Leukocyte Values Research Articles

Clinical characteristics and diagnostic accuracy of preliminary diagnoses in adults with infections in Danish emergency departments: a multicentre combined cross-sectional and diagnostic study

ObjectiveRapid and accurate infection diagnosis is a prerequisite for appropriate antibiotic prescriptions in an ED. Accurately diagnosing acute infections can be difficult due to nonspecific symptoms and limitations of diagnostic...

CSF Prognostic Index in Ventriculoperitoneal Shunt Infection

Considering the consequences of shunt infection, the importance of early diagnosis and effective treatment becomes clear. However, there is no clear parameter to predict the management of shunt infection. Since we thought that an index including cerebrospinal fluid (CSF) leukocyte, glucose, and protein levels may affect treatment guidance, we aimed to investigate its effect on prognosis using the index we defined as CSF prognostic index. Ventriculoperitoneal shunt infection patients' age, gender, etiology of hydrocephalus, serum glucose, leukocytes, white blood cell, CRP, CSF leukocyte, glucose, and leukoglycemic index (LGI) at admission were included. A new index was defined to include leukocyte, glucose, and protein values in CSF and investigate their effect on prognosis. CSF prognostic index = CSF leukocyte x CSF protein / CSF glucose. The study included 46 patients under 18 years of age with shunt infection. There was no correlation between serum glucose, CRP, leukocytes, monocytes, lymphocytes, platelets, serum LGI, CSF LGI and treatment duration. A positive correlation was found between CSF prognostic index and treatment duration, which was statistically significant (p = 0.011). The CSF prognostic index is an index that can be easily evaluated with CSF findings at the time of presentation and can predict both the duration of treatment and the need for intrathecal treatment. Considering the use of broader spectrum antibiotherapies initially in patients with a high CSF prognostic index will avoid possible complications, provide less psychosocial impact on the patient and his/her relatives, and reduce the cost of treatment.

Phytochemical, Growth Performance and Haematological Indices of Aqueous Extract of Aphrodisiac Formulation against Acetaminophen Induced Hepatocyte Injuries in Wistar Rats

Zainacin Dadin duniya is known for its antioxidant and liver-protecting properties. This research assesses the phytochemical characteristics and impact of Zainacin Dadin Duniya water extract on growth and hematological factors in Wister rats with acetaminophen-induced liver damage. 60 female and 30 male rats were divided into five groups with each group consisting of 18 rats selected randomly. Group 1 received saline, group 2 received a liver medicine, group 3 received acetaminophen, group 4 received a daily dose of aqueous extract at 500 mg/kg, and group 5 received a daily dose of aqueous extract at 500 mg/kg along with 3 ml/day of acetaminophen, all administered for 28 days. The animals were weighed before and following the experiment. The hematological parameters were determined, including packed Cell Volume (PCV), Red blood Cell (RBC), Haemoglobin (Hb), Mean Cell Volume (MCV), and White Blood Cell (WBC). Findings indicated that the extract contains a considerable quantity of phytochemicals. Findings indicated a notable weight gain (P<0.05) in Groups 1, 2, 4, and 5 and weight reduction in Group 3. In Group 3, there was a significant decrease in erythrocyte counts (4.29%), packed cell volume (33.00%), and hemoglobin (6.17%) values, while there was an increase in leukocyte (9.62%) and Mean Cell Volume (54.33%) values compared to the other groups. The presence of acetaminophen in the treatment given to Group 3 rats could lead to a decline in their growth performance and trigger adverse reactions in their blood parameters, potentially impacting their overall development. The segment may act as a strong remedy for acetaminophen-induced hepatocytes by blocking those reactive oxygen species.

Correlation of the severity of the clinical presentation of SARS-CoV-2 pneumonia with respiratory function parameters in the post-COVID period.

Since COVID-19 first surfaced in 2019, it has seriously threatened public health. The most prevalent symptoms are respiratory ones. This study aimed to present the correlation between the severity of the clinical presentation of the disease and the results of respiratory function tests conducted within 6 months after hospital discharge. This retrospective study included 99 patients with confirmed SARS-CoV-2 virus infection. Of all patients 24.2% had accentuated bronchovascular pattern, 9.1% had unilateral, and 29.3% had bilateral pneumonia. In comparison, 35.4% patients had diffuse changes, which were described as acute respiratory distress syndrome (ARDS) on computed tomography (CT). Patients with unilateral, bilateral pneumonia or diffuse lung damage had significantly lower forced vital capacity (FVC) values. They were treated with non-invasive mechanical ventilation (NIV) or invasive mechanical ventilation (MV) and had lower FVC values (0.039). A negative, weak correlation existed between CT findings during the infection and Diffusing capacity for carbon monoxide (DLCO) measured after the infection (0.003). A negative, weak correlation was found between oxygen therapy, the use of NIV, and MV findings during the infection with DLCO. A negative correlation was noted between leukocyte values during the infection and forced expiratory volume in the first second (FEV1) and FVC after the infection. Patients with COVID-19 infection who need oxygen support and MV continue to suffer from loss of respiratory function after the resolution of COVID-19 infection. These findings highlight the negative predictive value of pulmonary tests in the long-term follow-up for the development of PC-ILD as well as decreased pulmonary capacity.

The Utility of C-Reactive Protein, Procalcitonin, and Leukocyte Values in Predicting the Prognosis of Patients with Pneumosepsis and Septic Shock.

Background and Objectives: The predictive value of changes in C-reactive protein (CRP), procalcitonin, and leukocyte levels, which are commonly used in the diagnosis of infection in sepsis and septic shock, remains a topic of debate. The aim of this study was to evaluate the effectiveness of changes in CRP, procalcitonin, and leukocyte counts on the prognosis of 230 patients admitted to the intensive care unit (ICU) with the diagnosis of sepsis and pneumonia-related septic shock between 1 April 2022 and 31 December 2023, and to investigate whether any of these markers have a superior predictive value over the others in forecasting prognosis. Materials and Methods: This single-center, retrospective, cross-sectional observational study included patients who developed sepsis and septic shock due to community-acquired pneumonia and were admitted to the ICU. Demographic data, 1-month and 90-day mortality rates, length of stay in the ICU, discharge to the ward or an outside facility, need for dialysis after sepsis, need for invasive or noninvasive mechanical ventilation during the ICU stay and the duration of this support, whether patients admitted with sepsis or septic shock required inotropic agent support during their stay in the ICU and whether they received monotherapy or combination therapy with antibiotics during their admission to the ICU, the Comorbidity Index score (CCIS), CURB-65 score (confusion, uremia, respiratory rate, BP, age ≥ 65), and Acute Physiology and Chronic Health Evaluation II (APACHE-II) score were analyzed. Additionally, CRP, procalcitonin, and leukocyte levels were recorded, and univariate and multivariate logistic regression analyses were performed to evaluate their effects on 1- and 3-month mortality outcomes. In all statistical analyses, a p-value of <0.05 was accepted as a significant level. Results: According to multivariate logistic regression analysis, low BMI, male gender, and high CCIS, CURB-65, and APACHE-II scores were found to be significantly associated with both 1-month and 3-month mortality (p < 0.05). Although there was no significant relationship between the first-day levels of leukocytes, CRP, and PCT and mortality, their levels on the third day were observed to be at their highest in both the 1-month and 3-month mortality cases (p < 0.05). Additionally, a concurrent increase in any two or all three of CRP, PCT, and leukocyte values was found to be higher in patients with 3-month mortality compared with those who survived (p = 0.004). Conclusions: In patients with pneumoseptic or pneumonia-related septic shock, the persistent elevation and concurrent increase in PCT, CRP, and leukocyte values, along with male gender, advanced age, low BMI, and high CCIS, CURB-65, and APACHE-II scores, were found to be significantly associated with 3-month mortality.

Antibiotic susceptibility of orofacial infections in Bratislava: a 10-year retrospective study

ObjectivesAim of this study was to analyse causal microbiological agents and their bacterial resistance in orofacial infections requiring hospital admission.Materials and methodsPresented is a 10-year retrospective study of patients hospitalised at a single department in 2014–2023. 744 patients were involved. In the statistical analysis, following data was evaluated: causal microbes and their resistance to Penicillin, Amoxicillin-Clavulanate, Clindamycin and Metronidazole.ResultsMost frequent aetiology was odontogenic with causal tooth in socket (n = 468; 62,9%), followed by odontogenic – post extraction (n = 152; 20.4%), jaw fracture (n = 41; 5.5%), sialadenitis n = 31 (4.2%), osteonecrosis n = 22 (3.0%), oncological diagnosis in head and neck (n = 17; 2.3%), unknown (n = 10; 1.3%) and multiple factors (n = 3; 0.4%). 408 patients (54.8%) underwent extraoral abscess revision, 336 patients (45.2%) patients were treated locally without extraoral revision. In odontogenic group with tooth still present, superior CRP (m = 145.8 mg/l; SD = 117.7) and leukocyte values (m = 13.6*109l; SD = 6.6) were observed in comparison to other groups. There were 698 cultivated bacteria in 362 patients. Most frequent bacteria were Streptococci (n = 162; 23.2%), Prevotella (n = 83; 11.2%) and Parvimonas (n = 65; 9.3%). Clindamycin resistance was highest (n = 180 resistant bacteria; 25.8%), followed by Metronidazole (n = 178; 25.5%), Penicillin (n = 107; 15.3%) and Amoxicillin-Clavulanate (n = 34; 4.9%).ConclusionsOrofacial infections in head and neck region are mostly of odontogenic origin with causal tooth still in socket. Causal bacteria show a high antibiotic resistance rate, especially to Clindamycin and Metronidazole.Clinical RelevanceAcquired data will be used to determine guidelines for empirical antibiotic prescription in cases of orofacial infections.

Effect of pentavalent antimony compounds on the inflammatory, hematological and biochemical parameters in patients with cutaneous leishmaniasis

Objective This study aimed to evaluate how systemic antimony treatment in cutaneous leishmaniasis (CL) patients affects biochemical, hematological, and inflammatory parameters in child and adult patient groups. Methods A total of 50 patients (29 adults, 21 children) who received systemic meglumine antimonate (MA) treatment in the skin and venereal diseases clinic between September 2022 and January 2024 and were diagnosed with CL by microscopic examination were included in the study. The medical records of the patients were examined retrospectively. Before and after treatment, neutrophil count, leukocyte count, lymphocyte count, hemoglobin concentration, platelet count, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), mean platelet volume (MPV), amylase, lipase, alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen and serum creatinine levels were recorded. Results In the children group, lymphocyte and platelet values decreased statistically significantly; and lipase value increased statistically significantly after treatment. In the adult group; hemoglobin, neutrophil, lymphocyte and leukocyte values decreased statistically significantly; ALT, AST, amylase, lipase, NLR and PLR values increased statistically significantly after treatment. Conclusion Based on the data in our study, it was stated that systemic meglumine antimonate treatment may lead to an increase in pancreatic enzymes and transaminases and bone marrow suppression. We also think that patients in the adult age group should be followed more closely regarding pancreatic enzymes and kidney function tests than the pediatric age group.

Approach to cases diagnosed with mesenteric panniculitis

Objective: In this study, it was aimed to report the diagnosis, treatment and follow-up results of patients who came to the hospital with complaints of abdominal pain and were diagnosed with Mesenteric Panniculitis (MP) by Abdominal Computed Tomography (ACT). Method: 32 patients diagnosed with MP by ACT were examined retrospectively. The patients' age, gender, admission leukocyte count, CRP values, comorbidities, medications prescribed at discharge, and relapse status were evaluated. Results: Of the 32 patients included in the study, 11 were male (34.4%), 21 were female (65.6%), and they had a mean age of 58.75±12.31 years. The average leukocyte value at first admission was 8240±2530 /mm³, CRP average 24.93±47.39 mg/L, neutrophil percentage was not above 80% in any patient. No patients were hospitalized. Recurrence was occurred in 2 (6.25%) patients (after 6 months and 28 months). No malignancy were during follow-up. Conclusion: MP was diagnosed with ACT. No biopsy was required for diagnosis. Medical treatment was sufficient, no surgical procedure was performed on the patients.

Prognostic value of hematological indicators in preeclampsia

The objective: to evaluate the changes in hematological indicators as early predictors of the development of preeclampsia.Materials and methods. A retrospective cohort study was conducted with the participation of 49 pregnant women in the period from March 2020 to January 2022. All women were observed in the women’s consultation of the private medical center “Leleka”.Pregnant women were divided into two groups: the main group – women who were diagnosed with preeclampsia at &gt;20 weeks of pregnancy, n=20), and the control group (n=29) – women without preeclampsia during pregnancy.Each woman underwent a general blood test, the systemic inflammatory response index (SIRI), allergy index (AI), immunoreactivity index (II), adaptation index (А) in I (up to 12 weeks), II (13–27 weeks) and III (from 28 weeks) trimesters of pregnancy, respectively, were calculated.Results. Pregnant women, in whom subsequently preeclampsia developed, had statistically significant differences in white blood cell count and erythrocyte sedimentation rate (ESR) compared to controls.The AI index decreased statistically significantly in the control group in the II trimester compared to the I trimester (р=0.05), while the changes in the main group were statistically insignificant. The median AI indicator in the main group decreases by 22.7% in the II trimester, and increases by 8.9% in the III trimester; in the control group the median AI decreases by 12.3% and 7.5%, respectively.The median adaptation index in the main group statistically significantly decreases by 25.7% in the II trimester and increases by 19.2% in the III trimester. In the control group, this index does not increase in the III trimester.Conclusions. The dynamics of the main hematological indicators and calculated indices can be useful for predicting of preeclampsia development. Carrying out a general blood test as a widely available method is possible in order to stratify the individual risk of preeclampsia development in combination with other generally accepted factors of this complication.High values of leukocytes and ESR in the early terms of pregnancy in women who subsequently developed preeclampsia confirm the role of inflammation as an etiopathogenetic factor. A change in the integral hematological indices of allergy and adaptation can be an early predictor of preeclampsia.The results of this study predict the presence of preeclampsia clusters, the determination of the mechanisms of which will allow to expand the possibilities of preventive measures, which needs to be confirmed in large-scale randomized studies in the future.

Genetic variants in the TNF pathway impact TNFi response in a mixed population with rheumatoid arthritis

Rheumatoid arthritis (RA) is a multifactorial autoimmune inflammatory disease that mainly affects the joints, on reducing functional capacity and impacting quality of life. Cytokines such as tumor necrosis factor (TNF) and interleukin 6 (IL-6) are crucial in the pathogenesis and treatment of this disease. Some patients using TNF inhibitors (TNFi) do not respond or lose their response to these medications. Clinical, sociodemographic, and genetic data were used to evaluate the associations of single nucleotide polymorphisms (SNP) in TNF, TNFRSF1A, and TNFRSF1B genes with the diagnosis of RA, standardized score results, laboratory tests, and response to TNFi. In one subsample, TNF and IL-6 serum levels cytokines were performed. A total of 654 subjects (360 healthy controls and 294 diagnosed with RA) were included in the analysis. Higher levels of TNF have been found in individuals diagnosed with RA. IL-6 levels were higher in individuals who did not respond to TNFi treatment, while responders had levels comparable to those without the disease. No associations were found between the SNPs studied and the diagnosis of RA; however, rs767455-C seems to play a role in the response to golimumab treatment, being related to better therapeutic response and lower mean serum leukocyte levels. In addition, rs1061622-G was associated with poorer functional capacity and rs1800629-A was associated with higher leukocyte values and serum transaminase levels. The rs1061622-G and rs767455-C may play a role in the response to TNFi treatment, especially for patients using golimumab, although they do not seem to be associated with the diagnosis of RA. Polymosphisms in the TNF pathway may impact baseline levels of immune cells and markers of renal and hepatic function in RA patients. Our results highlight the importance of evaluating the impact of these polymorphisms on TNFi response and safety, particularly in larger-scale studies.

Occult Serious Bacterial Infections in Neonates and Infants Up to Three Months of Age with Bronchiolitis: Are Invasive Cultures Required?

(1) Background: The literature reports a low risk of serious bacterial infections (SBIs) in febrile infants presenting with bronchiolitis or respiratory syncytial virus infection, but current microbiological techniques have a higher accuracy. (2) Methods: We assessed the risk of SBIs in neonates and infants with bronchiolitis from 2021 to 2023. We also evaluated C-reactive protein, procalcitonin, and leukocyte values. (3) Results: We included 242 infants. Blood cultures (BCs) were performed in 66/242 patients, with a positivity rate of 9.1% (including one BC with Staphylococcus hominis, considered as a contaminant). The cerebrospinal fluid culture was performed in 6/242 patients, and the results were all negative. Infection markers did not discriminate infants with positive BCs from those with negative ones. (4) Conclusions: Blood cultures should be performed in neonates and young infants with bronchiolitis fever, as the sepsis risk is not negligible. Conversely, our proposed algorithm is to wait for the respiratory panel results before decision-making for a lumbar puncture. Further studies are needed to understand lumbar puncture requirements.

Comparative analysis of the microbiota of prostate secretion in patients with chronic abacterial prostatitis of categories IIIa and IIIb

Numerous studies have established that chronic prostatitis/ chronic pelvic pain syndrome ( CP/CPPS) is the focus of attention of the global medical community, because it is the most common type of disease, the treatment of which has largely unsatisfactory results.Purpose of the work: to conduct a comparative analysis of the microbiota of prostate secretions in patients with CP/CPPS IIIa and IIIb using mass spectrometry of microbial markers (MSMM).Material and methods. A prospective comparative study was conducted from 2018 to 2023 at the SM-Clinic medical center. 205 patients with prostatitis-like symptoms and 70 males who applied for a screening examination with no complaints at the age of 25 to 50 years were selected. The subjects were divided into three groups: group 1 – patients with CP/CPPS category IIIa, group 2 ( n = 85) patients with CP/CPPS category IIIb with clinical manifestations of chronic prostatitis and group 3 ( n = 70) – without clinical manifestations prostatitis/control group. A study of the microbiota of prostate secretions was carried out using gas chromatograph mass spectrometer "Maestro" (LLC "Interlab", Russia).Results. The results of statistical analysis showed that the level of cocci and bacilli, anaerobes, actinobacteria, fungi and yeasts, as well as total viruses in patients with CP/CPPS IIIa, compared with patients with CP/CPPS IIIb and the control group, was significantly higher ( p = 0.0020 ; p &lt; 0.0001; p &lt; 0.0001; p = 0.0254; p = 0.0254). It was revealed that in patients with CP/CPPS IIIa, compared with patients with CP/CPPS IIIb and healthy people, there was a significant increase in the total load of cocci and bacilli, anaerobes, actinobacteria, fungi and yeasts, as well as total viruses . When analyzing the relationship between the absolute number of microorganisms, it was revealed that an increase in the level of many microorganisms is associated with an increase in the probability of detecting a leukocyte level 10. An analysis of the relationship between the occurrence of individual microorganisms and leukocyte values in prostate secretions ≥10 showed that an increase in the indicators of many microorganisms, compared with the control group, increased the chances of having a leukocyte level ≥10 several times.Conclusion. Identification of microbial associations in prostate secretions using the MSMM method and an increase in the total load of microorganisms in patients with CP/CPPS IIIa, compared with CP/CPPS IIIa and the control group, suggests the role of infection in a certain part of patients with CP/CPPS IIIa, which dictates the need to change the view of the urologist in the diagnosis and treatment strategy of these patients.

P-427 Do endometrial leucocytes and angiogenesis in the peri-implantation period predict hypertensive disorders in the subsequent pregnancy?

Abstract Study question Do endometrial leucocytes and angiogenesis in the peri-implantation period from women with a history of recurrent reproductive failure predict hypertensive disorders in the subsequent pregnancy? Summary answer uNK cells, T cells, B cells and macrophages in the peri-implantation endometrium did not correlate with hypertensive disease of pregnancy in the subsequent pregnancy. What is known already Women with a history of recurrent reproductive failure are thought to have a higher risk of hypertensive disorders of pregnancy (HDP) subsequently. Immunological interactions and vascular factors in the placental bed are considered to be two important pathways for the initiation and development of HDP. However, the prognostic value of endometrial leucocytes and angiogenesis around the time of implantation in a cycle prior to conception and HDP in the subsequent pregnancy is still unclear. Study design, size, duration This is a prospective cohort study. A total of 694 women were included in this study from Jan 2019 to Jun 2023. Participants/materials, setting, methods Immunohistochemistry for vWF and multiplex immunofluorescence for endometrial leukocytes, including CD56+ uNK cells, CD3+ T cells, CD20+ B cells and CD68+ macrophages, were performed in the precisely timed LH + 7 endometrium. The subsequent pregnancy outcomes of the subjects were followed up as well. Main results and the role of chance Endometrial leukocytes including CD56+ uNK cells, CD3+ T cells, CD20+ B cells and CD68+ macrophages were found in the peri-implantation endometrium. There was no significant difference in the CD56+ uNK cells, CD3+ T cells, CD20+ B cells and CD68+ macrophages numbers percentage between women with and without gestational hypertension in the subsequent pregnancy. The median micro vessel density in women who developed gestational hypertension in the subsequent pregnancy (9.4 ± 3.1 /mm2 ) was significantly (P=0.038) lower than the MVD in those who did not (13.5 ± 4.9/mm2 ). Limitations, reasons for caution 1. It is not clear whether the uNK cell number during the peri-implantation period is reflective of those in the first trimester when spiral artery remodelling occurs. 2. This study was carried out in women with reproductive failure and the results may not apply to the general populations. Wider implications of the findings Vascularization features in the endometrium may provide prognostic value of subsequent hypertensive disease of pregnancy. Trial registration number not applicable

Predictive value of leukocyte derived markers for postoperative delirium after cardiac valve surgery

To explore the predictive value of leukocyte derived markers for postoperative delirium (POD) in patients undergoing cardiac valve surgery. A prospective cohort study was conducted. The patients who underwent cardiac valve surgery admitted to Beijing Anzhen Hospital of Capital Medical University from October 2021 to March 2023 were enrolled. The demographic, baseline and perioperative data were collected, and the neutrophil to lymphocyte ratio (NLR) and platelet to white blood cell ratio (PWR) were calculated before operation and within 24 hours after operation. Delirium assessment was conducted twice a day for patients within 1-5 days after surgery or discharged within 5 days. According to the evaluation results, the patients were divided into delirium group and non-delirium group. The clinical indexes between the two groups were compared. Multivariate Logistic regression analysis was used to screen the independent risk factors of POD, and the POD predictive model was constructed. The predictive value of POD predictive model was evaluated by receiver operator characteristic curve (ROC curve). A total of 235 patients were enrolled in the analysis, of which 83 patients had POD (35.32%) and 152 patients did not have POD (64.68%). Compared with the non-delirious group, the patients in the delirious group had higher Charlson comorbidity index (CCI) score and lower mini-mental state examination (MMSE) score. In terms of perioperative data, compared with the non-delirium group, the patients in the delirium group had longer operative time, duration of cardiopulmonary bypass, length of intensive care unit (ICU) stay, duration of mechanical ventilation, and postoperative hospital stay, higher incidence of perioperative atrial fibrillation, and lower discharge life score. In terms of leukocyte derived markers, NLR within 24 hours after surgery in both groups were significantly higher than those before surgery, and PWR were significantly lower than those before surgery. The NLR within 24 hours after surgery, PWR difference and NLR difference in the delirium group were significantly higher than those in the non-delirium group. Multivariate Logistic regression analysis showed that CCI score [odds ratio (OR) = 1.394, 95% confidence interval (95%CI) was 1.038-1.872, P = 0.027], perioperative atrial fibrillation (OR = 3.697, 95%CI was 1.711-7.990, P < 0.001), duration of cardiopulmonary bypass (OR = 1.008, 95%CI was 1.002-1.015, P = 0.016), length of ICU stay (OR = 1.006, 95%CI was 1.002-1.010, P = 0.002), NLR difference (OR = 1.029, 95%CI was 1.009-1.050, P = 0.005) and PWR difference (OR = 1.044, 95%CI was 1.009-1.080, P = 0.013) were independently correlated with POD. POD predictive model was constructed by multivariate Logistic regression analysis result: POD predictive model index = -4.970+0.336×CCI score+1.317×perioperative atrial fibrillation+0.009×duration of cardiopulmonary bypass+0.006×length of ICU stay+0.030×NLR difference+0.044×PWR difference. ROC curve analysis showed that the area under the ROC curve (AUC) of NLR difference for predicting POD was 0.659 (95%CI was 0.583-0.735), the optimal critical value was 16.62, the sensitivity was 60.2%, and the specificity was 70.4% (P < 0.05). The AUC of PWR difference for predicting POD was 0.608 (95%CI was 0.528-0.688), the optimal critical value was 25.68, the sensitivity was 51.8%, and the specificity was 75.7% (P < 0.05). The AUC of POD predictive model for predicting POD was 0.805 (95%CI was 0.745-0.865), the optimal critical value was 0.39, the sensitivity was 74.7%, and the specificity was 79.6% (P < 0.05). The differences of NLR and PWR are independently related to POD, which has potential value in predicting POD after cardiac valve surgery.

Sickle Cell Disease and Gut Health: The Influence of Intestinal Parasites and the Microbiome on Angolan Children.

Parasitic infections are a common problem in developing countries and can intensify morbidity in patients with sickle cell disease (SCD), increasing the severity of anemia and the need for transfusions. It has been demonstrated that both helminths and protozoa can affect gut microbiome composition. On the other hand, the presence of specific bacterial communities can also influence parasite establishment. Considering this, our aim was to associate the presence of intestinal parasites with the results of hematological analyses and microbiome composition evaluations in a population of Angolan children with and without SCD. A total of 113 stool samples were collected, and gut microbiome analysis was performed using 16S sequencing and real-time PCR to detect eight different intestinal parasites. In our population, more than half of children (55%) had at least one parasitic infection, and of these, 43% were co-infected. Giardia intestinalis and Ascaris lumbricoides were more frequently found in children from the rural area of Bengo. Moreover, SCD children with ascariasis exhibited higher values of leukocytes and neutrophils, whereas the total hemoglobin levels were lower. In regards to the gut microbiome, the presence of intestinal parasites lowered the prevalence of some beneficial bacteria, namely: Lactobacillus, Bifidobacterium, Cuneatibacter, Bacteroides uniformis, Roseburia, and Shuttleworthia. This study presents the prevalence of several intestinal parasites in a high-risk transmission area with scarce information and opens new perspectives for understanding the interaction between parasites, the microbiome, and SCD.

Comparison of Monocyte to Lymphocyte and Platelet to Lymphocyte Ratio between Patients with Depression according to Severity of Disease

Background: Depression is one of the most common psychiatric disorders with global public health concern that is linked to systemic inflammation. The monocyte to lymphocyte (MLR) and platelet to lymphocyte ratio (PLR) are partially new markers which may be evaluated with simple blood test and which are shown to be highly informative in showing chronic low grade inflammation associated with pathophysiology of depressive disorder. Objective: To evaluate the relation of MLR and PLR between patients with depression according to severity of disease. Methods: This observational study was conducted in the Department of Psychiatry of Jahurul Islam Medical College Hospital (JIMCH), Bajitpur, Kishoregonj between November 2012 and April 2013. Subjects between the age group of 25 and 55 were included in the study that involved 253 subjects with diagnosed depressive disorder according to the criteria of Diagnostic and Statistical Manual of Mental Disorders, Revised Text (DSM IV-TR) who received no pharmacological therapy of depression within the past 01 month. A sociodemographic information form and the Hamilton Rating Scale for depression (HAM-D) were administered. Patients were classified into four groups according to their HAM-D score such as mild, moderate, severe, and very severe depression. Blood sample were taken for biochemical analysis and complete blood parameters were evaluated in the hematology laboratory of JIMCH. All data were expressed as mean±SD. For statistical analysis, Chi-square test (χ2) was used to compare categorical variables, frequencies, and ratios. An independent sample ‘t’ test was used to compare normally distributed variables between two groups. Results: In the present study, it was found significant differences in the MLR, PLR, monocyte, leukocyte values of the patient group with depression according to severity of disease. Severe and very severe depression had significantly higher MLR levels compared to patients with mild and moderate depression. On the other hand, mild and moderate depression. On the other hand, mild and moderate depression had significantly higher PLR levels compared to patients with severe and very severe depression. Conclusion: In summary, the findings of the study reveal that higher HAM-D scores are associated with higher MLR and lower PLR levels in patients with depressive illness compared to patients with lower HAM-D scores. Moreover, a high MLR values supports the view that inflammation is a critical factor in the etiology of depression. JAFMC Bangladesh, Vol 19, No 2 (December) 2023:12-15.

LEUKOCYTE PROFILE OF BROILER SLAUGHTERED AT A CHICKEN SLAUGHTERHOUSE IN JIMBARAN BALI

Currently, the poultry industry is trying to meet the demand for providing nutritious meat. Therefore, broiler health is a factor that determines the success of chicken cultivation, because the good health condition of the chickens that will be slaughtered will provide a sense of security that the meat produced is healthy and suitable for consumption. The study aims to determine the total and differential broiler leukocytes, and the differences between male and female broilers slaughtered at the Chicken Slaughterhouse in Jimbaran. This study used 20 broiler blood samples obtained from 10 female and 10 male broilers. Blood samples were taken randomly before the broilers were slaughtered via the brachial vein. Total leukocytes were counted using the Auto Hematology Analyzer Rayto RT-7600 for Vet. Differential leukocyte counting is carried out by examining blood smear preparations. The examination results showed that the average total leukocytes of female broilers (83.26 x 103/µl) were not significantly different (P&gt;0.05) from those of males (86.3 x 103/µl). Average differential of female broiler leukocytes: heterophils (23.74 x 103/µl), lymphocytes (53.01 x 103/µl), monocytes (4.11 x 103/µl), eosinophils (2.49 x 103/µl), basophils (0 x 103/µl). Average differential leukocytes of male broilers: heterophils (34.82 x 103/µl), lymphocytes (46.64 x 103/µl), monocytes (3.88 x 103/µl), eosinophils (1 x 103/µl), basophils (0.04 x 103/µl). Significant differences (P&lt;0.05) were only found in heterophils. Morphological studies of broiler leukocytes slaughtered at the Jimbaran Chicken Slaughterhouse show that the types of leukocytes are in accordance with the reference. Further research needs to be carried out to determine the normal value and morphology of broiler leukocytes in Bali and in Indonesia in general.

Does remote ischemic preconditioning affect the systemic inflammatory response by modulating presepsin levels?

We investigated the effect of Remote Ischemic Preconditioning (RIPC) on the inflammatory response during CPB by means of serum presepsin levels at preoperative and postoperative 1st and 24th h. In this prospective, randomized, cross-sectional study we included 81 patients undergoing coronary artery bypass graft surgery with cardiopulmonary bypass (CPB). Patients were randomized and RIPC was applied to 40 patients in the study group before anesthesia. The remaining 41 patients were determined as the control group. The relationships between RIPC and factors such as presepsin, C-reactive protein (CRP), and leukocyte levels were investigated. There was no significant difference between the groups in postoperative leukocyte and CRP values (p = 0.52, p = 0.13, respectively). When the preoperative and postoperative first hour presepsin values of the patients were compared, no significant difference was found in the control group (p = 0.17), but a significant difference was found in the study group (p < 0.05). When the presepsin values were compared between the groups, a significant difference was found only in the postoperative first hour value (p < 0.05). It was observed that RIPC application caused to increase the presepsin levels in the postoperative first hour significantly in the study group (p < 0.05).

Exploring biomarkers as predictors of left ventricular recovery in a national registry of takotsubo syndrome patients (RETAKO)

Abstract Funding Acknowledgements None. Introduction Tako-Tsubo Syndrome (TTS) is characterized by transient dysfunction of the left ventricle (LV) of uncertain etiology, although considered a benign entity, TTS has a mortality rate and complications similar to STEMI patients (1). Late LV recovery (&amp;gt;10 days) has been associated with a worse prognosis. Currently, there is no data on biomarkers that can predict the disease's progression. Purpose We aim to correlate different biomarkers with LV recovery in TTS patients. Method We used data from the National Multicenter Registry on Tako-Tsubo Syndrome (RETAKO). Information on biomarkers, including NT-proBNP, C-reactive protein (CRP), leukocytes, and platelets, was collected both upon admission and at peak values. Early recovery was considered when it occurred within the first 10 days after the index event. A non-parametric correlation analysis was conducted to assess the predictive capacity of different biomarkers on LV recovery. Results Out of a total of 1,463 patients, 373 (25.5%) experienced late LV recovery. The average age was around 73 years, with the majority of the sample being women (86%). Significant differences were observed between the groups in NT-proBNP, CRP, and peak values of leukocytes and platelets, with higher levels in the late recovery group. In the linear correlation analysis, a significant association was found between late recovery and higher levels of NT-proBNP, peak leukocytes and platelets, however it was not statistically significant for the levels of CRP. Conclusions In a large national cohort of TTS patients, higher levels of NT-proBNP, peak of leukocytes and platelets during the hospital stay were significantly associated with late LV recovery. This recovery appears to depend on the degree of LV dysfunction and the inflammatory response.Biomarkers table 1

The Prognostic Value of Perioperative Platelet and Leukocyte Values in Patients Undergoing Radical Cystectomy: A Prospective Long-Term Cohort Study

Introduction: Studies assessing the impact of preoperative and first-day postoperative values of leukocytes, thrombocytes, and platelet/leukocyte ratio (PLR) after radical cystectomy (RC) are sparse. We aimed to assess the impact of these factors on long-term survival after RC. Methods: An analysis of patients undergoing open RC from 2004 to 2023 at our center was performed. Leukocytosis was defined as ≥8,000 leukocytes/μL and thrombocytosis as ≥400,000 thrombocytes/μL. Similarly, the cutoff for PLR was set at 28. A multivariable Cox regression analysis was performed to assess the role of leukocytosis, thrombocytosis, and PLR on long-term survival after RC. For all analyses, hazard ratios (HRs) with the corresponding 95% confidence intervals (CIs) were estimated. Results: A total of 1,817 patients with a median age of 70 years (interquartile range [IQR]: 62–77) were included. Overall, 804 (44%), 175 (10%), and 1,296 (71%) patients presented with leukocytosis, thrombocytosis, and PLR ≥28 preoperatively. Accordingly, 1,414 (78%), 37 (2%), and 249 (14%) patients presented with leukocytosis, thrombocytosis, and PLR ≥28 on the first day after RC. At a median follow-up of 26 months (IQR: 8–68) after RC, 896 (49%) patients died. In the multivariate Cox regression analysis after adjusting for major perioperative risk factors, only preoperative leukocytosis (HR: 1.3, 95% CI: 1.1–1.6, p = 0.01), as well as both preoperative and first-day thrombocytosis (HR: 2.1, 95% CI: 1.5–2.9, and HR: 2.8, 95% CI: 1.6–5.1, p < 0.001, accordingly) were associated with worse overall survival. Conclusion: PLR should not be used as a prognostic marker for survival after RC. On the contrary, preoperative leukocytosis, as well as preoperative and first-day thrombocytosis should raise awareness among clinicians performing RC since they were independently associated with worse survival after RC.