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Objective: Acute appendicitis is one of the most common causes of abdominal pain requiring surgical intervention in children. Although clinical and imaging modalities play a central role in disease diagnosis, laboratory markers, such as white blood cell (WBC) count, neutrophil count, and electrolyte disturbances, particularly sodium levels, have been explored as potential indicators of disease severity. This study aimed to evaluate the relationship between serum sodium levels, WBC and neutrophil counts, and their respective ratios with the diagnosis and severity of appendicitis. Methods: This retrospective analysis included 176 pediatric patients who underwent appendectomy. Patients were divided into three groups based on pathological findings: Group 1 (non-appendicitis, n=59), group 2 (acute appendicitis, n=82), and group 3 (perforated appendicitis, n=35). WBC, neutrophil, and sodium levels were recorded. ANOVA and post-hoc Tukey's tests were used to assess differences between groups. A logistic regression model was employed to evaluate the combined ability of WBC, neutrophil, and sodium levels to distinguish group 1 from groups 2 and 3, and the model's performance was evaluated using the area under the ROC curve (AUC). Results: Significant differences were observed between group 1 and groups 2 and 3 regarding WBC (p<0.001), neutrophil (p<0.001), and sodium levels (p<0.001). Group 3 had the highest WBC count (17,123±4,491 cells/µL) and the lowest sodium levels (132.5±1.4 mEq/L), whereas group 1 had the lowest WBC count (10,660±3,804 cells/µL) and the highest sodium levels (137.5±2.6 mEq/L). Logistic regression analysis of the combined WBC, neutrophil, and sodium values obtained an AUC of 0.703, indicating moderate diagnostic utility. Conclusion: This study demonstrated that WBC count, neutrophil count, and sodium level, as well as their ratios, can aid in diagnosing appendicitis in pediatric patients. Although sodium levels were significantly lower in patients with appendicitis, no significant difference was found between acute and perforated appendicitis. The WBC/sodium and neutrophil/sodium ratios could be valuable in clinical practice, especially for distinguishing between appendicitis and non-appendicitis cases. Further research is warranted to explore their utility in larger populations. [ABSTRACT FROM AUTHOR]

Background: The impact of and countermeasures for Ureaplasma spp. in neonates remain controversial. The aim of this study was to evaluate the associated perinatal factors that can predict the likelihood of respiratory tract Ureaplasma spp. colonization and analyze the subsequent clinical course of affected infants, thereby providing the rationale for their diagnosis, treatment, and future study. Methods: This was a retrospective observational study of infants born at a gestational age (GA) of less than 32 weeks. Results: The prevalence of respiratory tract Ureaplasma spp. colonization was 25.8% (75/291), and it increased with a decrease in GA and birth weight (BW). Maternal vaginal Ureaplasma spp. colonization increased the risk of neonatal Ureaplasma spp. colonization, with an OR of 7.8 (95% CI: 3.1, 20.0). Infants with Ureaplasma spp. colonization had a higher white blood cell (WBC) count, normal C-reactive protein (CRP) level, and higher failure rate of weaning from mechanical ventilation (30.7% vs. 17.1%, p = 0.014); they also suffered more from interstitial pneumonia (20.0% vs. 5.6%, p < 0.001) and bronchopulmonary dysplasia (36.0% vs. 13.4%, p < 0.001). Infants receiving anti-Ureaplasma spp. treatment had a lower GA, lower BW, and more severe respiratory syndromes. However, the difference in respiratory manifestation became insignificant after adjusting for GA. Conclusions: GA and maternal vaginal Ureaplasma spp. colonization could be used to predict neonatal respiratory tract Ureaplasma spp. colonization. An elevated WBC count combined with normal CRP is a good marker of Ureaplasma spp. colonization/infection. It is conventional practice to start anti-Ureaplasma spp. treatment when infants present with a deteriorated respiratory condition. This practice warrants further investigation considering GA as a predominant intermediate variable. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) management continues to be a challenge globally; weakened immunity plays a significant role in the reactivation of TB. There is limited information on hematological parameters in patients with pulmonary TB and its association with outcome. Objectives: We present hematological parameters of newly diagnosed sputum-positive pulmonary TB patients enrolled in a randomized, clinical trial that assessed the efficacy and safety of 3 and 4 regimens using moxifloxacin. Materials and Methods: Blood hematological parameters at baseline, comparison of the baseline and end of treatment values, including the monocytes by lymphocytes ratio (M/L), neutrophil lymphocyte ratio (N/L), and platelet lymphocyte ratio (P/L) between the patients with favorable and unfavorable TB treatment outcome, and among different age group and sex presented in this paper. Results: Among the total 1059 patients, 782 were males, the mean hemoglobin (HB) ± standard deviation (SD) was 11.5 g/dL ± 2.0, the mean white blood cell (WBC) count ± SD was 9800 ± 3009 and the mean platelet count (in lakhs) ± SD was 4.24 ± 1.42 cells/uL. There was an increase from baseline in the mean hemoglobin, eosinophil, and lymphocyte count and a decrease in mean neutrophil, monocyte counts to the end of treatment. There was a decrease in baseline mean total WBC count posttreatment, both in favorable (10,271 cells/uL ± 3007 SD to 6689 cells/uL ± 1837 SD, [P ≤ 0.001]), and unfavorable TB outcome patients. Conclusion: An increase in HB, and a decrease in WBC count, M/L, N/L, and P/L ratio is possible at the end of TB treatment and future studies to correlate blood hematology parameters with TB treatment outcome.

Yin Cao,1– 4 Qingrong Xia,1– 4 Jun Liang,1– 4 Jiequan Wang,1– 4 Feng Shan,1– 4 Biao Dai1– 4 1Department of Pharmacy, Affiliated Psychological Hospital of Anhui Medical University, Hefei, People’s Republic of China; 2Department of Pharmacy, Hefei Fourth People’s Hospital, Hefei, People’s Republic of China; 3Psychopharmacology Research Laboratory, Anhui Mental Health Center, Hefei, People’s Republic of China; 4Department of Clinical Pharmacy, Anhui Clinical Research Center for Mental Disorders, Hefei, People’s Republic of ChinaCorrespondence: Jun Liang, Department of Pharmacy, Hefei Fourth People’s Hospital, 316 Huangshan Road, Hefei, 230000, People’s Republic of China, Email amhcliangj@163.comObjective: The present study aims to investigate the effect of common cold on the serum clozapine concentrations in hospitalized patients with schizophrenia.Methods: A total of 65 schizophrenic patients with common cold receiving clozapine treatment were retrospectively enrolled. The demographic data, medication situation, clozapine concentration, and parameters of routine haematological and biochemical laboratory tests were obtained from the medical record system. The serum clozapine concentration and clozapine concentration/dose (C/D) ratios between the baseline period and cold period were compared by paired-sample t tests. Association between the changes in serum concentration and C/D ratios of clozapine and changes in white blood cell (WBC) and neutrophil (NE) counts was evaluated using Pearson correlation analysis.Results: The serum clozapine concentration (t = − 9.856, P < 0.001) and clozapine C/D ratios (t = − 10.071, P < 0.001) were found to be significantly elevated in the cold period compared to the baseline period. Moreover, the changes in the serum clozapine concentration were found to be significantly elevated in female patients compared to male patients (t = − 2.483, P = 0.017). Furthermore, changes in the serum clozapine concentration were positively correlated to the changes in WBC (r = 0.303, P = 0.014) and NE (r = 0.315, P = 0.011) counts. Similarly, changes in clozapine C/D ratios were positively correlated to the changes in WBC (r = 0.275, P = 0.027) and NE (r = 0.328, P = 0.008) counts.Conclusion: The serum clozapine concentrations in patients with schizophrenia during the common cold period were increased, which might by related to the elevated WBC and NE counts.Keywords: clozapine, blood drug concentration, schizophrenia, white blood cell count, neutrophil count, common cold

Target values for 25-hydroxy vitamin D and 1,25(OH)2D or 1,25-dihydroxy vitamin D remain a topic of debate among clinicians. We analysed data collected from December 2012 to April 2020 from two cohorts. Cohort A, comprising 455,062 subjects, was used to investigate the relationship between inflammatory indicators (white blood cell [WBC] count and C-reactive protein [CRP]) and 25(OH)D/1,25(OH)2D. Cohort B, including 47,778 subjects, was used to investigate the connection between 25(OH)D/1,25(OH)2D and mineral metabolism markers (phosphate, calcium, and intact parathyroid hormone [iPTH]). Quadratic models fit best for all tested correlations, revealing U-shaped relationships between inflammatory indicators and 25(OH)D and 1,25(OH)2D. Minimal CRP and WBC counts were observed at 1,25(OH)2D levels of 60 pg/mL and at 25(OH)D levels of 32 ng/mL, as well as of 42 ng/mL, respectively. iPTH correlated inversely with both 1,25(OH)2D and 25(OH)D, while phosphate as well as calcium levels positively correlated with both vitamin D forms. Calcium-phosphate product increased sharply when 25(OH)D was more than 50 ng/mL, indicating a possible risk for vascular calcification. Multiple regression analyses confirmed that these correlations were independent of confounders. This study suggests target values for 25(OH)D between 30–50 ng/mL and for 1,25(OH)2D between 50–70 pg/mL, based particularly on their associations with inflammation but also with mineral metabolism markers. These findings contribute to the ongoing discussion around ideal levels of vitamin D but require support from independent studies with data on clinical endpoints. [ABSTRACT FROM AUTHOR]

Objective: White blood cells (WBC) play an important role in the inflammatory response of the body. Elevated WBC counts on admission in patients with subarachnoid hemorrhage (SAH) correlate with a poor prognosis. However, the role of longitudinal WBC trajectories based on repeated WBC measurements during hospitalization remains unclear. We explored the association between different WBC trajectory patterns and in-hospital mortality. Methods: We analyzed a cohort of consecutive patients with SAH between 2012 and 2020. Group-based trajectory modeling (GBTM) was used to group the patients according to their white blood cell patterns over the first 4 days. Stabilized inverse probability treatment weighting (sIPTW) was used to balance baseline demographic and clinical characteristics. We analyzed the association between the WBC trajectory groups and in-hospital mortality using a Cox proportional hazards model. Results: In total, 506 patients with SAH were included in this retrospective cohort. The final model identified two distinct longitudinal WBC trajectories. After adjusting for confounding factors, multivariate regression analysis suggested that an elevated longitudinal WBC trajectory increased the risk of in-hospital mortality (hazard ratio [HR], 2.476; 95% confidence interval [CI] 1.081–5.227; P = 0.024) before sIPTW, and (HR, 2.472; 95%CI 1.489–4.977; P = 0.018) after sIPTW. Conclusion: In patients with SAH, different clinically relevant groups could be identified using WBC trajectory analysis. The WBC count trajectory—initially elevated and then decreased— may lead to an increased risk of in-hospital mortality following SAH. [ABSTRACT FROM AUTHOR]

Background: Hematology is a diagnostic tool used to evaluate the health status of horses. However, breed differences are often not considered. Objectives: The objective was to compare complete blood count variables among Warmbloods, Thoroughbreds, and stock horses (SH). Methods: Ninety-six healthy horses were grouped by breed (Warmbloods, Thoroughbreds, and SH). Samples were collected through venipuncture for complete blood count analysis. One-way ANOVA with Tukey's tests or Kruskal–Wallis with Dunn's post hoc tests were used to compare hematologic variables among groups. Results: Warmbloods had a significantly lower total white blood cell (WBC) count (6.08 ± 1.11 × 109/L) and lymphocyte count (1.76 ± 0.41 × 109/L) than Thoroughbreds (7.28 ± 1.45; 2.28 ± 5.16 × 109/L, respectively; P< .001) and SH (7.21 ± 1.18 × 109/L, P< .01; 2.10 ± 5.17 × 109/L; P< .05). Warmbloods had a significantly lower red blood cell count (7.7 ± 0.8 × 1012/L) and higher mean corpuscular volume (MCV, 49.4 ± 2.2 fL) than Thoroughbreds (8.42 ± 1.2 × 1012/L, P< .01; 47.3 ± 3.0 fL). Warmbloods had lower MCVs than SH (49.4 ± 2.2 vs 51.2 ± 2.6 fL). The mean cell hemoglobin concentration (MCHC) was higher in Warmbloods (35.0, 33.8–36.2 g/dL) and Thoroughbreds (34.9, 33.4–35.7 g/dL) than in SH breeds (34.0, 33.4–35.4 g/dL; P< .001, both). Total protein concentrations were significantly lower in Thoroughbreds (67, 59–80 g/L) compared with SH (71, 64–83 g/dL) (P< .05). Conclusions: Warmbloods had decreased WBC and lymphocyte counts compared with Thoroughbreds and SH, and Thoroughbreds had increased red blood cell counts. Thoroughbreds had lower total protein concentrations than SH. Clinicians should consider breed differences when interpreting hematologic values. [ABSTRACT FROM AUTHOR]

There are established reference ranges for many laboratory values during pregnancy. Fewer studies exist regarding the expected white blood cell (WBC) count after delivery. The aim of this study was to determine appropriate postpartum leukocytosis in a diverse patient cohort. Patients who delivered a live fetus at 37 weeks or later were retrospectively identified. Complete blood counts collected on hospital admission and postpartum day one were used to quantify the change in WBC count associated with delivery. A total of 2245 patients were included; of these patients, 1476 delivered vaginally and 769 delivered via cesarean section. The average change in WBC count was 2.99 × 103/mm3. A WBC count of 20.19 × 103/mm3 defined the 95th percentile. The average rise in WBC count was 3.31 × 103/mm3 after vaginal delivery and 2.34 × 103/mm3 after cesarean section (p < 0.001). Patients with chorioamnionitis or endometritis had an average postpartum WBC rise of 7.38 × 103/mm3 compared to 2.99 × 103/mm3 in controls (p < 0.001). There was no difference in WBC count rise with comorbid asthma, diabetes, or chronic hypertension. A greater WBC count rise was found in patients with pregnancy-induced hypertension. This study provides reference values for the average rise in WBC count after delivery and the 95th percentile postpartum WBC count in a diverse, medically complex patient population with and without delivery complications. Our findings further highlight maternal medical comorbidities that may contribute to the degree of postpartum leukocytosis. [ABSTRACT FROM AUTHOR]

There are established reference ranges for many laboratory values during pregnancy. Fewer studies exist regarding the expected white blood cell (WBC) count after delivery. The aim of this study was to determine appropriate postpartum leukocytosis in a diverse patient cohort. Patients who delivered a live fetus at 37 weeks or later were retrospectively identified. Complete blood counts collected on hospital admission and postpartum day one were used to quantify the change in WBC count associated with delivery. A total of 2245 patients were included; of these patients, 1476 delivered vaginally and 769 delivered via cesarean section. The average change in WBC count was 2.99 × 103/mm3. A WBC count of 20.19 × 103/mm3 defined the 95th percentile. The average rise in WBC count was 3.31 × 103/mm3 after vaginal delivery and 2.34 × 103/mm3 after cesarean section (p < 0.001). Patients with chorioamnionitis or endometritis had an average postpartum WBC rise of 7.38 × 103/mm3 compared to 2.99 × 103/mm3 in controls (p < 0.001). There was no difference in WBC count rise with comorbid asthma, diabetes, or chronic hypertension. A greater WBC count rise was found in patients with pregnancy-induced hypertension. This study provides reference values for the average rise in WBC count after delivery and the 95th percentile postpartum WBC count in a diverse, medically complex patient population with and without delivery complications. Our findings further highlight maternal medical comorbidities that may contribute to the degree of postpartum leukocytosis.

Abstract Background and aims Current research has suggested that asialoglycoprotein receptor 1 (ASGR1) is involved in cholesterol metabolism and is also related to systemic inflammation. This study aimed to assess the correlation between the serum soluble ASGR1 (sASGR1) concentration and inflammatory marker levels. Moreover, the second objective of the study was to assess the association between sASGR1 levels and the presence of coronary artery disease (CAD). Methods The study subjects included 160 patients who underwent coronary angiography. Ninety patients were diagnosed with CAD, while seventy age- and sex-matched non-CAD patients served as controls. We measured the serum sASGR1 levels using an ELISA kit after collecting clinical baseline characteristics. Results Patients with CAD had higher serum sASGR1 levels than non-CAD patients did (P

BackgroundIn trials conducted in India, recombinant granulocyte colony stimulating factor (GCSF) improved survival in alcohol-associated hepatitis (AH). The aim of this trial was to determine the safety and efficacy of pegfilgrastim, a long-acting recombinant GCSF, in patients with AH in the United States.MethodsThis prospective, randomized, open label trial conducted between March 2017 and March 2020 randomized patients with a clinical diagnosis of AH and a Maddrey discriminant function score ≥32 to standard of care (SOC) or SOC+pegfilgrastim (0.6 mg subcutaneously) on Day 1 and Day 8 (clinicaltrials.gov NCT02776059). SOC was 28 days of either pentoxifylline or prednisolone, as determined by the patient's primary physician. The second injection of pegfilgrastim was not administered if the white blood cell count exceeded 30,000/mm3 on Day 8. Primary outcome was survival at Day 90. Secondary outcomes included the incidence of acute kidney injury (AKI), hepatorenal syndrome (HRS), hepatic encephalopathy, or infections.FindingsThe study was terminated early due to COVID19 pandemic. Eighteen patients were randomized to SOC and 16 to SOC+pegfilgrastim. All patients received prednisolone as SOC. Nine patients failed to receive a second dose of pegfilgrastin due to WBC > 30,000/mm3 on Day 8. Survival at 90 days was similar in both groups (SOC: 0.83 [95% confidence interval [CI]: 0.57-0.94] vs. pegfilgrastim: 0.73 [95% CI: 0.44-0.89]; p > 0.05; CI for difference: -0.18-0.38). The incidences of AKI, HRS, hepatic encephalopathy, and infections were similar in both treatment arms and there were no serious adverse events attributed to pegfilgrastim.InterpretationThis phase II trial found no survival benefit at 90 days among subjects with AH who received pegfilgrastim+prednisolone compared with subjects receiving prednisolone alone.Fundingwas provided by the United States National Institutes of Health and National Institute on Alcohol Abuse and Alcoholism U01-AA021886 and U01-AA021884.

• Multiple mendelian randomization (MR) methods examined the directions of genetically-predicted relationships between schizophrenia and white cell counts. • Bidirectional genetic genetically-predicted relationships for elevated lymphocyte counts and schizophrenia risk were supported by most MR methods. • Genetically-predicted liability to schizophrenia is associated with elevated lymphocyte, monocyte and neutrophil counts. • Genetically-predicted elevation of lymphocyte, eosinophil, and monocyte counts may contribute to the development of schizophrenia, consistent with the vulnerability-stress-inflammation model. • The SNP of rs13195636 located in the MHC region appears highly influential in MR results, shared by schizophrenia and white cell counts. Schizophrenia and white blood cell counts (WBC) are both complex and polygenic traits. Previous evidence suggests that increased WBC are associated with higher all-cause mortality, and other studies have found elevated WBC in first-episode psychosis and chronic schizophrenia. However, these observational findings may be confounded by antipsychotic exposures and their effects on WBC. Mendelian randomization (MR) is a useful method for examining the directions of genetically-predicted relationships between schizophrenia and WBC. We performed a two-sample MR using summary statistics from genome-wide association studies (GWAS) conducted by the Psychiatric Genomics Consortium Schizophrenia Workgroup (N = 130,644) and the Blood Cell Consortium (N = 563,946). The MR methods included inverse variance weighted (IVW), MR Egger, weighted median, MR-PRESSO, contamination mixture, and a novel approach called mixture model reciprocal causal inference (MRCI). False discovery rate was employed to correct for multiple testing. Multiple MR methods supported bidirectional genetically-predicted relationships between lymphocyte count and schizophrenia: IVW (b = 0.026; FDR p-value = 0.008), MR Egger (b = 0.026; FDR p-value = 0.008), weighted median (b = 0.013; FDR p-value = 0.049), and MR-PRESSO (b = 0.014; FDR p-value = 0.010) in the forward direction, and IVW (OR = 1.100; FDR p-value = 0.021), MR Egger (OR = 1.231; FDR p-value < 0.001), weighted median (OR = 1.136; FDR p-value = 0.006) and MRCI (OR = 1.260; FDR p-value = 0.026) in the reverse direction. MR Egger (OR = 1.171; FDR p-value < 0.001) and MRCI (OR = 1.154; FDR p-value = 0.026) both suggested genetically-predicted eosinophil count is associated with schizophrenia, but MR Egger (b = 0.060; FDR p-value = 0.010) and contamination mixture (b = -0.013; FDR p-value = 0.045) gave ambiguous results on whether genetically predicted liability to schizophrenia would be associated with eosinophil count. MR Egger (b = 0.044; FDR p-value = 0.010) and MR-PRESSO (b = 0.009; FDR p-value = 0.045) supported genetically predicted liability to schizophrenia is associated with elevated monocyte count, and the opposite direction was also indicated by MR Egger (OR = 1.231; FDR p-value = 0.045). Lastly, unidirectional genetic liability from schizophrenia to neutrophil count were proposed by MR-PRESSO (b = 0.011; FDR p-value = 0.028) and contamination mixture (b = 0.011; FDR p-value = 0.045) method. This MR study utilised multiple MR methods to obtain results suggesting bidirectional genetic genetically-predicted relationships for elevated lymphocyte counts and schizophrenia risk. In addition, moderate evidence also showed bidirectional genetically-predicted relationships between schizophrenia and monocyte counts, and unidirectional effect from genetic liability for eosinophil count to schizophrenia and from genetic liability for schizophrenia to neutrophil count. The influence of schizophrenia to eosinophil count is less certain. Our findings support the role of WBC in schizophrenia and concur with the hypothesis of neuroinflammation in schizophrenia. [ABSTRACT FROM AUTHOR]

Intoduction/Aim. Agreement or disagreement of inflammatory parameters becomes important for making diagnosis when disparate values are encountered in a patient with suspected sepsis. The aim of our study was to test the agreement between the four commonly used tests for diagnosing systemic infection: white blood cell count (WBC), serum levels of C-reactive protein (CRP), procalcitonin and presepsin. This cross-sectional study included 479 adult patients hospitalized in the Clinical Center Kragujevac during 2019, who were suspected to have systemic infection and whose microbiological analyses were positive. Results. In a sample of hospital patients with isolated bacteria from the sites of suspected infection, the parameters of inflammation showed low agreement when used for diagnosing systemic infection. Only presepsin serum levels showed significant level of agreement with CRP and procalcitonin (Cohen's kappa = 0,257, p = 0,000Cohen's kappa = 0,169, p = 0,000, respectively, but also with low kappa values, while the agreement between CRP and procalcitonin was insignificant, as well as between the white cell count and the remaining three parameters. Conclusions. When disparate values of parameters of inflammation are encountered in a patient with suspected sepsis, a decision about antibiotic therapy should be based on either of the two pairs of parameters, presepsin/C-reactive protein or presepsin/procalcitonin. Keywords: sepsis, presepsin, procalcitonin, C-reactive protein, white blood cell count. [ABSTRACT FROM AUTHOR]

Background and aims: Current research has suggested that asialoglycoprotein receptor 1 (ASGR1) is involved in cholesterol metabolism and is also related to systemic inflammation. This study aimed to assess the correlation between the serum soluble ASGR1 (sASGR1) concentration and inflammatory marker levels. Moreover, the second objective of the study was to assess the association between sASGR1 levels and the presence of coronary artery disease (CAD). Methods: The study subjects included 160 patients who underwent coronary angiography. Ninety patients were diagnosed with CAD, while seventy age- and sex-matched non-CAD patients served as controls. We measured the serum sASGR1 levels using an ELISA kit after collecting clinical baseline characteristics. Results: Patients with CAD had higher serum sASGR1 levels than non-CAD patients did (P < 0.0001). sASGR1 was independently correlated with the risk of CAD after adjusting for confounding variables (OR = 1.522, P = 0.012). The receiver operating characteristic (ROC) curve showed that sASGR1 had a larger area under the curve (AUC) than did the conventional biomarkers apolipoprotein B (APO-B) and low-density lipoprotein cholesterol (LDL-C). In addition, multivariate linear regression models revealed that sASGR1 is independently and positively correlated with high-sensitivity C-reactive protein (CRP) (β = 0.86, P < 0.001) and WBC (β = 0.13, P = 0.004) counts even after adjusting for lipid parameters. According to our subgroup analysis, this relationship existed only for CAD patients. Conclusion: Our research demonstrated the link between CAD and sASGR1 levels, suggesting that sASGR1 may be an independent risk factor for CAD. In addition, this study provides a reference for revealing the potential role of sASGR1 in the inflammation of atherosclerosis. [ABSTRACT FROM AUTHOR]

Abstract Objective Acute mesenteric vein thrombosis (AMVT) is an acute abdominal disease with onset, rapid progression, and extensive intestinal necrosis that requires immediate surgical resection. The purpose of this study was to determine the risk factors for nosocomial intestinal resection in patients with AMVT. Methods We retrospectively analysed 64 patients with AMVT diagnosed by CTA at the Affiliated Hospital of Kunming University of Science and Technology from January 2013 to December 2021. We compared patients who underwent intestinal resection (42 patients) with those who did not undergo intestinal resection (22 patients). The area under the ROC curve was evaluated, and a forest map was drawn. Results Among the 64 patients, 6 (9.38%) had a fever, 60 (93.75%) had abdominal pain, 9 (14.06%) had a history of diabetes, 8 (12.5%) had a history of deep vein thrombosis (DVT), and 25 (39.06%) had ascites suggested by B ultrasound or CT after admission. The mean age of all patients was 49.86 ± 16.25 years. The mean age of the patients in the enterectomy group was 47.71 ± 16.20 years. The mean age of the patients in the conservative treatment group (without enterectomy) was 53.95 ± 15.90 years. In the univariate analysis, there were statistically significant differences in leukocyte count (P = 0.003), neutrophil count (P = 0.001), AST (P = 0.048), total bilirubin (P = 0.047), fibrinogen (P = 0.022) and DD2 (P = 0.024) between the two groups. The multivariate logistic regression analysis showed that admission white blood cell count (OR = 1.153, 95% CI: 1.039–1.280, P = 0.007) was an independent risk factor for intestinal resection in patients with AMVT. The ROC curve showed that the white blood cell count (AUC = 0.759 95% CI: 0.620–0.897; P = 0.001; optimal threshold: 7.815; sensitivity: 0.881; specificity: 0.636) had good predictive value for emergency enterectomy for AMVT. Conclusions Among patients with AMVT, patients with a higher white blood cell count at admission were more likely to have intestinal necrosis and require emergency enterectomy. This study is helpful for clinicians to accurately determine whether emergency intestinal resection is needed in patients with AMVT after admission, prevent further intestinal necrosis, and improve the prognosis of patients.

Abstract Background Vitamin D has been suggested to influence the immune system, and vitamin D metabolites and the vitamin D receptor (VDR) are generated and expressed in white blood cells (WBC). Moreover, vitamin D status has been associated with incidence and prognosis of some respiratory tract infections (RTI). Therefore, we investigated the effect of vitamin D3 supplementation on WBC, acute phase reactants (APR), and the risk of developing RTIs. Methods A double-blinded, randomized, placebo-controlled clinical trial of 307 infertile men with multiple secondary immunological endpoints. The vitamin D3 group (n = 151) initially received 300,000 IU (7,500 µg) cholecalciferol once - followed by 1,400 IU (35 µg) daily for 150 days. The placebo group (n = 156) did not receive active ingredients. Results At baseline, stratification into clinically relevant groups of vitamin D status (75 nmol/L), showed an inverse association with total leucocyte concentrations (7.0 vs. 6.0 vs. 6.0 vs. 5.5 (109/L); p = 0.007), lymphocytes (2.4 vs. 2.1 vs. 2.0 vs. 2.0 (109/L); p = 0.048), CRP (2.0 vs. 1.7 vs. 1.2 vs. 1.2 (mg/L); p = 0.037), and orosomucoid (0.82 vs. 0.77 vs. 0.76 vs. 0.70 (g/L); p = 0.015). After 150 days, no differences were detected in WBC counts or APRs between the vitamin D3 and the placebo group. However, vitamin D3 treated men had a higher prevalence of self-reported RTIs compared with the placebo group (55% vs. 39%; p = 0.005). Conclusions High-dose vitamin D3 supplementation did not alter WBCs or APRs, but a higher prevalence of respiratory infections was observed in the vitamin D3 group. Serum 25(OH)D3 was negatively correlated with most WBCs, indicating that vitamin D status may be linked with inflammation and WBC turnover, but not an important determinant of developing RTIs. Trial registration NCT01304927 (ClinicalTrials.gov). Registered February 20, 2011.

Objective To explore the predictive value of serum amyloid A1 (SAA1) in acute myocardial infarction (AMI). Methods A total of 139 patients with AMI and 146 patients with non coronary atherosclerotic heart disease admitted to the China-Japan Union Hospital of Jilin University from September 2017 to April 2019 were selected as the research objects. Enzyme linked immunosorbent assay (ELISA) was used to determine the level of SAA1 in plasma. Logistic regression was used to analyze the independent influencing factors of AMI, and receiver operating characteristic (ROC) curve was used to analyze the value of SAA1 in the diagnosis of AMI. Results The level of SAA1 in the AMI group was lower than that in the control group [2.62 (2.08,3.21) ng/mL vs 5.18 (3.24,8.27) ng/mL, Z=10.169, P

Background: The impact of and countermeasures for Ureaplasma spp. in neonates remain controversial. The aim of this study was to evaluate the associated perinatal factors that can predict the likelihood of respiratory tract Ureaplasma spp. colonization and analyze the subsequent clinical course of affected infants, thereby providing the rationale for their diagnosis, treatment, and future study. Methods: This was a retrospective observational study of infants born at a gestational age (GA) of less than 32 weeks. Results: The prevalence of respiratory tract Ureaplasma spp. colonization was 25.8% (75/291), and it increased with a decrease in GA and birth weight (BW). Maternal vaginal Ureaplasma spp. colonization increased the risk of neonatal Ureaplasma spp. colonization, with an OR of 7.8 (95% CI: 3.1, 20.0). Infants with Ureaplasma spp. colonization had a higher white blood cell (WBC) count, normal C-reactive protein (CRP) level, and higher failure rate of weaning from mechanical ventilation (30.7% vs. 17.1%, p = 0.014); they also suffered more from interstitial pneumonia (20.0% vs. 5.6%, p < 0.001) and bronchopulmonary dysplasia (36.0% vs. 13.4%, p < 0.001). Infants receiving anti-Ureaplasma spp. treatment had a lower GA, lower BW, and more severe respiratory syndromes. However, the difference in respiratory manifestation became insignificant after adjusting for GA. Conclusions: GA and maternal vaginal Ureaplasma spp. colonization could be used to predict neonatal respiratory tract Ureaplasma spp. colonization. An elevated WBC count combined with normal CRP is a good marker of Ureaplasma spp. colonization/infection. It is conventional practice to start anti-Ureaplasma spp. treatment when infants present with a deteriorated respiratory condition. This practice warrants further investigation considering GA as a predominant intermediate variable.

Objective: Acute mesenteric vein thrombosis (AMVT) is an acute abdominal disease with onset, rapid progression, and extensive intestinal necrosis that requires immediate surgical resection. The purpose of this study was to determine the risk factors for nosocomial intestinal resection in patients with AMVT. Methods: We retrospectively analysed 64 patients with AMVT diagnosed by CTA at the Affiliated Hospital of Kunming University of Science and Technology from January 2013 to December 2021. We compared patients who underwent intestinal resection (42 patients) with those who did not undergo intestinal resection (22 patients). The area under the ROC curve was evaluated, and a forest map was drawn. Results: Among the 64 patients, 6 (9.38%) had a fever, 60 (93.75%) had abdominal pain, 9 (14.06%) had a history of diabetes, 8 (12.5%) had a history of deep vein thrombosis (DVT), and 25 (39.06%) had ascites suggested by B ultrasound or CT after admission. The mean age of all patients was 49.86 ± 16.25 years. The mean age of the patients in the enterectomy group was 47.71 ± 16.20 years. The mean age of the patients in the conservative treatment group (without enterectomy) was 53.95 ± 15.90 years. In the univariate analysis, there were statistically significant differences in leukocyte count (P = 0.003), neutrophil count (P = 0.001), AST (P = 0.048), total bilirubin (P = 0.047), fibrinogen (P = 0.022) and DD2 (P = 0.024) between the two groups. The multivariate logistic regression analysis showed that admission white blood cell count (OR = 1.153, 95% CI: 1.039–1.280, P = 0.007) was an independent risk factor for intestinal resection in patients with AMVT. The ROC curve showed that the white blood cell count (AUC = 0.759 95% CI: 0.620–0.897; P = 0.001; optimal threshold: 7.815; sensitivity: 0.881; specificity: 0.636) had good predictive value for emergency enterectomy for AMVT. Conclusions: Among patients with AMVT, patients with a higher white blood cell count at admission were more likely to have intestinal necrosis and require emergency enterectomy. This study is helpful for clinicians to accurately determine whether emergency intestinal resection is needed in patients with AMVT after admission, prevent further intestinal necrosis, and improve the prognosis of patients. [ABSTRACT FROM AUTHOR]

Aim: To explore the predictive value of white blood cell to hemoglobin ratio (WHR) for 30-day mortality in patients with intracerebral hemorrhage (ICH). Methods: In this cohort study, 2,848 patients with ICH were identified in the Medical Information Mart for Intensive Care (MIMIC)-III and MIMIC-IV. Least absolute shrinkage and selection operator (LASSO) regression screened covariates of 30-day mortality of ICH patients. COX regression analysis was used to study the association of different levels of WHR, white blood cell (WBC), and hemoglobin (Hb) with 30-day mortality. The median follow-up time was 30 (20.28, 30.00) days. Results: In total, 2,068 participants survived at the end of the follow-up. WHR was negatively correlated with the Glasgow Coma Score (GCS) (spearman correlation coefficient= -0.143, p < 0.001), and positively associated with the Sepsis-related Organ Failure Assessment (SOFA) score (spearman correlation coefficient= 0.156, p < 0.001), quick SOFA (qSOFA) score (spearman correlation coefficient= 0.156, p < 0.001), and Simplified Acute Physiology Score II (SAPS-II) (spearman correlation coefficient= 0.213, p < 0.001). After adjusting for confounders, WHR >0.833 (HR= 1.64, 95%CI: 1.39-1.92) and WBC >10.9K/uL (HR= 1.49, 95%CI: 1.28-1.73) were associated with increased risk of 30-day mortality of patients with ICH. The area under the curve (AUC) value of the prediction model based on WHR and other predictors was 0.78 (95%CI: 0.77-0.79), which was higher than SAPSII (AUC= 0.75, 95%CI: 0.74-0.76), SOFA score (AUC= 0.69, 95%CI: 0.68-0.70) and GCS (AUC= 0.59, 95%CI: 0.57-0.60). Conclusion: The level of WHR was associated with 30-day mortality in patients with severe ICH, and the WHR-based prediction model might provide a tool to quickly predict 30-day mortality in patients with ICH. [ABSTRACT FROM AUTHOR]

Background: Upper tract urothelial carcinoma (UTUC) is a rare clinical condition primarily characterized by symptoms such as gross or microscopic hematuria, flank pain, and renal colic. Although computed tomography urography (CTU) is currently the most accurate imaging modality for diagnosis, atypical presentations and physical examination findings can sometimes obscure lesions, posing diagnostic challenges. Case presentation: In this report, three patients exhibited atypical symptoms, sharing a common complaint of flank pain. Notably, the first patient, who had recently undergone laparoscopic right duplex nephrectomy, presented with microscopic hematuria, whereas the other two did not show any gross or microscopic hematuria. Computed tomography urography revealed hydronephrosis and infection without significant renal pelvic space-occupying lesions, with persistently elevated white blood cell (WBC) counts, but no fever. These atypical clinical presentations confounded clinicians, delaying the diagnosis of upper tract urothelial carcinoma until postoperative pathological examination for the first two patients and resulting in advanced-stage diagnosis for the third patient. Postoperative pathology confirmed high-grade invasive upper tract urothelial carcinoma in all three patients. Conclusion: Upper tract urothelial carcinoma can manifest atypically without hematuria and may be challenging to visualize on computed tomography urography, potentially leading to misdiagnosis. Therefore, clinicians should maintain a high level of suspicion for malignant tumors when patients exhibit hydronephrosis, infection on imaging, and persistently elevated white blood cell counts without fever, even in the absence of typical signs of upper urothelial carcinoma on computed tomography urography. [ABSTRACT FROM AUTHOR]

Objective: To investigate the levels of white blood cell count (WBC), procalcitonin (PCT), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) in patients with acute community-acquired lower respiratory tract infections and the value of their combined detection in predicting the occurrence of complications. Methods: A retrospective analysis was conducted on the clinical data of 218 patients with acute community-acquired lower respiratory tract infections admitted to Baoding No.1 Central Hospital from January 2021 to December 2021. All patients were divided into two groups according to the presence of complications during treatment: the group with complications (observation group) and the group without complications (control group). The treatment situation of the two groups was compared, and their levels of WBC, PCT, CRP and ESR were quantitatively detected and compared. Results: Patients in the observation group were hospitalized for significantly longer days than those in the control group (P<0.05), and their combined pleural effusion percentage and oxygen uptake rate were higher than those in the control group (P<0.05). The levels of WBC, PCT, CRP and ESR in the observation group were significantly higher than those in the control group at admission, with statistically significant differences (P<0.05). Moreover, the positive rates of WBC, PCT, CRP and ESR in the observation group were higher than those in the control group in the single detection and the combined detection (P<0.05). Conclusions: The combined detection of WBC, PCT, CRP and ESR has substantial predictive value in predicting the occurrence of complications in patients with community-acquired lower respiratory tract infections. [ABSTRACT FROM AUTHOR]

Background: Vitamin D has been suggested to influence the immune system, and vitamin D metabolites and the vitamin D receptor (VDR) are generated and expressed in white blood cells (WBC). Moreover, vitamin D status has been associated with incidence and prognosis of some respiratory tract infections (RTI). Therefore, we investigated the effect of vitamin D3 supplementation on WBC, acute phase reactants (APR), and the risk of developing RTIs. Methods: A double-blinded, randomized, placebo-controlled clinical trial of 307 infertile men with multiple secondary immunological endpoints. The vitamin D3 group (n = 151) initially received 300,000 IU (7,500 µg) cholecalciferol once - followed by 1,400 IU (35 µg) daily for 150 days. The placebo group (n = 156) did not receive active ingredients. Results: At baseline, stratification into clinically relevant groups of vitamin D status (< 25; 25–50; 50–75; >75 nmol/L), showed an inverse association with total leucocyte concentrations (7.0 vs. 6.0 vs. 6.0 vs. 5.5 (109/L); p = 0.007), lymphocytes (2.4 vs. 2.1 vs. 2.0 vs. 2.0 (109/L); p = 0.048), CRP (2.0 vs. 1.7 vs. 1.2 vs. 1.2 (mg/L); p = 0.037), and orosomucoid (0.82 vs. 0.77 vs. 0.76 vs. 0.70 (g/L); p = 0.015). After 150 days, no differences were detected in WBC counts or APRs between the vitamin D3 and the placebo group. However, vitamin D3 treated men had a higher prevalence of self-reported RTIs compared with the placebo group (55% vs. 39%; p = 0.005). Conclusions: High-dose vitamin D3 supplementation did not alter WBCs or APRs, but a higher prevalence of respiratory infections was observed in the vitamin D3 group. Serum 25(OH)D3 was negatively correlated with most WBCs, indicating that vitamin D status may be linked with inflammation and WBC turnover, but not an important determinant of developing RTIs. Trial registration: NCT01304927 (ClinicalTrials.gov). Registered February 20, 2011. [ABSTRACT FROM AUTHOR]

Background This study was performed to assess the impact of preaspiration antibiotics on synovial fluid analysis and timing of operative treatment in native-joint septic arthritis. Methods We performed a retrospective record review of adult patients from an urban level 1 trauma center with native joint septic arthritis in 2015–2019, identified by means of codes from the International Classification of Diseases (Ninth Revision and Tenth Revision). Univariate and multivariate analyses were performed to determine whether antibiotics were associated with lower synovial fluid white blood cell counts (WBCs), the percentage of polymorphonuclear neutrophil (PMNs), and rate of culture positivity. Secondary analysis included time elapsed from aspiration to surgery. Results Of the 126 patients with septic joints included, nearly two-thirds (n = 80 [63.5%]) received antibiotics before joint aspiration. The synovial fluid WBC count, percentage of PMNs, and rate of culture positivity were significantly lower in patients who received preaspiration antibiotics than in those who did not (mean WBC count, 51 379.1/μL [standard deviation, 52 576.3/μL] vs 92 162.7/μL [59 330.6/μL], respectively [ P <.001]; PMN percentage, 83.6% [20.5%] vs 91.9% [6.0%; P =.01]; and culture positivity, 32.5% vs 59.1% [ P =.008]). Multivariable analyses revealed that these associations remained after controlling for potential confounders (change in PMNs, −42 784.60/μL [95% confidence interval, −65 355/μL to −20 213.90/μL [ P <.001]; change in PMNs, −7.8% [−13.7% to −1.8%] [ P =.01]; odds ratio, 0.39 [.18–.87; P =.02). Patients with a synovial fluid WBC count ≤50 000/μL experienced significant delay in time from joint aspiration to operative intervention (mean [standard deviation], 10.5 [11.3] vs 17.9 [17.2] hours; P =.02). Conclusions The administration of antibiotics before joint aspiration for suspected septic arthritis appears to decrease the synovial fluid WBC count, the percentage of PMNs, and the rate of culture positivity. Efforts to limit antibiotic administration before joint aspiration are important to minimize diagnostic dilemmas and circumvent treatment delays. [ABSTRACT FROM AUTHOR]

Observational studies have suggested a protective role for eosinophils in colorectal cancer (CRC) development and implicated neutrophils, but the causal relationships remain unclear. Here, we aimed to estimate the causal effect of circulating white blood cell (WBC) counts (N = ~550 000) for basophils, eosinophils, monocytes, lymphocytes and neutrophils on CRC risk (N = 52 775 cases and 45 940 controls) using Mendelian randomisation (MR). For comparison, we also examined this relationship using individual‐level data from UK Biobank (4043 incident CRC cases and 332 773 controls) in a longitudinal cohort analysis. The inverse‐variance weighted (IVW) MR analysis suggested a protective effect of increased basophil count and eosinophil count on CRC risk [OR per 1‐SD increase: 0.88, 95% CI: 0.78‐0.99, P =.04; OR: 0.93, 95% CI: 0.88‐0.98, P =.01]. The protective effect of eosinophils remained [OR per 1‐SD increase: 0.88, 95% CI: 0.80‐0.97, P =.01] following adjustments for all other WBC subtypes, to account for genetic correlation between the traits, using multivariable MR. A protective effect of increased lymphocyte count on CRC risk was also found [OR: 0.84, 95% CI: 0.76‐0.93, P = 6.70e‐4] following adjustment. Consistent with MR results, a protective effect for eosinophils in the cohort analysis in the fully adjusted model [RR per 1‐SD increase: 0.96, 95% CI: 0.93‐0.99, P =.02] and following adjustment for the other WBC subtypes [RR: 0.96, 95% CI: 0.93‐0.99, P =.001] was observed. Our study implicates peripheral blood immune cells, in particular eosinophils and lymphocytes, in CRC development, highlighting a need for mechanistic studies to interrogate these relationships. [ABSTRACT FROM AUTHOR]

Objectives: This study evaluated the effects of sevoflurane-based inhalation anesthesia and propofol-based total intravenous anesthesia on hematological parameters in coronary artery bypass grafting (CABG). Methods: In this study, 125 patients who underwent elective on-pump CABG between November 2021 and April 2022 were retrospectively analyzed. Patients aged 35–80 years with an ejection fraction of ≥25% were included. The patients were separated into two groups: The sevoflurane group (Group SEVO) and the total intravenous anesthesia group (Group TIVA). Patient characteristics, operative clinical data, and preoperative and postoperative hematological parameters: [white blood cell (WBC) count, red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR)] were analyzed. Results: The mean age of the patients was 62.0±8.7 years. Group SEVO comprised 70 patients, and Group TIVA comprised 55 patients. Significant increases in postoperative WBC count, RDW, and NLR values were observed in both groups. No statistically significant differences in WBC count, RDW, and NLR values were observed between the two groups (p>0.05). Conclusion: The effects of sevoflurane-based inhalation anesthesia or propofol-based total intravenous anesthesia on WBC count, RDW, and NLR values among patients undergoing elective on-pump CABG were similar. [ABSTRACT FROM AUTHOR]

This study aims to construct a nomogram model for predicting poor prognosis in acute leukemia with trisomy 8. A retrospective analysis was conducted on 244 patients with primary acute leukemia with trisomy 8 who received treatment in our hospital, and they were randomly divided into the modeling group (122 cases, including 78 cases with good prognosis and 44 cases with poor prognosis) and the verification group (122 cases). R software was used to construct a nomogram model for predicting poor prognosis in acute leukemia with trisomy 8. The results of multivariate analysis showed that age >51 years old, and white blood cell count ≤20 × 109/L were risk factors for poor prognosis in acute leukemia patients with trisomy 8 (P < 0.05), and chemotherapy + transplantation was a protective factor for poor prognosis in acute leukemia patients with trisomy 8 (P < 0.05). The nomogram for poor prognosis of acute leukemia patients with trisomy 8 was constructed using the above four risk predictors. The Hosmer-Lemeshow goodness of fit test was = 6.371, P = 0.497, and the area under the ROC curve was 0.817 (95%CI: 0.742-0.892). The slope of the calibration curve of external validation was close to 1, Hosmer-Lemeshow goodness of fit test was $\chi ^2$ χ 2 = 6.507, P = 0.448, and the area under the ROC curve was 0.834 (95%CI: 0.748-0.921). The nomogram model constructed in this study for predicting poor prognosis among acute leukemia patients with trisomy 8 demonstrates excellent discrimination and consistency. [ABSTRACT FROM AUTHOR]

BackgroundLeukocytosis is a rise in white blood cell (WBC) count and clinical outcomes of moderate to severe leukocytosis in trauma patients have not been described. We hypothesized that trauma patients with severe leukocytosis (SL; ≥40.0 × 109 leukocytes/L) have higher rates of in-hospital complications and mortality than those with moderate leukocytosis (ML; 25.0-39 × 109 leukocytes/L).MethodsWe performed a retrospective analysis (2010-2017) on trauma patients developing ML or SL at a single Level-I trauma center. A multivariable logistic regression analysis for risk factors were performed.ResultsFrom 15,807 trauma admissions, 332 (2.1%) had ML or SL. Of these, 308 (92.8%) were ML and 24 (7.2%) were SL. Patients with ML and SL reached their peak WBC count in 1 and 10 days after admission respectively (p

Introduction: Stroke is one of the leading causes of mortality and morbidity worldwide, with ischaemic stroke being the most common . Inflammation plays a key role in the pathogenesis of ischaemic stroke and the tissue injury that occurs poststroke, leading to stroke severity. Aim: To assess whether the Neutrophil to Lymphocyte Ratio (NLR), Lymphocyte to Monocyte Ratio (LMR), and Platelet to Lymphocyte Ratio (PLR) ratios correlate with the severity of ischaemic stroke in acute ischaemic stroke cases. Materials and Methods: This was a prospective cohort study conducted at KR Hospital, Mysore, Karnataka, India from July 2021 to June 2022, wherein 106 ischaemic stroke cases presenting within 24 hours of symptom onset were assessed, and the outcomes at discharge or at the end of one week were noted. Routine investigations and Non Contrast Computed Tomography (NCCT) brain scans were performed at the time of admission. National Institute of Health Stroke Scale (NIHSS) scoring was conducted at admission, and patients were grouped into mild to moderate stroke (

BackgroundAsthma is a heterogeneous disease. Clinical blood parameters differ by race/ethnicity and are used to distinguish asthma subtypes and inform therapies. Differences in subtypes may explain population-specific trends in asthma outcomes. However, these differences in racial/ethnic minority pediatric populations are unclear.ObjectiveWe investigated the association of blood parameters and asthma subtypes with asthma outcomes and examined population-specific eligibility for biologic therapies in minority pediatric populations.MethodsUsing data from 2 asthma case-control studies of pediatric minority populations, we performed case-control (N = 3738) and case-only (N = 2743) logistic regressions to quantify the association of blood parameters and asthma subtypes with asthma outcomes. Heterogeneity of these associations was tested using an interaction term between race/ethnicity and each exposure. Differences in therapeutic eligibility were investigated using chi-square tests.ResultsRace/ethnicity modified the association between total IgE and asthma exacerbations. Elevated IgE level was associated with worse asthma outcomes in Puerto Ricans. Allergic asthma was associated with worse outcomes in Mexican Americans, whereas eosinophilic asthma was associated with worse outcomes in Puerto Ricans. A lower proportion of Puerto Ricans met dosing criteria for allergic asthma-directed biologic therapy than other groups. A higher proportion of Puerto Ricans qualified for eosinophilic asthma-directed biologic therapy than African Americans.ConclusionsWe found population-specific associations between blood parameters and asthma subtypes with asthma outcomes. Our findings suggest that eligibility for asthma biologic therapies differs across pediatric racial/ethnic populations. These findings call for more studies in diverse populations for equitable treatment of minority patients with asthma.

Bo Wang, Qi-Mao Wang, De-Xin Li Department of Neonatology, The Hospital of Suixi County, Huaibei, People’s Republic of ChinaCorrespondence: Bo Wang, Department of Neonatology, The Hospital of Suixi County, No. 114 of Xihe Road, Suixi County, Huaibei, Anhui, 235000, People’s Republic of China, Tel +86-05616091010, Email bowangwb1908@163.comObjective: To investigate the primary predictive factors for the occurrence of severe neonatal infection, construct a prediction model and assess its effectiveness.Methods: A total of 160 neonates hospitalised in the Department of Neonatology at Suixi County Hospital from January 2019 to June 2022 were retrospectively analysed. Clinical data was analyzed to determine the primary predictive factors for the occurrence of severe neonatal infection. Predictive efficacy was evaluated using a receiver operating characteristic curve, and a nomogram model was constructed according to the predictors. A bootstrap technique was used to verify the accuracy of the model.Results: The neonates were divided, based on the degree of infection, into a mild infection group (n = 80) and a severe infection group (n = 80) according to a 1:1 ratio. Multivariate logistic regression analysis showed that compared with the recovery stage, white blood cell count (WBC) and platelet count (PLT) in the two groups were significantly decreased in the early stage of infection, and the ratio of mean platelet volume to PLT, as well as C-reactive protein (CRP) and procalcitonin levels, was elevated (P

Objective: To explore the correlation between changes in the body fat ratio (BFR) and peripheral blood inflammatory markers according to smoking status in the adult Chinese male population. Methods: A total of 865 participants (aged 20–70 years) were included. All participants underwent a physical health examination at Xiguzhou Central Hospital between October 2015 and July 2016, including measurements of body mass index (BMI), BFR, white blood cell [WBC] count, and neutrophil–lymphocyte ratio [NLR]. Results: WBCs count and NLR were significantly higher in adult male smokers than in non-smokers (P = 0.00). According to the BFR stratification analysis, WBC count and NLR significantly increased in accordance with BFR (P = 0.00). This finding remained significant after adjusting for relevant confounding factors (P

Simple Summary: Blood reference intervals are important for the correct interpretation of blood results but are missing for many wild species. The aim of the present study was therefore to establish specific reference intervals for a series of clinical chemistry and haematology analytes for captive Humboldt penguins (Spheniscus humboldti). The results indicate that the factors of sex and age should be considered when interpreting the results of haematological and clinical biochemistry assays. Reference intervals for clinical chemistry and haematology analytes are essential for the interpretation of blood results, but limited data are available for Humboldt penguins (Spheniscus humboldti) in zoological collections as well as in the wild. The aim of the present study was therefore to establish reference intervals for a series of clinical chemistry and haematology analytes in a single zoological population of Humboldt penguins. Furthermore, possible variations of the analytes influenced by the age and sex of the individuals were investigated. Lithium heparinized plasma and whole blood samples from 39 animals were analysed and statistically evaluated. The following clinical chemistry analytes were significantly higher in females: glutamate dehydrogenase (p = 0.0003), alanine transaminase (p = 0.0005), alkaline phosphatase (p = 0.0245), aspartate aminotransferase (p = 0.0043), creatine kinase (p = 0.0016), lactate dehydrogenase (p < 0.0001), inorganic phosphorus (p = 0.0223), and sodium (p = 0.0415). No significant differences between males and females were found for any haematology analyte. Cholesterol (p = 0.0233; −0.39), white blood cell count (p = 0.0208; −0.40), and absolute heterophiles (p = 0.0148; −0.42) had significant negative correlations with the age of the penguins. The results indicate that the factors of sex and age should be considered when interpreting the results of haematological and clinical biochemistry assays, and further studies are needed to determine whether there are more differences in other age groups or seasons. [ABSTRACT FROM AUTHOR]

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Background and Objectives Blood indices have variation in Covid-19 that could affect diagnosis. Blood index changes in Covid-19 inpatiens were evaluated. Materials and Methods In a descriptive/cross-sectional study, 167 Covid-19 inpatients in Besat Hospital in Hamedan were selected and in terms of changes on the first and seventh days of the blood indices were investigated. Data analysis was done with SPSS software version 26. In order to compare the blood indices on the first and seventh days of hospitalization, Wilcoxon and Monte Carlo tests were used. Results The average blood indices on the first and seventh day were 4.64 ± 0.59 and 4.39 ± 0.62 million in microliter (p< 0.001) for RBCs, 6.20 ± 3.84 and 7.55± 4.13 thousand in microliter (p< 0.001) for white blood cells, 179.54 ± 90.14 and 269.76 ± 109.03 thousand in microliter (p< 0.001) for platelets, 13.20 ± 1.71 and 12.27 ± 1.77 g/dL (p< 0.001) for hemoglobin, 40.45 ± 4.67 and 38.16 ± 5.02 % (p< 0.001) for hematocrit, 12.5 ± 0.55 and 13.1 ± 0.66 % (p< 0.001) for RDW, 87.18 ± 5.43 and 87.15 ± 5.62 femtoliters for MCV, 28.47 ± 2.16 and 28.18 ± 2.03 picograms (p= 0.002) for MCH and 32.56 ± 1.63 and 32.35 ± 1.64 g/dL for MCHC. Conclusions Blood indices in Covid-19 inpatients undergo changes from the time of admission to the seventh day. White blood cell, platelet and RDW were increased and red blood cell, hematocrit, hemoglobin, MCV, MCH and MCHC decreased compared to the first day of hospitalization. [ABSTRACT FROM AUTHOR]

Background: Various organizations have published definitions for periprosthetic joint infection (PJI) with significant differences in the cut-offs of white blood cell (WBC) count and polymorphonuclear (PMN) leukocyte cells. Herein, we aim to analyze optimal cut-offs in patients which are planned to undergo a prosthesis revision and compare them with the actual published thresholds of the International Consensus Meeting (ICM) and European Bone and Joint Infection Society (EBJIS). Methods: A test kit was compiled in a monocentric prospective study, according to the ICM criteria (2018) and 2021 EBJIS criteria. The kit was implemented using: blood samples (including leukocyte count and C-reactive protein); samples for examining the synovial fluid (WBC count, PMN cell differentiation, microbiological culture for incubation over 14 days, alpha-defensin ELISA laboratory test, and leukocyte-esterase test). The cut-offs for WBC and PMN counts were investigated using ROC analyses and Youden index. The ICM 2018 criteria were applied, using alpha-defensin in all cases. Patients which have to undergo a prosthesis revision were included, a pre-operative joint aspiration had been performed, and the patients had been followed up prospectively. Results: 405 patients were examined with the compiled test kit; 100% had a complete dataset with respect to alpha-defensin; 383 patients, according to WBC count; and 256, according to PMN cell differentiation The cut-off of 2478.89 cells/µl in the WBC count (sensitivity: 87.70%; specificity: 88.10%) and the cut-off of 66.99% in PMN differentiation showed the best accuracy (sensitivity: 86.00%; specificity: 88.80%). Other published cut-offs for WBC were tested in this cohort and showed the following accuracy: 3000/µl (EBJIS/ICM; sensitivity: 82.10%; specificity: 91.00%), 2000/µl (sensitivity: 89.60%; specificity: 83.40%), and 1500/µl (sensitivity: 91.50%; specificity: 75.00%). The published cut-offs for PMN had the following accuracy in this cohort: 80% (ICM; sensitivity: 66.3%; specificity: 96.50%), 70% (sensitivity: 82.6%; specificity: 90%), and 65% (EBJIS, sensitivity: 86%; specificity: 88.8%). Conclusions: This study aims to improve current cut-offs for PMN- and WB-Count, even though PJI diagnosis is based on the combination of all defined tests. The optimal diagnostic cut-off of WBC and PMN counts was found to be 2479/µL and 67%, respectively, whereas ICM cut-offs in this cohort seem too high, as they provide high specificity but very low sensitivity. On the other hand, a cut-off for WBC count of 1500/µl alone would be very low, leading to low specificity and very high suspicion of PJI. The current consensus guidelines could be actualized considering these results to significantly improve the diagnostic quality. Level of evidence: II. [ABSTRACT FROM AUTHOR]

Background: Predicting disease severity can be informative for management of HUS. Dialysis requirement, volume depletion, elevated white blood cell counts, very young age, and use of antimotility agents are known factors associated with severe HUS. Methods: A retrospective cohort analysis was performed to identify factors associated with dialysis duration using electronic medical record and chart review of 76 children ≤ 18 years of age at presentation with STEC-HUS identified through billing data from July 2008 to April 2020 at James Whitcomb Riley Hospital for Children, Indiana University, Indiana. Results: Novel findings associated with prolonged dialysis duration were age ≥ 6 years old at presentation (p = 0.041) and lack of drop in platelets below 60,000/mm3 anytime during the illness (p = 0.015). In addition, children with NSAID exposure trended longer on dialysis: 15 days with vs. 10 days without (p = 0.117). Known risk factors for severe disease including elevated peak white blood cell (WBC) count and higher hematocrit at presentation were also associated with longer dialysis duration: children with peak WBC > 20,000/mm3 were on dialysis for 15 vs. 9.5 days (p = 0.002) and in children on dialysis ≥ 14 days hematocrit at presentation was 29.6% vs. 24.2% (p = 0.03). Children requiring dialysis for 20 days or longer were more likely to be on anti-hypertensive medications (p = 0.025) and have chronic kidney disease at 12-month follow up (p = 0.044). Conclusions: Age ≥ 6, elevated WBC count > 20,000/mm3, higher hematocrit at presentation, lack of drop in platelets to < 60,000/mm3, and possibly NSAID exposure during illness are associated with longer dialysis duration in STEC-HUS. [ABSTRACT FROM AUTHOR]

Objective: To investigate the application of heparin-binding protein along with albumin (HBP+ALB) in evaluating the severity of community-acquired pneumonia (CAP) and compares it with single HBP, white blood cells (WBCs), C-reactive protein (CRP), and procalcitonin (PCT). Methods: A total of 226 patients with CAP admitted to the Emergency Department of Zhujiang Hospital, Southern Medical University, Guangdong, China, between March 1, 2021, and March 1, 2022, were enrolled. The patients were grouped into two groups: mild CAP (n=175) and severe CAP (sCAP)(n=51). Patients' characteristics and laboratory data were obtained. ROC curve and the value of the area under the curve (AUC) were used to evaluate the predictive values of HBP, ALB, WBC, CRP, and PCT. Results: WBC count, CRP, PCT, HBP, creatinine, and D-dimer were higher in the sCAP group, while ALB was lower in the sCAP group (P<0.05) than those in the mild CAP group. The AUCs of WBC, CRP, PCT, HBP, and HBP+ALB were 0.633 (95% CI: 0.545-0.722, P<0.05), 0.635 (95% CI: 0.542-0.729, P<0.05), 0.705 (95% CI: 0.619-0.791, P<0.05), 0.809 (95% CI: 0.736-0.883, P<0.05), and 0.889 (95% CI: 0.842-0.936, P<0.05), respectively. Conclusions: HBP+ALB has a higher predictive value than single HBP, PCT, CRP and WBC used alone for the early assessment of CAP. [ABSTRACT FROM AUTHOR]

Adolescent health benefits of different physical activity (PA) intensities, especially of lower intensities, are debated due to challenges in accelerometer data processing and analyses. Using a new accelerometer data processing method and multivariate pattern analysis, this study investigated the association of PA intensities with indicators of cardiovascular and mental health. Adolescents (n = 1,235, mean age 13.6 years, 41% males) were examined for cardiovascular health: body mass index (BMI) z-score, waist circumference (WC), resting heart rate and blood pressure, white blood cell count (WBC), pulse wave velocity (PWV), and answered questionnaires assessing stress and psychosomatic symptoms. Sex, age, and socioeconomic status were confounders. Hip-worn accelerometer data were processed with 10 Hz frequency extended method and a spectrum of 22 PA intensity categories was analyzed for association with health using partial least squares regression. Total explained variances for BMI z-score, WC, resting heart rate, stress, and psychosomatic symptoms were higher (3.3%–8.7%) compared to diastolic blood pressure, WBC, and PWV (0.9%–1.4%). We found positive associations of high-end moderate PA and vigorous PA with cardiovascular and mental health indicators. More sedentary time and lower level of light PA were associated with higher BMI z-score, WC, resting heart rate, diastolic blood pressure, WBC, and PWV, but not with mental health indicators. Very vigorous PA was negatively associated with resting heart rate, stress, and psychosomatic symptoms. In adolescents, PA of varying intensities were generally found to be positively associated with better cardiovascular health, but only higher intensity PA was associated with better mental health. [ABSTRACT FROM AUTHOR]

The objective was to explore the hospital-level relationship between routine pre-discharge WBC utilization (RPD-WBC) and outcomes in children with complicated appendicitis. Multicenter analysis of NSQIP-Pediatric data from 14 consortium hospitals augmented with RPD-WBC data. WBC were considered routine if obtained within one day of discharge in children who did not develop an organ space infection (OSI) or fever during the index admission. Hospital-level observed-to-expected ratios (O/E) for 30-day outcomes (antibiotic days, imaging utilization, healthcare days, and OSI) were calculated after adjusting for appendicitis severity and patient characteristics. Spearman correlation was used to explore the relationship between hospital-level RPD-WBC utilization and O/E's for each outcome. 1528 children were included. Significant variation was found across hospitals in RPD-WBC use (range: 0.7–100%; p < 0.01) and all outcomes (mean antibiotic days: 9.9 [O/E range: 0.56–1.44, p < 0.01]; imaging: 21.9% [O/E range: 0.40–2.75, p < 0.01]; mean healthcare visit days: 5.7 [O/E 0.74–1.27, p < 0.01]); OSI: 14.1% [O/E range: 0.43–3.64, p < 0.01]). No correlation was found between RPD-WBC use and antibiotic days (r = +0.14, p = 0.64), imaging (r = −0.07, p = 0.82), healthcare days (r = +0.35, p = 0.23) or OSI (r = −0.13, p = 0.65). Increased RPD-WBC utilization in pediatric complicated appendicitis did not correlate with improved outcomes or resource utilization at the hospital level. III. Clinical Research [ABSTRACT FROM AUTHOR]

Background: Talaromyces marneffei (T. marneffei) infection detected in the peripheral blood smears has been described by several reports. We studied the effects of T. marneffei in peripheral blood samples on complete blood count (CBC) using a Sysmex XN-9000 analyzer. Methods: In a simulated T. marneffei infection model, blood samples with and without infectious diseases were selected, with high, medium, and low levels of white blood cell (WBC) and platelet (PLT) count, respectively. All samples were detected immediately and after a warm bath of 37°C for 2 hours. Results: WBC count of all samples was significantly increased by T. marneffei from a certain concentration and higher. For all samples, the effect of T. marneffei on WBC count after warm bath was significantly reduced compared to that on immediate WBC count from 4 - 6 x 109/L T. Marneffei and higher (p < 0.05). The presence of T. marneffei in all blood samples did not affect the results of PLT count. For all samples, the obvious effects of T. marneffei on WBC differential (WDF) and white cell nucleated red blood cell (WNR) scatter plots were from 4 - 6 x 109 T Marneffei and higher. Conclusions: As a kind of intracellular yeast, T. marneffei may affect WBC count, NRBC count, and WBC differential count of peripheral blood samples when the yeast concentration is (4 - 6) x 109 T Marneffei and higher. Moreover, the unique scatter plot cloud on WDF and WNR scatter plots caused by T. marneffei, may become an important clue pointing toward T. marneffei in peripheral blood. [ABSTRACT FROM AUTHOR]

Abstract Background Sexual minorities are at a higher risk of suffering from depressive symptoms compared with heterosexual individuals. Only a few studies have examined the conditions of having depressive symptoms within different sexual minority groups, especially people with sexual orientation uncertainty in a nationally representative sample. Furthermore, few studies have explored whether the mean white blood count (WBC) is different between people with and without depressive symptoms among different sexual minority groups in a nationally representative sample. Methods We analyzed the National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2014 with a sample of 14,090 subjects. We compared the prevalence of depressive symptoms in subpopulations stratified by sex, sexual minority status, and race. We also examined the difference in mean WBC count between depressed and non-depressed people among heterosexual individuals and different sexual minority groups. Additionally, two multivariable logistic regression models were used to explore the association between sexual minority status and depressive symptoms, treating sexual minority status as both a binary and categorical variable. Results Female sex (OR: 1.96, 95% CI: 1.72—2.22) and sexual minority status (OR: 1.79, 95% CI: 1.47—2.17) were both independently associated with depressive symptoms. Within the sexual minority population, subjects who were unsure about their sexual identities had the highest odds of having depressive symptoms (OR: 2.56, 95% CI: 1.40—4.68). In the subgroup analysis considering intersectionality, black sexual minority females had the highest rate of depressive symptoms (19.4%, 95% CI: 7.72—40.98). Finally, the mean WBC count differed significantly between people with and without depressive symptoms among male heterosexual individuals, female heterosexual individuals, and female sexual minorities, but not among male sexual minorities. Conclusions Based on sex, race, and sexual minority status, black females of sexual minority status had the highest rate of depressive symptoms. Within sexual minority groups, participants who were unsure about their sexual identities had the highest odds of having depressive symptoms. Finally, the mean WBC count was significantly higher among people with depressive symptoms than those without depressive symptoms only among male heterosexuals, female heterosexuals, and female sexual minorities, but not among male sexual minorities. Future research should investigate the social and biological mechanisms of the differences.

During home treatment with antibiotics, patients' laboratory results of total white blood cell count (WBC) with neutrophil counts and C-reactive protein (CRP) are drawn and monitored at the hospital. The aim of the study was to examine the feasibility and analytical accuracy of hospitalized patients 18 years or older self-testing using two point-of-care tests (POCT). The pilot study included 41 hospitalized patients. A subjective judgment of the patients' ability to conduct the self-testing was made along with a comparison of the POCT measurements of WBC, neutrophil counts and CRP with standard laboratory measurements. Correlation between the POCTs and laboratorial values was assessed by coefficient of determination and the level of agreement between the means was assessed by Bland Altman test. Of the 38 patients conducting self-testing, 78% were men and the mean age was 61.8 years. 28 patients (73.7%) successfully performed self-testing on the first try while, 10 (26.3%) 'HemoCue WBC DIFF' measurements showed an error code. All the patients successfully performed the 'QuickRead go CRP' self-test. Comparison of the 'HemoCue WBC DIFF' results with the laboratory results of WBC and neutrophil counts showed good agreement. On the other hand, 'QuickRead go CRP' results showed a small but significant systematic disagreement compared to the laboratory results. Our results showed that the POCTs can be used by some patients and factors influencing the patient participation included psychological and physical limitations. Both POCTs appeared to have an acceptable clinical level of accuracy. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the effects of Paracetamol, caffeine, bovis calculus sativus and chlorphenamine maleate capsules ( Ankahuangmin capsules) on blood concentration of clozapine in patients with mental disorder during cold. METHODS: Medical records of 44 inpatients with mental disorders who underwent stable treatment with clozapine and took Paracetamol, caffeine, bovis calculus sativus and chlorphenamine maleate capsules (Ankahuangmin capsules) during cold from Jan. 2020 to Oct. 2021 in the hospital were retrospectively collected to obtain information on patients’ gender, age, dosing regimen, drug combination and blood concentration of clozapine, and statistical analysis was performed by using SPSS 25. 0. RESULTS: The blood concentration of clozapine increased to different degrees in 44 patients treated with Paracetamol, caffeine, bovis calculus sativus and chlorphenamine maleate capsules (Ankahuangmin capsules), the mean blood concentration was (444. 23±289. 24) ng / mL at baseline period and (621. 43±375. 23) ng / mL at intervention period; the white blood cell count (WBC) also increased to different degrees, the median value of WBC was 6. 67×109 / L at baseline period and 8. 06×109 / L at cold period; 12 patients experienced adverse drug reactions after blood concentration elevation of clozapine. CONCLUSIONS: The application of Paracetamol, caffeine, bovis calculus sativus and chlorphenamine maleate capsules (Ankahuangmin capsules) during the cold period has an effect on blood concentration elevation of clozapine, while the elevation of WBC could not significantly affect the blood concentration of clozapine. The monitoring on blood concentration of clozapine after drug combination of Paracetamol, caffeine, bovis calculus sativus and chlorphenamine maleate capsules ( Ankahuangmin capsules) and clozapine is crucial to avoid adverse drug reactions related to blood concentration of clozapine. [ABSTRACT FROM AUTHOR]

Aim To investigate the relationship between conventional inflammatory markers and acute myocardial infarction (AMI) in patients with coronary heart disease. Methods The case-control study method was used to select the inpatients from August 2017 to February 2018 in China-Japan Friendship Hospital, among them, 99 patients with stable angina pectoris (SAP) were (60. 4±10. 4) years old, 96 patients with AMI aged (61. 9±14. 6) years old. 60 healthy people were collected as control group, aged (58. 2±9. 5) years old. Inflammatory markers were detected by automatic blood cell analyzer and biochemical analyzer, Logistic regression analysis was used to examine the correlation between inflammatory markers and AMI in patients with coronary heart disease, the prediction efficiency of each index was analyzed by ROC curve. Results Fasting blood glucose, total cholesterol (TC), low density lipoprotein cholesterol (LDLC), white blood cell count (WBC), neutrophil count (NEUT), high sensitivity C-reactive protein (hs-CRP) and homocysteine (Hcy) in AMI group were significantly higher than those in SAP group, while superoxide dismutase (SOD) was significantly lower than that in SAP group (P<0. 05). Logistic regression showed that serum SOD was negatively correlated with AMI (OR=0. 952, 95%CI: 0. 932 ~0. 973, P<0. 001), but WBC, NEUT and Hcy were positively correlated with AMI (OR= 1. 901, 95% CI: 1. 510 ~ 2. 393, P <0. 001; OR = 2. 059, 95% CI: 1. 580 ~ 2. 684, P <0. 001; OR = 1. 041, 95%CI: 1. 010 ~1. 073, P =0. 008). ROC curve analysis showed that the area under curve (AUC) of AMI predicted by combined predictors was 0. 836(95%CI: 0. 780 ~0. 891, P<0. 001), and the AUC in patients with normal TC and LDLC was 0. 852(95%CI: 0. 789 ~0. 914, P<0. 001). Conclusions Increased levels of WBC, NEUT, Hcy and decreased level of serum SOD are risk factors for AMI. Establishment of combined predictors by conventional inflammatory markers is significant for the prediction of AMI in patients with coronary heart disease. [ABSTRACT FROM AUTHOR]

This letter, published in the journal European Neurology, discusses the usefulness of cerebrospinal fluid (CSF) white blood cell count (WBC) in the diagnosis of neurosyphilis. The author reviewed several studies to determine the utility of elevated CSF WBC in patients with suspected neurosyphilis. The analysis showed a statistically significant greater likelihood of elevated CSF WBC in the neurosyphilis group compared to controls. However, there were methodological differences among the studies, and the current instrument standard for CSF cell counting has limitations. The author suggests that with improvements in laboratory technology, CSF WBC may become more important in diagnosing neurosyphilis and other neurological infectious diseases. [Extracted from the article]

ObjectiveTo determine whether the inclusion of white blood cell (WBC) counts in the SYNTAX score (SS) or SS II models could improve the models’ performance for risk stratification in individuals with chronic renal insufficiency (CRI) following percutaneous coronary intervention (PCI).MethodsIn total, 2,313 patients with CRI, who were subjected to PCI and had data available on in-hospital WBC (ih-WBC) counts, were recruited. Patients were divided into 3 groups as per their ih-WBC counts (low, medium, and high). The primary endpoints were all-cause mortality (ACM) and cardiac mortality (CM). The secondary endpoints incorporated myocardial infarction, stroke, unplanned revascularization, and major adverse cardiovascular and cerebrovascular events (MACCEs).ResultsDuring a median follow-up of 3 years, the high WBC group had the highest incidences of CM (2.4% vs. 2.1% vs. 6.7%; p