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Background: Prognostic nutritional index (PNI) could be used to evaluate the immuno-nutritional status. There is a possible association between nutritional and inflammatory indices and acute kidney injury (AKI) among critically ill patients. This research aimed to investigate the relationship between PNI and all-cause mortality among critically ill patients with AKI.Methods:Sixty-nine patients with AKI who were at the intensive care units of Zagazig University hospitals in this prospective observational study were classified regarding outcome into (nonsurvivors): 25 patients who died (36.2%) and (Survivors): 44 (63.8%) patients who recovered. The CBC, CRP, Albumin, Serum Creatinine and Pelvi-abdominal ultrasound were assessed in all patients in addition to the calculation of PNI.Results: Statistically significant positive correlations were revealed between PNI and total protein, serum calcium, C reactive protein and potassium (p<0.001, <0.001, 0.026, and 0.004). Among factors significantly related to mortality in univariate analysis, increasing white blood cell count and high APACHE II score independently increase mortality risk by 1.211 and 4.763 folds, respectively. Total protein (unstandardized ß=2.111, p=0.001), calcium (unstandardized ß=1.158, p=0.006), and CRP (unstandardized ß=0.009, p=0.038), significantly independently associated with PNI. The phosphorus level (unstandardized ß=1017.1, p=0.002) is significantly independently associated with the inflammatory index. Conclusion: PNI and SII were comparable between died and survivors among Critically Ill Patients with AKI however, Neutrophil/lymphocyte ratio was significantly higher among died patients compared to survivors.PNI and SII still could be significant risk factors associated with increased mortality. [ABSTRACT FROM AUTHOR]

Problem: This study aims to evaluate the effectiveness of inflammation indexes (systemic immune‐inflammation index [SII], systemic inflammation response index [SIRI], pan‐immune inflammation value [PIV], and neutrophil‐to‐lymphocyte ratio [NLR]) in the diagnosis of intrahepatic cholestasis of pregnancy (ICP). Method of Study: A retrospective study was conducted, reviewing medical records of patients diagnosed with ICP who delivered between October 1, 2022, and May 31, 2023, at the Perinatology clinic of Etlik City Hospital, Ankara. A control group of healthy pregnant women with uncomplicated pregnancies was also included. Demographic data, clinical characteristics, and laboratory results, including systemic inflammation indices and liver enzyme levels, were collected and analyzed. Results: A total of 242 participants were included, with 121 ICP patients and 121 controls. White blood cell count, neutrophil count, and monocyte count showed significant differences between the two groups (p = 0.011, p = 0.004, and p = 0.039, respectively). Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were significantly elevated in the ICP group (p < 0.001 for both). SII and NLR were higher in the ICP group compared to controls (p = 0.032 and p = 0.010, respectively). Receiver operating characteristic (ROC) analysis revealed moderate predictive values for SII (area under the curve [AUC] = 0.581, p = 0.030) and NLR (AUC = 0.598, p = 0.009), with no significant difference in their predictive power (p = 0.502). Conclusions: Systemic inflammation indices such as SII and NLR offer a cost‐effective and rapid means of diagnosing ICP, potentially complementing or surpassing traditional biomarkers like bile acid levels and liver function tests (LFTs). These indices can be easily integrated into routine clinical practice, providing timely intervention to improve maternal and fetal outcomes. Further research is warranted to confirm these findings and establish standardized protocols for their use in ICP management. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to investigate the relationship between systemic inflammatory index and various clinical and microbiological factors in patients with malignant otitis externa (MOE). Materials and Methods: In this retrospective study, patients diagnosed with MOE and treated between January 2017 and March 2023 were examined. The data include clinical evaluations, laboratory tests, and imaging results. All patients underwent computed tomography of the temporal bone, and MOE was staged according to Tengku's radiological classification Sil was calculated using neutrophil, platelet, and lymphocyte counts. Results: 11 patients were examined retrospectively, including 8 males (72.7%) and 3 females (27.3%). The mean age of the patients was 72.3±7.5 years. Comorbidities such as Diabetes Mellitus (DM) and Chronic Kidney Disease (CKD) were associated with higher Sil values. CT phases and cranial nerve involvement were also related to high Sil values. Microbiological analyses showed that pathogens such as Pseudomonas aeruginosa and Candida tropicalis were associated with high Sil values. Conclusion: Sil is an important biomarker in evaluating the prognosis and treatment response in MOE. Early diagnosis, a multidisciplinary approach, and personalized treatment strategies are critical in managing MOE. Further studies involving larger patient groups will contribute to validating these relationships and improving treatment processes. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate the clinical and prognostic associations of the systemic inflammatory index (SII) in polycythemia vera (PV) patients. SII integrates information on absolute neutrophil (ANC), lymphocyte (ALC), and platelet counts into one index (calculated as ANCxALC/platelet count) and was previously shown to predict thrombotic and mortality risks in the general population. Methods: A total of 279 PV patients treated in several hematologic centers in Croatia and Serbia was retrospectively evaluated. Results: The median SII for the overall cohort was 1960. Higher SII stratified at the specific cut-off points was significantly associated with shorter time to thrombosis (TTT; p = 0.004) driven by arterial thrombotic events, and shorter overall survival (OS; p < 0.001). Higher SII was able to refine the European Leukemia Net-defined high-risk patient subgroup for both thrombotic and survival risks, especially in individuals over 60 years of age. SII and all other evaluated CBC components and indices (leukocytes, ANC, ALC, platelets, neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR)) demonstrated low-to-modest prognostic properties, whereas SII outperformed other parameters with respect to TTT and OS prognostications. Discussion: The presented results complement prior studies evaluating the prognostic performance of different CBC components for thrombotic and survival risk predictions and offer more options to personalize PV treatments. [ABSTRACT FROM AUTHOR]

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

Background: systemic inflammation disorders were observed in chronic kidney disease (CKD). Whether the systemic inflammatory indicators could be optimal predictors for the survival of CKD remains less studied. Methods: In this study, participants were selected from the datasets of the National Health and Nutrition Examination Survey (NHANES) between 1999 to 2018 years. Four systemic inflammatory indicators were evaluated by the peripheral blood tests including systemic immune-inflammation index (SII, platelet*neutrophil/lymphocyte), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR). Kaplan-Meier curves, restricted cubic spline (RCS), and Cox regression analysis were used to evaluate the association between the inflammatory index with the all-cause mortality of CKD. Receiver operating characteristic (ROC) and concordance index (C-index) were used to determine the predictive accuracy of varied systemic inflammatory indicators. Sensitive analyses were conducted to validate the robustness of the main findings. Results: A total of 6,880 participants were included in this study. The mean age was 67.03 years old. Among the study population, the mean levels of systemic inflammatory indicators were 588.35 in SII, 2.45 in NLR, 133.85 in PLR, and 3.76 in LMR, respectively. The systemic inflammatory indicators of SII, NLR, and PLR were all significantly positively associated with the all-cause mortality of CKD patients, whereas the high value of LMR played a protectable role in CKD patients. NLR and LMR were the leading predictors in the survival of CKD patients [Hazard ratio (HR) =1.21, 95% confidence interval (CI): 1.07-1.36, p = 0.003 (3rd quartile), HR = 1.52, 95%CI: 1.35-1.72, p<0.001 (4th quartile) in NLR, and HR = 0.83, 95%CI: 0.75-0.92, p<0.001 (2nd quartile), HR = 0.73, 95%CI: 0.65-0.82, p<0.001 (3rd quartile), and = 0.74, 95%CI: 0.65-0.83, p<0.001 (4th quartile) in LMR], with a Cindex of 0.612 and 0.624, respectively. The RCS curves showed non-linearity between systemic inflammatory indicators and all-cause mortality risk of the CKD population. Conclusion: Our study highlights that systemic inflammatory indicators are important for predicting the survival of the U.S. population with CKD. The systemic inflammatory indicators would add additional clinical value to the health care of the CKD population. [ABSTRACT FROM AUTHOR]

Ulcerative colitis is a chronic idiopathic disease that causes inflammation of the colon and rectum, progressing with relapses and remissions. Systemic inflammatory index (SII) and pan-immune inflammatory value (PIV) are newly developed biomarkers. There are many studies in the literature showing the relationship between SII and PIV with malignancies and inflammatory diseases. In this study we aimed to determine the relationship between SII and PIV with the activity of ulcerative colitis. 146 Ulcerative colitis patients were retrospectively investigated by the time of diagnosis based on clinical, endoscopic and histolopathological findings. Patients and healthy individuals SII and PIV levels were calculated and compared with each other; and Mayo, DUBLIN, UCIES endoscopic subscores of patients were also obtained. Roc curve analysis were used to determine the cut-off value for PIV SII (468.6 ± 203.5 vs. 823.1 ± 555.1; p <.001), PIV (288.2 ± 159.9 vs. 912.2 ± 924.1; p <.001), were statistically different between groups. PIV (OR: 1.157; (1.041–1.432), p =.036), was also observed to be the independent predictor of ulcerative colitis. The best cut off value of PIV in the prediction of ulcerative colitis was ≥ 506 with 89.6% sensitivity and 63.7% specificity (AUC = 0.812; 95% CI 0.763–0.854, p <.001). Based on the results of our study, we found that SII and PIV levels were significantly increased in ulcerative colitis patients at the time of diagnosis and were associated with disease severity in the endoscopic scores RACHMILEWITZ, UCEIS and DUBLIN scores, but not for MES score. [ABSTRACT FROM AUTHOR]

Purpose: The overwhelming inflammatory response plays a critical role in the secondary injury cascade of traumatic spinal cord injury (tSCI). The systemic immune inflammatory index (SII) and systemic inflammatory response index (SIRI) are two novel inflammatory biomarkers. The SII was calculated based on lymphocyte, neutrophil, and platelet counts, while the SIRI was calculated based on lymphocyte, neutrophil, and monocyte counts. Their prognostic value in patients with tSCI remains unclear. Methods: Patients with tSCI admitted within 24 h of trauma were retrospectively and consecutively enrolled. Peripheral blood samples were collected on admission. The primary outcome was American Spinal Injury Association Impairment Scale (AIS) grade conversion at discharge. Multivariable logistic regression analysis was performed to determine the relationship between SII and SIRI and AIS grade conversion. We performed receiver operating characteristic curve (ROC) analysis to assess the discriminative ability of SII, and SIRI in predicting AIS grade conversion. Results: Among 280 included patients, 77 (27.5%) had improved AIS grade conversion at discharge. After adjustment for confounders, SII was independently associated with AIS grade conversion (per SD, odds ratio [OR], 0.68; 95% confidence interval [CI] 0.47–0.98, p = 0.040), while the association between SIRI and AIS grade conversion was insignificant (per 1 SD, OR, 0.77; 95% CI 0.55–1.08, p = 0.130). The ROC analysis revealed that the SII had the best predictive value for AIS grade conversion (area under curve: 0.608, 95% CI 0.536–0.678). Conclusions: Increased SII was independently associated with a decreased likelihood of improved AIS grade conversion. [ABSTRACT FROM AUTHOR]

Introduction: The main challenge to the optimal use of neoadjuvant chemotherapy (NAC) is the difficulty in selecting patients who may or may not benefit from NAC. Our aim in this study was to investigate whether the Systemic Inflammatory Index (SII) predicts response to chemotherapy in patients who receive NAC prior to cystectomy. Methods: We retrospectively analysed the data of patients who underwent NAC followed by cystectomy at our institution between January 2010 and September 2015 and whose 5-year follow-up was completed. All patients who underwent diagnostic biopsy with complete transurethral resection of bladder tumour at our hospital and whose pathology result was muscle-invasive transitional cell carcinoma were included in the study. At least 3 courses of gemcitabine/cisplatin NAC were given to all patients. A pathological response was defined as a reduction in cystectomy to a lower pathological stage after NAC. Results: The SII was 320.8 ± 51 in the responders and 388.28 ± 50 in the non-responders. SII optimal cut-off of 350 was determined. The sensitivity and specificity of SII in predicting response were found to be 80% and 83%, respectively. Low SII (<350) was found to be a significant predictor of response compared with the other factors on multivariate analysis. The mean overall survival time was 55.4 months in patients with a low SII value and 40.3 months in the high SII group. Conclusion: SII, together with known clinicopathological factors and newer genetic and molecular markers, can be used to select patients for NAC. [ABSTRACT FROM AUTHOR]

Problem: We aimed to investigate the predictive value of delta neutrophil index (DNI) for histological choriomanionitis (HCAM) and the effect of maternal inflammatory markers on neonatal outcomes and fetal inflammatory parameters. Method of Study: In this retrospective cross‐sectional study, 68 pregnant women without HCAM (group 1) and 46 pregnant women diagnosed with HCAM (group 2) were divided into two groups. Demographic stories of the groups; maternal hematological parameters; maternal DNI and systemic inflammatory index (SII) values; outcomes of newborns; fetal inflammatory markers were recorded and compared between groups. Results: Maternal DNI, and SII levels were significantly higher in group 2 (p value <.05 for all). Admission to the neonatal unit (NICU) was higher in group 2 than in group 1 (p =.0001). We found that fetal inflammatory markers were significantly higher in group 2 (p values.001 for CRP,.0001 for DNI, and.002 for leukocyte). Maternal DNI was determined to be significantly diagnostic at a value of ≥1.3 in HCAM (p =.001). We observed that SII had a significant predictive value of 953036.6 (p =.019) for NICU admission. There is also a positive correlation between fetal inflammatory markers and maternal inflammatory markers. Conclusions: We found that maternal inflammatory markers are high in HCAM, maternal DNI can predict patients who will develop HCAM, maternal SII value can predict NICU admission, fetal inflammatory markers are high in HCAM, and these markers are affected by maternal inflammatory markers. [ABSTRACT FROM AUTHOR]

Introduction: Blood loss is a common complication during percutaneous nephrolithotomy (PCNL), and may be severe enough to require a blood transfusion. Objective: To determine the risk factors associated with bleeding in PCNL. Method: Descriptive, retrospective, cross-sectional and observational study carried out in patients before and after undergoing PCNL in the period from August 2019 to October 2022. An analysis was performed using ROC curves. Results: Of 103 patients who underwent PCNL, 33 were men and 70 were women, and the mean age was 52.7 ±13.4 years. A total of 84 procedures were performed in supine decubitus and 19 in prone decubitus, which was related to a higher risk of bleeding (p = 0.015). The SII presented a higher AUC and specificity than the INL and LPI indexes. Regarding the complexity of the renal calculus, the CROES presented higher sensitivity and specificity when compared to the STONE classification. Conclusions: The SII and the LPI do correlate with bleeding, so they are independent risk factors for significant blood loss and can be used to predict bleeding, provided that the clinical picture is analyzed individually for each patient. [ABSTRACT FROM AUTHOR]

Objective: To determine the prognostic role of systemic inflammatory markers for Stage I epithelial ovarian cancer (EOC). Materials and Methods: We performed a retrospective, single‐center, observational study. We included patients with Stage I EOC cancer undergoing primary surgery between 1993 and 2016. Inflammatory markers were assessed by analyzing blood samples collected at initial diagnosis before EOC surgery. We evaluated these markers' association with disease‐free survival (DFS) and cancer‐specific survival (CSS). Results: We included 176 women in our study. The neutrophil‐to‐lymphocyte ratio (NLR), platelet‐to‐lymphocyte ratio (PLR), and systemic immune inflammation index (SII) were related to both DFS and CSS in the univariate analysis. In the multivariate Cox analysis, adjuvant chemotherapy (hazard ratio [HR] 0.17, 95% confidence interval [CI] 0.04–0.71, P = 0.02) and SII ≥730 (HR 6.84, 95% CI 1.30–35.9, P = 0.023) were independent predictors of DFS, while FIGO Stage IB–IC (HR 7.91, 95% CI 1.04–59.8, P = 0.04), NLR ≥3 (HR 56.8, 95% CI 7.46–433, P < 0.001) and PLR ≥169 (HR 49.1 95% CI 11.1–217.8, P = 0.005) were independent predictors of CSS. Conclusions: Systemic inflammatory markers are easily obtainable from patients' routine blood analyses and may represent inexpensive and reproducible prognostic markers in early‐stage EOC. Synopsis: Systemic inflammatory markers are related to disease‐free survival and cancer‐specific survival for Stage I epithelial ovarian cancer. [ABSTRACT FROM AUTHOR]

Abstract Background and purpose To explore the association of systemic inflammatory index (SIRI), systemic immune-inflammatory index (SII) and inflammatory prognosis index (IPI) with 90d outcomes in patients with acute ischemic stroke (AIS) after intravenous thrombolysis. Methods The patients who underwent intravenous thrombolysis were enrolled in the present study from September 2019 to December 2022. According to the relevant blood indexes obtained in 24 h after admission, the corresponding values of SIRI, SII and IPI were calculated. The correlation among SIRI, SII, IPI, and admission NIHSS scores was examined by Spearman correlation analysis. ROC curve analysis was conducted to determine the optimal cut-off value of SIRI, SII, IPI, and their corresponding sensitivity and specificity to evaluate their predictive value on admission for poor prognosis. To investigate whether high SIRI, SII, and IPI were independent predictors of poor outcomes within 90 days, variables with P-value

Introduction Cesarean scar pregnancy (CSP) is an increasing clinical condition that causes serious maternal morbidity and mortality. This study aimed to evaluate if inflammation markers measured by hemogram can aid in the diagnosis of CSP.

Background: Preeclampsia, affecting 2–8% of pregnancies, is characterized by new-onset hypertension, proteinuria, and edema, stemming from placental dysfunction and subsequent inflammatory cascade activation. This study aimed to test the predictive ability of hematological indices in predicting preeclampsia. Therefore, predicting the diagnosis of preeclampsia earlier with higher accuracy could potentially preserve the lives of both the mother and the fetus, while also reducing the rates of complications. Methods: This retrospective study included two groups: patients with preeclampsia and a matched control group without additional medical conditions, both having undergone childbirth in the same gestational week. The primary difference between the groups was the preeclampsia diagnosis. Hematological parameters and inflammatory indices were compared for analysis. Results: Statistical significance was observed between derived neutrophil-lymphocyte ratio (dNLR), systemic immune-inflammation index (SIRI) and pan-immune inflammation value (PIV) between groups. The dNLR and PIV showed predictive relevance for preeclampsia (p < 0.05). However, their predictive performance was weak (under the curve (AUC)

Aim: Prostate cancer (PCa) is the second most commonly diagnosed cancer in men. The cost-effectiveness of biomarkers assessed prior to the prostate biopsy is still a matter of debate. The present study aims to investigate the predictive role of inflammation markers that do not involve additional costs, before the first biopsy to increase the detection rates of clinically significant PCa and to avoid unnecessary biopsies. Materials and Methods: The present study was performed with a total of 236 patients who underwent prostate biopsy between January 2015 and December 2019 and who were selected by a random sampling method. The patients were divided into the two groups of benign (n = 140) and malignant (n = 96) based on the pathology results. Mann--Whitney U test and ROC analysis were used for the statistical analyses. A p value of <0.05 was considered significant. Results: The median (mean) age of the patients participating in the study was 66 (11) years. Compared to the patients with benign pathology results, the median age, PSA, and PSAD values of the patients diagnosed with PCa were higher, whereas the median PV levels were lower (p: 0.001, p: 0.001, p: 0.001, and p: 0.008, respectively). There was no statistically significant difference between the two groups in terms of inflammation markers levels (p>0.05). Conclusion: Inflammation biomarkers (NLR, PLR, and SII) assessed before prostate biopsy did not contribute to the predictive factors currently used in the prediction of biopsy results. [ABSTRACT FROM AUTHOR]

Background and purpose: To explore the association of systemic inflammatory index (SIRI), systemic immune-inflammatory index (SII) and inflammatory prognosis index (IPI) with 90d outcomes in patients with acute ischemic stroke (AIS) after intravenous thrombolysis. Methods: The patients who underwent intravenous thrombolysis were enrolled in the present study from September 2019 to December 2022. According to the relevant blood indexes obtained in 24 h after admission, the corresponding values of SIRI, SII and IPI were calculated. The correlation among SIRI, SII, IPI, and admission NIHSS scores was examined by Spearman correlation analysis. ROC curve analysis was conducted to determine the optimal cut-off value of SIRI, SII, IPI, and their corresponding sensitivity and specificity to evaluate their predictive value on admission for poor prognosis. To investigate whether high SIRI, SII, and IPI were independent predictors of poor outcomes within 90 days, variables with P-value < 0.05 during univariate analysis were included in multivariate analysis. Results: Compared with the good outcome group, the poor outcome group had higher SIRI, IPI, and SII. Spearman correlation analysis showed that the SIRI, IPI, and SII levels significantly correlated with the admission NIHSS score (r = 0.338, 0.356, 0.427, respectively; Ps < 0.001). Univariate analysis and Multivariate logistic regression analysis revealed high SIRI, SII, and IPI values as independent risk factors for poor 90-day prognosis (OR = 1.09, 1.003 and 7.109, respectively). Conclusions: High SIRI, IPI, and SII values are correlated with poor 90d outcomes in AIS patients undergoing intravenous thrombolysis. [ABSTRACT FROM AUTHOR]

Introduction Cesarean scar pregnancy (CSP) is an increasing clinical condition that causes serious maternal morbidity and mortality. This study aimed to evaluate if inflammation markers measured by hemogram can aid in the diagnosis of CSP. Materials and Methods A total of 86 patients were included in the study. The cases were divided as CSP (n : 42) and normal pregnancy (NP) (n : 44). At the time of admission, peripheral blood neutrophils, lymphocytes, monocytes, thrombocytes, systemic inflammatory index (SII) (neutrophil × platelet/lymphocyte), neutrophil–lymphocyte ratio, monocyte–lymphocyte ratio, and platelet–lymphocyte ratio were all measured. CSP and NP diagnoses were made by transabdominal or vaginal ultrasonography. Results In the CSP group, mean age (p < 0.001), gravida (p < 0.001), parity (p < 0.001), number of surviving children (p < 0.001), number of abortions (p < 0.001), cesarean number (p <.001), dilatation and curettage count (p = 0.013), monocyte (M) value (p = 0.039) and monocyte/lymphocyte value (MLR) (p = 0.035) were significantly higher than the control group. The optimal M value cut-off value was found to be > 0.40, the sensitivity value was 78.57, and the specificity value was 50.00. AUC = 0.632 (SE = 0.061) for the MLR value. The optimal MLR cut-off value was found to be > 0.232, the sensitivity value was 61.90, and the specificity value was 63.64. Conclusion Hemogram parameters, which are simple, inexpensive, and easily accessible, M and MLR are significantly higher in the diagnosis of CSP and can be used as an auxiliary parameter for ultrasonography. [ABSTRACT FROM AUTHOR]

BACKGROUND AND AIM: Coronavirus Disease 2019 (COVID-19) can affect multliple systems simultaneously, particularly the respiratory system. New inflammatory markers have been used to identify high-risk patients and accelerate the decision-making process for admission to intensive care. One of these markers is the Systemic Inflammatory Index (SII), which is a prognostic index associated with peripheral blood parameters such as neutrophils, platelets, and lymphocytes. This study aimed to determine the effect of SII and other inflammatory markers in assessing the need for intensive care. METHODS: The study included patients over the age of 18 who were admitted to the hospital and hospitalized with COVID-19 pneumonia. They were divided into two groups: those with and without direct admission to intensive care. Demographic, clinical, and laboratory results were obtained retrospectively from the hospital data system. RESULTS: A total of 335 patients were included in the study. SII, C-reactive protein (CRP), ferritin, and D-dimer values were significantly higher (p<0.05) in the group with direct Intensive Care Unit (ICU) hospitalization. In the multivariate reduced model, a significant independent (p<0.05) efficacy of age, SII, CRP, ferritin and D-dimer values was observed in differentiating patients who required direct ICU hospitalization from those who did not. An SII cutoff value of 127 was found to be significant (area under the curve 0.786) in distinguishing between the two groups. CONCLUSIONS: COVID-19 leads to alterations in peripheral blood parameters. Clinical symptoms and disease severity may be associated with the levels of inflammatory cells. These parameters should also be examined to determine the need for intensive care and enable prompt treatment initiation. [ABSTRACT FROM AUTHOR]

Background: Covid-19 has undergone many mutations over time. The most prominent variants have been the Alpha, Beta, Delta, Gamma, and finally, the Omicron variants. This study aims to determine the availability of neutrophil/lymphocyte rate (NLR), platelet/lymphocyte rate (PLR) and Systemic Inflammatory Index (SII), prognostic and diagnostic significance, in the differentiation of variants in pediatric Covid-19 patients. Materials and Methods: In this retrospective study, 141 pediatric patients who were found to be positive for Covid-19 in Harran University Medical Faculty Hospital between January 2021 and April 2022 were included. A control group was formed from 107 healthy children selected from among those who applied to the general pediatric outpatient clinic for routine health evaluations. Results: When the age distribution of the patients was examined, the median was 7.0 (0.1-18) years. When the variants were compared, there was a significant difference between lymphocyte values, while leukocyte, neutrophil, C-reactive protein (CRP) and Mean Platelet Volume (MPV) did not change significantly. At the same time, there was a statistically significant difference between NLR, PLR and SII variants in Covid-19 positive patients (p<0.05); It was found that CRP, CRP/albumin rate (CAR), and MPV values did not change significantly between variants (p>0.05). It was observed that the NLR, PLR and SII delta variants increased significantly compared to the omicron variant (p<0.05). CRP and CAR were significantly increased in the severe clinical course compared to the asymptomatic group (p<0.05). Conclusions: In our study, it was seen that patients with delta variant had higher NLR, PLR and SII values compared to omicron variant when viewed from the point of view of Covid-19 variants. Therefore, we think that during the diagnosis of Covid-19 accompanied by these parameters, variant analysis can be performed, especially in terms of the delta variant, and it will shed light on the differential diagnosis, appropriate treatment, and measures to be taken by early and simple means. [ABSTRACT FROM AUTHOR]

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

Introduction: The systemic inflammation index (SII) might serve as an indicator of the equilibrium between the inflammatory and immune responses. The aim of the study was to determine the clinical value and prognostic significance of SII in the cohort of multiple myeloma (MM) patients treated with a regimen of pomalidomide and dexamethasone (Pd). Material and methods: This retrospective, real-life study included patients who received a Pd regimen in our centre between November 2018 and July 2022. The systemic inflammation index was calculated from peripheral blood counts of platelets, neutrophils, and lymphocytes collected shortly before commencement of Pd treatment using the equation: SII = N × P/L, where N, P, and L are the respective counts per litre of peripheral blood for neutrophils, platelets, and lymphocytes. Results: The study group consisted of 54 patients. Most patients received Pd as the third (38.9%) or fourth (37.0%) line of treatment. The median number of completed treatment cycles was 5 (IQR: 1-12). The median progression-free survival (PFS) was 6.8 months and overall survival (OS) 14.8 months. High SII (> 374) was an independent prognostic factor for PFS (HR = 3.0, 95% CI: 1.4-6.3, p < 0.01) and OS (HR = 2.2, 95% CI: 1.0-4.6, p = 0.04). In the low SII group, the respective median PFS and OS values were 9.6 and 21.7 months, compared to 2.6 (p = 0.018) and 5.5 months (p = 0.035) in the high SII group. Conclusions: The systemic inflammation index has prognostic significance in MM patients treated with Pd. A high SII predicts a poorer outcome in pretreated MM patients undergoing Pd treatment evaluation. As such, it may well be a key factor for guiding subsequent treatment decisions. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the prognostic importance of the preoperative systemic immune-inflammatory index (SII) in laryngeal lesions and to investigate its predictive importance compared to the neutrophil-lymphocyte ratio (NLR) and plateletlymphocyte ratio (PLR). Material and Methods: Retrospective comparisons were made between the preoperative blood parameters (NLR, PLR, and SII) and clinicopathological features of 133 patients who underwent surgery for a localized laryngeal lesions between March 01, 2010 and June 31, 2021. Receiver-operating characteristic analysis was used to calculate the cut-off value of the SII. Results: Of the 133 patients with laryngeal lesions, 81 (60.9%) had benign lesions, 20 (15%) had premalignant lesions, and 32 (24.1%) had malignant pathology results. The mean SII value was determined to gradually increase in the order of benign, premalignant, and malignant pathology (444.36; 525.69; 738.07, respectively). A statistically significant difference was found between the SII values of the groups classified as benign, premalignant, and malignant according to laryngeal pathologies (p<0.001). A statistically significant moderate-level correlation of approximately 35% was determined between the benign, premalignant, and malignant pathology results and SII, between the pathology results and NLR at 36%, and with PLR at 29%. Conclusion: A significant relationship was observed between the tendency of the disease and malignancy in laryngeal pathologies and the SII. This significant relationship was also determined by NLR and PLR. In this context, the SII was evaluated as an inexpensive, routine screening test that can be used to evaluate the prognosis of patients with laryngeal pathology. [ABSTRACT FROM AUTHOR]

Background: The systemic inflammatory index (SII) is a new inflammatory marker that has been the subject of various studies in diseases with chronic inflammation. Diabetic nephropathy is a disease associated with chronic inflammation. We aimed to evaluate the relationship between SII and diabetic nephropathy. Methods: Patients with diabetes who applied to our outpatient clinic were included in the study. Diabetic patients were divided into two groups: those with diabetic nephropathy and those without. In addition, healthy individuals who applied to our clinic for general check-ups during these dates were included as the control group. The SII values and other characteristics of the three study groups were compared. Results: The median SII value for those with DKI was 584 (178–4819); for those without DKI, it was 282 (64–618); and for the control group, it was 236 (77.5–617) (p < 0.001). SII was significantly and positively correlated with BMI, weight, blood glucose, HbA1c, CRP, and creatinine, and negatively correlated with the glomerular filtration rate (GFR) value. SII values higher than 336 have 75% sensitivity and 70% specificity in detecting DKI. Conclusion: The SII value can predict diabetic kidney injury in diabetics, and it can be used as an adjunctive diagnostic tool. [ABSTRACT FROM AUTHOR]

Background: There are important parameters in understanding the severity of COVID-19 infection. We aimed to observe the role of systemic inflammatory index and neutrophil lymphocyte ratios in Covid-19 infections and the changes seen during the infection process. Methods: This retrospective single-center study was conducted between April 2020 and May 2020. Clinical, demographic and laboratory data of patients with COVID-19 were analyzed. All COVID-19 case confirmation made with reverse transcription polymerase chain reaction. Neutrophil/lymphocyte ratio and SII change and relationship were examined. Results: 140 patients were included in our study and 50 of them were female. There was no statistically significant difference in SII according to gender (p>0.05) but there was a difference in SII between age categories (p=0.009). A statistically significant difference was found (p=0.003) regardless of the presence of comorbidities. Tobacco users had a significantly lower SII (p=0.028). A statistically significant difference was found between SII and Covid Severity Index (p=0.020). A statistically significant difference was found in the SII values of those receiving favipiravir treatment and those receiving hydroxychloroquine treatment (p<0.001). A statistically significant difference was found between those who received treatment in the outpatient clinic and those who received treatment in the intensive care unit (p=0.043). A statistically significant difference in the SII values was found between the patients who died and those who survived (p= 0.009) Conclusion: The Systemic Inflammatory Index is a parameter that can be used for the Covid-19 patient follow-up and estimating mortality. [ABSTRACT FROM AUTHOR]

Objective To investigate the correlation between systemic inflammatory parameters and other inflammatory parameters and bone mineral density ( BMD ) in male patients with primary osteoporosis. Methods A total of 311 male patients meeting the inclusion and exclusion criteria were selected from the First Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2021 to May 2022. The patients were divided into osteoporosis group, osteopenia group, and normal bone mass group according to the diagnostic criteria and were retrospectively studied. Results SIi, NLR, MLR, and ESR in osteoporosis group were significantly higher than those in normal bone mass group, and the difference was statistically significant ( P<0. 05 ). Binary logistics regression analy sis showed that PLR ( P

Aim: Hyperemesis gravidarum (HEG) is a condition characterized by nausea and vomiting, fluid electrolyte and acid–base imbalance, dehydration, weight loss, and ketonuria in early pregnancy. The relationship of HEG with inflammation has been studied in many studies. This study aimed to investigate the role of serum delta neutrophil index (DNI), a new inflammatory marker, and other inflammatory markers in demonstrating the disease's presence and severity in HEG patients. Material and Method: This retrospective study was conducted by accessing the electronic data of 79 pregnant women diagnosed with HEG in a tertiary center between 2017 and 2022 and 100 healthy pregnant women. The demographic characteristics of the study and control groups, as well as the hematological parameters in the complete blood count and the levels of inflammatory markers, were recorded. Results: There was no significant difference between the groups regarding hematological parameters, DNI, platelet‐lymphocyte ratio, monocyte‐lymphocyte ratio, and systemic inflammation index (p > 0.05). Neutrophil count and neutrophil‐lymphocyte ratio (NLR) were higher in the HEG group compared to the control group (p < 0.05). Conclusion: This is the first study to determine the relationship between HEG and serum DNI, a new inflammatory marker. We found that serum DNI values in HEG patients were not different from normal pregnancies and did not reflect the presence and severity of the disease. We also found that inflammatory markers other than the NLR were not different from normal pregnancies in HEG patients. [ABSTRACT FROM AUTHOR]

(1) Background: Trauma is one of the leading causes of death worldwide, with the chest being the third most frequent body part injured after abdominal and head trauma. Identifying and predicting injuries related to the trauma mechanism is the initial step in managing significant thoracic trauma. The purpose of this study is to assess the predictive capabilities of blood count-derived inflammatory markers at admission. (2) Materials and Methods: The current study was designed as an observational, analytical, retrospective cohort study. It included all patients over the age of 18 diagnosed with thoracic trauma, confirmed with a CT scan, and admitted to the Clinical Emergency Hospital of Targu Mureş, Romania. (3) Results: The occurrence of posttraumatic pneumothorax is highly linked to age (p = 0.002), tobacco use (p = 0.01), and obesity (p = 0.01). Furthermore, high values of all hematological ratios, such as the NLR, MLR, PLR, SII, SIRI, and AISI, are directly associated with the occurrence of pneumothorax (p < 0.001). Furthermore, increased values of the NLR, SII, SIRI, and AISI at admission predict a lengthier hospitalization (p = 0.003). (4) Conclusions: Increased neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic inflammatory index (SII), aggregate inflammatory systemic index (AISI), and systemic inflammatory response index (SIRI) levels at admission highly predict the occurrence of pneumothorax, according to our data. [ABSTRACT FROM AUTHOR]

Background: Abdominal trauma is defined as a variety of injuries to the abdominal wall, solid or hollow intra-abdominal organs, and various intra-abdominal vessels. Recently, there has been a significant amount of interest in the establishment of a reliable biomarker that can predict the outcome in patients with an abdominal injury. The purpose of this study is to confirm the predictive role of inflammatory biomarkers and underlying risk factors and the risk of acute kidney insufficiency (AKI) developing and mortality in abdominal trauma patients; Materials and methods: The current study was intended as an observational, analytical, retrospective cohort study and included all patients over 18 years of age with a diagnosis of abdominal trauma confirmed through a CT scan admitted to the County Emergency Clinical Hospital of Targu-Mureș, Romania between January 2017, and December 2021; Results: Non-survivor patients had a greater age (p = 0.02), as well as a higher prevalence of ischemic heart disease (IHD) (p = 0.007), history of myocardial infarction (MI) (p = 0.002), peripheral arterial disease (PAD) (p = 0.01), chronic kidney disease (CKD) (p = 0.01), and all risk factors (p = 0.0004 and p < 0.0001). In terms of injured organs, we have in the second group a higher incidence of kidney injury (p = 0.003) and hemoperitoneum (p = 0.008). Multivariate analysis showed a high baseline value for all inflammatory biomarkers that are independent predictors of adverse outcomes for all recruited patients. Furthermore, for all hospitalized patients, the history of MI (p = 0.03; p = 0.001; and p = 0.003), PAD (p = 0.01; p = 0.01; and p = 0.002), obesity (for all p < 0.0001), CKD (p < 0.001; p = 0.01; and p = 0.001), and kidney injury (p = 0.02; p = 0.004; and p = 0.01) were independent predictors of all outcomes. Moreover, IHD (p = 0.008 and p = 0.02), tobacco (p < 0.0001 and p = 0.02), and hemoperitoneum (p = 0.009 and p = 0.01) were predictors of mortality and composite endpoint, but not for AKI risk, as well as atrial fibrillation [AF] (p = 0.04) as predictors of the composite endpoint Conclusions: Higher monocyte to lymphocyte ratio (MLR), platelets to lymphocyte ratio (PLR), systemic inflammatory index (SII), neutrophil to lymphocyte ratios (NLR), aggregate inflammatory systemic index (AISI), and systemic inflammatory response index (SIRI) levels at admission, according to our data, highly predict AKI risk and death. [ABSTRACT FROM AUTHOR]

• Recurrent gliomas exhibit an increased infiltration of lymphocyte and macrophage. • Macrophage promotes an immunosuppressive status in recurrent gliomas. • Intratumoral macrophage abundance serves as a prognostic marker for recurrent gliomas. • Systemic inflammatory indices can predict the outcome of recurrent gliomas. Reoperation is a treatment option for recurrent gliomas, yet factors impacting survival following reoperation remain poorly defined. Tumor immunity is profoundly associated with disease progression. Here, we analyze the immune status characteristics and their prognostic implications in recurrent gliomas. Intratumoral and peripheral immune characteristics between primary and recurrent gliomas were compared by conducting immunohistological staining and hematological examination with our in-house samples, and analyzing bulk and single-cell sequencing data from publicly available sources. Survival analysis was conducted to identify immunological markers with prognostic significances. We observed a significant reduction in peripheral lymphocyte count, while an elevation in neutrophil-to-lymphocyte ratio (NLR) and red cell distribution width-to-platelet ratio (RPR) in patients with recurrent gliomas than in newly-diagnosed patients. Higher NLR and RPR indicated worse survival following reoperation in recurrent patients. Transcriptomic and immunohistological analysis showed an increased infiltration of tumor-associated macrophages (TAMs) and CD8+ T cell in recurrent gliomas compared to primary gliomas in both IDH-wildtype and mutant subtypes. Moreover, the abundance of TAMs emerged as an independent indicator for an inferior prognosis in recurrent gliomas. Single-cell profiling revealed a significant heterogeneity in the phenotypes of TAMs between primary and recurrent gliomas. Notably, TAMs enriched in recurrent gliomas exhibited elevated expression of interferon-γ-induced genes, multiple immunosuppressive molecules (TGFB1, CD276), and increased activity in glycose and lipid metabolism, indicating metabolic reprogramming. Recurrent gliomas demonstrate augmented immune cell infiltration, but they fail to overcome TAMs-induced immunosuppression. Immunosuppressive indices, including TAM abundance, peripheral NLR and RPR, have prognostic implications for recurrent gliomas. [ABSTRACT FROM AUTHOR]

The objective of this study was to examine the values of MX dynamin-like GTPase 1 (Mx1), high mobility group box-1 (HMGB1), systemic inflammatory response index (SIRI), systemic inflammatory index (SII), tumor necrosis factor (TNF), and other hematological indices in calves with systemic inflammatory response syndrome (SIRS). The study material was divided into two groups: the SIRS group (comprising 13 calves) and the control group (comprising 10 calves). The independent samples t-test and Mann-Whitney U test were employed for normally distributed and non-normally distributed data, respectively. The relationship between the two groups was determined using Spearman correlation coefficient analysis. Significant differences were identified between the SIRS group and the control group with regard to white blood cell (WBC; P < 0.05), neutrophil (NEU; P < 0.01), and neutrophil-to-lymphocyte ratio (NLR; P < 0.001) values, in addition to SIRI (P < 0.05), SII (P < 0.01) values. Furthermore, HMGB1 (P < 0.001), Mx1 (P < 0.05), and TNF values (P < 0.001) demonstrated notable disparities between the two groups. As a result of this study, it was concluded that there were significant increases in inflammatory hematological indices, as well as in the levels of HMGB1, Mx1, and TNF, in calves with SIRS. [Display omitted] • MX dynamin-like GTPase 1 (Mx1), high mobility group box-1 (HMGB1), tumor necrosis factor (TNF) values are increased in calves with systemic inflammatory response syndrome (SIRS). • Systemic inflammation response index (SIRI), systemic inflammatory index (SII) and hematological indices increase in calves with SIRS. • HMGB1, Mx1, TNF, SIRI, SII and hematological indices show a significant correlation in determining the inflammatory status in calves with SIRS. [ABSTRACT FROM AUTHOR]

Background and Objective: This study explored the role of various laboratory biomarkers on inflammatory indices for predicting disease progression toward severity in COVID-19 patients.Methods: This retrospective study was conducted on 1233 adults confirmed for COVID-19. The participants were grouped undermild, moderate, and severe grade disease. Serum bio-inflammatory index (SBII) and systemic inflammatory index (SII) were calculated and correlated with disease severity. The study variables, including clinical details and laboratory variables, were analyzed for impact on the inflammatory indices and severity status using a sequential multiple regression model to determine the predictors for mortality. Receiver operating characteristics defined the cut-off values for severity. Results: Among the study population, 56.2%, 20.7%, and 23.1% were categorized as mild, moderate, and severe COVID-19 cases. Diabetes with hypertension was the most prevalent comorbid condition. The odds for males to have the severe form of the disease was 1.6 times (95% CI = 1.18–2.18, P = 0.002). The median (inter-quartile-range) of SBII was 549 (387.84–741.34) and SII was 2097.6 (1113.9–4153.73) in severe cases. Serum urea, electrolytes, gamma-glutamyl transferase, red-cell distribution width-to-hematocrit ratio, monocytopenia, and eosinopenia exhibited a significant influence on the SpO2, SBII, and SII. Both SBII (r = −0.582, P < 0.001) and SII (r = −0.52, P < 0.001) strongly correlated inversely with SpO2 values [Figure 3]a and [Figure 3]b. More than 80% of individuals admitted with severe grade COVID-19 had values of more than 50th percentile of SBII and SII. The sensitivity and specificity of SBII at 343.67 for severity were 81.4% and 70.1%, respectively. SII exhibited 77.2% sensitivity and 70.8% specificity at 998.72. Conclusion: Serial monitoring of the routinely available biomarkers would provide considerable input regarding inflammatory status and severity progression in COVID-19.

The incidence of ischemic heart disease (IHD) increases every year. This cardiovascular disease has an inflammatory factor in its etiology due to different immune cells that influence atherogenesis. New inflammatory biomarkers—the Systemic Inflammatory Index (SII) and the Systemic Inflammatory Response (SIRI)—attempt to describe the pro- and anti-inflammatory balance and quantify the complex impact of the immune system on atherosclerosis, while vitamin D has a multidirectional impact on the human body, including the cardiovascular and immune systems. Hence, the objective of this research was to analyze the association between SII and SIRI and serum vitamin D concentrations in patients with IHD. A significant correlation was observed between SIRI and 25(OH)D in the whole group and between both biomarkers (SII and SIRI) and 25(OH)D in the group of patients with ACS but not in the group of patients with stable IHD. The role of vitamin D in IHD complications and its association with new inflammatory biomarkers requires further well-designed, large-scale research. [ABSTRACT FROM AUTHOR]

Atherosclerosis, the underlying cause of coronary artery disease (CAD), has a significant inflammatory component. White blood cell count is an affordable and accessible way to assess the systemic immune response, as it comprises many subgroups with distinct and complex functions. Considering their multidirectional effect on atherosclerosis, new biomarkers integrating various leukocyte subgroups, the Systemic Inflammatory Index (SII) and the Systemic Inflammatory Response Index (SIRI), were recently devised to describe the balance between inflammation and immune reaction. This research aimed to evaluate the relationship of the intensity of inflammation measured by these biomarkers with the severity of CAD assessed with coronary angiography and with the diagnosis of acute coronary syndrome (ACS) or stable CAD in 699 patients. SIRI, but not SII, was associated with the diagnosis, having the highest values for patients with ACS (STEMI), significantly higher than in patients with stable CAD (p < 0.01). The highest SII and SIRI values were observed in patients with three-vessel CAD. SII and SIRI require further in-depth and well-designed research to evaluate their potential in a clinical setting. [ABSTRACT FROM AUTHOR]

The objective of this study was to identify characteristic factors for pathological complete response (pCR) in patients with locally advanced breast cancer (LABC) undergoing surgery and neoadjuvant chemotherapy (NACT). We retrospectively collected pathological data from 237 LABC patients treated in Affiliated Fuzhou First Hospital of Fujian Medical University from January 2010 to June 2021 and divided them into a training group (n = 166) and a validation group (n = 71) in a 7:3 ratio. A predictive model for pCR was established through logistic regression analysis and evaluated using the receiver operating characteristic (ROC) curve and the area under the curve (AUC). Significant differences between the pCR and non-pCR groups were observed in tumor size (P = 0.001), T stage (P = 0.003), estrogen receptor (ER) (P = 0.031), progesterone receptor (PR) (P = 0.013), human epidermal growth factor receptor 2 (HER-2) (P = 0.001), and molecular type (P = 0.001). The pCR group also had lower levels of carbohydrate antigen 19-9 (P = 0.013), cancer antigen 125 (P = 0.011), carcinoembryonic antigen (CEA) (P = 0.001), and systemic inflammatory index (SII) (P = 0.006), but a higher prognostic nutritional index (PNI) (P = 0.001) compared to the non-pCR group. There were no statistical differences in baseline data between the training and validation groups (P>0.05). Multivariate logistic regression analysis identified tumor size (P = 0.001), HER-2 (P = 0.010), CA125 (P = 0.005), CEA (P = 0.001), SII (P = 0.010), and PNI (P = 0.001) as independent risk factors for pCR. We constructed and visualized a nomogram model that included these 6 factors and developed a dynamic prediction model using the Dynamic Nomogram (DynNom) package. In a random sample of 6 patients, the probability of non-pCR reached 98.8%. The model's AUC was 0.881 in the training group, with a clinical benefit rate of 71.68% and a concordance index (C-index) of 0.881, indicating a good fit. In the validation group, the AUC was 0.722, with a clinical benefit rate of 70.2% and a C-index of 0.722, also indicating a good fit. The Delong test showed a significant difference in AUC between the two groups (P = 0.027). In conclusion, this study constructed and validated a Nomogram model based on clinical pathological features and hematological indicators, finding that higher pCR rates were associated with smaller tumor size, HER-2 positivity, lower levels of CA125 and CEA, lower SII, and higher PNI, significantly enhancing breast cancer management and offering important clinical implications., Competing Interests: None., (AJCR Copyright © 2024.)

Introduction: The objective of this study is to predict the probability of prostate cancer in PI-RADS 3 lesions using machine learning methods that incorporate clinical and mpMRI parameters., Methods: The study included patients who had PI-RADS 3 lesions detected on mpMRI and underwent fusion biopsy between January 2020 and January 2024. Radiological parameters (Apparent diffusion coefficient (ADC), tumour ADC/contralateral ADC ratio, Ktrans value, periprostatic adipose tissue thickness, lesion size, prostate volume) and clinical parameters (age, body mass index, total prostate specific antigen, free PSA, PSA density, systemic inflammatory index, neutrophil-lymphocyte ratio [NLR], platelet lymphocyte ratio, lymphocyte monocyte ratio) were documented. The probability of prostate cancer prediction in PI-RADS 3 lesions was calculated using 6 different machine-learning models, with the input parameters being the aforementioned variables., Results: Of the 235 participants in the trial, 61 had malignant fusion biopsy pathology and 174 had benign pathology. Among 6 different machine learning algorithms, the random forest model had the highest accuracy (0.86±0.04; 95% CI 0.85-0.87), F1 score (0.91±0.03; 95% CI 0.91-0.92) and AUC value (0.92±0.06; 95% CI 0.88-0.90). In SHAP analysis based on random forest model, tumour ADC, tumour ADC/contralateral ADC ratio and PSA density were the 3 most successful parameters in predicting malignancy. On the other hand, systemic inflammatory index and neutrophil lymphocyte ratio showed higher accuracy in predicting malignancy than total PSA, age, free PSA/total PSA and lesion size in SHAP analysis., Conclusion: Among the machine learning models we developed, especially the random forest model can predict malignancy in PI-RADS 3 lesions and prevent unnecessary biopsy. This model can be used in clinical practice with multicentre studies including more patients., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: There is no conflict of interest between the authors. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: The systemic inflammatory index (SII) is a new inflammatory marker that has been the subject of various studies in diseases with chronic inflammation. Diabetic nephropathy is a disease associated with chronic inflammation. We aimed to evaluate the relationship between SII and diabetic nephropathy. Methods: Patients with diabetes who applied to our outpatient clinic were included in the study. Diabetic patients were divided into two groups: those with diabetic nephropathy and those without. In addition, healthy individuals who applied to our clinic for general check-ups during these dates were included as the control group. The SII values and other characteristics of the three study groups were compared. Results: The median SII value for those with DKI was 584 (178–4819); for those without DKI, it was 282 (64–618); and for the control group, it was 236 (77.5–617) (p < 0.001). SII was significantly and positively correlated with BMI, weight, blood glucose, HbA1c, CRP, and creatinine, and negatively correlated with the glomerular filtration rate (GFR) value. SII values higher than 336 have 75% sensitivity and 70% specificity in detecting DKI. Conclusion: The SII value can predict diabetic kidney injury in diabetics, and it can be used as an adjunctive diagnostic tool.

Introduction: The transmission risk of Severe Acute Respiratory Syndrome Coronavirus‐2 virus infection is increased in maintenance hemodialysis (MHD) patients, and also the disease causes much higher mortality than the normal population. The aim of this study is to define the predictive value of neutrophil‐to‐lymphocyte ratio (NLR) in terms of worse outcomes in MHD patients. Methods: A total of 123 MHD patients who had received inpatient care due to COVID‐19 infection were included in this multicentered retrospective study. Receiver operating curve analysis were plotted to illustrate C reactive protein (C‐rp), systemic inflammatory index (SII) and NLR best cut‐off values for estimation of need for intensive care unit (ICU) and mortality. Multivariate regression analysis and Cox proportional hazard models were constructed to determine the association between C‐rp, SII and NLR and mortality. Results: Twenty‐eight (23%) patients with MHD were dead due to COVID‐19. Nonsurvivor patients was significantly older than the survivors (p < 0.001) and also had higher rates of diabetes mellitus (p = 0.01) and coronary artery disease (p = 0.02). Cox regression analysis revealed that NLR >5.17 significantly associated with mortality [HR: 6.508, p < 0.001]. Similarly, SII > 726 [HR: 3.124, p = 0.006] and C‐rp > 88 [HR: 4.590, p = 0.002] were significantly associated with mortality due to COVID‐19 in hospitalized MHD patients. Multivarite logistic regression analysis showed that age older than 60 years, higher ferritin, and NLR > 5.17 were independent factors associated with mortality. Conclusion: NLR had favorable predictive value than the C‐rp and SII in terms of need for ICU and mortality in MHD patients. Determining the poor prognosis with simple and easily applicable markers may reduce mortality in these patients with early supportive treatments. [ABSTRACT FROM AUTHOR]

Background and Objective: This study explored the role of various laboratory biomarkers on inflammatory indices for predicting disease progression toward severity in COVID-19 patients.Methods: This retrospective study was conducted on 1233 adults confirmed for COVID-19. The participants were grouped undermild, moderate, and severe grade disease. Serum bio-inflammatory index (SBII) and systemic inflammatory index (SII) were calculated and correlated with disease severity. The study variables, including clinical details and laboratory variables, were analyzed for impact on the inflammatory indices and severity status using a sequential multiple regression model to determine the predictors for mortality. Receiver operating characteristics defined the cut-off values for severity. Results: Among the study population, 56.2%, 20.7%, and 23.1% were categorized as mild, moderate, and severe COVID-19 cases. Diabetes with hypertension was the most prevalent comorbid condition. The odds for males to have the severe form of the disease was 1.6 times (95% CI = 1.18–2.18, P = 0.002). The median (inter-quartile-range) of SBII was 549 (387.84–741.34) and SII was 2097.6 (1113.9–4153.73) in severe cases. Serum urea, electrolytes, gamma-glutamyl transferase, red-cell distribution width-to-hematocrit ratio, monocytopenia, and eosinopenia exhibited a significant influence on the SpO2, SBII, and SII. Both SBII (r = −0.582, P < 0.001) and SII (r = −0.52, P < 0.001) strongly correlated inversely with SpO2 values [Figure 3]a and [Figure 3]b. More than 80% of individuals admitted with severe grade COVID-19 had values of more than 50th percentile of SBII and SII. The sensitivity and specificity of SBII at 343.67 for severity were 81.4% and 70.1%, respectively. SII exhibited 77.2% sensitivity and 70.8% specificity at 998.72. Conclusion: Serial monitoring of the routinely available biomarkers would provide considerable input regarding inflammatory status and severity progression in COVID-19. [ABSTRACT FROM AUTHOR]

To investigate the value of prognostic nutrition index (PNI) and systemic immunoinflammatory index (SII) for predicting pathological responses of patients with advanced gastric cancer (GC) after neo-adjuvant chemotherapy (NACT). The clinicopathological data of 326 patients with advanced GC who received NACT in Xiangya School of Medicine, Central South University (The First People's Hospital of Changde City) from January 2017 to December 2021 were retrospectively collected. The SII and PNI of patients were calculated. The receiver operating characteristics (ROC) curve was leveraged for getting the optimal cutoff values of SII and PNI. The pathological response of patients after NACT, as obtained from their postoperative pathological examinations, was evaluated based on the tumor regression grade (TRG) criteria. Multivariate regression analysis was employed for identifying factors that led to various pathological responses after NACT in advanced GC patients. The log-rank test was utilized for between-group comparison of patients' survival curves. The SII and PNI were 507.45 and 48.48 respectively, and their levels were divided into high and low groups. Pathological response (TRG 0-1) was observed in 66 cases (20.25%), while non-pathological response (TRG 2-3) was observed in 260 cases (79.75%). The results of multivariate logistic regression analysis showed that tumor diameter < 5 cm, ypT T0-T2, ypN N0, chemotherapy regimen XELOX (capecitabine combined with oxaliplatin), SII < 507.45 (P=0.002), PNI > 48.48 were all independent factors affecting the pathological responses of advanced GC patients after NACT (all P < 0.05). With SII and PNI being included, the AUC was 0.821 (95% CI: 0.765-0.876), and the specificity was 87.90% and the sensitivity was 64.20%. The Kaplan-Meier survival curve analysis showed that NACT patients with tumor diameter < 5 cm, ypT T0-T2, ypN N0, XELOX chemotherapy regimen, SII < 507.45 and SII ≥ 507.45 had a higher survival rate. (P < 0.001). Before treatment, tumor diameter < 5 cm, ypT T0-T2, ypN N0, chemotherapy regimen XELOX, SII < 507.45, PNI > 48.48 were all independent factors affecting the pathological response of advanced GC patients after NACT. Moreover, the inclusion of SII and PNI increased the accuracy of predicting the pathological response of patients after NACT., Competing Interests: None., (AJCR Copyright © 2024.)

Background: Numerous tools, including nutritional and inflammatory markers, have been evaluated as the predictors of poor outcomes in COVID-19 patients. This study aims to verify the predictive role of the prognostic nutritional index (PNI), CONUT Score, and inflammatory markers (monocyte to lymphocyte ratio (MLR), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic inflammatory index (SII), Systemic Inflammation Response Index (SIRI), and Aggregate Index of Systemic Inflammation (AISI)) in cases of deep vein thrombosis (DVT) and acute pulmonary embolism (APE) risk, as well as mortality, in COVID-19 patients. Methods: The present study was designed as an observational, analytical, retrospective cohort study, and included 899 patients over the age of 18 who had a COVID-19 infection, confirmed through real time-polymerase chain reaction (RT-PCR), and were admitted to the County Emergency Clinical Hospital and Modular Intensive Care Unit of UMFST “George Emil Palade” of Targu Mures, Romania between January 2020 and March 20212. Results: Non-Surviving patients were associated with a higher incidence of chronic kidney disease (p = 0.01), cardiovascular disease (atrial fibrillation (AF) p = 0.01; myocardial infarction (MI) p = 0.02; peripheral arterial disease (PAD) p = 0.0003), malignancy (p = 0.0001), tobacco (p = 0.0001), obesity (p = 0.01), dyslipidemia (p = 0.004), and malnutrition (p < 0.0001). Multivariate analysis showed that both nutritional and inflammatory markers had a high baseline value and were all independent predictors of adverse outcomes for all enrolled patients (for all p < 0.0001). The presence of PAD, malignancy, and tobacco, were also independent predictors of all outcomes. Conclusions: According to our findings, higher MLR, NLR, PLR, SII, SIRI, AISI, CONUT Score, and lower PNI values at admission strongly predict DVT risk, APE risk, and mortality in COVID-19 patients. Moreover, PAD, malignancy, and tobacco, all predicted all outcomes, while CKD predicts APE risk and mortality, but not the DVT risk.

Background: systemic inflammation disorders were observed in chronic kidney disease (CKD). Whether the systemic inflammatory indicators could be optimal predictors for the survival of CKD remains less studied., Methods: In this study, participants were selected from the datasets of the National Health and Nutrition Examination Survey (NHANES) between 1999 to 2018 years. Four systemic inflammatory indicators were evaluated by the peripheral blood tests including systemic immune-inflammation index (SII, platelet*neutrophil/lymphocyte), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR). Kaplan-Meier curves, restricted cubic spline (RCS), and Cox regression analysis were used to evaluate the association between the inflammatory index with the all-cause mortality of CKD. Receiver operating characteristic (ROC) and concordance index (C-index) were used to determine the predictive accuracy of varied systemic inflammatory indicators. Sensitive analyses were conducted to validate the robustness of the main findings., Results: A total of 6,880 participants were included in this study. The mean age was 67.03 years old. Among the study population, the mean levels of systemic inflammatory indicators were 588.35 in SII, 2.45 in NLR, 133.85 in PLR, and 3.76 in LMR, respectively. The systemic inflammatory indicators of SII, NLR, and PLR were all significantly positively associated with the all-cause mortality of CKD patients, whereas the high value of LMR played a protectable role in CKD patients. NLR and LMR were the leading predictors in the survival of CKD patients [Hazard ratio (HR) =1.21, 95% confidence interval (CI): 1.07-1.36, p = 0.003 (3 rd quartile), HR = 1.52, 95%CI: 1.35-1.72, p<0.001 (4 th quartile) in NLR, and HR = 0.83, 95%CI: 0.75-0.92, p<0.001 (2 nd quartile), HR = 0.73, 95%CI: 0.65-0.82, p<0.001 (3 rd quartile), and = 0.74, 95%CI: 0.65-0.83, p<0.001 (4 th quartile) in LMR], with a C-index of 0.612 and 0.624, respectively. The RCS curves showed non-linearity between systemic inflammatory indicators and all-cause mortality risk of the CKD population., Conclusion: Our study highlights that systemic inflammatory indicators are important for predicting the survival of the U.S. population with CKD. The systemic inflammatory indicators would add additional clinical value to the health care of the CKD population., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Chen, Nie, Wu, Li, Zheng, Zhu, Min, Ling and Liu.)

Abstract Background The discrepant concordance between biopsy and radical prostatectomy (RP) specimen are well reported. To validate the clinical usefulness of neutrophil-lymphocyte ratio (NLR) in discriminating real GS ≥ 7 PCa from biopsy-based GS ≤ 6 PCa in comparison with serum total prostate-specific antigen (tPSA) and value of their combination. Methods One hundred one patients who underwent physical examinations incidentally found elevated tPSA and subsequently received biopsy with a conclusion of GS ≤ 6 and RP with an interval of 4-6 weeks after biopsy were enrolled. NLR and tPSA were obtained within 15 days prior to biopsy. Logistic regression model was applied appropriately; McNemar tests and AUC model were performed to evaluate differences among tPSA, NLR and their combination and corresponding diagnostic power respectively. Results The pathological results from RP specimen comprised 61 patients with GS ≤ 6 and 100 patients with GS ≥ 7. Higher tPSA and NLR were significantly associated with patients with actual GS ≥ 7 (All P