Blood Count Values Research Articles

Karbon Monoksit Zehirlenme Şiddeti ile Kan Parametrelerinin İlişkisi

Introduction: Carbon monoxide (CO) poisoning is one of the most common poisonings worldwide. Many studies have investigated the relationship between predictive parameters and CO poisoning severity. We aimed to investigate the relationship between blood parameter values with poor outcome in CO poisoning, and CO values measured in blood. Methods: This is a retrospective study. Patients who had CO levels ≥ %10 in their blood gas were included in the study. Patients were divided into 2 groups as those who required hyperbaric oxygen and those who do not. Demographic data such as age, gender of the patients, as well as CO levels in the blood gases of the patients, hemoglobin, leukocyte, neutrophil, platelet counts of the blood count, and MPV and PDW values were recorded. Also, creatinine, troponin, CRP, ALT values were recorded as well. Results: The study was conducted with 110 patients. The mean age of the patients was 46.80±18.18 years. When the parameters were examined, the median WBC count of patients with patients who required HBO therapy was 8.73[7.54-11.83], and the median WBC count of patients who did not require HBO therapy was 8.01[6.96-9.72] (p=0.038). The median lymphocyte count of patients who required HBO therapy was determined as 2.73[1.85-3.36], and this value was found to be higher than patients who did not require HBO therapy (p=0.026). Conclusion: WBC and lymphocyte counts are higher in CO poisoning patients who required hyperbaric oxygen therapy. But these two values were not found to be independent risk factors in predicting hyperbaric oxygen therapy.

The role of immature granulocyte in the early prediction of gastrointestinal tract perforations

Background/Aim: Gastrointestinal system (GIS) perforations cause acute abdomen an indication for emergency intervention. Early detection is very important in gastrointestinal perforations to prevent mortality and morbidity. This study aimed to examine whether immature granulocyte (IG) and IG percentages (IG%) can be used as a simple and easy marker for identifying gastrointestinal system perforations early on.
 Methods: Between January 1, 2020, and January 1, 2022, 120 patients who presented to Hitit University Erol Olçok Training and Research Hospital's emergency service and underwent surgery on by the General Surgery Clinic with the diagnosis of the acute abdomen were investigated. The patients were divided into two groups. Patients in group 1 included those with peptic ulcers and bowel perforations. Group 2 was considered the control group. Of the 36 patients in group 2, 22 had acute appendicitis, 12 had ileus-related bridectomy or bowel resection, and two had acute cholecystitis. The common patient feature in this group was full-thickness or serosal iatrogenic bowel injury and repair. Pre-operative IG and IG% values were obtained from routine complete blood count values. IG and IG% values were compared between groups 1 and 2, and the predictive value of these biomarkers in the early diagnosis of GIS perforations was investigated.
 Results: The mean age of the patients was 55.49 (19.58). The study consisted of 45 (37.5%) female patients and 75 (62.5%) male patients. Group 1 had 84 patients, whereas Group 2 had 36. When the two groups were evaluated, the IG value was higher in Group 1 (P < 0.001). In terms of the percentage value of immature granulocytes, a statistically significant difference was found between Groups 1 and 2 (P = 0.001). As a result, Group 1's IG and IG% values were much greater than those in Group 2.
 Conclusion: IG and IG% values are inflammatory parameters that can be easily studied in routine hematology tests. According to this study, IG and IG% values were found to be higher in gastrointestinal tract perforations based on result blood tests taken at the time of admission to the emergency department.

Prognostic role of pan-immune-inflammation value in patients with metastatic castration-resistant prostate cancer treated with androgen receptor-signaling inhibitors.

To assess the prognostic effect of pan-immune inflammation value (PIV) in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with abiraterone acetate (AA) or enzalutamide. Patients with mCRPC treated with AA or enzalutamide between January 2010 and June 2021 were included in this study. The most recently examined complete blood count values in the 1-month period before treatment were used for calculating PIV. The relationship between overall survival (OS) and PIV was evaluated by multivariate analysis. By using PIV and lactate dehydrogenase (LDH) levels which had shown survival effect at multivariate analysis, PIV-LDH combined score was established. A total of 114 patients were included in this study. At the median follow-up of 34.6 months (95% confidence interval [CI]: 32.4-36.8), the median OS was 21 months (95% CI: 17.6-21.3). The median OS in the low-PIV group was significantly higher than in the high-PIV group (34.4 months (95% CI: 21.3-47.5) vs. 14.3 months (95% CI: 10.0-18.7), p < 0.001). In the multivariate analysis for OS, high PIV (hazard ratio [HR]: 1.86, 95% CI: 1.11-3.13, p = 0.018) and LDH value 1.5 times the upper limit of normal and above (HR: 3.65 95%, CI: 1.86-7.16, p < 0.001) were associated with shorter OS. When survival analysis was performed according to the PIV-LDH combined score, the median OS was 34.4 months (95% CI: 22.2-46.6) in the low-risk group, 17.7 months (95% CI: 11.7-23.6) in the intermediate-risk group, and 8.4 months (95% CI: 5.1-11.7) in the high-risk group (p < 0.001). The C-index of the combined PIV-LDH score was higher than the C-index of PIV (0.65 vs. 0.61). In this study, we demonstrated that PIV was an independent prognostic factor for OS in patients with mCRPC treated with AA or enzalutamide. Additionally, PIV-LDH combined score may be considered a promising composite peripheral blood-based biomarker to predict OS in those patients.

Outcome of Neonates Born to SARS-CoV-2-Infected Mothers: Tertiary Care Experience at US-Mexico Border.

Background: SARS-CoV-2 has affected millions of people around the world. There is a need for data on the effects of this infection on neonates admitted to neonatal intensive care (NICU) units born to infected mothers. Here, we decided to analyze neonates born to mothers who tested positive for SARS-CoV-2 and admitted to NICU compared with neonates who remained with their mothers. Methods: All pregnant mothers who tested positive for SARS-CoV-2 during pregnancy between 1 June 2020 and 30 June 2021, along with all neonates born to infected pregnant women, were included in this study. We then compared the neonates admitted to NICU with the neonates who remained with their mothers. Results: Eighty-eight neonates were born to eighty-eight SARS-CoV-2-positive mothers. Fifteen of these neonates were admitted to the NICU. The mothers of the neonates admitted to the NICU were more likely to have received prenatal care outside of the USA. In addition, the neonates admitted to the NICU were more likely to have needed significant resuscitation at birth. Respiratory distress was the most common reason for NICU admission. None of the NICU-admitted neonates were SARS-CoV-2-positive. There were no differences between the values of the complete blood counts, morbidities at discharge, lengths of hospitalization, or rates of readmission to hospital in the first month of life observed between the two groups. Conclusions: The vertical transmission of the SARS-CoV-2 infection remains rare; there was no difference in the hospital outcomes in the neonates of infected mothers. Unlike other studies, which show an increased tendency toward preterm birth in SARS-CoV-2-positive mothers, our study indicates no such association.

Blood cytology in children with down syndrome

IntroductionDown syndrome is associated with various congenital anomalies and metabolic alterations such as hematological alterations. Values for the major hematological indicators vary with age and sex, but these values have not been described for Mexican children with Down syndrome.ObjectiveTo describe the complete blood count (CBC) values of pediatric patients with Down syndrome in México and report the most common non-malignant hematological alterations.Materials and methodsThe analysis includes data from 450 patients with Down syndrome, 55.5% ware males, aged 0-18 years who were patients at the Mexican National Institute of Pediatrics and whose clinical charts included CBC panel results for the period January 2008 through March 2018.ResultsA total of 3438 CBC panels were analyzed with descriptive statistics to find the values and statistical dispersion of the major indicators, with percentiles, and reported separately by sex and age group. The most common non-malignant hematological alterations found were macrocytic anemia, leukopenia, lymphopenia, and thrombocytosis. There were differences in values in all three series.ConclusionsThe CBC panels and hematological alterations are summarized for patients with Down syndrome.

The Predictive Value of Systemic Inflammation Markers for the Success of Labor Induction with Foley Catheter

Amaç: Sistemik inflamasyon belirteçlerinin foley kateter ile doğum indüksiyonu başarısını öngörmedeki değerini araştırmak. Gereç ve Yöntem: Retrospektif kohort çalışmaya foley kateter ile doğum indüksiyonu uygulanan ≥ 37 hafta, tek, canlı, verteks geliş olan düşük riskli gebeler dahil edildi. Doğum indüksiyonu sonrası sezaryen ile doğumun gerçekleşmesi indüksiyon başarısızlığı olarak kabul edildi. Çalışma popülasyonu doğum indüksiyonu sonrası vajinal doğum yapanlar ve sezaryen doğum yapanlar olarak iki gruba ayrıldı. İki grubun demografik ve klinik özellikleri, prepartum tam kan sayımı değerleri, nötrofil/lenfosit oranı ve platelet/lenfosit oranı karşılaştırıldı. Bulgular: Çalışmaya toplam 308 gebe dahil edildi. Olguların 159’unda (%51,6) doğum indüksiyonu sonrası vajinal yolla doğum gerçekleşirken, 149’unda (%48,4) sezaryen doğum ile gebelik sonlandı. Nulliparite oranı sezaryen ile doğum yapan olgularda (%68,5) vajinal yolla doğum yapanlara (%54,1) göre daha yüksek bulundu (p=0,01). Vajinal yolla doğum yapan ve sezaryen doğum gereksinimi olan olguların lökosit sayıları (9804,9 ± 3283,4 h/mm3’e karşı 10437,1 ± 4439,8 h/mm3), nötrofil/lenfosit oranı (4,7 ± 4,1’e karşı 4,4 ± 3,9) ve trombosit/lenfosit (149,3 ± 67,0’e karşı 139,3 ± 50,1) oranı arasında istatistiksel olarak anlamlı bir fark saptanmadı (p&amp;gt;0,05). Sonuç: Doğum indüksiyonu öncesi bakılan sistemik inflamasyon belirteçleri ile doğum indüksiyon başarısı arasında anlamlı ilişki bulunmadı. Bununla birlikte nulliparitenin foley kateter ile doğum indüksiyon başarısızlığı için bir risk faktörü olduğu saptandı.

Management of deep neck infections in adults and importance of clinical and laboratory findings

This study aimed to analyze laboratory and radiological imaging results in the prediction of treatment strategy in patients with deep neck infections. Eighty-three patients (55 (66.3%) men, mean age: 38.2±14.5...

Predictors of Recurrent Acute Chest Syndrome in Pediatric Sickle Cell Disease: A Retrospective Case-Control Study.

Acute chest syndrome (ACS) is a common cause of death in sickle cell disease (SCD) patients. Multiple studies investigated the risk factors of developing ACS; however, predictors of recurrent ACS episodes have not been thoroughly investigated. We aim to examine the clinical and laboratory predictors of recurrent ACS in pediatric patients with SCD. A retrospective case-control study included pediatric patients with SCD (˂14 years) admitted with ACS or developed ACS during admission for another indication. Patients were classified into recurrent ACS episodes (≥2 episodes) and a single ACS episode groups. Ninety-one ACS episodes (42 patients) were included, with a mean age at diagnosis of 7.18 ± 3.38 years. Twenty-two (52.4%) patients were male, and twenty-five (59.5%) patients had recurrent ACS. Younger age at first ACS was significantly associated with recurrence (p = 0.003), with an optimal cutoff at 7.5 years (area under the receiver operating characteristic curve [AUROC] = 0.833; p < 0.001). Higher SCD-related hospitalizations were significantly associated with recurrence (p = 0.038). Higher mean values of baseline white blood count (WBC) (p = 0.009), mean corpuscular volume (MCV) (p = 0.011), and reticulocyte (p = 0.036) were significantly associated with recurrence. Contrarily, lower baseline hematocrit values (p = 0.016) were significantly associated with recurrence. The ACS frequencies were significantly lower after hydroxyurea (p = 0.021). The odds of ACS recurrence increased with a positive C-reactive protein (CRP) at admission (p = 0.006). In conclusion, several baseline and admission laboratory data showed significant associations with recurrence. Hydroxyurea therapy demonstrated reduced ACS episodes.

Abstract 5901: Germline tissue sequencing in patients with solid tumors uncovers clonal hematopoiesis variants

Abstract The peripheral blood (PB) is broadly used as a source of germline tissue for next generation sequencing in both clinical and research settings. Incidental or secondary findings are often uncovered at the time of germline sequencing. Current guidelines focus on secondary findings as they relate to inherited cancer predisposition. However, sequencing done on the PB has the potential of uncovering cancer-associated somatic variants. Somatic variants in genes associated with hematologic malignancies could indicate the presence of clonal hematopoiesis, clonal cytopenias or in rare instances an undiagnosed hematologic malignancy. In this abstract, we describe leukemia-associated somatic variants identified through whole exome sequencing (WES) in the PB of genomic research participants. A total of 24 patients with clonal hematopoiesis were identified from our institutional cohort of the ORIEN avatar study of 807 patients with solid tumors. Pathogenic and likely pathogenic variants were selected from protein coding sequences and splice sites of 64 genes involved in hematologic malignancies. Matched tumor and PB samples allowed for inclusion of variants found exclusively in the PB sample. Chart reviews were performed, and blood indices were collected for patients with clonal hematopoiesis variants. The median age of patients in this cohort was 73 years old (range 42-82) and 54% (n=13) were still living at the time of chart review. There were 27 variants distributed amongst 24 patients with 8% (n=2) of patients having 2 or more variants identified. The median reported variant allele frequencies (VAF) was 0.447. Most variants were missense (n=14) followed by stop gain (n=5), frameshift (n=3), splice site (n=3), stop lost (n=1), and inframe insertion (n=1). TP53 and DNMT3A (n=4) variants were identified most frequently followed by JAK2, KRAS, MYD88 (n=3), and PTEN (n=2). The rest of the genes accounted for one variant each, including TET2 and IDH2. Complete blood count (CBC) values were recorded for WBC, Hgb, MCV, RDW, platelets, and ANC, 79% (n=19) of patients had abnormal CBCs. No patients in this cohort were seen by a hematologist. Our results indicate that approximately 3% of patients identified in a research based solid tumor cohort had clonal hematopoiesis. Most of these patients had abnormalities in their hematologic parameters and would likely benefit from referral to hematology. Our data demonstrate the importance of considering somatic variation when the PB is used as germline tissue in research settings. Clonal hematopoiesis has significant clinical consequences ranging from risk of blood cancers to cardiovascular disease. We argue for the need to establish accepted frameworks for identification and evaluation of clonal hematopoiesis in participants of genomics research. Further analysis of associations between incidence of CHIP, cancer type, and prior treatment are underway Citation Format: Jennie Vagher, Aaron Atkinson, Mikaela Larson, David Nix, Andrew Post, Courtney Scaife, Jonathan Tward, Cindy Matsen, Jason P. Hunt, Marcus Monroe, Mia Hashibe, Deborah M. Stephens, Nicola J. Camp, Wallace L. Akerley, Trudy Oliver, Douglas Grossman, Sheri L. Holmen, Howard Colman, Randy Jensen, Kevin B. Jones, Afaf E. Osman. Germline tissue sequencing in patients with solid tumors uncovers clonal hematopoiesis variants [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5901.

КЛИНИЧЕСКИЙ АНАЛИЗ КРОВИ ПРИ ДИФФЕРЕНЦИАЛЬНОЙ ДИАГНОСТИКЕ ТУБЕРКУЛЕЗА ЛЕГКИХ И ВНЕБОЛЬНИЧНОЙ ПНЕВМОНИИ У ПАЦИЕНТОВ С ВИЧ-ИНФЕКЦИЕЙ

Abstract. Introduction. Nowadays, methods for detecting Mycobacterium tuberculosis are being improved, but at the same time, general clinical methods of laboratory diagnostics, which include a complete blood count, included in the diagnostic minimum of tuberculosis screening, do not lose their significance. Aim. The aim of the study is to evaluate the value of a complete blood count in the differential diagnosis of pulmonary tuberculosis and pneumonia in patients with HIV infection. Material and methods. The parameters of the complete blood count were studied in 159 patients in the pulmonology department who were at the stage of differential diagnosis with tuberculosis. For analysis, indicators of erythrocyte sedimentation rate, leukocytes, lymphocytes and hemoglobin were selected. According to the diagnostic results, the diagnoses of pulmonary tuberculosis (n=119) and pneumonia (n=40) were verified. Statistical processing was carried out using the statistical software package IBM SPSS Statistics 22.0. Results and discussion. In a comparative analysis of the complete blood count parameters of a group of patients with a confirmed diagnosis of tuberculosis and pneumonia, statistically significant differences were found in the average hemoglobin level (by 13.25 g/l more in tuberculosis, p&lt;0.001) and the average level of leukocytes (by 4.44*109/l less with tuberculosis, p&lt;0.001). When studying the dependence of changes in the main indicators of a clinical blood test in HIV-infected patients on the level of CD4+ T-lymphocytes, a direct correlation (r=0.451) between the number of CD4+ T-lymphocytes and the level of hemoglobin (p&lt;0.001) was established, the lower the number of CD4+ T-lymphocytes the lower the hemoglobin level. Conclusion. A complete blood count does not differentiate between pneumonia and tuberculosis in patients with HIV infection, but can be used in the algorithm for forming a risk group for tuberculosis in a pulmonology department. Being the most important laboratory test, it can evaluate the changes characteristic of inflammatory (infectious) lung diseases.

Innate and Acquired Cellular Immunity in Children with Familial Hypercholesterolemia Treated with Simvastatin.

The aim of this cross-sectional study was to assess the influence of simvastatin treatment in children with familial hypercholesterolemia (FH) on parameters of cellular immunity. Twenty-six children with FH were included, of which thirteen were treated with 10 mg simvastatin for at least 26 weeks, and thirteen were age- and sex-matched with a low-cholesterol diet only. Total WBC count and lipid profile were measured. Flow cytometry was used to identify lymphocyte subsets and determine the expression of adhesion molecules (AM) and toll-like receptors (TLRs) on leukocytes. No differences were found in the basic values of peripheral blood count and subpopulations of lymphocytes between groups. The percentage of granulocytes with the expression of AM was higher in those treated with statins. The TLR-2 expression on granulocytes and monocytes showed higher values, whereas the TLR-4 expression was lower on lymphocytes and granulocytes in simvastatin-treated children. Treatment with simvastatin in children with FH is not associated with alterations in the amounts of granulocytes and monocytes. There is no association between statin treatment and the pattern of peripheral blood lymphocyte subpopulations. The role of AM and TLRs needs further investigation, given the effect of statins on the innate immunity may be important for their efficacy and safety during growth.

Neutrophil-to-Lymphocyte Ratio: An Easy Marker for the Diagnosis and Monitoring of Inflammatory Bowel Disease in Children.

The neutrophil-to-lymphocyte ratio (NLR) is a simple and inexpensive inflammation biomarker that reflects systemic inflammation based on complete blood count values. In our study, we aimed to compare the NLR values in pediatric inflammatory bowel disease (IBD) and in healthy controls, and to define NLR levels in children with IBD during diagnosis, active disease, and remission. NLR values of patients with IBD at diagnosis, remission, and active disease of the patients were recorded retrospectively. Age- and sex-matched healthy subjects enrolled as the control group. Sixty-three patients with IBD and 92 healthy subjects as the control group enrolled. The mean age of the patients with IBD was 9.31 ± 5.24years, and 57.1% were males. The mean NLR values of the patients with IBD at diagnosis and remission were significantly higher than that of healthy controls (p < 0.001). The mean NLR values of the patients at diagnosis and active disease were significantly higher than that of during remission (p < 0.001). The best cutoff of NLR for prediction of diagnosis of IBD in children was 1.46 with a sensitivity of 86.2% and specificity of 93.5%. There was no significant difference regarding NLR between patients with IBD with and without associated diseases. At diagnosis the mean NLR level of patients with Crohn's disease was significantly higher than that of ulcerative colitis (p = 0.019). It was shown for the first time that NLR levels were significantly increased at diagnosis and active disease of childhood IBD, compared to the remission period. We believe that NLR can be a non-invasive inflammatory biomarker that should be used in the initial evaluation and follow-up of the disease activity in children.

Complete blood collection-based systemic inflammation biomarkers for patients with hidradenitis suppurativa.

Hidradenitis suppurativa (HS) is a relatively common chronic inflammatory condition of intertriginous skin. In recent years, the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR) and platelet/neutrophil ratio (PLR) have been shown to be indicators of systemic inflammation correlating with severity of inflammatory conditions. We aimed to analyse for the first time the systemic inflammation biomarkers also including the pan-immune-inflammation value (PIV) and the systemic immune-inflammation index (SII) in HS patients and controls. This study retrospectively investigated clinical and laboratory data of 142 patients with HS. Moreover, a sex-age-matched healthy control group was included. The severity of HS was routinely assessed by the Hurley staging, the mHSS and the SAHS score. All inflammation-based biomarkers were calculated from absolute values of complete blood counts. Receiver-operating characteristics analyses, including the Youden index, were performed in order to determine optimal cut-off values and test performance. Whereas PIV and SII were significantly higher in HS patients, PLR, MLR and PNR were significantly lower in HS patients when compared to controls. Almost all inflammation-based biomarkers significantly correlated with disease severity. However, PIV was the only test that was significantly associated with HS severity as indicated by a Youden index of 0.56 (associated criterion: 756.4; AUC: 0.79, P < 0.0001). Although all systemic inflammation-based biomarkers investigated are more or less associated with HS severity, the PIV appears to have the best performance in this regard. It may be employed in adjunction with the clinical scores for treatment decision making or clinical trial assessments.

Seropositivity and neutralising antibodies at six months after BNT162b2 vaccination in patients with solid tumours

AimPatients with cancer are at an increased risk for severe coronavirus disease of 2019. We previously reported initial findings from a single centre prospective study evaluating antibody response after BNT162b2 vaccine, showing that adequate antibody response was achieved after two doses, but not after one, in patients with cancer vaccinated during anticancer therapy. Herein, we report a follow-up study, evaluating antibody response six months after the second vaccine dose. MethodsThe study included patients with solid tumours undergoing anticancer treatment, and immunocompetent health-care workers serving as controls. Serum titres of the receptor-binding domain (RBD) IgG and neutralising antibodies (Nabs) were measured approximately six months after the second vaccine dose. Complete blood count values were collected and evaluated as predictors for antibody response. ResultsThe analysis included 93 patients with cancer (66.7% metastatic). Six months after the second vaccine dose (mean 176 ± 20 days), seropositivity rate among patients and controls was 83.9% versus 96.3% (p = 0.0001), respectively. Median RBD-IgG titre was lower among patients compared with controls (2.3 versus 3.2, p = 0.0002). Among seropositive individuals, median Nabs titre was similar between patients with cancer and controls (p = 0.566). Among patients with cancer, lymphocyte and neutrophil counts were not correlated with either RBD-IgG or Nabs titres. ConclusionsSeropositivity rates and RBD-IgG titre at six months after second BNT162b2 vaccine dose are lower among patients with cancer compared with healthy controls. However, Nabs titre is similar, suggesting a comparable protection among seropositive individuals. Lymphocyte count is not predictive of antibody response.

Platelet-lymphocyte ratio predicts poor prognosis in stage II/III colon and rectum cancer

Objective: There is an increasing number of studies in the literature reporting that serum platelet/lymphocyte ratio (PLR) can provide useful prognostic data for various cancers. In the present study, the effects of platelet-lymphocyte ratio on survival in stage II/III colorectal cancers (CRC) were examined. Material and Method:A total of 106 Stage II/III CRC patients who underwent curative surgery 2015-2020 were included in the study. Emergency cases and patients diagnosed with other than adenocarcinoma were excluded from the study. The demographic data of the patients, preoperative imaging and laboratory results, postoperative pathology reports, and patient follow-up examination data were obtained from hospital records. The relations between demographic, histopathological, hematological values ​​and the prognosis was analyzed in terms of statistical significance. Results:Among the 106 patients, 62 (58.5%) were male and 44 (41.5%) were female. The mean age was 64.3±12.01 (23-89). The mean follow-up period was calculated as 24.6±15.8 (2-63) months. When the pathology reports were reviewed, it was found that the mean tumor diameter was 5.3±2.33 cm (2-17) and the mean metastatic lymph node was 1.8±2.4 (0-10). The PLR ratio was determined as a poor prognostic factor affecting survival in the cox regression analysis, in which preoperative complete blood count, c-reactive protein and albumin values, neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), and PLR were compared, and was separated from other variables (P=0.002 CI= 95%). When variables such as age, clinical stage, and tumor diameter were included in the model, PLR was similarly found to be an important predictive variable (P= 0.002). When only NLR, LMR, and PLR were evaluated, PLR again came to the forefront with a significance value of P=0.01. Also, high neutrophil count, increased platelet distribution volume (PDW), advanced age, and perineural invasion (PNI) were found to be significant factors in predicting poor prognosis. Conclusions: High PLR is a poor prognostic factor for CRC patients. For this reason, it may be necessary to follow a more aggressive strategy in the management of postoperative treatment in patients who have high PLR.

Relationship of the CRP/albumin ratio and the systemic immune-inflammation index with Forrest classification in patients with gastrointestinal bleeding

Aim: The present study aimed to investigate CRP/albumin ratio and the systemic immune-inflammation index (SII) and Forrest classification in patients who presented to the emergency department with acute upper gastrointestinal (GI) bleeding. &#x0D; Materials and Method: Patients over 18 years of age who presented to the emergency department of our hospital with melena, hematemesis, and hematochezia and were diagnosed with upper GI bleeding via esophagoduodenoscopy were included in the study. Esophagoduodenoscopy results, and accordingly, the Forrest classifications, together with complete blood count, including hemoglobin, platelet, and neutrophil values, as well as demographic characteristics were recorded. SII (calculated by multiplying the platelet count with neutrophil count and dividing the value obtained by the lymphocyte count [platelet (P)×neutrophil (N)/lymphocyte (L)]) and CRP/albumin ratio was calculated.&#x0D; Results: No statistically significant difference was observed among the Forrest classification groups in terms of the median SII values as well as median CRP/albumin ratios. However, a statistically significant difference in median CRP/albumin ratios was observed among the dichotomized Forrest classification groups. &#x0D; Conclusion: The SII is not a reliable parameter either predicts GI bleeding or the Forrest classification in patients with upper GI bleeding. The CRP/albumin ratio might be a poor predictor of bleeding; however, it can not predict the Forrest classification.

Complete Blood Count and Myocardial Markers Combination with Sequential Organ Failure Assessment Score Can Effectively Predict the Mortality in Sepsis: A Derivation and Validation Study.

PurposeThe purpose of our study was to explore the prognostic value of complete blood count and myocardial markers combination with Sequential Organ Failure Assessment (SOFA) score in predicting the 28-day mortality among sepsis patients.Patients and methodsA retrospective observational cohort study was performed. Three hundred and nineteen sepsis patients who were hospitalized at the Second Affiliated Hospital of Chongqing Medical University, China, from January 2019 to September 2021 were included. The clinical and laboratory data, the Acute Physiological and Chronic Health Evaluation II (APACHE II) score and SOFA score at the time of the initial sepsis diagnosis were collected, and the predictive values of the single and combination variables for 28-day mortality were compared.ResultsThe derivation cohort consisted of 221 patients and included 59 (26.7%) died. The area under the curve (AUC) [95% confidence interval (CI)] of RDW and cTnT were 0.735 (0.663–0.807) and 0.753 (0.678–0.827) for mortality, and the cut-off value were 14.05% and 0.039 ng/mL, respectively. The combination of RDW, cTnT and the SOFA score showed a better performance for the prediction of mortality, and the AUC was significantly higher than that of the SOFA score (0.791 vs 0.726, DeLong test: P=0.032). Multivariate Cox analysis identified that the combination of RDW, cTnT and the SOFA score (HR=6.133, P=0.004) and APACHE II score (HR=1.093, P<0.001) were independent detrimental factors for 28-day mortality. The validation cohort consisted of 98 patients and included 23 (23.5%) died. Similarly, the AUC of the RDW, cTnT and the SOFA score combination is significantly higher than that of the SOFA score (0.821 vs 0.739, DeLong test: P=0.035).ConclusionRDW and cTnT showed good performance in predicting 28-day mortality rates among patients with sepsis. Combined RDW and cTnT with the SOFA score can significantly improve the predictive value of SOFA score for the prognosis of sepsis.

Evaluation of patients with acute pancreatitis associated with SARS-CoV-2 (COVID-19); The importance of lipase/lymphocyte ratio in predicting mortality.

SARS-CoV-2 is the cause of a pandemic with high mortality. In the present study, the effects of the lipase/lymphocyte ratio on mortality were investigated in cases diagnosed with Covid-19 and acute pancreatitis. A total of 21 patients who were diagnosed with Covid-19 and acute pancreatitis, 34 patients who were not diagnosed with COVID-19 but diagnosed with acute pancreatitis, and 55 healthy control groups were divided into 3 groups and included in the study retrospectively. The patients who had positive RT-PCR (real‑time polymerized chain reaction) test results were included in the study. Complete blood count and biochemical values ​​of the patients were compared with those of the control group. When the data of the cases diagnosed with COVID-19 and acute pancreatitis were examined retrospectively, the amylase, lipase, lipase/lymphocyte ratio, and D-dimer levels were found to be significantly higher than in the control group (p < 0.01). In the ROC analysis, the amylase, lipase, and lipase/lymphocyte ratio had a high AUC (area under the curve) value (0.993 / 0.949 / 0.978, respectively). The lipase/lymphocyte ratio can be used in cases diagnosed with Covid-19 and acute pancreatitis to predict mortality (Tab. 3, Fig. 3, Ref. 23).

Hematological and biochemical values in Breton breed horses in Brasília-DF.

Due to the scarcity of information on Breton horses, the objective was to study hematobiochemical values of this breed. Blood samples were collected from 29 Bretons, males and females, of different ages, in Brasília-DF, distributed into groups, according to age, without distinction of sex (G1): animals from 4 to 9 years old (n=16) and (G2): from 10 to 26 years old (n=13). The horses were also distributed into males and females for comparisons between the sexes. Values for red blood cells, hemoglobin, creatinine, and urea were statistically higher in females. Fibrinogen was higher in males. Lymphocyte values were higher in G1, but mean corpuscular volume, monocytes, neutrophils, and GGT in G2 were higher than G1. The hematocrit value differed between the ages of the females and was higher than that of the males, while the older male animals showed higher values than the young animals. Females presented lower platelet values than males, with older females having higher platelet values than younger females, in the same way as males. G1 females had the highest leukocyte values. The leukocyte values in males of G2 were higher than those of G1. This same behavior occurred for lymphocytes, eosinophils, and creatine kinase. Considering the albumin and aspartate aminotransferase variables, females had the highest values in the group of animals aged 4 to 9 years. Bretons are considered cold-blooded animals, which is consistent with the observed blood count values. However, it is concluded that these horses have biochemical values similar to warm-blooded breeds.

Toxic Effects of Formalin on Ist Year M.B.B.S. Students: A Cohort Study

Background: Formalin can lead to allergy, toxicity, and carcinomas. In the anatomy department, students get exposed to formalin either by inhaling it or by the skin as fluids containing formaldehyde may be absorbed. Formalin interacts with molecules on the cell membrane producing changes in the nuclei, changes in proteins, vacuolation of cytoplasm, and changes in DNA.&#x0D; Objective: To estimate the toxic effects of formalin on Ist year medical students.&#x0D; Methodology: The participants for this prospective cohort study will be Ist year M.B.B.S. students at Jawaharlal Nehru Medical College, Sawangi (meghe), Wardha. The self-administered questionnaire will be given, and complete blood count and thyroid function tests will be done before the study. After cadaveric dissection, a repeat blood sample will be collected to estimate the complete blood count and thyroid function tests.&#x0D; Expected Results: Exposure to formalin may lead to abnormal values of complete blood count(CBC) and thyroid function tests (TFT).&#x0D; Conclusion: The study can focus on the toxic effects of formalin on Ist year M.B.B.S. students, which may necessitate reconsidering the formalin volume and ventilation issue in the dissecting halls. There should be regular assessment of working practices to control the effects of formalin at the department of Anatomy.