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Following a large-scale radiological event, timely collection of samples from all potentially exposed individuals may be precluded, and high-throughput bioassays capable of rapid and individualized dose assessment several days post-exposure will be essential for population triage and efficient implementation of medical treatment. The objective of this work was to validate the performance of a biomarker panel of radiosensitive intracellular leukocyte proteins (ACTN1, DDB2, and FDXR) and blood cell counts (CD19+ B-cells and CD3+ T-cells) for retrospective classification of exposure and dose estimation up to 7 days post-exposure in an in-vivo C57BL/6 mouse model. Juvenile and adult C57BL/6 mice of both sexes were total body irradiated with 0, 1, 2, 3, or 4 Gy, peripheral blood was collected 1, 4, and 7-days post-exposure, and individual blood biomarkers were quantified by imaging flow cytometry. An ensemble machine learning platform was used to identify the strongest predictor variables and combine them for biodosimetry outputs. This approach generated successful exposure classification (ROC AUC = 0.94, 95% CI: 0.90–0.97) and quantitative dose reconstruction (R2 = 0.79, RMSE = 0.68 Gy, MAE = 0.53 Gy), supporting the potential utility of the proposed biomarker assay for determining exposure and received dose in an individual. [ABSTRACT FROM AUTHOR]

Ovarian cancer is the fifth most prevalent cancer in women. Chemotherapy is a major treatment option for patients with advanced ovarian cancer (OC). Quinoline-2-thione and its derivatives are potential candidates for tumor therapy. In this study, we investigated the anticancer activity of the quinoline-2-thione derivative KA3D against ovarian cancer. The effect of KA3D on the viability of ovarian cancer cells was evaluated using MTT assay, and its effects on apoptosis and the cell cycle were detected using flow cytometry. Western blotting was performed to identify apoptosis-and cell cycle-related proteins altered by KA3D treatment. A xenograft model was used to verify the inhibitory effect of KA3D in vivo. H&E staining, biochemical indicator detection, and blood cell counts were used to observe the toxicity and side effects of KA3D. KA3D treatment impeded cell viability, induced apoptosis, and impeded the G2 phase of the cell cycle in ovarian cancer cells. Mechanistically, we found that KA3D enhanced the expression of proapoptotic molecules such as BAX and Caspase 3, while antiapoptotic proteins such as BCL2 were inhibited. The G0/G1 phase-related protein cyclin D1 was reduced and the G2 phase-related protein cyclin B1 was upregulated. In vivo, KA3D displayed potent anticancer activity, with no apparent toxicity in BABLC/c nude mice bearing SKOV3 cells. KA3D demonstrated remarkable chemotherapeutic drug efficacy in terms of significant cancer suppression in vitro and in vivo with low toxicity. [ABSTRACT FROM AUTHOR]

Background and Objectives Study Design and Methods Results Conclusion Reproductive‐aged women are at an increased risk of developing iron deficiency (ID). We aimed to develop a non‐invasive screening tool to identify ID in women and assess the acceptability of screening.We screened women (age 18–49 years) in the community of Western Australia. Primary outcome: acceptability of screening, assessed by the feasibility of recruiting the required sample size (n = 323). Secondary outcomes: Hand grip strength, finger prick haemoglobin concentration (Hb), prevalence of heavy menstrual bleeding (HMB), diet, pregnancy history, blood donation, symptoms of ID and history of ID or anaemia (Hb < 120 g/L). Those with Hb <130 g/L and no history of iron therapy in the past 2 years were given referrals for venous full blood count and ferritin sampling.Across 5 days, we recruited 640 eligible women. Of which, 178 (28%) had HMB and 79 (12%) were anaemic. Mean age was 33.5 ± 9.2 years, and mean Hb was 132.4 ± 11.9 g/L. In the past 2 years: 335 (52%) were diagnosed with ID or anaemia; 322 (50%) had taken oral iron; and 210 (33%) had an intravenous iron infusion. Vegetarian diets were followed by 89 (14%); 40 (6%) were regular blood donors; 290 (45%) had a previous pregnancy.HMB increased the risk of symptoms of ID and having prior ID/anaemia diagnosis (67% vs. 47%) or treatment (p < 0.022). Hand grip strength showed a positive relationship with both Hb (adjusted R2 = 0.012, p = 0.004) and ferritin (adjusted R2 = 0.135, p = 0.005).ID screening was well accepted by women in the community, with high recruitment rates over a short period. Future screening tool development may consider incorporating hand grip strength and HMB assessment. [ABSTRACT FROM AUTHOR]

Background Aims Study Design Results Conclusions Relevance to Clinical Practice Evidence suggests that 8%–10% of ICU patients receive renal replacement therapy. However, there is a high rate of unplanned CRRT interruption, ranging between 17% and 74%. Studies on unplanned interruption of CRRT mainly focused on the retrospective investigation of related risk factors and conclusions have been diverse.This article aims to clarify the main influencing factors related to unplanned interruption of continuous renal replacement therapy (CRRT) in adult patients in intensive care units (ICUs).A literature review and meta‐analysis were undertaken. Following the application of the Newcastle–Ottawa Scale (NOS), a total of 15 articles were included in a total of 2132 patients who underwent 3690 CRRT procedures and 2181 unplanned interruption times. The methodological guideline of a scoping review was applied for the evidence synthesis while applying the meta‐analysis quantitative methodological guideline to identify and clarify main influencing factors related to unplanned interruption of CRRT. The reporting Prisma Protocol was followed.Longer filter life and prothrombin activation time, higher red blood cell count, greater transmembrane pressure, faster blood flow rate, intermittent saline irrigation, lower creatinine level, low prothrombin activity and pre‐dilution are factors identified to potentially affect unplanned CRRT in ICU patients.Available evidence suggests four clinical challenges associated with unplanned CRRT interruption, namely: (a) effects of red blood cell count, filter life, cross‐mode pressure, blood flow velocity, prothrombin activity and activated partial thrombin time on unplanned interruption; (b) influence of dilution mode on unplanned interruption; (c) influence of intermittent saline irrigation on unplanned interruption; (d) influence of Scr level on unplanned interruption.The potential to increase the ability to better manage unplanned CRRT in ICUs has been identified in this article and constitutes a relevant potential health care management contribution that can be implemented by nurses. [ABSTRACT FROM AUTHOR]

Objective: The clinical management of catatonia has always been a focus of psychiatric nursing. Unfortunately, there is still limited research on the risk factors and nursing methods for patients with catatonia and bacterial pneumonia. Few studies have identified and analyzed the clinical risk factors for catatonia patients with bacterial pneumonia. This study aims to explore the risk factors and preventive nursing measures for pneumonia in patients with catatonia. Methods: A total of 88 patients with catatonia treated in the emergency department of a psychiatric hospital from January 2019 to October 2021 were selected. They were divided into bacterial pneumonia group (n=17) and nonpneumonia group (n=71) based on whether they had pneumonia. The demographic data and clinical characteristics of the two groups were compared. Logistic regression analysis and point-biserial correlation were used to analyze the risk factors for developing pneumonia in patients with catatonia. Results: The incidence of pneumonia in patients with catatonia was 19.32%. Correlation analysis showed that age (r=0.216, p=0.043), The Activities of Daily Living Scale (ADL) score (r=0.265, p=0.013), cell count of white blood (r=0.591, p<0.001), neutrophil count (r=0.599, p<0.001), percentage of neutrophils (r=0.311, p=0.003), C-reactive protein (r=0.558, p<0.001), bedridden days (r=0.470, p<0.001), and albumin level (r=-0.288, p=0.007) were significantly associated with pneumonia. Multivariate logistic regression analysis showed that smoking, bedridden days, family support, and nutritional status were risk factors for pneumonia in patients with catatonia. Conclusion: Reducing smoking and bedridden days, improving nutrition, and providing timely preventive nursing care by family members can reduce the occurrence of pneumonia in patients with catatonia. [ABSTRACT FROM AUTHOR]

Background: Platelets play a key role in the natural history of aortic stenosis (AS) and after transcatheter aortic valve implantation (TAVI). An echo-based staging system stratifies patients with severe AS into 5 groups according to the associated cardiac damage phenotype. We aimed to correlate these AS stages with platelet indices in post-TAVI patients. Methods: Patients with severe AS who underwent TAVI and were admitted to intensive cardiac care unit (ICCU) were prospectively identified and divided into 5 groups according to extra-valvular cardiac damage [no extravalvular cardiac damage (Stage 0), left ventricular damage (Stage 1), left atrial or mitral valve damage (Stage 2), pulmonary vasculature or tricuspid valve damage (Stage 3), or right ventricular damage (Stage 4)]. Baseline characteristics and complete blood count including mean platelet volume (MPV) and immature platelet fraction (IPF) were collected within 2 h after the procedure and analyzed in relation to aortic stenosis staging. Results: A total of 220 patients were included. The mean age was 81 years old and 112 (50.9%) were female. Two (1%) patients were classified in stage 0; 34 (15%) in stage 1; 48 (22%) in stage 2; 49 (22%) in stage 3 and 87 (40%) in stage 4. Higher mean MPV values were correlated with higher AS staging (10.8 fL, 11 fL, 11.3 fL and 10.8 fL in stages 1, 2, 3 and 4, respectively, P = 0.02) as well as lower hemoglobin values (12 mg/dl, 11.6 mg/dl, 11 mg/dl and 11.3 mg/dl in stages 1, 2, 3 and 4, respectively P = 0.04). Mean IPF values were 5.3%, 5.58%, 5.57% and 4.83% in stage 1, 2, 3 and 4, respectively (P = 0.4). In a multivariate logistic regression model only MPV (OR = 2.6, P = 0.03) and body mass index (BMI) (OR = 1.17, P = 0.004) were correlated with higher staging (0–3) of AS. Conclusions: Although IPF and MPV levels increased in stages 0–3, there was a decrease in indices in stage 4, (probably due to bone marrow dysfunction) in this end-stage population. Higher levels of MPV and lower levels of hemoglobin were independently correlated with higher stages (0–3) of AS. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease (CVD) is the leading cause of excessive and premature mortality in patients with bipolar disorder (BD). Despite immune cells participating considerably in the pathogenesis of CVD, limited data are available regarding leukocyte phenotypes in patients with BD and CVD. This study aimed to evaluate associations between circulating leukocyte subset and CVD among patients with BD. Methods: A total of 109 patients with BD-I and cardiologist-confirmed CVD diagnosis (i.e., case) were matched with 109 BD-I patients without CVD (i.e., control) according to the age (± 2 years), sex, and date of most recent psychiatric admission because of acute mood episode (± 2 years). Leukocyte subset data were retrieved from complete blood count tests performed on the next morning after the most recent acute psychiatric admission. Results: During the most recent acute psychiatric hospitalization, circulating monocyte counts in the case group were significantly higher than those in the age- and sex-matched controls (p = 0.020). In addition, monocyte–lymphocyte ratios (MLRs) in the case group were significantly higher than those in the control group (p = 0.032). Multiple logistic regression showed that together with serum levels of uric acid and manic symptoms, circulating monocyte counts (95% CI, OR: 1.01–1.05) and MLRs (95% CI, OR: 1.01–1.09) were significantly associated with CVD in patients with BD, respectively. Conclusions: Monocyte activation in an acute manic episode may play a critical role in the pathogenesis of CVD among patients with BD. Future research is required to investigate markers of monocyte activation and indices of cardiovascular structure and function across the different mood states of BD. [ABSTRACT FROM AUTHOR]

Inflammation plays a crucial role in cancer development. The neutrophil-to-lymphocyte ratio (NLR), a measure of inflammation, is obtained from a complete blood count. However, little is known about the association between NLR and cancer in the general adult population in the United States. This study aimed to evaluate whether NLR is associated with cancer in American adults. This retrospective cross-sectional study included 28,016 adult participants from the National Health and Nutrition Examination Survey (NHANES) dataset spanning 2005 to 2018. Data on demographics (age, sex, race, marital status, Poverty-Income Ratio, education level), lifestyle factors (smoking, alcohol consumption, body mass index), medical conditions (hypertension, diabetes, cardiovascular disease), and laboratory parameters (hemoglobin, platelet count, alanine aminotransferase, creatinine, albumin, and lactate dehydrogenase), were collected. Logistic regression analysis was used to investigate the research objectives. Of the total 28,016 participants, 2639 had cancer. The mean age was 49.6 ± 17.6 years, and 50% were male. A positive association between NLR and cancer risk was observed after multivariate adjustment (OR = 1.20, 95% confidence interval (CI) = 1.05–1.36, p = 0.006). Similar patterns were observed in subgroup analyses (all p-values for interaction > 0.05). A higher NLR was directly correlated with an increased risk of developing cancer in adults. [ABSTRACT FROM AUTHOR]

The effects of meteorological conditions on IOP using a large-scale health examination cohort were investigated. There were a total of 811,854 measurements from 126,630 eyes of 63,839 subjects in 9 years from a health checkup cohort followed up annually for age, sex, body height, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), and IOP. The effects of these variables and the meteorological data of daily average temperature (TP), daily average local atmospheric pressure (AP), daily average volumetric humidity (VH), and daily amount of rainfall (RF) on the day of IOP measurement on IOP were investigated. Several variables were significantly associated with IOP, including sex, age, body height, BMI, SBP, DBP, average TP, average AP, average VH, RF, white blood cell count, red blood cell count, hemoglobin, aspartate aminotransferase, alanine aminotransferase, guanosine triphosphate, calcium, and HbA1c. This study indicated a correlation between meteorological factors and IOP. Higher AP and RF were associated with elevated IOP, whereas higher TP and VH were associated with decreased IOP. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives Methods Results Conclusions Anaemia is a key cause of morbidity in chronic kidney disease (CKD). Androgen deficiency (AD) in males can contribute to anaemia of all causes, including in CKD. We sought to examine the prevalence of AD in men with CKD, the extent to which it contributed to anaemia and whether it was independently associated with long‐term survival.This cross‐sectional observational study was conducted among males aged 18 years and over with CKD stages 4 and 5. The study analysed morning blood samples with regard to their full blood count, urea and electrolytes, albumin, lipids, testosterone (T) and sex hormone binding globulin, with calculation of free testosterone by mass action equation. Mortality data were obtained 15 years later for survival analysis.Among 322 patients with a mean age of 63 years, the overall prevalence of AD was 68.9%. There was a statistically significant negative correlation between erythropoiesis stimulating agent (ESA) dose and testosterone concentrations (Pearson correlation −0.193, p = 0.05). There was a positive correlation between haemoglobin (Hb) and free testosterone level among patients not on ESA therapy (Pearson correlation 0.331, p < 0.001). Kaplan‐Meier plots showed p < 0.001 on log‐rank analysis, indicating that AD was significantly associated with worse survival. However, in Cox regression analysis, free testosterone was not associated with survival (95% CI for free testosterone 0.997–1.000).AD is highly prevalent among this population, and increases further with older age and more severe CKD warranting haemodialysis. Association of lower Hb and higher ESA dose with lower T concentration might be causative, which has important pharmaco‐economic as well as clinical implications. Lower survival in men with low T, more likely reflects overall poor health rather than causation. A properly constituted randomised controlled study evaluating the effect of native T replacement is warranted in men with CKD and AD. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodsResultsConclusion\nHIGHLIGHTSIn this study, we wanted to investigate the usability of routine blood samples taken at the beginning of hospitalisation in inpatients to predict the presence of psychotic symptoms in patients.We divided the hospitalised patients into two groups those with and without psychotic symptoms according to their ICD-10 diagnosis codes. Then, we compared the complete blood count, c-reactive protein (CRP), and fasting glucose levels, which can be used as simple markers of inflammation.In this retrospective study, which included 349 patients, we found that blood leukocytes, neutrophils, CRP, and fasting glucose levels were higher in patients with psychotic symptoms than in patients without psychotic symptoms (p = 0.015; p = 0.013; p = 0.002; and p = 0.001, respectively). According to regression analysis, patients with high glucose levels were 4.9 times more likely to have psychotic symptoms than those with low glucose levels. In addition, according to the ROC analysis results; when we used 87 mg/dl as the cut-off value for fasting glucose, it was observed that it predicted psychotic symptoms with approximately 69% sensitivity and 71% specificity.Although our results still have some limitations, they are promising for the future use of simple biomarkers of inflammation for the differential diagnosis of psychiatric disorders. Inflammatory parameter levels are higher in patients with psychotic symptomsHigh glucose level is assosiated with a higher likelihood of psychotic symptomsBlood fasting glucose levels can be used to predict psychotic symptomsThe difference between groups disappears in repeated hospitalisations.Inflammatory parameter levels are higher in patients with psychotic symptomsHigh glucose level is assosiated with a higher likelihood of psychotic symptomsBlood fasting glucose levels can be used to predict psychotic symptomsThe difference between groups disappears in repeated hospitalisations. [ABSTRACT FROM AUTHOR]

The Nix-TB clinical trial evaluated a new 6 month regimen containing three oral drugs; bedaquiline (B), pretomanid (Pa), and linezolid (L) (BPaL regimen) for the treatment of tuberculosis (TB). This regimen achieved remarkable results as almost 90% of the multidrug-resistant or extensively drug-resistant TB participants were cured but many patients also developed severe adverse events (AEs). The AEs were associated with the long-term administration of the protein synthesis inhibitor linezolid. Spectinamide 1599 is also a protein synthesis inhibitor of Mycobacterium tuberculosis with an excellent safety profile, but it lacks oral bioavailability. Here, we propose to replace L in the BPaL regimen with spectinamide (S) administered via inhalation and we demonstrate that inhaled spectinamide 1599, combined with BPa--BPaS regimen--has similar efficacy to that of the BPaL regimen while simultaneously avoiding the L-associated AEs. The BPaL and BPaS regimens were compared in the BALB/c and C3HeB/FeJ murine chronic TB efficacy models. After 4-weeks of treatment, both regimens promoted equivalent bactericidal effects in both TB murine models. However, treatment with BPaL resulted in significant weight loss and the complete blood count suggested the development of anemia. These effects were not similarly observed in mice treated with BPaS. BPaL and BPa, but not the BPaS treatment, also decreased myeloid to erythroid ratio suggesting the S in the BPaS regimen was able to recover this effect. Moreover, the BPaL also increased concentration of proinflammatory cytokines in bone marrow compared to mice receiving BPaS regimen. These combined data suggest that inhaled spectinamide 1599 combined with BPa is an effective TB regimen without L-associated AEs. [ABSTRACT FROM AUTHOR]

Objective: Early identification of complicated acute diverticulitis(cAD) is especially significant for clinical physician and surgeon to reduce the antibiotic usage and the risk of emergency surgery. This study was aimed to investigate the significance of immature granulocyte(IG) count in early prediction for right-side(Rt-side) cAD. Methods: The patients with Rt-side colonic acute diverticulitis was enrolled between January, 2019 and March, 2024, and divided into complicated and simple acute diverticulitis group(cAD and sAD). The data about demographic, clinical and laboratory parameters were collected and compared. Logistic regression analysis and receiver operator characteristic(ROC) curves were used to assess the predictive values of these parameters for Rt-side complicated diverticulitis. Results: 289 participants who met the inclusion criteria were followed as 31 patients in cAD group and 258 in sAD group. Compared to sAD group, cAD group had the higher body mass index(BMI) and peripheral blood routine parameters, especially IG count, systemic immune inflammation index(SII) and neutrophil-to-lymphocyte ratio(NLR), with the statistically significant differences(P<0.001). Moreover, logistic regression analysis indicated that IG count was a significant and independent predictors for cAD(OR 4.92, 95%CI 3.86–8.39). In the ROC analysis, area under the ROC curves (AUC) was found for IG count(0.93(95%CI 0.88–0.99)) and SII(0.88(95%CI 0.820–0.95)). The optimal cut-off value of IG count was 0.10 with the largest sensitivity of 80.60% and specificity of 100.00% for identifying Rt-side colonic complicated diverticulitis. Conclusion: IG count was a more comparable and independent predictor for Rt-side colonic complicated diverticulitis with a largest AUC than other markers in complete blood count (CBC). Given its early arise, easy accessibility and no-radiation, it can largely convince physicians' decision-making of antibiotic abuse and surgeons' early intervention in Rt-side colonic cAD. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction Methods Results Conclusions Complete blood count is the most common, basic test requisitioned in hematology. The normal reference ranges of hematological parameters are required owing to variable socioeconomic, environmental, and genetic factors in populations. The current study determines the reference ranges of the healthy Indian donor population of a high socioeconomic group.The study was conducted in the Department of Transfusion Medicine at a tertiary care hospital in India and included 4098 individuals, aged 18–65 years coming for voluntary blood donation from July 2021 to October 2022. Blood samples were collected in K2EDTA, analyzed on the Sysmex XN–31 hematology analyzer, and using statistical tools, the normal reference ranges were calculated.The reference ranges for hemoglobin (HB) (137–185 g/L), WBC (5.1–1.7 × 109/L), platelet count (115.6–370.0 × 109/L) were noted. No statistically significant changes were observed in different age groups. There were gender‐wise differences noted in nearly all parameters. The HB and hematocrit (HCT) range was slightly higher in other Indian and other Asian populations with comparable values with the Chinese, Korean populations, and Western populations; RBC parameters were overall comparable with minor differences; the WBC count was higher than the other Indian and Asian populations particularly the upper limit of lymphocyte and monocyte; and the range of platelet counts had a comparable upper limit with all populations and had the lowest lower value in males in our study, which was comparable to only the Chinese population.It is concluded that reference ranges of common parameters were calculated with minor changes noted in all hematological parameters on comparing with other Indian, Asian population, and Western data. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusions We aimed to detect subclinical cardiac impairment in children with ulcerative colitis (UC) and test the association between absolute monocytic count (AMC) and lymphocyte‐to‐monocyte ratio (LMR) with disease activity.A group of children with UC and a comparable group as healthy controls were included. All children underwent history‐taking, clinical examination and blood testing for complete blood counts with white blood cell differentials, LMR and erythrocyte sedimentation rate (ESR). Disease severity was assessed using the Paediatric UC Activity Index score. We used echocardiography for tissue Doppler, M‐Mode, two‐dimensional and three‐dimensional (3D) speckle tracking echocardiography (STE) for left ventricular function assessment.Forty children were included, 20 with UC as cases, and 20 healthy controls. Disease activity was mild in 75% cases and moderate in 25% cases. Cases had significantly higher ESR than the control group (P < 0.001). Among cases, positive correlations were observed between monocytic, and platelet counts with left ventricular end‐diastolic diameter (r = 0.5, P = 0.02; r = 0.5, P = 0.03). Children with UC had significantly lower ejection fraction and impaired left ventricular systolic function compared to the control group (P < 0.001) assessed by 3D STE, yet this observation was not reached by the conventional method (P = 0.3).In children with UC, 3D STE could detect subclinical left ventricular systolic dysfunction that conventional echocardiography could not. AMC and LMR showed no significant difference between children with UC and controls. [ABSTRACT FROM AUTHOR]

Background: Eosinophilic airway inflammation has been detected in up to 40% of chronic obstructive pulmonary disease (COPD) patients during stable periods of the disease, and increased sputum eosinophil count was associated with better lung function, more future exacerbations, and symptoms that responded better to treatment with inhaled and oral corticosteroids. The aim of this work was to investigate the relationship of blood eosinophils and plasma periostin with lung function changes related to ICS and long-acting beta2-agonist combination treatment in stable COPD patients for 3 months. Methods: This prospective experimental study was carried out on 50 COPD patients with post-bronchodilator FEV1/FVC ratio < 70%. Patients collected from outpatient clinics of Chest Department Tanta University Hospitals, Tanta Chest Hospital, and Mansoura Chest Hospital from February 2020 to February 2022. Patients were subjected to complete history taking, and clinical examinations including general and local examinations and laboratory investigations (complete blood count to assess eosinophilic count, arterial blood gases, and plasma periostin) and spirometry were done for all patients pre- and post-treatment. All patients received 3 months of treatment with a fixed dose of combined inhalers of ICS and LABA, and then they were classified into FEV1 responder and FEV1 non-responder according to improvement in FEV1 at least 12% and 200 mL from baseline of 3 months of combined treatment with ICS/LABA. Results: Blood eosinophil count had a significant positive correlation with smoking index (pack/year), negative correlations with FEV1% of predicted, FEV1 actual value (L), and FEV1/FVC ratio. Plasma periostin concentration had significant positive correlation with blood eosinophil count, COPD grade, and FVC actual value (L) and significant negative correlations with FEV1% of predicted, FEV1 actual value (L), and FEV1/FVC. Cutoff values of blood eosinophil count > 265 cell/µL, plasma periostin concentration > 15.747 ng/mL, and FEV1% < 40.5% were associated with posttreatment FEV1 response. Conclusions: COPD patients with poor lung functions regarding FEV1/FVC ratio, FEV1 actual value (L), and FEV1% of predicted as well as high blood eosinophil count and high plasma periostin concentration are predicted to have FEV1 response with fixed-dose ICS/LABA combination treatment. [ABSTRACT FROM AUTHOR]

This article provides a comprehensive overview of an algorithm for diagnosing betalactam (BL) allergy. The diagnostic process involves a clinical history, skin tests, in vitro tests, lymphocyte transformation tests, and drug provocation tests. The sensitivity and specificity of these tests vary, with skin tests and in vitro tests showing lower sensitivity but higher specificity. The article also discusses risk stratification, the development of assessment tools, and the use of alternative drugs for allergic patients. It includes a list of various antibiotics categorized by generation, along with recommendations for administration and testing based on structural similarities. The document is authored by a group of researchers and clinicians from Spain and provides references for further exploration. [Extracted from the article]

The production of nanoparticles in the presence of biomaterials has become a promising substitute to traditional chemical and physical manufacturing procedures. Zinc oxide nanoparticles (ZnO-NPs) were prepared using Phyla nodiflora leaf extracts as a natural reducing agent, along with distilled water. The nanoparticles were analysed using various methods such as transmission electron microscopy, Fourier transformed infrared spectroscopy, UV-visible spectroscopy, energy dispersive X-ray, X-ray diffraction, dynamic light scattering, and zeta potential to examine their synthesis, structural morphology, chemical bonding, elemental composition, and crystalline structure. ZnO-NPs were orally provided for three weeks instead of usual drinking water to assess their therapeutic efficacy. Blood biochemical examinations were performed, including liver and kidney function tests, lipid profiles, and complete blood counts. The study exhibited a notable reduction in blood urea, creatinine, and uric acid levels, substantially alleviating hyperuricemia and gouty arthritis. A slight increase in liver enzymes, alkaline phosphatase (ALP), aspartate transaminase (AST), and alanine transaminase (ALT) was detected in the study groups, with no negative changes histopathologically found in the liver, muscle, or kidney tissues. The results indicate that ZnO-NPs have the potential to be an effective alternative to current pharmaceutical treatments for hyperuricemia and gouty arthritis. [ABSTRACT FROM AUTHOR]

Pancytopenia is a hematological condition characterized by a decrease in three blood cell lines: erythrocytes, leukocytes, and platelets. This condition is not an independent disease, but a manifestation of various underlying diseases. Pancytopenia can be caused by impaired blood cell production in the bone marrow or increased destruction of blood cells in the periphery. Precise and prompt identification of the etiology is essential, given that pancytopenia can be life-threatening if not treated properly. This study aims to analyze and identify the causes of pancytopenia in patients at Batang Regency Hospital, as well as provide recommendations for appropriate treatment based on the etiology found. The methods used were clinical observation, laboratory examination, and diagnostic imaging in a 58-year-old patient with the main complaint of weakness and a history of pancytopenia. The examination includes a complete blood count, a smear of peripheral blood, and a clinical evaluation. The results showed that the patient had central type pancytopenia, with a suspected etiology of aplastic anemia or myelodysplastic syndrome. Other differential diagnoses include vitamin B12 deficiency. Although a bone marrow biopsy is necessary to confirm the diagnosis, initial therapy with blood transfusions and nutritional improvements has shown an improvement in the patient's condition. The conclusion of this study is the importance of a thorough evaluation to identify the etiology of pancytopenia. Proper treatment should be based on the underlying cause, which will affect the prognosis and prevent recurrence. A comprehensive approach can improve patients' quality of life and reduce the risk of complications. [ABSTRACT FROM AUTHOR]

Introduction: Hypothyroidism has long been known to cause metabolic deceleration, including its effects on haematopoietic tissue, leading to anaemia. Anaemia and hypothyroidism can co-exist and present challenges for each other, resulting in a decline in quality of life. Aim: To address the gender-specific association of Thyroid Stimulating Hormone (TSH) with various haematological indices among a cohort of hypothyroid patients. Materials and Methods: A cross-sectional observational study was conducted at a tertiary care teaching hospital in Hyderabad, Telangana, India, from October 2022 to February 2023, after obtaining ethical clearance from the institutional ethics committee. A total of 347 newly diagnosed, biochemically proven hypothyroid patients attending the hospital were included in the study. The patients were divided into subclinical and overt hypothyroid groups based on their TSH values and thyroxine levels. All patients underwent blood tests for a complete blood count, including all haematological indices such as erythrocyte count, Haemoglobin (Hb), Packed Cell Volume (PCV), Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin (MCH), Mean Corpuscular Haemoglobin Concentration (MCHC), and Red cell Distribution Width (RDW). Gender-based stratification of the study population was performed. Data were analysed using the Student's unpaired t-test, Chi-square test, and univariate linear regression with Statistical Package for the Social Sciences (SPSS) version 22.0. Results: The study highlighted a high prevalence of anaemia among overt hypothyroid patients 88 (54%) compared to subclinical hypothyroid patients 63 (34.24%). Moreover, the prevalence of anaemia was higher in females than in males. The most common type of anaemia encountered was microcytic anaemia, followed by normocytic anaemia. Linear regression analysis yielded a positive correlation between TSH and all haematological parameters, including RDW. This correlation was especially significant among females. Conclusion: TSH affected all the haematological parameters, including RDW, and the association was stronger in females as compared to males in both subclinical and overt hypothyroidism. [ABSTRACT FROM AUTHOR]

Background & Objective: Pre-emptively identifying individuals at risk of developing sepsis and septic shock remains challenging. In septic patients, the Lactate/Albumin Ratio (LAR) and C-reactive protein (CRP)/Albumin ratio (CAR) have been suggested to be promising prognostic indicators for prediction of intensive care unit (ICU) mortality. We compared the prognostic values of CAR and LAR in patients with sepsis and septic shock. Methodology: Eighty adult patients diagnosed with sepsis and admitted to the ICUs of Ain Shams University Hospitals, were included in this observational prospective study. CRP levels, serum lactate, serum albumin, complete blood count (CBC), procalcitonin levels, and SOFA scores were assessed upon admission, with subsequently observing 28-day mortality among the selected patients. Results: CAR values were comparable between the mortality and survival groups (P = 0.807). However, LAR values were significantly elevated in the mortality group vs the survival group (P = 0.044). ROC analysis for mortality indicated that LAR had an AUC of 0.633 at a cutoff value > 0.68, achieving sensitivity and specificity of 89.4% and 21.2%, respectively. In contrast, CAR had an AUC of 0.484 at a cutoff value ≥ 1.54, with sensitivity and specificity values of 63.8% and 57.6%, respectively. Length of ICU stay (P < 0.001), duration of mechanical ventilation (P < 0.001), cardiovascular support (P < 0.001) and the need for renal replacement therapy (P < 0. 039), were increased in the mortality group compared to the survival group. Conclusion: Lactate/albumin ratio is superior and more reliable bio-marker predictor compared to C-reactive protein (CRP)/albumin ratio for ICU mortality. [ABSTRACT FROM AUTHOR]

Background: Hyperuricemia is associated with increased systemic inflammation. The systemic immune‐inflammation index (SII) and systemic inflammation response index (SIRI) are novel systemic inflammation markers and prognostic markers. However, no studies have evaluated the association between the SII/SIRI and mortality risk in individuals with hyperuricemia. This study aimed to investigate the predictive value of the SII and SIRI for all‐cause and cardiovascular mortality in a large cohort of hyperuricemia patients. Methods: We conducted a prospective cohort study using data from the National Health and Nutrition Examination Survey (NHANES) 2001‐2020. Hyperuricemia was defined as serum uric acid (SUA) levels of ≥7 mg/dL in men and ≥6 mg/dL in women. The SII and SIRI were calculated based on complete blood count parameters. Associations with all‐cause and cardiovascular mortality were analyzed using Cox proportional hazards models. Nonlinearity and effect modification were assessed using restricted cubic splines (RCS) and interaction analysis. Results: Among the 6181 participants with hyperuricemia aged 20 years and older, over a total 181 months of follow‐up, there were 936 all‐cause deaths, of which 195 were cardiovascular mortality. In the fully adjusted models, the hazard ratios (HRs) were 1.73 (95% CI 1.42‐2.13) for the SII and 2.18 (95% CI 1.82‐2.62) for the SIRI with all‐cause mortality. The adjusted HRs were 2.08 (95% CI 1.37‐3.14) for the SII and 2.32 (95% CI 1.56‐3.45) for the SIRI with cardiovascular mortality. Spline models identified nonlinear U‐shaped (SII) and J‐shaped (SIRI) relationships of inflammation markers with mortality. Conclusions: Elevated SII and SIRI are independent predictors of mortality in hyperuricemia patients. These inflammatory biomarkers may improve risk stratification in this high‐risk population. Further research should evaluate utility in guiding preventive interventions. [ABSTRACT FROM AUTHOR]

The association of Healthy Eating Index 2020 (HEI‐2020), especially its components with systemic inflammatory biomarkers, has not been examined. The aim of this study was to investigate the relationship between HEI‐2020 and its components with systemic inflammatory biomarkers, and to provide a dietary pattern suggestion to combat systemic inflammation. Participants aged 20 years and older with complete information on two reliable dietary recalls, blood cell counts and demographic characteristics, were recruited from six NHANES cycles from 2007 to 2018. Weighted general linear methods showed that HEI‐2020 was negatively associated with systemic immune‐inflammation index (SII) and systemic inflammation response index (SIRI). Weighted quantile regression (WQS) models and quantile g‐computation (QGC) models supported the negative association between the mixed components and systemic inflammation. High intakes of whole fruits, whole grains, greens and beans, and seafood and plant proteins, along with a low intake of added sugars, were associated with reduced systemic inflammation. In contrast, the scores of sodium, dairy, total protein, and refined grains showed no significant effect. Briefly, our study provides an anti‐inflammatory dietary pattern suggestion based on the 13 components of HEI‐2020 and Dietary Guidelines for Americans. [ABSTRACT FROM AUTHOR]

This preliminary study evaluated the biocompatibility of a novel degradable intravaginal plug contraceptive composed of PEG 4000 and chitosan in cats using haematological profiling and vaginal cytology. Five healthy, non‐pregnant female cats were fully anaesthetised and fitted with an intravaginal plug (10 × 0.3 mm) using an applicator, following oestrogen administration 3 h prior. Blood samples were collected from the cephalic vein on days 0 (pre‐insertion) and 3 and 7 (post‐insertion). Vaginal cytology examinations were conducted on day 0 (pre‐ and post‐oestrogen injection) and days 1, 3 and 7 post‐insertion. Haematological parameters, including red blood cell count, haemoglobin levels, haematocrit values, total white blood cell count and differentiation, showed no significant changes after contraceptive insertion (p > 0.05). Vaginal cytology indicated an acute inflammatory response in one out of five subjects on day three post‐insertion. The distribution of vaginal epithelial cells (parabasal, intermediate and superficial) remained unaffected by contraception. Oestrogen injection resulted in the dominance of superficial cells up to day 7 of observation (p < 0.05). Overall, PEG 4000 and chitosan‐based intravaginal plug contraceptives demonstrated sufficient biocompatibility, indicating their potential as viable contraceptive options for feline use. [ABSTRACT FROM AUTHOR]

Objective: Heart failure affects 1–2% of the population in developed countries. Hemogram biomarkers are cheap, rapid, readily accessible and are known to have prognostic benefit in cardiovascular, infectious and oncologic diseases. Methods: The aim of the current study is to evaluate lymphocyte-to-white-blood-cell ratio (LWR) as a prognostic predictor in patients with heart failure. Patients with heart failure were recruited between January 2000 and July 2001. Exclusion criteria included metastatic malignancy, exposure to chemotherapy, radiotherapy or medications known to affect complete blood count. Results: 338 patients were enrolled, 33 were excluded. Mean age was 70.1 ± 10.8, 225 patients were male (73%) and 80 were female (27%). All patients were divided into three groups according to LWR. Group 1 < 0.2, group 2—0.2 < LWR < 0.35 and group 3 > 0.35. Patients with LWR ratio < 0.2 had the poorest survival while patients in the highest LWR (ratio > 0.35) had the best long-term survival. Conclusions: Patients with congestive heart failure and LWR < 0.2 showed significant increased mortality. LWR was shown as independent prognostic predictor for HF patients compared to other main outcome parameters, including CRP, NYHA, EF and LDL. [ABSTRACT FROM AUTHOR]

Background: The activation of the growth hormone receptor (GHR) is a major determinant of body growth. Defective GHR signaling, as seen in human Laron dwarfism, resulted in low plasma IGF-1 concentrations and limited growth, but also marked absence in the development of breast cancer and type 2 diabetes. In vitro, we identified a small molecule (C#1) that inhibits the translation of GHR mRNA to receptor protein. Methods: Before its application in humans as a potential anticancer drug, C#1 was tested in animals to evaluate whether it could be administered to achieve a plasma concentration in vivo that inhibits cell proliferation in vitro without causing unwanted toxicity. To evaluate the efficacy and toxicity of C#1, a group of six intact female Beagle dogs was treated daily each morning for 90 days with an oral solution of C#1 in Soiae oleum emulgatum at a dose of 0.1 mg/kg body weight. During treatment, dogs were closely monitored clinically, and blood samples were taken to measure plasma C#1 concentrations, complete blood counts (CBC), clinical chemistry, and endocrinology. At the end of the treatment, dogs were euthanized for gross and histopathological analysis. An additional group of six female Beagle dogs was included for statistical reasons and only evaluated for efficacy during treatment for 30 days. Results: Daily administration of C#1 resulted in a constant mean plasma concentration of approximately 50 nmol/L. In both groups, two out of six dogs developed decreased appetite and food refusal after 4–5 weeks, and occasionally diarrhea. No significant effects in CBC or routine clinical chemistry were seen. Plasma IGF-1 concentrations, used as biomarkers for defective GHR signaling, significantly decreased by 31% over time. As plasma growth hormone (GH) concentrations decreased by 51% as well, no proof of GHR dysfunction could be established. The measured 43% decrease in plasma acylated/non-acylated ghrelin ratios will also lower plasma GH concentrations by reducing activation of the GH secretagogue receptor (GHSR). C#1 did not directly inhibit the GHSR in vivo, as shown in vitro. There were no significant effects on glucose, lipid, or folate/homocysteine metabolism. Conclusions: It is concluded that with daily dosing of 0.1 mg C#1/kg body weight, the induction of toxic effects prevented further increases in dosage. Due to the concomitant decrease in both IGF-1 and GH, in vivo inhibition of GHR could not be confirmed. Since the concept of specific inhibition of GHR synthesis by small molecules remains a promising strategy, searching for compounds similar to C#1 with lower toxicity should be worthwhile. [ABSTRACT FROM AUTHOR]

Background: Proteinuria is a key indicator of kidney damage in diabetic nephropathy, and its severity correlates with the progression of the disease. In diabetic patients, it is crucial to identify reliable predictors for proteinuria and its severity for early detection and management of kidney damage. Materials and Methods: This cross-sectional study was conducted from November 16, 2022, to May 20, 2023, on patients with type 2 diabetes mellitus (T2DM) who were outpatients at clinics of Shahid Modarres Hospital, Tehran, Iran. Participants were categorized based on their level of proteinuria during 24-h as follows: group A1 (normal to mildly increased proteinuria), Group A2 (moderately increased proteinuria), and Group A3 (severely increased proteinuria). Then, complete blood cell count and other laboratory parameters, were compared between study groups. Results: In this cross-sectional study, 128 participants, including 53 (41.4%) men and 75 (58.6%) women with T2DM, were enrolled. The mean age of participants was 56.40 ± 13.31 years. Although there were no significant differences between cell count and parameters of three groups, a statistically significant difference was seen in neutrophil-to-lymphocyte ratio (NLR) (1.93 ± 0.76, 2.34 ± 0.93, and 2.73 ± 1.07 in A1, A2, and A3 groups, respectively; P = 0.003). Further analysis showed that NLR was significantly higher in Group A3 compared to A1 (2.73 ± 1.07 vs. 1.93 ± 0.76, respectively; P = 0.006), but there was no significant difference between Groups A3 and A2 (2.73 ± 1.07 vs. 2.34 ± 0.93, respectively; P = 0.482) and between Groups A2 and A1 (2.34 ± 0.93 vs. 1.93 ± 0.76, respectively; P = 0.257). Conclusion: Overall, this study suggests that some routine laboratory parameters may be associated with proteinuria and its severity in patients with T2DM. NLR, in particular, showed this association in our study, promising future studies evaluating this association and whether it can help as a predictor or not. [ABSTRACT FROM AUTHOR]

The study explores the bioactive compounds and molecular mechanisms of ShenFuShanYuRou decoction (SFSY) in enhancing regulatory T (Treg) cell function against hemorrhagic shock/resuscitation (HS/R) injury. SFSY treatment promotes FOXP3 expression, increases Treg cell function, and ameliorates HS/R-induced metabolic disorders and organ injuries. The bioactive compounds in SFSY, such as ginsenoside Ro, hypaconitine, and loganic acid, play a role in enhancing Treg cell function through different mechanisms, including Stat1- and Gbp5-dependent pathways. This research provides new insights into potential therapeutic strategies for mitigating HS/R-induced injury. [Extracted from the article]

SARS-CoV-2 infection usually results in multi-organ affection, and severe inflammatory response which associated with significant affection of blood cell count and coagulation profile. We aimed to study the changes in haematological parameters among patients infected with SARSCoV2 and its relation to the severity of infection. A retrospective cohort investigated data from patients hospitalized at the Armed Forces Hospital in Jeddah, Saudi Arabia, between July 2020 and July 2022. Patient who tested positive for SARS-CoV 2 infection were compared to negative patients. A total of 586 patients were included, 387 tested positive for SARS-CoV-2. COVID-19 patients had significant lower leukocyte, and eosinophil counts along with lower red blood cell indices, suggesting a potential impact on the hematopoietic system. Deviation in leukocyte count was correlated with disease severity. the mortality was higher in the non-COVID-19 group (14.1 vs. 7.5%). COVID-19 patients had significantly higher fibrinogen levels and lower prothrombin time than non-COVID-19 patients. No difference was found regarding liver enzymes, renal function tests or acute-phase reactants. Haematological parameters could be used as markers for early detection, assessment of disease severity, and prognosis of SARS-CoV-2 infection. Further studies are necessary to understand the underlying mechanisms and their clinical significance. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer (CRC) screening is essential to reduce incidence and mortality rates. However, participation in screening remains suboptimal. ColonFlag, a machine learning algorithm using complete blood count (CBC), identifies individuals at high CRC risk using routinely performed tests. This study aims to review the existing literature assessing the efficacy of ColonFlag across diverse populations in multiple countries. Methods: The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) were followed in reporting this systematic review. Searches were conducted on PubMed, Cochrane, ScienceDirect, and Google Scholar for English articles, using keywords related to CBC, machine learning, ColonFlag, and CRC, covering the first development study from 2016 to August 2023. The Cochrane Prediction Model Risk of Bias Assessment Tool (PROBAST) was used to assess the risk of bias. Results: A total of 949 articles were identified during the literature search. Ten studies were found to be eligible. ColonFlag yielded Area Under the Curve (AUC) values ranging from 0.736 to 0.82. The sensitivity and specificity ranged from 3.91% to 35.4% and 82.73% to 94%, respectively. The positive predictive values ranged between 2.6% and 9.1%, while the negative predictive values ranged from 97.6% to 99.9%. ColonFlag performed better in shorter time windows, tumors located more proximally, in advanced stages, and in cases of CRC compared to adenoma. Conclusion: While ColonFlag exhibits low sensitivity compared to established screening methods such as the fecal immunochemical test (FIT) or colonoscopy, its potential to detect CRC before clinical diagnosis suggests an opportunity for identifying more cases than regular screening alone. [ABSTRACT FROM AUTHOR]

Background A common acute gastrointestinal inflammatory condition in both children and adults is appendicitis, often requiring surgical intervention and hospitalization. An estimated 14,000 persons in the Netherlands get an appendectomy annually to address suspected appendicitis. Acute appendicitis may be delineated into two distinct forms: basic and complex. A suppurative or phlegmonous appendicitis is a condition marked by inflammation, ulceration, or thrombosis in the transmural layer of the appendix, with or without surrounding pus. Complex appendicitis includes perforated appendicitis, gangrenous (transmural inflammation with necrosis) appendicitis, and/or appendicitis of the pelvis or abdomen accompanied by abscess development. An estimated 25-30% of patients are classified as complex appendicitis. Timely and appropriate administration of preventive antibiotics reduces the likelihood of surgical site infections (SSIs) after surgery. Nevertheless, there is no conclusive guideline regarding the duration of antibiotic use. Several randomized controlled studies have recommended a single preoperative prophylactic dose. Aim The aimed to determine the need for postoperative antibiotics after laparoscopic appendicectomy for nonperforated appendicitis. Material and Method This randomized control research (RCT) was conducted by the Department of General Surgery. This research included all patients who were hospitalized with acute appendicitis and had emergency open appendectomy. Data on the patients' demographics, medical histories, and details of their clinical exams were recorded on a pre-established proforma. Furthermore, apart from conventional examinations such as an abdominal ultrasonography, also conducted were tests including blood urea, serum creatinine, and complete blood counts. Random assignment of groups was conducted using the opaque envelope method. Seventy opaque polymer envelopes containing cards were manufactured. Among these envelopes, thirty-five had a card identifying the study group, Group A, while the other thirty-five contained a card identifying the control group, Group B. Results The average age of Group B was 28.62±8.52 years, while the average age of Group A was 28.54±9.62 years. Baseline right iliac fossa discomfort was seen in every participant in the study. The three patients in group A and the two patients in group B who had grade III SSIs were treated with conservative therapy. There was no statistically significant disparity in the occurrence of surgical site infections (SSIs) between the two groups. No significant differences were seen between the two groups in terms of mean age, gender distribution, pain, fever, nausea/vomiting, McBurney's soreness, bowel sounds, total leukocyte count, ultrasonography, diagnosis, and histology report. While the average hospitalized duration of group B was greater than that of group A, there was no statistically significant disparity. Conclusion A single preoperative dosage of the preventive antibiotics cefotaxime and metronidazole at the time of induction is enough to lower the incidence of postoperative surgical site infections, and further postoperative doses do not provide a statistically meaningful advantage. A comprehensive investigation including a range of abdominal procedures is necessary to determine the true need of postoperative prophylactic antibiotics in minimizing surgical site infections (SSIs). [ABSTRACT FROM AUTHOR]

Background: Pleural effusion is an excess fluid that accumulates between two pleural layers. Pleural fluid analysis and cytology are the mainstays for diagnosing various pulmonary diseases. Aim and objective: To study the clinico-radiological and etiological profile of pleural effusion patients diagnosed at a tertiary care hospital. Material and Method: All the patients who are clinic radiologically suspected were broadly evaluated clinically by the presenting complaints, detailed history, general, followed by systemic examination, and routine investigations like a complete blood count (CBC), pleural fluid cytopathological, biochemical, mirobiological, and CBNAAT (Cartridge-Based Nucleic Acid Amplification Test) examination were done. Results: The majority of patients were in the age group of 31-40 years (n = 25). 31.25% followed by 20-30 years (n = 17) 21.25%. The most common symptom was breathlessness (52.25%), followed by fever (45%), chest pain (35%), cough (31.25%), and weight loss (27.25%). 45 (52.25%) cases were of exudative effusion and 35 (43.75%) cases of transudative effusion. CCF (16/35) 45.71% is the commonest cause of transudative pleural effusion, followed by CKD (11/35) at 31.42% and cirrhosis (6/35) at 17.14%. Tuberculosis 40% was the common cause of exduative pleural effusion, followed by malignancy (28.89%), empyema (11.11%), and synpneumonic (8.88%). High levels of ADA (above 40) were seen in 55% (11/20). CBNAAT detected MTB in 13.75% cases among exudative effusion, while cytobiochemistry and pleural biopsy favor tuberculosis (13.75% and 1.25%, respectively) in exudative effusion. Conclusion: While evaluating a case of pleural effusion, a combined approach involving clinical evaluation, radiographic and sonographic evaluation, pleural fluid analysis, pleural fluid cytology, and in cases where possible thoracoscopic pleural biopsy, must be utilized for fruitful and accurate diagnosis. CBNAAT could also be a useful rapid diagnostic tool for suspected tuberculouspleural effusion/empyema. [ABSTRACT FROM AUTHOR]

BACKGROUND Microalbuminuria is a key risk factor for several cardiovascular diseases and renal impairment. This is particularly true for diabetics, in whom it is common and can be used to predict the development of complications. MATERIALS AND METHODS A case control study. Participants were divided into 2 different groups: Group I - Control (n = 140), Group II - Patients with type II diabetes mellitus with IHD (n = 140),. Medical history, physical examination, complete blood count, ECG, chest X-ray and urine examination, tests for microalbuminuria, echocardiogram and fluorescein angiography were performed. RESULTS Mean age of patients in group I and II were 54.35 ± 9.45 and 53.87 ± 8.98 years respectively. 46% participants were taking oral anti diabetic agents. Out of 280 patients of type 2 DM-64% were micral test negative and 36% were micral test positive. In group III, 32% were normoalbuminuric and 68% were microalbuminuric. Positive correlation was found between duration of DM and presence of microalbuminuria. Serum cholesterol and serum triglycerides level were more in microalbuminurics than normoalbuminurics and the difference was statistically significant while the difference in the levels of serum LDL and serum HDL was statistically insignificant between two groups. 55.6% of the diabetics with microalbuminuria were hypertensive. CONCLUSION Microalbuminuria can be considered as one of the predictive factors for overt nephropathy and various complications of DM. Thus, detection of microalbuminuria at an early stage may help in preventing the diabetic complications. [ABSTRACT FROM AUTHOR]

Background: Recurrent pregnancy loss is considered as two or more miscarriages. Clinical investigation may be initiated after two pregnancy losses. The occurrence of spontaneous miscarriage in India is reported to be around 6.37%, recurrent miscarriage is around 1 to 2%. The risk of miscarriage in subsequent pregnancy is 30% after 2 losses compared to 33% after 3 losses. The prevalence of Hyperhomocysteinemia in recurrent pregnancy loss in India is 38%. Objective: to study the levels of maternal serum homocysteine in pregnant women with 2 or more consecutive miscarriages and compare with control group and to determine if hyperhomocysteinemia is associated with RPL Methods: 100 patients with history of 2 or more consecutive pregnancy losses are taken as cases and 100 pregnancy lady with alteration one previous live mother are taken as controls. In the study both cases and controls had not taken folic acid in the last 3 months was confirmed by history. Both cases and control group previous records were examined for laboratory investigation to rule out associated co-morbidities like uterine anomaly on ultrasound, complete blood count for platelets, coagulation profile, thyroid profile, blood glucose, renal and liver function test, urine albumin, urine routine and microscopy and serology test for Human immune virus, Hepatitis B, syphilis, TORCH infection. Results: Out of 100 cases, 17 patients show increased homocysteine levels. Homocysteine group shows P value of 0.001, which is significant at 1% levels. Homocysteine levels more than 10.5 µmol/dl is a risk factor for pregnancy loss. This shows positive correlation between RPL and hyperhomocysteinemia. Conclusions: This study shows there is positive correlation of socioeconomic class with hyperhomocysteinemia. Pregnant women belonging to Lower class of Kuppuswamy class had higher serum homocysteine level indirectly indicating poor nutrition among this pregnant. [ABSTRACT FROM AUTHOR]

In this study, the protective effects of Panax notoginseng saponins (PNS) against gamma radiation‐induced DNA damage and associated physiological alterations in Swiss albino mice were investigated. Exposure to gamma radiation led to a dose‐dependent increase in cytokinesis‐blocked micronuclei (CBMN) double‐strand DNA breaks (DSBs), dicentric aberrations (DC), formation in peripheral blood mononuclear cells. However, pretreatment with PNS at concentrations of 1, 5, and 10 µg/mL significantly attenuated the frequencies of DC and CBMN in a concentration‐dependent manner. PNS administration before radiation exposure also reduced radiation‐induced DSBs in BL, indicating protection against reactive oxygen species generation and DNA damage. Notably, pretreatment with PNS at 10 µg/mL prevented the overexpression of γ‐H2AX, proteins associated with DNA damage response, in irradiated mice. In addition, in vivo studies showed intraperitoneal administration of PNS (25 mg/kg body weight) for 1 h before radiation exposure mitigated lipid peroxidation levels and restored antioxidant status, countering oxidative damage induced by gamma radiation. Furthermore, PNS pretreatment reversed the decrease in hemoglobin (Hb) content, white blood cell count, and red blood cell count in irradiated mice, indicating preservation of hematological parameters. Overall, PNS demonstrated an anticlastogenic effect by modulating radiation‐induced DSBs and preventing oxidative damage, thus highlighting its potential as a protective agent against radiation‐induced DNA damage and associated physiological alterations. Clinically, PNS will be beneficial for cancer patients undergoing radiotherapy, but their pharmacological properties and toxicity profiles need to be studied. Significance Statement: Radiation induces DNA damage in human cells, posing risks to genomic integrity and cellular function. The study assessed Panax notoginseng saponins (PNS) for protection against gamma radiation‐induced DNA damage in human peripheral lymphocytes and Swiss albino mice. PNS reduced lymphocyte DNA damage markers, lowered lipid peroxidation, restored antioxidants, and maintained hematological parameters. It notably suppressed γ‐H2AX overexpression, indicating DNA damage response modulation. PNS demonstrated potential as an anticlastogenic agent, mitigating radiation‐induced DNA damage and oxidative stress, suggesting its suitability as a protective measure against radiation‐induced physiological changes. [ABSTRACT FROM AUTHOR]

Introduction: COVID-19 can have long-lasting effects, but the effects on blood parameters and inflammation are poorly understood. The aim of this study was to evaluate morphological and inflammatory markers in long-term COVID-19 patients. Aim: To evaluate complete blood count, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and morphology in mild versus severe long COVID-19. Material and methods: In total, 39 long COVID-19 patients were stratified into mild (n = 25) and severe (n = 14) groups. Blood counts, NLR, PLR were measured. Cell morphology was analysed. ROC curves were used to determine biomarker thresholds. Survival was assessed using Kaplan-Meier curves. Results and discussion: Severe patients had lower leukocytes but higher neutrophils, indicating greater inflammation. NLR and PLR were significantly increased in severe patients compared to mild patients (NLR 12 vs 8; PLR 140 vs 100). NLR and PLR were higher than in controls, confirming their utility as inflammatory markers. NLR and PLR effectively discriminated between mild and severe disease. High NLR and PLR predicted poorer prognosis. Altered leukocyte morphology such as cytoplasmic vacuolization correlated with severity. Conclusions: NLR and PLR are promising biomarkers for assessing severity of long COVID-19, while morphological changes in blood cells provide additional evidence of inflammation. Further studies in larger populations are warranted. [ABSTRACT FROM AUTHOR]

Introduction: Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT) is a rare autoimmune disorder affecting the central nervous system, characterized by a spectrum of neurological and psychiatric symptoms. Aim: This case study aims to highlight the diagnostic challenges and the successful management of SREAT syndrome in a young woman with autoimmune thyroiditis. Case study: A 21-year-old woman with documented Hashimoto's thyroiditis and polycystic ovary syndrome was admitted to the Clinic of Neurology following a 5-minute tonic seizure and subsequent confusion state lasting several hours. Initial brain MRI showed no abnormalities, and EEG revealed generalized slowness. Comprehensive laboratory assessments, including a complete blood count, biochemical analysis, and electrolyte panels, all yielded normal results. Further investigation revealed a significantly elevated anti-thyroid peroxidase antibody (anti-TPO) titer exceeding 1000 IU/mL. The suspicion of SREAT syndrome was considered. Pulse therapy with methylprednisolone was associated with rapid recovery. The patient was discharged from the hospital with an oral corticosteroid tapering regimen. Results and discussion: The administration of pulse therapy with methylprednisolone resulted in a rapid and very good response in the patient, evidenced by the resolution of seizure activity and improvement in confusion. Laboratory investigations, particularly the markedly elevated anti-TPO titer, supported the diagnosis of SREAT syndrome. The subsequent management with an oral corticosteroid tapering regimen maintained the patient's clinical stability. Conclusions: This case highlights the importance of considering autoimmune encephalopathy in patients with a history of autoimmune thyroiditis presenting with neurological and psychiatric symptoms. Further research is warranted to better understand the underlying pathomechanisms. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to characterize the relationship between a novel radiographic measurement on initial AP pelvis radiograph (termed "bladder shift," BS) to intraoperative blood loss (IBL) during acetabular surgical fixation. Methods: All adult patients receiving unilateral acetabular fixation (Level 1 academic trauma; 2008–18) were reviewed. AP pelvis radiographs were reviewed for visible bladder outlines and then measured to determine the percentage deformation toward the midline. Hemoglobin & hematocrit data were then used to calculate quantitative blood loss between pre- and post- operative blood counts for data analysis. Results: 371 patients with unilateral traumatic acetabular fractures requiring fixation were reviewed; 99 of these had visible bladder outlines, complete blood count and transfusion data (2008–2018; 66% associated patterns). Median bladder shift (BS) was 13.3%. Every 10% of bladder shift was associated with 123 mL greater IBL. Patients with full bladder shift to midline sustained a median 1.5L IBL (interquartile range [IQR] 0.8 to 1.6). Associated patterns had a threefold greater median BS (associated: 16.5% [15.4 to 45.9] vs. elementary: 5.6% [1.1 to 15.4], p < 0.05) and received intraoperative pRBC twice as frequently (57% vs. 24%, p < 0.01). Conclusions: Radiographic bladder shift is an easily available visual marker, in patients sustaining acetabular fractures, that may predict intraoperative hemorrhage and need for transfusions. [ABSTRACT FROM AUTHOR]

Summary: There has been an expansion in our understanding of the multifaceted roles of circulating blood cells in regulating haemostasis and contributing to thrombosis. Notably, there is greater recognition of the interplay between coagulation with inflammation and innate immune activation and the contribution of leucocytes. The full blood count (FBC) is a time‐honoured test in medicine; however, its components are often viewed in isolation and without consideration of their haemostatic and thrombotic potential. Here, we review how the individual components of the FBC, that is, haemoglobin, platelets and leucocytes, engage with the haemostatic system and focus on both their quantitative and qualitative attributes. We also explore how this information can be harnessed into better management of people with multiple long‐term conditions because of their higher risk of adverse clinical events. [ABSTRACT FROM AUTHOR]

The article in the British Journal of Haematology discusses a case report of a 61-year-old male with acute myeloid leukaemia (AML) who was found to have a gene fusion between NUP98 and POU6F2. This fusion is the first documented instance of POU6F2 involvement in a haematological malignancy, making it the second known occurrence within the POU family of transcription factors. The study highlights the importance of identifying and studying cases with genetic changes like these to better understand their impact on disease prognosis and treatment in AML. [Extracted from the article]

The article in Clinical & Experimental Allergy explores the connection between lymphopenia, basopenia, and eosinopenia in chronic spontaneous urticaria (CSU) patients, particularly those with autoimmune CSU. The study involved 300 CSU patients and found that lymphopenia was associated with lower counts of basophils, eosinophils, monocytes, and platelets. The research suggests that lymphopenia may reflect the migration of lymphocytes from the bloodstream into skin lesions, similar to basophils and eosinophils. The study also identified associations between basopenia and high anti-C1q levels, supporting the hypothesis that these antibodies may be a marker of autoimmune CSU. [Extracted from the article]

A 40-year-old man presented with erythematous changes on his lower legs, diagnosed as telangiectasia macularis eruptiva perstans (TMEP). Despite initial concerns of systemic mastocytosis due to mast cell increase, further investigations ruled out this diagnosis. The final diagnosis was cutaneous collagenous vasculopathy (CCV), a rare microangiopathy primarily affecting middle-aged and older White individuals, characterized by widespread cutaneous telangiectasias. The article highlights the importance of histological confirmation for diagnosing CCV and discusses potential treatment options for cosmesis. [Extracted from the article]

Background: Clinical fundus examination in addition to fundus photography of Type 1 diabetes mellitus (T1DM) children patients to detect complications like diabetic retinopathy (DR). This study aimed to evaluate direct ophthalmoscopy accuracy compared to fundus photography in diagnosing diabetic retinopathy in children with T1DM at Zagazig University Hospital. Methods: We carried out this cross-sectional study on 42 children diagnosed with T1DM for over five years who attended the Pediatrics Outpatient Clinic at Zagazig University Hospital. Routine laboratory investigations, such as complete blood count and blood glucose level, HbA1c, and albumin/creatinine ratio in urine, were done on all patients, in addition to direct ophthalmoscopy and fundus photography, for diagnosis of diabetic retinopathy. Results: Direct ophthalmoscopy had a sensitivity of 25% and a specificity of 100%. On the other hand, fundus photography demonstrated a sensitivity of 80.69% and a specificity of 92.23%.Regarding positive predictive value (PPV) and negative predictive value (NPV), direct ophthalmoscopy showed a PPV of 100% and an NPV of 75%. In comparison, fundus photography in another study demonstrated a PPV of 62% and an NPV of 90%. Direct ophthalmoscopy and fundus photography identified one case of DR concordantly, while three cases initially identified as absence of DR by direct ophthalmoscopy were later confirmed as DR by fundus photography. Conclusion: Direct ophthalmoscopy's sensitivity and specificity for detecting the presence and severity of DR were found to be lower than the recommended levels for a DR screening test. This suggests that fundus photography is more accurate than direct ophthalmoscopy for screening DR. [ABSTRACT FROM AUTHOR]

Background: Intense exercise leads to neutrophil extracellular traps (NETs) formation, which triggers cell disintegration. NET, as well as other processes of apoptosis, necrosis, and spontaneous secretion, result in increased levels of cell-free DNA (cf-DNA) in the circulation. An increment of cf-DNA is also observed in autoimmune diseases, such as type 1 diabetes mellitus (T1DM). Repeated exhaustive exercises are an impulse for physiological adaptation; therefore, in this case–control study, we compared the exercise-induced increase in cf-DNA in men with T1DM and healthy controls to determine the development of the tolerance to exercise. Methods: Volunteers performed a treadmill run to exhaustion at a speed matching 70% of their personal VO2 max at three consecutive visits, separated by a 72 h resting period. Blood was collected before and after exercise for the determination of plasma cell-free nuclear and mitochondrial DNA (cf n-DNA, cf mt-DNA) by real-time PCR, blood cell count and metabolic markers. Results: Each bout of exhaustive exercise induced a great elevation of cf n-DNA levels. An increase in cf mt-DNA was observed after each run. However, the significance of the increase was noted only after the second bout in T1DM participants (p < 0.02). Changes in cf-DNA concentration were transient and returned to baseline values during 72 h of resting. The exercise-induced increment in circulating cf n-DNA and cf mt-DNA was not significantly different between the studied groups (p > 0.05). Conclusions: Cf-DNA appears to be a sensitive marker of inflammation, with a lower post-exercise increase in individuals with T1DM than in healthy men. [ABSTRACT FROM AUTHOR]

Background: Intermittent pneumatic compression is a non-invasive therapeutic technique that has been gaining popularity in recent years due to its potential use in many areas of medicine. It can be successfully used alone or in combination with other therapeutic methods. The aim of this study was to investigate whether and how a series of pressotherapy treatments on the lower limbs affects the rheological properties of blood (blood count, red blood cell deformability and aggregation, and blood viscosity), lipid profile (total cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein), and renal profile (urea, creatinine, and estimated glomerular filtration rate) in young, healthy women. Methods: The study group consisted of 15 healthy women aged 20–26 (22.5 ± 1.5), without chronic diseases and not practicing competitive sports. The participants underwent a series of 10 lower limb pressotherapy treatments. A single treatment lasted 30 min and each time the pressure used during the treatment was individually selected according to the participants' preference. The first blood test was performed a week before the treatments; the second on the day of the start of treatment, but before the pneumatic massage; the third after the completed series of pressotherapy treatments; and the fourth a week after the completed series of treatments. Results: In the conducted study, the analysis of the values of the complete blood count showed the following: a significant decrease in red blood cell count, hemoglobin, average hemoglobin concentration in erythrocytes, average red blood cell volume, average hemoglobin mass in red blood cells; a significant increase in average red blood cell volume; and an average hemoglobin mass in red blood cells. The analysis of the values of rheological parameters showed the following: a significant decrease in elongation indices 0.58, 1.13, 4.24, 15.95, 30.94, and 60.00; blood viscosity; the aggregation index; the degree of complete aggregation; and a significant increase in elongation indices 0.30, 1.13, 8.23, 30.94, 60.00; blood viscosity; the degree of complete aggregation; and the half-time of complete aggregation. A decrease in the concentration of low-density lipoprotein and high-density lipoprotein fractions was also noted. No significant changes were found in the values of total cholesterol and triglycerides, as well as in renal profile elements. Conclusions: The application of a series of 10 lower limb pressotherapy treatments has a beneficial effect, with a decrease in blood viscosity and the aggregation index, and an increase in the elongation index at shear stress from 0.30 [Pa] to 8.23 [Pa] in young, healthy women. A series of 10 lower limb pressotherapy treatments may affect the decrease in the values at high shear stress forces of 30.95 [Pa] and from 60.00 [Pa] in young, healthy women. The use of a series of 10 lower limb pressotherapy treatments increases the values of hemoglobin, the average red blood cell volume, and the average hemoglobin concentration in erythrocytes, and also reduces the values of red blood cell count, average hemoglobin mass in red blood cells and low-density lipoproteins and high-density lipoproteins in young, healthy women (it also does not cause any adverse changes). The use of pressotherapy on the lower limbs seems to be an effective element of the multi-component prevention of circulatory system diseases. [ABSTRACT FROM AUTHOR]

Background/Objectives: Elevated RDW has emerged in cardiac surgery as a potential means of preoperative risk stratification with the capacity to predict short- and long-term postoperative mortality, acute kidney injury, and postoperative atrial fibrillation. The question as to whether perioperative hemodynamic instability may be predicted by such a marker remains a topic of ongoing debate. The aim of this study was to explore the relationship between preoperative RDW and prolonged postoperative catecholamine use in minimally invasive mitral valve surgery. Methods: We performed a retrospective monocentric cohort study in an academic hospital; we enrolled patients who had undergone minimally invasive mitral valve surgery (including both robot-assisted and non-robot-assisted procedures) between January 2019 and December 2022. We considered the use of inotropes and/or vasopressors for at least twelve hours after post-surgery ICU admission to qualify as the prolonged postoperative use of catecholamines (PPUC). The RDW was obtained from the routine full blood count analysis performed upon admission or a maximum of 72 h before surgery. We also performed a multivariable logistic regression analysis with PPUC as the dependent variable. Results: We finally enrolled 343 patients. Upon multivariate analysis, RDW >14.4% was independently associated with prolonged postoperative catecholamine use when compared to the reference group (OR 2.62 [1.06–4.84]; p = 0.03). Moreover, the EuroSCORE II score (OR 1.38 [1.03–1.85]; p = 0.03), the cross-clamp time (OR 1.01 [1.01–1.02]; p < 0.01), and robot-assisted mitral valve surgery (OR 0.53 [0.30–0.93]; p < 0.03) were independently associated with the prolonged postoperative use of catecholamines. Conclusions: This study identified that an elevated preoperative RDW (>14.4%), the EuroSCORE II score, and the cross-clamp time independently predict prolonged postoperative catecholamine use in minimally invasive mitral valve surgery patients. Conversely, the robot-assisted approach was associated with a smaller hemodynamic impairment. [ABSTRACT FROM AUTHOR]

Background and Objectives: This retrospective study aimed to evaluate the efficacy of preoperative blood transfusions in correcting anemia for pediatric patients with congenital malformations (CMs) versus those with acute abdomen (AA) conditions. The study hypothesized that the response to transfusions might vary significantly between these groups due to the differences in the underlying pathology and clinical status. Methods: The study included 107 pediatric patients admitted to Timisoara 'Louis Turcanu' Emergency Hospital for Children between January 2015 and May 2023, who required blood transfusions for preoperative anemia. Hemoglobin (HGB), hematocrit (HCT), and red blood cell counts (RBC) were assessed at admission, 48 h post-transfusion, and at discharge. Statistical analyses, including Student's t-test, Pearson correlation, and chi-square tests, were utilized to compare outcomes between the groups. The study population was divided into 53 children with CM and 54 with AA. Results: Initial analyses showed that children with CM had statistically significantly higher baseline HGB (8.54 ± 1.00 g/dL vs. 7.87 ± 1.02 g/dL, p = 0.001) and HCT (26.07 ± 3.98% vs. 23.95 ± 2.90%, p = 0.002) compared to those with AA. Post-transfusion, children with CM exhibited a greater increase in HGB, with the highest increases noted in patients with central nervous system defects (mean increase of 3.67 g/dL, p = 0.038). In contrast, the increases in HGB for children with AA were less pronounced, with the highest being 2.03 g/dL in those with peritonitis (p = 0.078). Conclusions: No significant gender differences were noted in response to transfusion. Children with congenital malformations respond more effectively to preoperative blood transfusions compared to those with acute abdomen conditions. These findings suggest that differential transfusion strategies may be required based on the underlying medical condition to optimize the management of preoperative anemia in pediatric patients. Tailoring transfusion approaches according to specific patient needs and conditions could enhance clinical outcomes and resource utilization in pediatric surgical settings. [ABSTRACT FROM AUTHOR]

Background: Hemoglobin, Albumin, Lymphocyte, and Platelet Score (HALP) is an accessible score that is easily reproducible from routine laboratory testing while also reflecting patients' immune-nutritional status. Along with other immuno-nutritional scores, such as the Prognostic Nutrition Index (PNI), HALP has been associated with a number of clinical and pathological features. The goal of our study was to evaluate the prognostic utility of HALP and PNI scores in testicular germ cell cancer (GCT) patients. Methods: This case-only study included 203 testicular GCT patients who were classified according to the disease stage and HALP and PNI cut-offs. Complete blood count and albumin concentration were routinely determined. Results: The values of HALP and PNI significantly differed among different clinical stages (p < 0.05). Moreover, they clearly exposed a significantly higher risk of advanced clinical stage development for those testicular GCT patients with lower values of HALP and PNI (p < 0.05). Finally, lower score levels were associated with larger tumor size (p < 0.05). Conclusion: Our investigation could provide evidence that specific immune-nutritional scores can help distinguish individuals diagnosed with testicular GCT who are more likely to be identified with advanced disease stages. [ABSTRACT FROM AUTHOR]

Background: Neuromuscular blocking agents (NMBAs) are a crucial component of anesthesia and intensive care through the relaxation of skeletal muscles. They can lead to adverse reactions such as postoperative residual neuromuscular block. Only one agent is capable of an instant block reversal in deep block situations, but is restricted to aminosteroid agents. Among animal models, non‐human primates are an essential model for a great diversity of human disease models. The main objective of this study was to establish a model for NMBA monitoring with current available drugs before testing new reversal agents. Methods: Seven healthy male cynomolgus macaques were randomly assigned to this study. Experiments using macaques were approved by the local ethical committee (CEtEA #44). All animals were anesthetized according to institutional guidelines, with ketamine and medetomidine, allowing IV line placement and tracheal intubation. Anesthesia was maintained with isoflurane. Either rocuronium bromine (with or without sugammadex reversal) or atracurium besylate was evaluated. Monitoring was performed with two devices, TOF‐Watch and ToFscan, measuring the T4/T1 and the T4/Tref ratios, respectively. Nonparametric Mann–Whitney statistical analyses were done when indicated. Results: NMBA monitoring required adaptation compared to humans, such as stimulus intensity and electrode placement, to be efficient and valid in cynomolgus macaques. When administered, both NMBAs induced deep and persistent neuro‐muscular block at equivalent doses to clinical doses in humans. The rocuronium‐induced profound neuromuscular block could be reversed using the cyclodextrin sugammadex as a reversal agent. We report no adverse effects in these models by clinical observation, blood chemistry, or complete blood count. Conclusion: These results support the use of non‐human primate models for neuromuscular block monitoring. This represented the first step before the forthcoming testing of new NMBA‐reversal agents. [ABSTRACT FROM AUTHOR]

This document contains abstracts from the journal Veterinary & Comparative Oncology, covering various studies on cancer in animals. The studies include topics such as the treatment of canine intracranial meningiomas, electrochemotherapy protocols for feline cutaneous squamous cell carcinoma, palliative-intent hypofractionated radiotherapy for canine nasal tumors, the use of trametinib in inhibiting the growth of canine oral squamous cell carcinoma, chemotherapy protocols for canine multicentric T-cell or hypercalcemic lymphoma, intravenous administration of L-asparaginase to dogs with lymphoma, and the long-term outcomes and toxicity of dogs with anal sac gland carcinoma receiving radiation therapy. These studies provide valuable information on treatment options, efficacy, and toxicity for different types of cancer in animals. [Extracted from the article]