Total Leukocyte Count Research Articles

Assessment of the Severity of Intermediate Coronary Artery Stenosis Using the Systemic Inflammatory Response Index

Background: Fractional Flow Reserve (FFR) is a method that enables the hemodynamic assessment of coronary artery stenosis. The Systemic Inflammatory Response Index (SIRI) is a new marker calculated by multiplying the neutrophil-to-lymphocyte ratio (NLR) with the monocyte count. It is indicative of the presence and severity of coronary artery disease. This study evaluates the relationship between the functional significance of FFR measurements and the SIRI in intermediate coronary stenosis. Methods: A total of 294 patients with 50–70% stenosis in their coronary arteries based on quantitative measurement following angiography who underwent FFR measurement were included in the study before the FFR procedure. Total and differential leukocyte counts and routine biochemical tests were performed. Results: A total of 37% of the patients were found to have a positive FFR, while 63% had a negative FFR. Significant differences were observed in the neutrophil count, monocyte count, Systemic Inflammation Response Index (SIRI), total cholesterol, and amount of adenosine used between the groups (p < 0.05). A SIRI value of 1.16 was 77% sensitive and 55% specific for FFR positivity. Multivariate logistic regression analysis identified the SIRI as an independent predictor of FFR positivity. Conclusions: Our study has demonstrated that high values of the SIRI may serve as a new biomarker for predicting FFR positivity.

Rebound tonometry intraocular pressure reference values for conscious adult Egyptian vultures (Neophron percnopterus).

To obtain standard reference values of intraocular pressure measured with rebound tonometry in conscious healthy Egyptian vultures (Neophron percnopterus). 17 Egyptian vultures presented for a routine health check, involving a full physical examination, blood film examination, Hct, manual total leukocyte count, and plasma biochemistry. 15 animals considered healthy and with no signs of stress underwent an ophthalmic examination, including observation of facial symmetry, adnexa, and direct fundoscopy to screen for ocular disease. Healthy animals, with no evidence of ocular disease and no signs of stress, were included in the study. The birds were manually restraint in an upright position for rebound tonometry of the right and left eyes. Mean and SD of intraocular pressure were 27.33 ± 3.54 mm Hg for the right eye and 27.00 ± 4.11 mm Hg for the left eye. There was no statistical difference when comparing the right and left eyes. The combined mean ± SD for both eyes was 27.2 ± 3.76 mm Hg. Rebound tonometry was well tolerated in all animals included in the study. The results of intraocular pressure with rebound tonometry can be used as reference values during the ophthalmological examination of Egyptian vultures. The investigation of vision threatening diseases in Egyptian vultures may necessitate rebound tonometry as part of a comprehensive ophthalmologic examination. Rebound tonometry values obtained from anesthetized Egyptian vultures, or Egyptian vultures restrained in lateral, dorsal, or sternal positions, may differ from those reported here.

From Cell to Organ: Exploring the Toxicological Correlation of Organophosphorus Compounds in Living System.

Malathion is an organophosphate compound widely used as an insecticide in the agriculture sector and is toxic to humans and other mammals. Although several studies have been conducted at different level in different animal models. But there is no work has been conducted on the toxicological correlation from cellular to behavioral level on surviving species model. Addressing this gap through further research is essential for a comprehensive understanding of malathion's impact on biological systems, facilitating better risk assessment and management strategies. Current research systemically evaluated the effects of malathion on the central nervous system and peripheral immune cells using immunological techniques in the BALB/c mice models. For this, animals were placed inside an inhalation chamber containing malathion (dose of 89.5mg/ml/m3) for a specific exposure time. The group exposed for 6minutes has shown a significant change in plasma-neurotransmitter (serotonin, dopamine) levels and decreased expression of Tyrosine hydroxylase in striatum and SNPC region of brain. The depolarized mitochondria and increased level of cleaved caspase-3 level and mature neurons in DG, CA1 and CA3 were also observed in the brain. Peripheral blood analysis illustrated a decrease in total leukocyte count and an increased level of early apoptosis at the same time point. From neurobehavioral results a significant locomotor hyperactivity, restlessness, and risk-taking behavior was observed. Taken together, results from the current study indicate that exposure to malathion at prolonged time durations induces neuronal and immune cell toxicity, and its toxicity may be mediated via changes in neurotransmitter levels and metabolite concentrations.

A Neonate Presenting With Large Abdominal Mass: A Rare Case of Congenital Leukemia.

Leukemia symptoms occurring in the first 4 weeks of infancy are known as congenital leukemia. We present a case of congenital leukemia in a full-term neonate manifesting at birth with a grossly distended abdomen due to a large abdominal mass. Ultrasonography of the abdomen showed a large abdominal mass originating from the liver. Congenital leukemia was suspected based on the very high total leukocyte counts and the presence of blast cells in the peripheral blood smear, which was confirmed by bone marrow aspiration. The bone marrow aspirate smear showed 42% blast cells. Due to overwhelming sepsis, the baby died at the neonatal intensive care unit on day 4 after birth. This report highlights the atypical presentations of congenital leukemia in the neonatal period.

Anti-asthmatic and antioxidant activity of flavonoids isolated from Mentha longifolia subspecies typhoides (Briq.) Harley. and Mentha longifolia subspecies schimperi (Briq.) Briq. on ovalbumin-induced allergic asthma in mice: In-vivo and in-silico study.

Mentha longifolia L. has been employed to treat cough, lung inflammation, and bronchial asthma disorders. Our study was carried out to investigate the medicinal effect of the flavonoids derived from M. longifolia, specifically didymin, linarin, rutin, and TMF, as well as the whole extracts of M. longifolia subsp. typhoides and M. longifolia subsp. schimperi, in comparison to dexa, in a mice model of ovalbumin-allergic asthma (OVA). After inhaling OVA, the mice developed acute asthma symptoms. Mice were subjected orally to Dexa and/or isolated flavonoids. The study assessed total and differential leukocyte counts, LDH concentration, and total protein concentration in BALF, reduced levels of GSH and total NOx products in lung tissues and analyzed the lung specimens by staining them with hematoxylin and eosin (H & E). Histopathological analysis of the right lung lobes demonstrated that the isolated flavonoids exhibited a significant anti-inflammatory effect higher than Dexa as shown by decreasing the overall and distinct leukocyte counts, LDH levels, and total protein levels in BALF, as compared to the OVA group (p<0.05). TMF was the most effective and the other tested flavonoids are more effective than Dexa but less than TMF. In addition, all tested flavonoids and Dexa significantly (p<0.05) mitigated OVA-induced oxidative stress as evidenced by diminished lung NOx level and elevated GSH level. Computational docking studies proved recognition of didymin, linarin, rutin, and TMF to the human leukocyte elastase binding sites. The tested flavonoids; didymin, linarin, rutin, and TMF successfully inhibit Ova-induced allergic asthma in mice through their anti-inflammatory and antioxidant activities and may represent promising candidate as a remedy for allergic asthma.

Profile and resistance pattern of Stenotrophomonas maltophilia in Dr. Soetomo General Academic Hospital During 2020-2022 Period

Introduction: Stenotrophomonas maltophilia is a challenging respiratory tract pathogen with increasing number of cases. S. maltophilia also shows a high resistance towards various antibiotics. The aim for this study is to know the antibiotic resistance pattern and profile of patient infected with S. maltophilia in order to find out effective antibiotic therapy in treating future cases. Methods: This cross-sectional study uses descriptive analytic method using medical record data of 36 patients infected with S. maltophilia in Dr. Soetomo General Academic Hospital during 2020-2022 period. The measured variables included antibiotic resistance pattern, age, sex, clinical diagnosis, comorbidity, signs and symptoms, medical device usage, total leukocyte count, and mortality rate. Result: S. maltophilia shows highest sensitivity index towards Trimetophrim-sulfomethoxazole (56%). Cases of S. maltophilia is most often found in 0-17 years age group (53%) and male (63%). It may cause infection whether alone or alongside other bacteria. The most common clinical diagnosis that occurs in S. maltophilia infections is pneumonia (81%). Dyspnea is the most occurred symptoms. Hypertension is a common comorbidity. IV infusion is the most used medical device. Might cause infection alongside other bacteria. Leukocytosis is often present. Mortality rate among subjects is 50%. Conclusion: Trimetophrim-sulfomethoxazole is the best treatment for S. maltophilia infections. Cases most often occurs in age 0-17 years, male, diagnosed with pneumonia, and has hypertension as comorbidity. In the future, antibiotics must be used wisely to prevent bacterial resistance and regular changing of medical device is encouraged to prevent nosocomial infections.

Effect of The Garlic as Chelation Therapy in Reducing Lead and Cadmium Deposition on Suckling Mice

The study was conducted on suckling mice to determine the effects of chelation therapy in reducing the deposition of lead (Pb) and cadmium (Cd). A total of 45 suckling mice were randomly divided into three main groups A (control), B, and C. Groups B and C contained Pb and Cd, respectively, at a concentration of 100 mg/kg bwt with 0, 1.70, 3.35, and 6.70% garlic given (B1, B2, B3, B4, and C1, C2, C3, C4). Mice exposed to Pb and Cd exhibited pronounced toxic symptoms along with a marked decrease in total erythrocyte and total leukocyte count, hemoglobin levels, and packed cell volume. Additionally, there is a significant increase in serum glutamate pyruvate transaminase (SGPT) and serum glutamate oxaloacetate transaminase (SGOT) levels. The mean body weight of mice of groups B4, and C4 was the highest among the treated groups. Groups B1 and C1, exposed to Pb and Cd without garlic, showed significant declines in all parameters. Group A (control) shows stable and normal SGOT and SGPT levels. Group C1, exposed to Cd without garlic, experiences the highest increases in both SGOT (98.53 U/L) and SGPT (132.83 U/L), indicating severe liver damage. The group treated with Pb and Cd showed a significant reduction in total erythrocyte count, packed cell volume, and hemoglobin levels after 42-d of treatment. However, mice treated with a combination of Pb, Cd, and 6.70% garlic exhibited nearly normal levels of hematological and biochemical parameters. SGPT and SGOT levels were significantly decreased in all treated groups along with garlic. This experiment demonstrates that garlic possesses both protective and curative effects against Pb and Cd toxicity.

Predictors of Mortality in Patients with Spontaneous Bacterial Peritonitis.

Despite treatment with antibiotic therapy, spontaneous bacterial peritonitis (SBP) accounts for approximately 20-40% mortality in hospitalized patients. The data is scarce regarding mortality predictors in SBP. Recently, multiple factors have been studied for effectiveness in prognosis prediction in SBP. Therefore, in this study, our main objective was to evaluate the mortality predictors in SBP. This prospective observational study was conducted at the Department of Hepatogastroenterology, from January 2022 to June 2023. All the patients aged between 18 and 65 years having decompensated chronic liver disease and diagnosed with SBP were enrolled in the study. The excluded population comprised of those who were on hemodialysis, those having history of any solid organ malignancy or transplantation or patients suffering from infections such as those caused by human immunodeficiency virus (HIV) or infections other than SBP. These patients were followed during the hospital stay and after the discharge monthly for 3 months and then at 6 months to assess mortality. A total of 142 cirrhotic patients having SBP were enrolled in the study. Among them, most of them were males [98 (69%)]. Viral hepatitis (65.4%) was the most common cause of cirrhosis in studied population. On univariate analysis, serum total leukocyte count (TLC), international normalized ratio (INR), ascitic TLC, ascitic neutrophils, ascitic lactate, ascitic LDH, CTP score, MELD-Na were significantly higher while serum albumin was significantly lower in the patients who died as compared to those who survived. However, on multivariate cox regression analysis, high serum TLC (p = 0.013), ascitic fluid lactate (p < 0.001) along with high CTP (p = 0.041) and MELD-Na score (p = 0.037) at presentation were the factors that were identified as an independent poor prognostic factors in SBP population. Cirrhotic patients with SBP are at increased risk of mortality. In our study we observed that high prognostic scores such as CTP and MELD-Na at presentation along with increased white blood cell counts and high ascitic fluid lactate levels at presentation are the potential and reliable predictors of mortality in SBP patients. Kumar D, Kumar V, Khan RTY, et al. Predictors of Mortality in Patients with Spontaneous Bacterial Peritonitis. Euroasian J Hepato-Gastroenterol 2024;14(2):125-128.

EFFECTS OF MELATONIN AS ADJUVANT THERAPY IN TREATMENT OF NEONATAL SEPSIS

Background: Neonatal sepsis is a critical concern, causing significant morbidity and mortality, especially in preterm and low-birth-weight infants. Traditional treatments, including antibiotics and supportive care, often fall short in reducing high mortality rates, emphasizing the need for effective adjunct therapies. Melatonin, known for its antioxidant and anti-inflammatory properties, may offer therapeutic benefits by modulating immune responses and mitigating oxidative stress in neonatal conditions. Objective: This study evaluates the effectiveness of melatonin as an adjunct therapy in neonatal sepsis, focusing on improvements in clinical and laboratory outcomes. Methods: In this randomized controlled trial conducted at the Department of Neonatology at Children Hospital, PIMS, Islamabad from September 1, 2023, to February 28, 2024, 60 neonates diagnosed with sepsis were divided into two groups. The experimental group (Group A) received 20 mg of enteral melatonin in addition to standard care, while the control group (Group B) received standard care alone. Key metrics such as sepsis scores, C-reactive protein (CRP) levels, and complete blood counts were assessed at baseline and 48 hours post-treatment. Results: Significant improvements were observed in the melatonin group, with sepsis scores decreasing from an average of 12.2 ± 3.1 to 6.1 ± 1.8, CRP levels reducing from 12.5 mg/ml to 6.5 mg/ml, and total leukocyte counts dropping from 12,500 cells/µL to 9,800 cells/µL. The control group showed lesser improvements across these parameters. Conclusion: Melatonin shows potential as an adjunct treatment in neonatal sepsis, effectively reducing inflammation and enhancing clinical outcomes. Further research is needed to substantiate these findings and integrate melatonin into broader clinical practices.

Effects of Salinity Changes on Hematological Blood Parameters and Stress Responses in Red Tilapia (Oreochromis spp.) Infected with Vibrio harveyi

The effect of salinity manipulation on the blood parameters and stress responses of red tilapia, Oreochromis spp. During infection with Vibrio harveyi was investigated. The fish were reared in five different salinities (0, 5, 10, 15, and 20 ppt) with three replicates for 30 days and were injected with 106 CFU/mL V. harveyi intramuscularly in all treatments except the negative control. After infection, the fish were observed for clinical signs for 14 days, collected blood samples, and measured stress responses in 0, 2, 3, 4, 5, 6, 7, and 14-days post-infection (dpi) with V. harveyi, meanwhile the cortisol plasma was taken on 0, 2, 3, 4, 5, and 6-dpi. The analysis of blood parameters consisted of total erythrocyte count (RBCs), total leucocyte count (WBCs), hemoglobin (Hb) level, percentage of monocytes (Mon), lymphocytes (Lym) and neutrophils (Neu). The stress response parameters included primary responses (cortisol plasma), secondary responses (blood glucose), and tertiary responses (ventilation rate). The results indicate that salinity manipulation influenced the resistance of red tilapia after infection with V. harveyi.

Point-of-care platform integrated with deep-learning, convolutional neural network algorithms effectively evaluates canine and feline peripheral blood smears.

To perform a diagnostic assessment of a point-of-care veterinary multiuse platform integrated with a model comprised of deep-learning, convolutional neural network algorithms for evaluating canine/feline peripheral blood smears compared to board-certified clinical pathologists (CPs). This study had a blinded, randomized, incomplete block design, and results were compared between CPs and algorithms. Blood smears from convenience samples from veterinary diagnostic reference laboratories from October to December 2021 were used. Study phase A comprised 2 parts: (1) object class identifier algorithm (leukocytes, platelets, polychromatophils, and nucleated erythrocytes) versus CP within the same field of view (FOV); and (2) monolayer detection algorithm plus object class identifier algorithm versus CPs with different FOVs. Study phase B comprised algorithms versus CP for platelet clump identification. Study phase C comprised algorithms versus CP for polychromatophil identification. Metrics including sensitivity, specificity, and agreement were used. The sample size was 59 dogs and 60 cats in phase A, 92 dogs and 69 cats in phase B, and 47 dogs and 12 cats in phase C. For study phase A, part 1, the 5-part leukocyte differential count agreement was 96.6% for canine and 91.7% for feline blood smears, and for part 2, the agreement for estimated total leukocyte, platelet, polychromatophil, and nucleated erythrocyte counts ranged from 70% to 95% across species. In study phase B, the algorithm had 90% sensitivity and 88% specificity. The algorithm for polychromatophils had 100% agreement with CP results in phase C. This platform achieved results comparable to those of CPs. Results are meant to complement automated CBC results. Veterinarians may add this assessment as part of their standard in-clinic hematology analysis for patients.

Acute effect of the maximal cardiorespiratory capacity test on the levels of leukocytes, neutrophils, NK, B and T cells in soccer players

Performance of maximal cardiorespiratory capacity (V̇O2max) tests is common in intermittent aerobic sports such as soccer. V̇O2max test is considered a strenuous exercise, which can modulate immunity. Thus, it is necessary to understand how immunological indicators react after performing a V̇O2max test. We aimed to analyze the acute effect of the V̇O2max test on immunological indicators in football athletes. Pre-experimental trial with a sample of 16 college soccer athletes (male gender, age: 22.0±1.7). The athletes underwent V̇O2max test performed on a mechanical treadmill; respiratory gas analysis occurred by ergoespirometry. Blood samples (20mL) were collected from the athletes at the pre and post V̇O2max test moments. Immunological indicators were determined by complete blood count tests for total leukocyte count and subtypes (lymphocytes, NK-cells and neutrophils) and immunophenotyping (T/B-lymphocytes) by flow cytometry. After V̇O2max testing, there was a significant increase in total leukocyte (Effect-size: 3.4, p: 0.001) and lymphocyte (Effect-size: 3.1, p: 0.001) counts, and a decrease in the percentage of neutrophils (Effect-size: 1.1, p&lt;0.001). There was an increase in T lymphocyte subpopulations: CD3-CD16-56, CD16-56, CD56, CD3, CD3-CD4, CD3-CD8 (Effect-size&gt;0.6, p&lt;0.05), as well as an increase in CD-20 B-lymphocytes (Effect size: 0.6). In soccer athletes, the V̇O2max test promotes increased levels of total leukocytes and lymphocytes, as well as, promotes reduced levels of neutrophils.

Impact of Ovarian Suspensory Ligament Rupture on Surgical Stress in Elective Ovariohysterectomy in Bitches.

Ovariohysterectomy (OVH) is a common procedure in bitches, where ovarian suspensory ligament (OSL) rupture facilitates hemostasis but may also have adverse effects. Given the importance of minimizing the surgical stress response, this study aimed to evaluate the impact of OSL rupture in 20 healthy bitches undergoing elective open OVH; a celiotomy via the ventral midline was performed, and hemostasis achieved using bipolar coagulation, either with OSL rupture (OSL-R) or without (OSL-NR). Pain was assessed over 24 h post-surgery using the Visual Analogue Scale and the Short Form of the Glasgow Composite Measure Pain Scale. The physical parameters, complete blood count, glucose levels, erythrocyte sedimentation rate, and neutrophil oxidative and phagocytic functions were evaluated pre-surgery and at 6, 12, 24, and 48 h, as well as 10 days after. Oxidative metabolism was assessed through vitamin C and protein thiols, reduced glutathione, and thiobarbituric acid reactive substances. No differences in trans- and postoperative pain were observed between techniques, except for analgesic rescue rates. Differences were noted in the heart rate, total leukocyte count, segmented neutrophils, eosinophils, and monocytes. Both techniques resulted in low oxidative and phagocytic changes. Overall, OSL rupture appears to elicit a slightly more intense surgical stress response than the non-rupture technique.

Evaluation of wound healing efficiency using collagen matrices on a thermal burn model

Every year dozens of new local wound treatment agents are developed and improved in the world, which undergo preliminary testing on laboratory animals due to the presence of common phases of the wound healing process with humans. Wound healing effect was studied on a thermal burn model on Wistar rats in 4 groups: 1st - control (natural wound healing); 2nd - intact animals (normal, without burn). 3rd - experimental ( collagen treatment ); 4th - experimental 2 , comparison group (" Levomekol "); Wound healing was assessed based on the results of planimetry on the 1st, 3rd, 5th, 7th, 9th and 13th days and histological analysis of skin tissue on the 6th, 13th and 20th days. Results. Thermal skin damage resulted in a IIIA degree burn, accompanied by the development of dry coagulation necrosis. The use of collagen matrices restored the total leukocyte count and reduced the area of the burn wound. Histomorphometric studies confirmed the dynamics of skin tissue recovery after the burn. The effectiveness of the matrices was comparable to the pharmacopoeial drug " Levomekol ". A higher wound-healing effect was noted with the use of collagen. Conclusion. The wound-healing effect of collagen matrices was established on the thermal burn model, as evidenced by the results of restoration of the number of leukocytes, reduction of the burn wound area and restoration of the skin histostructure .

Comparative effect of two probiotic lactic acid bacterial strains on nutrient digestibility and health status in geriatric dogs

Similar to humans, the population of elderly companion animals is increasing. As dogs age, they experience diminished physical capabilities and metabolic changes, necessitating specialised senior care. Although the use of probiotics as functional food in animal feed is rising, research specifically focusing on geriatric dogs remains limited. This study evaluated the impact of two probiotic strains for their potential on nutrient utilisation and improving health among senior dogs. Fifteen neutered, medium-sized, non-descript geriatric dogs were randomly assigned to three equal groups and fed a basal pelleted diet (CP-25.5%, ME-3100 Kcal/kg) either without probiotics (control; T1) or supplemented with the probiotic strain Lactobacillus johnsonii (109 CFU)( T2) or Enterococcus faecium (3x108 CFU)( T3) of canine origin for 30 days. A three-day digestibility trial was conducted starting from the 28th day. Blood samples were collected on days 0 and 27 to assess haematological parameters. After the 30-day supplementation period, probiotics were discontinued and selected parameters were measured on day 40 to assess the persistence of the effect by the organisms. The study results indicated no significant variations (p &gt; 0.05) in voluntary food intake between the groups. While the digestibility of most macronutrients remained consistent across groups, fibre digestibility improved significantly (p=0.008) in dogs receiving either of the probiotic strain. Additionally, both period-wise and treatment-wise values assessed on 0th, 27th and 40th days were similar across the group with respect to haematological parameters such as haemoglobin level, haematocrit values, differential leucocyte counts and total leucocyte counts. The supplementation L. johnsonii reduced serum glucose level but the persistence effect after the withdrawal of the probiotic was not evident. Overall, the Lactobacillus strain demonstrated superior effects compared to the control and enterococcus in geriatric dogs. Keywords: Geriatric dog, probiotics, Escherichia coli, Clostridium, Lactobacillus johnsonii, Enterococcus faecium

Chamomile flowers extract protects against thinner inhalation-induced lung toxicity via attenuating cytochrome P2E1 activity, surfactant deficiency, and alveolar structural injury in rats

BackgroundLungs are adversely affected by repeated exposure to thinner fumes. This study aimed to examine the pulmonary toxic effects of chronic thinner inhalation and the possible protection by chamomile administration. Adult male Wistar rats were exposed to thinner fumes for 8 weeks (4 h/day, 6 days/week), while chamomile flower extract (400 mg/kg body weight) was given orally during thinner exposure for the same period.ResultsThe study showed lung damage following chronic thinner exposure through increased cytochrome P2E1 (CYP2E1), superoxide anion (O2•−), hydrogen peroxide (H2O2), and malondialdehyde (MDA), with decreased antioxidant enzymes; superoxide dismutase (SOD), and catalase (CAT). Moreover, an elevation of lung enzymes; alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), and lactate dehydrogenase (LDH) with depletion in total protein and albumin contents in serum and bronchoalveolar lavage fluid were observed. Thinner exposure also exhibited increased lung deoxyribonucleic acid (DNA) damage, transforming growth factor-β1 (TGF-β1), insulin-like growth factor-1 (IGF-1), hydroxyproline (HYP), and collagen type 1 (COL-1), with decreased serum surfactant protein-A (SP-A), total and differential leukocytes (WBCs) count, except for neutrophils. Histological investigations revealed deteriorative changes along with accumulated collagen fibers affecting the lung and other respiratory organs.ConclusionSupplementation of chamomile extract succeeded in preventing thinner-induced lung oxidative stress, enzyme leakage, surfactant deficiency, DNA damage, fibrosis, and histological injury. Therefore, consumption of chamomile extract could be recommended for alleviating thinner-induced health hazards and lung toxicity.

Influence of puberty stage in immune-inflammatory parameters in well-trained adolescent soccer-players, following 8-weeks of pre-seasonal preparation training

Aim: The immune system can experience temporary suppression following acute or prolonged strenuous exercise, potentially increasing susceptibility to infections. Young athletes, who must balance school, training, studies, and social life, may further disrupt their immune-inflammatory responses. This study aimed to investigate the effects of an 8-week pre-season training on circulating leukocyte responses in well-trained adolescent soccer-players at different stages of puberty. Methods: Thirty-six soccer players, divided into two groups based on their biological age-under sixteen (U16) and above sixteen (A16)-underwent two rounds of assessments. These included evaluations of anthropometrics, physical fitness, and immune parameters before and after an 8-week pre-season soccer training program. Results: No significant treatment or interaction effects were found for erythrocyte sedimentation rate (ESR), platelets, total leucocyte count, immune inflammation markers (IIM), weekly rating of perceived exertion, body composition, sit-and-reach flexibility, or VO2max (P &gt; 0.05). However, post-intervention neutrophil counts were increased, while lymphocyte counts decreased, and IIM levels rose in both groups (P &lt; 0.05). Neuromuscular explosiveness and strength endurance were significantly higher in the A16 group compared to the U16 group (P &lt; 0.05). Body fat was reduced, and all physical fitness parameters improved in both groups over time (P &lt; 0.05). Conclusions: The 8-week soccer-specific training program did not lead to different effects on immune-inflammatory parameters between youth soccer players at different stages of puberty. However, training adaptations, including improvements in physical fitness, were observed in both groups. This suggests that when the same training load (frequency, duration, intensity) is applied to adolescents at different stages of puberty, immune-inflammatory responses are not significantly influenced by age, but physical fitness improves regardless of puberty stage. A key limitation of this study is the lack analysis of lymphocyte subpopulations, which could provide a deeper understanding of the cellular effects of training on immune function.

Low Renalase Levels in Newly Diagnosed CML: Dysregulation Sensitive to Modulation by Tyrosine Kinase Inhibitors.

Background: A dysregulated proinflammatory microenvironment is considered one of the reasons why current therapies of chronic myeloid leukemia (CML) with tyrosine kinase inhibitors (TKI) do not secure disease control. Therefore, the development of BCR-ABL1-independent therapies is encouraged. Renalase (RNLS) is a multifunctional protein that exhibits both enzymatic and non-enzymatic cytokine-like properties, along with potent anti-inflammatory and anti-apoptotic effects. It is expressed in various tissues, including tumors. Methods: We investigated the levels of RNLS in the blood of CML patients in the chronic phase, treatment naïve patients, and those in remission under TKI treatment (either imatinib or nilotinib) and compared them to healthy individuals. Results: Renalase concentration was markedly decreased in treatment-naive CML patients compared to other groups (p = 0.000), while lower levels in the TKI group were not statistically significant compared to controls. The levels correlated negatively with the total leukocyte and neutrophil count (p < 0.05), while a positive correlation was present with CRP levels in treatment naïve patients. Conclusions: Dynamic regulation of RNLS expression and activity is coupled with transcription factors NF-κB and STAT3. Interpretation of our results might rely on differential requirements of activated STATs (STAT3/5) during CML clone development and maintenance, including the observation of RNLS rise upon TKI introduction. Overall, our research provides new insights into the field of hematological malignancies. Unlike other malignancies studied, RNLS plasma levels are significantly decreased in CML. In future perspectives, RNLS could potentially serve as a diagnostic, prognostic, or therapeutic option for these patients.

Empiric gram-negative antibiotics usage among critically ill patients across 13 ICUs of Nepal: A retrospective cohort study

Background This study aims to investigate the associations between patient characteristics and the receipt of empiric broad-spectrum gram-negative antimicrobials among adult patients admitted to ICUs in Nepal. Methods A retrospective cohort study was conducted in 13 ICUs in Nepal between January 1st, 2020, and December 31st, 2022. Empiric antibiotic use was defined as receiving gram-negative antibiotics within the first two days of ICU admission without evidence of infection from culture. Patient characteristics between patients receiving narrow-spectrum antibiotics and broad-spectrum gram-negative antibiotics were compared. Continuous variables were compared using mean and standard deviation, with mean differences and 95% confidence intervals calculated. Categorical variables were compared using the chi-square test. A multi-level multivariable regression model assessed the relationship between selected variables and broad-spectrum antibiotic usage, treating admitting ICU as a random factor. Results Among 12,349 eligible patients, 8720 (70.6%) received Empiric gram-negative antibiotics. Of those, 3240 (37.15%) received empiric narrow-spectrum gram-negative antibiotics, and 5480 (62.8%) received Empiric broad-spectrum gram-negative antibiotics. Patients receiving broad-spectrum gram-negative antibiotics were older (57.4 vs 53.8 yrs); had higher mean heart rates (97.3 vs 89.5 bpm), respiratory rates (24 vs 21.9), a fraction of inspired oxygen ( 50% vs 40%), blood sugar levels (163.4 vs 153.9 mg/dl), total leucocyte counts (12,685 vs 10,647 cells/cu mm) and serum creatinine (2.06 vs 1.03 umol/l) compared to narrow spectrum antibiotics. Similarly, patients receiving broad-spectrum gram-negative antibiotics had lower systolic blood pressure (122.6 vs 126.5 mm Hg), partial pressure of oxygen (96.7 vs 105.3), and pH ( 7.33 vs 7.36) compared to narrow-spectrum antibiotics. On multivariable regression; patients with readmission, cardiac support, and mechanical ventilation were more likely to receive broad-spectrum antibiotics. Conclusion The rate of empiric broad-spectrum gram-negative antibiotics usage in intensive care units is significantly high and associated with features of increased severity of illness.

Clinical Features and Outcomes of Patients With COVID-19 Infection and Acute Kidney Injury Requiring Hemodialysis in an Intensive Care Unit: A Retrospective Study From a Tertiary Care Center in Eastern India.

During the COVID-19 pandemic, it has been observed that acute kidney injury (AKI) especially requiring intervention support of hemodialysis has notably increased mortality rates among COVID-19-positive critically ill patients;however, comprehensive data regarding this from India, especially the eastern territory, remains sparse. This study aims to outline the demographic, clinical, and biochemical characteristics, along with the outcomes, of these patients. A retrospective study was performed at the All India Institute of Medical Sciences (AIIMS), Patna, from March 1, 2020, to March 31, 2021. Included were patients diagnosed with COVID-19 and AKI necessitating hemodialysis during their intensive care unit (ICU) stay. These patients tested positive for COVID-19 and met the Kidney Disease: Improving Global Outcomes (KDIGO) criteria for AKI stages 1-3, requiring ICU admission and hemodialysis. Medical history, clinical features, laboratory results, comorbidities, and demographic data were collected and analyzed. Patients were tracked from admission to discharge or death. Gaussian-distributed values were compared using the unpaired t-test or Pearson's test, while non-Gaussian continuous variables were analyzed using the Mann-Whitney test or Spearman's test. The study employed the Kolmogorov-Smirnov test to assess Gaussian distribution, while categorical data were compared using the Chi-square test. Among 773 patients with positive COVID-19 tests who were admitted to the ICU, 236 patients developed AKI, andamong them, 139 patients required hemodialysis. The total mortality rate was 167 (70.7%) among people who had AKI and 102(77%) in patients with AKI who required hemodialysis. AKI was also a risk factor associated with higher mortality rates in older patients (>45 years) (n=150 (73.2%)), those needing invasive ventilation (n=163 (88.1%)), and patients with elevated total leucocyte count (TLC) (n=130 (79.3%)), lactate dehydrogenase (LDH) (n=159 (72.9%)), interleukin-6 (IL-6) (n=153 (72.2%)), and serum ferritin (n=51 (73.7%)) and hypoalbuminemia (n=152 (73.1%)). AKI requiring hemodialysis significantly increases mortality risk in COVID-19 patients. Other risk factors for mortality with AKI in COVID-19-positive patients include age, elevated leucocyte count, invasive ventilation, and deranged inflammatory markers.