergency physicians to prevent SA-AKI.

Donor Parameters and Platelet Yield during Plateletpheresis: A Cross-sectional Prospective Study

Abstract Background: Platelet transfusion can be life-saving in bleeding patients with thrombocytopenia or reduced platelet function. Single donor platelets (SDP) unit use is preferred due to the various advantages like reduction in transfusion-transmitted diseases and transfusion reactions. The quality of SDP is determined by platelet yield. Therefore, we conducted this study to assess the donor parameters affecting platelet yield during plateletpheresis. Materials and Methods: This cross-sectional prospective study included 160 single-donor platelet apheresis procedures done for 1 year. The pre-donation platelet count of the donor was set to 250 × 109/L to get double-dose platelet. Plateletpheresis was performed using Trima Accel single-needle separator apheresis machine. The demographic and hematologic parameters of donors were correlated with their platelet yield. Data obtained were tabulated using version 20 of the Statistical Package for the Social Sciences (SPSS). A relationship between pre-donation donor variables and platelet yield was studied using the Pearson correlation coefficient (r). P &lt; 0.05 was considered statistically significant. Results: There was a significant positive correlation between platelet yield and body mass index (BMI) (r = 1710 and P = 0.0304), total leukocyte count (TLC) (r = 0.2220 and P = 0.0048), and platelet count (r = 0.8880 and P &lt; 0.0001). The mean platelet volume (MPV) showed a negative correlation with platelet yield (r = −0.1910 and P = 0.0156). Age, hemoglobin, hematocrit, and platelet distribution width showed no significant correlation with the platelet yield. Conclusion: Donor parameters such as pre-donation platelet count, BMI, TLC, and MPV need to be considered while recruiting the donors for the SDP procedure for better yield of platelets.

Comparison of the efficacy of aescin and diclofenac sodium in the management of postoperative sequelae and their effect on salivary Prostaglandin E2 and serum C-reactive protein levels after surgical removal of impacted mandibular third molar: a randomized, double-blind, controlled clinical trial.

Surgical removal of an impacted third molar is one of the most common oral surgical procedures performed in dental offices. The postoperative phase is often associated with severe inflammation. Non-steroidal anti-inflammatory drugs (NSAIDs) are usually prescribed to manage postoperative discomfort. NSAIDs have been associated with gastrointestinal bleeding, renal function disturbances, and platelet count reductions. Thus, the present study demonstrates the utility of aescin in managing postoperative discomfort after the surgical removal of impacted mandibular third molars.This study aimed to correlate and compare the impact of aescin and diclofenac on salivary PGE2 levels and serum C-reactive protein levels after surgical extraction of the mandibular third molar. The study will also evaluate and compare the effectiveness of individual drug therapy in managing postoperative pain, swelling and mouth opening. The planned study is a single-center, double-blind, randomized, parallel, prospective clinical trial. Each patient will be prescribed either diclofenac sodium 150 mg/day or aescin (escin) 120 mg/day to be taken orally in divided doses for five days after surgically removing the impacted mandibular third molar.Pain will be assessed using a visual analog scale. Facial swelling and mouth opening will be recorded using a metric scale with standardized reference points. ELISA (enzyme-linked immunosorbent assay (ELISA) will be employed to measure salivary Prostaglandin E2 and serum C-reactive protein levels. All parameters will be recorded preoperatively (T0) on the second postoperative day (T1) and fifth postoperative day (T2). The proposed study is expected to show a clinically acceptable response to the administration of aescin for the management of postoperative discomfort compared to diclofenac sodium after third molar surgery.The proposed study is expected to positively manipulate the levels of salivary Prostaglandin E2 and serum C-reactive protein, which are reliable inflammatory markers.The outcome of this study may provide an efficacious and safe alternative to conventional nonsteroidal anti-inflammatory drugs for managing postoperative discomfort following third molar surgery.

Afebrile Kawasaki disease: A case report

Objective: Kawasaki disease (KD) is an acute, self-limiting vasculitis and the most common cause of acquired heart disease in children under 5 years old. Despite over 50 years of research, the etiology and long-term prognosis of KD remain unclear.Case presentation: A 2-year-7-month-old boy presented with all the typical KD symptoms, including conjunctival injection, cracked lips, strawberry tongue, and membranous desquamation of the fingers and toes, but without fever. The patient was admitted with a 9-day history of peeling skin on his fingers, and no history of illness or fever in the past two weeks. Laboratory tests revealed elevated platelet count. An echocardiogram showed normal coronary arteries. The patient was diagnosed with KD and treated with low-dose aspirin and dipyridamole. He was discharged on the third day and showed complete symptom resolution and normal coronary arteries at follow-up.Conclusions: This case report describes an instance of afebrile KD, emphasizing the need for clinical vigilance and comprehensive assessment for diagnosis and treatment. Afebrile KD poses a diagnostic challenge as fever is a major diagnostic criterion. However, clinicians should consider afebrile KD when other clinical features and laboratory results suggest KD, and initiate appropriate treatment to prevent severe complications like coronary artery lesions. This case underscores the importance of early diagnosis, timely intervention, and multidisciplinary team collaboration for effective management of KD.

Testosterone replacement has a beneficial effect on the hemostatic system by altered gene expression of coagulation factors

This study aimed to investigate the effects of testosterone replacement therapy on hemostasis and some procoagulant gene expression in mice. 42 mice were randomly divided into two groups of non-orchiectomized (non-ORX) and orchiectomized (ORX) with three subgroups (n = 7) each, were subcutaneously administered with sesame oil (control), 2 and 20 mg/kg/week testosterone enanthate. Orchiectomized mice were allowed to recover for one week before treatment. On the 7th week of treatment, blood samples were collected for coagulation parameters analysis and measurement of plasma testosterone levels. Moreover, quantitative real-time PCR analysis was performed on liver samples to assess the expression of factor IX, factor X, and prothrombin genes. The results showed that supraphysiological doses (20 mg/kg) of testosterone significantly increased plasma testosterone levels in all groups, while physiological doses (2 mg/kg) only increased testosterone levels in non-ORX animals. Although testosterone administration had no effect on prothrombin time (PT) and activated partial thromboplastin time (aPTT), supraphysiological doses reduced bleeding time and clotting time. Furthermore, platelet count increased in a dose-dependent manner with testosterone enanthate treatment. The expression of coagulation factors was also decreased with supraphysiological doses of testosterone. In conclusion, testosterone had significant effects on primary hemostasis and common coagulation pathway, including increased platelet number and aggregation, decreased clotting time, and altered gene expression of coagulation factors.

Predicting survival benefits of immune checkpoint inhibitor therapy in lung cancer patients: a machine learning approach using real-world data.

Due to the heterogeneity in the effectiveness of immunotherapy for lung cancer, identifying predictors is crucial. This study aimed to develop a machine learning model to identify predictors of overall survival in lung cancer patients treated with immune checkpoint inhibitors (ICIs). A retrospective analysis was performed on data from 1314 lung cancer patients at the Chongqing University Cancer Hospital from September 2018 to September 2022. We used the random survival forest (RSF) model to identify survival-influencing factors, using backward elimination for variable selection. A Cox proportional hazards (CPH) model was constructed using the most significant predictors. We assessed model performance and generalizability using time-dependent receiver operating characteristics (ROC) and predictive error curves. The RSF model demonstrated better predictive accuracy than the CPH (IBS 0.17 vs. 0.17; C-index 0.91 vs. 0.68), with better discrimination and prediction performance. The influential variables identified included D-dimer, Karnofsky performance status, albumin, surgery, TNM stage, platelet count, and age. The RSF model, which incorporated these variables, achieved area under the curve (AUC) scores of 0.95, 0.94, and 0.98 for 1-, 3-, and 5-year survival predictions, respectively, in the training set. The validation set showed AUCs of 0.94, 0.90, and 0.95, respectively, exceeding the performance of the CPH model. The study successfully developed a machine learning model that accurately predicted the survival benefits of ICI therapy in lung cancer patients, supporting clinical decision-making in lung cancer treatment.

Clinical characteristics and prognostic analysis of pediatric hemophagocytic lymphohistiocytosis using lasso-logistic regression.

This study aims to evaluate and predict mortality risks among pediatric patients with hemophagocytic lymphohistiocytosis (HLH). We conducted a retrospective analysis of pediatric patients with HLH diagnosed at the Affiliated Hospital of Zunyi Medical University between January 2012 and April 2023. Patients were divided into a death group and a survival group based on their outcomes. Risk factors for mortality were analyzed using a lasso-logistic regression model. This study included 142 pediatric patients with HLH, with a median age of 40.5 (14.75-84) months, of whom 78 (54.93%)were male. The overall mortality rate was 34.51%. Through lasso-logistic regression analysis, five independent prognostic factors were identified: concurrent central nervous system involvement, multiple organ dysfunction syndrome involving three or more organs, platelet count ≤ 42.5 × 109/L, activated partial thromboplastin time ≥ 54.05s, and the utilization of blood purification in conjunction with the HLH-94/2004 treatment protocol. The predictive value of the lasso-logistic regression model is better than that of the traditional logistic regression model (AUC: 0.906 vs 0.811, P = 0.001). Subsequently, a lasso-logistic regression-based predictive model incorporating these identified risk factors was developed. Our lasso-logistic regression-based prediction model may help to identify high-risk patients with HLH early, thereby enabling the timely initiation of appropriate treatment interventions.

In Silico and In Vivo Evaluation of Anti-Arthritic Effects of Bakuchiol from Psoralea corylifolia Seeds in Experimental Rat Model.

Rheumatoid arthritis is an autoimmune disease mainly affecting the joints categorized by inflammation, swelling of the synovium and decrease in the joint movement. Bakuchiol, a meroterpene class of natural product present in Psoralea corylifolia known to possess anti-inflammatory effects by a variety of mechanisms. However, its effects in rheumatoid arthritis still remain unclear. In the present investigation, we studied the anti-arthritic effects of bakuchiol via in silico and in vivo experiments. It also showed antioxidant effects measured using DPPH assay where it showed free radical scavenging activity with IC50 value 468.26 μg/ml. Molecular Docking studies carried out on COX-1 (PDB ID: 3 N8Z), COX-2 (PDB ID: 4PH9) and TNF-α (PDB ID: 7JRA), proteins involved in inflammation in arthritis. Bakuchiol showed the maximum binding affinity for TNF-α with binding affinity score is -7.29 kcal/moland less affinity was observed for COX-1 and 2. In vivo antiarthritic effects were studied in arthritic female wistar rats model prepared by intradermal injection of freund's complete adjuvant. Bakuchiol was administered orally at dose of 10,20 and 40 mg/kg for 21 days. Our treatment showed that bakuchiol at 20 and 40 mg/kg exhibited significant anti-inflammatory effects (p<0.001) showed by significant decrease in paw volume, paw diameter, spleen and thymus weight and increase in pain threshold and body weight in arthritic rat model. A significant decrease in hematological parameters such as total leukocyte count (TLC), platelet count, CRP and rheumatoid arthritis factor (RF) and increase in red blood cells count, ESR and hemoglobin further demonstrated that bakuchiol treatment suppresses the progression of adjuvant induced arthritis (AIA) in arthritic rat model. Histological analysis further revealed that bakuchiol ameliorates the pathological manifestations of AIA and reverse the abnormality induced by AIA in rats shown by protection against bone necrosis involved with low influx of inflammatory cells. Therefore, in silico and in vivo results revealed that bakuchiol has the potential to be developed as potent antiarthritic agent.

Evaluation of some haematological and coagulation profiles of occupationally heat stress individuals of bakery industries in Kano, Nigeria

Bakers are exposed to heat stress in their work places, which can result in a variety of outcomes ranging from mild heat cramps to heat stroke. There is paucity of published data on the wallop of heat stress on haematologic and haemostatic parameters of individuals occupationally exposed to heat stress from bakery industries. This study attempted to evaluates some haematological and coagulation parameters of bakery workers who are occupationally exposed to heat stress in the baking industries. One hundred (100) individuals who consented to participate among which are: 70 bakers and 30 non-bakers were enrolled into the study. Blood samples were obtained using aseptic venepuncture and assessed for haematologic and haemostatic parameters by Haematology-analyser for full blood count parameters and manual standard coagulation method for Prothrombin time (PT) and activated partial thromboplastin time (aPTT) respectively. The data obtained was analyzed using IBM SPSS version 23. The results are presented as mean and standard deviation and p-value was set at ≤0.05as statistically significant. Platelets, red and white blood cells counts and their indices were counted along with some coagulation parameters (PT and aPTT). A statistically significant increase (p≤0.05) in platelets counts were observed in bakers compared with controls. Similarly, some coagulation parameters were found to be reduced and was statistically significant (p≤0.05) in bakers compared with non bakers as controls. The findings of the study showed insignificant changes in haematologic parameters coupled with altered coagulation parameters. This may be suggestive that individuals occupationally exposed to heat stress are prone to hypercoagulable state and its attending consequences.

Is There a Correlation Between Platelet Count, Mesenteric Lymph Node Involvement, and Hematogenous Metastases in Advanced Stage Ovarian Cancer?

Ovarian cancer remains a major cause of death in women worldwide, mainly due to late diagnosis and the lack of a reliable screening test for early detection of the disease. In this context, attention has been focused on the identification of other prognostic factors that might allow a better identification of cases with worse long-term outcome. Data of patients who underwent cytoreductive surgery between 2014-2019 were retrospectively reviewed and 57 patients were considered eligible for this study. These cases were further classified according to preoperative platelet count, with a cut-off value of 335,000/μl as a positive predictive value for long-term survival. According to this value, there were 27 cases with a preoperative platelet count lower than 335,000/μl and 30 cases with a preoperative platelet count higher than 335,000/μl. Cases in the second group had a significantly higher peritoneal carcinomatosis index (p=0.002), a higher proportion of digestive serosa involvement (p<0.001), and a higher proportion of mesenteric lymph node involvement and hematogenous metastases (p=0.005 and p=0.001, respectively). When analyzing long-term outcomes, all these factors had a significant impact on overall survival. Preoperative thrombocytosis appears to be positively associated with gastrointestinal serosa involvement, mesenteric lymph node invasion, and the presence of hematogenous metastases, thus significantly influencing the long-term outcome of patients with advanced ovarian cancer.