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Objectives: Inflammatory disorders including periodontitis have been investigated for their impact on systemic inflammation and bone health. The present study was conducted with an aim to evaluate impact of control of periodontal inflammation through subgingival instrumentation on serum interleukin 6 and serum C-terminal telopeptide of type I collagen (CTX) in premenopausal females with stage II and III periodontitis. Method and materials: In this single-arm prospective study, periodontal parameters, serum interleukin 6, serum CTX, and hematologic parameters (total leukocyte count, differential leukocyte count, platelet count, mean platelet volume, and platelet distribution width) were assessed at baseline. Subgingival instrumentation was done, and oral hygiene instructions were given. At week 4, professional plaque control was performed, and oral hygiene instructions were reinforced. Serum and hematologic parameters were reassessed at 8 weeks after subgingival instrumentation, in individuals meeting the clinical endpoints (ie, bleeding on probing < 10%). Results: There was significant reduction in serum interleukin 6 of 0.168 ± 0.164 pg/mL (P = .000), and serum CTX of 17.459 ± 4.363 pg/mL (P = .000) at 8 weeks after subgingival instrumentation. There was significant decrease in eosinophil count (P = .018) and mean platelet volume (P = .016) at 8 weeks after subgingival instrumentation; however, no significant change was found in other hematologic parameters. Conclusion: Following subgingival instrumentation, biomarkers of both systemic inflammation (interleukin 6) and bone turnover (CTX) were observed to reduce significantly. This finding hints towards a positive impact of periodontal intervention on bone health. [ABSTRACT FROM AUTHOR]

The article discusses a case of acute myeloid leukemia with minimal differentiation (AML-M0) accompanied by plasmacytoid dendritic cell (pDC) proliferation. The patient, a 73-year-old male, presented with fever, leukocytosis, anemia, and thrombocytopenia. The diagnosis was established through bone marrow aspirates, immunohistochemical staining, flow cytometry, and genetic testing. The patient received chemotherapy and achieved partial remission. The article emphasizes the importance of accurate diagnosis of pDC neoplasms, highlighting the challenges in distinguishing between different types of pDC proliferations and their implications on patient prognosis. [Extracted from the article]

Objective Method Results Conclusion This paper evaluates the accuracy of C‐reactive protein (CRP), leukocyte count, and neutrophil‐to‐lymphocyte ratio (NLR) for diagnosing tubo‐ovarian abscess (TOA) and assessing the cost‐effectiveness of different treatment regimens for pelvic inflammatory disease (PID), with and without TOA.A retrospective cohort study was conducted between January 1, 2003, and December 30, 2021, including women aged 13–80 years diagnosed with PID. The analysis focused on the incremental cost‐effectiveness ratio of different treatment regimens.C‐reactive protein, leukocyte count, and NLR were found to be statistically significant markers for diagnosing TOA. Out of 907 PID cases, 705 achieved clinical cure with initial treatment. The most cost‐effective treatment for mild PID without TOA was ceftriaxone combined with azithromycin, which was considered less costly and more effective in the cost‐effectiveness analysis. For severe PID with TOA, ampicillin combined with gentamicin and clindamycin was more cost‐effective compared to ampicillin with sulbactam plus doxycycline, given a willingness‐to‐pay threshold of US$213.57 for a 4.2% increase in cure rate.The study's findings support the use of CRP, leukocyte count, and NLR as diagnostic tools for TOA. Ceftriaxone combined with azithromycin is recommended as the first‐line treatment for mild PID at our institution due to its cost‐effectiveness. For TOA, ampicillin combined with gentamicin and clindamycin is a cost‐effective option if the healthcare system's willingness to pay exceeds US$213.57 for a 4.2% increase in cure rate, contributing valuable insights for PID treatment strategies from a hospital's perspective. The average time of hospital admission for TOA was 3 days. After discharge, patients received oral doxycycline until completing 14 days of treatment. [ABSTRACT FROM AUTHOR]

The document discusses the use of chromosomal genomic array testing (CGAT) in adults with newly diagnosed acute lymphoblastic leukemia (ALL) to enhance risk stratification and inform treatment decisions. The study found recurrent chromosomal abnormalities in patients, including deletions and gains in specific genomic loci. While CGAT identified high-risk genetic signatures like IKZF1plus, there was no significant difference in overall survival between patients with IKZF1 alterations and those without. Additionally, ETV6 and ZCCHC7 deletions were associated with adverse prognostic outcomes in adults with ALL. The study suggests integrating CGAT into the initial workup of ALL patients but acknowledges the need for further prospective studies due to the limitations of the retrospective analysis. [Extracted from the article]

Brain metastases are a common complication in patients with non-small-cell lung cancer (NSCLC) lacking actionable driver mutations, with limited treatment options and poor prognosis. We aimed to investigate the efficacy and safety of brain radiotherapy combined with camrelizumab and platinum-doublet chemotherapy in patients with newly diagnosed advanced NSCLC and brain metastases. This multicentre, single-arm, phase 2 trial was done across nine tertiary hospitals in China. Eligible patients were aged 18 years or older, had newly diagnosed brain metastases from NSCLC with no actionable driver mutations (EGFR , ALK , or ROS1), and had an Eastern Cooperative Oncology Group performance status of 0 or 1. Eligible patients were treated with stereotactic radiosurgery or whole-brain radiotherapy combined with camrelizumab (200 mg intravenously once every 3 weeks) and investigator-selected platinum-doublet chemotherapy (pemetrexed 500 mg/m2 plus platinum [carboplatin, area under curve (AUC) of 5, or cis-platinum 75 mg/m2] for non-squamous NSCLC, and nab-paclitaxel 260 mg/m2 plus platinum [carboplatin AUC 5, or cis-platinum 75 mg/m2] for squamous NSCLC) for four to six cycles. Patients with controlled disease then received maintenance treatment with camrelizumab alone (200 mg intravenously once every 3 weeks; for squamous NSCLC) or camrelizumab plus pemetrexed (500 mg/m2 every 3 weeks; for non-squamous NSCLC). The primary endpoint was 6-month progression-free survival rate in the full analysis set, which included all patients who received at least one dose of study treatment regardless of whether they had measurable brain lesions per RECIST 1.1. The trial was registered with ClinicalTrials.gov , NCT04291092 , and is ongoing. Between May 6, 2020, and Jan 30, 2023, 67 patients were assessed for eligibility. Two patients were excluded (brain lesions less than 5 mm) and 65 patients were enrolled and treated. Median age was 66 years (IQR 62–70). 60 (92%) of 65 patients were male and five (8%) were female. All 65 patients were Han Chinese. 50 (77%) of 65 patients had non-squamous NSCLC and 46 (71%) were symptomatic. The 6-month progression-free survival rate was 71·7% (95% CI 58·9–81·1) during the median follow-up of 14·1 months (IQR 9·0–20·3; data cutoff Dec 13, 2023). The most common grade 3–4 treatment-related adverse events were decreased neutrophil count (14 [22%] of 65 patients), decreased white blood cell count (ten [15%]), decreased platelet count (ten [15%]), and decreased lymphocyte count (nine [14%]). Neurological toxic effects of grade 3 occurred in three (5%) of 65 patients. Radiation necrosis occurred in three (5%) of 65 patients; all were grade 1 or 2. There were no treatment-related deaths. Brain radiotherapy combined with camrelizumab and platinum-doublet chemotherapy shows promising efficacy and manageable toxicity and could be a potential treatment option for patients with brain metastases from NSCLC. Randomised controlled trials will be required to confirm these findings. Beijing Xisike Clinical Oncology Research Foundation and Jiangsu Hengrui Pharmaceuticals. For the Chinese translation of the abstract see Supplementary Materials section. [ABSTRACT FROM AUTHOR]

Patients with locally advanced non-small-cell lung cancer (NSCLC) who undergo concurrent chemotherapy and radiotherapy often experience synergistic toxicity, and local regional control rates remain poor. We assessed the activity and safety outcomes of primary tumour stereotactic body radiotherapy (SBRT) followed by conventional chemoradiotherapy to the lymph nodes and consolidation immunotherapy in patients with unresectable locally advanced NSCLC. In this multicentre, single-arm, phase 2 trial, patients aged 18 years and older were enrolled at eight regional cancer centres in North Carolina and South Carolina, USA. Patients were eligible if they had stage II–III, unresectable, locally advanced NSCLC (any histology), with peripheral or central primary tumours that were 7 cm or smaller, excluding central tumours within 2 cm of involved nodal disease, and an Eastern Cooperative Oncology Group performance status of 0–2. Patients who had previously received systemic therapy or radiotherapy were excluded. Participants received SBRT to the primary tumour (50–54 Gy in three to five fractions) followed by standard radiotherapy (planned up to 60 Gy in 30 2 Gy fractions) to the involved lymph nodes with concurrent platinum doublet chemotherapy (either paclitaxel 50 mg/m2 intravenously plus carboplatin area under the curve 2 mg/mL per min every 7 days for a total of six 1-week cycles or etoposide 50 mg/m2 intravenously on days 1–5 and days 29–33 plus cisplatin 50 mg/m2 intravenously on days 1, 8, 29, and 36 for two cycles of 4 weeks). An amendment to the protocol (Dec 11, 2017) permitted the administration of consolidation durvalumab at the discretion of the treating investigator. An additional protocol amendment on Jan 13, 2021, directed patients without disease progression after chemoradiotherapy to receive consolidation durvalumab (10 mg/kg intravenously on day 1 and day 15 of a 4-week cycle for up to 12 cycles or 1500 mg intravenously on day 1 of a 4-week cycle for up to 12 cycles). The primary endpoint was 1-year progression-free survival (per Response Evaluation Criteria in Solid Tumours version 1.1), assessed in all participants who received at least one fraction of SBRT and had radiological follow-up data up to 1 year. A 1-year progression-free survival rate of greater than 60% was required to reject the null hypothesis and show significant improvement in 1-year progression-free survival. One-sided exact binomial tests were used to compare the primary endpoint versus the historical control 1-year progression-free survival rate used to determine the sample size. Safety was assessed in all patients who received at least one fraction of SBRT. This study is registered with ClinicalTrials.gov , NCT03141359 , and is closed to accrual. Between May 11, 2017, and June 27, 2022, 61 patients were enrolled and received at least one dose of fractionated SBRT, of whom 59 were evaluable for the primary endpoint. Median age was 67 years (IQR 61–72), 28 (46%) of 61 were female, 33 (54%) were male, 51 (84%) were White, seven (11%) were Black, and three (5%) were of other or unknown race. Of the 61 patients enrolled, 47 received at least one dose of consolidation durvalumab. As of data cutoff (July 12, 2023), median follow-up was 29·5 months (IQR 14·9–47·1). 1-year progression-free survival was 62·7% (90% CI 51·2–73·2; one-sided p=0·39, compared with the historical control rate), with 37 of 59 evaluable participants progression free and alive 1 year after enrolment (n=14 progressed, n=8 died). The most common grade 3–4 treatment-related adverse events were decreased neutrophil count (nine [15%] of 61 patients), decreased white blood cell count (five [8%]), and anaemia (four [7%]). Treatment-related serious adverse events occurred in 11 (18%) of 61 patients, which included lung infection (three [5%]), pneumonitis (two [3%]), decreased neutrophil count (two [3%]), febrile neutropenia (two [3%]), and dyspnoea, hypoxia, respiratory failure, sinus tachycardia, bronchial infection, and acute kidney injury (each in one [2%] patient). Treatment-related deaths occurred in four (7%) of 61 patients (one each of respiratory failure, respiratory failure and dyspnoea, lung infection, and pneumonitis). Although this study did not meet the primary endpoint, activity and safety profiles of primary lung tumour SBRT followed by concurrent mediastinal chemoradiotherapy were favourable compared with other modern trials treating locally advanced NSCLC with chemoradiotherapy. These findings serve as the basis for the ongoing randomised phase 3 study NRG Oncology LU008 (NCT05624996). AstraZeneca and Atrium Health Levine Cancer Institute. [ABSTRACT FROM AUTHOR]

The performance of synovial fluid biomarker D-lactate to diagnose septic arthritis (SA) and differentiate it from crystal-induced arthritis (CA), other non-infectious rheumatic joint diseases (RD) and osteoarthrosis (OA) was evaluated. Consecutive adult patients undergoing synovial fluid aspiration due to joint pain were prospectively included in different German and Swiss centers. Synovial fluid was collected for culture, leukocyte count and differentiation, detection of crystals, and D-lactate concentration. Youden's J statistic was used to determine optimal D-lactate cut-off value on the receiver operating characteristic (ROC) curve by maximizing sensitivity and specificity. In total 231 patients were included. Thirty-nine patients had SA and 192 aseptic arthritis (56 patients with OA, 68 with CA, and 68 with RD). The median concentration of synovial fluid D-lactate was significantly higher in patients with SA than in those with OA, CA, and RD (p<0.0001, p<0.0001 and p<0.0001, respectively). The optimal cut-off of synovial fluid D-lactate to diagnose SA was 0.033 mmol/L with a sensitivity of 92.3 % and specificity of 85.4 % independent of previous antimicrobial treatment. Sensitivity and specificity of synovial fluid leukocyte count at a cut-off of 20,000 cells/µL was 81.1 % and 80.8 %, respectively. Synovial fluid D-lactate showed a high performance for diagnosing SA which was superior to synovial fluid leukocyte count. Given its high sensitivity and specificity, it serves as both an effective screening tool for SA and a differentiator between SA and RD, especially CA. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to explore the clinical characteristics and risk factors for hypersensitivity reactions induced by antituberculosis drugs. Methods: A retrospective analysis was conducted on the medical records of patients with active tuberculosis (TB) treated in the TB ward at West China Hospital, Sichuan University, from November 2010 to April 2020. Results: Out of 7106 patients with active tuberculosis, 205 experienced hypersensitivity reactions to antituberculosis drugs; the incidence of hypersensitivity was 2.9%. The predominant clinical manifestation was a rash, observed in 57.1% (117/205) of these cases. Additionally, 19.0% (39/205) of patients presented with concurrent liver injury. The laboratory parameters white blood cell count, total lymphocyte count, monocyte count, eosinophil count, basophil count, alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase were significantly elevated in patients with hypersensitivity compared to those without. In 38 patients who tested positive for oral antituberculosis drug provocation, 14 (36.8%) were allergic to more than two antituberculosis drugs. Significant risk factors included being female (odds ratio [OR] = 1.387, 95% confidence intervals [CI]: 1.016–1.894), under 65 years of age (OR = 1.826, 95% CI: 1.145–2.913), existing liver disease (OR = 2.464, 95% CI: 1.822–3.333) and a history of allergic diseases (OR = 6.633, 95% CI: 2.681–16.406) and were significantly correlated with hypersensitivity to antituberculosis drugs. Conclusions: Hypersensitivity reactions to antituberculosis drugs primarily affect the skin, with significant associations observed with liver injury. Females, individuals younger than 65 years, those with pre‐existing liver disease and patients with a history of allergic diseases are at elevated risk for hypersensitivity. [ABSTRACT FROM AUTHOR]

The diagnosis and management of neurosarcoidosis (NS) in pediatric patients remain challenging, with limited case documentation to guide clinicians. Most existing reports focus on initial presentations. This study aimed to outline the clinical features, management, and medium-term outcomes of pediatric NS In this retrospective, multicentric, observational study, we collected data from pediatric patients followed in French pediatric rheumatology centers with a diagnosis of NS between January 2001 and June 2023. We identified 11 patients diagnosed with NS, comprising eight girls and three boys. The mean age at diagnosis of sarcoidosis was 10 (5 to 15) years, and the mean age of diagnosis of NS was 11.5 (5 to 17) years. Predominant neurological symptoms included headache (nine of 11 patients), papilledema (6 of 11 patients), facial palsy (two patients), seizures (one patient), and motor deficit (two patients). Nine of 11 patients had eye involvement, which consisted of granulomatous and bilateral uveitis. All patients exhibited meningitis, with cerebrospinal fluid white blood cell counts ranging from 6 to 70 cells/mm3. Six individuals presented neurological abnormalities on imaging, detailed in this study. Treatment primarily involved corticosteroids, methotrexate, and tumor necrosis factor alpha (TNF-alpha) inhibitors. Biologics targeting TNF-alpha were necessary to achieve remission in eight of 11 patients. In two patients who did not receive this treatment initially, it was required later in the course of evolution. This study enhances understanding of the clinical course of pediatric NS and supports the early use of TNF-alpha biologics for improved management in affected children. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the effects of inserting a Foley catheter after ureteroscopy (URS) and JJ stent placement on pain scores, voiding patterns, biochemical parameters and postoperative complications. Patients and Methods: A randomised clinical trial (1:1) with adult patients following unilateral URS + JJ stent placement was planned. In Group A, no Foley catheter was placed, in Group B, a Foley catheter was placed following URS + JJ stent placement. The primary objective was to evaluate effect of placing a Foley catheter on International Prostate Symptom Score (IPSS), Ureteric Stent Symptom Questionnaire (USSQ) score and postoperative biochemical parameters. The secondary objective was to evaluate postoperative complications. Results: A total of 112 patients were included (56/group). A ureteric access sheath was used in each patient. Patients had similar demographic and surgical parameters. The pre‐ and postoperative biochemical analyses including white blood cell count, C‐reactive protein, procalcitonin and creatinine levels were similar between the two groups. The IPSS were similar between the two groups. All the subdomains of the USSQ were similar between two groups except Total Body Pain score, which was lower in Group B. The visual analogue scale scores were similar. Complications were all Clavien–Dindo Grade I and II, and the complication rate was 5.4% and 8.9% in Group A and B, respectively. Conclusion: Placing a Foley catheter following URS + JJ stent placement did not show significant effects on postoperative biochemical parameters and voiding symptoms. However, a Foley catheter lowered the Total Body Pain score on the USSQ without having significant effects on VAS scores. The practice of placing a Foley catheter following URS and JJ stent placement should be based on surgeon's preference keeping in mind the potential positive effect on pain scores. [ABSTRACT FROM AUTHOR]

Type 2 diabetes mellitus (T2DM) is not just a local health issue but a significant global health burden, affecting patient outcomes and clinical management worldwide. Despite the wealth of studies reporting T2DM biomarkers, there is an urgent need for a comparative review. This review aims to provide a comprehensive analysis based on the reported T2DM biomarkers and how these are linked with other conditions, such as inflammation and wound healing. A comparative review was conducted on 24 001 study participants, including 10 024 T2DM patients and 13 977 controls (CTL; age 30–90 years). Four main profiles were extracted and analysed from the clinical reports over the past 11 years: haematological (1084 cases vs. 1458 CTL), protein (6753 cases vs. 9613 CTL), cytokine (975 cases vs. 1350 CTL) and lipid (1212 cases vs. 1556 CTL). This review provides a detailed analysis of the haematological profile in T2DM patients, highlighting fundamental changes such as increased white blood cells and platelet counts, accompanied by decreases in red blood cell counts and iron absorption. In the serum protein profile, a reduction in albumin and anti‐inflammatory cytokines was noted along with an increase in globulin levels and pro‐inflammatory cytokines. Furthermore, changes in lipid profiles were discussed, specifically the decreases in high‐density lipoprotein (HDL) and the increases in low‐density lipoprotein (LDL) and triglycerides. Understanding the changes in these four biomarker profiles is essential for developing innovative strategies to create diagnostic and prognostic tools for diabetes management. [ABSTRACT FROM AUTHOR]

Myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) are heterogeneous neoplasms of hematopoietic stem cells that are challenging to diagnose, differentiate, and prognosticate. Cytogenetic and mutational analyses are useful in humans but unavailable for dogs, where diagnosis and classification still rely largely on hematologic and morphologic assessment. The objectives of this study were to apply a classification scheme to myeloid neoplasms and to assess outcome in relation to predictor variables. Keyword search of a laboratory database, application of sequential exclusion criteria, and consensus from 3 reviewers yielded 70 cases of myeloid neoplasia with hematology results, and cytologic (11), histologic (14), or both (45) types of marrow specimens. Based on blast percentage and morphology, 42 cases were classified as MDS and 28 as AML. Dogs with MDS had significantly lower body weights, hemoglobin concentrations and blood blasts, and higher red blood cell size variability and platelet numbers than dogs with AML. Estimates of median survival using Kaplan-Meier curves for dogs with MDS and AML were 384 and 6 days, respectively (P <.001). The instantaneous risk of death for dogs with MDS was approximately 5× lower than that of dogs with AML. Significant predictor variables of survival were body weight, white blood cell count, platelet count, and percent blood blasts (P <.05). Hazard ratios (HRs) derived from best-fitting Cox regression models were 1.043, 0.998, and 1.061 for increased neutrophils, decreased platelets, and increased blood blasts, respectively. Findings from this study suggest that hematologic and morphologic variables are useful to predict outcomes in myeloid neoplasia. [ABSTRACT FROM AUTHOR]

Introduction: Glucocorticoids (GCs) are widely used as a treatment for rheumatoid arthritis (RA), leading to high cumulative doses in long-term treated patients. The impact of a high cumulative GC dose on the systemic inflammatory response in RA remains poorly understood. Methods: We investigated long-treated patients with RA (n = 72, median disease duration 14 years) through blood counts and the serum levels of 92 inflammation-related proteins, and disease activity was assessed using the Simple Disease Activity Index (SDAI). Patients were grouped based on the cumulative GC dose, with a cut-off value of 20 g (low/high, n = 49/23). Results and discussion: Patients with a high cumulative GC dose within the active RA group had elevated serum levels in 23 inflammation-related proteins compared with patients with a low dose (cytokines/soluble receptors: CCL3, CCL20, CCL25, IL-8, CXCL9, IL-17A, IL-17C, IL-18, sIL-18R1, IL-10, sIL-10RB, OSM and sOPG; growth factors: sTGFα and sHGF; other inflammatory mediators: caspase 8, STAMBP, sCDCP1, sirtuin 2, 4E-BP1, sCD40, uPA and axin-1; pcorr < 0.05). In non-active RA, the high and low GC groups did not differ in analysed serum protein levels. Moreover, patients with active RA with a high GC dose had an increased white blood cell count, increased neutrophil–lymphocyte and platelet–lymphocyte ratios and a decreased lymphocyte–monocyte ratio compared with the low dose group (p < 0.05). This is the first study to report elevated serum levels in inflammation-related proteins and deregulated blood counts in patients with active RA with a high cumulative GC dose. The elevated systemic inflammation highlights the importance of improving care for patients receiving high cumulative GC doses. [ABSTRACT FROM AUTHOR]

Introduction: The present study investigates the effects of mushroom powder (MP) on growth parameters, haematological indices, innate immune response, and serum biochemical indices in beluga (Huso huso) juveniles. Methods: A total of 120 fish (45 ± 0.5 g) were stocked with 10 fish in each 300-L tank. Experimental diets were prepared by inclusion of 0, 0.5, 1.0, and 2.0% MP. At the end of the feeding trial haemato-immunological parameters as well growth performance were measured. Results: The growth parameters results revealed that body weight, specific growth rate (SGR), and body length increased significantly in the fish fed diets containing 1% and 2% MP (P <0.05). Haematological indices results indicated that none of the experimental diets showed significant effects on red blood cell count (RBC), hemoglobin, mean corpuscular volume (MCV), mean cell hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) (P >0.05). However, the haematocrit increased significantly in the fish fed diets containing 1% MP compared to the control (P <0.05). White blood cell count (WBC) in the fish fed 2% MP was significantly higher than that in the fish fed 0% and 0.5% MP (P <0.05). Furthermore, MP treatments caused no significant change in the activity of complement C3 (P >0.05), while C4 activity increased significantly in the fish fed 2% MP (P <0.05). Total immunoglobulin in 1% MP had no significant difference when compared with control (P >0.05). Albumin level was significantly higher in fish fed 2% MP compared to control (P <0.05). Discussion: In conclusion, MP (2%) can be considered to improve growth parameters and immune indices in beluga juveniles. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to analyze the predictive value of the systemic immune inflammation index (SII) for the severity of disease in tetanus patients. Methods: Clinical data of 34 tetanus patients admitted to the Second People's Hospital of Fuyang from January 1, 2019 to December 31, 2022 were analyzed. Based on whether patients received intensive care unit (ICU) treatment after admission, the patients were divided into ICU and non-ICU groups. The diagnostic value of SII for the severity of tetanus was assessed. Results: Among the 34 patients, 18 (52.90%) were classified into the ICU group, and 16 (47.10%) into the non-ICU group. There were statistically significant differences in white blood cell count, platelet count, neutrophil count, and SII between the two groups (P<0.05). Logistic regression analysis revealed that SII was a risk factor for tetanus patients requiring ICU treatment. The area under the curve (AUC) for SII predicting ICU treatment in tetanus patients was 0.896 (95% CI 0.790–1.000, P<0.001). Conclusion: The SII can serve as an objective predictive indicator for tetanus patients requiring ICU treatment. [ABSTRACT FROM AUTHOR]

Background: Autoimmune thyroid diseases (AITD) and allergic rhinitis (AR) are prevalent conditions; however, limited research has investigated their association. This study aimed to evaluate whether AR can be considered a risk factor for developing AITD. Methods: A retrospective cohort study analyzed the records of AITD patients who visited Alexandria University Students Hospital between January 2017 and December 2021. The parameters included in the study were thyroid-stimulating hormone (TSH), Free triiodothyronine (FT3), free thyroxine (FT4), thyroid peroxidase antibodies (TPOAb), thyrotropin receptor antibody (TRAb), eosinophils count, and IgE. Results: Out of 4,515 eligible patients, 41.7% were diagnosed with AR in addition to AITD. Among the patients with both conditions, 81% were females, their mean age was 45.71 ± 24.14 years, and the mean duration of AITD was 7.32 ± 2.11 years. The Kaplan–Meier analysis revealed that the AR cohort had a higher cumulative incidence of AITD than did the non-AR cohort (log-rank test, p = 0.001). Multivariate-adjusted hazardous ratios showed that patients with AR, female sex, higher white blood cell count, and diagnosis in November had a higher risk of developing AITD. Conclusions: Screening for AITD should be conducted at the time of diagnosis of AR as it could be a risk factor for AITD. [ABSTRACT FROM AUTHOR]

To investigate the effect of serum galectin-3 on naive neovascular AMD and its use as a serum marker by revealing the variation in this molecule between patient and control groups. Fifty-six naive neovascular AMD patients and 30 healthy control age-matched healthy subjects were included in this prospective case‒control study. Blood samples were obtained and used for analysis of complete blood count; High sensitivity C-reactive protein (HsCRP), erythrocyte sedimentation rate (ESR), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), total cholesterol, homocysteine, HbA1c and galectin-3 levels. The average HsCRP level in the AMD group was significantly higher than that in the control group (p < 0.001). The median leukocyte count was significantly higher in the AMD group than in the control group (p < 0.001). Total cholesterol, LDL and TG levels were significantly higher in the AMD group than in the control group (p < 0.001; in all comparisons). The mean HDL level was significantly lower in the AMD group than in the control group (p < 0.001). The mean galectin-3 level was 8.79 ± 0.55 in the AMD group and 6.55 ± 0.55 in the control group. There was a statistically significant increase in galectin-3 levels in the AMD group (p < 0.001). There was a significant positive correlation between CMT and galectin-3 levels in the control (r = 0.495, p = 0.005) and AMD (r = 0.776, p < 0.001) groups. This study reports that serum Gal-3 concentration was higher in the AMD group compared to the control group and positively correlated with CMT. [ABSTRACT FROM AUTHOR]

Background: Recently, there have been an increasing number of reports on the association between inflammatory markers and the prognosis of malignant tumors. However, the current inflammatory indicators have limited accuracy. We aimed to develop a new scoring system for predicting endometrial cancer recurrence using inflammatory markers, tumor markers, and histological diagnoses. Methods: Patients with primary, previously untreated, and suspected endometrial cancer who underwent surgery at the Nara Medical University Hospital between January 2007 and December 2020 were included and followed up until March 2024. Items were divided into positive and negative using scores based on cutoff values and placed into the new scoring system, the endometrial tumor-related (ETR) score. Results: We found that positive postoperative histological examination of lymph node metastasis and myometrial invasion, high levels of carcinoembryonic antigen and D-dimer in preoperative blood tests, and a large difference in preoperative and postoperative white blood cell counts were significantly associated with recurrence. The sensitivity and specificity of recurrence prediction using the ETR score were not inferior to those using the International Federation of Gynecology and Obstetrics staging system, which is considered the best prognostic factor for survival. Conclusions: The ETR score is a significant prognostic marker of recurrence in patients who have undergone staging surgery, with complete surgical tumor removal. [ABSTRACT FROM AUTHOR]

ABSTRACT Venetoclax with hypomethylating agents (HMA) is the standard of care for acute myeloid leukemia (AML) in patients ineligible for intensive chemotherapy and is associated with tumor lysis syndrome (TLS). TLS prophylaxis and the use of Cairo Bishop versus Howard diagnostic criteria are not standardized. Here we report TLS prophylaxis and incidence in a retrospective cohort of 100 consecutive AML patients treated with venetoclax and HMA. Thirty four patients developed laboratory Cairo Bishop TLS; 8 of these met criteria for clinical Cairo Bishop TLS. Only 6 of patients met Howard TLS criteria. Fourteen patients had spontaneous TLS. Ninety two out of 100 patients had a white blood cell count (WBC) < 25 000 cells/μL at treatment start. Prophylaxis like the original venetoclax trial with allopurinol (56%), intravenous fluids (21%), and frequent lab monitoring (56%) was less common. There was a trend toward increased Cairo Bishop TLS in patients with WBC ≥ 15 000 cells/μL. In our study Howard TLS criteria better identified patients with significant TLS. Aggressive TLS prophylaxis was uncommon in our cohort and is likely unnecessary for most patients at low risk of TLS. [ABSTRACT FROM AUTHOR]

Objective: A ureteric stone is a type of urinary tract stone that is found within the ureter. While most cases can be managed with conservative treatment or minimally invasive surgery, these methods often cause significant pain for the patient. Interestingly, a new type of ureteroscope has shown considerable promise in treating patients with ureteric stones, and this study aims to explore its clinical application. Methods: A total of 120 patients with ureteric stones were recruited from our hospitals between January 1, 2023, and December 31, 2023. These patients were randomly assigned to either the control group, which received the traditional straight ureteroscope, or the experimental group, which was treated with the new type of ureteroscope. Both groups provided general data and blood samples for further analysis. A logistic regression analysis was conducted to examine the factors influencing infection following surgery in patients with ureteric stones, including preoperative CRP greater than 8 mg/L, postoperative CRP greater than 8 mg/L, preoperative white blood cell count (> 109/L), postoperative white blood cell count (> 109/L), preoperative urinalysis count greater than 28 (/ul), postoperative urinalysis count greater than 28 (/ul), and urine routine leukocyte count. Results: The findings indicated no significant differences between the observation group and the control group regarding preoperative demographic, participants general data (P > 0.05). Postoperative CRP > 8 mg/L, white blood cell count > 10 × 109/L, urinalysis count > 28/µL, and urine leukocyte count significantly decreased in the experimental group compared to the control group (P < 0.05). Binary logistic regression showed that postoperative CRP > 8 mg/L (OR = 7.03), white blood cell count > 109/L (OR = 3.86), urinalysis count > 28/µL (OR = 2.83), and urine leukocyte count (OR = 1.004) were predictive factors for ureteric stones. Preoperative values showed no significant difference (P > 0.05). Conclusions: The binary logistic regression analysis identified Postoperative CRP > 8 mg/L, white blood cell count > 10 × 109/L, urinalysis count > 28/µL, and urine leukocyte count as significant predictors of postoperative infections. Our research findings indicate that the new ureteroscope has significant advantages over traditional ureteroscopes in terms of ease of entry into the ureteral lumen, stone fragmentation angle during surgery, surgical field of view, surgical operability, and reducing the risk of postoperative potential infections. These characteristics demonstrate that the new ureteroscope has significant potential in clinical applications, warranting further promotion and use. [ABSTRACT FROM AUTHOR]

Background: Psychiatric illness is thought to be a brain somatic crosstalk disorder. However, the existing phenomenology-based Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic framework overlooks various dimensions other than symptoms. In this study, we investigated the associations between peripheral blood test indexes with various symptom levels of major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SCZ) to explore the availability of peripheral blood test indexes. Methods: We extracted cases diagnosed with MDD, BD, and SCZ at West China Hospital from 2009 to 2021, translated their main complaints into Research Domain Criteria (RDoC) symptom severity scores using nature language processing (NLP), and collected their detailed psychiatric symptoms and peripheral blood test results. Then, generalized linear models were performed between seven types of peripheral blood test values with their transformed RDoC scores and detailed symptom information adjusted for age, gender, smoking, and alcohol history. Results: Several inflammatory-related indexes were strongly associated with the negative valence system (NVS) domain (basophil percentage adjusted β = 0.275, lymphocyte percentage adjusted β = 0.271, monocyte percentage adjusted β = 0.223, neutrophil percentage adjusted β = −0.310, neutrophil count adjusted β = −0.301, glucose adjusted β = −0.287, leukocyte count adjusted β = −0.244, NLR adjusted β = −0.229, and total protein adjusted β = −0.170), the positive valence system (PVS) domain (monocyte percentage adjusted β = 0.228, basophil count adjusted β = 0.176, and glutamyl transpeptidase adjusted β = 0.171), and a wide range of mood, reward, and psychomotor symptoms. In addition, glucose, urea, urate, cystatin C, and albumin showed considerable associations with multiple symptoms. In addition, based on the direction of associations and the similarity of symptoms in terms of RDoC thinking, it is suggested that "positive" mood symptoms like mania and irritability and "negative" mood symptoms like depression and anxiety might be on a continuum considering their opposite relationships with similar blood indexes. Limitations: The cross-sectional design, limited symptoms record, and high proportion of missing values in some other peripheral blood indexes limited our findings. Conclusion: The proportion of high inflammatory indexes in SCZ was relatively high, but in terms of mean values, SCZ, BD, and MDD did not differ significantly. Inflammatory response showed a strong correlation with NVS, PVS, and a range of psychiatric symptoms especially mood symptoms, psychomotor symptoms, and cognitive abilities. [ABSTRACT FROM AUTHOR]

Introduction: Primary bone marrow diffuse large B-cell lymphoma is a rare clinical entity, and the "bone marrow–liver–spleen" type of diffuse large B-cell lymphoma is rarer, with only a few published cases in literature. Though bone marrow–liver–spleen-type diffuse large B-cell lymphoma has unique presentations such as fever, cytopenias, and hemophagocytic lymphohistiocytosis, no cases with cold autoimmune hemolytic anemia have been reported. Case presentation: A 39-year-old Sri Lankan woman, previously healthy, presented with shortness of breath, productive cough, and fever for 4 days. Examination revealed pallor, icterus, and massive hepatosplenomegaly with no peripheral lymphadenopathy. Further investigation revealed pancytopenia (hemoglobin 58 g/L, white blood cell count 1.73 × 109/L, platelets 23 × 109/L, a reticulocyte index of 4.43%, and lactate dehydrogenase levels of 1690 U/L). Blood picture analysis was suggestive of hemolytic anemia, which was confirmed by a positive direct antiglobulin test with anti-C3d. The bone marrow biopsy revealed markedly hypercellular marrow with polymorphic infiltrate of mononuclear cells accounting for about 80–85% of nucleated cells. These cells were predominantly medium to large cells in size with scanty cytoplasm, irregular nuclear margins, prominent nucleoli, and many mitotic figures. These mononuclear cells were positive for immunohistochemical markers of CD20, BCL2, and CD10. The Ki-67 index was 24%. In addition, this patient had cold autoimmune hemolytic anemia. Contrast-enhanced computed tomography of the chest, abdomen, and pelvis revealed homogeneously enlarged liver and spleen with no significant lymphadenopathy. These findings were compatible with the diagnosis of bone marrow–liver–spleen-type diffuse large B-cell lymphoma. The patient was referred for specialized oncological management. Conclusion: Though there are reported cases of primary bone marrow diffuse large B-cell lymphoma presenting with cold autoimmune hemolytic anemia, no such cases of bone marrow–liver–spleen-type diffuse large B-cell lymphoma have been reported. As this unique entity has a rather grim prognosis, it is of utmost importance to identify it early and treat aggressively. Owing to the limited availability of published accounts of this uncommon disease, we believe it is important to document our case to add to the understanding of this rare condition and its various presentations, which can easily be misinterpreted. [ABSTRACT FROM AUTHOR]

The purpose of this study is to address the gap in the existing literature regarding the risk factors for systemic inflammatory response syndrome (SIRS) in patients with a solitary kidney who undergo percutaneous nephrolithotomy (PCNL).This retrospective study reviewed the clinical data of 51 patients with solitary kidney stones who underwent PCNL from January 2018 to January 2024.The study evaluated demographic information, stone characteristics, and laboratory data. Among the 51 patients evaluated, 12 (23.5%) developed SIRS. Multivariate analysis showed that a high urinary white blood cell count (p = 0.041; OR, 1.004; 95% CI, 1.000-1.008), prolonged operation time (p = 0.040; OR, 1.054; 95% CI, 1.005–1.107), and postoperative blood leukocyte count (p = 0.031; OR, 1.459; 95% CI, 1.020–2.061) were independent risk factors for SIRS after PCNL in patients with a solitary kidney. Given the unique physiological conditions of patients with solitary kidneys, who face a higher incidence of kidney stones and have lower risk tolerance, the results of this study provide insights into the risk factors for SIRS after PCNL in these patients. By identifying these factors, clinicians can better stratify risk, implement preventive and therapeutic measures in a timely manner, reduce the risk of SIRS, and improve overall patient outcomes. [ABSTRACT FROM AUTHOR]

Background: Neuromyelitis Optica Spectrum Disorders (NMOSD) comprise a group of autoimmune-mediated, inflammatory, demyelinating central nervous system diseases caused by aquaporin-4 (AQP4) IgG autoantibodies. Efgartigimod is a human IgG Fc fragment that reduces antibody titers by targeting the neonatal Fc receptor (FcRn). This study documents the efficacy of efgartigimod combined with intravenous methylprednisolone (IVMP) in the acute phase of NMOSD. Methods: In this retrospective study, the medical records of NMOSD patients with acute attack who received efgartigimod plus IVMP or IVMP were reviewed. Treatment efficacy was assessed by the Expanded Disability Scale Score (EDSS) before and one month after treatment. Any side effects that occurred during the treatment period were recorded. Results: This study was performed on 11 patients (efgartigimod plus IVMP group [n = 4] and IVMP group [n = 7]). Efgartigimod plus IVMP was effective and had a satisfactory safety profile. EDSS was reduced by 0.5 ± 0.32 compared with the IVMP group (0.27 ± 0.02). Immunoglobulin was decreased in three patients, and the immunoglobulin G (IgG) levels gradually increased approximately 8 weeks after the last administration. Hyperlipidemia and elevated white blood cell count were common side effects. No infections or deaths occurred. Conclusions: Efgartigimod plus IVMP treatment is safe and well-tolerated in patients with acute-phase NMOSD. [ABSTRACT FROM AUTHOR]

Objective: To refine decision-making regarding expectant management for ectopic pregnancy (EP) using machine learning. Methods: This retrospective study addressed expectant management in stable patients with ampullar EP, 2014–2022. Electronic medical record data included demographics, medical history, admission data, sonographic findings, and laboratory results. Follow-up data on βhCG levels and success rates were collected. Statistical analysis incorporated a Decision Tree Classifier, a decision tree-based machine learning model. The cohort was divided into training and testing groups for the machine learning model. This model was evaluated for accuracy, precision, recall, and F1 score to predict success of expectant management. Results: Among 878 cases of EP, the expectant management cohort, comprising 221 cases, exhibited a success rate of 79.6%, with 20.4% requiring subsequent intervention. Mean βhCG levels on admission were 1056.8 ± 1323.5 mIU. The Decision Tree Classifier demonstrated an accuracy of 89%, with precision, recall, and F1 scores of 92%, 95%, and 94%, respectively. Factors for predicting success included clinical symptoms such as pain, the percentage decrease in βhCG levels, gestational age and βhCG level at decision day. Moderate impactful features were white blood cell count, gravidity and maximum tubal dimensions. Smoking status, duration (hours) from time of EP diagnosis to second βhCG test and marital status were minimal significant predictors of success. Conclusion: The Decision Tree-Based classifier model, with 92% precision and 95% recall, may be a valuable tool for predicting treatment success in hemodynamically stable patients with EP, particularly within the initial 24 h of βhCG follow-up. [ABSTRACT FROM AUTHOR]

Objective: This study aims to investigate the diagnostic, biochemical, and hematological characteristics of patients with gouty arthritis and analyze their correlations with baseline characteristics to guide clinical practice, develop personalized treatment strategies, and improve patient outcomes. Methods: A single-center retrospective analysis was conducted on 8,344 patients with acute gouty arthritis admitted to our hospital between January 2014 and December 2023. Baseline characteristics and laboratory data, including uric acid, blood glucose, triglycerides, total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine, erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (hs-CRP), C-reactive protein (CRP), white blood cell count, neutrophil count, lymphocyte count, monocyte count, fibrinogen, and serum albumin, were collected. General linear and Pearson correlation analyses were performed to identify significant relationships. Results: Significant correlations were observed between baseline characteristics (age, body mass index (BMI), smoking, and drinking status) and uric acid levels. High uric acid levels were positively correlated with inflammatory markers (hs-CRP, white blood cell count, and neutrophil count) and metabolic indicators (triglycerides, LDL-C, and creatinine) but negatively correlated with HDL-C. Notable differences in blood and biochemical indicators were identified across age, gender, and BMI groups. Conclusion: This study highlights key laboratory characteristics of gouty arthritis, emphasizing the need for individualized treatment strategies. Comprehensive interventions focusing on managing inflammation and metabolic disturbances in patients with elevated uric acid levels are critical for optimizing prognosis and improving quality of life. [ABSTRACT FROM AUTHOR]

Introduction: Many COVID-19 patients experience mild to severe symptoms, including respiratory system involvement. Different treatment instructions have been suggested for patients with COVID-19. Echinacea has known antiviral effects. However, there is still not enough evidence that it is effective in treating COVID-19. This study was conducted with the aim of determining the effect of Echinacea extract syrup on the outcomes of the lower respiratory tract in patients with COVID-19. Methods: In this single-blind randomized controlled trial, 40 patients with COVID-19 who were inpatients in the hospitals of Mashhad University of Medical Sciences, Iran, were randomly selected and assigned to two equal control and experimental groups (n = 20). In addition to receiving routine care and treatment (oxygen supply, remdesivir, enoxaparin and heparin), the experimental group received 5 cubic centimeter (CC) of Imogen syrup three times a day for 5 days each. The control group only received routine care and treatment. The data were collected on the first, third and fifth days after hospitalization and were analyzed using descriptive and analytical tests in Statistical Package for the Social Sciences (SPSS). The significance level was set at p < 0.05. Results: The mean white blood cell count in the experimental group after the intervention decreased significantly compared to that before the intervention (t = 0.434, p = 0.045, df = 19). Arterial oxygen pressure increased significantly in both the experimental group (t = 4.382, p = 0.000, df = 19) and control group (t = 3.239, p = 0.004, df = 19), however no statistical differences were observed between experimental and control groups after intervention. The level of lung involvement (p = 0.320) and cough symptoms (P = 0.347) were not significantly different between the experimental and control groups after the intervention. In addition, there were no significant differences between the experimental and control groups in terms of the mean oxygen saturation, temperature, and number of breaths per minute on the first, third, and fifth day (p > 0.05). Discussion: The consumption of Echinacea extract syrup may not be able to improve the symptoms of acute lower respiratory tract infection in patients with COVID-19 with 3 daily doses for 5 days. More studies should be conducted to investigate the clinical effects of Echinacea extract in the treatment of patients with pulmonary complications. Trial Registration: IRCT20130522013423N2. [ABSTRACT FROM AUTHOR]

Background: Amulirafusp alfa (IMM0306) is a fusion protein of CD47 binding domain of signal-regulatory protein alpha (SIRPα) with CD20 monoclonal antibody on both heavy chains. This study aimed to evaluate the safety and preliminary efficacy of amulirafusp alfa in relapsed or refractory (r/r) B-cell non-Hodgkin lymphoma (B-NHL). Methods: We enrolled patients with CD20 + r/r B-NHL who had previously received at least two lines of therapy to receive a single-dose of amulirafusp alfa in the first 2 weeks, followed by a multiple-dose period, in which the patients received the same intravenous dose every week in 4-week cycles. The primary endpoints were to evaluate the safety, determine the maximum tolerated dose (MTD) and the recommended phase 2 dose (RP2D) of amulirafusp alfa. Results: Between May 22, 2020 and February 10, 2022, 48 patients with r/r B-NHL were enrolled and received amulirafusp alfa at the doses of 40–2000 μg/kg. As of the data cut-off date of April 18, 2024, no dose-limiting toxicity was observed, and the MTD was not reached. The dose of 2000 μg/kg was identified as the RP2D. All grades and ≥ grade 3 treatment-related adverse events (TRAEs) occurred in 48 (100%) and 33 (68.8%) patients, respectively. The most common ≥ grade 3 TRAEs were lymphocyte count decreased (28/48, 58.3%), white blood cell count decreased (10/48, 20.8%), absolute neutrophil count decreased (9/48, 18.8%) and anemia (5/48, 10.4%). At the doses of 800–2000 μg/kg, objective response rate in follicular lymphoma and marginal zone lymphoma was 41.2% (7/17, 95% confidence interval [CI] 18.4–67.1) and 33.3% (2/6, 95% CI 3.7–71.0), respectively. Conclusion: Amulirafusp alfa showed favorable safety profile and preliminary efficacy in patients with r/r B-NHL, meriting further investigation. Trial registration NCT05805943. [ABSTRACT FROM AUTHOR]

Background: Septic arthritis (SA) of the hip joint is a serious infection that can result in irreversible complications. Distinguishing septic arthritis from transient synovitis, the most common cause of hip pain in children, is crucial for preventing severe outcomes. Existing research has primarily focused on identifying clinical signs and laboratory findings that indicate high-risk patients who may need invasive diagnostic procedures; however, results have been inconsistent. This study aims to evaluate the correlation of various clinical indicators in differentiating septic arthritis from pediatric transient synovitis of the hip. Methods: This study followed the PRISMA guidelines rigorously and was registered with PROSPERO. We conducted a systematic search of PubMed, Embase, and Cochrane Library databases for relevant literature up to September 2024. Studies included in the analysis were required to evaluate the predictive value of clinical indicators distinguishing septic arthritis and transient synovitis of the hip in children under 18 years of age. The risk of bias and quality of the included studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) and RevMan 5.3. Data synthesis was performed using Stata MP-64 18.0 software to facilitate meta-analysis. Results: A total of eleven studies were ultimately included for the final analysis, comprising 1810 cases. The results of meta-analysis revealed that history of fever emerged as a significant risk factor for differentiating septic arthritis from pediatric transient synovitis of the hip (OR = 6.04, 95% CI = 2.44–14.97, P < 0.001). Other notable risk factors included non-weight-bearing status (OR = 5.23, 95% CI = 1.38–19.75, P = 0.015), erythrocyte sedimentation rate (OR = 3.98, 95% CI = 1.29–12.30, P = 0.017), and serum white blood cell count (OR = 2.73, 95% CI = 1.23–6.03, P = 0.013). In contrast, C-reactive protein was not a significant risk factor (OR = 7.12, 95% CI = 0.59–85.70, P = 0.122). Conclusion: The clinical indicators involving a history of fever, non-weight-bearing status, erythrocyte sedimentation rate, and serum white blood cell count have been identified as cost-effective routine tests with potential value in differentiating septic arthritis from pediatric transient synovitis of the hip. To enhance the reliability of these findings, further prospective studies are essential. Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodsResultsConclusion\nPLAIN LANGUAGE SUMMARYThis study aimed to describe clinical characteristics—including blood counts and pharmacologic cytoreductive treatment patterns—and outcomes after 6 months of hydroxyurea (HU) treatment among patients with polycythemia vera (PV) in US community practices.This retrospective observational study included adult patients with a PV diagnosis (1JAN2008–31JAN2020) and ≥2 postdiagnosis visits in the iKnowMed electronic health record database (US Oncology Network and non-Network clinics). Suboptimal HU response required ≥1 criterion after ≥3 months of treatment: white blood cell count (WBC) >10 × 109/L, platelet count >400 × 109/L, and/or hematocrit >45%. Patient characteristics were summarized from structured data using descriptive statistics; overall survival was assessed by Kaplan–Meier method.Among 5871 patients, mean age at diagnosis was 66.1 years (69.8% ≥60 years); 67.2, 59.4, 38.2, and 33.9% of patients had elevated hematocrit, hemoglobin, WBC, and platelets, respectively; 6.1% had a previous thrombotic event. Of 4185 (71.3%) high-risk and 1675 low-risk patients, 55.0 and 32.0% received pharmacologic cytoreductive treatment, most commonly HU (89.8 and 88.9%). After 6 months of pharmacologic cytoreductive treatment, 56.9% had a suboptimal response. Five-year survival probability was 81.5 and 84.3% among patients with suboptimal and optimal responses to HU, respectively, which was not statistically different but suggests potential for survival benefits with longer follow-up.Nearly half of high-risk patients with PV did not receive pharmacologic cytoreductive treatment. Of those who did, over half had suboptimal response, suggesting these patients may need dose adjustments, improved adverse effect management, or alternative treatments. Longer follow-up may be needed to assess an association between HU response and survival.Polycythemia vera (PV) is a rare blood cancer that causes an overproduction of blood cells. The aim of treatment is to reduce the number of blood cells and prevent blood clots. Hydroxyurea is a drug often used for treatment, but it does not work for all patients and the side effects can lead some patients to discontinue treatment. For this analysis, the authors looked at health records of almost 6000 patients with PV who were treated in community practices in the United States between 2008 and 2020. The study found that after 6 months of receiving hydroxyurea, blood cell numbers remained elevated in over half of the patients, indicating the treatment was inadequate. This finding suggests that patients with PV may need medication dosage adjustments, improved management of their treatment side effects, or alternative treatments sooner than is currently common. [ABSTRACT FROM AUTHOR]

The article explores the potential association between IL-25 and periostin serum concentrations with COVID-19 severity and recovery. IL-25 is linked to immune responses in the airways and may suppress immunity against respiratory viruses, while periostin is involved in tissue repair and remodeling. The study analyzed 51 COVID-19 patients in Poland and found that IL-25 levels were higher in severe cases, with a positive correlation to inflammatory markers. Decreases in IL-25 and periostin levels were observed during recovery, suggesting they may serve as prognostic factors. Further research is needed to confirm their clinical significance. [Extracted from the article]

Background: Attention is increasingly paid to length of stay (LOS) in neonatal intensive care units (NICUs) across countries. Few published data on neonatal LOS exist in Africa, where there is a high burden of neonatal morbidity and mortality. Thus, this study investigated the factors associated with neonatal LOS in the NICU of Gadarif Hospital, Eastern Sudan. Methods: A hospital-based retrospective study was conducted at Gadarif Hospital in Eastern Sudan from May to December 2020. Sociodemographic, maternal, and neonatal data were obtained from the hospital records. Poisson regressions were used to determine the adjusted relative risk (aRR) values and 95.0% confidence intervals (CIs). Results: This study enrolled 333 neonates admitted to the NICU and discharged alive. The median (interquartile range [IQR]) of maternal age and parity was 27.0 (23.0‒30.0) years and 3 (2‒5), respectively. Of the 333 neonates, 160 (48.0%) were males; 136 (40.8%) were delivered via cesarean section; 258 (77.5%) had low Apgar scores, and 74 (22.2%) had birth asphyxia. There were 140 (42.0%) low birth weight (LBW) neonates and 133 (39.9%) preterm neonates. The LOS range was 1–29 days (mean = 5.1 days), and its median (IQR) was 4 (2‒7) days. The multivariate Poisson analysis showed that increasing maternal age (aRR = 1.02, 95% CI = 1.01‒1.05), LBW (aRR = 1.48, 95% CI = 1.16‒1.90), preterm delivery (aRR = 1.27, 95% CI = 1.01‒1.61), a low Apgar score (aRR = 1.32, 95% CI = 1.06‒1.42), and an increasing white blood cell (WBC) count (aRR = 1.001, 95% CI = 1.001‒1.002) were associated with LOS. Parity (aRR = 0.85, 95% CI = 0.80‒0.91) was inversely associated with LOS. However, neonatal jaundice and mode of delivery were associated with LOS only in the univariate analysis. Conclusion: Increasing maternal age, preterm newborn, LBW, and a low Apgar score prolonged the LOS in this region of Sudan. Healthcare providers could leverage these identified factors to predict extended neonatal LOS in Eastern Sudan, enabling proactive interventions to enhance neonatal outcomes. [ABSTRACT FROM AUTHOR]

Simple Summary: Feline Panleukopenia (FPL) caused by feline panleukopenia virus (FPV), a DNA virus from genus Protoparvovirus, family Parvoviridae, is a highly contagious infectious disease of cats, often fatal, characterized by acute severe enteritis, vomiting, depression, dehydration and reduction in circulating white blood cell count. Given the low rate of survival, the lack of a specific antiviral drugs against FPV and the severe decrease in circulating white blood cell count resulting in immunosuppressed cat patients, over the years, several drugs were proposed and tested in order to find a cure. However, a promising human drug, represented by a granulocyte colony-stimulating factor (G-CSF), filgrastim, respectively, was tested and adapted in veterinary medicine therapy. The use of this hG-CSF in FPV cases from our study was demonstrated to be effective, providing evidence for its safe use. Human granulocyte colony stimulating factor represented by filgrastim should be regarded as a promising therapeutic option in cats diagnosed with FPL. Feline Panleukopenia (FPL) infection is caused by feline panleukopenia virus (FPV), and it is considered one of the most severe cat's infectious diseases. Since there is no specific antiviral treatment for FPL, the therapeutic protocol usually is focused on fluid therapy and supportive care. However, filgrastim, a granulocyte colony-stimulating factor (G-CSF) used in human medicine to treat neutropenia and leukopenia, has been lately used in treating FPV disease, providing promising results. During January 2022 and September 2024, twenty-two cats diagnosed with feline panleukopenia virus were subjected to filgrastim (Zarzio®, Sandoz, Kundl, Austria) administration at a dose of 6 µg/kg for 3 consecutive days. The 4th day was a break day, and in the 5th day, the complete blood count was repeated. White blood cells, lymphocytes, monocytes, neutrophils and eosinophils parameters improved after Zarzio® administration, with a significant statistical difference (p < 0.01) when their values between day 1 (pre Zarzio® administration) and day 5 (post Zarzio® administration) were analysed. However, red blood cells, haemoglobin, haematocrit and platelets parameters registered a considerable reduction from day 1 to day 5 with a significant statistical difference (p < 0.01), considered as post-administration side effects. In our study, the survival rate following Zarzio® administration was 100%, suggesting that the protocol involving three doses is effective in restoring the leukopenia and neutropenia. [ABSTRACT FROM AUTHOR]

Simple Summary: Nasal adenocarcinoma is the second most common nasal tumor in cats, and radiotherapy (RT) is a common treatment. Ki-67, a prognostic marker in human cancers treated using RT, was investigated in this retrospective study of 19 cats with nasal adenocarcinoma that had been treated using hypofractionated RT. Based on the results, white blood cell counts were significantly higher before treatment than after. Cats with a favorable response to treatment had significantly longer survival times than those with a poor response. Additionally, cats with high Ki-67 expression had significantly longer survival times than those with lower Ki-67 levels. Ki-67 has been reported as a prognostic marker in human cancers treated using RT. The current study investigated the prognostic significance of Ki-67 expression and its association with clinicopathological characteristics in 19 cats diagnosed with nasal adenocarcinoma and treated using hypofractionated RT. Data collected encompassed signalment, clinical signs, clinicopathological variables, treatment outcomes, and survival times. Median survival times (MST) were estimated using Kaplan–Meier curves and analyzed based on the log-rank test. Based on the results, white blood cell counts were significantly (p < 0.001) higher before treatment than after, although this was not associated with survival time. The overall MST was 550 days (range: 56–1118 days). Cats achieving a favorable response (complete or partial response) had significantly (p = 0.006) longer survival times (1055 days) than those with a poor response (stable or progressive disease; 369 days). Cats with high Ki-67 expression had significantly (p = 0.028) longer survival times (1055 days) than those with low Ki-67 expression (256 days). These results suggested that Ki-67 may be a potential prognostic factor for feline nasal adenocarcinoma. [ABSTRACT FROM AUTHOR]

The article discusses the treatment of polycythaemia vera (PV) with ropeginterferon alfa-2b, focusing on the molecular remission and complete haematological response achieved in patients. The study enrolled 49 patients in China, all carrying the JAK2V617F mutation, and demonstrated a significant reduction in JAK2V617F allele burden over 24 months of treatment. Ropeg treatment at a higher initiating dose regimen showed strong anti-neoplastic effects, leading to durable complete molecular remission and favourable safety outcomes in patients with PV. The study was conducted ethically and with patient consent, with data availability upon request. [Extracted from the article]

Background: Podoconiosis is a geo-chemically induced, non-infectious, familial, chronic lymphedema of the legs that occurs among barefoot people in rural, farming communities with extreme poverty. Despite a growing body of research surrounding the disease, the pathogenesis of the disease is relatively unknown. This study aims to investigate the immunological and hematological profiles of individuals affected by podoconiosis in comparison to healthy controls. Methodology/Principal findings: A comparative cross-sectional study was conducted in West Gojjam Zone of Ethiopia involving adult individuals clinically diagnosed with podoconiosis (n = 53) and healthy controls (n = 67) from the same area. A survey was conducted to gather information on sociodemographic, lifestyle characteristics, and clinical features of the disease. About nine ml whole blood samples were collected for hematological and immunological testing, which included IL-4, TNF-α, IL-6, IL-17, IL-10, TGF β and IFN-γ. Overall, we observed significant differences in hematological parameters between individuals with podoconiosis and healthy controls. Specifically, we found a notable reduction in white blood cell count, with an adjusted mean difference (AMD) of -1.15 (95% CI: -2.09 to -0.21; p = 0.017). Additionally, the differential white blood count showed a decrease in absolute neutrophils (AMD = -3.42, 95% CI: -4.15 to -2.69; p < 0.001) and absolute eosinophils (AMD = -0.20, 95% CI: -0.37 to -0.03; p = 0.019). Conversely, we noted an increase in absolute lymphocytes (AMD = 0.98, 95% CI: 0.50 to 1.46; p < 0.001) and monocytes (AMD = 0.54, 95% CI: 0.22 to 0.85; p = 0.001). However, we didn't observe a significant difference in cytokine profile between podoconiosis patients and healthy controls Conclusions/Significance: The decrease in neutrophil counts among podoconiosis cases compared to healthy controls may provide insight into the potential disease pathogenesis, suggesting the involvement of autoimmune-related mechanisms, as it demonstrates a similar hematological profile to other autoimmune disorders. Author summary: Podoconiosis, a non-infectious form of elephantiasis, is a neglected tropical disease whose immunopathology remains poorly understood. This study aimed to investigate the hematological and immunological aspects of podoconiosis. Our findings revealed significant hematological changes, particularly a reduction in absolute neutrophil counts in podoconiosis cases, which may suggest an autoimmune process. We hypothesize that chronic inflammation activates immune cells (lymphocytes, macrophages, or monocytes), which may contribute to the destruction of circulating neutrophils. We also found reduced hemoglobin levels in podoconiosis patients, possibly due to mechanisms such as hemolysis, iron sequestration, and cytokine-mediated inhibition of erythropoiesis. However, future mechanistic research is needed to confirm our observations and elucidate the role of reduced neutrophils in the pathogenesis of podoconiosis. [ABSTRACT FROM AUTHOR]

The letter to the editor published in "Leukemia & Lymphoma" discusses the case of a patient who transitioned from polycythemia vera (PV) to acute myeloid leukemia (AML) and the utility of next-generation sequencing (NGS)-based minimal residual disease (MRD) monitoring in post-myeloproliferative neoplasm AML. The study highlights the distinct molecular features of post-MPN AML compared to de novo AML and emphasizes the importance of NGS-based MRD monitoring in secondary AMLs. The case study challenges assumptions about germline variants based on variant allele frequency (VAF) stability and underscores the complexity of clonal evolution during disease progression. Further research is needed to validate the findings and hypotheses presented in the study. [Extracted from the article]

Since bacteremia complicates childhood Acute myeloid leukemia (AML) patients, we assessed bacteremia rates in Israeli children with de-novo AML. All chemotherapy courses of patients enrolled in NOPHO-DBH-2012 AML protocol were included. Down syndrome, acute promyelocytic leukemia were excluded. Among 69 patients, seven had focal bacterial infections. Of the remaining 62, 77.4% had 1–8 bacteremias. Of 238 chemotherapy courses, 98 (41.2%) had bacteremia: 66 (67.3%) predominantly Gram-negative rods (GNR); 28 (28.6%) Gram-positive cocci. Escherichia coli; followed by Klebsiella were most common. Older age, Arab ethnicity, and presenting white blood cell count were associated with an increased risk of bacteremia in the univariable analysis, but these associations were not confirmed in the multivariable analysis. Mortality was high (9.7%), and bacteremia increased PICU utilization 7-fold half from GNR. Most isolates were sensitive to vancomycin/meropenem (94.7%), but GNR had low sensitivity to quinolones (61.8%). High mortality and morbidity of de-novo AML patients from predominantly GNR bacteremia require specific interventions but limited susceptibility to quinolones hampers prophylaxis. [ABSTRACT FROM AUTHOR]

Organic acid salts can modulate fish growth performance and antioxidant/immune systems, thus they can be used as feed additives for intensive fish culture. Hence, this study investigated the effects of dietary sodium butyrate (NaB) supplementation on growth, antioxidant, immunological and stress indicators in common carp, Cyprinus carpio, reared at high stocking density. Three levels of dietary NaB (0, 1 and 2 g/kg) and two stocking densities [5 (L) and 10 (H) g/L, corresponding to 20 and 40 fish/aquarium, respectively] were combined to have six triplicate treatments: B0-L: 0 g/kg NaB + L; B1-L: 1 g/kg NaB + L; B2-L: 2 g/kg NaB + L; B0-H: 0 g/kg NaB + H; B1-H: 1 g/kg NaB + H; B2-H: 2 g/kg NaB + H. Fish (10.5 ± 0.17 g) were daily fed at a rate of 3% of biomass for eight weeks. The results showed that NaB contributed to stress mitigation by lowering plasma glucose levels and hepatic transaminases, while increasing plasma triiodothyronine levels. NaB boosted antioxidant capacity by increasing hepatic/intestinal superoxide dismutase, catalase and total antioxidant capacity and lowering malondialdehyde levels. NaB supplementation increased blood leukocyte count, neutrophil percentage, alternative complement activity, mucosal/humoral immunoglobulin levels and mucosal/intestinal lysozyme activities. NaB improved growth performance and feed efficiency, likely due to a reduction in stress and energy expenditure and/or an improvement in overall gut and hepatopancreas health and function. Overall, the inclusion of 1 g/kg NaB in the feed is recommended for optimal health and growth performance of common carp kept at high stocking densities. [ABSTRACT FROM AUTHOR]

Microfluidic impedance flow cytometry has been widely used in leukocyte differential and counting, but it faces a bottleneck due to the trade-off between impedance detection throughput and sensitivity. In this study, a microfluidic impedance flow cytometer based on a virtual constriction microchannel was reported, in which the virtual constriction microchannel was constructed by crossflow of conductive sample and insulated sheath fluids with underneath micro-electrodes for impedance measurements. Compared to conventional mechanical constriction microchannels, this virtual counterpart could effectively avoid direct physical contact between cells and the microchannel walls to maintain high throughputs, and significantly reduce the volume of the impedance detection region for sensitivity improvements. Using the developed microfluidic impedance flow cytometer, impedance pulses of three leukemia cell lines, K562, Jurkat, and HL-60, were detected, achieving a 99.8% differentiation accuracy through the use of a recurrent neural network. Furthermore, impedance pulses of four white blood cell subpopulations (neutrophils, eosinophils, monocytes, and lymphocytes) from three donors were detected, achieving a classification accuracy of ≥99.2%. A classification network model was established based on purified white blood cell and applied to impedance pulses of two white blood cell mixtures, resulting in proportional distributions of four leukocyte subpopulations within theoretical ranges. These results indicated that the developed microfluidic impedance flow cytometer based on the virtual constriction microchannel could achieve both high detection throughput and high sensitivity, showing great potentials for clinical diagnostics and blood analysis. [ABSTRACT FROM AUTHOR]

Codonopsis pilosula polysaccharide (CPP) and rare element selenium (Se) have been proved to exert various biological activities, and our previous study demonstrated that selenium nanoparticles modified with CPP (CPP-SeNPs) possessed significantly enhanced tumor cytotoxicity in vitro. This study aimed to investigated the inhibitory effects of CPP-SeNPs complex on H22 solid tumors via immune enhancement. In this study, the H22 tumor-bearing mice model was constructed, and the potential mechanisms of CPP-SeNPs antitumor effects were further explored by evaluating cytokines expression levels, immune cells activities and tumor cells apoptotic indicators in each group. The results demonstrated that CPP-SeNPs effectively exerted dose-dependent protective effects on the immune organs of tumor-bearing mice in vivo, leading to increase in peripheral white blood cell counts and inhibition of solid tumor growth with inhibitory rate of 47.18% in high-dose group (1.5 mg/kg). Furthermore, CPP-SeNPs treatment significantly elevated the levels of TNF-α, IFN-γ, and IL-2 in mice sera, enhanced NK cell cytotoxicity, augmented macrophage phagocytosis capacity, as well as increased both the amounts and proliferation activity of lymphocyte subsets. CPP-SeNPs improved the immune system's ability to clear tumor cells by up-regulating Bax expression while down-regulating Bcl-2 expression within solid tumors, indicating the potential activation of mitochondrial apoptosis pathway. Therefore, CPP-SeNPs administration can effectively inhibit tumor growth by enhancing immune response in tumor-bearing mice, which might be relevant to the regulation of gut microbiota short-chain fatty acids metabolisms. These findings could provide theoretical support and data foundation for further development of CPP-SeNPs as functional food and drug adjuvants. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate ocular manifestations in patients with neurosyphilis and their association with general indexes. Methods: This retrospective study was conducted among patients who were hospitalized for neurosyphilis from 2012 to 2022. Clinical manifestations, laboratory tests, brain MRI, and ocular examinations were reviewed and analyzed. Results: A total of 106 neurosyphilis patients were included, of which 10 patients presented with ocular signs as their initial symptoms. The most common main complaint was reduced vision (6/10), followed by diplopia (2/10) and ptosis (2/10). The causes of vision loss included optic neuropathy (4/6) and posterior uveitis (2/6), with all six patients showing optic nerve involvement. A total of 29 (27.4%) patients exhibited pupil abnormalities. A lumbar puncture was performed on all 106 patients, and abnormal cerebrospinal fluid (CSF) findings were revealed in 101 (95.3%) patients, indicating central nervous involvement. The median white blood cell count in the CSF of the patients with pupil abnormalities was significantly higher than that of those without pupil abnormalities (14.0 vs. 6.0 cells/μl, p = 0.037). In addition, the patients with abnormal pupillary light reflex (PLR) were more likely to have multiple brain lesions compared to those with normal PLR (77.3% vs. 29.2%, p < 0.001). Conclusion: Optic nerve involvement is the main cause of vision loss in neurosyphilis. Patients with optic neuropathy or posterior uveitis should undergo prompt diagnostic evaluation for syphilis. Pupil abnormalities can serve as indicators of more severe CSF and MRI findings. [ABSTRACT FROM AUTHOR]

Background: Dachaihu decoction (Dachaihu tang) plays a crucial role in treating acute illnesses. Recently, a significant number of clinical studies on Dachaihu decoction for acute cholecystitis (AC) have been published. This study was conducted to assess the efficacy and safety of Dachaihu decoction in patients with this condition. Methods: To identify relevant randomized controlled trials (RCTs), eight databases and three clinical trial registries were searched from inception to 30 June 2024. Two researchers independently screened and extracted data from eligible studies using EndNote X9 and Microsoft Office Excel 2019. RoB 2.0 was used to assess the risk of bias in the included studies. Stata 17.0 was used for data analysis. Publication bias and its impact on result stability were evaluated using a funnel plot and the "trim-and-fill" method. The quality of evidence was graded using the GRADE assessment system. Results: Thirty-three RCTs involving 2,851 participants were included. The treatment group demonstrated improved clinical efficacy (RR = 1.18; 95% CI = 1.13 to 1.24), significantly reduced length of hospital stay (MD = −1.78 days; 95% CI = –2.02 to −1.53), and the incidence of adverse events (RR = 0.31; 95% CI = 0.20 to 0.48). Additionally, there appeared to be reductions in the time for abdominal pain to resolve (MD = −1.92 days; 95% CI = –2.33 to −1.51), fever to disappear (MD = −1.52 days; 95% CI = –1.90 to −1.14), white blood cell count to return to normal (MD = −2.89 days; 95% CI = –3.32 to −2.46), alanine aminotransferase (ALT) levels (MD = −11.88 U/L; 95% CI = –15.29 to −8.47), aspartate aminotransferase (AST) levels (MD = −8.74 U/L; 95% CI = –9.76 to −7.72), neutrophil percentage (MD = −9.68; 95% CI = –11.33 to −8.03), TNF-α levels (SMD = −2.10 pg/L; 95% CI = –2.43 to −2.78), and certainty of evidence (moderate-to-low certainty). Conclusion: Dachaihu decoction may be an effective botanical formula for managing AC and a lower incidence of adverse events. However, due to the substantial risk of bias and heterogeneity across the included studies, these findings should be interpreted with caution and require further validation through well-designed, high-quality trials. Systematic Review registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=573332. [ABSTRACT FROM AUTHOR]

Background: Intestinal epithelial barrier dysfunction is intricately linked to the pathogenesis of ulcerative colitis (UC). Dietary interventions that bolster intestinal epithelial barrier function can effectively thwart UC onset. Our prior research revealed that p-Hydroxy benzaldehyde (HD), a phenolic compound from Nostoc commune (an edible cyanobacterium), markedly upregulated the expression of E-cadherin, a pivotal protein in intestinal mucosa, thereby mitigating mucosal damage in mice afflicted with dextran sulfate sodium (DSS)-induced colitis. Nevertheless, the precise molecular mechanisms underpinning HD's ameliorative effects on intestinal epithelial barrier dysfunction remain elusive. Methods: Dextran sodium sulfate (DSS)-induced colitis mouse model was established, and the successful establishment of the model was determined by evaluating the changes in body weight, disease activity index (DAI), colonic histopathology, and white blood cell count. Transmission electron microscopy (TEM) observed the ultrastructural changes of intestinal villi. The levels of inflammatory factors (IFN-γ IL-13) and intestinal permeability indicators (FITC-Dextran, DAO, ET, and D-LA) were detected by Enzyme-linked immunosorbent assay (ELISA). Western blotting (WB) and immunohistochemistry (IHC) were used to detect the expression of intestinal barrier integrity-related factors such as tight junction protein TJs (ZO-1, occludin) and adhesion junction protein AJs (E-cadherin). Furthermore, WB, Pull-down assay, drug affinity reaction target stability (DARTS) assay, molecular docking and molecular dynamics (MD) simulation were used to determine the potential target and molecular mechanism of HD. Results: HD intervention significantly alleviated the symptoms of colitis mice, inhibited the weight loss and colon shortening, reduced DAI score and colon pathological score, maintained the ultrastructure of intestinal villi in colon tissue, and significantly reduced the inflammatory factors IFN-γ, IL-13 and the number of white blood cells in colon tissue of colitis mice. HD could also reduce the levels of FITC-Dextran, DAO, ET, and D-LA and increase the expression of ZO-1, occludin, and E-cadherin in the colonic tissues of colitis mice, thereby maintaining the impaired intestinal barrier function caused by colitis. Mechanically, HD augmented the expression of hepatocyte nuclear factor 1β (HNF-1β) and DRA. Adeno-associated virus (AAV)-HNF-1β shRNA or Lentivirus-mediated HNF-1β knockdown effectively abolished HD-induced intestinal barrier protection, as well as the promotion of solute carrier family 26 member 3 (SLC26A3) expression levels. SLC26A3 siRNA effectively reversed the inhibition of intestinal permeability by HD. Pull-down assay, DARTS analysis, molecular docking, and MD results showed high binding strength, interaction efficiency and remarkable stability between HNF-1β and HD. Conclusion: This study elucidates HD's role in forestalling intestinal epithelial barrier disruption under colitis conditions. Mechanistic investigations revealed that HD fortifies TJs and AJs expression via the HNF-1β/SLC26A3 pathway, thus preserving the lower intestinal epithelial barrier's integrity in UC. [ABSTRACT FROM AUTHOR]

Background: Predicting the survival time of patients at the end of life can provide more accurate treatment and care programs for patients. The purpose of this study was to investigate the factors impacting 14-day survival at the end of life. Method: This was a retrospective study. Patients with advanced cancer admitted to the Department of Palliative Medicine in a tertiary hospital in China in 2021 were included and classified into group A (survival time ≤ 14 days) or group B (survival time > 14 days). Patient demographic characteristics, palliative performance scale (PPS) scores, Barthel index scores, Fracture Risk Assessment Scale (FRAIL) scale scores, clinical features and laboratory test results were extracted from medical records. Univariable and multivariable logistic regression analyses were used to identify predictors of death within 14 days. Survival time was compared between frail and nonfrail patients. Results: A total of 261 patients were included (122 in group A and 139 in group B), with a median survival time of 17 (13.04, 20.96) days. There were significant differences in age, FRAIL score, PPS, Barthel index, dyspnea, edema, C-reactive protein and white blood cell count between the two groups. According to the multivariable logistic regression analysis, the PPS could predict the risk of death within 14 days (OR = 6.818, 95% CI = 3.944–11.785, p < 0.001). The median survival time was 48 (33.71, 62.29) days in the nonfrail group (n = 34) and 15 (12.46, 17.54) days in the frail group (n = 227) (p < 0.001). Conclusions: A lower PPS increases the risk of 14-day mortality in patients at the end of life. Frailty may shorten the survival time of patients at the end of life. [ABSTRACT FROM AUTHOR]

In recent years, zinc oxide nanoparticles (ZnO NPs) have gained attention as feed additives due to their high bioavailability. However, research on their impact on fish growth and health is limited. To investigate the influences of dietary addition of ZnO NPs on growth performance and immune function of rare minnow, rare minnows were fed diets with different ZnO NPs content. Growth analysis showed that ZnO NPs had a negative effect on the weight of rare minnow, decreasing and then increasing condition factors (CFs) and specific growth rate. Additionally, the accumulated zinc (Zn) level was significantly higher (p < 0.05), and the liver injury index was significantly higher (p < 0.05) in the dietary ZnO NPs group compared to the control group. The number of erythrocytes and leukocytes in blood samples increased and then decreased after treatment with ZnO NPs. It was further found that ZnO NPs as a dietary supplement significantly increased the Zn content and markedly repressed the expression of growth‐related genes after 60 days of accumulation in muscle tissues, and accumulation in liver tissues for 60 days significantly enhanced the expression of immune modulation–related genes expression (p < 0.05). The findings suggested that short‐term supplementation of ZnO NPs could positively affect fish growth and immune function. However, prolonged supplementation of dietary ZnO NPs resulted in reduced body weight and compromised immune function owing to the buildup of Zn in different tissues. [ABSTRACT FROM AUTHOR]

Background: There is little information about the risk of drug-induced QT prolongation by remdesivir as the most important FDA approved anti COVID-19 drug. Prolongation of corrected QT interval (QTc) is considered as an indicator of an unfavorable outcome which may ultimately induce torsade de pointes and provoke ventricular fibrillation. The aim of this study was to determine the effects of remdesivir on QTc in patients with severe COVID 19 disease. Methods: A historical cohort study was conducted on 249 patients who experienced severe COVID-19 disease and were candidate for treatment by intravenous remdesivir. We obtained a 12 lead electrocardiogram at the admission time and five days later to find any significant change in QTc and QT interval following therapy. We took blood samples at the time of hospitalization and then every day to determine the serum levels of electrolytes, complete blood count, fasting blood sugar (FBS), creatinine (Cr), and complete blood count. Results: The results of this analysis showed blood pressure and heart rate (HR) were lower and total white blood cells and neutrophil counts, FBS and Cr levels were higher at fifth day than first day of study (P value < 0.001). Furthermore, QT interval was more prolonged at fifth day compared with beginning of remdesivir therapy (379.51 ± 34.90ms vs. 366.72 ± 30.97ms, P value < 0.001). However, QTc was not significantly increased at fifth day in comparison with first day (402.37 ± 33.62ms vs. 400.76 ± 30.18ms, P value = 0.524 by Bazett's formula and 402.81 ± 36.33 vs. 400.78 ± 32.49, P value = 0.459 by Fridericia's formula). Conclusions: The current study found no evidence linking the administration of remdesivir with prolongation of the QTc interval. [ABSTRACT FROM AUTHOR]

To evaluate the clinical efficacy and safety of oral versus intravenous macrolide antibacterials in managing pediatric pneumonia attributable to Mycoplasma pneumoniae (MP), we conducted a retrospective analysis of clinical data from 100 pediatric patients treated in our pediatric outpatient and inpatient departments between January 2020 and August 2023. These patients were divided into two groups based on the method of antibiotic administration: one oral group (n = 50) and one intravenous group (n = 50). The oral group received either azithromycin or clarithromycin, while the intravenous group received azithromycin or roxithromycin, both at a dosage of 10 mg/kg/d, for a continuous treatment duration of 3-7 d. We compared various clinical parameters, including clinical features, body temperature, white blood cell count, C-reactive protein levels, improvement in chest radiography, recovery time, overall efficacy rate, and incidence of adverse reactions before and after treatment in both groups. Our results reveal ed no statistically significant differences in clinical features, laboratory test results, or chest radiographic manifestations between the two groups before treatment (P > 0.05). Following treatment, significant reductions in body temperature, white blood cell count, and C-reactive protein levels were observed in both groups. Additionally, chest radiographic improvement was noted in 100% of cases, with shortened recovery times and an overall efficacy rate of 100%, demonstrating no significant difference between the groups (P > 0.05). The incidence of adverse reactions was 6% in the oral group and 8% in the intravenous group, primarily consisting of mild gastrointestinal reactions. No severe adverse reactions were reported, and the difference in incidence between the groups was not statistically significant (P > 0.05). Our study underscored the comparable clinical efficacy and safety of oral and intravenous macrolide antibiotics in treating pediatric pneumonia caused by MP. Considering its convenience and cost-effectiveness, oral administration emerged as a favorable treatment option. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to determine the mechanism of action of Pithecellobium dulce aqueous extract on Jatropha oil-induced hemorrhoidal disease in rats. Methods: 36 Wistar rats were divided into 6 groups of 6 animals, including 3 controls (normal, negative and positive) and 3 tests groups. Hemorrhoidal disease was induced with Jatropha oil (100 μL) for 5 days in all animals except the normal control group. Recto-anal coefficient, hemorrhoidal permeability, hematological parameters, oxidative stress parameters and inflammatory cytokines were evaluated. Results: Quantitative phytochemistry and in-vitro anti-inflammatory and anti-radical activity of the extract were determined. Extract of P. dulce at doses of 100, 200 and 400 mg/kg significantly (p ˂ 0.01) reduced recto-anal coefficient, prostaglandin E2 (PGE2), TNF-α, IL-6, nitric oxide (NO) and C-reactive protein (CRP) concentrations, accompanied by a significant (p < 0.001) increase of IL-5 and IL-10. Extract of P. dulce at different doses significantly reduced leukocyte and platelet counts and increased erythrocyte and hematocrit levels. Extract of P. dulce also significantly (p < 0.05, p < 0.01 and p < 0.001) increased superoxide dismutase (SOD), catalase (CAT) and reduced glutathione (GSH) activities and significantly (p < 0.001) decreased malondialdehyde (MDA) levels. Extract of P. dulce was able to trap DPPH (2,2-Diphenyl-2-picrylhydrazyl) radicals (64.9%) and ABTS (2,2'-azinobis-3-ethylbenzothiaoline-6-sulfonic acid) radicals (69.1%), as well as a high iron reducing power (FRAP) of 56.2% and the 50% inhibitory concentration (IC50) of the ABTS radical was 150 μg/mL compared to the butylhydroxytoluene (BHT) control (130μg/mL). In addition, extract of P. dulce showed high concentrations of polyphenols, flavonoids and saponins. Conclusion: extract of P. dulce possesses anti-hemorrhoidal properties via mechanisms involving vasoconstriction, alongside enhancement of anti-inflammatory and antioxidant status. [ABSTRACT FROM AUTHOR]