Search

Bovine leukemia virus (BLV) establishes a lifelong persistent infection in dairy cattle. White blood cell count (WBC) is correlated with proviral load in the blood and milk of BLV-infected cattle, and testing WBC can be used to assess both BLV infectiousness levels and risk of BLV transmission from different types of infected animals. The objective of the study was to compare effective transmission rates (β) and the basic reproduction ratio (Ro) among two types of BLV-infected dairy cows in Chile: those affected with persistent lymphocytosis (PL) vs. aleukemic (AL). The estimated (β) coefficient was higher in PL cattle [1.1; 95% Confidence interval (CI) (-1.6, 3.8)], compared to AL cattle (-3.1; 95% CI = -3.7, -2.5). In addition, the Ro was higher in PL cattle (60.4; 95% CI = 3.5; 820.6), compared to AL cattle (1.5; 95% CI = 0.7, 3.1). The ratio between PL/AL expected rate of cases was 73.9. The estimated effective transmission rate and the Ro were higher in PL cattle compared to AL cattle. The WBC test is a convenient alternative that can be considered for risk identification and risk management of BLV infection in dairy herds; particularly in livestock regions where laboratory capacity is limited (e.g., use of PCR or gene sequencing techniques) and/or molecular tests are not cost-effective. Therefore, when prevalence of infection is high, the removal of PL cattle should be engaged to control BLV within-herds. [ABSTRACT FROM AUTHOR]

Background: Sodium-glucose transporter-2 inhibitors (SGLT-2i) are recommended for use in patients with type 2 diabetes comorbid atherosclerotic cardiovascular disease, heart failure, or chronic kidney disease. Limited reports are currently available for their use in dialysis patients. In an observational, retrospective follow-up study, we reported the clinical characteristics of chronic peritoneal dialysis (PD) patients on SGLT-2i. Methods: We enrolled 50 diabetic chronic PD patients, and 11 continued SGLT-2i after PD treatment. We reported the patients' ultrafiltration, HbA1c, urinary tract infection episodes, and venous CO2 during follow-up and compared the differences in these factors between patients with and without SGLT-2i. Results: The mean age of the patients was 65 ± 15 years, and 16 (32%) patients were female. The age, gender, heart failure, and primary kidney disease were not different between patients with and without SGLT-2i at enrollment. In an average of 31 months follow-up, patients with SGLT-2i had higher ultrafiltration (1322 ± 200 ml/day vs. 985 ± 415 ml/day, p = 0.013), hemoglobin (11.2 ± 1.7 vs. 10.2 ± 1.7 g/dl), white blood cell count (9.2 ± 3.7 vs. 7.4 ± 2.1 109/L), and a lower venous CO2 (p = 0.036). The urine amount, the overall survival, the technical survival, and the chance of UTI were not different between patients with and without SGLT2i. Conclusion: SGLT-2i may increase ultrafiltration volume and hemoglobin levels in chronic PD patients. SGLT-2i did not increase urinary tract infection but was linked to subclinical metabolic acidosis. What was known: The effect of SGLT-2i in chronic PD patients is not clear? This study adds: SGLT-2i is associated with increased ultrafiltration, hemoglobin, white blood cell counts, and a decreased CO2 in PD patient. Potential impact: SGLT-2i may increase ultrafiltration in PD patients. [ABSTRACT FROM AUTHOR]

Background: The alarming increase in the prevalence of obesity and arthritis in America in recent times is concerning both in terms of the deleterious health effects on the individuals and economic cost. The wear and tear on the musculoskeletal and the inflammatory effects of obesity may be the reasons for the rise in arthritis among individuals with obesity. Objective: To investigate the association between obesity and the development of arthritis among adults in the United States. Design: A total of 17 016 participants were included from the 2012 to 2018 National Health and Nutrition Examination Survey (NHANES). Most of the participants were aged 30 years and above (79.7%). The racial distribution included 64.0% Non-Hispanic whites, 15.3% Hispanics, 11.4% Non-Hispanics blacks, and 9.4% from all other races. Methods: Obesity was defined as a body mass index (BMI) > 30 kg/m², and the outcome variable of interest, arthritis status, was self-reported. Survey weighted logistic regression was performed to calculate the odds ratio (OR) and 95% confidence interval controlling for potential confounding factors. Result: Nearly 40% of all participants were individuals with obesity, and 27.5% reported having some form of arthritis. The risk of developing arthritis was higher in individuals with obesity (OR: 1.55, 95% CI: 1.35-1.80), women (OR: 1.94, 95%CI: 1.66-2.28), and individuals 30 years or older (OR: 10.81, 95% CI: 6.36-18.37) with non-Hispanic whites being the most affected race. The C-reactive protein (CRP) and white blood cell count (WBC) levels were higher in all individuals with obesity even though there was no statistical difference between individuals with obesity with and without arthritis. Conclusions: Obesity substantially heightens the risk of developing arthritis due to the mechanical stress on weight-bearing joints and subsequent chronic-low level inflammation contributing to disease progression. Plain Language Summary: What is already known about this subject? Studies show overweight and individuals with obesity are more likely to develop any of the different types of arthritis. Obesity and arthritis are both caused by a combination of risk factors, including genetics and environmental factors. What does this study add? Explored relationship between obesity and arthritis has been focused mainly on a single type of arthritis, often in adults over 40 years old, and ignoring important covariates. This study does more; by looking at the relationship between obesity and several types of arthritis together in individuals 30 years and above taking into consideration most of the potential confounders. The study also explores further whether it is the inflammatory or the effects of increased wear-and-tear with obesity that drive the increase in arthritis prevalence in the United States. How might this impact on clinical practice? Study findings highlight the importance of lifestyle modification such as dieting and exercising aimed at weight management in individuals with obesity who are at particular risk for many diseases and health conditions such as the development of arthritis. [ABSTRACT FROM AUTHOR]

This document discusses the relevance of next-generation sequencing (NGS)-based minimal residual disease (MRD) monitoring in the context of post-myeloproliferative neoplasm (MPN) acute myeloid leukemia (AML). It highlights a case study of a patient with secondary AML from an MPN who has remained healthy for over a year since diagnosis, suggesting that not all secondary AMLs have a poor prognosis. The presence of a specific mutation, SF3B1 K666N, throughout the patient's pre-hematopoietic stem cell transplantation (HSCT) period raises questions about its germline nature, but subsequent analysis confirmed it as somatic. The case emphasizes the importance of analyzing both cancerous and germline material to determine the origin of a mutation and underscores the complex dynamics of clonal evolution during disease progression. Further research is needed to validate these findings. [Extracted from the article]

Background: Accurate diagnosis of enteric fever is challenging, particularly in low- and middle-income countries, due to the overlap of clinical and laboratory features with other pathogens. To better understand the difficulties in enteric fever diagnosis, we evaluated the characteristics of patients clinically diagnosed with enteric fever and the real-world performance of TUBEX TF, one of the most used tests in Indonesia. Methodology/Principal findings: Patients were recruited through the AFIRE (Etiology of Acute Febrile Illness Requiring Hospitalization) study at eight Indonesian hospitals. Blood culture was performed for all patients, and TUBEX TF was performed for suspected enteric cases. Salmonella PCR and ELISA tests were performed at a reference lab. Sensitivity and specificity of TUBEX TF and IgM and IgG anti-S. Typhi ELISA were determined. Of 301 patients clinically diagnosed with enteric fever, 50 (16.6%) were confirmed by blood culture and/or PCR. Confirmed cases were mostly school-aged children presenting with fever, anorexia, dizziness and/or abdominal pain with normal leukocyte count or leukopenia. TUBEX TF demonstrated a sensitivity of 97.6% to 70.7% and specificity of 38.3% to 67.2% at cutoffs of 4 and 6, respectively. Acute IgG demonstrated the best sensitivity and specificity, at 90.7% and 82.7%, respectively, and the best ROC characteristics. Conclusions/Significance: A substantial proportion of enteric fever was misdiagnosed at all study hospitals, likely due to the overlap of clinical characteristics and lab parameters with those of other common pathogens. The TUBEX TF rapid serological assay demonstrated suboptimal performance in our setting and tended to over-diagnose enteric fever. The role of IgG from acute specimens for identification of enteric fever cases merits additional consideration. Author summary: Enteric fever is a major health problem in Indonesia. Blood culture, the gold standard for enteric fever diagnosis, is expensive and requires several days to produce a result, leading to diagnoses being made through rapid tests such as TUBEX TF in Indonesia and other LMICs. In a real-world setting, we found that TUBEX TF over-diagnosed enteric fever by more than 50% in comparison to blood culture and PCR. Over-diagnosis may result in over-treatment and the subsequent increase of antimicrobial resistance. Given the suboptimal performance of TUBEX TF, the use of readily available clinical and laboratory data to facilitate identification of enteric fever cases has been considered. In our study, the majority of enteric fever patients were school-aged children. Although non-specific, gradually increasing fever, gastrointestinal symptoms, and cough were often present; hematologic parameters did not distinguish enteric fever from other etiologies. Interestingly, diagnostic accuracy was better by S. Typhi IgM and best by S. Typhi IgG in acute specimens. These findings may reflect the inaccuracy or subjectivity of TUBEX TF. The surprisingly excellent performance of S. Typhi IgG ELISA merits further evaluation. [ABSTRACT FROM AUTHOR]

Urban areas, i.e. dense housing and reduced green spaces, can significantly impact avian health, through altering land use and increasing biotic and abiotic stress. This study assessed the association of urbanization on haemosporidian infections, vectors, immune response, and body condition in Parus major nestlings, across four classes of urbanization along an urban-to-rural gradient in Vienna, Austria. Contrary to our expectations, vector abundance remained consistent across the gradient, while an increase in leukocyte count is positively associated with total parasite intensity. We found that nestlings in more urbanized areas exhibited higher parasite intensity and altered immune response, as evidenced by variations in the heterophil to lymphocyte ratio and leukocyte counts. Culicidae female vectors were associated with nestlings' total parasites, scaled mass index, and industrial units. Nestlings in highly developed areas had higher infection rates than those in forests, suggesting increased exposure to infections. However, there was no clear relationship between total female vectors and total parasites. The level of urbanization negatively affected nestling body condition, with a decrease in fat deposits from forested to highly urbanized areas. Our findings highlight the complex interplay between urbanization, vector-borne parasite transmission, and host immune response, emphasizing the need for comprehensive urban planning to improve wildlife health and guarantee ecosystem functioning. Understanding how urbanization affects bird immunity and parasite infections is critical for adapting urban landscapes for wildlife health and ecosystem integrity. [ABSTRACT FROM AUTHOR]

Purpose: Active radiation skin injury (ARSI) has the highest incidence of acute adverse reactions caused by radiotherapy (RT) in patients with head and neck cancer (HNC). This study aimed to screen risk factors that can facilitate the identification of HNC patients at high risk of ARSI. Methods: Data from 255 stage III-IV HNC patients who underwent intensity-modulated radiation therapy (IMRT) were collected. The data from our medical records, including clinical characteristics and hematological indices before RT, were retrospectively collected and arranged. The Common Terminology Criteria for Adverse Events Criteria (CTCAE), Radiation Therapy Oncology Group Criteria (RTOG), World Health Organization Criteria (WHO), Oncology Nursing Society (ONS), Acute Radiation Dermatitis Graduation Scale, Douglas & Fowler and Radiation Dermatitis Severity Scale (RDSS) were used to assess ARSI. Of these, CTCAE was used for further analysis. Binary logistic regression analyses were used to identity risk factors. To establish the correction between each risk factor and the ARSI score, the odds ratio (OR) and 95% confidence interval (CI) were computed. Results: The assessment results of the CTCAE with RTOG, WHO, ONS, Graduation Scale, Douglas & Fowler and RDSS have good consistency. After radiotherapy, 18.4% of patients had at least 3 (3 +) grade ARSI. Multivariate logistic regression analysis revealed that the KPS score, blood glucose level, white blood cell count, and plasma free thyroxine (FT4) concentration were independent risk factors for 3 + grade ARSI. A nomogram was constructed on the basis of these risk factors, which demonstrated good predictive power according to the area under the ROC curve (AUC). The satisfactory consistency and clinical efficacy of the nomogram were confirmed by calibration curves and decision curve analysis (DCA). Conclusion: A low KPS score, high blood glucose level, high white blood cell count, and high thyroid hormone prior to radiotherapy for stage III-IV HNC are independent risk factors for grade 3 + RSI. [ABSTRACT FROM AUTHOR]

AbstractAlthough there have been advances in treating pediatric patients with acute myeloid leukemia (AML) in developed countries, outcomes in low- to middle-income countries remain poor. The goal of this study was to investigate the outcomes in children with AML who were treated at a tertiary care center in Thailand. We divided the study into 4 research periods based on the chemotherapy protocols employed. The 5-year probabilities of event-free survival (pEFS) rates for periods 1–4 were 19.0%, 20.6%, 17.4%, and 37.3% (p value = 0.32), while the 5-year probabilities of overall survival (pOS) rates were 19.0%, 24.7%, 18.7%, and 42.5% (p value = 0.18), respectively. The multivariable model indicated an improvement in 5-year pOS between periods 1 and 4 (p value = 0.04). Age, white blood cell count, and study period were significant predictors of survival outcomes. The pOS of AML patients improved over time, increasing from 19.0% to 42.5%. [ABSTRACT FROM AUTHOR]

Background: Acute pancreatitis (AP) is characterized as a systemic inflammatory condition posing challenges in diagnosis and prognosis assessment. Lipid metabolism abnormalities, especially triacylglycerol (TAG) levels, have been reported, indicating their potential as biomarkers in acute pancreatitis. However, the performance of the TAG cycle, including phospholipid and glycerolipid metabolism, in AP patients has not yet been reported. Methods: This study enrolled 91 patients with acute biliary pancreatitis (ABP), 27 with hyperlipidaemic acute pancreatitis (HLAP), and 58 healthy controls (HCs), and their plasma phospholipid and glycerolipid levels were analyzed through liquid chromatography‒mass spectrometry. The phospholipid and glycerolipid contents of plasma collected from AP patients on the first, third, and seventh days of hospitalization were also measured. An orthogonal partial least squares discriminant analysis model served to differentiate the ABP, HLAP and HC groups, and potentially diagnostic lipids were evaluated via receiver operating characteristic curves in both the test and validation sets. Correlations between clinical data and lipids were conducted using Spearman's method. Clustering via the 'mfuzz' R package and the Kruskal‒Wallis H test were conducted to monitor changes during hospitalization. Results: Compared with those in HCs, the levels of phosphatidylcholine (PC), phosphatidylethanolamine (PE), and phosphatidic acid (PA) were lower in AP patients, whereas the levels of phosphatidylinositol (PI) and phosphatidylglycerol (PG) showed the opposite trend. Interestingly, TAG levels were positively correlated with white blood cell counts in ABP patients, and TAGs containing 44–55 carbon atoms were highly correlated with plasma TAG levels in HLAP patients. Phospholipid levels exhibited an inverse correlation with AP markers, in contrast to glycerolipids, which demonstrated a positive correlation with these markers. Additionally, PE (O-16:0/20:4) and PE (18:0/22:6) emerged as potential biomarkers because of their ability to distinguish ABP and HLAP patients from HCs, showing area under the curve (AUC) values of 0.932 and 0.962, respectively. PG (16:0/18:2), PG (16:0/20:4), PE (P-16:0/20:2), PE (P-18:2/18:2), PE (P-18:1/20:3), PE (P-18:1/20:4), PE (O-16:0/20:4), and TAG (56:6/FA18:0) were significantly changed in ABP patients who improved. For HLAP patients, PC (18:0/20:3), TAG (48:3/FA18:1), PE (P-18:0/16:0), and TAG (48:4/FA18:2) showed different trends in patients with improvement and deterioration, which might be used for prognosis. Conclusions: Phospholipids and glycerolipids were found to be potential biomarkers in acute pancreatitis, which offers new diagnostic and therapeutic insights into this disease. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to identify risk factors associated with acute complicated appendicitis (CA) in children aged three years or younger, providing a theoretical foundation for the management and treatment of acute appendicitis (AA). Methods: A retrospective analysis was conducted on 135 pediatric patients with AA, admitted to the Department of General Surgery at Anhui Children's Hospital between December 2020 and December 2023, who underwent successful surgical treatment. Based on the intraoperative and postoperative pathological findings, patients were categorized into two groups: complicated appendicitis (CA) (n = 97 cases) and uncomplicated appendicitis (UA) (n = 38 cases). Clinical data including gender, age, weight, disease duration, preoperative white blood cell count (WCC), neutrophil granulocyte (NEUT) count, C-reactive protein (CRP) levels, total bilirubin (TBil) levels, procalcitonin (PCT) levels, calprotectin (Cal) levels, preoperative ultrasound results indicating the presence or absence of fecaliths, maximum appendix diameter, and pediatric appendicitis sore (PAS) were collected and analyzed. Comparative analysis was performed to investigate the differences between the groups and identify risk factors of CA. Results: The CA group exhibited significantly higher values in disease duration, CRP levels, PCT, Cal, presence of appendiceal fecaliths, maximum appendix diameter, and PAS compared to the UA group (P < 0.05). Multivariate analysis identified CRP levels, maximum appendix diameter, and PAS as independent risk factors for CA. Specifically, differences in CRP level (OR = 1.045, 95% CI:1.024 ~ 1.067, P < 0.001), PAS (OR = 1.768, 95% CI:1.086 ~ 2.879, P = 0.022), and maximum appendix diameter (OR = 1.860, 95% CI:1.085 ~ 3.191, P = 0.024) were significant. The area under the receiver operating characteristic curve values were 0.6776 for the PAS, 0.7663 for CRP, and 0.5604 for the maximum appendix diameter. Conclusion: CRP levels, PAS, and maximum appendix diameter are independent risk factors for CA in children under three years of age. These parameters are valuable for the early diagnosis of CA. [ABSTRACT FROM AUTHOR]

Background: Leprosy reactions represent immunologically mediated episodes of acute inflammation that, if not diagnosed and treated promptly, can cause irreversible impairment of nerve function and permanent disabilities. A frequent type of reaction experienced by patients with lepromatous leprosy (LL) and borderline lepromatous leprosy (BL) is erythema nodosum leprosum (ENL), an inflammatory complication that may become chronic or recur in multiple episodes. Although ENL is commonly described as a neutrophil-mediated immune disease, the role of neutrophils is not fully understood. In this study, we assess neutrophilic leukocytosis in a retrospective cohort of patients affected by BL or LL leprosy. Materials and methods: A retrospective observational study was performed using data from 146 patients with BL and LL leprosy diagnosed and treated at the Souza Araújo Outpatient Clinic, Fiocruz, Rio de Janeiro, Brazil. Clinical, demographic, and hematological data were extracted from medical records. Skin biopsy samples obtained from patients for ENL diagnosis were used for histopathological evaluations. Results: Most patients were male (75%) and had a reactional episode (85%), of which 65% were ENL. Multiple episodes were common, 55% of the 80 patients with ENL presented more than 2 episodes (average of 2.6 episodes). In treatment-naive BL/LL patients, the median blood neutrophil counts of patients who developed ENL at some points of their disease course were higher than those who did not experience any reaction (median= 4,567 cells/mm3 vs 3,731 cells/mm3 respectively, p=0.0286). A correlation between the increase in median neutrophil counts and ENL severity was confirmed (6,066 cells/mm3 for mild ENL vs 10,243 cells/mm3 for moderate/ severe ENL, p=0.0009). A longitudinal assessment was also performed in 34 patients, confirming the neutrophilic leukocytosis (BL/LL: 4896 cells/mm3 vs ENL: 8408 cells/ mm3, p<0.0001). Moreover, increased NLR was associated with a greater neutrophilic infiltration in ENL lesions. Conclusion: We demonstrate that ENL episodes in patients affected by leprosy are associated with elevated blood leukocyte and neutrophil counts and an increased NLR. These findings highlight the significant involvement of neutrophils in the ENL immunological/inflammatory process. [ABSTRACT FROM AUTHOR]

Background: Spinal muscular atrophy (SMA) is a progressive neurodegenerative disorder that can be treated with intrathecal nusinersen, an antisense oligonucleotide. In addition to efficacy, safety is a determining factor in the success of any therapy. Here, we aim to assess the safety of nusinersen therapy in paediatric patients with SMA. Methods: Laboratory data of paediatric patients with SMA who received nusinersen between October 2019 and May 2022 were retrospectively analysed. Results: During the observation period, 46 infants and children aged 2.9 months to 13.6 years received a total of 213 nusinersen doses without safety concerns. Inflammatory markers were stable throughout the study. International normalized ratio was increased by 0.09 per injection. Urea levels were increased by 0.108 mmol/L, and cystatin C decreased by 0.029 mg/L per injection. There were no significant changes in platelet count, activated partial thrombin time, creatinine levels or liver enzyme levels during treatment. The cerebrospinal fluid (CSF) leukocyte count remained stable, and total protein increased by 24.038 mg/L per injection. Conclusion: Our data showed that nusinersen therapy is generally safe in children with SMA. Laboratory monitoring did not identify any persistent or significantly abnormal findings. CSF protein should be monitored to gain more insights. [ABSTRACT FROM AUTHOR]

BACKGROUND: Swimming is an important non-pharmacological treatment for knee osteoarthritis, which can effectively alleviate the disease. However, the effect and mechanism of swimming on senile knee osteoarthritis are still unclear. OBJECTIVE: To investigate the effect of swimming exercise on the articular cartilage of aged mice with knee osteoarthritis. METHODS: Six 3-month-old male C57BL/6 mice were selected as the young group, and twelve 18-month-old male C57BL/6 mice were randomized into the aged group and the swimming group, with six mice in each group. Mice in the swimming group received adaptive swimming for 1 week and formal swimming for 8 weeks. After the intervention, stride length analysis and sampling were performed in each group. The total number of leukocytes and lymphocytes in peripheral blood was detected by blood routine examinations. The morphology of the articular cartilage was observed by hematoxylin-eosin and safranin O-fast green staining. Chondrocyte counts and the modified Mankin’s score were used to evaluate the degree of articular cartilage damage. The protein and mRNA expressions of type II collagen, aggrecan and matrix metalloproteinase 13 in articular cartilage were detected by immunohistochemical staining and RT-qPCR. RESULTS AND CONCLUSION: Compared with the young group, the mice in the aged group showed significantly decreased stride length (P < 0.05), significantly increased numbers of peripheral leukocytes and lymphocytes (P < 0.05), significantly decreased count of chondrocytes (P < 0.05), significantly increased modified Mankin’s score (P < 0.05), significantly decreased protein and mRNA expression of type II collagen and aggreca (P < 0.05), and significantly increased matrix metalloproteinase 13 expression (P < 0.05). Moreover, hematoxylin-eosin and safranin O-fast green staining showed the uneven surface of the articular cartilage, abnormal chondrocytes, and proteoglycan loss in the aged group. Compared with the aged group, swimming exercise significantly improved the stride length of mice (P < 0.05), decreased the count of peripheral blood lymphocytes (P < 0.05), increased the count of chondrocytes (P < 0.05), decreased the modified Mankin’s score (P < 0.05), increased the protein and mRNA expression of type II collagen and aggrecan (P < 0.05), and decreased the expression of matrix metalloproteinase 13 (P < 0.05). Hematoxylin-eosin and safranin O-fast green staining showed that the articular surface of mice in the swimming group was smooth, chondrocytes were normal, and proteoglycan loss was less. All these findings indicate that swimming exercise can reduce the number of inflammatory cells in the blood of aged mice, improve articular chondrocytes, matrix composition and cartilage tissue morphology; thus, it has a protective effect on the cartilage of aged mice with knee osteoarthritis. [ABSTRACT FROM AUTHOR]

Purpose: On February 6, 2023, two earthquakes of magnitude 7.7 and 7.6 occurred consecutively in Turkey and Syria. This study aimed to investigate the predisposing factors for wound infection (WI) and the microbiological characteristics of wounds after earthquake-related injuries. Methods: This descriptive study evaluated pediatric patients' frequency of WI, and the clinical and laboratory parameters associated with the development of WI were investigated. Results: The study included 180 patients (91 female). The mean age of the patients was 123.9 ± 64.9 months and 81.7% (n = 147) of them had been trapped under rubble. Antibiotic treatment to prevent WI had been administered to 58.8% (n = 106) of all patients. WI was observed in 12.2% (n = 22) of the cases. In patients who developed WI, the incidence of exposure to a collapse, crush syndrome, compartment syndrome, multiple extremity injury, fasciotomy, amputation, peripheral nerve injury, thoracic compression, blood product use, intubation, and the use of central venous catheters, urinary catheters, and thoracic tubes were more frequent (p < 0.05). The need for blood product transfusion was associated with the development of WI (OR = 9.878 [95% CI: 2.504–38.960], p = 0.001). The negative predictive values of not developing WI at values of white blood cell count of < 11,630/mm3, creatine kinase < 810 U/L, potassium < 4.1 mEq/L, ALT < 29 U/L, AST < 32 U/L, and CRP < 45.8 mg/L were 93.7%, 96.8%, 90.8%, 93.3%, 100%, and 93.5%, respectively. Gram-negative pathogens (81%) were detected most frequently in cases of WI. Seventy-five percent of patients were multidrug- and extensively drug-resistant. Conclusion: This study leans empirical approach of our disaster circumstances. In cases with risk factors predisposing to the development of WI, it may be rational to start broad-spectrum antibiotics while considering the causative microorganisms and resistance profile to prevent morbidity. [ABSTRACT FROM AUTHOR]

Objectives: Cerebral small vessel disease (CSVD) visible on MRI can be asymptomatic. We sought to develop and validate a model for detecting CSVD in rural older adults. Methods: This study included 1,192 participants in the MRI sub-study within the Multidomain Interventions to Delay Dementia and Disability in Rural China. Total sample was randomly divided into training set and validation set. MRI markers of CSVD were assessed following the international criteria, and total CSVD burden was assessed on a scale from 0 to 4. Logistic regression analyses were used to screen risk factors and develop the diagnostic model. A nomogram was used to visualize the model. Model performance was assessed using the area under the receiver-operating characteristic curve (AUC), calibration plot, and decision curve analysis. Results: The model included age, high blood pressure, white blood cell count, neutrophil-to-lymphocyte ratio (NLR), and history of cerebral infarction. The AUC was 0.71 (95% CI, 0.67-0.76) in the training set and 0.69 (95% CI, 0.63-0.76) in the validation set. The model showed high coherence between predicted and observed probabilities in both the training and validation sets. The model had higher net benefits than the strategy assuming all participants either at high risk or low risk of CSVD for probability thresholds ranging 50-90% in the training set, and 65-98% in the validation set. Conclusion: A model that integrates routine clinical factors could detect CSVD in older adults, with good discrimination and calibration. The model has implication for clinical decision-making. [ABSTRACT FROM AUTHOR]

Objective: White blood cell (WBC) counts has been identified as a prognostic biomarker which frequently predict adverse outcomes and mortality risk in various conditions. However, evidence for the association between WBC counts and short-term outcomes after intracranial tumor resection remains limited. This study aimed to explore associations between preoperative WBC counts and thirty-day surgical mortality after craniotomy in adult intracranial tumor patients. Methods: This retrospective cohort study performed secondary analysis of 18,049 intracranial tumor craniotomy patients from the ACS NSQIP database (2012-2015). The major exposure and outcome were preoperative WBC counts and thirty-day surgical mortality, respectively. Cox regression modeling assessed the linear association between them. Non-linear associations between them were evaluated by conducting smooth curve fitting using an additive Cox proportional hazard model in conjunction with segmented linear regression modeling. Subgroup analysis and interaction testing assessed effect modification. Sensitivity analysis evaluated result robustness. Results: The total thirty-day surgical mortality after craniotomy was 2.49% (450/18,049). The mean of preoperative WBC counts was 9.501 ± 4.402 × 10-9/L. Fully adjusted model shows that elevated preoperative WBC counts was independently associated with increased thirty-day surgical mortality (HR = 1.057, 95%CI: 1.040, 1.076). Further analysis revealed a non-linear association between them: below a WBC threshold of 13.6 × 10-9/L, higher WBC counts elevated thirty-day mortality (HR = 1.117; 95%CI: 1.077, 1.158), while risk plateaued and no significant mortality rise occurred above this level (HR = 1.015, 95%CI: 0.982, 1.050). Steroid usage status has a significant effect modification on the WBCmortality association (P for interaction = 0.002). The non-linear WBC-mortality association was only present for non-steroid users (HR = 1.158, 95%CI: 1.108, 1.210) but not steroid users (HR = 1.009, 95%CI: 0.966, 1.055). The sensitivity analysis confirmed the result robustness. Conclusion: Elevated preoperative WBC counts were independently and nonlinearly associated with an increased risk of thirty-day surgical mortality in adult non-steroid use patients undergoing craniotomy for intracranial tumors. As a convenient predictor, preoperative WBC data allows improved risk profiling and personalized management in adult intracranial tumor patients. [ABSTRACT FROM AUTHOR]

Background: Onion waste was reported to be a valuable source of bioactive constituents with potential health-promoting benefits. This sparked a surge of interest among scientists for its valorization. This study aims to investigate the chemical profiles of peel and root extracts of four onion cultivars (red, copper-yellow, golden yellow and white onions) and evaluate their erectogenic and anti-inflammatory potentials. Methods: UPLC-QqQ-MS/MS analysis and chemometric tools were utilized to determine the chemical profiles of onion peel and root extracts. The erectogenic potential of the extracts was evaluated using the PDE-5 inhibitory assay, while their anti-inflammatory activity was determined by identifying their downregulating effect on the gene expression of IL-6, IL-1β, IFN-γ, and TNF-α in LPS-stimulated WBCs. Results: A total of 103 metabolites of diverse chemical classes were identified, with the most abundant being flavonoids. The organ's influence on the chemical profiles of the samples outweighed the influence of the cultivar, as evidenced by the close clustering of samples from the same organ compared to the distinct separation of root and peel samples from the same cultivar. Furthermore, the tested extracts demonstrated promising PDE-5 and anti-inflammatory potentials and effectively suppressed the upregulation of pro-inflammatory markers in LPS-stimulated WBCs. The anti-inflammatory activities exerted by peel samples surpassed those of root samples, highlighting the importance of selecting the appropriate organ to maximize activity. The main metabolites correlated with PDE-5 inhibition were cyanidin 3-O-(malonyl-acetyl)-glucoside and quercetin dimer hexoside, while those correlated with IL-1β inhibition were γ-glutamyl-methionine sulfoxide, γ-glutamyl glutamine, sativanone, and stearic acid. Taxifolin, 3'-hydroxymelanettin, and oleic acid were highly correlated with IL-6 downregulation, while quercetin 4'-O-glucoside, isorhamnetin 4'-O-glucoside, and p-coumaroyl glycolic acid showed the highest correlation to IFN-γ and TNF-α inhibition. Conclusion: This study provides a fresh perspective on onion waste as a valuable source of bioactive constituents that could serve as the cornerstone for developing new, effective anti-PDE-5 and anti-inflammatory drug candidates. [ABSTRACT FROM AUTHOR]

This study assessed qualitative and quantitative leukocyte evaluation as potential broiler chicken welfare indicators, contributing to the limited literature on white blood cell (WBC) morphology as a diagnostic tool for welfare. Broiler chicken welfare within four poultry houses (PH) 1 to 4, each on a different farm, was assessed using on-field indicators of affective states and health, and WBC morphology was examined. Affective states were evaluated using the Qualitative Behavior Assessment (QBA), with 25 behavioral expressions scored on a visual analogue scale (VAS) and grouped into two categories. Health indicators included assessments of lameness, footpad dermatitis, dermatitis on the breast and abdominal areas, hock burn, and feather cleaning. Blood samples were collected, differential leukocyte counts were performed, and a cell score was created for the recognition, classification, and interpretation of morphologic diversity of heterophils and lymphocytes. The heterophil to lymphocyte ratio (H/L) was also determined. Descriptive statistics and generalized linear models for binomial responses were used to analyze the results. PH4 differed from the other farms, showing a higher frequency of birds within QBA group 1 ('Attentive' to 'Desperate'), while birds in PH1, PH2, and PH3 were more frequent in QBA group 2 ('Relaxed' to 'Positively occupied'). Elevated proportions of heterophils in birds from PH4 (0.61, CI95%: 0.58; 0.64) and PH3 (0.60, CI95%: 0.57; 0.63) suggested higher stress levels and inflammatory responses. Birds in PH2 and PH4 exhibited higher frequencies of health issues such as dermatitis and lameness, and higher proportions of abnormalities in WBC number and morphology. PH3 and PH4 exhibited higher H/L ratios of 3.03 and 2.58, respectively, consistent with the on-field health and behavioral indicators. Blood samples from birds in PH2 and PH4 showed a proportion of 90% toxic change in heterophils, while in PH1 and PH3 it was 70%, indicating high levels of abnormal WBC morphology across all PHs. The findings emphasize the multifactorial nature of welfare impairments, including environmental conditions, health, and affective states. This highlights the need for indicators that reflect multiple welfare impacts, such as WBC counts and morphological alterations, which can serve as powerful tools in the complex task of assessing animal welfare. [ABSTRACT FROM AUTHOR]

Background: Hemorrhagic varicella (HV) is a particular form of chicken pox.,with high mortality in adults. This form of the disease is rare, to date, approximately 4 cases have been reported. Occasional cases of HV have been documented in adults with hematologic disorders or other diseases. While there is one reported case of simultaneous reactivation of cytomegalovirus in an adult with chickenpox, there is a lack of information regarding changes in liver function indicators for such patients. This is unfortunate, as CMV reactivation can further exacerbate liver failure and increase mortality. In this report, we present a case of hemorrhagic varicella reactivation with cytomegalovirus and provide some relevant discussions. Case presentation: We present the case of a 25-year-old male with HV, who had a history of nephrotic syndrome generally controlled with orally administered prednisone at a dosage of 50 mg per day for two months. The patient arrived at the emergency room with complaints of abdominal pain and the presence of hemorrhagic vesicles on his body for the past 3 days. Despite medical evaluation, a clear diagnosis was not immediately determined. Upon admission, the leukocyte count was recorded as 20.96 × 109/L on the first day, leading to the initiation of broad-spectrum antibiotic treatment. Despite the general interpretation that a positive IgG and a negative IgM indicate a previous infection, the patient's extraordinarily elevated IgG levels, coupled with a markedly increased CMV DNA quantification, prompted us to suspect a reactivation of the CMV virus. In light of these findings, we opted for the intravenous administration of ganciclovir as part of the treatment strategy. Unfortunately,,the patient succumbed to rapidly worsening symptoms and passed away. Within one week of the patient's demise, chickenpox gradually developed in the medical staff who had been in contact with him. In such instances, we speculate that the patient's diagnosis should be classified as a rare case of hemorrhagic varicella. Conclusion: Swift identification and timely administration of suitable treatment for adult HV are imperative to enhance prognosis. [ABSTRACT FROM AUTHOR]

Background: Mechanical thrombectomy (MT) has become the mainstay of treatment for acute ischemic stroke (AIS) recently. This case-control study aimed to identify the pivotal role of inflammation in the prognosis of AIS patients after MT. Methods: Altogether, 70 AIS patients who underwent MT were retrospectively recruited for this study. Receiver operating characteristic analysis was performed to demonstrate the sensitivity and specificity of the inflammatory variables for predicting prognosis. A meta-analysis was performed to pool the published results together. Stata software was used for analysis. Results: There was no differences in pre-MT inflammatory biomarkers between patients who survived and those who died, as well as patients with modified Rankin Scale (mRS) 0–2 and mRS ≥ 3. In contrast, post-MT C-reactive protein (CRP) levels might be a potential parameter to predict death after thrombectomy [area under the curve (AUC), 95%confidence interval (CI), 0.737, 0.587–0.887; p = 0.005; optimal cutoff value = 4.565]. Moreover, post-MT monocyte count might be an appropriate parameter to predict poor long-term prognosis after thrombectomy (AUC, 95%CI, 0.704, 0.575–0.833; p = 0.017; optimal cutoff value = 0.345). A meta-analysis revealed that the pre-MT inflammatory indices, including white blood cell count (weighted mean difference, 95%CI, 1.32, 1.01—1.63), neutrophil count (1.23, 0.95—1.51), monocyte count (0.05, 0.02—0.09), neuthrophil-to-lymphocyte ratio (2.42, 1.98—2.87) and platelet-to-lymphocyte ratio (24.65, 7.99—41.32), were higher in patients with 3-month mRS ≥ 3, and the lymphocyte count (−0.31,−0.43 to −0.18) was lower in this cohort. Conclusions: Inflammatory indices were significantly associated with the prognosis of patients undergoing MT, especially post-MT CRP and monocyte count, which can predict long-term outcomes. [ABSTRACT FROM AUTHOR]

Background: The low-grade inflammation score (INFLA-score) is a composite index that assesses chronic inflammatory status using multiple inflammatory markers. However, its correlation with cardiometabolic diseases (CMDs) in obese populations remains unclear. Methods: We conducted a prospective cohort study involving 79,160 participants with obesity (BMI ≥ 30 kg/m2) from the UK Biobank. The INFLA-score was calculated based on high-sensitivity C-reactive protein, leukocyte count, platelet count and granulocyte/lymphocyte ratio. We employed Kaplan–Meier survival curves, multivariable Cox regression, restricted cubic splines and accelerated time-to-failure models to analyse the association between the INFLA-score and CMDs risk, including coronary heart disease (CAD), stroke and type 2 diabetes mellitus (T2DM). Results: Over a median follow-up of 161.41 months, we recorded 14,903 CMDs events, comprising 7184 CAD cases, 1914 strokes and 7924 T2DM cases. Cox regression analysis revealed that each unit increase in the INFLA-score corresponded to a 1.5%, 1.1%, 1.2% and 2.4% increase CMDs risk (HR: 1.015, 95% CI 1.013–1.018), CAD risk (HR: 1.011, 95% CI 1.007–1.015), stroke risk (HR: 1.012, 95% CI 1.004–1.020) and T2DM risk (HR: 1.024, 95% CI 1.020–1.028), respectively. Restricted cubic spline analysis indicated a non-linear relationship between cumulative INFLA-score and CMDs risk (P = 0.044). Subgroup analysis revealed interactions between sex, age, history of lipid-lowering drug use, and INFLA-score regarding CMDs risk. Sensitivity analysis corroborated the main findings. Conclusion: Our findings strongly support the close association between INFLA-score and CMDs risk, particularly notable in women, those aged < 55, and individuals with a history of lipid-lowering drug use. These findings offer new insights into the role of inflammation in obesity-related CMDs, suggesting potential applications for prevention and identification of high-risk populations. [ABSTRACT FROM AUTHOR]

Objective: Twenty percent of all classical Hodgkin lymphoma (CHL) cases relapse and recur, especially in advanced stages with a high International Prognostic Score (IPS). Cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) is a regulatory molecule that can inhibit the immune response and is related to tumor aggressiveness. This study aimed to determine the relationship between CTLA-4 expression in advanced-stage CHL and IPS, identifying it as a potential therapy target. Results: In advanced-stage CHL, the group with a high IPS exhibited significantly higher mean CTLA-4 expression compared to the group with a low IPS (p = 0.003).The group with Hb level < 10.5 g/dl, leukocyte count > 15,000/µL, lymphocyte count < 8%, albumin level < 4 g/dl, and stage 4 exhibited higher CTLA-4 expression than the other group, although only leukocyte count and stage showed statistical significance (p = 0.004 and p = 0.020). Mean CTLA-4 expression was 239.84 ± 76.36 for nodular sclerosis, 293.95 ± 147.94 for mixed cellularity, 271.4 ± 23.56 for lymphocyte depleted, and 225.2 for lymphocyte-rich subtypes. The results suggest that CTLA-4 expression is associated with adverse prognostic factors in the IPS for advanced-stage CHL, supporting the notion that immune checkpoints play a role in cancer progression. [ABSTRACT FROM AUTHOR]

Background: The inappropriate use of pesticides including fungicides creates severe biological hazards that can endanger fish health and impede sustainable aquaculture. Objective: This study investigated the negative impacts of metiram (MET), a fungicide on the health status of Nile tilapia (Oreochromis niloticus) for a 96-hour duration as an acute exposure in a static renewal system. Methods: Three hundred fish (average body weight: 37.50 ± 0.22 g) were assigned into six groups (50 fish/group) with five replicates (10 fish/replicate). Fish were exposed to various six concentrations (0, 1.5, 3, 4.5, 6, and 7.5 mg/L) of MET as a water exposure to for 96-hour without water exchange. The fish's behavior, clinical signs, and mortalities were documented every day of the exposure period. Additionally, MET's impact on blood profile, stress biomarkers, hepato-renal functions, immune-antioxidant status, and brain biomarker were closely monitored. Results: The lethal concentration (LC50) of MET estimated using Finney's probit technique was 3.77 mg/L. The fish's behavior was severely impacted by acute MET exposure, as clear by an increase in surfacing, loss of equilibrium, unusual swimming, laterality, abnormal movement, and a decline in aggressive behaviors. The survivability and hematological indices (white and red blood cell count, differential white blood cell count, hematocrit value, and hemoglobin) were significantly reduced in a concentration-dependent manner following MET exposure. Acute exposure to MET (1.5–7.5 mg/L) incrementally increased stress biomarkers (nor-epinephrine, cortisol, and glucose), lipid peroxides (malondialdehyde), and brain oxidative DNA damage biomarker (8-hydroxy-2-deoxyguanosine). A hepato-renal dysfunction by MET exposure (4.5–7.5 mg/L) was evidenced by the significant increase in the alanine and aspartate aminotransferases and creatinine values. Moreover, a substantial decline in the immune parameters (lysozyme, complement 3, serum bactericidal activity, and antiprotease activity) and antioxidant variables (total antioxidant capacity, superoxide dismutase, and glutathione peroxidase) resulted from acute MET exposure. Conclusion: According to these findings, the 96-hour LC50 of MET in Nile tilapia was 3.77 mg/L. MET exposure triggered toxicity in Nile tilapia, as seen by alterations in fish neuro-behaviors, immune-antioxidant status, hepato-renal functioning, and signifying physiological disturbances. This study emphasizes the potential ecological dangers provoked by MET as an environmental contaminant to aquatic systems. However, the long-term MET exposure is still needed to be investigated. [ABSTRACT FROM AUTHOR]

Objective: Preterm birth (PTB) is the leading cause of neonatal morbidity and mortality worldwide, and cervical incompetence (CIC) is a significant contribution. Cervical cerclage (CC) is an effective obstetric intervention. However, many clinical factors affect the success rate of surgery. The objective was to investigate and compare the pregnancy and neonatal outcomes of patients who underwent ultrasound- and physical examination-indicated cervical cerclage and to explore the influencing factors of preterm delivery before 34 weeks. Methods: The sociodemographic characteristics and clinical data of patients with a diagnosis of cervical incompetence who underwent ultrasound- and physical examination-indicated transvaginal cervical cerclage at Nanjing Maternal and Child Health Hospital from January 2020 to December 2022 were retrospectively analyzed. The pregnancy and neonatal outcomes of the patients were evaluated. Continuous variables were compared using Student's t test (for normally distributed data) or the Mann-Whitney U test (for nonnormally distributed data). Categorical variables were analysed using the chi-square test or Fisher's exact test. Additionally, logistic regression analyses and receiver operating characteristic curves were used to evaluate the associations of inflammatory markers with maternal and neonatal outcomes. Results: This study included 141 participants who underwent cervical cerclage, including 71 with ultrasound-indicated cerclage and 70 with physical examination-indicated cerclage. Compared to those in the ultrasound-indicated cerclage group, the duration from cerclage to delivery, birth weight, and APGAR score in the physical examination-indicated cerclage group were significantly lower, and the rates of delivery at < 28 weeks, < 32 weeks, < 34 weeks, and < 37 weeks of gestation and neonatal mortality were significantly higher (all P < 0.05). Compared to those in the physical ultrasound-indicated cerclage group, in the physical examination-indicated cerclage group, maternal blood inflammatory markers, such as C-reactive protein (CRP), the systemic immune-inflammation index (SII) and the systemic inflammation response index (SIRI) were significantly higher (P < 0.05). Additionally, maternal blood inflammatory markers, such as the CRP, white blood cell count, platelet to lymphocyte ratio (PLR), SII, and SIRI were significantly higher in the group with delivery before 34 weeks of gestation. Furthermore, the results demonstrated that twin pregnancy had the highest OR for preterm delivery before 34 weeks of gestation (OR = 3.829; 95% CI 1.413–10.373; P = 0.008), as well as the following: the SII level (OR = 1.001; 95% CI 1.000-1.002; P = 0.003) and CRP level (OR = 1.083; 95% CI 1.038–1.131; P = 0.022). The risk factors for preterm delivery before 34 weeks of gestation were twin gestation, an increased SII level and an increased CRP level, which had good combined predictive value. Conclusion: In patients with cervical insufficiency, ultrasound-indicated cervical cerclage appears to lead to better pregnancy outcomes than physical examination-indicated cerclage. Twin pregnancy and maternal blood inflammatory markers, such as the CRP level and the SII, are associated with preterm delivery before 34 weeks of gestation. [ABSTRACT FROM AUTHOR]

Background: In 2019, the shortage of cefazolin led to the demand for cefotiam and cefmetazole exceeding the supply. The Department of Nephro-urology at Nagoya City University Hospital used fosfomycin as a substitute for perioperative prophylaxis. This retrospective preliminary study evaluated the efficacy of fosfomycin and cefotiam for preventing infections following ureterorenoscopy. Methods: The study included 182 patients who underwent ureterorenoscopy between January 2018 and March 2021). Perioperative antibacterial treatment with fosfomycin (n = 108) or cefotiam (n = 74) was administered. We performed propensity score matching in both groups for age, sex, preoperative urinary catheter use, and preoperative antibiotic treatment. Results: The fosfomycin and cefotiam groups (n = 69 per group) exhibited no significant differences in terms of patients' median age, operative duration, preoperative urine white blood cell count, preoperative urine bacterial count, and the rate of preoperative antibiotic treatment. In the fosfomycin and cefotiam groups, the median duration of postoperative hospital stay was 3 and 4 days, respectively; the median maximum postoperative temperature was 37.3 °C and 37.2 °C, respectively. The fosfomycin group had lower postoperative C-reactive protein levels and white blood cell count than the cefotiam group. However, the frequency of fever > 38 °C requiring additional antibiotic administration was similar. Conclusions: During cefotiam shortage, fosfomycin administration enabled surgeons to continue performing ureterorenoscopies without increasing the complication rate. [ABSTRACT FROM AUTHOR]

The increase in incidence and geographical expansion of viruses transmitted by the Aedes mosquitoes, such as dengue (DENV) and zika (ZIKV) in the Americas, represents a burden for healthcare systems in tropical and subtropical regions. These and other under-detected arboviruses co-circulate in Costa Rica, adding additional complexity to their management due to their shared epidemiological behavior and similarity of symptoms in early stages. Since diagnostics of febrile illness is mostly based on clinical symptoms alone, we gathered acute-phase serum and urine from 399 samples of acute dengue-like cases from two healthcare facilities of Costa Rica, during an outbreak of arboviruses from July 2017 to May 2018, and tested them using molecular and serological methods. The analyses showed that of the clinically presumptive arbovirus cases that were reported, only 39.4% (n=153) of the samples were confirmed positive by RT-PCR to be DENV (DENV (10.3%), CHIKV (0.2%), ZIKV (27.3%), or mixed infections (1.5%). RT-PCR for other alphaviruses and flaviviruses, and PCR for Leptospira sp were negative. Furthermore, to assess flavivirus positivity in post-acute patients, the negative sera were tested against Dengue-IgM. 20% of sera were found positive, confounding even more the definitive number of cases, and emphasizing the need of several distinct diagnostic tools for accurate diagnostics. Molecular characterization of the prM and E genes from isolated viruses revealed that the American/Asian genotype of DENV-2 and the Asian lineage of ZIKV were circulating during this outbreak. Two different clades of DENV-2 American/Asian genotype were identified to co-circulate in the same region and a difference in the platelet and leukocyte count was noted between people infected with each clade, suggesting a putative distinct virulence. Our study sheds light on the necessity for healthcare strategies in managing arbovirus outbreaks, emphasizing the importance of comprehensive molecular and serological diagnostic approaches, as well as molecular characterization. This approach aids in enhancing our understanding of the clinical and epidemiological aspects of arboviral diseases during outbreaks. Our research highlights the need to strengthen training programs for health professionals and the need to increase research-based on laboratory evidence for diagnostic accuracy, guidance, development and implementation of public health interventions and epidemiological surveillance. [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]

Background & Objective: Cerebrospinal fluid (CSF) analysis is helpful in the diagnosis of infections of the central nervous system (CNS), especially after neurosurgical procedures. This study aimed to evaluate the diagnostic value of CSF markers for diagnosis of post-neurosurgical meningitis (PNM). Methods: Patients with neurosurgical procedures whose CSF was obtained for any reason (meningitis and non-meningitis) during 2020 and 2022, at Imam Khomeini Hospital Complex, Tehran, Iran, were included. Serum and CSF lactate dehydrogenase (LDH), glucose, protein, white blood cells (WBC), red blood cells (RBC), and CSF/serum glucose and LDH ratio were compared between the patients who were diagnosed with PNM and those without meningitis. Results: A total of 115 patients were included, of whom 23 patients were diagnosed with PNM and 92 with non-meningitis. No significant differences were observed in patients' age, gender, and underlying diseases between the two groups. Findings showed a significantly (P=0.029) lower level of the mean CSF glucose (59.5 mg/dL ±33.9) in patients with meningitis than in patients without meningitis (76.8 mg/dL ± 37.5). The mean CSF/serum glucose ratio was 43.7% in the meningitis group and 56.3% in the non-meningitis group (P=0.008). The mean WBC count and neutrophil dominance were significantly higher in the meningitis group. No significant differences were observed in CSF LDH, Protein, and RBC between the two groups. Conclusion: A CSF glucose level of less than 60 mg/dL, a CSF/serum glucose ratio of less than 0.44, and a higher CSF WBC and neutrophil count can help diagnose PNM. [ABSTRACT FROM AUTHOR]

Self-poisoning with p-phenylenediamine (PPD) is a common method in individuals experiencing social or economic stress. The current study was planned to determine various physiological effects of the poison and to identify an effective antidote against PPD toxicity. The hemato-biochemical profile along with histo-pathological examination of kidneys, brain, heart and lungs were conducted in the adult male albino rats (n=25) supplemented with methylene blue, coconut and olive oils post- PPD toxicity. A significant (p<0.05) decrease in the hematological parameters except a significant (p<0.05) increase in the leukocyte count was observed in the animals injected only with PPD (30mg/kg BW) compared to the control negative group. The animals supplemented with methylene blue, olive, or coconut oils post-PPD injection showed a significant (p<0.05) amelioration in the hematological parameters compared to the PPD-only control group. PPD toxicity significantly (p<0.01) increased the hepatic (ALT, AST, bilirubin) and renal (urea, creatinine) markers and level of CK-MB compared to the control negative group. The supplementation of animals with methylene blue, coconut and olive oils showed protective effects by significantly (p<0.05) decreasing the levels of hepatic and renal markers and CK-MB along with improvement in the histo-architecture of the heart, kidneys, lungs and brain. The animals supplemented with olive oil showed better results, since it has been found to partially reverse the effects of PPD toxicity compared to methylene blue and coconut oil and thus, could be used as a possible anti-dote against PPD toxicity. [ABSTRACT FROM AUTHOR]

The primary aim of poultry production is to obtain a high yield and quality end product. To reduce the risk of disease, many direct-fed microbial products have been developed. That appears to be an excellent tool for disease prevention. We evaluated the influence of the commercial, competitive exclusion (CE) product, Broilact®, on the growth rate, hematology, serum biochemistry, and innate immunity in male ROSS-308 chickens, randomly divided into two groups (Broilact® treatment and control) raised for 42 days. The birds' body weight was determined at 1, 7, 14, 28, 35, and 42 days, and the blood samples were collected at days 22 and 42 of life. We observed lower mortality, better gait score, and higher final body weight in the Broilact® group. At day 22, birds from the treated group presented higher white blood cells counts (WBC) and T cytotoxic lymphocyte (CD8+) counts, higher total protein (TP) (fraction globulin and albumin), and lower triglyceride (TAG) and Ca2+ plasma concentrations. No differences were found in acute phase proteins (APPs). At day 42, only the K+ and Na+ concentrations were higher, while the IL-10 was lower in treated birds' blood serum. Our results indicate that treatment with one dose of the Broilact® product at day one of life has a beneficial influence, which improves the chickens' performance, leg health and some serum enzymes activity, maintains electrolyte homeostasis, and influences leukocyte count with the rise of T CD8+ subpopulations. [ABSTRACT FROM AUTHOR]

Objective To investigate the changes of angiotensin-converting enzyme (ACE) and angiotensin-converting enzyme 2 (ACE2) levels in children with severe Mycoplasma pneumoniae pneumonia (SMPP) and evaluates their clinical values in predicting the severity of SMPP. Methods A total of 71 children with Mycoplasma pneumoniae pneumonia (MPP group) and 63 with severe Mycoplasma pneumoniae pneumonia (SMPP group) admitted to the Second Hospital of Lanzhou University from October 2020 to December 2023 were recruited in this study. Additionally, 20 healthy children undergoing routine health check-ups during this period were selected as the control group. The serum concentrations of ACE and ACE2 in the three groups were measured using the enzyme-linked immunosorbent assay (ELISA), and laboratory test results were collected for comparison and correlation analysis between the MPP and SMPP groups. The receiver operating characteristic (ROC) curve was delineated to assess the predictive values of one single index or combined for SMPP. Results In the three groups, the serum ACE level was the highest in the SMPP group and the lowest in the healthy control group. The serum ACE2 level was the highest in the MPP group and the lowest in the healthy control group (all P < 0.008). Compared to the MPP group, the SMPP group exhibited significantly elevated white blood cell count (WBC), neutrophil percentage (NE%), C-reactive protein (CRP), serum amyloid A protein (SAA), procalcitonin (PCT), interleukin-6 (IL6), erythrocyte sedimentation rate (ESR), and D-dimer (all P < 0.001) and these indexes were positively correlated with ACE levels (all P < 0.05), but negatively correlated with ACE2 levels (all P < 0.05). The lymphocyte percentage (LY%) was significantly reduced (P < 0.001), which was positively correlated with ACE2 levels (P < 0.05), whereas negatively correlated with ACE levels (P < 0.05). Lactate dehydrogenase (LDH) was elevated (P < 0.05), which was negatively correlated with ACE2 levels (P < 0.05), but not correlated with ACE levels (P > 0.05). The monocyte percentage (MO%) showed neither significant difference nor correlation (both P > 0.05). ROC curve analysis revealed that ACE, ACE2, CRP, D-dimer, LDH, and combined detection of ACE+ACE2, CRP+D-dimer+LDH all had predictive values for SMPP. Among them, the combined detection of ACE+ACE2 showed the highest predictive value, with an AUC of 0.991 and 95% CI: 0.981-1.000. Conclusion The levels of ACE and ACE2 are likely associated with the onset and progression of SMPP in children, and both ACE and ACE2 serve as good indicators for predicting SMPP. [ABSTRACT FROM AUTHOR]

Background: Chronic hepatitis B (CHB) is a significant global public health concern in Malaysia. It is a potentially life-threatening liver disease caused by the hepatitis B virus (HBV), which can lead to long-term complications such as cirrhosis, liver failure and hepatocellular carcinoma. In managing CHB, nucleos(t)ide analogues (NAs) have become the preferred treatment due to their ability to suppress viral replication and prevent disease progression. The question of liver-associated comorbidities related to patients with CHB on NAs remains unresolved in Malaysia despite the impending burden of CHB in the country. This study intends to address this and related aspects. Method: We assessed 136 CHB patients on NAs in one centre, the Hospital Universiti Sains Malaysia. Demographic and epidemiological data on the treatment, concomitant disease and monitoring strategies were collected and analysed. Result: Patients on NAs aged 50 years old--70 years old had the highest proportion of CHB (45.59%), with males representing 61.03% of that age group. There was a statistical significance in CHB acquisition and presence of comorbidities at P > 0.005. Our cohort displayed seven comorbidities (diabetes, obesity, rheumatoid diseases, renal impairment, spontaneous bacterial peritonitis, hypertension, non-hepatocellular malignancies and carcinoma); hypertension had the highest incidence (69.12%), while renal impairment had the lowest incidence (8.09%). Whole blood count, liver function and creatinine tests were the major monitoring tests used in over 90% of the cohort compared to viral load (6.1%). Conclusion: Diabetes, hypertension and obesity were independent risk factors for acquiring liver cirrhosis and hepatocellular carcinoma. Malaysian CHB patients treated with NAs have several comorbidities that could affect disease outcomes. Therefore, careful monitoring is required. [ABSTRACT FROM AUTHOR]

Objective: To discuss the clinical presentations, diagnosis, and treatment methods of the patients with Fournier’s gangrene, and to enhance the clinicians’ awareness of this condition. Methods: The clinical data including symptoms, signs, radiological findings, and surgical outcomes of one patient with Fournier’s gangrene were collected. The relevant literatures were reviewed to summarize the clinical characteristics, diagnosis, and treatment methods for this condition. Results : The patient, a 42-year-old male, was admitted because of a history of infection around the perineum, scrotum, and perianal area for 13 d. His medical history included acute myeloid leukemia for 10 months, during which the patient underwent eight chemotherapy sessions in the local hospital. The abdominal CT scan results showed thickened, dense, and turbid soft tissue in the left inguinal area. The complete blood count reuslts showed the white blood cell count was 23. 99×109 L-1. The cultures of wound secretions grew the Escherichia coli and Proteus mirabilis. The examination results showed there was necrosis of the scrotal skin and skin near the anus on the left buttock; the skin was blackened, hard, and demarcated from the surrounding normal skin with slight purulent exudation and no foul smell. The surrounding skin was significantly swollen and red; the rectal examination results showed no bleeding or fistulas. The patient underwent emergency debridement surgery on the admission day, followed by dressing changes, multiple applications of simplified negative pressure, perineal flap reconstruction, and skin grafting. The patient recovered well with normal function and had no complications. Conclusion: Fournier gangrene has acute onset and rapid progression, and the clinical manifestations are non-specific. The range of infection is not consistent with the progression of the disease. The diagnosis mainly depends on intraoperative exploration. Repeated radical surgery is the main treatment. The prognosis of this disease is good, and the recurrence rate is low, although long-term follow-up is still necessary after surgery. [ABSTRACT FROM AUTHOR]

Background: Gastric antral vascular ectasia (GAVE) is a condition characterized by abnormal blood vessel growth in the stomach's antrum, leading to gastrointestinal bleeding. Treatment options typically include endoscopic band ligation (EBL) and argon plasma coagulation (APC), but their combined efficacy has not been thoroughly investigated. Objective: To compare the effectiveness of EBL, APC, and a combined EBL + APC approach in treating GAVE. Patients and Methods: A total of 75 patients with GAVE were enrolled and divided into three groups: Group I (EBL, n=25), Group II (APC, n=25), and Group III (Combined EBL + APC, n=25). Each patient underwent endoscopic treatment according to their group assignment. Pre- and post-treatment evaluations included hemoglobin levels, platelet counts, total leukocyte counts, and the presence of occult blood in stool. Follow-up assessments were conducted at 3 weeks and at 3 and 9 months to monitor recurrence and overall improvement. Results: The combined EBL + APC approach demonstrated superior outcomes compared to EBL or APC alone. Hemoglobin levels increased significantly more in Group III (10.60 ± 0.32 g/dl) than in Groups I (9.00 ± 0.52 g/dl) and II (9.55 ± 0.20 g/dl). Additionally, Group III showed a significant reduction in recurrence rates and better endoscopic results. Statistical analysis revealed significant differences in hemoglobin levels and recurrence rates between the combined and individual treatment groups (P < 0.001 for all comparisons). Conclusion: The combined EBL and APC approach is more effective in managing GAVE, leading to better clinical outcomes and fewer complications. Further research using greater sample sizes and extended follow-up are needed to confirm these findings and potentially establish this combined method as a standard treatment for GAVE. [ABSTRACT FROM AUTHOR]

Background: Spontaneous bacterial peritonitis (SBP), a life-threatening infection in patients with advanced liver cirrhosis, is traditionally diagnosed by a high white blood cell count (polymorphonuclear leukocyte count (PMN) > 250/μL) in ascitic fluid. However, this method can be slow. Objective: This study explores ascitic fluid calprotectin as a potentially faster and more accurate diagnostic tool.Patients and Methods: Ninety patients with decompensated liver cirrhosis (45 with confirmed SBP and 45 without SBP) were included. Ascitic fluid calprotectin levels were measured in all participants. Results: SBP patients had significantly higher calprotectin levels than the non-SBP group. Additionally, calprotectin levels correlated with white blood cell counts and other inflammatory markers in the ascitic fluid. Using a cut-off value of 433.7 ng/ml, calprotectin achieved a sensitivity of 73.3% and a specificity of 85.1% for detecting SBP. Conclusion: Ascitic fluid calprotectin shows promise as a reliable and potentially faster method for diagnosing SBP in patients with cirrhosis. It could serve as a valuable addition to existing diagnostic tools. [ABSTRACT FROM AUTHOR]

Cisplatin, known as "penicillin of cancer" is an inorganic compound that is considered one of the best and first metal-based chemotherapeutic drugs. Hesperidin is one of the major dietary flavanones that is found abundantly in many citrus fruits. The present study was aimed to evaluate the ameliorative effects of hesperidin (@100 & 200 mg/kg b. wt.) in cisplatin (@ 7.5 mg/kg b.wt.) induced haemato-biochemical alteration in rats (n=32) over a period of 14 days. There was a decrease in mean values of haemoglobin, packed cell volume, platelets, total erythrocyte count and total leukocyte count in Group II (cisplatin, 7.5 mg/kg) and III (cisplatin plus 100 mg/ kg hesperidin) in comparison with Group I (control, 0.5 mL of carboxy methyl cellulose) and IV (cisplatin plus 200 mg/kg hesperidin) at 14th day of experiment. Similarly, a significant elevation in serum AST, ALT, cholesterol, urea, creatinine and triglyceride values as well as significant decrease in total protein and albumin values were noted in cisplatin treated rats (Group II) at 14th day of experiment. [ABSTRACT FROM AUTHOR]

This retrospective study investigated the effect of preoperative antibiotic prophylaxis on postoperative complications in equids admitted to the Clinic for Equine Surgery, University of Zurich, for clean surgical procedures and diagnostic imaging. The medical records were searched for equids that were healthy and had a rectal temperature within the reference range preoperatively and were admitted between June 1, 2020 to December 1, 2020 for a surgical procedure performed under general anesthesia. The search yielded 46 equids, which were divided into two groups: Group 1 (no AB) did not receive prophylactic antibiotics and Group 2 (AB) received prophylactic antibiotics. The same surgical procedure was selected for comparative purposes, yielding 23 pair-matched equids. All equids underwent a thorough clinical examination and daily monitoring of the rectal temperature one day before to two days after the operation. In addition, hematological testing including the measurement of serum amyloid A (SAA), collection of nasal swab samples for microbiological analysis, ultrasono graphic examination of the lungs and jugular veins and endoscopy of the airways were carried out postoperatively. The differences between the groups were statistically analyzed. Eight of the 23 surgical procedures per group were primary castrations and 6 were arthroscopies. An inguinal approach was chosen for the primary castrations, whereby all layers were sutured again. The aim of this closed castration was to achieve primary healing, that’s why they are called primary castrations. Fever (rectal temperature > 38.5 °C) was one of the most common postoperative complications. The incidence of fever after general anesthesia was 21.7% (n = 5 of 23 equids) in the no AB group and 4.3% (n = 1 of 23 equids) in the AB group, but the difference was not significant (p = 0.09). The only horse in the AB group with a fever postoperatively developed a local wound infection. Fever in the five horses in the no AB group occurred within two days after the surgical procedure. The maximum temperature recorded was 40.6 °C. Of the five horses in the no AB group, three underwent primary-closure castration and two underwent an orthopedic procedure. All horses were successfully treated with postoperative systemic antibiotics. The most frequent cause of fever was attributable to respiratory tract infection. There were no significant differences between the two groups with regard to breed (p = 0.7), gender (p = 0.4) or age (p = 0.77). The surgeon (p = 0.72), the mean duration of anesthesia (p = 0.20) and the duration of surgery (p = 0.57) had no effect on postoperative complications. The number of cases per group (n = 23) was small, which may have contributed to a lack of a significant difference between the two groups (p = 0.09). Clinically, however, several horses in the no AB group had postoperative complications associated with the respiratory tract. One developed severe bacterial pleuropneumonia with abscessation and pleural effusion. The results of this study showed that administering antibiotics before a clean surgical procedure under general anesthesia is generally not necessary, but it may reduce postoperative complications such as the incidence of fever. Perioperative antibiotics should no longer be routinely administered because of widespread antibiotic resistance and instead should be reserved for cases in which the risk of postoperative complications is high. This entails thorough preoperative assessment of horses with attention to factors such as age and husbandry to prevent postoperative complications, particularly respiratory tract infections. In unclear cases, a blood test (leukocyte count, fibrinogen and SAA) is also required. [ABSTRACT FROM AUTHOR]

Background: Kawasaki disease is an acute immune vasculitis, which is more common in children under 5 years old. Kawasaki disease mainly affects the cardiovascular system, especially the coronary arteries. Once coronary artery damage occurs, it can significantly impact the patient’s prognosis. Therefore, in some countries and regions, Kawasaki disease has become a common acquired heart disease. Methods: First, univariate analysis was conducted on each predictive factor. Then, Least Absolute Shrinkage and Selection Operator and random forest algorithms were used to screen all predictive factors, and the prediction model was evaluated using receiver operating characteristic curve, calibration curve, and Decision Curve Analysis. Results: This study, based on data from 228 Kawasaki disease patients, utilized a random forest model to identify four predictive factors: white blood cell count, creatine kinase isoenzyme MB, albumin, and neutrophil count. These factors were used to construct a prediction model, which achieved an area under the curve of 0.743. Conclusions: We developed a forest plot based on white blood cell count, creatine kinase isoenzyme MB, albumin, and neutrophil count to effectively predict the occurrence of coronary artery lesions in Kawasaki disease. [ABSTRACT FROM AUTHOR]

Introduction: Preoperative diagnosis of periprosthetic shoulder infections (PSI) is difficult. Infections are mostly caused by low virulence bacteria and patients do not show typical signs of infection. The aim of this study was to determine the diagnostic value and reliability of ultrasound-guided biopsies for cultures alone and in combination with multiplex polymerase chain reaction (mPCR), serum markers, and/or synovial markers for the preoperative diagnosis of PSI in patients undergoing revision shoulder surgery. Materials and methods: A prospective explorative diagnostic cohort study was performed including 55 patients undergoing revision shoulder replacement surgery. A shoulder puncture was performed preoperatively before incision to collect synovial fluid for mPCR analysis and for measurement of interleukin-6, calprotectin, white blood cell count (WBC), and polymorphonuclear cells. Also prior to revision surgery, six ultrasound-guided synovial tissue biopsies were collected for culture and two for mPCR analysis. A blood sample was obtained to determine serum C-reactive protein, WBC, and erythrocyte sedimentation rate. Six routine care tissue biopsies were taken during revision surgery and served as reference standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV; the primary outcome measure), and accuracy were calculated for ultrasound-guided biopsies, blood and synovial markers, mPCR, and combinations thereof. Results: Routine tissue cultures were positive for infection in 24 patients. Cultures from ultrasound-guided biopsies diagnosed infection in 7 of these patients, yielding a sensitivity, specificity, PPV, NPV, and accuracy of 29.2%, 93.5%, 77.8%, 63.0%, and 65.6%, respectively. The best diagnostic value was found for the combination of ultrasound-guided biopsies for culture, synovial WBC, and calprotectin with a sensitivity of 69.2%, specificity of 80.0%, PPV of 69.2%, and NPV of 80.0%. Conclusion: Ultrasound-guided biopsies for cultures alone and in combination with mPCR, and/or blood and/or synovial markers are not reliable enough to use in clinical practice for the preoperative diagnosis of PSI. Level of evidence: Diagnostic study level II. [ABSTRACT FROM AUTHOR]

Introduction: The benefits of intracorporeal anastomosis in laparoscopic colorectal cancer surgery remain unclear. Therefore, we aimed to investigate the short‐term postoperative outcomes of intracorporeal anastomosis. Methods: We retrospectively analyzed 87 patients who underwent laparoscopic surgery for right‐sided colon tumors using a colon database. Results: Of the 87 patients, 23 underwent intracorporeal anastomosis and 64 underwent extracorporeal anastomosis. Intraoperative bleeding, wound length, exhaust gas, preoperative white blood cell count, and C‐reactive protein (postoperative day 1) were higher in the extracorporeal anastomosis group than in the intracorporeal anastomosis group. The incidence of wound infection was higher in the intracorporeal anastomosis group than in the extracorporeal anastomosis group. In the irrigation water bacterial culture collected after anastomosis, the positive group had a higher white blood cell count on postoperative day 1 and higher C‐reactive protein levels on postoperative day 3 than did the negative group. Patients who underwent chemical preparation had lower C‐reactive protein levels on postoperative day 1 than did the group who did not undergo chemical preparation. Conclusion: Despite the advantages of intracorporeal anastomosis in terms of wound length and intraoperative bleeding, the risk of infection may increase during the introduction phase. Fever and inflammatory responses are significantly elevated in culture‐positive cases. [ABSTRACT FROM AUTHOR]

Background: To explore the correlation between left atrial appendage morphology, blood flow velocity and plasma galectin-3 and thrombosis in patients with atrial fibrillation. Methods: Patients with atrial fibrillation who received treatment and completed ultrasound examination in hospital from 2022 to December 2023 were enrolled. According to whether there was left atrial appendage thrombosis, the patients were divided into a control group (no left atrial appendage thrombosis was found) and a study group (left atrial appendage thrombosis was found). The morphology and structure of the left atrial appendage, blood flow velocity and plasma galectin-3 level were recorded exploring its correlation with left atrium thrombosis. Results: A total of 330 patients with atrial fibrillation were enrolled, including 278 in the control group and 52 in the study group. Left group and the control group of morphological structure differences (P < 0.05). The main lobe length, ostial area, longest diameter, shortest diameter, left atrial appendage volume and left atrial volume in the study group were higher than those in the control group (P <0.05). The left atrial appendage emptying velocity, filling velocity and left ventricular ejection fraction of the study group were lower than those of the control group, and the left ventricular end-diastolic diameter was higher than that of the control group (P < 0.05). Group of white blood cell count, neutrophils/lymphocyte ratio, plasma galactose lectin-3 levels were higher than control group (P < 0.05). ROC curve analysis of left atrial appendage emptying velocity, left atrial appendage filling velocity, left atrial enddiastolic diameter and left atrial ejection fraction had higher diagnostic value (P < 0.05). Conclusions: Left atrial appendage morphology, blood flow velocity and plasma galectin-3 level are important factors to evaluate the risk of left atrial appendage thrombosis in patients with atrial fibrillation. This study improves the understanding of thrombosis, further elucidates the risk factors for thrombosis, and improves patient prognosis. [ABSTRACT FROM AUTHOR]

Canine parvoviral enteritis (CPE) is a common, highly contagious viral disease characterized by severe hemorrhagic gastroenteritis in dogs. Leukopenia and neutropenia in dogs with parvoviral enteritis are considered negative prognostic indicators. This study aimed to investigate the effect of filgrastim [recombinant methionyl human granulocyte colony-stimulating factor (r-metHuG-CSF)] on leukocyte counts in dogs with parvoviral enteritis. The animal material consisted of thirty-seven owned dogs with parvoviral enteritis from various breeds, which were brought to the Small Animal Clinic of the Department of Internal Medicine, Faculty of Veterinary Medicine, Erciyes University. The dogs included in the study were divided into two groups. The first group received standard treatment (ST=18) and the second group received Filgrastim (ST+Filg=19) in addition to the standard treatment. For the assessment of leukocyte counts, blood samples were taken on day 0 (before starting treatment), day 3, and day 5 after treatment. It was observed that 16 out of the nineteen dogs treated with Filgrastim in addition to standard treatment (84.21%) showed improvement. In the ST+Filg group, the median WBC and neutrophil values on the 5th day after treatment were significantly higher than on the 0th day (P=0.001, P=0.006, respectively). In addition, the median WBC, lymphocyte and neutrophil values of the dogs in the ST+Filg group on the 3rd and 5th days after treatment were found to be significantly higher than the same day measurements of the ST group (P<0.001). As a result, this study determined that filgrastim (r-metHuG-CSF) contributed positively to the improvement of leukopenia in dogs with CPE, in conjunction with clinical recovery. It was concluded that filgrastim (r-metHuG-CSF) may be included in treatment protocols as one of the immunostimulant drugs to increase leukocyte counts in the treatment of dogs with parvoviral enteritis. [ABSTRACT FROM AUTHOR]

In this study, the suppressive effects of vincristine and Turkish mad honey alone and in co-applications were biochemically, hematologically, and histopathologically investigated in a mammary tumor model induced with 7,12-dimethylbenz[a]anthracene (DMBA) in rats. A total of 72 rats, 43-49 days old, were divided into 6 groups of 12 rats each. The control group (CG) consisted of healthy rats. The vehicle group (VG) received only vehicle substance and the cancer control group (CCG) was given only DMBA. DMBA and the honey group (HG) given group. DMBA and the vincristine (VinG) given group, and DMBA, the vincristine-honey group (VHG) received both Turkish mad honey and vincristine. Turkish mad honey and/or vincristine was given in the last 4 weeks of the 13-week trial period. White blood cell and lymphocyte counts differed significantly in the CCG and VG groups. Alanine transaminase and total protein levels were higher in the CCG and VinG groups. Aspartate transaminase was higher in the CCG, HG and VG groups. Caspase-3 and Bax protein levels were in the HG and VHG groups significantly higher than CCG. In caspase-8 protein level VHG significantly higher than other groups. Caspase -9 protein level was in CG and VG groups significantly lower than other groups. Bcl-xL increased more in the CCG group. Anaplasia was reduced in the HG and VinG groups, although apoptosis and other cellular damages increased. It was concluded that mad honey and vincristine could be considered together as effective therapeutic agents in this model of DMBA-induced breast cancer. [ABSTRACT FROM AUTHOR]

Severe acute pancreatitis (SAP) has high mortality. Early identification of high-risk factors that may progress to SAP and active intervention measures may improve the prognosis of SAP patients. Clinical data within 24 h after admission were retrospectively analyzed to provide an evidence for early screening of high-risk factors in patients with SAP. A review of clinical data of acute pancreatitis patients from January 1, 2018, to December 31, 2022, was conducted. We compared the clinical data of SAP and non-SAP patients, and a multivariable logistic regression model was used to identify the independent predictors of SAP. The receiver operating characteristic (ROC) curve of SAP was drawn for continuous numerical variables to calculate the optimal clinical cutoff value of each variable, and the predictive value of each variable was compared by the area under the ROC curve. Based on the multivariate logistic regression analysis of Age (odds ratio (OR), 1.032;95% confident interval (CI),1.018–1.046, p < 0.001), body mass index (BMI) (OR, 1.181; 95% CI,1.083–1.288, p < 0.001), Non-HTGAP (nonhypertriglyceridemic acute pancreatitis) (OR, 2.098; 95% CI,1.276–3.45, p = 0.003), white blood cell count (WBC) (OR,1.072; 95% CI,1.034–1.111, p < 0.001), procalcitonin (PCT) (OR, 1.060; 95% CI, 1.027–1.095, p < 0.001), serum calcium (Ca) (OR,0.121; 95% CI, 0.050–0.292, p < 0.001), computed tomography severity index (CTSI) ≥4 (OR,12.942;95% CI,7.267–23.049, p < 0.001) were identified as independent risk factors for SAP. The area under the ROC curve (AUC) and optimal CUT-OFF values of continuous numerical variables for predicting SAP were Age (0.6079,51.5), BMI (0.6,23.25), WBC (0.6701,14.565), PCT (0.7086, 0.5175), Ca (0.7787,1.965), respectively. Age, BMI, non-HTGAP, WBC, PCT, serum Ca and CTSI≥4 have good predictive value for SAP. [ABSTRACT FROM AUTHOR]

This article discusses a case of chronic nonbacterial osteomyelitis (CNO) complicated by recurrent erythema nodosum (EN) and its successful treatment with salazosulfapyridine (SASP). CNO is a condition characterized by bone lesions and can also present with mucocutaneous symptoms. EN is a skin condition associated with inflammation of the subcutaneous tissue. The patient initially received naproxen for treatment but experienced persistent symptoms. SASP was then introduced and led to remission of both CNO and EN. The use of SASP as a second-line treatment for refractory CNO and EN is suggested. [Extracted from the article]

This article presents a case study of a 37-year-old woman who was diagnosed with osteogenesis imperfecta (OI) after experiencing subchondral insufficiency fractures (SIF) in both femoral heads. The patient had a history of multiple fractures, blue sclera, and mild bilateral sensorineural hearing loss, which led to the diagnosis of OI. Genetic testing revealed a mutation in the COL1A1 gene. After conservative therapy, the patient's symptoms improved, and after four years, both hips were pain-free with no evidence of osteoarthritis progression. The article highlights the association between OI and SIF and emphasizes that bilateral SIF is rare in cases of OI. [Extracted from the article]

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]