Search

This article discusses a rare case of Kikuchi-Fujimoto disease (KFD) with gluteal myositis. KFD is a self-limiting disease characterized by fever and cervical lymphadenopathy, but in this case, the patient presented with persistent fever and right hip pain. The article explores possible mechanisms for the association between KFD and gluteal myositis, including concomitant infective myositis, autoimmune disease-related myositis, and extranodal involvement. The authors emphasize the importance of considering KFD in patients with unknown fever origins, even if the clinical findings appear unrelated to KFD. [Extracted from the article]

This article presents a case report of a 17-year-old boy with Kikuchi-Fujimoto disease (KFD), a condition characterized by fever and swollen lymph nodes in the neck. The boy experienced low body temperature, slow heart rate, and low blood pressure while being treated with glucocorticoids or cyclosporine A. These side effects resolved after stopping the medications and providing fluids. The article suggests that using a low dose of cyclosporine A may be a viable alternative for KFD patients who experience these adverse effects. It also mentions that caution should be exercised when using nonsteroidal anti-inflammatory drugs (NSAIDs) alongside this treatment. [Extracted from the article]

This article explores the use of stellate ganglion block (SGB) as a potential treatment for SAPHO syndrome, a rare and challenging inflammatory disease that affects the bones and skin. The study presents a case where SGB successfully alleviated symptoms and prevented disease progression in a patient with SAPHO syndrome. SGB, which blocks sympathetic nerves and improves immune function, has been used to treat other chronic pain and inflammatory conditions. The article suggests that SGB may be a promising treatment option for SAPHO syndrome and calls for more research in this area. [Extracted from the article]

A previously healthy 55-year-old male patient presented repeatedly to the emergency department with severe episodic periumbilical abdominal pain. After an extensive diagnostic work-up and subsequent clinical deterioration, appendiceal diverticulitis was diagnosed. We identified a correlation of white blood cell counts and possibly faecal calprotectin with the clinical presentation. We suggest that appendiceal diverticulitis should be considered in middle-aged patients with recurrent episodes of abdominal pain that correlate with laboratory markers of inflammation. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy and safety of telitacicept in SLE patients specifically with hematological involvement. Method: A total of 22 patients with SLE and hematological involvement were included in this study. These patients received telitacicept in addition to standard therapy. We compared their demographic characteristics, clinical manifestations, and laboratory indicators before and after the administration of telitacicept. Results: A total of 22 patients received telitacicept treatment for a median duration of 10.4 months (ranging from 6 to 19 months). Following telitacicept therapy, significant improvements were observed in various parameters compared to baseline. Specifically, white blood cell count increased from (3.98 ± 1.80) 109/L to (6.70 ± 2.47) 109/L, (P = 0.002), hemoglobin levels increased from (100 ± 19) g/L to (125 ± 22) g/L, (P < 0.001), and platelet count increased from (83 ± 60) 109/L to (161 ± 81) 109/L, (P = 0.004). SLE Disease Activity Index (SLEDAI) scores decreased from 12(5,15) to 0(0,4), (P < 0.001). Additionally, C3 and C4 levels showed improvement. Telitacicept treatment also resulted in a significant reduction in serum IgG levels and daily prednisone dosage. Only one adverse event (4.5%) was reported during the treatment, which was a urinary tract infection. Conclusion: The combination of telitacicept and standard treatment demonstrated significant improvements in anemia, as well as increased leukocyte and platelet levels in patients with SLE and hematological involvement. Importantly, the observed adverse events were manageable and controllable. Key Points • Telitacicept effectively improves anemia, clinical outcomes, and increases leukocyte and platelet counts. • Treatment with telitacicept leads to decreased levels of lgG, IgA, anti-dsDNA, and SLEDAI scores, while serum complement C3 and C4 returned to normal. • During the follow-up period there were observed changes in individual parameters, clinical symptoms, and organ involvement, all without significant adverse events. [ABSTRACT FROM AUTHOR]

AIM: To evaluate the effectiveness of heparin-binding protein (HBP) in combination with organ function indicators for early diagnosis and prognosis prediction in patients with severe trauma complicated with sepsis. METHODS: A retrospective analysis was conducted on 184 patients with multiple injuries who were admitted to the Emergency Medicine Department of the Second Affiliated Hospital of Zhejiang University Medical College between January 2019 and September 2020 and underwent HBP testing. Patients were classified according to the SEPSIS 3. 0 diagnostic criteria into a sepsis group (n=89) and a non-sepsis group (n=95). Clinical outcomes were tracked, dividing patients into a deceased group (n=43) and a survival group (n=141). HBP levels were continuously measured, and the peak values of the two groups were compared to assess the efficacy of diagnosing sepsis. Further analysis on the correlation of HBP peak value median with clinical prognosis was conducted. The effectiveness of HBP alone and in combination with total bilirubin (TBil) and white blood cell (WBC) count in prognosis assessment was evaluated. RESULTS: (1) No significant difference was found in the peak level of HBP between the sepsis group (n=89) and the non-sepsis group (n=95) (71. 7± 68. 6 vs 52. 5±56. 1, P=0. 051). (2) Among the 184 patients, the peak level of HBP was positively correlated with WBC count (r=0. 244, P<0. 01) and TBil levels (r=0. 241, P<0. 01). (3) The area under curve (AUC) for independent diagnosis of sepsis using TBil levels, WBC count, and PCT levels were 0. 618, 0.631, and 0. 718, respectively, and the combined AUC was 0. 684, with a diagnostic sensitivity of 60. 7% and specificity of 71. 6% (P<0. 05). (4) Prognostic analysis of mortality showed that patients in the high HBP level group had a significantly higher mortality rate than those in the low-level group (30. 4% vs 16. 3%, P<0. 05). The WBC count was also significantly higher in the deceased group than in the survival group (17. 5±6. 9 vs 12. 8±4. 7, P<0. 01), especially in those with sepsis (P<0. 01). The AUCs for predicting sepsis mortality prognosis using HBP peak level, TBil levels, WBC count, SOFA score, and APACHE-II score were 0. 618, 0. 603, 0. 719, 0. 823, and 0. 811, respectively. The combined AUC of HBP with TBil and WBC for assessing sepsis prognosis was 0. 750, with a sensitivity of 74. 4% and specificity of 74. 5%, showing statistically significant differences (P<0. 05). (5) The combined assessment of these three indicators showed no statistically significant difference from artificial scoring systems in predicting sepsis prognosis (P>0. 05). CONCLUSION: The combination of HBP, TBil, and WBC is highly effective in predicting the risk of sepsis in patients with multiple injuries and has significant clinical value in predicting the mortality risk of trauma patients with sepsis. [ABSTRACT FROM AUTHOR]

Listeriosis is a foodborne infection caused by Listeria monocytogenes. Three main forms of listeriosis are well characterised, but little is known about L monocytogenes -associated spontaneous bacterial peritonitis. We used data from the French national surveillance of listeriosis to perform a nationwide retrospective study. All patients with L monocytogenes isolated by culture from a peritoneal fluid sample in France between April 1, 1993, and Dec 31, 2022, were included. Individuals for whom bacterial peritonitis was not confirmed and those who also had another type of invasive listeriosis were excluded. A standardised checklist was used to collect demographic, clinical, and biological data as well as antibiotic treatment and follow-up data. The primary outcome was to determine the characteristics of L monocytogenes -associated spontaneous bacterial peritonitis. We did descriptive analyses and assessed risk factors for 1-month mortality using an exploratory multivariable Cox model analysis. Among the 8768 L monocytogenes cases reported, 208 (2%) were patients with L monocytogenes -associated spontaneous bacterial peritonitis. Mean age was 65 years (SD 13), 50 (24%) of 208 patients were female, and 158 (76%) were male (no data on race or ethnicity were available). 200 (98%) of 205 patients with L monocytogenes -associated spontaneous bacterial peritonitis with available data had immunosuppressive comorbidities, including cirrhosis (148 [74%] of 201 with available data), ongoing alcoholism (58 [62%] of 94), and ongoing neoplasia (60 [31%] of 195). Causes of ascites included cirrhosis (146 [70%] of 208), ongoing neoplasia (26 [13%]), end-stage heart failure (13 [6%]), and peritoneal dialysis (11 [5%]). Among those with available data, presentation was pauci-symptomatic and non-specific; only 67 (50%) of 135 patients presented with fever, 49 (37%) of 132 with abdominal pain, and 27 (21%) of 129 with diarrhoea. 61 (29%) of 208 patients were dead at 1 month, 92 (44%) were dead at 3 months, and 109 (52%) were dead at 6 months after diagnosis. Ongoing neoplasia (hazard ratio 2·42 [95% CI 1·05–5·56]; p=0·039), septic shock (8·03 [2·66–24·02]; p=0·0021), and high blood leukocyte count (1·05 [1·00–1·09]; p=0·045) were independently associated with 1-month mortality. Despite the non-specific and mild presentation of L monocytogenes -associated spontaneous bacterial peritonitis, the outcome is poor and similar to that of neurolisteriosis, and so identification of L monocytogenes in ascitic fluid samples requires urgent parenteral amoxicillin-based treatment to avoid a fatal outcome. Institut Pasteur, Inserm, and French Public Health Agency. For the French translation of the abstract see Supplementary Materials section. [ABSTRACT FROM AUTHOR]

Objective: To determine the possible association between acute fetal stress during labor and maternal blood levels of osteopontin (OPN), white blood cells, sedimentation, and C-reactive protein (CRP). Methods: The study included women with a term pregnancy (37 weeks or more) who had a cesarean section during the active phase of labor. The study included 30 term pregnancies who underwent cesarean section for fetal distress and 30 pregnant women who underwent cesarean section for other indications (prior uterine surgery, head-pelvis incompatibility, large baby, non-progressing plot) as a control group. The levels of OPN and other inflammatory markers (leukocytes, sedimentation, CRP) in the maternal venous blood of 60 pregnant women were compared, and whether there was a significant association between the groups was investigated. Results: OPN levels in the fetal stress group were higher than those in the control group, and the difference was statistically significant (p=0.008). There was no statistically significant difference in white blood cell, blood sedimentation, and CRP levels between the two groups (p>0.005). Conclusion: Placental inflammation plays a role in the etiology of fetal stress, and OPN may be released because of fetal stress. The increase in OPN in maternal blood during labor may be an important marker for predicting fetal stress. [ABSTRACT FROM AUTHOR]

Background: The incidence, predictors, and association of cardiac troponin with mortality in hospitalized COVID-19 were not adequately studied in the past and were also not reported from an Indian hospital. Methods: In this retrospective cohort study, the cardiac troponin of 240 hospitalized COVID-19 patients was measured. The incidence, predictors, and association of elevated cardiac troponin with in-hospital mortality were determined among hospitalized COVID-19 patients. Results: The cardiac troponin was elevated in 12.9% (31/240) of the patients. The troponin was elevated in the patients in the older age group (64 years vs. 55 years, p =.002), severe COVID-19 illness (SpO2 < 90%) (93.5% vs. 60.8%, p <.001), low arterial oxygen saturation (SpO2) (80% vs. 88%, p =.001), and low PaO2/FiO2 ratio (p <.0001). The patients with elevated cardiac troponin had elevated total leukocyte counts (TLC) (p =.001), liver enzyme (p =.025), serum creatinine (p =.011), N-terminal-Pro Brain natriuretic peptide (p <.0001), and d-dimer (p <.0001). The majority of the patients with elevated cardiac troponin were admitted to the intensive care unit (90.3% vs. 51.2%; p <.0001), were on a ventilator (61.3% vs. 21.5%; p <.0001), and had higher mortality (64.5% vs. 19.6%; p <.0001). The Kaplan–Meir survival analysis showed that the patients with elevated troponin had worse survival (p log-rank<.0001). Age, NT-ProBNP, d-dimer, and ventilator were the predictors of elevated troponin in multivariate logistic regression analysis. The Cox-regression analysis showed a significant association between elevated cardiac troponin and in-hospital mortality (adjusted hazard ratio 2.13; 95% confidence interval [CI] 1.145–3.97; p =.017). Two-thirds (65%) of patients with elevated cardiac troponin died during their hospital stay. Conclusions: COVID-19 patients with elevated cardiac troponin had severe COVID illness, were more commonly admitted to an intensive care unit, were on a ventilator, and had high in-hospital mortality. [ABSTRACT FROM AUTHOR]

Bacterial co-infected pneumonia is an acute inflammatory reaction of the lungs mainly caused by Gram-negative bacteria. Antibiotics are urgently important but have the disadvantage of antibacterial resistance, and alternative treatments with medicinal plants are attractive. On the Qinghai–Tibet Plateau, Thalictrum delavayi Franch. (T. delavayi) is an important member of the buttercup family (Ranunculaceae), is rich in alkaloids and has been used in folk medicine for thousands of years. In this study, the extraction process of total alkaloids from the whole T. delavayi plant was optimized and the extract's therapeutic potential against pulmonary infection caused by Klebsiella pneumoniae and Escherichia coli was investigated. The results showed that the optimum experimental conditions for the total alkaloids (2.46%) from T. delavayi were as follows: hydrochloric acid volume fraction of 0.8%, solid–liquid ratio of 1:12 and sonication time of 54 min. The treatment reduced bacterial counts, white blood cell counts and inflammatory cell classification in bronchoalveolar lavage fluid (BALF) and the levels of inflammatory cytokines interleukin-4 (IL-4), interleukin-6 (IL-6), tumor necrosis factor α (TNF-α), procalcitonin (PCT) and C-reactive protein (CRP), procalcitonin (PCT) and C-reactive protein (CRP) in the serum in experimental groups. The results in our experimental preliminary work suggested that the total alkaloids from T. delavayi had therapeutic effects on mice with Klebsiella pneumoniae and Escherichia coli mixed infectious pneumonia, providing experimental support for the plant's therapeutic potential in treating pulmonary infections caused by Klebsiella pneumoniae and Escherichia coli. [ABSTRACT FROM AUTHOR]

Introduction: Central nervous system leukemia (CNSL) remains a serious complication in patients with acute myeloid leukemia (AML) and an ambiguous prognostic factor for those receiving allo‐geneic hematopoiesis stem cell transplantation (allo‐HSCT). It is unknown whether using more sensitive tools, such as multiparameter flow cytometry (MFC), to detect blasts in the cerebrospinal fluid (CSF) would have an impact on outcome. Methods: We retrospectively analyzed the clinical outcomes of 1472 AML patients with or without cytology or MFC positivity in the CSF before transplantation. Abnormal CSF (CSF+) was detected via conventional cytology and MFC in 44 patients at any time after diagnosis. A control group of 175 CSF‐normal (CSF−) patients was generated via propensity score matching (PSM) analyses according to sex, age at transplant, and white blood cell count at diagnosis. Results: Compared to those in the CSF‐negative group, the conventional cytology positive and MFC+ groups had comparable 8‐year nonrelapse mortality (NRM) (4%, 4%, and 6%, p = 0.82), higher cumulative incidence of relapse (CIR) (14%, 31%, and 32%, p = 0.007), lower leukemia‐free survival (LFS) (79%, 63%, and 64%, p = 0.024), and overall survival (OS) (83%, 63%, and 68%, p = 0.021), with no significant differences between the conventional cytology positive and MFC+ groups. Furthermore, multivariate analysis confirmed that CSF involvement was an independent factor affecting OS and LFS. Conclusion: Our results indicate that pretransplant CSF abnormalities are adverse factors independently affecting OS and LFS after allotransplantation in AML patients. [ABSTRACT FROM AUTHOR]

Background and purpose: Clinically, the ability to identify individuals at risk of ischemic stroke remains limited. This study aimed to develop a nomogram model for predicting the risk of acute ischemic stroke. Methods: In this study, we conducted a retrospective analysis on patients who visited the Department of Neurology, collecting important information including clinical records, demographic characteristics, and complete hematological tests. Participants were randomly divided into training and internal validation sets in a 7:3 ratio. Based on their diagnosis, patients were categorized as having or not having ischemic stroke (ischemic and non-ischemic stroke groups). Subsequently, in the training set, key predictive variables were identified through multivariate logistic regression and least absolute shrinkage and selection operator (LASSO) regression methods, and a nomogram model was constructed accordingly. The model was then evaluated on the internal validation set and an independent external validation set through area under the receiver operating characteristic curve (AUC-ROC) analysis, a Hosmer-Lemeshow goodness-of-fit test, and decision curve analysis (DCA) to verify its predictive efficacy and clinical applicability. Results: Eight predictors were identified: age, smoking status, hypertension, diabetes, atrial fibrillation, stroke history, white blood cell count, and vitamin B12 levels. Based on these factors, a nomogram with high predictive accuracy was constructed. The model demonstrated good predictive performance, with an AUC-ROC of 0.760 (95% confidence interval [CI]: 0.736–0.784). The AUC-ROC values for internal and external validation were 0.768 (95% CI: 0.732–0.804) and 0.732 (95% CI: 0.688–0.777), respectively, proving the model's capability to predict the risk of ischemic stroke effectively. Calibration and DCA confirmed its clinical value. Conclusions: We constructed a nomogram based on eight variables, effectively quantifying the risk of ischemic stroke. [ABSTRACT FROM AUTHOR]

Background: On February 6th, 2023, two consecutive earthquakes struck southeastern Türkiye with magnitudes of 7.7 and 7.6, respectively. This study aimed to analyze the clinical and laboratory findings, as well as management of pediatric victims with Crush Syndrome (CS) and Acute Kidney Injury (AKI). Methods: The study included pediatric earthquake victims who were presented to Mersin University Hospital. Clinical and laboratory characteristics of the patients were collected retrospectively. Results: Among 649 patients, Crush injury (CI), CS and AKI was observed in 157, 59, and 17 patients, respectively. White blood cell count (12,870 [IQR: 9910–18700] vs. 10,545 [IQR: 8355–14057] /µL, P < 0.001), C-reactive protein (51.27 [IQR: 14.80–88.78] vs. 4.59 [1.04–18.25] mg/L, P < 0.001) and myoglobin levels (443.00 [IQR: 198.5–1759.35] vs. 17 [11.8–30.43] ng/ml) were higher in patients with CS, while their sodium (IQR: 134 [131–137] vs. 136 [134–138] mEq/L, P < 0.001) levels were lower compared to non-CS patients. An increase in myoglobin levels was identified as an independent risk factor for developing CS (OR = 1.017 [1.006–1.027]). Intravenous fluid replacement was administered to the patients with CS at a dose of 4000 cc/m2/day. Hypokalemia was observed in 51.9% of the CS patients on the third day. All patients with AKI showed improvement and no deaths were reported. Conclusions: Hyponatremia and increase in inflammation markers associated with CS may be observed. An increase in myoglobin levels was identified as a risk factor for CS. Hypokalemia may be seen as a complication of vigorous fluid therapy during hospitalization. [ABSTRACT FROM AUTHOR]

Inflammation of the synovium, known as synovitis, plays an important role in the pathogenesis of osteoarthritis (OA). Synovitis involves the release of a wide variety of pro‐inflammatory mediators in synovial fluid (SF) that damage the articular cartilage extracellular matrix and induce death and apoptosis in chondrocytes. The composition of synovial fluid is dramatically altered by inflammation in OA, with changes to both hyaluronic acid and lubricin, the primary lubricating molecules in SF. However, the relationship between key biochemical markers of joint inflammation and mechanical function of SF is not well understood. Here, we demonstrate the application of a novel analytical framework to measure the effective viscosity for SF lubrication of cartilage, which is distinct from conventional rheological viscosity. Notably, in a well‐established equine model of synovitis, this effective lubricating viscosity decreased by up to 10,000‐fold for synovitis SF compared to a ~4 fold change in conventional viscosity measurements. Further, the effective lubricating viscosity was strongly inversely correlated (r = −0.6 to −0.8) to multiple established biochemical markers of SF inflammation, including white blood cell count, prostaglandin E2 (PGE2), and chemokine ligand (CCLs) concentrations, while conventional measurements of viscosity were poorly correlated to these markers. These findings demonstrate the importance of experimental and analytical approaches to characterize functional lubricating properties of synovial fluid and their relationships to soluble biomarkers to better understand the progression of OA. [ABSTRACT FROM AUTHOR]

Recently, we identified artifactual hypoglycemia in patients with soft tissue sarcoma (STS) who received pegfilgrastim-supported chemotherapy. In the present study, we measured white blood cell count and fasting blood glucose levels after the administration of pegfilgrastim in patients with STS and showed the relationship between artifactual hypoglycemia and white blood cell count. A total of 19 patients were included in this study. The mean age of the patients was 54 years. They received chemotherapy and administration of pegfilgrastim. Pegfilgrastim was injected subcutaneously 48 h after chemotherapy. No patient had a history of diabetes mellitus. Fifty-nine cycles were administered to 19 patients. One hundred and twenty-eight samples were obtained within one week after the of pegfilgrastim administration. Hypoglycemia was observed in 38 of the 13 patients. There were no symptoms of hypoglycemia in any patient. The white blood cell count in samples from patients with hypoglycemia was significantly higher than that in samples without hypoglycemia (p < 0.001). The median white blood cell count in samples with hypoglycemia was 29,415 and 3420 in samples without hypoglycemia. Age, sex, body mass index, performance status, and red blood cell count were not associated with hypoglycemia. White blood cell count was strongly negatively correlated with fasting blood glucose levels (Pearson's r: 0.786, 95% confidence interval: 0.844–0.709, p < 0.001). Of the 38 samples with hypoglycemia, 32 were measured within 2 days after pegfilgrastim administration. If a lack of symptoms due to hypoglycemia and leukocytes is confirmed, physicians should wait and identify the normalization of the level of glucose according to the neutrophil nadir following temporal leukocytes, which prevents further invasive examination for hypoglycemia. [ABSTRACT FROM AUTHOR]

Objectives: The main risk factor involved in CIN2+ recurrence after treatment is the HPV persistent infection. The dysregulation of the immune system permits only HR-HPVs to become persistent infections, to promote cancer development, and to increase the risk of recurrence after treatment. Therefore, there is a shift to a Th2-type cytokine pattern during the carcinogenesis pathway; for this reason, the neutrophil-lymphocytes ratio (NLR) could be a marker of this immunological change. The study aimed to analyse the predictive role of NLR in the recurrence of high-grade CIN (CIN2+) after excisional treatment in a real-world life setting of patients treated for CIN2+. Design: This study wascross-sectional study. Participants/Materials, Setting, Methods: We examined a retrospective database of 444 patients, who attended the colposcopy service of our department from 2011 to 2020 due to an abnormal screening Pap smear, and we compared the clinical characteristics to NLR performed at the time of diagnosis. All analysed patients were treated according to an established protocol (colposcopy every 6 months for the first 2 years and every year for over 3 years) and HPV-DNA test and cervical biopsy were performed at entry and the end of follow-up. All patients underwent a blood sample examination, including complete white blood cell counts and collecting neutrophil and lymphocyte values expressed as 103/mL. Results: The sensitivity (SE) and specificity (SP) of the NLR cut-off point of 1.34 for the diagnosis of CIN2+ recurrence were 0.76 and 0.67, respectively. We found that CIN2+ recurrences were significantly higher in patients with NLR <1.34 (3.7% vs. 0.6%, p = 0.033) and the 5-year recurrence-free survival was higher in patients with NLR ≥1.34 (97% vs. 93%, p = 0.030). Limitations: Firstly, the retrospective analysis and low incidence of recurrence may limit the conclusions. Second, for the retrospective design of the study, we did not take into consideration the patient's comorbidities and habits (smoking) that may influence the NLR. On the other hand, the median duration of follow-up in our study was 26 months (IQR: 22–31), which fully reflects the incidence of recurrences. Conclusions: It is well known that CIN2+ lesions are sustained by deregulation of the immune system caused by persistent HPV infection, which may lead to cervical cancer. Among the actors underlying dysregulation of immunity, lymphocytes are involved in the permission of persistent infection and for this reason, NRL could be a reliable and cost-effective biomarker in predicting the risk of recurrence, especially for high-grade cervical lesions. [ABSTRACT FROM AUTHOR]

Background: Hemodialysis patients are prone to infection due to the inadequate response of their innate and adaptive immune systems. During the early phase of the coronavirus disease 2019 (COVID-19) pandemic, hemodialysis patients had a high risk of mortality. In this study, we evaluated COVID-19 infection characteristics, seroconversion rates, related factors, and 90-day mortality after the disease in hemodialysis patients before vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: Patients followed in outpatient hemodialysis units were included in the study. The relationships between biochemical and dialysis-related parameters of the patients, polymerase chain reaction positivity, seroconversion and mortality were examined. Results: The prevalence of COVID-19 infection among hemodialysis patients was 15.3%. The seroconversion rate was 79.1% in 112 days. Higher C-reactive protein levels during COVID-19 infection were associated with higher SARS-CoV-2 immunoglobulin G titers (P = .014, r = 0.384) and higher parathyroid hormone levels were associated with lower antibody titers (P = .009, r = -0.375). These results were regardless of the phosphorus-lowering treatment and serum calcium or phosphorus levels. The mortality rate was 28.5%, and white blood cell count during infection was an independent risk factor for mortality (P = .004; hazard ratio = 1.451; 95% CI, 1.125-1.872). Conclusion: In experimental studies, it has been shown that elevated parathyroid hormone adversely affects the immune response of hemodialysis patients. Our study is the first to show that the high level of parathyroid hormone negatively affects the antibody response during COVID-19 infection. [ABSTRACT FROM AUTHOR]

The effects of dietary Lagnaria breviflora leaves extract (LBLE) on the growth performance, feed utilisation and haematological parameters of juveniles African catfish, Clarias gariepinus (mean = 8.45 ± 0.6 g) raised in a flow water (mean temperature 26.7°C, mean pH 7.52, mean dissolved oxygen 6.05 mg/L) were assessed in this study. Diets (400 g/kg crude protein; 4631.5 kcal/kg gross energy) supplemented with LBLE at levels of 0 (control), 0.5, 1.0, 1.5 or 2.0 g/kg diet were served to fish in triplicates (each replicate has 20 fish) until they appeared satiated for 12 weeks. Then, they were challenged with Aeromonas hydrophila infection for further 2 weeks. Fish served dietary LBLE had considerable higher weight gain (64.76 g) and specific growth rate (765.5% g/day) than the fish group fed with the control diet with a reduced feed conversion ratio (1.45) (p < 0.05). Compared to fish fed with the control diet, the villi height (146.30 µm) and width (284.35 µm) of the intestines increased greatly in a dose (LBLE in diets) dependent order. Similarly, dietary LBLE increased (p < 0.05) the packed cell volume (46.11%) and haemoglobin (17.03 g/dL), whereas 1.5 g of LBLE increased the counts of white blood cells. Glutathione S‐transferase (769.43 U/mg protein), glutathione peroxidase (84.14 U/mg protein) and superoxide dismutase (433.15 U/mg protein) activities were significantly higher (p < 0.05) in fish fed with diets supplemented with LBLE compared to the control one. Additionally, dietary LBLE increased phagocytic and lysozyme activities and protected C. gariepinus against bacterial infections where the lowest death was observed in the fish fed on the diet containing 1.5 g LBLE/kg feed. These findings showed that the fish fed with LBLE/kg diet improved their immune system, antioxidant and growth performance in addition to providing protection from A. hydrophila infection with the optimum dose of 1.80 g/kg diet. [ABSTRACT FROM AUTHOR]

Objective: Patients with ovarian cancer have a high risk of developing thrombosis. We aimed to investigate laboratory parameters associated with deep vein thrombosis (DVT) in patients treated for ovarian cancer. Methods: We retrospectively analyzed pre-operation laboratory data of patients with ovarian cancer for DVT at the National Cancer Center, Korea, between January 2000 and February 2021. The test items were white blood cell count, absolute neutrophil count (ANC), hemoglobin, platelets, monocytes, serum glucose, CA125, D-dimer, fibrinogen, prothrombin time (PT), activated partial thromboplastin time (aPTT), and body mass index (BMI). Differences between patients with and without DVT were compared with Wilcoxon rank-sum test. We analyzed the variables using logistic regression. Items with significant odds ratios were included in multivariate logistic regression. Significant variables were selected using backward elimination. Items were further categorized based on reference ranges. Univariate and multivariate analyses were performed to identify items with abnormal values associated with DVT. Results: From 3,147 patient samples analyzed, 286 (9.1%) patients with DVT were selected. Differences between patients with vs without DVT were statistically significant for hemoglobin, monocyte, serum glucose, CA125, PT, aPTT, fibrinogen, D-dimer, and BMI. After univariate and multivariate analysis, monocyte, glucose, and PT remained significant. Among the categorical variables, low hemoglobin, high monocyte, high CA125, prolonged PT, and high BMI remained significant after univariate and multivariate analysis. Conclusion: Pre-operation laboratory data of low hemoglobin, high monocyte percentage, high serum glucose, high CA125, prolonged PT, and high BMI were associated with DVT. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusion Autologous hematopoietic stem cell transplantation (ASCT) has gained extensive application in the treatment of lymphoma and multiple myeloma (MM). Plenty of studies demonstrate that peripheral blood indicators could be considered potential predictive biomarkers for hematopoietic stem cells (HSCs) collection efficiency, including white blood cell count (WBC), monocyte count (Mono), platelet count (PLT), hematocrit, and hemoglobin levels. Currently, clinically practical predictive models based on these peripheral detection indicators to quickly, conveniently, and accurately predict collection efficiency are lacking.In total, 139 patients with MM and lymphoma undergoing mobilization and collection of ASCT were retrospectively studied. The study endpoint was successful collection of autologous HSCs. We analyzed the effects of clinical characteristics and peripheral blood markers on collection success, and screened variables to establish a prediction model. We determined the optimal cutoff value of peripheral blood markers for predicting successful stem cell collection and the clinical value of a multi‐marker prediction approach. We also established a prediction model for collection efficacy.Univariate and multivariate logistic regression analyses showed that the mobilization regimen, Mono, PLT, mononuclear cell count (MNC), and peripheral blood CD34+ cell count (PB CD34+ counts) were significant predictors of successful collection of peripheral blood stem cells (PBSC). Two predictive models were constructed based on the results of multivariate logistic analyses. Model 1 included the mobilization regimen, Mono, PLT, and MNC, whereas Model 2 included the mobilization regimen, Mono, PLT, MNC, and PB CD34+ counts. Receiver operating characteristic (ROC) curve analysis showed that the PB CD34+ counts, Model 1, and Model 2 could predict successful HSCs collection, with cutoff values of 26.92 × 106/L, 0.548, and 0.355, respectively. Model 1 could predict successful HSCs collection with a sensitivity of 84.62%, specificity of 75.73%, and area under the curve (AUC) of 0.863. Model 2 could predict successful HSCs collection with a sensitivity of 83.52%, specificity of 94.17%, and AUC of 0.946; thus, it was superior to the PB CD34+ counts alone.Our findings suggest that the combination of the mobilization regimen, Mono, PLT, MNC, and PB CD34+ counts before collection has predictive value for the efficacy of autologous HSCs collection in patients with MM and lymphoma. Using models based on these predictive markers may help to avoid over‐collection and improve patient outcomes. [ABSTRACT FROM AUTHOR]

This document is a collection of abstracts from the journal Digestive Endoscopy, covering a wide range of topics related to endoscopic procedures and treatments for gastrointestinal conditions. The studies evaluate the effectiveness and safety of different techniques, such as narrow-band imaging and magnifying endoscopy, and highlight the positive outcomes and low complication rates associated with these procedures. However, further research is needed to optimize the techniques and improve long-term outcomes. The document also includes summaries of studies and case reports on specific topics, such as colorectal cancer, liver and pancreatic diseases, and pediatric gastroenterology. These resources provide valuable insights for library patrons conducting research in these areas. [Extracted from the article]

The epidemiological and clinical characteristics of acute poisoning with liquid laundry detergent capsules have been comprehensively reported. However, studies of laboratory test results in these exposures are uncommon. This study analyzed the impact of the ingestion of liquid laundry detergent capsules on admission laboratory tests in paediatric patients. This retrospective study was conducted in the clinical toxicology unit of a paediatric poison centre between 2015 and 2021. Paediatric patients (less than 18 years of age) who ingested liquid laundry detergent capsules were included. The relationship between the European Association of Poisons Centers and Clinical Toxicologists/European Commission/International Programme on Chemical Safety Poisoning Severity Score and admission laboratory test results was assessed using Fisher's exact test or analysis of variance. A total of 156 patients were included in the study. A considerable proportion of patients presented with leucocytosis, acidosis, hyperlactataemia or base deficit. The median values of white blood cell count (P = 0.042), pH (P = 0.022), and base excess (P = 0.013) were significantly different among the Poisoning Severity Score groups. Hyperlactataemia was strongly associated with the Poisoning Severity Score (P = 0.003). Leucocytosis is a non-specific marker of severity following ingestion of liquid laundry detergent capsules. The incidence of metabolic acidosis and hyperlactataemia was higher in this study than in previous reports, but these metabolic features were not related to the severity of exposure. The exact mechanisms of toxicity are not yet known, but the high concentration of non-ionic and anionic surfactants, as well as propylene glycol and ethanol, in the capsule are likely contributing factors. Pediatric patients who ingest liquid laundry detergent capsules may develop leucocytosis, metabolic acidosis, hyperlactataemia, and a base deficit. [ABSTRACT FROM AUTHOR]

Background: Accumulating evidence suggests that peripheral inflammation is associated with the pathogenesis of Parkinson's disease (PD). We examined peripheral immune profiles and their association with clinical characteristics in patients with DLB and compared these with values in patients with PD. Methods: We analyzed peripheral blood from 93 participants (drug-naïve DLB, 31; drug-naïve PD, 31; controls, 31). Absolute leukocyte counts, absolute counts of leukocyte subpopulations, and peripheral blood inflammatory indices such as neutrophil-to-lymphocyte ratio were examined. Associations with clinical characteristics, cardiac sympathetic denervation, and striatal 123I-2-carbomethoxy-3-(4-iodophenyl)-N-(3-fluoropropyl) nortropane (123I-FP-CIT) binding were also examined. Results: Patients with DLB had lower absolute lymphocyte and basophil counts than did age-matched controls (both; p < 0.005). Higher basophil counts were marginally associated with higher global cognition (p = 0.054) and were significantly associated with milder motor severity (p = 0.020) and higher striatal 123I-FP-CIT binding (p = 0.038). By contrast, higher basophil counts were associated with more advanced PD characterized by decreased global cognition and severe cardiac sympathetic denervation. Although lower lymphocyte counts had relevance to more advanced PD, they had little relevance to clinical characteristics in patients with DLB. Higher peripheral blood inflammatory indices were associated with lower body mass index in both DLB and PD. Conclusions: As in patients with PD, the peripheral immune profile is altered in patients with DLB. Some peripheral immune cell counts and inflammatory indices reflect the degree of disease progression. These findings may deepen our knowledge on the role of peripheral inflammation in the pathogenesis of DLB. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the antibiotic resistance of microorganisms isolated in cases of culture-positive nosocomial late-onset neonatal sepsis in the neonatal intensive care unit. Materials and Methods: Infants admitted to our neonatal intensive care unit between October 2015 and June 2022 were retrospectively screened. A total of 458 different cultures from 386 sepsis incidents in 250 infants were analyzed. Results: Over an 8-year period, 407 cases of culture-positive nosocomial late-onset neonatal sepsis were reviewed in a total of 4244 infants. Twenty-one cases were excluded due to insufficient data. The incidence of culture-positive nosocomial sepsis was 6.3%. Coagulase-negative Staphylococcus and Staphylococcus aureus were the most common gram-positive bacteria found in cultures. Resistance to ampicillin and cephalosporin treatments was high, while resistance to vancomycin, teicoplanin, and linezolid was low. Klebsiella spp. were the most frequent gram-negative bacteria isolated in cultures and showed high resistance to non-carbapenembased regimens. The only fungal microorganisms isolated in cultures were Candida spp., which had a high mortality rate despite their low resistance profile. The mortality rate due to nosocomial sepsis was 19.6%. Conclusion: Our study demonstrated that microorganisms and their antibiotic resistance profiles changed over time in the newborn intensive care unit. Gram-negative pathogens exhibited high antibiotic resistance, while fungi had high mortality rates. It is essential to adjust empirical antibiotic regimens for nosocomial sepsis based on thorough surveillance. [ABSTRACT FROM AUTHOR]

Introduction: Suspected infection or inflammation of unknown origin in in-patients remains challenging. Literature on [18F]FDG-PET/CT is abundant in classic fever of unknown origin (FUO), but evidence is complex and may not always reflect clinical reality. This study explores the application of [18F]FDG-PET/CT in a diverse clinical population of in-patients with suspected infection not defined by stringent FUO-criteria. Methods: Retrospective chart review of consecutive in-patients who underwent [18F]FDG-PET/CT in the workup of suspected infection or inflammation from 1 July 2022 to 31 December 2022 was conducted. We evaluated indications, diagnostic yield, and clinical impact of [18F]FDG-PET/CT, and compared the findings of [18F]FDG-PET/CT and stand-alone CT. Univariate logistic regression assessed associations between [18F]FDG-PET/CT outcome and clinical parameters. Receiver operating characteristic curve (ROC) analysis evaluated diagnostic performance. Results: 77 patients met the inclusion criteria. [18F]FDG-PET/CT established a diagnosis in 35% of cases, ruled out focal infection in 26%, and thus was helpful in 61% of patients. It prompted 72 additional examinations resulting in seven incidental diagnoses, including two cancers. Antibiotic treatment was changed in 26% of cases. Regression analysis found white blood cell counts (WBC) associated with true positive outcomes. [18F]FDG-PET/CT was compared to stand-alone CT findings, and was concordant in 69% of cases. Conclusions: Results were comparable to findings in more classic FUO. [18F]FDG-PET/CT was clinically helpful in 61% of cases but also prompted many additional examinations with relatively few clinically important findings. WBC count was a predictor of true positive outcome. CT and [18F]FDG-PET/CT were discordant in 31%, of cases, especially in cases of endocarditis and spondylodiscitis. [ABSTRACT FROM AUTHOR]

Demethylcantharidin (DEM) is a widely used antitumor drug; however, its poor tumor targeting and serious organotoxicity limit its application. The aim of this study was to develop a new drug delivery system for efficient delivery of DEM. Nanoemulsion based lipid nanoparticles containing demethylcantharidin (DNLNs) were prepared by loading nanoemulsions into lipid nanoparticles. The cells proliferation, apoptosis, cycle, and uptake were investigated by Cell counting kit‐8 (CCK‐8), flow cytometry, and in situ fluorescence assays, respectively. Then, we established the H22 tumor‐bearing mouse model to evaluate the antitumor efficacy of DNLNs and further studied its organ toxicity and distribution. DNLNs significantly inhibited the proliferation and promoted apoptosis of H22 cells, and H22 cells could take up more DNLNs. Compared with DEM, DNLNs had certain tumor‐targeting properties, and the tumor inhibition rate increased by 23.24%. Moreover, DNLNs can increase white blood cell count and reduce organ toxicity. This study paves the way for nanoemulsion‐based lipid nanoparticle (NLNs)‐efficient DEM delivery to treat liver cancer. [ABSTRACT FROM AUTHOR]

Introduction: This study involves the collation and analysis of clinical characteristics and laboratory findings in patients with multiple myeloma (MM) combined with renal insufficiency. The objective was to assess the impact of various treatment methods on patient outcomes and the incidence of adverse events in individuals with MM and renal insufficiency. Methods: We analyzed the correlation between clinical characteristics, gene loci, fluorescence in situ hybridization, treatment methods, and prognosis in patients with MM and renal insufficiency. The differences in hematological and therapeutic efficacy indexes between two groups subjected to different treatments were evaluated. The assessment of treatment effectiveness was based on the total effective rate, calculated as the sum of stringent CR rate, complete remission rate, very good partial remission rate, and partial remission rate. Results: (1) The renal insufficiency group exhibited higher percentages of bone marrow abnormal plasma cells, lactate dehydrogenase (LDH), blood calcium, white blood cell count, percentage of neutrophils, and blood β2-microglobulin (β2-MG) levels compared to the normal renal function group. Conversely, hemoglobin levels and lymphocyte percentage were lower in the renal insufficiency group. Binary logistic regression analysis identified hemoglobin, blood calcium values, blood β2-MG, and LDH as independent risk factors for the development of renal insufficiency in patients with MM (p < 0.05). (2) Based on the Durie-Salmon staging criteria, the proportion of Stage III patients was the highest (up to 81.8%), indicating that patients with MM usually suffer from insidious disease, often with high tumor load and late-disease stage at the time of consultation. International Staging System (ISS) and Revised ISS staging also revealed a higher proportion of Stage III patients in the renal insufficiency group (p < 0.05), indicating a worse long-term prognosis in patients with MM and renal insufficiency. (3) Before treatment, there was no significant difference between the two groups in the analysis of various indices. Complications such as sepsis, herpes zoster, peripheral neuropathy, thrombosis, secondary pulmonary infection, and cardiac complications were significantly lower in the BCD group (Bortezomib + Cyclophosphamide + Dexamethasone) compared to the BD group (Bortezomib + Dexamethasone) (χ2 = 6.333, p < 0.05), suggesting fewer complications with the BCD regimen. (4) The clinical treatment effects analysis indicated that the BCD group demonstrated a more significant impact than the BD group in the treatment of MM. Conclusion: The application of the BCD regimen in the treatment of MM has shown significant efficiency, effectively alleviating clinical symptoms with fewer adverse reactions and high safety. [ABSTRACT FROM AUTHOR]

Introduction: In this study, we investigated the correlation and clinical significance of peripheral blood leukocytes, neutrophils, C-reactive protein (CRP), and procalcitonin (PCT) in patients with acute urticaria. Methods: Complete blood count with differential, CRP, and PCT tests were conducted on patients with acute urticaria. A total of 614 patients with acute urticaria were divided into three groups: the first group consisted of patients with elevated leukocyte and neutrophil count, the second group consisted of patients with normal leukocyte and neutrophil count, and the third group consisted of patients with abnormal leukocyte and neutrophil count. A correlation analysis was conducted to investigate the levels of leukocytes, neutrophils, CRP, and PCT in the three groups. Results: The results of Kruskal-Wallis' nonparametric test revealed statistically significant variations in leukocytes, neutrophils, CRP, and PCT among the three groups (p < 0.001). However, CRP and PCT showed no statistically significant differences between the second and third groups (p < 0.001, p = 0.0041, p = 0.0032). Additional multiple comparisons in Spearman correlation analysis indicated statistically significant differences (p = 0.55). Across all groups, there was a statistically significant difference in the correlation between CRP-PCT and leukocytes-neutrophils (p = 0.53). Conclusion: Leukocytes and neutrophils are sensitive to the impact of medications and stress on the body. Combining CRP and PCT, as well as routine blood test, may be a comprehensive assessment of infection presence and severity in patients, providing guidance for antibiotic treatment. [ABSTRACT FROM AUTHOR]

Background: Pruritus is a symptom profoundly impairing patients' quality of life (QoL). It is a common symptom in chronic heart failure (CHF) patients of yet unknown nature. The aim of this study was to evaluate the risk factors of pruritus in CHF patients. Methods: For this monocentric, prospective cohort study, CHF patients were recruited and CHF symptoms, comorbidities and drug intake were assessed using a structured report. Additionally, a questionnaire evaluated pruritus symptoms. Detailed medical histories including laboratory test results were retrieved from patient files for all participants. Results: We evaluated data from 550 CHF patients. Of those, 25.3% reported pruritus to occur frequently (3–5 times per week), often (1–2 times per week) or daily. Patients of higher NYHA classes (NYHA III + IV) experienced significantly more pruritus (31.2%) than lower NYHA classes (NYHA I + II) (21.1%, p = 0.024). Patients with pruritus reported disproportionately often concomitant stasis dermatitis (p = 0.026) and chronic lung disease (p = 0.014). Other parameters reflecting cardiac, liver, kidney and thyroid function, as well as medical therapies showed no significant differences between patients with and without pruritus. In the multivariate logistic regression analysis, only NYHA class (p = 0.016, OR 1.55, 95% confidence interval (CI): [1.09; 2.20]) and elevated leukocyte count (p = 0.007, OR 1.11, CI [1.03; 1.21]) remained significantly associated with pruritus in CHF patients. Conclusions: NYHA class is an independent predictor for pruritus in CHF patients. Besides NYHA class, leukocyte count was also associated with increased pruritus. Pruritus may impair QoL in CHF patients and should thus be included in the assessment of those patients. We suggest that providing best care for CHF patients can be achieved through an interdisciplinary approach of cardiologists and dermatologists and should include a pruritus assessment. [ABSTRACT FROM AUTHOR]

Aim Materials and Methods Results Conclusions To investigate the associations between oral health and depression, anxiety and their comorbidity in the UK Biobank cohort.Oral health problems were self‐reported at baseline. Symptoms of depression and anxiety were assessed using the Mental Health Questionnaire (PHQ‐4) in a cross‐sectional study. In the cohort study, diagnoses of depression and anxiety disorders were based on hospital records. Logistic regression and Cox regression models were used to analyse the association between oral health and depression/anxiety.A total of 305,188 participants were included in the cross‐sectional study, and multivariate analysis showed that periodontal disease was associated with depression and/or anxiety (odds ratio [OR]: 1.79, 95% confidence interval [CI]: 1.73–1.86). In the prospective cohort study involving 264,706 participants, periodontal disease was significantly associated with an increased risk of depression and/or anxiety (hazard ratio [HR]: 1.14, 95% CI: 1.10–1.19), depression (HR: 1.19, 95% CI: 1.13–1.25) and anxiety (HR: 1.13, 95% CI: 1.07–1.19). Periodontal disease was also significantly associated with comorbid depression and anxiety (HR: 1.27, 95% CI: 1.16–1.38). Multiple mediation analysis using baseline inflammatory factors showed that white blood cell count and C‐reactive protein explained 3.07% and 3.15% of the association between periodontal disease and depression and anxiety, respectively. However, the results of longitudinal multiple mediation analysis of inflammatory factors at first follow‐up (N = 10,673) were not significant.Periodontal disease was found to be consistently associated with an increased risk of depression, anxiety and their comorbidity. [ABSTRACT FROM AUTHOR]

Introduction: Inflammatory responses and coagulation disorders are a relevant challenge for successful cardiac xenotransplantation on its way to the clinic. To cope with this, an effective and clinically practicable anti‐inflammatory and anti‐coagulatory regimen is needed. The inflammatory and coagulatory response can be reduced by genetic engineering of the organ‐source pigs. Furthermore, there are several therapeutic strategies to prevent or reduce inflammatory responses and coagulation disorders following xenotransplantation. However, it is still unclear, which combination of drugs should be used in the clinical setting. To elucidate this, we present data from pig‐to‐baboon orthotopic cardiac xenotransplantation experiments using a combination of several anti‐inflammatory drugs. Methods: Genetically modified piglets (GGTA1‐KO, hCD46/hTBM transgenic) were used for orthotopic cardiac xenotransplantation into captive‐bred baboons (n = 14). All animals received an anti‐inflammatory drug therapy including a C1 esterase inhibitor, an IL‐6 receptor antagonist, a TNF‐α inhibitor, and an IL‐1 receptor antagonist. As an additive medication, acetylsalicylic acid and unfractionated heparin were administered. The immunosuppressive regimen was based on CD40/CD40L co‐stimulation blockade. During the experiments, leukocyte counts, levels of C‐reactive protein (CRP) as well as systemic cytokine and chemokine levels and coagulation parameters were assessed at multiple timepoints. Four animals were excluded from further data analyses due to porcine cytomegalovirus/porcine roseolovirus (PCMV/PRV) infections (n = 2) or technical failures (n = 2). Results: Leukocyte counts showed a relevant perioperative decrease, CRP levels an increase. In the postoperative period, leukocyte counts remained consistently within normal ranges, CRP levels showed three further peaks after about 35, 50, and 80 postoperative days. Analyses of cytokines and chemokines revealed different patterns. Some cytokines, like IL‐8, increased about 2‐fold in the perioperative period, but then decreased to levels comparable to the preoperative values or even lower. Other cytokines, such as IL‐12/IL‐23, decreased in the perioperative period and stayed at these levels. Besides perioperative decreases, there were no relevant alterations observed in coagulation parameters. In summary, all parameters showed an unremarkable course with regard to inflammatory responses and coagulation disorders following cardiac xenotransplantation and thus showed the effectiveness of our approach. Conclusion: Our preclinical experience with the anti‐inflammatory drug therapy proved that controlling of inflammation and coagulation disorders in xenotransplantation is possible and well‐practicable under the condition that transmission of pathogens, especially of PCMV/PRV to the recipient is prevented because PCMV/PRV also induces inflammation and coagulation disorders. Our anti‐inflammatory regimen should also be applicable and effective in the clinical setting of cardiac xenotransplantation. [ABSTRACT FROM AUTHOR]

Introduction: The goal of the current study was to determine how the leukocyte count varied on a monthly basis during the various stages of the menstrual cycle. Periodic vaginal bleeding is a cyclical phenomenon associated with the menstrual cycle, which impacts all bodily systems. It takes place in the course of a woman's reproductive life and is governed by a planned progression of structural, functional, and hormonal systems. A regular menstrual cycle typically lasts 28 days, with an average blood loss of 20 to 60 millilitres and a flow that lasts 2 to 6 days. The menstrual cycle is regulated by the pituitary-ovarian system. Material and Methods: 38 healthy females in the 16-28 age range with regular cycles lasting 28-28 days were examined.The current study was conducted at the Obstetrics & Gynaecology Department of MKCG MCH, Berhampur, between August 2014 and October 2015. 38 healthy female subjects, ages 16 to 28, with average menstrual cycles lasting 28P2 days participated in the study. Women with irregular periods, gastrointestinal disorders, anaemia, a history of drug usage that interfered with their menstrual cycle, a history of chronic disease, or a fever at the time of sample collection were not included in the research. Each female participant informedly consented to the research after learning about its protocols. The tests were carried out in accordance with ethical standards. Result: During the secretory phase, the total leukocyte count significantly increased. When it came to the differential leukocyte count, the neutrophil count increased significantly during the secretory phase, the lymphocyte count increased during both the menstrual and secretory phases, the monocyte count increased during the proliferative phase but did not significantly change, and the eosinophil count did not significantly change throughout the three phases. Conclusion: In order to better understand a variety of illnesses, this study sought to ascertain the typical fluctuation in the leucocyte count during the various phases of the menstrual cycle.This study shows variations in the total leukocyte count and differential leukocyte count during the various stages of the menstrual cycle and offers information on a variety of disorders that affect women and are linked to monthly swings. [ABSTRACT FROM AUTHOR]

Sepsis is defined as a life-threatening organ dysfunction due to a dysregulated inflammatory host response to infection. Among the vulnerable population, Geriatric patients stand out as a high-risk group due to age-related physiological changes, immunosenescence, and a higher prevalence of comorbidities displaying higher mortality rates. We wanted to explore the various etiologies, clinical profiles, and outcome of sepsis in geriatric patients in a tertiary hospital. We conducted a cross-sectional observational study, where geriatric patients aged 65 years and above, admitted in the Departments of General Medicine (Wards and ICUs) in King George hospital, Visakhapatnam, diagnosed with sepsis were followed up from admission until their discharge or until the end of their hospital stay. The clinical profile of the patients and their outcome was assessed. The study population consisted predominant male (69.3%)and belonged to the age group 65-70years (73.9%). The study revealed an in-hospital mortality rate of 31.8% among geriatric patients admitted with sepsis, with diabetes mellitus being the most prevalent comorbid condition. Common presenting symptoms included fever (17.6%), shortness of breath (17%), and limb swelling (10.8%), with skin and soft tissue infections being the most frequent infection site (37%), followed by urosepsis (35.2%) and respiratory tract infections (14.8%). Klebsiella was the most common organism isolated from cultures, followed by Staphylococcus aureus. Patients who succumbed to sepsis had a higher mean age, shorter duration from symptom onset to hospitalization, higher respiratory rates, elevated white blood cell counts, lower Glasgow Coma Scale (GCS) scores, and higher Sequential Organ Failure Assessment (SOFA) score. [ABSTRACT FROM AUTHOR]

Problem: Achieving pregnancy through in vitro fertilization (IVF) remains a challenge, with less than one‐third of women succeeding. There is a pressing need for reliable predictive tools to assess the likelihood of post‐IVF pregnancy. While some serum inflammatory biomarkers have been investigated for their predictive potential, substantial knowledge gaps persist. This study examined the utility of different inflammatory markers in predicting IVF outcomes. Method of Study: Inflammatory markers including the white blood cell count, neutrophil‐to‐lymphocyte ratio (NLR), platelet count, mean platelet volume, platelet distribution width, platelet‐to‐lymphocyte ratio (PLR), C‐reactive protein (CRP), erythrocyte sedimentation rate, and vitamin D3 were assessed. Study outcomes were chemical pregnancy (positive serum beta‐human chorionic gonadotropin 2 weeks post‐embryo transfer), clinical pregnancy (detection of pregnancy sac via transvaginal ultrasonography), and viable pregnancy (detection of fetal heart rate). Univariate and multivariate logistic regression analyses were conducted, with multivariate analysis incorporating age, body mass index, infertility duration, type, and etiology, as well as all studied serum inflammatory markers, embryo count, stage, quality, and endometrial thickness. Results: Lower NLR (p < 0.001, odds ratio [OR] = 0.372 [0.247–0.559]) and CRP (p = 0.035, odds ratio = 0.956 [0.916–0.997]) predicted chemical pregnancy in univariate analysis, with NLR maintaining significance in multivariate analysis (p = 0.022, OR = 0.319 [0.120–0.848]). Lower NLR (p < 0.001, OR = 0.309 [0.198–0.482]) and PLR (p = 0.013, OR = 0.994 [0.990–0.999]) predicted clinical pregnancy, with NLR surviving multivariate analysis (p = 0.005, OR = 0.217 [0.075–0.626]). Lower NLR (p < 0.001, OR = 0.320 [0.198–0.516]) also predicted viable pregnancy, maintaining statistical significance in multivariate analysis (p = 0.002, OR = 0.177 [0.058–0.541]). Other studied inflammatory markers did not predict IVF outcomes. Conclusions: NLR emerged as a robust independent predictor of pregnancy attainment after IVF. [ABSTRACT FROM AUTHOR]

Background: Both the high-risk human papillomavirus (HR-HPV) infection and tobacco exposure are significantly associated with cervical neoplasm risk. Immune cells play important roles in carcinogenesis. However, it is still unclear whether immune cells have a mediating effect on the HR-HPV infection and tobacco exposure with cervical neoplasm development. Aim: The aim of this study was to determine how the increased white blood cell (WBC) count affects the relationship between HR-HPV DNA load and tobacco exposure in the development of cervical neoplasia. Methods: A hospital-based case–control study design was conducted with a total of 108 cases of Taiwanese women with ≥ cervical intraepithelial neoplasia (CIN) I confirmed by biopsy, and 222 healthy Taiwanese female subjects with negative findings on a Pap smear were assigned to the control group. The study evaluated HR-HPV status and immune cell counts (WBCs, natural killer (NK) cells) and tobacco exposure by a self-construct questionnaire. Results: Both HR-HPV DNA load and tobacco exposure significantly independently increased cervical neoplasm risk (AORs: 1.28 and 1.42, respectively). Similar significant results were found for WBCs and NK cells, with respective AORs of 1.20 and 1.00. Moreover, increased WBCs (β = 0.04, 95% CI corrected: 0.01–0.07) and tobacco exposure (β = 0.02, 95% CI corrected: 0.01–0.04) mediated the relationship between the high-risk HPV DNA load and cervical neoplasm risk. Conclusions: Elevated WBC count acts as both predictor and mediator in cervical neoplasm development linked to HR-HPV DNA load. Monitoring and maintaining WBC levels within the normal range could be a preventive strategy for cervical neoplasm development. [ABSTRACT FROM AUTHOR]

High hyperdiploid karyotype with ≥ 49 chromosomes (which will be referred to as HHK) is rare in acute myeloid leukemia (AML). The European leukemia network (ELN) excluded those harboring only numerical changes (with ≥ 3 chromosome gains) from CK and listed them in the intermediate risk group, while the UK National Cancer Research Institute Adult Leukaemia Working Group classification defined ≥ 4 unrelated chromosome abnormalities as the cutoff for a poorer prognosis. Controversies occurred among studies on the clinical outcome of HHK AML, and their molecular characteristics remained unstudied. We identified 1.31% (133/10,131) HHK cases within our center, among which 48 cases only had numerical changes (NUM), 42 had ELN defined adverse abnormalities (ADV) and 43 had other structural abnormalities (STR). Our study demonstrated that: (1) No statistical significance for overall survival (OS) was observed among three cytogenetic subgroups (NUM, STR and ADV) and HHK AML should be assigned to the adverse cytogenetic risk group. (2) The OS was significantly worse in HHK AML with ≥ 51 chromosomes compared with those with 49–50 chromosomes. (3) The clinical characteristics were similar between NUM and STR group compared to ADV group. The former two groups had higher white blood cell counts and blasts, lower platelet counts, and mutations associated with signaling, while the ADV group exhibited older age, higher chromosome counts, higher percentage of myelodysplastic syndrome (MDS) history, and a dominant TP53 mutation. [ABSTRACT FROM AUTHOR]

This study aimed to analyse the characteristics and treatment outcomes of adult patients with acute lymphoblastic leukaemia (ALL) and construct nomogram predictive models for prognosis prediction. Between January 2017 and June 2022, 462 adult patients with ALL were included in this retrospective analysis. Patients' ages ranged from 14 to 84 years. B-cell origin was observed in 82.7% of these patients, while 17.3% of the cases were of T-cell origin. The BCR/ABL1 fusion gene was detected in 32.9% of those with B-ALL. Complete remission was achieved in 83.7% of the patients after induction chemotherapy. The median disease-free survival (DFS) and overall survival (OS) of patients were 19.0 and 39.1 months, respectively. The 5-year DFS and OS rates were 29.5% and 41.8%, respectively. The BCR/ABL1 fusion gene had a significant adverse impact on DFS and OS when patients were treated with tyrosine kinase inhibitors (TKIs) and chemotherapy; however, this effect was eliminated when patients underwent transplantation. Multivariate analysis identified that age ≥ 35 years, white blood cell count ≥ 30 × 109/L, platelet count < 100 × 109/L, failure to achieve complete remission after induction chemotherapy, positive measurable residual disease (MRD), and absence of transplantation were independent adverse prognostic factors for DFS and/or OS. Nomogram predictive models constructed by the rms package in R software based on these prognostic factors demonstrated precise predictive value. In conclusion, adult patients with ALL experience poor survival. TKIs in combination with transplantation can eliminate the adverse effects of BCR/ABL1 fusion genes on prognosis. Nomogram predictive models were accurate for prognostic prediction and will be useful in clinical practice. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to perform a method comparison between the CellaVision preclassification neutrophil count and the reclassification neutrophil count performed by trained laboratory technicians, and to evaluate the diagnostic performance of the preclassification neutrophil count at clinical decision levels. Methods: We retrospectively identified patient samples through 2019–2022 in which the differential count was performed on Cellavision (n = 4,354). Data on sample characteristics and leukocyte- and differential counts was extracted from the electronic medical journal. For each sample, data containing the pre- and reclassification leukocyte classification, respectively, was extracted from the Cellavision software. Method comparison between the pre-and reclassification neutrophil count was performed using Bland Altman analysis. Diagnostic performance of the preclassification neutrophil count was evaluated according to four pre-specified categories of results with the reclassification as reference method. Results: The median difference between the pre- and reclassification neutrophil count was 0.044 x 109/L. The preclassification neutrophil count categorised 95.6% of all samples correctly according to the four categories. The sensitivity, specificity, positive predictive value and negative predictive value for detecting neutrophilia > 7.00 x 109/L was 98.8%, 97.2%, 95.8%, and 99.2%, respectively. In samples with leukopenia (n = 543), the sensitivity, specificity, positive predictive value and negative predictive value for detecting severe neutropenia (< 0.50 x 109/L) was 97.7%, 99.1%, 98.6%, and 98.5%, respectively. Conclusion: The diagnostic performance of the CellaVision preclassification neutrophil count was satisfactory. The preclassification neutrophil count may be released to the electronic medical journal to improve turnaround time and benefit laboratory management. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Sichuan University (Medical Science Edition) is the property of Editorial Board of Journal of Sichuan University (Medical Sciences) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Aneurysmal subarachnoid hemorrhage (aSAH) patients typically have poor prognoses. The anion gap (AG) has been proven to correlate with mortality in various critically ill patients. However, hypoalbuminemia can lead to underestimations of the true anion gap levels. This study was conducted to verify the prognostic value of single AG and albumin-corrected anion gap (ACAG) among aSAH patients. Methods: Significant factors in the univariate logistic regression analysis were included in the multivariate logistic regression analysis to explore the risk factors for mortality in aSAH patients and to confirm the independent relationship between ACAG and mortality. The restricted cubic spline (RCS) was used to visually show the relationship between ACAG level and mortality risk of aSAH patients. The predictive model for mortality was developed by incorporating significant factors into the multivariate logistic regression analysis. The prognostic value of ACAG and the developed model was evaluated by calculating the area under the receiver operating characteristics curve (AUC). Results: Among 710 aSAH patients, a 30-day mortality was observed in 20.3% of the cases. A positive relationship was demonstrated between the ACAG level and mortality in aSAH patients using the RCS curve. The multivariate logistic regression analysis helped discover that only six factors were finally and independently related to mortality of aSAH patients after adjusting for confounding effects, including the Hunt-Hess scale score (p = 0.006), surgical options (p < 0.001), white blood cell count (p < 0.001), serum chloride levels (p = 0.023), ACAG (p = 0.039), and delayed cerebral ischemia (p < 0.001). The AUC values for the AG, albumin, and ACAG in predicting mortality among aSAH patients were 0.606, 0.536, and 0.617, respectively. A logistic regression model, which includes the Hunt-Hess scale score, surgical options, white blood cell count, serum chloride levels, ACAG, and delayed cerebral ischemia, achieved an AUC of 0.911 for predicting mortality. Conclusion: The ACAG is an effective prognostic marker for aSAH patients. A prognostic model incorporating ACAG could help clinicians evaluate the risk of poor outcomes among aSAH patients, thereby facilitating the development of personalized therapeutic strategies. [ABSTRACT FROM AUTHOR]

Neurosyphilis is a central nervous system infection caused by Treponema pallidum that imitates various neurological and mental disorders. Therefore, patients with this disease are prone to misdiagnoses. Here, we report a case of neurosyphilis with a psychotic disorder as the main manifestation. A young girl exhibited mental and behavioural abnormalities after a heartbreak, which manifested as alternating low mood, emotional irritability, and a lack of interest in social relations, followed by memory loss. The cerebrospinal fluid protein - Treponema pallidum particle agglutination test was positive, the toluidine red unheated serum test titre was 1:4, the white blood cell count was 5 × 10^6/L, the cerebrospinal fluid protein level was 0.97 g/L, and the brain CT was abnormal. After admission, the possibility of neurosyphilis was considered and the patient received intravenous penicillin G treatment. The patient's clinical symptom ms improved. This case emphasises that doctors should maintain clinical suspicion of Treponema pallidum infection in adolescent patients with mental abnormalities. [ABSTRACT FROM AUTHOR]

Complex pelvic masses with elevated CA125 could be due to malignant and benign condition. Tubo-ovarian abscess, with irritation of the peritoneum, could increase the level of CA125 and mimic advanced ovarian cancer. Preoperatively, high accuracy radiological evaluation can reduce the high risk and unnecessary laparotomies. The patient was a 50-year-old near menopause woman with abdominal pain, fever and recent vaginal bleeding with highly elevated CA125(>4000 u/ml) and complex pelvic mass, suspected of ovarian cancer with final pathology of tubo- ovarian abscess (TOA). Misdiagnosed TOA with ovarian cancer only based on highly elevated CA_125 and performing upfront radical surgery in stable patients could result in visceral injury. [ABSTRACT FROM AUTHOR]

Background: Pre-clinical studies showed the anti-tumor mechanisms of PARP inhibitors (PARPi) and platinum have some crossover and overlap in the DNA damage repair pathway, patients who respond to platinum-based chemotherapy are also more likely to be sensitive to PARPi. This real-world study mainly aimed to evaluate whether TRAE (treatment-related adverse event) between platinum based chemotherapy (PBC) and niraparib are also associated. Methods: Patients received niraparib as maintenance treatment or salvage therapy for advanced ovarian cancer at the First Affiliated Hospital of Gannan Medical University from January 2020 to August 2023 were included. Survival data of niraparib treatment and adverse events occurred during the last platinum-based chemotherapy cycle before starting niraparib treatment and during niraparib treatment are documented. Fisher's exact test were used for correlation analysis. Results: 1. 40 patients treated with niraparib were included in the analysis, including 31 patients treated with niraparib for 1st-line maintenance therapy, 6 patients for PSR (platinum-sensitive recurrence) maintenance therapy, and 3 patients for salvage therapy. The overall median follow-up time was 15.0 months (ranged from 2.2 months to 32.1 months). 2. Overall grade=3 TRAE (40% vs 70%, p=0.012) including anemia (20% vs 45%, p=0.041) and neutrophil count decreased (17.5% vs 57.5%, p<0.001) was significantly lower during niraparib treatment compared to during chemotherapy. 3. Any grade TRAE (75% vs 100%, p=0.002) including white blood cell count decreased (47.5% vs 87.5%, p<0.001), red blood cell count decreased (57.5% vs 92.5%, p<0.001), anemia (55% vs 87.5%, p<0.001) and neutrophil count decreased (35% vs 85%, p<0.001) were also significantly lower in niraparib treatment group compared with chemotherapy group. No new safety signals were identified. Conclusion: 1. In this real-world practice, we observed that patients with advanced ovarian cancer who experienced any grade and grade =3 TRAE during chemotherapy were well tolerated when treated with niraparib, particularly the incidence of any grade and grade =3 anemia, and neutrophil count decreased during niraparib treatment were significantly lower compared with that during chemotherapy. 2. For patients with ovarian cancer who have experienced grade =3 hematological adverse reactions during prior platinumbased chemotherapy, greater attention should be paid to the monitoring and management of hematological adverse reactions during subsequent treatment with niraparib. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study analysed the incidence of lower extremity amputation and its associated risk factors in patients with diabetic foot ulcers. This study systematically searched both Chinese and English databases, including CNKI, Wanfang, VIP, PubMed, EMBASE and Web of Science, to identify cohort studies related to lower extremity amputation and associated risk factors in patients with diabetic foot ulcers up to October 2023. The patients were stratified based on whether they underwent lower extremity amputation, and relevant data, including basic information, patient characteristics, complications, comorbidities and pertinent laboratory test data, were extracted from the included studies. The literature quality assessment in this study utilized the Newcastle‐Ottawa Scale to screen for high‐quality literature, resulting in the inclusion of 16 cohort studies, all of which were of at least moderate quality. Meta‐analysis of outcome indicators was conducted using the Stata 14.0 software. The results indicate that the overall amputation rate of lower extremities in patients with diabetic foot ulcers is 31% (0.25, 0.38). Among the 16 variables evaluated, gender (male), smoking history, body mass index (BMI), hypertension, cardiovascular disease, kidney disease, white blood cell count, haemoglobin and albumin levels were found to be correlated with the occurrence of lower extremity amputation in patients with diabetic foot ulcers. However, no significant correlation was observed between age, diabetes type, duration of diabetes, stroke, glycosylated haemoglobin, creatinine and total cholesterol levels and lower extremity amputation in patients with diabetic foot ulcers. This meta‐analysis indicates that the overall amputation rate in patients with diabetic foot ulcers is 31%. Factors such as gender (male), smoking history, high BMI, hypertension, cardiovascular disease, kidney disease, white blood cell count, haemoglobin and albumin levels are identified as significant risk factors for lower extremity amputation in diabetic foot ulcer patients. These findings suggest that attention should be focused on these risk factors in patients with diabetic foot ulcers to reduce the risk of lower extremity amputation. Therefore, preventive and intervention measures targeting these risk factors are of significant importance in clinical practice. (Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier [CRD42024497538]). [ABSTRACT FROM AUTHOR]

Background: The general practice out-of-hours (GPOOH) service is under pressure to treat more patients in less time, while reducing referrals and minimising diagnostic errors. Point-of-care (POC) testing involves rapid clinical tests that can be used to generate results during the consultation, and has the potential to facilitate managing these competing demands safely. Aim: To describe current availability of POC tests in GPOOH in Scotland, and identify barriers, enablers, benefits, and drawbacks to its use. Design & setting: Cross-sectional mixed-methods study, which surveyed opinions of clinicians working in the GPOOH service in NHS Scotland. Method: An electronic questionnaire was developed, designed, piloted, and distributed to clinicians, which had closed questions and areas for free text. Results: In total, 142 responses were received. Urine dipstick testing (99.2%), pregnancy tests (98.5%), oxygen saturation (97.7%), and blood glucose testing (93.9%), were the only POC tests commonly available in GPOOH in NHS Scotland. There was strongest support for the provision of POC tests, particularly C-reactive protein (CRP; 79.4%), strep A (76.0%), and D-dimer (75.2%). Responders felt that POC tests would improve confidence (92.3%) and safety (89.8%) surrounding clinical decision making, improve patient satisfaction (80.6%), and reduce hospital and secondary care referrals (77.5%). Barriers to POC test use were availability of the test kits and machines (94.5%), training requirements on how to use the machine (71.1%) and interpret results (56.3%), and time to do the test (62.0%). Conclusion: Few POC tests are in regular use in GPOOH in Scotland. GPOOH clinicians are supportive of using POC testing. They identified a number of benefits to its use, with very few drawbacks. Increased provision of POC testing in GPOOH in NHS Scotland should be considered urgently. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to explore the influence of serum leukocytes on urologic cancers (UC) using observation-based investigations. In the present study, Mendelian randomization (MR) was employed to assess the link between leukocyte count (LC) and the risk of UC development. Methods: Five LC and three major UC patient prognoses were obtained for MR analysis from genome-wide association studies (GWAS). Furthermore, in order to evaluate reverse causality, bidirectional studies were conducted. Finally, a sensitivity analysis using multiple methods was carried out. Results: There was no significant correlation found in the genetic assessment of differential LC between the co-occurrence of bladder cancer (BCA) and renal cell carcinoma (RCC). Conversely, an individual 1-standard deviation (SD) rise in neutrophil count was strongly linked to a 9.3% elevation in prostate cancer (PCA) risk ([odd ratio]OR = 1.093, 95% [confidence interval]CI = 0.864-1.383, p = 0.002). Reverse MR analysis suggested that PCA was unlikely to cause changes in neutrophil count. Additional sensitivity studies revealed that the outcomes of all MR evaluations were similar, and there was no horizontal pleiotropy. Primary MR analysis using inverse-variance weighted (IVW) revealed that differential lymphocyte count significantly influenced RCC risk (OR = 1.162, 95%CI = 0.918-1.470, p = 0.001). Moreover, altered basophil count also affected BCA risk (OR = 1.249, 95% CI = 0.904-1.725, p = 0.018). Nonetheless, these causal associations were not significant in the sensitivity analysis. Conclusion: In summary, the results revealed that increased neutrophil counts represent a significant PCA risk factor. The current research indicates a significant relationship between immune cell activity and the cause of UC. [ABSTRACT FROM AUTHOR]

Introduction: This randomized, placebo-controlled, double-blind, parallel study aimed to evaluate the effect of 3-month supplementation of bovine colostrum (BOV-COL; 8x400 mg per day) on the outcomes of depression treatment in hospitalized patients with substance use disorder (SUD). The hypothesis is that BOV-COL supplementation as an add-on treatment results in favorable alternations in selected blood inflammatory markers or neurotransmitters, leading to better depression treatment outcomes compared with placebo (PLA). Methods: Patients with a Minnesota Multiphasic Personality Inventory-2 score =60 points were enrolled. Twenty-nine participants (n=18 in the BOV-COL group and n=11 in the PLA group) completed the protocol. Results: The mean Beck Depression Inventory-II score was significantly reduced after supplementation in both groups. However, the mean 17-point Hamilton Depression Rating Scale score was decreased in the BOV-COL group, but not in the PLA group. In the BOV-COL group, there was a reduction in interleukin (IL)-1, IL-6, IL-10, the IL-6:IL-10 ratio, IL-17, and tumor necrosis factor alpha (TNF-a), while in the PLA group only IL-6 decreased. Favorable alternations in the total count and differentials of white blood cell subsets were more pronounced in the BOV-COL. There were no changes in neurotransmitter concentrations. Conclusions: BOV-COL supplementation is a promising add-on therapy in patients with depression and SUD. [ABSTRACT FROM AUTHOR]

This study aimed to identify the risk factors and construct a reliable prediction model of 28-day all-cause mortality in critically ill patients with acute pancreatitis (AP) using machine learning techniques. Methods: A total of 534 patients from three different institutions were included. Thirty-eight possible variables were collected from the Intensive care unit (ICU) admission for investigation. Patients were split into a training cohort (n = 400) and test cohort (n = 134) according to their source of hospital. The synthetic minority oversampling technique (SMOTE) was introduced to handle the inherent class imbalance. Six machine learning algorithms were applied in this study. The optimal machine learning model was chosen after patients in the test cohort were selected to validate the models. SHapley Additive exPlanation (SHAP) analysis was performed to rank the importance of variable. The predictive performance of the models was evaluated by the calibration curve, area under the receiver operating characteristics curves (AUROC), and decision clinical analysis. Results: About 13.5% (72/534) of all patients eventually died of all-cause within 28 days of ICU admission. Eight important variables were screened out, including white blood cell count, platelets, body temperature, age, blood urea nitrogen, red blood cell distribution width, SpO2, and hemoglobin. The support vector machine (SVM) algorithm performed best in predicting 28-d all-cause death. Its AUROC reached 0.877 (95% CI: 0.809 to 0.927, p < 0.001), the Youden index was 0.634 (95% CI: 0.459 to 0.717). Based on the risk stratification system, the difference between the high-risk and low-risk groups was significantly different. Conclusion: In conclusion, this study developed and validated SVM model, which better predicted 28-d all-cause mortality in critically ill patients with AP. In the future, we will continue to include patients from more institutions to conduct validation in different contexts and countries. [ABSTRACT FROM AUTHOR]