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Introduction: The 2019 Kidney Disease Outcome Quality Initiative guidelines emphasize the importance of selecting dialysis based on the life expectancy of the patient. However, it is difficult to predict the life expectancy of a patient during arteriovenous fistula creation. We investigated whether neutrophil-to-lymphocyte, monocyte-to-lymphocyte, and platelet-to-lymphocyte ratios measured before dialysis could predict mortality. Materials and methods: Between January 2016 and December 2020, we retrospectively analyzed electronic medical records of 448 patients aged ≥ 70 years undergoing first-time arteriovenous access surgery at three tertiary care hospitals, all of whom had not received prior dialysis treatment. Only patients undergoing blood tests on the day before surgery were included in the analysis. Patients who died within one year after surgery were included in the non-survival group, while those who died after one year were included in the survival group. Results: Patients were categorized into non-survival (n = 52) and survival (n = 396) groups. Multivariate analysis for one-year mortality revealed that the preoperative neutrophil-to-lymphocyte ratio demonstrated a 1.15 hazard ratio (p < 0.001). Also, cancer (HR 2.50, p = 0.02) and peripheral arterial disease (HR 4.62, p < 0.001) were risk factor for one-year mortality. The preoperative platelet-to-lymphocyte and monocyte-to-lymphocyte ratios were not identified as one-year mortality risk factors. In the total mortality multivariate analysis, monocyte-to-lymphocyte ratios were one of the risk factors (HR 2.74, p < 0.007). Conclusion: The neutrophil-to-lymphocyte ratio was a risk factor associated with one-year mortality in patients aged ≥ 70 years. However, further research is required to determine whether these can be used for predictive purposes. [ABSTRACT FROM AUTHOR]

Background: Cerebrospinal fluid (CSF) analysis is essential for diagnosing various disorders affecting the central nervous system (CNS). Traditionally, CSF cell count analysis is performed manually using a Neubauer chamber hemocytometer, which is labor-intensive and prone to subjective interpretation. Methods: In this study, we evaluated the analytical and clinical performance of the Microscanner C3, an automated cell counting system, for CSF analysis using artificially prepared samples and 150 clinical CSF samples. Results: The lowest detectable white blood cell (WBC) count was 3.33 cells/µL, and the lowest detectable red blood cell (RBC) count was 3.67 cells/µL. The coefficients of variation (CV%) for the Microscanner C3 were lower than those for the Neubauer chamber at all cell concentrations. The correlation coefficients (R) between the Microscanner C3 and conventional methods were high: 0.9377 for WBCs and 0.9952 for RBCs when compared with the Neubauer chamber, and 0.8782 for WBCs and 0.9759 for RBCs when compared with the flow cytometer. Additionally, the Microscanner C3 showed good agreement with both the Neubauer chamber and flow cytometer in the Passing–Bablok regression analysis and Bland–Altman analysis for WBC count at all concentrations and RBC count at concentrations of 0–1000 cells/µL. Conclusions: The Microscanner C3 proved to be more sensitive, precise, and consistent compared to the conventional hemocytometer. The new system is also compact, convenient, and cost-effective, making it a valuable option for clinical laboratories. [ABSTRACT FROM AUTHOR]

Introduction: Recent guidelines recommend restrictive red blood cell transfusion; therefore, hospitals have started introducing and implementing patient blood management programs. This is the first study to analyze changes in the trends of blood transfusions in the whole population over the past 10 years according to sex, age group, blood component, disease, and hospital type. Methods: This cohort study analyzed blood transfusion records for 10 years, from January 2009 to December 2018, using nationwide population-based data from the Korean National Health Insurance Service-Health Screening Cohort database. Results: The proportion of transfusion procedures conducted in the total population has increased constantly for 10 years. Although its proportion in the age group of 10–79 years decreased, the total number of transfusions increased significantly due to the increase in the population and proportion of transfusions in those aged 80 years or older. Furthermore, the proportion of multicomponent transfusion procedures increased in this age group, which was greater than that of transfusions. The most common disease among transfusion patients in 2009 was cancer, of which gastrointestinal (GI) cancer accounted for more than half, followed by trauma and hematologic diseases (GI cancers > trauma > other cancers > hematologic diseases). The proportion of patients with GI cancer decreased, whereas that of trauma and hematologic diseases increased over the 10 years, with trauma becoming the most common disease type in 2018 (trauma > GI cancers > hematologic diseases > other cancers). Although transfusion rates per hospitalization decreased, the total number of inpatients increased, thus increasing the number of blood transfusions in all types of hospitals. Discussion/Conclusions: The proportion of transfusion procedures in the total population increased owing to the increase in the total number of transfusions in patients aged 80 years or older. The proportion of patients with trauma and hematologic diseases has also increased. Moreover, the total number of inpatients has been increasing, which subsequently increases the number of blood transfusions performed. Specific management strategies targeting these groups may improve blood management. [ABSTRACT FROM AUTHOR]

Background: Neonatal clavicle fracture in cesarean delivery is rare and has not been extensively studied.Methods: We performed a retrospective review of cesarean deliveries with neonatal clavicle fracture during a 12-year period. Maternal and neonatal factors as well as surgical factors related to cesarean delivery for the fracture were determined and compared to the control group to analyze their significance.Results: Among a total 89 367 deliveries during the study period, 36 286 babies were born via cesarean section. Nineteen cases of clavicle fractures in cesarean section were identified (0.05% of total live births via cesarean section). In the analysis of maternal and neonatal risk factors, birthweight, birthweight ≥ 4000  g and maternal age were significantly associated with clavicle fracture in cesarean section. However, clavicle fractures were not correlated with the selected surgical factors such as indication for cesarean section, skin incision to delivery time and incision type of skin and uterus. Logistic regression analysis showed that birthweight was the major risk factor for clavicle fracture.Conclusion: Clavicle fractures complicated 0.05% of cesarean deliveries. The main risk factor related to a clavicle fracture in cesarean section was the birthweight of an infant. As reported in previous studies associated with vaginal delivery, clavicle fracture is considered to be an unavoidable event and may not be eliminated, even in cesarean delivery. [ABSTRACT FROM AUTHOR]