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Introduction: The British HIV Association (BHIVA) guidelines were amended during the coronavirus (COVID‐19) pandemic, allowing for less frequent monitoring of routine bloods. We assessed the impact of this on patient outcomes. Methods: Between April 2020 and March 2021, routine blood appointments at our HIV clinic were replaced by virtual consultations in 'stable' people living with HIV (PLWH), defined using standard operating procedure (SOP) criteria. All had an undetectable HIV viral load (VL) (<50 copies/mL). Demographic, HIV clinical information, and antiretroviral treatment (ART) data were collated using the electronic patient record (EPR). Blood results from before (baseline) and after (follow‐up) the omitted appointment were analysed for each parameter. Results: In all, 791/2395 PLWH were scheduled to have blood tests omitted; 381 were excluded for reasons including not fitting the SOP criteria or presenting to clinic early, and 410 were included in analysis. The demographics of the group were consistent with our whole HIV cohort. HIV VL became detectable in 8/410 individuals (1.95%, range 51–730 copies/mL). VL resuppressed in 6/8 after a median of 29 days. VL remained detectable in two individuals, both of whom remain in care. Routine blood monitoring revealed baseline and follow‐up blood parameters that were largely within normal range. Four out of 12 parameters had statistically significant changes but were not considered clinically significant; 59/410 (14.4%) changed ART, most commonly for simplification. Conclusion: For the majority of stable PLWH included in our evaluation, the omission of routine blood monitoring during the pandemic did not have a negative impact on HIV suppression or blood monitoring outcomes. ART switch was uncommon. [ABSTRACT FROM AUTHOR]

Background and methods: Our study sought to evaluate if an association exists between Helicobacter pylori (H. pylori), metabolic dysfunction- associated steatotic liver disease (MASLD), and liver fibrosis in patients with severe obesity (BMI > 35). Our retrospective study included 584 patients over the age of 18 years with severe obesity, who underwent preoperative liver transient elastography (VCTE), upper endoscopy, blood work, and intra-operative liver biopsy concurrent with bariatric surgery at a single institution from July 2020 to September 2021. Liver fibrosis scores including FIB-4, APRI, NAFLD fibrosis score, BARD score, AST: ALT ratio, and NAFLD activity score (NAS) were calculated from the laboratory results and liver biopsy findings. The presence or absence of H. pylori was determined based on gastric biopsies obtained during upper endoscopy. Other variables collected included age, gender, mean preoperative weight, BMI, and the presence or absence of comorbidities. Student's t-test and non-parametric testing were used for the analysis of continuous variables and Chi-square analysis was used for categorical data. Results: Of the 584 patients, 14.7% were H. pylori positive and 85.3% were negative. Liver fibrosis scores including FIB-4, APRI, and NAFLD fibrosis scores were significantly higher in the positive group (p < 0.05), but there was no difference in AST: ALT ratio and BARD score. A significantly higher VCTE steatosis and fibrosis scores were noted in the H. pylori-positive group (p < 0.05). Similarly, a significantly higher NAS (NAFLD activity score) on liver biopsies was noted in the positive group, with all the individual components of NAS (steatosis, lobular inflammation, and hepatocyte ballooning) being significantly higher in the positive group (p < 0.05). A significantly higher incidence of fibrosis on liver biopsies was noted in the positive group overall and across all stages of fibrosis (p < 0.05). There were no significant differences between the groups in relation to gender, mean weight, BMI, presence of comorbidities including Diabetes Mellitus, and laboratory values. Conclusion: Our study demonstrates that H. pylori colonization or infection is associated with a higher risk of development of MASLD and progression to fibrosis. Further, population-based studies are needed to corroborate our findings. [ABSTRACT FROM AUTHOR]

Background and Aims: The natural history of untreated patients with type 1 Gaucher disease (GD1) is not well documented, and there is controversy over when and how to treat such patients, especially if they are only mildly symptomatic. Treatment of GD1 is inconvenient, very costly, and may result in undesirable side effects. We documented the clinical history of 31 untreated patients with GD1 followed in our clinic for 4–26 (median 15) years. Methods: This was a retrospective, observational study of the progress of untreated adult patients with GD1 followed by blood tests (haemoglobin, platelet counts, ferritin and chitotriosidase), organ volumes (spleen and liver), bone manifestations (through magnetic resonance imaging and dual X‐ray absorptiometry scans) and neurological and quality of life issues. Statistical analyses were performed with the use of the Student paired t test and the modified Wald test for 95% confidence intervals. Results: We found that the above parameters remained stable in most patients over a period of 4–26 (median 15) years. Five patients progressed from normal bone density to osteopenia and two from osteopenia to osteofibrosis; six were peri‐ or post‐menopausal females. The DS‐3 was stable over time. Only four of the 31 patients were started on enzyme or substrate reduction therapy. Conclusions: Our results demonstrate that many patients with GD1, provided with close follow‐up by a specialist centre, can be followed for many years without requiring treatment and with no or minimal worsening of their GD1 manifestations. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the associations between intermediate hyperglycemia (IH) and increased body mass index (BMI), abdominal obesity (AO), high-sensitivity C-reactive protein (hs-CRP), and leptin levels in Korean adults. Methods: The participants were 248 adults (≥ 19 years) who understood the purpose of the study, had no cognitive impairment, and were able to communicate. Physical examinations, BMI, AO measurements, and blood tests were performed. Data were analyzed using the t-test, chi-square test, Pearson correlation coefficients, and multiple logistic regression analyses. The risk factors for IH were predicted after adjusting for BMI, waist circumference (WC), age, hs-CRP and leptin levels, education, and economic status. Results: WC, hs-CRP and leptin levels, and age were higher in the IH group than in the non-IH group. According to the multiple logistic regression analysis, the factors affecting IH prevalence were WC, hs-CRP, leptin, and age. AO (male, WC ≥ 90 cm; female, WC ≥ 85 cm) exhibited an adjusted odds ratio of 5.45 for IH. IH was 2.43 times higher in those with hs-CRP > 3 mg than in those with hs-CRP < 1 mg. As leptin levels increased, the odds ratio for IH increased by 3.05 times. IH was 8.07, 8.79, 18.42, and 35.33 times more common for those in their 30s, 40s, 50s, and ≥ 60 years of age, respectively, than those 19-29 years old. Conclusion: This study provides evidence that interventions for AO should be included in IH management programs. Identifying the predictive factors for IH may contribute to the early detection of type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

Purpose: This retrospective study was conducted to identify factors associated with repeated suicide attempts by analyzing the electronic medical records of suicide attempters who visited emergency medical centers due to drug intoxication. Methods: Data from January 1, 2020 to December 31, 2021 were collected for this study and analyzed using SPSS/WIN 25.0. Results: In this study, the factors affecting repeated suicide attempts among individuals who visited the emergency medical center due to acute drug intoxication were the presence or absence of psychiatric diseases, the season of drug intoxication, and age. In order to identify the factors affecting repeated suicide attempts in those who presented with acute drug intoxication, logistic regression analysis was performed by inputting psychiatric diseases, season of drug intoxication, and age, all of which exhibited significant differences between those who did and did not attempt suicide again. The presence of psychiatric diseases (odds ratio [OR] = 1.99, 95% confidence interval [CI] = 1.04~3.80), intoxication occurring in the fall (vs. spring; OR = 3.35, 95% CI = 1.28~8.75), and age ≥ 65 (vs. those under the age of 18; OR = 12.96, 95% CI = 2.02~83.17). The regression model was found to be statistically significant (F = 30.01, p < .001), and the coefficient of determination of Cox and Snell, which represents the explanatory power of the model, was 12.0%. Conclusion: This study suggests that to prevent repeated suicide attempts, it is necessary to develop a tool to evaluate the risk of suicide, use it to evaluate the risk of suicide, and then manage individuals accordingly. [ABSTRACT FROM AUTHOR]

To determine the role of platelet counts in the context of the decision to treat patients with non-compounded, non-surgically-treated blunt traumatic brain injury (NCNS-bTBI) with anticoagulants/antiaggregants. A retrospective analysis of 141 anticoagulants/antiaggregants-naïve patients with NCNS-bTBI. Changes in PT-INR and prolonged aPTT were examined and correlated with Marshall and Rotterdam scores, clinical and neuroradiological outcomes. Three groups of platelet counts were identified. Group 1 (83% of patients) had normal platelet counts (150,000–450,000 platelets/mm3) from admission to discharge. Group 2 (13%) developed transient thrombocytopenia (<150,000 platelets/mm3) 2–3 days post-trauma. Group 3 (4%) developed extreme thrombocytosis > 1,000,000/mm3 platelets 6–9 days post-trauma. Neither acute coagulopathy of trauma nor progressive hemorrhagic insults followed NCNS-bTBI. Moreover, while patients with thrombocytosis/extreme thrombocytosis presented with a worse Glasgow coma score (GCS) on admission (8.8 ± 2.9 vs. 13 ± 2, p < 0.01) and had longer hospitalization (13.5 ± 10.4 vs. 4.5 ± 2.1 days), their improvement at discharge was the highest (delta GCS, 4 ± 2.8 vs. 1.2 ± 2.1, p = 0.05). Traumatic subarachnoid hemorrhage was associated with isolated thrombocytosis and 'best improvement.' No thromboembolic or hemorrhagic complications occurred. NCNS-bTBI, thrombocytosis was correlated with better outcomes and was not associated with an increased risk for developing thromboembolism or hemorrhage, precluding the immediate need for any additional antiaggregates. [ABSTRACT FROM AUTHOR]

PURPOSE: In Southeastern Ontario, increased patient distance from the regional lung cancer diagnostic assessment program (LDAP) is associated with a lower likelihood of patient care via LDAP while receiving care via LDAP is associated with improved survival. We implemented an LDAP outreach clinic to provide specialist assessment for patients with suspected lung cancer at a regional community hospital and assessed the impact on timeliness and accessibility of care. MATERIALS AND METHODS: The Kingston Health Sciences Centre LDAP team engaged with community hospital partners to develop and launch the LDAP outreach clinic. We performed a retrospective chart review of LDAP patients (N = 1,070) before (August-November 2021; n = 234) and after implementation of the outreach clinic (November 2021-October 2022; n = 836). Descriptive data are reported as No. (%). Unpaired t tests and statistical process control charts assess for significance. A cost analysis of out-of-pocket patient costs related to travel and parking is presented in 2022 Canadian dollars (CAD). RESULTS: Compared with a 3-month matched time period before (August-October 2021) and after outreach clinic (August-October 2022), the mean time from referral to assessment and time from referral to diagnosis decreased from 20.3 to 14.4 days (P =.0019) and 40.0 to 28.9 days (P =.0007), respectively. Over 12 months, the total patient travel was reduced by 8,856 km, which combined with parking cost-savings, resulted in patient out-of-pocket savings of CAD $5,755.60 (CAD $47.60/patient). Accounting for physician travel, the total travel saved was 5,688 km, corresponding to reduced CO2 emissions by 1.9 tCO2. CONCLUSION: Implementation of a lung cancer outreach clinic led to improved timeliness of care, patient cost-savings, and reduced carbon footprint while serving patients in their community. LDAP outreach clinic led to faster lung cancer diagnosis, reduced patient costs, and lessened environmental impact. [ABSTRACT FROM AUTHOR]

Emergency medical services (EMSs) face critical situations that require patient risk classification based on analytical and vital signs. We aimed to establish clustering-derived phenotypes based on prehospital analytical and vital signs that allow risk stratification. This was a prospective, multicenter, EMS-delivered, ambulance-based cohort study considering six advanced life support units, 38 basic life support units, and four tertiary hospitals in Spain. Adults with unselected acute diseases managed by the EMS and evacuated with discharge priority to emergency departments were considered between January 1, 2020, and June 30, 2023. Prehospital point-of-care testing and on-scene vital signs were used for the unsupervised machine learning method (clustering) to determine the phenotypes. Then phenotypes were compared with the primary outcome (cumulative mortality (all-cause) at 2, 7, and 30 days). A total of 7909 patients were included. The median (IQR) age was 64 (51–80) years, 41% were women, and 26% were living in rural areas. Three clusters were identified: alpha 16.2% (1281 patients), beta 28.8% (2279), and gamma 55% (4349). The mortality rates for alpha, beta and gamma at 2 days were 18.6%, 4.1%, and 0.8%, respectively; at 7 days, were 24.7%, 6.2%, and 1.7%; and at 30 days, were 33%, 10.2%, and 3.2%, respectively. Based on standard vital signs and blood test biomarkers in the prehospital scenario, three clusters were identified: alpha (high-risk), beta and gamma (medium- and low-risk, respectively). This permits the EMS system to quickly identify patients who are potentially compromised and to proactively implement the necessary interventions. [ABSTRACT FROM AUTHOR]

Hyperbilirubinemia is a physiological health problem of newborn infants, mostly occurring in the first week of life, which can delay development or cause disabilities or death. Massaging newborn infants early after delivery can promote bilirubin excretion and reduce hyperbilirubinemia. This quasi-experimental study aimed to determine the effect of infant massage performed by mothers on bilirubin levels and re-hospitalization for hyperbil- irubinemia. The study was conducted at an obstetrics and gynecology ward of a secondary hospital in Bangkok, Thailand. The participants were 30 paired full-term infants and mothers who met the inclusion criteria. The experimental group (n = 15) received body massage performed by their mother for 15 minutes twice a day for four consecutive days, while the control group (n = 15) received only usual care. The transcutaneous bilirubin levels were recorded at 6, 48, and 96 hours after birth. Data on re-hospitalization with hyperbilirubinemia were recorded on Day 7 after birth and analyzed using Fisher's exact test, independent t-test, and repeated measures ANOVA. The results revealed that the infants who received the massage had significantly lower mean bilirubin levels than those in the control group. However, there was no difference in the re-hospitalization with hyperbilirubinemia between the groups. In addition, the frequency of defecation on the first and fourth days in the experimental group was significantly greater than in the control group. The present study's result indicated that mothers' infant massage can help reduce bilirubin levels in full-term infants. The findings hold promise for nurses to integrate infant massage in training mothers at an early stage after birth for the prevention of hyperbilirubinemia in newborn infants. However, further testing with a larger sample size and randomized controlled trials are needed. [ABSTRACT FROM AUTHOR]

The article presents letter to the editor focuses on comparing blood cell counts in leukemoid reaction (LR) and chronic myeloid leukemia (CML) using Scopio blood cell counter and statistical analysis. Topics include the diagnostic challenges between LR and CML, the morphological and statistical differences in white blood cell counts, and the study's implications for clinical practice, highlighting its contribution to medical literature and the need for further multi-institutional studies.

Introduction: Ethylenediaminetetraacetic acid (EDTA)‐dependent platelet aggregation (PA) can cause medical errors. Currently, there is no reliable method for completely solving this problem. This study aims to solve this problem that has plagued clinical practice for many years by using oscillation method. Methods: Sixty‐one EDTA‐PA samples were collected, divided, and disaggregated using the oscillation method at various times and speeds. The samples were analyzed using routine blood tests and blood smears. Results: Platelet counts (PLT) were increased significantly after oscillation. PLT in the 3000 rpm for 0.5 min group was significantly higher than that in the 500 rpm for 0.5 min group (p < 0. 01). After 3000 rpm oscillation, the PLT gradually increased with time, while compared with the 10‐min group, the PLT in the 13‐min group showed no significant differences. The effective disaggregation rates in the EDTA‐PA samples using the oscillation method and sodium citrate anticoagulant were 96.72% and 65.57%, respectively. There were no significant changes in white blood cell (WBC) or red blood cell (RBC) counts or morphology after the use of the oscillation method. Conclusion: The oscillation method effectively depolymerized EDTA‐PA without adverse effects on WBC and RBC. The implementation of this technique promises to resolve the issue of EDTA‐PA. [ABSTRACT FROM AUTHOR]

Background and Design: Hematological parameters have been used as laboratory markers to evaluate the systemic inflammation in several rheumatic disease. The aim of this study is to determine the difference of hematological parameters between the patients who have been just fulfilled the Behçet's disease (BD) criteria and patients with recurrent aphthous stomatitis (RAS). Materials and Methods: Twenty patients with newly diagnosed BD and 47 patients with RAS whose oral ulcerations appeared at least three times a year were enrolled in this cross-sectional study. Demographic and clinical characteristics of patients, complete blood count, C-reactive protein (CRP) and erythrocyte sedimentation rate were recorded. Results: Patients' characteristics including gender, age, duration, and frequency of oral aphthous ulcerations in both study groups were comparable (p>0.05). CRP was significantly higher in newly diagnosed BD group when compared to the RAS group (p=0.001). CRP value higher than 2.7 g/dL, mean platelet volume (MPV) value higher than 7.58 fL and lymphocyte count higher than 2.85 103/μL were found to be the markers for distinguishing patients with BD from patients with RAS [odds ratio (OR): 12.76 (95% confidence interval (CI): 2.86-56.88), OR: 5.61 (95% CI: 1.11-28.42), OR: 15.24 (95% CI: 1.77-131.31), respectively]. Conclusion: The elevated CRP, MPV and lymphocyte count were associated with patients with newly diagnosed BD rather than patients with RAS. Further large prospective studies with the healthy control group are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Background: Older adults with diabetes mellitus require drug treatment considering their frailty, cognitive function, and hypoglycemia. Objective: We investigated the association between diabetic pharmacologic therapy and both diabetic complications and frailty across eight diabetes-specific outpatient clinics nationwide. Methods: Participants (aged 60–80 years) who had type 2 diabetes and did not require nursing care were included in the study. Basic attributes, patient background, complications, hypoglycemic status, body weight, body composition, blood tests, grip strength, and Kihon Checklist (a frailty index) and self-care scores were obtained. Descriptive statistics, t-test, chi-square test, and regression analyses were employed for evaluation. Results: Overall, 417 participants were included (224 men, 193 women, mean age 70.1 ± 5.4 years, diabetes duration 14.9 ± 10.9 years, body mass index 24.5 ± 3.8, glycated hemoglobin 7.22 ± 0.98%, proportion of individuals with frailty and prefrailty, 19.9% and 41.0%, respectively). All drugs were used more frequently in prefrailty conditions. Each diabetes medication was related to complications, body composition, and frailty, as follows: sulfonylurea (lower hypoglycemia); glinide (severe hypoglycemia, retinopathy, weaker grip strength, high Kihon Checklist score, decreased physical activities); alpha-glucosidase inhibitors (no association); biguanide (high body mass index, high body fat, stronger grip strength); thiazolidinedione (decreased instrumental activities of daily living); dipeptidyl‐peptidase‐4 inhibitors (no association); sodium-glucose cotransporter 2 inhibitors; retinopathy, high body mass index and Kihon Checklist score, and depressive mood); glucagon-like peptide-1 receptor agonists (high body mass index and body fat and poor nutritional status); and insulin preparations (hypoglycemia, retinopathy, neuropathy, nephropathy, cardiovascular diseases, weaker grip strength, and high Kihon Checklist score and physical inactivity). Conclusions: Some formulations, such as glinide, sodium-glucose cotransporter 2 inhibitors, and insulin, are associated with an increased frequency of frailty, warranting careful and individualized diabetes treatment. [ABSTRACT FROM AUTHOR]

Objectives: The triglyceride-glucose (TyG) index is a sign of atherosclerosis in cardiovascular diseases. The TyG index is thought to have clinical significance for the assessment of vascular damage. In this study we aimed to demonstrate the connection between the TyG index and retinal vein occlusion (RVO). Materials and Methods: This case-control observational study involved 492 participants aged 40-90, admitted to the ophthalmology outpatient clinic of our hospital. TyG index was calculated using the formula: ln(fasting TG [mg/dL] ´ fasting plasma glucose [mg/dL]/2). Results: The RVO group included 387 patients (181 women and 206 men) and the control group included 115 patients (61 women and 54 men). The average patient age was 62.9±11.1 years in the RVO group and 56.7±8.7 years in the control group. The TyG index was higher in the RVO group (8.9±0.7) than in the control group (8.8±0.6). This difference was statistically significant (p=0.04). The correlation was statistically significant when evaluated according to age and sex by multivariate logistic regression analysis (odds ratio: 1.45, confidence interval: 1.03-2.02, p=0.03). Conclusion: The TyG index is a novel atherogenicity index that is derived from routine blood tests and can be used to determine the risk of RVO in at-risk individuals with a simple calculation. Therefore, the TyG index could help as a reliable guide to identify individuals at RVO with high risk and initiate early intervention. [ABSTRACT FROM AUTHOR]

Up to 75% of marathon runners ingest non-steroidal anti-inflammatory drugs (NSAIDs) during competition. Despite the doubt whether or not they contribute to performance, the effect of NSAID in endurance sports is unclear. We evaluated the effect of ibuprofen (IBU) use on oxidative stress, muscle damage, physical performance, and vertical jump of runners participating in a 42-km-trail running. The sample consisted of 12 men randomly divided into 2 groups: a placebo group (placebo) and an ibuprofen group (IBG). A 400-mg IBU capsule was administered to the IBG 15 min prior to the start of the trial and during the course after 5 h. In the intergroup analysis, placebo 70.1% increase (p < 0.0001; Cohen's d = 4.77) of the thiobarbituric acid reactive substances (TBARS); the IBG exhibited a 31.46% increase of the sulphhydryl groups (SH) (p = 0.024, Cohen's d = 0.27), 55% of squat jump (SJ) (p < 0.01; Cohen's d = 1.41) with no significant effect on creatine kinase (CK), pace, speed, and finish time. In summary, IBU had positive evidence on oxidative stress and muscle fatigue, but had no effect on physical performance and muscle damage. [ABSTRACT FROM AUTHOR]

Ventilator-associated pneumonia (VAP) is common in Pediatric Intensive Care Units. Although early detection is crucial, current diagnostic methods are not definitive. This study aimed to identify lung ultrasound (LUS) findings and procalcitonin (PCT) values in pediatric patients with VAP to create a new early diagnosis score combined with the Clinical Pulmonary Infection Score (CPIS), the CPIS-PLUS score. Prospective longitudinal and interventional study. Pediatric patients with suspected VAP were included and classified into VAP or non-VAP groups, based on Centers of Disease Control (CDC) criteria for the final diagnosis. A chest-X-ray (CXR), LUS, and blood test were performed within the first 12 h of admission. CPIS score was calculated. A total of 108 patients with VAP suspicion were included, and VAP was finally diagnosed in 51 (47%) patients. CPIS-PLUS showed high accuracy in VAP diagnosis with a sensitivity (Sn) of 80% (95% CI 65–89%) and specificity (Sp) of 73% (95% CI 54–86%). The area under the curve (AUC) resulted in 0.86 for CPIS-PLUS vs. 0.61 for CPIS. In conclusion, this pilot study showed that CPIS-PLUS could be a potential and reliable tool for VAP early diagnosis in pediatric patients. Internal and external validations are needed to confirm the potential value of this score to facilitate VAP diagnosis in pediatric patients. [ABSTRACT FROM AUTHOR]

Background: An infection with SARS-CoV-2 can lead to a variety of symptoms and complications, which can impair athletic activity. Objective: We aimed to assess the clinical symptom patterns, diagnostic findings, and the extent of impairment in sport practice in a large cohort of athletes infected with SARS-CoV-2, both initially after infection and at follow-up. Additionally, we investigated whether baseline factors that may contribute to reduced exercise tolerance at follow-up can be identified. Methods: In this prospective, observational, multicenter study, we recruited German COVID elite-athletes (cEAs, n = 444) and COVID non-elite athletes (cNEAs, n = 481) who tested positive for SARS-CoV-2 by PCR (polymerase chain reaction test). Athletes from the federal squad with no evidence of SARS-CoV-2 infection served as healthy controls (EAcon, n = 501). Questionnaires were used to assess load and duration of infectious symptoms, other complaints, exercise tolerance, and duration of training interruption at baseline and at follow-up 6 months after baseline. Diagnostic tests conducted at baseline included resting and exercise electrocardiogram (ECG), echocardiography, spirometry, and blood analyses. Results: Most acute and infection-related symptoms and other complaints were more prevalent in cNEA than in cEAs. Compared to cEAs, EAcon had a low symptom load. In cNEAs, female athletes had a higher prevalence of complaints such as palpitations, dizziness, chest pain, myalgia, sleeping disturbances, mood swings, and concentration problems compared to male athletes (p < 0.05). Until follow-up, leading symptoms were drop in performance, concentration problems, and dyspnea on exertion. Female athletes had significantly higher prevalence for symptoms until follow-up compared to male. Pathological findings in ECG, echocardiography, and spirometry, attributed to SARS-CoV-2 infection, were rare in infected athletes. Most athletes reported a training interruption between 2 and 4 weeks (cNEAs: 52.9%, cEAs: 52.4%), while more cNEAs (27.1%) compared to cEAs (5.1%) had a training interruption lasting more than 4 weeks (p < 0.001). At follow-up, 13.8% of cNEAs and 9.9% of cEAs (p = 0.24) reported their current exercise tolerance to be under 70% compared to pre-infection state. A persistent loss of exercise tolerance at follow-up was associated with persistent complaints at baseline, female sex, a longer break in training, and age > 38 years. Periodical dichotomization of the data set showed a higher prevalence of infectious symptoms such as cough, sore throat, and coryza in the second phase of the pandemic, while a number of neuropsychiatric symptoms as well as dyspnea on exertion were less frequent in this period. Conclusions: Compared to recreational athletes, elite athletes seem to be at lower risk of being or remaining symptomatic after SARS-CoV-2 infection. It remains to be determined whether persistent complaints after SARS-CoV-2 infection without evidence of accompanying organ damage may have a negative impact on further health and career in athletes. Identifying risk factors for an extended recovery period such as female sex and ongoing neuropsychological symptoms could help to identify athletes, who may require a more cautious approach to rebuilding their training regimen. Trial Registration Number: DRKS00023717; 06.15.2021—retrospectively registered. [ABSTRACT FROM AUTHOR]

Aims Research has demonstrated a negative association between type 2 diabetes mellitus and male gonadal function, with reductions observed in serum levels of testosterone, folliclestimulating hormone, and luteinizing hormone. Conversely, resistance training has been shown to positively influence these hormones in healthy men. This study aimed to investigate the effect of resistance training on blood glucose, testosterone, follicle-stimulating hormone, and luteinizing hormone levels in men with type 2 diabetes. Instrument & Methods This semi-experimental study included 20 men with type 2 diabetes (aged 45-60 years) who were randomly assigned to the resistance training or the control groups (n=10 per group). The training group participated in an eight-week supervised program targeting major muscle groups. Blood samples were collected pre- and postintervention to measure blood glucose, testosterone, luteinizing hormone, and folliclestimulating hormone levels. Data were analyzed by SPSS 26 using the mixed ANOVA and an independent t-test. Findings The resistance training group demonstrated significant improvements (p<0.05) in blood glucose, testosterone, and luteinizing hormone levels compared to the control group and baseline measurements. No significant changes were observed in follicle-stimulating hormone (p>0.05). Conclusion Eight weeks of resistance training enhance blood glucose control and gonadal function in men with type 2 diabetes. [ABSTRACT FROM AUTHOR]

BACKGROUND: Although the terms “aphthous ulcers” and “aphthous stomatitis” have been used interchangeably in the past, the latter is now preferable. It is a widespread illness that affects 20% of the general population and 9% of children, according to estimates. Due to the high prevalence, pediatric patients who complain of mouth ulcers frequently present to medical and dental specialists. OBJECTIVES: Hematological assessments of patients with oral aphthous ulcer and comparison with healthy control. MATERIALS AND METHODS: A case–control study of 120 kids was conducted. The study included 100 patients with oral aphthous ulcer (56 male and 44 female) and a group of 20 healthy controls (10 males and 10 females). Data were collected using questionnaires. The questionnaires had two sections. The first section involved personal information. The second section is related to hematological examinations, such as hemoglobin level, serum iron level, folic acid level, Vitamin B12 level, and mean corpuscular volume. Statistical analysis was carried out using the t‑test, and the LSD was employed to significantly compare the means. RESULTS: The level of hemoglobin in the control group was statistically highly significantly increased when compared with patients with mean ± standard error (SE) (13.14 ± 0.20) versus mean ± SE (10.39 ± 0.19). Serum iron showed an increased level in the control group compared to patients with statistically showed highly significant correlation with mean ± SE (71.77 ± 5.14) versus mean ± SE (46.76 ± 2.79). A highly significant correlation existed when compared the control group and patients concerning Vitamin B12 levels with mean ± SE (517.02 ± 28.11) versus mean ± SE (367.32 ± 21.25). CONCLUSIONS: Hemoglobin, serum iron, and Vitamin B12 levels of patients are higher than that of controls. It is very important to observe the hemoglobin, folic acid, Vitamin B12, and serum iron levels in patients with oral ulcer before it starts to suggest treatments for oral ulcer. [ABSTRACT FROM AUTHOR]

Background and Aims: Hemoglobin A1c (HbA1c) is widely used for assessment of glycemic status and diagnosis of diabetes. HbA1c levels are influenced by age, ethnicity, and conditions that alter the red cell turnover or survival. We aimed to assess the effect of iron deficiency anemia (IDA) on HbA1c levels among adult diabetic and nondiabetic patients and correlate HbA1c with iron profile. Materials and Methods: A cross-sectional study was carried out among 150 patients, of whom 50 were diagnosed diabetics with IDA, 50 were nondiabetics with IDA, and 50 were controls. They were investigated for hemogram, renal function test, HbA1c, and iron profile. Results: Mean HbA1c value among controls was 5.03 ± 0.34%, among diabetics with IDA was 8.69 ± 0.92%, and among nondiabetics with IDA was 5.87 ± 0.76% and this difference was statistically significant. Total iron binding capacity (TIBC) was 332.54 ± 58.32 µg/dL among controls, 420.63 ± 119.03 µg/dL among nondiabetics with IDA, and 495.88 ± 126.79 µg/dL among diabetics with IDA. Pearson's correlation coefficient of HbA1c with serum ferritin was -0.444, with serum iron was -0.357, and with TIBC was 0.476. Conclusion: HbA1c levels are elevated in diabetes with IDA. HBA1c is negatively correlated with serum iron and ferritin and positively correlated with TIBC. [ABSTRACT FROM AUTHOR]

Objective There are well-described impacts of biological rhythms on human physiology. With the increasing push for routine blood tests for preventative medical care and clinical and physiological research, optimizing effectiveness is paramount. This study aimed to determine whether it is feasible to assess diurnal variations of peripheral lymphocyte prevalence using finger prick blood in a small sample size. Methods Using polychromatic flow cytometry, the prevalence of lymphocytes was assessed using 25 µL fingertip blood samples at 8 AM and 5 PM from 8 participants. Results TH cells and B cells showed significantly higher percentages in the 5 PM samples, whereas NK cells demonstrated a significantly higher morning percentage. T cells, leukocytes, and cytotoxic T cells showed no significant changes. Conclusion The detection of diurnal variations demonstrates that small blood volumes can be used to detect lymphocyte variations. The lower blood volume required provides a new testing method for clinical and research settings. [ABSTRACT FROM AUTHOR]

Aim: Tumor necrosis factor (TNF) inhibitors are used in patients resistant to conventional treatments for rheumatologic diseases such as rheumatoid arthritis (RA) and spondyloarthropathy (SpA). Agents used for treating rheumatic diseases affect hematological parameters. In this study, we evaluated hematological parameters in patients with inflammatory rheumatic diseases who started anti-TNF treatment at our center. Material and Methods: A total of 109 patients diagnosed with RA, SpA without psoriatic arthritis (PsA) and PsA who applied to the İnönü University Rheumatology Clinic and started TNF inhibitor treatment were included in the study. The patients' diagnoses, demographic data such as age and gender, and laboratory parameters (white blood cell, eosinophil, lymphocyte, monocyte, neutrophil counts, hemoglobin, platelet (PLT), mean platelet volume (MPV) ratio, neutrophil to lymphocyte ratio, monocyte/lymphocyte ratio and eosinophil/lymphocyte ratio) at the beginning of treatment and at the first month of treatment were recorded. Results: The rheumatic inflammatory patients included in our study comprised 29 RA, 16 PsA, and 64 spondyloarthritis without PsA patients. Seventy-seven patients were female (70.6%), and 32 were male (29.4%), with a mean age of 46 (18-78). When all patients were evaluated together, a statistically significant decrease in white blood cell, neutrophil, and PLT counts, a statistically significant increase in hemoglobin, lymphocyte, and eosinophil counts, and a statistically significant decrease in neutrophil to lymphocyte and monocyte to lymphocyte ratios with an increase in MPV and mean platelet volume to platelet count were observed at the 1st month of treatment. No complications related to laboratory changes were observed, and no patient discontinued treatment. Conclusion: Although there were changes in hematological parameters in patients receiving TNF inhibitor treatment in our study, we believe that regular hemogram monitoring should be performed at regular intervals in patients undergoing anti-TNF treatment, despite the absence of any complications in our study, as cases of severe cytopenia and eosinophilia have been reported in the literature following TNF inhibitor treatment. [ABSTRACT FROM AUTHOR]

Background: Alcohol use disorder (AUD) is associated with increased mortality and morbidity risk. A reason for this could be accelerated biological aging, which is strongly influenced by disease processes such as inflammation. As recent studies of AUD show changes in DNA methylation and gene expression in neuroinflammation‐related pathways in the brain, biological aging represents a potentially important construct for understanding the adverse effects of substance use disorders. Epigenetic clocks have shown accelerated aging in blood samples from individuals with AUD. However, no systematic evaluation of biological age measures in AUD across different tissues and brain regions has been undertaken. Methods: As markers of biological aging (BioAge markers), we assessed Levine's and Horvath's epigenetic clocks, DNA methylation telomere length (DNAmTL), telomere length (TL), and mitochondrial DNA copy number (mtDNAcn) in postmortem brain samples from Brodmann Area 9 (BA9), caudate nucleus, and ventral striatum (N = 63–94), and in whole blood samples (N = 179) of individuals with and without AUD. To evaluate the association between AUD status and BioAge markers, we performed linear regression analyses while adjusting for covariates. Results: The majority of BioAge markers were significantly associated with chronological age in all samples. Levine's epigenetic clock and DNAmTL were indicative of accelerated biological aging in AUD in BA9 and whole blood samples, while Horvath's showed the opposite effect in BA9. No significant association of AUD with TL and mtDNAcn was detected. Measured TL and DNAmTL showed only small correlations in blood and none in brain. Conclusions: The present study is the first to simultaneously investigate epigenetic clocks, telomere length, and mtDNAcn in postmortem brain and whole blood samples in individuals with AUD. We found evidence for accelerated biological aging in AUD in blood and brain, as measured by Levine's epigenetic clock, and DNAmTL. Additional studies of different tissues from the same individuals are needed to draw valid conclusions about the congruence of biological aging in blood and brain. [ABSTRACT FROM AUTHOR]

Background: It is crucial for medical personnel to be aware of cancer symptoms and engage in appropriate screening practices. This study aimed to investigate the knowledge of Iranian healthcare staff regarding cancer warning symptoms, their attitudes towards cancer risk factors, and their willingness to undertake cancer screening tests. Method: This cross-sectional study involved administering validated questionnaires to 145 medical staff. In addition to descriptive statistics, independent sample t-test and Analysis of Variance (ANOVA) were utilized to compare knowledge, attitudes, and performance of cancer screening tests. Pearson's correlation coefficient was used to determine the relationship between demographic and occupational variables and participants' knowledge and attitudes regarding cancer risk factors and screening practices. Results: The mean knowledge and attitude scores were 7.97 ± 2.01 and 35.41 ± 4.69, respectively. Among the 125 female participants aged 25-57 years, only 44% performed monthly breast self-examinations, 22.1% sought specialist physicians for breast cancer screening, and only 20.51% of female participants over the age of 40 underwent mammography. Regarding cervical cancer screening, 27.2% had undergone annual Pap smear tests, and 17.6% referred to a specialist for annual pelvic examinations. Among staff older than 45 years (24 participants), only one had undertaken an occult blood test and colonoscopy for colorectal cancer screening. Conclusion: Although most healthcare workers demonstrated awareness of cancer warning signs, they did not engage in regular preventive screening practices. Regular educational programs should be implemented to encourage healthcare personnel to perform routine cancer screening. [ABSTRACT FROM AUTHOR]

Background: Low birth weight, post-partum haemorrhage still births and maternal deaths are associated with anaemia in pregnancy. If prevalence of anemia will be reduced then there will be improvement in maternal and child health and its outcome. Aim & Objectives: To evaluate the changes in the hematological profile of the study subjects and to determine the impact of intensive health education intervention on anemia status of pregnant women. Methodology: A Community based interventional study was conducted among 200 Pregnant women of selected villages in rural area of Etawah district (100 women in each interventional and non-interventional group) using a selfdeveloped, pre designed, pretested, structured and validated questionnaire. statistical package for social sciences (SPSS) software was used to analyse the data. Result: After health education intervention there is significant increase in the haematological profile of study participants of interventional group (p<0.05) as before intervention values of mean Hb was 10.58±1.79 gm/dl which became 11.72±1.48 gm/dl There were 34 (73.9%) participants in the interventional group that were originally anaemic before the study, but after the intervention, they became non-anaemic. Conclusion: Health education sessions helped the pregnant women to improve their knowledge regarding anemia in pregnancy, as well as improve their ability to select iron rich foods, increase compliance with iron supplementation, and raise their haemoglobin levels [ABSTRACT FROM AUTHOR]

Introduction: In addition to boosting calcium absorption in the small intestine and preserving sufficient levels of calcium and phosphate in the serum to support proper bone mineralization, Vitamin D3 fortifies the immune system. Vitamin D3 deficiency can occur when regular intakes are gradually below recommended levels and when people get little sunshine exposure. Materials and Methods: The study was conducted using a case series study approach. A structured checklist was utilized on 107 individuals who had recovered from corona disease to identify the causes behind the unfavorable health effects they continue to experience. In addition, the patients underwent extensive laboratory blood testing in a specialized laboratory and received follow-up care for a period of 6 months. The results were analyzed using the Chi-square test and the Paired t-test using the SPSS software. Results: Despite the finding that 84.1% of the study group had Vitamin D3 levels below the normal range, their physical health conditions had considerably improved as a result of the treatment they received. Conclusion: The study found that patients with coronavirus infection had a high prevalence of Vitamin D3 deficiency. After 6 months, this percentage dropped considerably, raising the possibility that the coronavirus may have contributed to the drop in plasma Vitamin D3 levels. To find out how long-lasting COVID-19 symptoms are related to Vitamin D3 deficiency, more research is required. [ABSTRACT FROM AUTHOR]

BACKGROUND: Volume indices and count of platelets through sickle cell anemia (SCA) steady state are modified by chronic hemolysis, red blood cell sickling, and vaso-occlusion induced by this structural hemoglobinopathy. The bone pain crises additionally change these parameters. The recognition of the modification in platelet indices has a significant impact on understanding the pathogenesis and outcome of sickle cell disease patients. OBJECTIVES: This study objective is to compare volume indices and count of platelets of SCA patients in steady and through bone pain crisis states. PATIENTS AND METHODS: This is a retrospective cohort study that included 82 SCA patients who received care between October 2022 and October 2023 at the Hereditary Blood Disease Center, Basra, Iraq Written consent was obtained from all the participants and legal guardians. The criteria of inclusion involved SCA patients of 13 years old and older who presented to the center at the period of the stdy. They had their platelet count and volume indices measured during the crises of bone pain and in the steady state later on. Platelet count, platelet distribution width (PDW), plateletcrit (PCT), mean platelet volume (MPV), and platelet-large cell ratio (P-LCR) were measured by the automatic analyzer. RESULTS: Through bone pain crises as well as steady state, patients had a normal mean platelet count in comparison to the reference values of non-SCA population. It was found that MPV, PDW, PCT, and P-LCR were different in a significant way between the steady and bone pain crisis states, with P ≤ 0.001 with the mean values of 9.69 ± 1.25 versus 11.09 ± 0.99 for MPV, 13.27 ± 0.46 versus 15.78 ± 0.65 for PDW, 0.31 ± 0.03 versus 0.36 ± 0.01 for PCT, and 0.16 ± 0.01 versus 0.18 ± 0 for P-LCR, respectively. CONCLUSIONS: Through the steady state as well as bone pain crisis, the platelet count of SCA patients showed a normal value according to the range of reference for the normal population with no SCA. The P-LCR, MPV, PCT, and PDW were different significantly between SCA two clinical states as they became higher through the state of bone pain crises. This finding reflects the increment in the activation of platelets and the existence of large platelets in circulation at the time of vaso-occlusive crises. [ABSTRACT FROM AUTHOR]

Introduction: Inflammatory indicators such as procalcitonin (PCT) and C-reactive protein (CRP) may vary depending on the etiology of bloodstream infections. In this study, we aimed to investigate the role of serum PCT and CRP levels in predicting etiology in bloodstream infections. Methods: Blood cultures sent to our hospital's microbiology laboratory between January 2018 and July 2021 were retrospectively evaluated, and 501 patients with positive blood cultures were included in the study. According to blood culture growth, the patients were divided into Gram-negative bacteria (GNB), Gram-positive bacteria (GPB), fungus, Enterobacterales, and non-fermenter groups. We investigated whether there was a significant difference in the PCT and CRP values between the groups. Student's t-test was used to compare normally distributed numerical data, and the Mann-Whitney U test was used to compare non-normally distributed numerical data. The median value for continuous variables in each group was given as the first quartile (Q1) and third quartile (Q3). A comparison of categorical data was done with χ$178; test. Results: The PCT median value was found to be significantly higher in the GNB group compared with the GNB-GPB group. There was no significant difference between any of the groups for the CRP median value. In the GNB-GPB group comparison, the area under the curve for PCT cut-off value of 0.5 ng/mL was found to be 0.675 in the ROC curve (95% confidence interval=0.623-0.726; p<0.001), and the optimal cut-off value was found to be 1.45 ng/mL with 75% sensitivity, 53% specificity. Conclusions: Procalcitonin was found to be a marker that can be used to differentiate Gram-negative bacteremia from Gram-positive bacteremia. We concluded that CRP cannot be used to predict the etiology of bacteremia. [ABSTRACT FROM AUTHOR]

Background Ribonucleotide reductase subunit M2 (RRM2) plays a key role in cell and hepatitis B virus (HBV) replication. Nevertheless, its clinical implications for managing liver diseases have been inadequately studied. Methods A total of 412 participants were enrolled, including 60 healthy control individuals, 55 patients with chronic hepatitis B (CHB), 173 patients with cirrhosis, and 124 patients with hepatocellular carcinoma (HCC). Serum RRM2 was measured via ELISA. Results The level of serum RRM2 in patients with CHB, cirrhosis, and HCC was higher than that in healthy controls (P < .05). A large difference in serum RRM2 was found between HBV-related and non–HBV-related patients in the cirrhosis group (P < .001), compared with the difference between HBV-related HCC and non–HBV-related HCC (P  = .86). In the HBV-related cirrhosis group, the serum RRM2 level showed significant positive correlations with HBV DNA, hepatitis B surface antigen, hepatitis B e antigen, Child-Pugh scores, and MELD scores and played a strong role in diagnosing HBV-related cirrhosis in CHB, compared with fibrosis-4 score and aspartate aminotransferase–to-platelet ratio index. Conclusions Serum RRM2 is a reliable biomarker for accurate HBV-related cirrhosis diagnosis and evaluation. Also, serum RRM2 could reflect the expression state of HBV replication in patients with HBV-related cirrhosis. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to make a systematic analysis of cuproptosisrelated genes (CRGs) in immunological characterization and predictive drugs in Alzheimer's disease (AD) through bioinformatics and biological experiments. Methods: The molecular clusters related to CRGs and associated immune cell infiltrations in AD were investigated. The diagnostic models were constructed for AD and different AD subtypes. Moreover, drug prediction and molecular docking were also performed. Subsequently, a molecular dynamics (MD) simulation was conducted to further verify the findings. Finally, RT-qPCR validation was performed. Results: The characterization of 12 AD-related CRGs was evaluated in AD, and a diagnostic model for AD showed a satisfying discrimination power based on five CRGs by LASSO regression analysis. The dysregulated CRGs and activated immune responses partially differed between patients with AD and healthy subjects. Furthermore, two molecular subtypes (clusters A and B) with different immune infiltration characteristics in AD were identified. Similarly, a diagnostic model for different AD subtypes was built with nine CRGs, which achieved a good performance. Molecular docking revealed the optimum conformation of CHEMBL261454 and its target gene CSNK1D, which was further validated by MD simulation. The RT-qPCR results were consistent with those of the comprehensive analysis. Conclusion: This study systematically elucidated the complex relationship between cuproptosis and AD, providing novel molecular targets for treatment and diagnosis biomarkers of AD. [ABSTRACT FROM AUTHOR]

Background: Maintenance of immune system integrity is a vital requirement to protect human body against pathogens/cancers. Natural compounds have long been used due to their benefits for the immune system. One of which is bee venom that contains a peptide called melittin having antimicrobial and anticancer effects. Since a limited number of studies regarding the effects of melittin on the immune system have been carried out, we aimed to evaluate the effects of melittin on BALB/c mice immune system parameters. Methods: Female BALB /c mice were treated intraperitoneally (i.p) with 0.75 and 1.5 mg/kg doses of melittin for 14 days (5 doses per week). The negative control group received i.p normal saline whereas the positive controls received i.p 20 mg/kg cyclophosphamide (CYP). Immunological parameters such as hematological parameters, delayed-type hypersensitivity (DTH), hemagglutination titer (HA), spleen cellularity, splenocytes proliferation, as well as spleen and bone marrow histopathological assessment were evaluated. Results: Our findings showed that melittin has no gross pathological effect on the spleen and bone marrow. It was also demonstrated that melittin has no any significant effect on hematological parameters. Melittin did not cause any significant changes to proliferation response of splenocytes to PHA and LPS, spleen cellularity, DTH response, as well as the production of anti-SRBC antibodies. According to our results, melittin at 0.75 and 1.5 mg/kg doses could not induce significant changes on immune parameters and as a result, melittin was found to be safe for the mice immune system. [ABSTRACT FROM AUTHOR]

Arterial blood specimens collected in evacuated tubes are unacceptable for blood gas analysis. However, evacuated tubes are routinely used for venous blood-gas analysis. The impact of the blood to heparin ratio on venous blood in evacuated tubes is unclear. Venous blood was drawn into lithium and sodium heparin evacuated tubes that were 1/3 full, ½ full, 2/3 full, and fully filled. Specimens were analyzed for pH, ionized calcium (iCa), lactate, and potassium on a blood-gas analyzer. The results for specimens filled only 1/3 full for lithium and sodium heparin tubes revealed a significant increase in pH and a significant decrease in the iCa. Underfilling the lithium and sodium heparin evacuated tubes did not significantly impact the lactate or potassium results. Venous whole-blood specimens should be filled to at least 2/3 full for accurate pH and iCa results. [ABSTRACT FROM AUTHOR]

Objective Reduced left ventricular ejection fraction (LVEF) is common in hemodialysis (HD) patients. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is considered an important determinant of cardiovascular events. The aim of the study was to evaluate the relationship between Lp-PLA2 and LVEF in HD patients. Methods Fifty-seven HD patients with coronary heart disease were enrolled. Predialysis and postdialysis venous whole blood samples were collected. The patients were divided into preserved and reduced LVEF groups. The relationship between Lp-PLA2 and LVEF was assessed. Results A significant difference in C-reactive protein (CRP) and Lp-PLA2 was observed, with higher levels noted in patients with reduced LVEF (P  ≤ .001). Both Lp-PLA2 and CRP were negatively correlated with LVEF in the HD patients. Only Lp-PLA2 remained associated with LVEF in multiple regression analysis. Conclusion Lipoprotein-associated phospholipase A2 levels are associated with LVEF and could potentially be used to evaluate chronic heart failure with reduced LVEF in HD patients for risk stratification management. [ABSTRACT FROM AUTHOR]

Sarcopenia and anemia are common diseases in the elderly and are caused by various factors. In this study, the association between sarcopenia and anemia in an elderly Korean population was examined. The Korea Centers for Disease Control and Prevention's cross-sectional, nationally representative Korea National Health and Nutrition Examination Survey (KNHANES, 2008–2011) served as the source of the data for this study. Of the 2769 participants (1167 men and 1602 women) included in this study, a significant association was found between sarcopenia and anemia in the elderly in Korea. In Model 1, unadjusted for covariates, the prevalence of sarcopenia in all participants was 1.805 (95% CI 1.364–2.388) and 2.746 (95% CI 1.740–4.334) in men, and 1.494 (95% CI 1.045–2.138) in women. In Model 4, adjusted for all covariates, the prevalence of sarcopenia in all participants was 1.455 (95% CI 1.064–1.989) and 2.649 (95% CI 1.475–4.755) in men, but it was insignificant in women. While prior studies failed to consider variables such as exercise status and nutritional intake, this research incorporated these factors as covariates. Despite this comprehensive approach, this study still revealed an independent association between sarcopenia and anemia. Moreover, a significant association was uncovered among elderly men, with no corresponding association identified among women. [ABSTRACT FROM AUTHOR]

BACKGROUND Cardiovascular disease is a significant contributor to the disease burden in geriatric patients. Underlying systemic inflammation is thought to be the cause of age-related changes in the bone marrow and a major risk factor for atherosclerosis. The purpose of the study was to assess the accuracy of these hematological biomarkers in predicting 30-day mortality in older patients with acute coronary syndrome (ACS). METHODS This was a prospective observational study of 601 older adult patients (age > 60 years) with ACS who underwent percutaneous coronary intervention over two years (2017-2019). The relationship between baseline hematological parameters and mortality was assessed during the 30-day follow-up. Logistic regression analysis and receiver operating characteristic curve analysis were done to evaluate for diagnostic accuracy of various hematological parameters. RESULTS The mean age of presentation was 77 ± 17 years. The mean neutrophil-lymphocyte ratio (NLR) value was 5.07 ± 4.90 and the mean platelet-lymphocyte ratio (PLR) value was 108.65 ± 85.82. On univariate analysis, total leucocyte count [odds ratio (OR) = 0.85, P = 0.021], hematocrit (OR = 0.91, P = 0.018), NLR (OR = 1.10, P = 0.001) and PLR (OR = 1.05, P = 0.001) were associated with mortality. On receiver operating characteristic curve analysis, NLR predicted mortality with 68.1% and PLR with 65.7% accuracy. On multivariate analysis, NLR (OR = 1.096, 95% CI: 1.006-1.15, P = 0.035) was an independent predictor of 30-day mortality. CONCLUSIONS For the risk classification of all elderly ACS patients, we highly advise using NLR rather than the total white blood cell count. [ABSTRACT FROM AUTHOR]

Introduction: Regular whole blood donors often suffer from iron deficiency (ID) or iron deficiency anemia due to the loss of 200–300 mg of iron with each donation. Hemoglobin (Hb) as donor eligibility criterion reflects iron stores only poorly. ID in blood donors is typically prevented or treated with orally administered ferrous salts, which frequently cause gastrointestinal side effects. A high daily oral iron dose is counterproductive due to hepcidin upregulation. Oral sucrosomial iron (sucriron) is encapsulated ferric pyrophosphate that may be an option for blood donors due to its supposed high bioavailability and good tolerability. Methods: This monocentric single-cohort pilot study included fifty whole blood donors (divided into premenopausal women, postmenopausal women, and men) who did not meet Hb donation criteria. Participants aged 18–65 years with ferritin <30 ng/mL and venous Hb <12.5 g/dL in women and Hb <13.5 g/dL in men received oral sucriron (30 mg iron) for 90–120 days. Primary endpoints were the increase of Hb and ferritin. Results: Forty-seven participants completed the study. With the limitation that no control group was included, there was a substantial overall median increase of 0.94 g/dL Hb and 4.97 ng/mL ferritin (standardized on 90 days of iron intake). These value improvements were likewise observed in each of the subgroups. sucriron was very well tolerated, with almost no gastrointestinal side effects identified. Conclusion: A clear increase of Hb and ferritin was observed after the intake of sucriron, so it may be a reasonable and useful alternative to traditional oral iron therapy. The ease of administration, pleasant taste, dietary supplement status, and, most importantly, good tolerability highlight the value of sucriron supplementation. [ABSTRACT FROM AUTHOR]

Due to the high level of urbanisation in Ukraine, during the years 2021-2023, there is a tendency for a rapid increase in the number of companion animals in large cities - dogs and cats. Humanity has not yet finally eliminated the SARS-CoV-2 coronavirus pandemic, as world scientists have established the involvement of these animals in its spread, which causes concern among specialists and requires a comprehensive investigation. The purpose of the scientific study was to determine marker changes in haematological parameters and haematopoiesis parameters under the influence of coronavirus infection in dogs and cats. For this purpose, spectrophotometric and refractometric methods of haematological studies were used: morphological and biochemical parameters of blood, the functional state of erythro- and leukocytopoiesis. Considering changes in blood morphological parameters, the main parameters of the identity of the pathogenic effect of coronavirus on the body of dogs and cats were established, namely: a decrease in the number of lymphocytes, glucose content, and protein coefficient. There was a significant increase in the activity of alkaline phosphatase in the blood and α-amylase, the content of total bilirubin, and the erythrocyte sedimentation rate. In particular, it has been experimentally established that the use of leukocyte indices increases the information content of the general blood test for coronavirus infection, and additional analysis of integral changes based on leukocyte blood parameters allows determining not only the state of reactivity of the body, but also the extent of endogenous intoxication. The results of changes in blood morphological parameters are somewhat comparable to those in humans, which indicates the need for an in-depth study of the genetic potential of coronavirus pathogens in companion animals and humans at the molecular and biological levels. Experimentally determined marker changes in haematological parameters for coronavirus infection in dogs and cats can be useful for its timely diagnosis and prediction of the severity of the disease. [ABSTRACT FROM AUTHOR]

In the production of broiler poultry products, market operators use intensive technologies that involve the use of various, environmentally friendly nutraceuticals, in particular, probiotic preparations. In the technology of raising broiler chickens, probiotic preparations are necessary as a means for the prevention and treatment of gastrointestinal diseases, stimulating the growth and increasing the productivity of poultry. The purpose of the study is to investigate the effect of probiotic biologics on haematological parameters when it is fed to broiler chickens. The experiment used 20 broiler chickens, which were given a probiotic from 28 to 42 days in the following amounts: 0.5 g/10 dm3, 2.0 and 4.0 g/10 dm3 of water. It was found that the morpho-biochemical parameters of poultry blood corresponded to the physiological standards for broiler chickens of the established age and confirmed the absence of pathophysiological changes in their body. On days 35 and 42 of rearing, an increase in the number of leukocytes from 4.4 to 17.2% and the haemoglobin content by 3.9 and 6.2%, respectively, was observed in the blood of broiler chickens fed the probiotic at a dose of 4.0 g/10 dm3 compared to the control group. On day 35 of the study, a 1.2-fold increase in total serum protein was observed when drinking a probiotic in poultry, respectively, at doses of 2.0 and 4.0 g/10 dm3 of water, and on day 42 - 1.0 times for its drinking at a dose of 4.0 g/10 dm3 of water. It was found that the content of inorganic calcium and phosphorus in the poultry blood serum corresponded to physiological limits, which indicates a sufficient level of mineral nutrition in the body of broiler chickens. The absence of changes in the activity of alanine aminotransferase and aspartate aminotransferase, the content of total lipids, cholesterol, and creatinine in the blood serum of broiler chickens of the experimental groups indicates the hepato- and nephronethoxicity of the probiotic. Based on the results obtained, the drug under study can be recommended to increase the resistance of the poultry body and regulate metabolism. [ABSTRACT FROM AUTHOR]

The prevalence of malnutrition among children under five is alarmingly high in Pakistan. However, there are ready-to-use therapeutic foods (RUTF) available which may be used to treat children with severe acute malnutrition (SAM). This study aims to assess the efficacy of prebiotics as a synergistic additive to RUTF to enhance blood parameters and anthropometric measurements in children with uncomplicated SAM living in Southern Punjab, Pakistan. A double-blind parallel treatment randomized controlled trial was conducted on 204 children aged 6–59 months. Participants were randomized and allocated to the placebo (n = 102) or experimental arms (n = 102) in a 1:1 ratio. One group of children was provided with RUTF and 4 g prebiotics, while the other group was given RUTF and starch as a placebo. Participants recruited for both arms were given treatment for eight weeks, and then their biochemical and anthropometric outcomes were evaluated. A substantial difference between the mean weight, mid-upper-arm circumference, haemoglobin, haematocrit, platelet count, mean corpuscular volume, mean corpuscular haemoglobin, and albumin was revealed. During the two-month follow-up phase of the trial, children who were enrolled in the treatment group gained about 20% of their initial weight (pre-study mean weight = 5.44 ± 1.35 kg; post-study mean weight = 6.53 ± 1.45 kg). The analysis showed a significant difference (p < 0.005) between the control and treatment groups for MUAC and complete blood counts. Conclusively, supplementation with RUTF and prebiotics has proven to be an efficient, effective, and safe therapy for children suffering from SAM to improve their growth and development indicators and reduce the dangers of malnutrition in comparison to RUTF alone. [ABSTRACT FROM AUTHOR]

Surgery is associated with a post-operative stress response, changes in cardiopulmonary reserve, and metabolic demand. Here recovery after abdominal aortic aneurysm repair is investigated using cardiopulmonary exercise testing and patient-reported questionnaires. Patients undergoing open (n = 21) or endovascular (n = 21) repair undertook cardiopulmonary exercise tests, activity, and health score questionnaires pre-operatively and, 8 and 16 weeks, post-operatively. Oxygen uptake and ventilatory parameters were measured, and routine blood tests were undertaken. Recovery was characterised by falls in anaerobic threshold, peak oxygen uptake, and oxygen pulse at 8 weeks which appeared to be associated with operative severity; the fall in peak oxygen uptake was greater following open vs. endovascular repair (3.5 vs. 1.6 ml.kg−1.min−1) and anaerobic threshold showed a similar tendency (3.1 vs. 1.7 ml.kg−1.min−1). In the smaller number of patients re-tested these changes resolved by 16 weeks. Reported health and activity did not change. Aortic repair is associated with falls in the anaerobic threshold, peak oxygen uptake, and oxygen pulse of a magnitude that reflects operative severity and appears to resolve by 16 weeks. Thus, post-operatively patients may be at higher risk of further metabolic insult e.g. infection. This further characterises physiological recovery from aortic surgery and may assist in defining post-operative shielding time. Abdominal aortic aneurysm repair is a life-saving operation, the outcome from which is influenced by pre-operative cardiopulmonary reserve; individuals with poor reserve being at greater risk of peri-operative complications and death. However, for this operation, the physiological impact of surgery has not been studied. In a relatively small sample, this study suggests that AAA repair is associated with a significant decline in cardiopulmonary reserve when measured 8 weeks post-operatively and appears to recover by 16 weeks. Moreover, the impact may be greater in endovascular vs. open repair. [ABSTRACT FROM AUTHOR]

Background: Gout is triggered by high urate levels and causes inflammation, pain, and an impaired quality of life. Immersion in water at 20-30°C reduces inflammation and pain in arthritis. Yet, relationships of immersion in water at 20-30°C with urate levels and the nucleotide-binding domain (NOD)-like receptor protein 1 (NLRP1) inflammasome have never been clarified. Objectives: We aimed to investigate the effects of immersion in water at 20-30°C on urate levels, the NLRP1 inflammasome, pain, and quality of life among acute gout patients. Methods: A community-based randomized control trial design was used with 2 parallel-intervention groups: immersion in water at 20-30°C (20 min/day for 4 weeks) group and a control group. In total, 76 eligible participants in Tomohon City, Indonesia, were assigned using block randomization. We analyze the results (coef. ß) and 95% confidence intervals (CIs) using a generalized estimating equation model. We analyzed mediating effects using a path analysis. Results: Significant pain alleviation (ß = -2.06 [95% CI = -2.67~-1.45]; ß = -2.42 [95% CI = -2.97~-1.87]) and improved quality of life (ß = 5.34 [95% CI = 3.12-7.57]; ß = 9.93 [95% CI = 7.02-12.83]) were detected at 2 and 4 weeks of follow-up compared to the pre-test and control group. Urate levels (ß = -0.34 [95% CI = -0.52~-0.16]) were reduced at the 2-week follow-up, but there was no significant change in the NLRP1 inflammasome compared to the pre-test and control group after immersion in water at 20-30°C. Both the NLRP1 inflammasome (ß = -0.48 [95% CI = -0.63~-0.34]); water 0.01) and urate levels (ß = -0.11 [95% CI = -0.24~-0.03]; p < 0.01) had partial indirect (mediating) effects on the link between immersion in water at 20-30°C and pain at the 4-week follow-up. Conclusions: Immersion in water at 20-30°C significantly decreased pain and increased the quality of life. Immersion in water at 20-30°C mediated NLRP1 and urate levels to decrease pain, although it had no significant effect on the NLRP1 inflammasome concentration after 4 weeks of follow-up and reduced urate levels only at 2 weeks after immersion in water at 20-30°C. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pneumonia epidemic that started in 2020 and the management of its cases are not completely clear. Moreover, the process becomes more complicated in patients with comorbidities. In this study, we presented COVID-19 pneumonia patients diagnosed with rectus sheath hematoma (RSH). Methods: We retrospectively analyzed 12 patients that we followed up in the pandemic clinic between March 2020 and September 2021. The examinations performed at admission, the blood values and imaging findings in the detection of RSH, and the procedures performed were recorded. Results: Six of our cases were male and six were female, and the mean age was 77 (range: 68-89) years. In treatment protocols, low-molecular-weight heparin 0.6 milliliter and prednol 40 milligrams (IV) were administered twice a day. The diagnosis of RSH was made on the 8th (6-12) day on average of hospitalization and the start of treatment. A possible intra-abdominal connection of the hematoma or other intra-abdominal bleeding foci were excluded by computed tomography (CT) in all cases. After LMWH was discontinued, all patients were followed conservatively by recording their daily examinations and hematoma diameters, and the hematoma stopped and regressed spontaneously. All patients were followed conservatively and bleeding was successfully stopped. No morbidity or mortality associated with RSH was observed. Discussion and Conclusion: CT is the main tool used to determine the origin, amount, and type of bleeding in the diagnosis of RSH. Although it is a self-limiting entity, it may rarely require intervention. Hypercoagulation appears to play a key role in the pathogenesis of COVID-19. Side effects seen while intervening in the coagulation cascade require rapid diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Background: Periprocedural myocardial infarction (PMI) is one of the mortality-related complications of percutaneous coronary intervention (PCI) and significantly affects short- and long-term adverse outcomes and immediate cardiovascular events. Our present study aimed to evaluate the association of preprocedural serum laboratory parameters and PMI in patients who received primary PCI and attempted to provide detailed data on the predictors of PCI-related PMI. Methods: A total of 1184 consecutive coronary artery disease (CAD) patients who received primary and elective PCI between July 2015 and June 2017 were included and divided into control group and PMI group. The data of serum laboratory parameters were collected from the electronic database of Meizhou People's Hospital. Results: The results indicated that preprocedural fasting blood glucose were higher in PMI group compared with the control group (p <.001). Patients with prior hyperlipidemia were more likely to have experienced PCI-related PMI (p =.018) and the preprocedural level of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non-HDL-C, apolipoprotein B (Apo B), and LDL-C/high density lipoprotein cholesterol (HDL-C) were significantly enhanced in PMI group (p <.001). Multivariate regression analysis revealed that preprocedural fasting blood glucose > 6.11 mmol/L (p <.001, OR = 1.949, 95% CI: 1.444–2.630) and LDL-C levels ≥130 mg/dL (p =.005, OR = 1.941, 95% CI: 1.217–3.098) independently predicted PCI-related PMI. Conclusion: Our results indicated preprocedural fasting blood glucose >6.11 mmol/L and LDL-C levels ≥130 mg/dL may be useful predictors for PCI-related PMI. The study may provide a detailed data on the predictors of PCI-related PMI. [ABSTRACT FROM AUTHOR]

Background: The percutaneous extraction of endovascular cardiostimulation and defibrillation leads is the most frequent technique nowadays. The tools used today must guarantee the success of the procedure, with the minimum of complications. Our objective was to analyze the safety and efficacy of lead extraction using the Evolution mechanical dissection tool (Cook Medical, USA). Methods: A retrospective study was carried out in a total of 826 consecutive patients from October 2009 to December 2018 who underwent the procedure with the Evolution mechanical dissection tool. Preoperative study included complete blood tests, echocardiogram, and chest X‐ray. The procedures were performed in the operating room, under general anesthesia and echocardiographic control. Results: A total of 1227 leads were extracted with a mean chronicity of 10.3 ± 5.1 years. Clinical success (CS) rate was 99.7%. A total of 16 (1.9%) complications occurred, 2 (0.24%) were major complications and 14 (1.7%) were minor complications. There was no operative mortality. There was no statistically significant relationship between implant chamber and complete efficacy. The complete extraction was achieved in all left ventricular leads, in 762 of 774 (98.45%) of right ventricular lead removal, and in 330 of 334 (98.8%) of right atrial leads (p =.31). Conclusion: In our experience, percutaneous extraction of intravenous leads via the use of the Evolution tool (Cook Medical, USA), is a very effective and safe technique that offers low morbidity and mortality. [ABSTRACT FROM AUTHOR]

Introduction: The effect of Centaurea behen (Cb) on patients with systolic heart failure is not known academically. This study was conducted to evaluate the effect of Cb on improving the quality of life (QoL) and echocardiographic and biochemical blood parameters in patients with systolic heart failure. Methods: This study was a parallel double-blind, placebo-controlled randomized trial of 60 patients with systolic heart failure, was conducted from May 2018 up to August 2019. Intervention group received 150 mg twice daily Cb capsules for two months + Guideline directed medical therapy (GDMT), and control group received GDMT + placebo capsules for two months. The main aim of the present study was to assess the QoL based on the 6-minute walk test (6MWT) and the Minnesota living with heart failure questionnaire (MLHFQ). Independent T-test, paired T-test, and ANOVA were used for the analysis. Results: At the beginning of the present study there were no significant differences between study groups in terms of QoL and clinical results. After treatment, the average values of QoL based on MLHFQ and 6MWT instruments were significantly improved 15.5 and 36.18, respectively (P < 0.05). Conclusion: Based on the MLHFQ, and 6MWT tests, the consumption of Centaurea behen root extract was associated with significant improvement in the quality of life of patients with systolic heart failure. [ABSTRACT FROM AUTHOR]

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(1) Background: Retinopathy of prematurity (ROP) can cause severe visual impairment or even blindness. We aimed to assess the hematological risk factors that are associated with different stages of ROP in a cohort of preterm newborns, and to compare the clinical characteristics and therapeutic interventions between groups. (2) Methods: This retrospective study included 149 preterm newborns from a tertiary maternity hospital in Romania between January 2018 and December 2018, who were segregated into: Group 1 (with ROP, n = 59 patients), and Group 2 (without ROP, n = 90 patients). The patients that were affected by ROP were subsequently divided into the following subgroups: Subgroup 1 (Stage 1, n = 21), Subgroup 2 (Stage 2, n = 35), and Subgroup 3 (Stage 3, n = 25). The associations were analyzed using multivariate logistic regression and sensitivity analysis. (3) Results: Platelet mass indexes (PMI) that were determined in the first, seventh, and tenth days of life were significantly associated with Stage 1 ROP. PMI determined in the first day of life was also significantly associated with Stage 2 ROP. The sensitivity and specificity of these parameters were modest, ranging from 44 to 57%, and 59 to 63%. (4) Conclusions: PMI has a modest ability to predict the development of ROP. [ABSTRACT FROM AUTHOR]