Complete Blood Count Results Research Articles

Effects of circadian variation, lifestyle and environment on hematological parameters: A narrative review.

The complete blood count (CBC) is the most widely prescribed laboratory test. It plays a key role in screening, diagnosing, and monitoring a variety of medical disorders. Preanalytical and analytical variables are responsible for more than 50% of laboratory errors that may lead to spurious CBC results. The effects of blood sampling, transport, storage, and analytical errors on hematological parameters have been well described. Circadian variation and changes in lifestyle and environment can also affect blood cells. It has been extensively studied in the past, but highly variable methodology and the presence of confounding factors have provided scattered and inconsistent results. We have investigated the literature to define the impact of circadian variation, modification of the sleep-wake cycle, acute and chronic exercise, eating habits, alcohol, tobacco, drugs of abuse, high-altitude, heat/cold exposure, and air pollution on CBC results. The affected cell type along with the intensity and duration of changes are detailed for each condition. We aim at providing a comprehensive overview of which situations may induce clinically significant changes and have to be taken into account by healthcare professionals before considering a hematological parameter as pathological and requesting complementary tests.

Neutrophil-to-lymphocyte ratio is a prognostic predictor in emergency department patients with cutaneous adverse drug reaction.

We aimed to evaluate the prognostic value of neutrophil-to-lymphocyte ratio (NLR) in emergency department (ED) patients with cutaneous adverse drug reactions to identify the severe patients at an early stage. In this retrospective study, patients aged 18 and over who admitted to the ED of a university hospital with the diagnosis of cutaneous adverse drug reaction were included. For included patients, clinical findings and ED admission complete blood count results were recorded. The primary outcome was hospitalization and the secondary outcome was the type of drug reaction. A total of 135 patients were included in the study. The median age of patients was 50 (36-64) years. There was no significant difference between the patients hospitalized and discharged from the ED in terms of age and gender (p = 0.340 and p = 0.762, respectively). There was no significant difference between hospitalized and discharged patients in terms of complete blood count parameters (p > 0.05, for all). The median NLR of hospitalized patients was significantly higher than that of patients discharged from the ED (6.13 vs. 3.69, p = 0.006). The median NLR of the patients with erythema multiform/Steven Johnson syndrome/toxic epidermal necrosis was significantly higher than the NLR of the patients with maculopapular and fixed drug eruptions (p = 0.022 and p = 0.015, respectively). The area under the curve value of NLR in predicting hospitalization was 0.640 (0.546-0.734). For 8.4 of NLR cutoff value, specificity was 83.9%. NLR is a useful and simple prognostic parameter as an indicator of systemic inflammatory involvement in ED patients with cutaneous adverse drug reactions. NLR is a useful parameter for deciding which patient will be admitted to the hospital in that patient group.

Surgical Treatment of Sialolithiasis Leads to Improvement in the Complete Blood Count.

Simple SummarySialolithiasis is a disease in which inflammation and infection are caused in a salivary gland and its duct secretion system due to a formation of a sialolith (salivary stone) in the gland. Anemia of inflammation is a well described pathology where chronic inflammation causes a reduction in the red blood cell count is. In this study, we examined the complete blood count results of patients who underwent surgical removal of a sialolith and found that removal of the stone and cessation of the symptoms lead to an improvement in the complete blood count results. We believe that the improvement in blood count values after surgery is due to resolution of the anemia of inflammation. To our knowledge, this is the first report about the relationship between surgery for removal of a salivary stone and improvement in the wellbeing of patient expressed by blood count values.Sialolithiasis is a chronic disease in which a sialolith (salivary stone) causes recurrent inflammation of the affected salivary gland. Anemia of inflammation is a well-described pathology in which a chronic inflammatory disease leads to a reduction in the red blood cell count, hemoglobin and hematocrit values. In this retrospective cohort study, we aim to find whether removal of the sialolith and alleviation of the inflammation affect the complete blood count results. We examined data regarding forty-nine patients who underwent surgery for the removal of a submandibular gland sialolith using the duct-stretching technique. Complete blood counts two years before and after the surgical procedure were collected. The average pre-procedure and post-procedure values were calculated for each patient to establish the average blood profile. The pre- and post-procedure values were compared to evaluate the effect of the surgical treatment on the blood profile. We found that the average blood count values for patients with sialolithiasis were towards the lower end of the normal range. Post-surgery, a significant increase in hematocrit, hemoglobin and red blood cell count was observed, which was more pronounced in the older age group and in patients with co-morbidities. We conclude that sialolith removal surgery is associated with significant improvement in the complete blood count values, especially in the elderly and in patients and with co-morbidities. The speculated pathogenesis is relative anemia of inflammation.

Dynamics of COVID-19 Lockdown on Blood Indices and Its Impact on Individuals' Immunological Health Status: A Cohort Study in Madinah, Saudi Arabia.

ObjectiveThe complete blood count (CBC) is an essential blood test that has been used for decades to assess individuals’ overall health status. This study aimed to investigate the contributions of lockdown conditions to individuals’ overall health status using blood indices as biological markers. During lockdown, people are limited to confined spaces, have access to limited nutritional supply options, experience increased stress, and are exposed to other environmental factors.MethodsOur study’s target population included all outpatients who were severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-negative and requested CBC assessments as part of their routine health checks. A total of 2414 CBC results were included, covering a period from February 2019 to December 2020. The average of different blood indices during the COVID-19 lockdown was compared to the 10-month period preceding the lockdown.ResultsThe average counts of RBCs, hemoglobin, and hematocrit showed a significant increase during the lockdown period, which lasted from May 2020 to September 2020. Reductions were observed for the RBC distribution width, total white blood cell count, platelets, and platelet distribution width.ConclusionOur findings suggested that the overall health status of individuals improved during the lockdown period in the short term, but health status might be adversely affected under these conditions of a longer period. Both RDW and PDW could be used as indicators for the overall health status when assessed against other blood indices.

Evaluation of Hematocrit in Adults with Dengue by a Laboratory Information System.

The implementation of a laboratory information system (LIS) at the Hospital for Tropical Diseases in Thailand provides valuable medical resources, particularly for dengue. Hematocrit (Hct), which is often derived from hemoglobin (Hgb), is important in the diagnosis and management of dengue. This study aimed to evaluate the Hct value obtained from the LIS automated analyzer. We prospectively enrolled 163 hospitalized adults with dengue, for whom 1,141 real-time complete blood count (CBC) results were obtained via a hematology analyzer and updated in the LIS database. The median (interquartile range (IQR)) duration of analytic turnaround times (TATs) was 40.0 (30.0–53.0) minutes. Linear regression analysis indicated a significant relationship between Hgb and Hct with a coefficient of determination (Pearson's R2) of 0.92 at red blood cell distribution width (RDW) ≤18, but Pearson's R2 decreased to 0.78 at RDW >18. The Hct calculated from the three-fold conversion method and from the analyzer had a Pearson's R2 of 0.92. At Hgb <12 g/dl and ≥16 g/dl, a greater difference between the two Hct values was observed, with median (IQR) differences of −0.8% (−1.9%–0.2%) and 0.8% (−0.1%–1.7%), respectively (P value <0.05). In conclusion, the Hgb and Hct of patients with dengue were highly correlated at RDW ≤18. The Hct calculated from the three-fold conversion method and from the analyzer had an excellent relationship, except when the Hgb was <12 g/dl or ≥16 g/dl. Apart from routine CBC evaluation, the LIS could help for accurate data collection in clinical research and development.

Association between Novel Marker (Platelet-Lymphocyte Ratio, Neutrophil-Lymphocyte Ratio, and Delta Neutrophil Index) and Outcomes in Sudden Cardiac Arrest Patients.

Purpose It is important that clinicians accurately predict the outcome of patients with sudden cardiac arrest (SCA). The complete blood count (CBC) is an easy and inexpensive test that provides information on blood content. Platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), and delta neutrophil index (DNI) are relatively novel biomarkers that have been used in the prognosis of various diseases. We aimed to determine the usefulness of PLR, NLR, and DNI in predicting the outcomes of SCA. Materials and Methods This retrospective observational study was performed on patients with SCA. Patients who visited the tertiary university hospital from January 2015 to December 2019 were targeted. The inclusion criteria were all nontraumatic adult out-hospital cardiac arrest patients. We analyzed DNI, PLR, and NLR based on the CBC results of all enrolled patients. The exclusion criteria were as follows: no data on laboratory study, traumatic arrest, age < 18 years, and a history of leukemia, myelodysplastic syndrome, and myelofibrosis. The primary outcome was assessed as return of spontaneous circulation (ROSC), the secondary outcome as survival to discharge, and the tertiary outcome as neurological outcome. Results From January 1, 2015, to December 31, 2019, 739 patients were enrolled. ROSC was seen in 324 patients, of whom 60 had survival to discharge and 24 had good neurological outcome at the time of discharge (cerebral performance categories (CPCs) 1-2). The PLR of the ROSC group was 42.41 (range: 4.21–508.7), which was higher than that of the No-ROSC group (p=0.006). The DNI value of the survival group was 0.00 (range: 0.00–40.9), which was lower than that of the nonsurvival group. Conclusions Patients with SCA and subsequent ROSC had higher PLR and NLR, while those with survival to discharge had lower DNI values than those with nonsurvival to discharge (p=0.005).

The Association between Bone Mineral Density and Complete Blood Count in Postmenopausal Women: A Cross-Sectional Study

Objective: To demonstrate the relationship between anemia and complete blood count (CBC) parameters with bone mineral density (BMD) in postmenopausal women. Materials and Methods: A cross-sectional chart-review study was conducted between November 2017 and June 2019. Three hundred twenty-four postmenopausal women aged 50 years or older who had BMD and CBC results were included in the present study. Results: The prevalence of osteopenia and osteoporosis diagnosed by T-score were 53.1% and 32.7%, respectively. Simple and multiple linear regression analyses showed that no association between CBC parameter with BMD except basophil count, which was negatively associated with BMD (p=0.011). There was no correlation between anemia and BMD status (p=0.168). Conclusion: CBC parameters such as hemoglobin or white blood cell count were not statistically correlated with BMD. This is the first study demonstrating that basophil count may be an associated factor for deceased BMD. Keywords: Postmenopausal women, Bone mineral density, Complete blood count, Basophil

Investigation of the relationship between alopecia areata and inflammatory blood parameters.

Alopecia areata (AA) is an inflammatory condition that causes regional shedding without scarring on the hair or eyebrows, eyelashes, and beard. In studies conducted, it has been concluded that platelet/lymphocyte ratio (PLR), neutrophil/lymphocyte ratio (NLR), and mean platelet volume (MPV) are significant indicators of systemic inflammation in various diseases. In the present study, our aim was to examine these parameters in AA patients and to investigate their relationship with the disease. A total of 135 AA patients and 135 healthy controls who did not have any systemic, inflammatory, infectious, or autoimmune diseases were included in this study. Demographic characteristics and complete blood count (CBC) results were analyzed retrospectively and recorded, and statistical analysis was performed. PLR, NLR, and MPV values were not differ between AA patients and the control group. It can be concluded that PLR, NLR, and MPV values are not convenient parameters to show inflammatory response in AA.

Can Automated Hematology Analyzers Predict the Presence of a Genetic Hemoglobinopathy? An Analysis of Hematological Biomarkers in Cambodian Women.

Genetic hemoglobinopathies are the most common single-gene disorder worldwide. Some automated hematology analyzers have the capability of flagging individuals who may have hematological disorders based on complete blood count (CBC) biomarkers. We aimed to evaluate the accuracy of a hematology analyzer in identifying genetic hemoglobinopathies in Cambodian women and to determine which hematological biomarkers are the best predictors. A CBC was completed using a Sysmex XN-1000 analyzer and hemoglobinopathies were determined with capillary hemoglobin electrophoresis for 808 nonpregnant Cambodian women. Sysmex XN-1000 Interpretive Program (IP) messages, which flag potential hematological disorders, were produced from CBC results. Then, 2 × 2 tables were used to determine sensitivity and specificity of the IP message “Hemoglobin defect” to detect a genetic hemoglobinopathy. Receiver operating characteristic (ROC) analyses assessed the diagnostic ability of six CBC biomarkers to predict a genetic hemoglobinopathy. In total, 74% of women had a hemoglobinopathy (predominantly Hb E and α-thalassemia). “Hb defect” IP message sensitivity and specificity for genetic hemoglobinopathy detection were 10.4% and 98.6%, respectively. Variable selection strategies yielded a two-variable model including mean corpuscular volume (MCV) and red blood cell (RBC) count (AIC = 99.83, AUCROC = 0.98 (95% CI: 0.97, 0.99)) for the prediction of a homozygous EE disorder. Sensitivity and specificity values do not justify the use of Sysmex XN-1000 IP flag messages for identification of genetic hemoglobinopathies in Cambodian women. Development of an algorithm based on MCV and RBC biomarkers may optimize the screening ability of automated hematology analyzers.

Isolated Neutropenia/Benign Ethnic Neutropenia: A Common Clinical and Laboratory Finding in Southern and Western Saudi Arabia.

ObjectiveIsolated mild neutropenia is a common clinical problem in some ethnicities including Arabs and Middle Eastern population. The current study aims to authenticate the prevalence of isolated neutropenia in Southern and Southwestern Saudi Arabia, explore the effect of altitude or regional differences and to suggest a new reference range for neutrophil count.MethodsIn this retrospective cross-sectional study, laboratory results of a commercial laboratory were screened over a period of 5 years (2016–2020) in seven different cities of different altitudes in South and southwestern Saudi Arabia. Participants’ laboratory investigations were reviewed and excluded for any abnormal complete blood count, renal profile, liver profile, lipid profile, thyroid function test, fasting blood glucose, or HbA1c findings. Descriptive analysis and 95th percentile range were calculated using standard statistical methods.ResultsA total of 91,880 complete blood count results were included in the final analysis. Isolated neutropenia was common laboratory finding, with a prevalence ranging from 11% to 23%. The 2.5th percentile of the neutrophil count was lower than currently utilized 1.5×109/L in all studied seven cities.ConclusionMild to moderate neutropenia is common in Southern and Southwestern Saudi Arabia. Benign ethnic neutropenia (BEN) likely explains this high prevalence. Since BEN has no clinical significance, the reference range for normal neutrophil counts needs to be adjusted to reflect the effect of BEN.

Reliability of Different RBC Indices and Formulas in the Discrimination of ?-Thalassemia Minor and Iron Deficiency Anemia in Surabaya, Indonesia

In this study, we evaluated the RBC indices in differentiating ?-thalassemia minor and iron deficiencyanemia in a healthcare center. This was an observational analytic study with a cross-sectional design usingblood specimens of children aged 3 years to 17 years with microcytic hypochromic anemia based onthe results of complete blood counts and evaluation of peripheral blood smears. Calculation of the RBCindices was performed as an initial screening to differentiate ?-thalassemia minor and iron deficiencyanemia. Iron profile examination and hemoglobin electrophoresis were performed to confirm the diagnosisof ?-thalassemia minor and iron deficiency anemia. The results of the independent samples t-test showedsignificant differences in Hb, MCV, MCH, and MCHC between ?-thalassemia minor and iron deficiencyanemia (p <0.05). The results of the Mann Whitney test showed a significant difference in the MentzerIndex to distinguish between ?-thalassemia minor and iron deficiency anemia (p <0.05). Also, the resultsof the independent samples t-test showed significant differences in the Green & King formula, Sirdah etal. formula, and the Maltos and Carvalho Index (p <0.05). The Green and King formula has a diagnosticsensitivity of 78.6% and a specificity of 76.6% and an accuracy of 78.03%. Various formulas based on theresults of complete blood count parameters have been developed to detect ?-thalassemia minor in areas witha high prevalence of ?-thalassemia with different sensitivity and specificity. In this study, it showed that theGreen and King formula has a diagnostic sensitivity of 78.6% and a specificity of 76.6%, and an accuracyof 78.03%. Green and King’s formula can be applied as an initial screening to differentiate ?-thalassemiaminor and iron deficiency anemia

Predicting Burn Mortality Using a Simple Novel Prediction Model.

Background Prediction of outcome for burn patients allows appropriate allocation of resources and prognostication. There is a paucity of simple to use burn-specific mortality prediction models which consider both endogenous and exogenous factors. Our objective was to create such a model. Methods A prospective observational study was performed on consecutive eligible consenting burns patients. Demographic data, total burn surface area (TBSA), results of complete blood count, kidney function test, and arterial blood gas analysis were collected. The quantitative variables were compared using the unpaired student t -test/nonparametric Mann Whitney U-test. Qualitative variables were compared using the ⊠2-test/Fischer exact test. Binary logistic regression analysis was done and a logit score was derived and simplified. The discrimination of these models was tested using the receiver operating characteristic curve; calibration was checked using the Hosmer—Lemeshow goodness of fit statistic, and the probability of death calculated. Validation was done using the bootstrapping technique in 5,000 samples. A p -value of <0.05 was considered significant. Results On univariate analysis TBSA ( p <0.001) and Acute Physiology and Chronic Health Evaluation II (APACHE II) score ( p = 0.004) were found to be independent predictors of mortality. TBSA (odds ratio [OR] 1.094, 95% confidence interval [CI] 1.037–1.155, p = 0.001) and APACHE II (OR 1.166, 95% CI 1.034–1.313, p = 0.012) retained significance on binary logistic regression analysis. The prediction model devised performed well (area under the receiver operating characteristic 0.778, 95% CI 0.681–0.875). Conclusion The prediction of mortality can be done accurately at the bedside using TBSA and APACHE II score.

Conidiobolomycosis in Ovine in Southeast Bahia - Brazil

Background: Conidiobolomycosis is a highly lethal, granulomatous disease that primarily affects the respiratory system of sheep. The etiological agents are fungi of the genus Conidiobolus, including Conidiobolus coronatus, C. incongruus, and C. lamprageus. In Northeast Brazil, this disease is particularly important considering the significant impact sheep and goats have on the regional economy. The present report describes the occurrence of conidiobolomycosis in two sheep from the same property in the Itabuna-BA region that were referred to the Veterinary Hospital of the State University of Santa Cruz, Bahia, Brazil. Case: The primary complaint in both animals was bilateral bloody nasal discharge over a period of approximately 15 days and frequent coughing. On physical examination, the animals exhibited “goosebumps” and opaque hair, with a body score of 1 (scale, 1-5), mild dehydration (7%), apathy, frequent cough with putrid odor, bilateral serosanguinolent nasal discharge, craniofacial asymmetry, expiratory dyspnea, enlargement of the retropharyngeal lymph nodes, audible pulmonary rales, and pain on percussion of the pulmonary field. A therapeutic support protocol was established to stabilize the animals until the results of complete blood count, radiography, and microbiological evaluation of nasal content were available. Definitive diagnosis of disease was made by direct positive mycological examination, that revealed the presence of wide rarely septate hyphae, and isolation and cultivation of the fungus Conidiobolus sp., with microculture on slides and staining with lactophenol blue cotton. Due to disease diagnosis and the severity of injuries observed, the prognoses of both animals were considered to be unfavorable and led to euthanasia and necropsy. At necropsy, the most relevant findings were granulomatous rhinitis with ascending inflammatory processes to the meninges and adjacent structures, in addition to cranioventral areas of pulmonary consolidation with drainage of purulent exudate at the cut surface, suggestive of bronchopneumonia. Histopathology revealed intense pyogranulomatous inflammation associated with the presence of hyphae in negative images within the cytoplasm of multinucleated giant cells in the nasal cavity, lungs, meninges, and brain. Discussion: The association of necropsy findings, histopathological changes, and microbiological isolation of the fungus facilitated understanding of the changes observed in the respiratory system and other organs, and enabled correlation between the recorded lesions and clinical manifestations exhibited by the animals. Based on the lesions observed clinically and at necropsy, both cases were diagnosed with rhinopharyngeal conidiobolomycosis. The histopathological and macroscopic changes observed were similar to what are often described in severe cases of the disease. Considering the severity of the disease and its high lethality in these animals, conidiobolomycosis can lead to significant damage of the production chain; this was observed in the present property, where three animals in a herd of 20 died with signs of the disease, highlighting the importance of the disease, particularly in the Northeast region, where the largest flocks of sheep are found in Brazil. The implementation of prophylactic measures is particularly important considering the unfavorable prognosis and the absence of effective treatments.

Evaluation of diagnostic and predictive values of the serum VEGF-A level and systemic immune-inflammation index in small cell lung cancer.

Purpose: To evaluate diagnostic and predictive values of the serum vascular endothelial growth factor-A (VEGF-A) level and systemic immune-inflammation index (SII) in small cell lung cancer (SCLC) patients.Methods: From January 2018 to April 2020, we prospectively enrolled 59 untreated SCLC patients in the study group and 50 non-neoplastic patients in the control group. Blood samples were collected at baseline, after the first two cycles of chemotherapy and at progression in the study group and at entry in the control group. Serum VEGF-A was measured by chemiluminescence, SII was calculated based on complete blood count results, and the relationship between the VEGF-A/SII and clinicopathological characteristics, chemotherapeutic efficacy and progression-free survival (PFS) of SCLC patients was analyzed.Results: Baseline serum VEGF-A was significantly higher in SCLC patients than in non-neoplastic patients (P<0.001), while baseline SII was not (P=0.114). There was no correlation between baseline VEGF-A and SII in SCLC patients (P=0.123); however, there was a significant correlation between baseline VEGF-A and disease stage and central nervous system (CNS) metastasis (P=0.021 and P=0.012, respectively), as well as between baseline SII and disease stage and liver metastasis (P=0.026 and P=0.018, respectively). Serum VEGF-A was significantly lower than the pretreatment level after 2 cycles of treatment (P=0.049) but was not different at progression (P=0.247). Baseline VEGF-A was correlated with the treatment response of first-line chemotherapy (P=0.001), while baseline SII was not (P=0.392). Kaplan-Meier survival analysis suggested that the PFS of first-line chemotherapy was significantly longer in the low-VEGF-A group at baseline than the high-VEGF-A group (11.37 vs. 6.17 months, P<0.001). There was a trend toward longer PFS of first-line chemotherapy in the low-SII group at baseline than the high-SII group, but the difference was not significant (12.10 vs. 9.10 months, P>0.050). Univariate and multivariate Cox regression analyses suggested that baseline VEGF-A (HR: 3.443, 95% CI: 1.330-8.908, P=0.011) was an independent prognostic factor for PFS in SCLC patients.Conclusions: Baseline serum VEGF-A and SII are associated with important clinicopathological characteristics of SCLC patients. VEGF-A, but not SII, has the ability of diagnosis and predicting first-line chemotherapeutic efficacy and prognosis in SCLC patients.

Mean Platelet Volume and Neutrophil/Lymphocyte Ratio among Patients with Ulcerative Colitis as an Indicator of Activation

Introduction: To determine the changes in mean platelet volume (MPV) and the neutrophil/lymphocyte ratio (NLR) in activation period among patients with ulcerative colitis (UC). Methods: Overall, 83 patients (49 female and 34 male) diagnosed with UC were retrospectively screened and includ- ed in this study. The complete blood count results, including hemoglobin, white blood cell (WBC) count, NLR, platelet count, and MPV, of all patients were recorded in both activation and remission periods. The serum C-reactive protein (CRP) and sedimentation levels of all patients were also recorded. Endoscopic disease activities (endoscopic activity index (EAI)) were also noted. Results: Compared with the remission periods, MPV values were statistically significantly lower (p=0.023) and NLR values were statistically significantly higher (p=0.011) in activation periods. In the correlation analysis, MPV levels were correlated with disease age (p=0.019), hemoglobin (p=0.012), WBC count (p=0.009), platelet count (p=0.001), sedimentation rate (p=0.001), CRP levels (p=0.009), and EAI (p=0.008) during activation periods. Conversely, the NLR did not correlate with MPV, hemoglobin, WBC, platelet count, or sedimentation and CRP levels; however, the NLR was also correlated with EAI (p=0.036). Discussion and Conclusion: We have studied two inexpensive, easily applicable, and noninvasive serum biomarkers, MPV and NLR, to determine UC activation and found that these two parameters are well correlated with other inflam- matory markers and EAI.

Okul Çağı Çocuklarında Obezite, Hipertansiyon ve Anemi Sıklığı: Bir Aile Sağlığı Merkezinden Retrospektif Kesitsel Bir Çalışma

Objective: This study aimed to evaluate the frequency of obesity, hypertension and anemia in the periodic follow-up of school-age children and adolescents aged between 6-19 years. Methods: In this retrospective cross-sectional study, weight, height, body mass index (BMI), systolic/diastolic blood pressure measurements and complete blood count results were compiled between January 2018 and August 2019 at a family health center. School-age children and adolescents examined for periodic screening purposes and whose completed measurement records were included while incompleted records were excluded from the study. IBM SPSS 22.0 program was used to analyze the data, and statistical significance was accepted as p&lt;0.05. Results: The follow-up results include the data of 1049 children, (536 boys; 513 girls), with an average age of 11.4±3.2 years. The frequency of obesity, hypertension, anemia, short height, and underweight was 7.3%, 24.5%, 76.6%, 1.9%, and 21.3% respectively. The frequency of anemia was observed higher in girls (85.2%) than in boys (68.6%) (p&lt;0.001). While there is no significant difference between age groups and genders in terms of the presence of hypertension (p=0.299 and p=0.270), a higher hypertension diagnosis rate was observed in primary school children (26.1%) than children with hypertension diagnosis in secondary school (24.3%) and high school (19.9%), significantly (p&lt;0.001 and p&lt;0.001). Although the frequency of hypertension (31%) and anemia (85%) was higher in obese groups compared to other groups, it was not found statistically significant (p=0.151 and p=0.196). Conclusion: This study was performed in a primary health care institution; despite the prevalence of obesity at a similar rate to previous studies, it has demonstrated that one out of every four children was hypertensive or underweight, and almost all of the girls were anemic, resulting in cautionary results in terms of preventing growth and development problems, adult cardiovascular and maternal-fetal mortality risks.

Predictors of serious bacterial infections using serum biomarkers in an infant population aged 0 to 90 days: a prospective cohort study

ObjectiveYoung febrile infants represent a vulnerable population at risk for serious bacterial infections (SBI). We aimed to evaluate the diagnostic accuracy of components of the complete blood count in comparison...

Evaluation of Beta Globin Gene Mutations in Beta Thalassemia Carrier Children in Aydın Province and its Environment

Objective: Beta thalassemia carriers (BTC) in Turkey is observed with a frequency of 2.1%, and it is the most common cause of anemia after iron deficiency. There are few studies showing the effect of genotype on phenotype in beta thalassemia carrying children. The aim of this study is to determine the mutation diversity of these children in and around Aydın and evaluate the effects of these mutations on complete blood count parameters and hemoglobin electrophoresis. Methods: This study included mutation analysis of 65 patients who were diagnosed as BTC in Adnan Menderes University, Faculty of Medicine, Department of Child Health and Diseases, Pediatric Hematology Outpatient Clinic between 01.01.2014 and 01.08.2019. Complete blood count, hemoglobin electrophoresis and mutation analysis results were obtained from the computer data system and patient files. Research data were evaluated by using SPSS 21.0 statistics program. Results: 39 (60.0%) of the sixty-five patients were male, 26 (40.0%) were female, and the mean age was 8.34±4.94 years. When full blood count parameters were analyzed, 87.7% had anemia, 100% microcytosis and high red cell distribution width (RDW) level, 49.2% hypochromia and 87.7% high red blood cell (RBC) count. RDW level was ≥16 in 66.2% of the cases. Seventeen different mutations were detected. The mutations most frequently occurred in “intron 1” gene region (66.1%). The most common ones were IVS I-110 (44.11%), IVS I-1 G&gt;A Heterozygotes (8.8%,) IVS I-6 T&gt;C Heterozygotes (7.5%) and IVS II-745 (7.5%). RDW level was ≥16 in 66.2% of the cases. Seventeen different mutations were detected. The mutations most frequently occurred in “intron 1” (66.1%) gene region. IVS I-110 (44.11%), IVS I-1 G&gt;A Heterozygotes (8.8%,) IVS I-6 T&gt;C Heterozygotes (7.5%) and IVS II-745 (7.5%) were observed most commonly. In patients with IVS I-110 mutation, mean Hb level was 10.55 gr/dL, MCV level was 58.44 fL, RDW level was 16.51, RBC level was 5680x10⁹/L, HbA2 level was 4.77%, HbF level was 2.34%. Mutations detected in 12 patients with HbF level above 5% were as IVS I-110 (5 people), IVS I-6 T&gt;C Heterozygotes, Codon 39 C&gt;T Heterozygotes, IVS I-116, c.25-26 del AA (plys9Valfs) Heterozygotes, c.27dupG (pSer10valfs*14), c316-373 (IVSII-478 C&gt;A Heterozygotes), -87 C&gt;T Heterozygotes. Mentzer index was calculated as &gt;13 in six patients (9.2%). The mutations seen in these patients were IVS-I 110, c.27dupG (p.Ser10valfs*14), c316-373 (IVS II-478 C&gt;A Heterozygotes), -87 C&gt;T Heterozygotes. There were four patients (6.1%) with a RDW index &gt;220. Two of these patients had c.27dupG (p.Ser10valfs*14) and others had c316-373 (IVS II-478 C&gt;A Heterozygotes) and -87 C&gt;T Heterozygotes mutations. Mutations detected in four patients with HbF levels in the range of 9.48-15.67 were IVS I-116 T&gt;G Heterozygotes, IVS I-110 G&gt;A Heterozygotes, c.25-26 del AA (p.lys59valfs) Heterozygotes, c27 dupG (pSer10 valfs*14) and three of these mutations carrying β° mutation type were located in exon 1 and one of them carrying β⁺ mutation type (IVS I-110) was in intron 1. Conclusion: The same mutations detected in patients with beta thalassemia carriers have different effects on complete blood count parameters. HbA2 and HbF levels suggest that these mutations are not effective on the phenotype alone and there may be additional factors which should be clarified. We think that there may be BTC in cases with low RBC, Mentzer index ≥13 and RDW index ≥220, HbA2 &lt;3.5 and studying the mutation analysis of these patients will contribute significantly to the literature.

Integration of pre-surgical blood test results predict microvascular invasion risk in hepatocellular carcinoma

Microvascular invasion (MVI) is one of the most important factors leading to poor prognosis for hepatocellular carcinoma (HCC) patients, and detection of MVI prior to surgical operation could great benefit patient’s prognosis and survival. Since it is still lacking effective non-invasive strategy for MVI detection before surgery, novel MVI determination approaches were in urgent need. In this study, complete blood count, blood test and AFP test results are utilized to perform preoperative prediction of MVI based on a novel interpretable deep learning method to quantify the risk of MVI. The proposed method termed as “Interpretation based Risk Prediction” can estimate the MVI risk precisely and achieve better performance compared with the state-of-art MVI risk estimation methods with concordance indexes of 0.9341 and 0.9052 on the training cohort and the independent validation cohort, respectively. Moreover, further analyses of the model outputs demonstrate that the quantified risk of MVI from our model could serve as an independent preoperative risk factor for both recurrence-free survival and overall survival of HCC patients. Thus, our model showed great potential in quantification of MVI risk and prediction of prognosis for HCC patients.

Reference intervals for complete blood count from Umbilical Cord Blood in newborns and comparison with Venous Blood Values.

Background and Objective:Umbilical cord blood which can be obtained by a non-invasive method can be informative about the clinical status of the newborn. It was aimed to establish reference intervals for umbilical cord blood parameters, and to compare complete blood count results between umbilical cord and venous blood samples in this study.Methods:This study was conducted at Medipol University Sefaköy Hospital, Department of Pediatrics, Istanbul, Turkey. A total of 1898 newborns who were born in a two-year period between January 2018 and December 2019 were included in the study. Venous blood samples were taken from 184 of them, and umbilical cord blood samples were taken from 1714 newborns.Results:The percentiles were determined according to gender and delivery method for the hematological parameters of umbilical cord blood. While mean platelet, eosinophil and mean corpuscular volume values were similar between the groups (p>0.05 for each), and significant differences were found between the groups in terms of all other mean hematological parameters (p<0.05 for each).Conclusion:The results of the complete blood count of umbilical cord blood samples can provide reliable information about the newborn. There are significant differences between umbilical cord and venous blood samples in terms of hematological parameters. For these reasons, it is necessary to determine reliable value ranges for umbilical cord blood hematological parameters in newborns. Data of our study can be a guide for further studies and clinicians.