White Blood Cell Values Research Articles

Nettle (Urtica dioica) supplementation: impact on growth, hematology, immune response, and resilience to Aeromonas hydrophila in Labeo rohita fingerlings.

The significance of plant-derived products in aquaculture lies in their potential to offer sustainable alternatives, promoting eco-friendly practices. This study investigated the impact of nettle (Urtica dioica) leaves powder on the growth efficiency, hemato-biochemical variables and non-specific immune system of rohu, Labeo rohita fingerlings. To achieve this objective, sample average weight (5.23 ± 0.34g) were categorized into four groups, namely control, T1, T2 and T3 in triplicate and administered diets fortified with nettle in amounts of 0, 1, 3 and 5% respectively for a duration of 60 days. After 60 days of fortified diet, the fish underwent intraperitoneal injection with bacteria (Aeromonas hydrophila), and subsequent relative percentage survival (RPS) was observed. The growth performance, including "weight gain (WG), specific growth rate (SGR), feed conversion ratio (FCR) and feed efficiency ratio (FER)", were notably higher in the T3 group (5%) than in others. The hematological values of White blood cell, hematocrit, and hemoglobin revealed higher levels with a fortified diet. The dietary supplementation of nettle reduced serum cholesterol and glucose concentration, whereas it increased albumin, globulin, and total protein in the fish blood. Enhancements in lysozyme and myeloperoxidase activity were observed in the intervention groups with feed containing nettle supplementation. The nettle diet at a 5% concentration demonstrated a higher RPS than the others following injection with A. hydrophila. The findings indicate the potential of nettle as a valuable nutritional supplement for increasing fish immunological reaction and bolstering pathogen resistance.

Sex differences in inflammatory parameters after shoulder arthroplasty and blood loss.

In many diseases, sex differences in diagnostics and therapy play role that is increasingly becoming recognized as important. C-reactive protein (CRP) and white blood cell (WBC) levels are determined as inflammatory markers to detect inflammation and even infection after total shoulder arthroplasty (TSA). The general course of white blood cell, CRP, and hemoglobin (Hb) levels after TSA is well known, but there is insufficient evidence of a possible association with sex. Therefore, we aimed to investigate whether there is an influence of sex on CRP, WBCs, and Hb after TSA in the first 10 days after surgery in a complication-free course in male and female patients and to re-evaluate the specific postoperative CRP, WBC, and Hb course with their maximums (minimum for Hb) and further course until the end of the inpatient period. We retrospectively studied patients treated with TSA, reverse shoulder arthroplasty (RSA), and prosthesis replacement between 2015 and 2021. Patients with active inflammation, rheumatoid arthritis, secondary osteoarthritis, active cancer, and documented postoperative complications were not included. CRP, WBC, and Hb levels before shoulder arthroplasty (SA) and up to 10 days after SA were recorded and analyzed for sex differences. Data from a total of 316 patients (209 women and 107 men) were finally analyzed. There were no sex differences in the CRP and WBC values, but women had significantly lower preoperative Hb values, postoperative Hb values, and minimum Hb values. There were no significant differences in Hb, CRP, or WBC levels in the prosthesis exchange group. The progression of CRP and WBC levels showed no sex-specific significant differences after TSA within the first 7 postoperative days. The study confirmed a decreased Hb value for women at all stages of SA. Blood loss was significantly higher for RSA than for TSA for both men and women.

White Blood Cell and Peripheral Blast Counts in Leukemia Patients with Non-Graying WBC-Diff Scattergram

Graying scattergram of White Blood Cell differential (WBC-diff) is often accompanied by blasts in the blood and/or leukocytosis in leukemia patients. Therefore, monitoring White Blood Cell (WBC) and peripheral blast count is crucial for patient management. In contrast, patients with non-graying WBC-diff scattergrams may have varying WBC counts and peripheral blasts. This study aimed to establish the cut-off values of WBC and peripheral blast counts that could predict a non-graying scattergram in leukemia patients. A retrospective descriptive study with a cross-sectional design analyzed secondary data from 21 leukemia patients. The acute and chronic leukemia diagnosis were based on bone marrow aspirates, which simultaneously showed a graying WBC-diff scattergram on Complete Blood Count (CBC). Receiver Operating Characteristic (ROC) curve analysis was conducted when the patient’s CBC displayed a non-graying scattergram. The cut-off value for WBC count was 16,380 x 109/L with an Area Under Curve (AUC) of 0.932, a sensitivity of 85.7%, p = 0.001, and the cut-off for peripheral blast count was 35.5% with an AUC of 0.872, the sensitivity of 76.2%, p=0.001. The results suggest that a non-graying scattergram of the WDF channel in leukemia is more likely associated with WBC counts below 16,380 x 109/L and peripheral blast counts below 35.5%, which have excellent and good predictive value.

Evaluation of Inflammatory Markers in Predicting Coronary Complexity: Insights from the SYNTAX II Score in NSTEMI Patients.

Objectives: Non-ST-elevation myocardial infarction (NSTEMI) is characterized by the absence of pathological ST segment elevation but an increase in biological markers. The SYNTAX II score (SS-II) is calculated to evaluate the complexity of coronary artery disease and to guide treatment decisions between percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). The aim of this study is to evaluate the relationship of socio-demographic data and biochemical markers with SS-II in NSTEMI patients. Materials and Methods: Six hundred patients who were admitted to the private Aktif International Hospital cardiology clinic between January 2020 and January 2024 and were diagnosed with NSTEMI were included in the study. Severity, extent, and clinical evaluation of atherosclerosis were determined using risk factors, laboratory tests, and coronary angiography. Patients were divided into two groups according to their SS-II score: low (≤ 22) and high SS-II (> 32). Socio-demographic data, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and monocyte-to-HDL-C ratio (MHR) were compared between the two groups. Results: Group 1 (SS-II ≤ 22) included 380 patients, and group 2 (SS-II > 32) included 220 patients. There was a statistically significant difference in HDL, creatine value, white blood cell, troponin I, hs-TnT, and monocyte values in group 2 compared with group 1 (p = 0.001, p = 0.018, p = 0.031, and p = 0.001, respectively). NLR, MLR, MHR, and SS values were statistically significantly higher in group 2 compared with group 1 (p = 0.015, p = 0.002, p = 0.001, and p = 0.001, respectively). The risk factors were found to be significantly associated with high-risk NSTEMI (SS-II > 32) in a logistic regression analysis and included peripheral artery disease (PAD) (OR: 3.028, p = 0.040), troponin I (OR: 3.575, p = 0.015), hs-TnT (OR: 4.221, p = 0.010), NLR (OR: 1.528, p = 0.024). MLR (OR: 5.248, p = 0.012), and MHR (OR: 7.122, p = 0.010). ROC analysis revealed that NLR (AUC: 0.691, p = 0.016), MLR (AUC: 0.731, p = 0.004), and MHR (AUC: 0.824, p = 0.003) had higher predictive power than other parameters in patients with high-risk NSTEMI (SS-II > 32). Conclusions: We found that NLR, MLR, and MHR levels are associated with the severity of coronary artery disease. We think that adding these easily and quickly measurable parameters to routine laboratory results may support the clinician in evaluating the complexity of coronary artery disease and guiding treatment decisions in NSTEMI patients.

Hematological and Biochemical Profiles of Gagnoa High School Students (Côte D’ivoire)

Objectives: The purpose of this study is to determine the normal hematological values and those of some biochemical parameters of the students of the city of Gagnoa (Côte d’Ivoire). Design et Methods: The study was conducted in 184 adolescents (94 girls and 90 boys), aged 11 to 18 years old, recruited in moderne high schools of Gagnoa. The hematological values were determined using an automatic analyzer (Sysmex XP3000, France). The concentrations of biochemical parameters (albumin, protein total, cholesterol total, triglycerides, calcium, magnesium, chloride, potassium and sodium) were determined by spectrophotometer (KENZA MAX BioChemis Try, France) on the venous blood samples were taken from the fold of the elbow with an empty stomach. The results were treated with the statistical analysis software XLSTAT-PRO 7.1. 2018. Results: The median values of red blood cells were 4.5,106/µL (girls) and 4.9,106/µL (boys). The median values of hemoglobin in girls was 12.3 g/dL and among boys was 13 g/dL. The median values of hematocrit girls was 35.9 % and boys was 38 %. The median values MCV were 79.3 fL (girls) and 77 fL (boys). The median values of MCH were 27.6 pg/cell among girls and 26.9 pg/cell among boys. The median values of MCHC girls 34.5 g/dL and boys 34.8 g/dL. The médians values of white blood cells were 6.1.103/µL among girls and 5.8.103/µL among boys. The median values of granulocyte were 2.2,103/µL among girls and 2.4, 103/µL among bboys. The median values of lymphocytes among girls and boys were the same (3,103/µL). The median values of monocyte were 0.7, 103/µL among girls and 0.6 103/µL in boys. The median values of platelet among girls and boys were equal to 247,103/µL and 242,103/µL. The median valeues of protein total among girls and boys were 68 g/L and 69 g/L. The median values of albumin were respectively 47 g/L and 45.7 g/L among girls and boys. The median values of cholesterol total in girls and boys were the same (1.3 g/L). The median values .....

A Comprehensive Analysis Exploring the Vital Role of the Systemic Immune-Inflammatory Index Upon Admission in Severe Hemorrhagic Fever with Renal Syndrome.

To explore the value of the systemic immune-inflammatory index (SII) and the systemic inflammatory response index (SIRI) in patients with severe hemorrhagic fever with renal syndrome (HFRS) upon admission. This study included a total of 165 patients with HFRS, who were divided into mild and severe groups based on the severity of the disease. By reviewing medical records, we collected the white blood cell (WBC), SII, and SIRI values of patients upon admission. Univariate and multivariate logistics regression analyses were performed to identify risk factors for severe HFRS. The receiver operating characteristic (ROC) curve was applied to calculate the area under the ROC curve (AUC) to analyze the predictive value of SII and SIRI for severe HFRS, and the results were compared with WBC and SIRI. Compared with the mild HFRS group, patients in the severe HFRS group had a longer duration of illness (P < 0.05), higher levels of WBC, neutrophil (NEUT), lymphocyte (LYMP), monocyte (MONO), procalcitonin (PCT), SIRI, alanine transaminase (ALT), and creatinine (Scr) (P < 0.05), while lower levels of ALB, platelet (PLT), platelet-to-lymphocyte rate (PLR), and SII, with statistically significant differences (P < 0.05). Binary logistics regression analysis indicated that WBC (OR: 1.190, 95% CI: 1.032-1.371), SII (OR: 0.967, 95% CI: 0.951-0.984), and SIRI (OR: 4.743, 95% CI: 2.077-10.830) were risk factors for severe HFRS. The AUCs of WBC, SII, and SIRI for predicting severe HFRS were 0.765, 0.803, and 0.785, respectively. Low levels of SII and high levels of WBC and SIRI upon admission are risk factors for severe HFRS and have certain value in predicting the progression of HFRS to severe cases, among which SII exhibits the best predictive value.

The Impact of Frailty on the Toxic Reaction of Chemotherapy in Patients With Cervical Cancer: A Longitudinal Study.

Longitudinal research on the impact of frailty on chemotherapy toxicity in patients with cervical cancer is limited. To explore the impact of frailty on chemotherapy toxicity in patients with cervical cancer. Two hundred fifty-nine postoperative cervical cancer patients from a hospital located in Northwest China were enrolled between July 2020 and December 2021. Participating patients were followed up for 4 chemotherapy cycles after surgery. Frailty was measured using the Tilburg Frailty Indicator. Chemotherapy toxic reactions were evaluated using the Common Terminology Criteria for Adverse Events 4.0. Repeated-measures analysis of variance and Cox regression analysis were used to analyze the effect of frailty on chemotherapy toxicity. Cox regression analysis showed that frailty could serve as an independent risk factor for total toxicity (hazard ratio [HR], 5.423; 95% confidence interval [CI], 3.260-9.023; P < .001), nausea (HR, 3.967; 95% CI, 2.446-6.433; P < .001), and vomiting (HR, 3.081; 95% CI, 1.921-4.942; P < .001). Repeated-measures analysis of variance showed that the white blood cell values of the frail group were lower than those of the nonfrail group (Fgroup effect = 4.172, P = .043), and the hemoglobin values of the frail group were lower than those of the nonfrail group (Fgroup effect = 6.589, P = .012). Frailty can increase the risk of total chemotherapy toxicity, nausea, and vomiting. Frailty can reduce the white blood cell and hemoglobin values of postoperative adjuvant chemotherapy cervical cancer patients. Findings may assist healthcare providers in taking effective measures to reduce the toxicity of chemotherapy.

Discharge C-reactive protein predicts 90-day readmission after pancreatoduodenectomy: a conditional inference tree analysis

BackgroundThe aim of this study was to assess the predictive value of discharge C-reactive protein (CRP) and white blood cell (WBC) levels for 90-day readmission after pancreatoduodenectomy (PD). MethodsA two-centre, retrospective study was performed between 2008 and 2022. Receiver operating characteristic (ROC) curve analysis was used to determine the predictive value of CRP level and WBC count at discharge. A conditional inference tree (CTREE) was constructed to identify combined risks within subgroups using variables associated with readmission. ResultsOf 438 patients, 54 (12%) were readmitted. The median WBC count at discharge was comparable between the readmitted and not readmitted groups (9.1 vs. 8.5 G/l). The CRP levels at discharge were predictive of 90-day readmission, with an area under the ROC curve (AUC) of 0.63 (95% CI: 0.55−0.63). A CRP concentration below 105 mg/l ruled out 90-day readmission, with a negative predictive value (NPV) of 90% (95% CI: 81%–95%). CTREE confirmed the diagnostic value of CRP at discharge (AUC = 0.68, 95% CI 0.60–0.68). CTREE additionally identified previous wound infection as a second risk factor for readmission in patients with CRP levels less than 101 mg/l (P = 0.003). ConclusionCRP levels below 105 mg/l at discharge allow for a safe discharge with a low 90-day readmission rate. Wound infection, but not WBC count, was a positive predictor of 90-day readmission with moderate accuracy, suggesting the need for predischarge imaging for undetected complications in this patient cohort. Trial registrationOur retrospective analysis did not require registration with a publicly accessible registry.

Normal range of white blood cells among Sudanese in Wad-Medani, Gezira state, Sudan “2015 to 2022”

Introduction: The white blood cells (WBCs) count is a crucial parameter used to assess the immune system’s function and diagnose various diseases, including infections, autoimmune disorders and certain types of cancers. Appropriate local reference values for hematological parameters are important for diagnosis, treatment, follow up and screening. It is well noticed by practicing medical personnel for many years that, WBCs count in Sudanese patients is much lower than standard references for the rest of the world. SO knowing the baseline values of WBCs in the Sudanese population is essential. Therefore, this study aimed to determine the normal range of WBCs among Sudanese people in Wad-Medani, Gezira state, Sudan. Method and material: Retrospective descriptive cross-sectional study was conducted to patients attending Dr. Ahmed A. Adam private clinic in Wad-Medani city. Sample was selected from medical records from 2015 to 2022 and 1st of August to 2nd of November 2023, by trained medical students in the period from the 1st of August to the 2nd of November 2023. Semi-structured questionnaire containing personal data and other information related to health status was obtained from medical records. Result: A total of 673 healthy participants were included, 357 males (53%) and 316 females (47), with age range between 14 to 100 years. The mean ± SD of WBCs count for the Sudanese population in the study in Wad-Madani state was 6.04 ± 1.31 × 103/ µl Conclusion: The results of this study showed that normal WBCs Count of Sudanese people was similar to WBCs count in African countries but was less than the international count.

The effect of sleep and its restriction on selected inflammatory parameters

Insufficient sleep duration may lead to a series of immune dysfunctions. One of the factors influencing this effect could be physical activity (PA). The study aimed to assess the impact of deprivation of sleep (DS) on selected inflammatory parameters. Seventy-seven participants completed the protocol consisting of polysomnography (PSG) conducted in a sleep laboratory and DS, monitored with an actigraph. PA was assessed with actigraphy, which categorized participants as active or inactive. White blood cells (WBC) values negatively correlated with sleep efficiency based on sleep diaries and PSG parameters (total sleep time, sleep efficiency, and REM duration), but regression analysis showed that WBC depends only on the sleep diary parameter. Granulocytes (GRA) positively correlated with REM latency, and negatively with sleep efficiency. After DS, all participants exhibited an elevated GRA count. The number of WBC and GRA increased also in the active group; inactive participants showed no changes in inflammatory parameters. The overall number of WBC depends primarily on the quality of sleep over a period of several days. Under the influence of sleep deprivation, the number of GRA increases, but the number of leukocytes depends on the level of physical activity during DS.

Assessment of inflammatory biomarkers to identify surgical/death necrotizing enterocolitis in preterm infants without pneumoperitoneum.

Necrotizing enterocolitis (NEC) is a life-threatening disease that affects premature infants. However, the role of inflammatory biomarkers in identifying surgical/death NEC without pneumoperitoneum remains elusive. We aimed to verify the value of platelet-to-lymphocyte ratio (PLR) and the combination of white blood cell (WBC), absolute neutrophil count (ANC), absolute lymphocyte count (ALC), neutrophil lymphocyte ratio (NLR), PLR, C reactive protein (CRP) and procalcitonin (PCT) in predicting the severity of NEC, and to construct a model to differ surgically NEC from non-surgically NEC. A retrospective analysis was performed on 191 premature infants with NEC. Based on the inclusion and exclusion criteria, 90 infants with Stage II and IIIA NEC were enrolled in this study, including surgical/death NEC (n = 38) and medical NEC (n = 52). The values of inflammatory biomarkers were collected within 24h of onset. The univariate analysis revealed that the values of WBC (p = 0.040), ANC (p = 0.048), PLR (p = 0.009), CRP (p = 0.016) and PCT (p < 0.01) in surgical/death NEC cohort were significantly higher than medical NEC cohort. Binary multivariate logistic regression analysis indicates that ANC, PLR, CRP, and PCT are capable of distinguishing infants with surgical/death NEC, and the AUC of the regression equation was 0.79 (95% CI 0.64-0.89; sensitivity 0.63; specificity 0.88), suggesting the equation has a good discrimination. Elevated PLR is associated with severe inflammation in surgical/death NEC patients. The prediction modelling of combination of ANC, PLR, CRP and PCT can differentiate surgical/death NEC from infants with medical NEC, which may improve risk awareness and facilitate effective communication between nurses and clinicians. However, multicentre research is needed to verify these findings for better clinical management of NEC.

Inflammation patterns in early post-operative cholangitis predict long-term outcomes in biliary atresia: a potential role of non-suppurative cholangitis.

Frequent post-operative cholangitis in biliary atresia (BA) affects the long-term native liver survival. This study assessed the characteristics of early cholangitis and their influence on the prognosis. Forty-three patients with BA who underwent surgery between 2000 and 2020 were analyzed for routine inflammatory markers. Early cholangitis characteristics were compared between native liver survivor (NLS) and living donor liver transplant (LDLT) patients. Among the 43 patients, 30 (69.8%) experienced 130 episodes of cholangitis. In the area under the receiver operating characteristics curve (AUROC) analysis, the cutoff value of the total cholangitis episodes was 3, with an area under the AUROC curve of 0.695 (95% confidence interval 0.522-0.868). Before 3years old, 113 episodes (86.9%) of cholangitis were observed. The white blood cell, C-reactive protein, and alanine aminotransferase values at cholangitis onset did not markedly differ between the LDLT and NLS groups. Conversely, the neutrophil-to-lymphocyte ratio in the NLS group was significantly lower than in the LDLT group (0.85 vs. 1.63, p < 0.001). Cholangitis in the NLS group was lymphocyte-dominant and atypical in its pathogenesis. Lymphocyte-dominant cholangitis is non-suppurative, and future research should clarify its pathogenesis to improve the treatment and prognosis of BA.

The Inflammatory Response and Long-Term Outcomes Between Open and Laparoscopic Pancreatoduodenectomy:A Propensity-Matched Single-Institution Study.

Background: In recent years, although laparoscopic pancreatoduodenectomy (LPD) has experienced rapid development both domestically and internationally, however, there are still varying opinions toward LPD. Methods: From January 2020 to July 2022, the data were collected. We compared the inflammatory response at various postoperative time points and evaluated long-term outcomes between the two groups. Results: In the early stage, the LPD group exhibited lower values of white blood cells, C-reactive protein, neutrophils, and platelets after surgery compared with open pancreatoduodenectomy (OPD) (P all<0.05). However, no statistically significant differences were observed in terms of procalcitonin, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio. Before propensity score matching, no statistical significance was observed between two groups, whether in terms of disease-free survival (DFS) (P = .406) or overall survival (OS) (P = .851). However, to further control for confounding factors, propensity score matching was used. The analysis revealed that DFS still showed no significant difference (P = .928), but, in the term of OS, a statistical significance was observed between the two groups. Conclusion: LPD demonstrates a comparable long-term outcomes to OPD and even slightly superior OS. Moreover, the LPD group exhibits a lower inflammatory response during early postoperative period.

Relationship between inflammatory laboratory parameters and severity of adolescent idiopathic scoliosis: A pilot study.

Adolescent idiopathic scoliosis is a complex condition whose pathogenesis may include inflammation and signs of joint and bone degeneration. The main objective of this study is to evaluate the relationship between the severity of adolescent idiopathic scoliosis and inflammatory blood parameters. The study recruited patients with adolescent idiopathic scoliosis who attended the Rehabilitation Center of the Apostolo Foundation in Merate (LC). The scoliosis curve (Cobb's angle) was used as a severity index to compare with inflammatory blood parameters (white blood cells subpopulations, immunoglobulins, protein electrophoresis). In addition, the study used an overall severity grading called "Scoliosis Score" which includes all spine angles and Risser's score (bone development index). Thirty-four subjects were recruited (mean age 14years, 2months), 30females and 2males. A significant correlation was found between Cobb's angle and the percentage values of beta-2 globulins in a directly proportional manner (r= 0.42, p= 0.01), and gamma globulins in an inversely proportional manner (r=-0.366, p= 0.04). However, no significant correlation between Cobb's angle and the absolute values of white blood cells and percentage subpopulations was found (r= 0.0821 p= 0.655). A moderate, inverse correlation was found between the Scoliosis Score and the percentage of neutrophils (r=-0.385, p= 0.02), a direct correlation was found between the Scoliosis Score and the percentage of lymphocytes (r= 0.404, p= 0.02). In addition, there was a strong correlation of the Scoliosis Score with alpha-2 globulin (r= 0.564, p= 0.0012), beta-1 globulin (r= 0.478, p= 0.0074), and beta-2 globulin (r= 0.370, p= 0.044) and an inverse relationship with gamma globulin (r=-0.625, p= 0.0002). The main correlations were confirmed by regression analysis. The correlation between beta-2 globulins and gamma globulins with Cobb's angle and the Scoliosis Score suggests a link between spinal curvature and inflammation in scoliosis patients, This link may indicate the significance of these parameters for diagnosing, staging the disease, and monitoring therapies.

Interpretation of inflammatory markers in lung cyst hydatid disease.

Studies on alterations in inflammatory markers and risk factors for perforation in hydatid cysts of the lung are rare. In our study, we planned to investigate the effect of inflammatory markers on prognosis of hydatid cyst disease. 37 patients underwent surgery for pulmonary hydatid cyst between February 2022 and October 2023 and analyzed retrospectively. Inflammatory markers were calculated from preoperative and postoperative 3rd-month peripheral blood results. Cyst size was 58.5 ± 28.0mm, 5 patients had bilateral cysts and 11 patients had multifocal cysts. Preoperative white blood cell, white blood cell difference, preoperative and postoperative eosinophils, preoperative neutrophils, neutrophils difference, preoperative systemic immune inflammatory index, systemic immune inflammatory index difference and preoperative eosinophil lymphocyte ratio were higher in patients with perforated cysts, the cut-off value for preoperative white blood cell for perforation was 10,535, preoperative cut-off value for eosinophils was 230, preoperative cut-off value for neutrophils was 8815, the cut-off value for preoperative systemic immune inflammatory index was 1129.83 and the cut-off value for preoperative eosinophil-lymphocyte ratio was 0.09. In patients with preoperative eosinophil, neutrophil, white blood cell, eosinophil-lymphocyte ratio and systemic immune inflammatory index values above the cut-off value, the probability of perforation increased 7.5, 13.6, 6.3, 9.6, and 9.3 times, respectively.

Predictiveness of preoperative laboratory values for postoperative delirium.

Postoperative delirium (POD) is a common postoperative complication, especially in patients over 60 years, with an incidence ranging from 15% to 50%. In most cases, POD manifests in the first 5 days after surgery. Multiple contributing risk factors for POD have been detected. Besides the predisposing factors such as higher age, cognitive impairment, high blood pressure, atrial fibrillation, and past stroke, pathophysiological mechanisms like neuroinflammation are also considered as contributing factors. In a subanalysis of the "PRe- Operative Prediction of postoperative DElirium by appropriate SCreening" (PROPDESC) study, the preoperative laboratory values of sodium, potassium, total protein, hemoglobin concentration (Hgb), and white blood cells as well as the biomarkers creatinine, HbA1c, NT-pro-BNP, high sensitive Troponin T (hsTnT), and C-reactive protein (CRP) were assessed to investigate a possible relationship to the occurrence of POD. After correction for age, physical status classification, surgery risk after Johns Hopkins, and operative discipline (cardiac surgery vs. noncardiac surgery), male patients with a Hgb <13 g/dL had significantly higher odds for POD (p = 0.025). Furthermore, patients with CRP ≥ 10 mg/L, HbA1c value ≥ 8.5% as well as patients with hypernatraemia (>145 mmol/L) presented significantly higher odds to develop POD (p = 0.011, p < 0.001, and p = 0.021, respectively). A raised (>14-52 ng/L) or high (>52 ng/L) hsTnT value was also associated with a significantly higher chance for POD compared to the patient group with hsTnT <14 ng/L (p < 0.001 and p = 0.016, respectively). Preoperative Hgb, CRP, HbA1c, sodium, and hsTnT could be used to complement and refine the preoperative screening for patients at risk for POD. Further studies should track these correlations to investigate the potential of targeted POD protection and enabling hospital staff to initiate POD-preventing measures in time.

The Value of Red Cell Distribution Width and Its Correlation with Other Parameters in Ovarian Cancer

Abstract Background: The red cell distribution width (RDW) is a measure of the range of variation in the red blood cell size. It reflects red blood cell volume heterogeneity and is a part of the whole blood cell count. The use of the RDW in the diagnosis of malignant tumors has recently attracted much attention. Related research has mainly focused on endometrial cancer, lung cancer, and liver cancer. Aim of the Study: This study investigated the correlation between the RDW and ovarian cancer by observing changes in the RDW in patients with different stages of ovarian cancer. Patients and Methods: A case–control study involving 50 females with ovarian cancer and 50 healthy females conducted at Baghdad Oncology Teaching Hospital, and Al-Imamian Al-Kadhimiyain Medical City from January 1, 2022, to December 30, 2022. Data collection included demographic data, complete blood count with the calculation of platelets to lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR), transferrin saturation, and cancer antigen 125 (CA-125). Adult females with histologically proven ovarian cancer were included in this research. Patients with conditions that affect red blood cells were excluded from the study. Results: The mean age was 52.6 ± 10.4 years old for the cases and 50.0 ± 11.4 years for the control group. Platelets count (PLT), absolute neutrophil count (ANC), PLR, NLR, RDW, and CA-125 were significantly higher in the women with ovarian cancer in comparison to the control group (P &lt; 0.001). RDW values were found to be positively correlated with white blood cell, PLT, ANC, NLR, PLR, and CA-125 values (P &lt; 0.001). RDW values were also positively associated with cancer stage; thus, higher values of RDW are to be expected with a higher stage of cancer (P &lt; 0.001). The optimal cutoff point for RDW was found to be 14.6% with a sensitivity of 92%, specificity of 90%, and an area under the curve of 96%. Conclusion: The RDW is increased with ovarian cancer, and a clear cutoff point for the prediction of ovarian cancer has been observed. Furthermore, RDW was positively correlated with cancer stage and inflammatory markers including PLT, ANC, PLR, NLR, and a tumor marker CA-125.

Evaluation of systemic immune inflammation index and neutrophil-to-lymphocyte ratio in schizophrenia, bipolar disorder and depression.

Numerous studies consistently report on the frequent presence of low-grade systemic inflammation in individuals with schizophrenia, bipolar disorder (BD), and depression. Neutrophil-to-lymphocyte ratio (NLR) and arecently established marker, systemic immune inflammation index (SII), are markers used to assess systemic inflammation and immune response. In this study, NLR and SII index values were examined and compared across patients diagnosed with major psychiatric disorders and healthy controls. The study included, totaling 129 patients, encompassed individuals who were diagnosed with schizophrenia in remission or BD in the euthymic period, and those undergoing treatment for major depressive disorder (MDD). The control group consisted of 62 healthy individuals. White blood cell (WBC), neutrophil, lymphocyte, platelet, and monocyte counts obtained retrospectively from complete blood profiles served as the basis for calculating NLR and SII values. In this study, higher WBC, neutrophil counts, NLR, and SII values were observed in schizophrenia and BD patients compared to the control group. In patients with MDD, no significant difference was found in terms of inflammatory blood cell markers compared to healthy controls. Higher NLR and Sİİ values were found in patients with schizophrenia and BD compared to patients with MDD. The results of the study indicate that the significant difference in NLR and SII values persists after treatment in patients with schizophrenia and BD, and that the abnormal inflammatory response continues during the treatment process (Tab. 2, Ref. 41).

Growth and physiological response of Nile tilapia (Oreochromis niloticus) fed a fermented mixture of plant protein sources

This study aimed to assess the effects of diets containing a blend of plant protein sources (cottonseed meal, sunflower meal, and jojoba meal) fermented with yeast (Saccharomyces cerevisiae) at three different levels (25 %, 50 %, and 75 %) instead of fishmeal (FM) on the growth performance, anti-nutritional factors content, and blood profile response of Nile tilapia (Oreochromis niloticus). Four experimental diet (33.6 % crude protein) and (18.61 MJ kg−1 gross energy) were formulated. The study included four diets: a control diet, FCSJM-25 %, FCSJM-50 %, FCSJM-75 % which replaced fishmeal based on protein content. Fries (3.53± 0.07 g) were randomly allocated into twelve glass aquaria (180 L capacity) in triplicate per each treatment (25 fish/ aquarium) for 90 days. After the 90-day feeding trial, the results showed that fish fed the control diet, FCSJM-25 %, and FCSJM-50 % had the highest final body weight, weight gain, specific growth rate, and average daily gain, whereas fish fed FCSJM-75 % had the lowest values for these parameters. The best feed conversion ratio (FCR) was observed in fish fed FCSJM-25 % or FCSJM-50 % (P < 0.05). The highest apparent protein digestibility was found in fish fed the control diet or FCSJM-25 %. Diets with FCSJM-25 % had the highest white blood cells (WBCs) values (P < 0.05). Control diet, FCSJM-25 %, and FCSJM-50 % resulted in the highest levels of complement component (C3), C4, growth hormone, and IgM (P < 0.05). However, control diet had the highest triglyceride and HDL levels, while fish fed FCSJM-25 % had the highest levels of LDL (P < 0.05). Fish fed a diet with FCSJM-50 % recorded the highest cholesterol content. The control or FCSJM-25 % diets showed the highest values of creatinine, phosphorus, and calcium (P < 0.05). There were no significant differences in ALT, AST, and uric acid among the treatments. The study concluded that FM can be replaced with either FCSJM-25 % and FCSJM-50 % without affecting growth performance and feed utilization.

Biopsy-Proven Gastric Pathological Findings in Mechanically Ventilated Intensive Care Unit Patients.

Objectives Helicobacter pylori (H. pylori) is known to affect a large proportion of the world population. It plays a role in the pathogenesis of peptic ulcer (PU) and increases the likelihood of bleeding. In critically ill patients in intensive care units (ICUs), the risk of bleeding may be much higher due to many concomitant factors. The study aimed to determine the activation of H. pylori in mechanically ventilated (MV) intensive care patients and compare this with the general population. Methods This study was performed retrospectively by screening patients who underwent esophagogastroduodenoscopy and histopathological sampling in our hospital between January and June 2023. The study included 79 patients aged between 18 and 85 years. The patients were categorized into two groups: 35 patients in the ICU with mechanical ventilation (MV) support (EMV) and 44 patients who presented to the gastroenterology department due to dyspeptic symptoms and underwent endoscopy (ED). Age; sex characteristics; laboratory parameters such as hemoglobin (Hb), hematocrit (Htc), mean cellular volume (MCV), white blood cell (WBC), neutrophil, platelet, glucose, urea, creatinine, aspartate transaminase (AST), alanine transaminase (ALT), C-reactive protein (CRP), albumin, ferritin, thyroid-stimulating hormone (TSH), anti-hepatitis C virus (HCV), hepatitis B surface antigen (HBsAg), anti-HIV; and biopsy results (H. pylori positivity, intestinal metaplasia, and atrophy) were recorded. Results A total of 79 patients who underwent gastric biopsy were assessed. There were 35 patients in the EMV group and 44 patients in the ED group. There was no difference in gender and age distribution between the groups. Hb and Htc were significantly lower in EMV compared to ED (p=0.001). Hb was 9.4±1.7 g/dL in EMV and 10.8±2.1 g/dL in ED. Htc was 29.6±5.1 in EMV and 33.5±5.7 in ED. MCV, WBC, glucose, urea, AST, ALT, CRP, and ferritin values were statistically significantly higher in EMV (p<0.05). Albumin and creatinine levels were statistically significantly lower in EMV (p<0.05). There was no significant difference between the groups in terms of neutrophils, platelets, and TSH. In the EMV group, H. pylori activity was negative in 31 (88.6%) patients and positive in four (11.4%) patients. In the ED group, H. pylori activity was negative in 30 (68.2%) patients and positive in 14 (31.8%) patients. There was a statistically significant difference between the groups in terms of H. pylori positivity (p=0.032). Conclusions The prevalence of H. pylori in MV patients in the ICU is low compared to the average population. The incidence of atrophic gastritis and intestinal metaplasia is the same. The present study supports that ICU cases do not have a higher risk of gastric premalignant lesions compared to the average population.