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To determine whether pre-operative neutrophil-to-lymphocyte ratio (NLR) correlates with endometriosis severity in patients with pathology-confirmed endometriosis surgically staged by MIGS providers at our institution using the 2021 American Association of Gynecologic Laparoscopists (AAGL) endometriosis classification system. Retrospective chart review of all patients who underwent primary surgery for endometriosis between January 2018 and December 2023 at Stony Brook University Hospital with pathology-confirmed endometriosis. Large academic medical center in Long Island, New York. All patients who underwent primary surgery for endometriosis in the study time period with pathology-confirmed endometriosis. Patients with comorbidities or medication use that affect systemic inflammation (i.e. malignancy, active infection, autoimmune and hematological disorders) were excluded from the study. Demographic data, clinical history, and pre-operative bloodwork were retrospectively recorded. Using operative findings and pathology reports, all patients were staged according to the 2021 AAGL endometriosis classification system. Thus far, we have collected data and performed statistical analysis on 77 patients who met inclusion criteria. Our preliminary analysis of variance and Mood's median tests find statistically significant differences in NLR across stages 1 through 3 (p<0.05). Our preliminary data suggest that pre-operative NLR correlates positively with surgical stage of endometriosis. Therefore, NLR may be a useful prognostic marker in endometriosis and may aid in predicting surgical complexity pre-operatively. Data collection is ongoing in order to reach statistical power. [ABSTRACT FROM AUTHOR]

Aim: Parotid gland tumors are uncommon in the head and neck surgery practice and difficult to surgically treat. Planning is very important, especially while planning parotid gland surgery, considering the difficulty of revision surgery. In this context, fine-needle aspiration cytology and radiological imaging stand out. However, preoperative diagnosis is sometimes difficult due to the nature of the salivary gland. At this point, additional methods in preoperative diagnosis are questioned. In our study, it was aimed to determine the surgical modality based on the predictive value in parotid benign and malignant masses with inexpensive, fast and easily obtainable platelet indices, NLR (Neutrophil to Lymphocyte Ratio) and PLR (Platelet to Lymphocyte Ratio). Materials and Methods: The data of 236 patients who were operated on with parotid masses between 2010 and 2020 in our clinic were retrospectively analyzed. The data of the patients and the control group were evaluated statistically. Results: A total of 356 participants were included in the study, including 236 patients who had undergone parotid gland surgery and a control group of 120 healthy individuals. When the data of the participants were reviewed, there was no significant difference between the groups in terms of age. In terms of sex, the number of the male patients was significantly higher than the female participants in the group with only parotid benign neoplasia. Based on the collected data, the mean MPV (Mean Platelet Volume) values were mean 9.1548 ± 1.55152 in the parotid cancer patient group (n1), 9.3810 ± 1.57825 in the inpatient group with parotid benign mass (n2) and 10.49250± 1.05314 in the control group (n3). The mean NLR values were found as 3.6395 ± 3.36035 in the parotid cancer patients (n1), 2.0145 ± 1.04293 in the parotid benign masses (n2) and 1.9689 ± 1.54979 in the control group (n3). The mean PDW (Platelet Distribution Width) values were found as 14.1258 ± 2.82536 in the parotid cancer patient group (n1), 14.5220 ± 2.69823 in the parotid benign mass group (n2), and 12.5150 ± 2.49953 in the control group (n3). Conclusion: In our study, we observed that the MPV, PDW and NLR values were significantly changed in the parotid gland tumors. We concluded that NLR values may be used effectively, especially in the predictive diagnosis of malignant masses and in planning surgery. [ABSTRACT FROM AUTHOR]

Copyright of Hungarian Medical Journal / Orvosi Hetilap is the property of Akademiai Kiado 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.)

ObjectiveExploration of the Predictive Diagnostic Value of Mean Platelet Volume to Platelet Count Ratio (MPV/PLT,PVI) and Neutrophil-to-Lymphocyte Ratio (NLR) in the tPSA Gray Zone of Prostate CancerMethodsA retrospective study was conducted on 65 prostate cancer (Pca) patients and 52 benign prostatic hyperplasia (BPH) patients who underwent transperineal prostate biopsy at Xiangtan Central Hospital from December 2021 to December 2023. Descriptive statistics and logistic regression models were used to investigate the predictive diagnostic value of PVI and NLR in the tPSA gray zone of prostate cancer. Receiver operating characteristic (ROC) curves were constructed based on PVI and NLR values to determine the classification thresholds.ResultsA total of 117 patients were enrolled, including 65 cases of prostate cancer (PCa) and 52 cases of benign prostatic hyperplasia (BPH). There were no statistically significant differences in age, BMI, history of hypertension, history of diabetes, history of coronary heart disease, pre-biopsy white blood cell count, history of drinking, history of smoking, and tPSA between the PCa and BPH patients. The results of logistic regression analysis showed that PVI (OR=2.03, 95%CI: 1.34~3.07, P

Rectal cancer constitutes over one-third of all colorectal cancers (CRCs) and is one of the leading causes of cancer-related deaths in developed countries. In order to identify high-risk patients and better adjust therapies, new markers are needed. Systemic inflammatory response (SIR) markers such as LMR, NLR, and PLR have proven to be highly prognostic in many malignancies, including CRC; however, their roles in locally advanced rectal cancer (LARC) are conflicting and lack proper validation. Sixty well-selected patients with LARC treated at the Maria Sklodowska-Curie National Research Institute of Oncology in Warsaw, Poland, between August 2017 and December 2020 were prospectively enrolled in this study. The reproducibility of the pre-treatment levels of the SIR markers, their correlations with clinicopathological characteristics, and their prognostic value were evaluated. There was a significant positive correlation between LMR and cancer-related inflammatory infiltrate (r = 0.38, p = 0.044) and PD-L1 expression in tumor cells, lymphocytes, and macrophages (combined positive score (CPS)) (r = 0.45, p = 0.016). The PLR level was correlated with nodal involvement (p = 0.033). The SIR markers proved to be only moderately reproducible and had no significant prognostic value. In conclusion, the LMR was associated with local cancer-related inflammation and PD-L1 expression in tumor microenvironments. The validity of SIR indices as biomarkers in LARC requires further investigation.

Objective: The neutrophil–lymphocyte ratio (NLR) can be helpful both in demonstrating acute and chronic liver injury and predicting malignant potential. The mean platelet volume (MPV) is also a marker that can be used as a risk indicator in atherosclerosis-associated diseases, reflecting inflammation. Within the scope of this research, we aimed to elucidate the relationship between the mean platelet volume and neutrophil–lymphocyte ratio in liver fibrosis in chronic hepatitis B patients. Materials and Methods: A total of 84 patients who were followed up with the diagnosis of chronic hepatitis B and who underwent liver biopsy were included in this prospective study. Complete blood count parameters (neutrophil, lymphocyte, neutrophil–lymphocyte ratio, hemoglobin, thrombocyte, MCV, and MPV values), demographic data, biochemistry panel (AST, ALT), HBV DNA, and liver biopsy fibrosis scores obtained from hospital database were analyzed. Since the follow-up period of chronic hepatitis B patients is six months, patients were screened in order to include a full 3-year screening pool. Results: A total of 84 patients were enrolled within the scope of this study. The chronicity index was ‘0’ in 7.1% (n = 6), ‘1’ in 23.8% (n = 20), ‘2′ in 56% (n = 47), and ‘3’ in 13.1% (n = 11)of the patients. According to the chronicity index groups, there was a statistically significant difference between the medians of the hepatitis activity index (HAI) values at the 5% significance level (p < 0.001). The correlation analysis revealed a statistically significant relationship between the chronicity index and the mean platelet volume to lymphocyte ratio (MPVL). However, considering the degree of the relationship, it can be said that it was a positive and weak relationship (p = 0.046, r = 0.218). Conclusions: Regarding the outcomes of this research, a significant relationship was found between the neutrophil–lymphocyte ratio, mean platelet volume, and fibrosis.

Yan Zhang,1 Pengfei Zou,2 Hainv Gao,2 Meifang Yang,1 Ping Yi,1 Jianhe Gan,3 Yinzhong Shen,4 Weihong Wang,5 Wenhong Zhang,6 Jun Li,7 Peng Liu,8 Lanjuan Li11The State Key Laboratory for Diagnosis and Treatment of Infectious Disease, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Disease, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of China; 2Department of Infectious Disease, Shulan Hospital, Hangzhou, Zhejiang Province, People’s Republic of China; 3Department of Infectious Disease, The First Affiliated Hospital, Medical College of Soochow University, Suzhou, Jiangsu Province, People’s Republic of China; 4Department of Infectious Disease, Shanghai Public Health Clinical Center, Fudan University, Shanghai, People’s Republic of China; 5Department of Infectious Disease, Central Hospital of Huzhou, Zhejiang, People’s Republic of China; 6Department of Infectious Disease, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China; 7Department of Infectious Disease, Jiangsu Province People’s Hospital, Jiangsu, People’s Republic of China; 8Department of Infectious Disease, Ningbo No.2 Hospital, Ningbo, Zhejiang Province, People’s Republic of ChinaBackground: Avian AIV-H7N9 influenza progresses rapidly and has a high fatality rate. However, it lacks an early effective biomarker to predict disease severity and fatal outcomes successfully. Our study aimed to explore whether the neutrophil-to-lymphocyte ratio (NLR) taken within 24 h after admission can predict disease severity and fatality in AIV-H7N9-infected patients.Methods: We retrospectively studied 237 AIV-H7N9-infected patients from multiple centers from 2013 to 2015. We used univariate analysis and multivariate analysis to compare clinical variables between the survival and fatal groups to evaluate the prognostic value.Results: The NLR taken within 24 h after admission in the fatal group was significantly higher than that in the survival group (P

Simple Summary: Hypnosis sedation has been used for anesthesia in breast oncologic surgery. This manuscript reports the results of a multicentric, prospective non-randomized study evaluating three different modalities of anesthesia for breast cancer surgery: general anesthesia, general anesthesia preceded by virtual reality with a hypnorelaxation session and hypnosis sedation exclusively in place of general anesthesia. Local anesthesia was systematically administered in all patients. Some benefits of hypnosis sedation, a decrease in pain and the consumption of non-steroidal anti-inflammatory drugs are correlated with a significant reduction in the inflammatory reaction in the perioperative process. Background: Hypnosis sedation has recently been used for anesthesia in breast oncologic surgery. Methods: Between January 2017 and October 2019, 284 patients from our Breast Clinic (Cliniques Universitaires Saint-Luc, Université Catholique de Louvain) and from the Jolimont Hospital were prospectively included in an interventional non-randomized study approved by our two local ethics committees and registered on clinicaltrials.gov (NCT03330117). Ninety-three consecutive patients underwent surgery while on general anesthesia (GA group). Ninety-two consecutive patients underwent surgery while on general anesthesia preceded by a hypnorelaxation session (GAVRH group). Ninety-five consecutive patients underwent surgery while exclusively on hypnosis sedation (HYPS group). Clinical parameters (pain score, anxiety and distress score) were measured on days 0, 1 and 8 for all patients. All evaluable patients underwent NLR (neutrophil-to-lymphocyte ratio) and CRP (C-reactive protein) dosage on days 0, 1 and 8. Results: Pain scores and anxiety scores were statistically lower in the HYPS group on days 1 and 8, as was the duration of NSAID consumption. NLR and CRP values were significantly inferior on day 1 for all patients who benefited from hypnosis sedation. Conclusions: Some benefits of hypnosis sedation (reduction in postoperative pain, decrease in NSAID consumption) are correlated with a significant reduction in inflammatory parameters in the perioperative process. [ABSTRACT FROM AUTHOR]

Objective was to analyze the clinical and imaging features of Chlamydia psittaci pneumonia to enhance its diagnostic accuracy. Methods: We systematically reviewed the cases of Chlamydia psittaci diagnosed by next-generation sequencing at the Hunan University of Medicine General Hospital between March 2019 and June 2024, summarizing and analyzing their clinical characteristics and imaging features. Results: A total of 50 cases that met the inclusion criteria were ultimately included in the study analysis. The median age of the patients was 62.96± 11.08 years. Notably, 46 patients (92%) had potential exposure to birds or poultry. Forty-six patients (92%) temperature ≥ 39.0 °C, 37 patients (74%) had cough, 34 patients (68%) had moist rale, and 39 patients (78%) had a relatively slow pulse. Laboratory tests indicated that over 70% of patients exhibited elevated infection markers, accompanied by abnormalities in liver and renal function, electrolyte levels, and cardiac enzymes. Meanwhile, the patient's white blood cell count was normal. Chest CT (Computed Tomography) frequently revealed flaky shadows (94%), thoracic effusions (68%), and thickened pleura (54%). Bronchoscopy revealed significant bronchial mucosal hyperemia, swelling (93.478%), and reduced secretion (56.522%). A total of 44 patients (88%) showed a gradual improvement over 12 days. Forty patients (80%) were treated with doxycycline. Fifty patients were classified into two groups according to whether severe pneumonia occurred after admission. WBC (white blood cell), N% (percentage of neutrophils), NLR (Neutrophil-to-lymphocyte ratio), PLR (platelet/lymphocyte ratio), SII (platelet*Neutrophil/lymphocyte ratio), and PCT (procalcitonin) are indicators that suggest severe cases. Conclusion: The combination of the following indicators is expected to aid in diagnosis of Chlamydia psittaci pneumonia: opportunities to come into contact with birds or poultry, high fever, relatively slow pulse, and elevated infection indicators accompanied by organ injury. Treatment with doxycycline was effective and resulted in favorable prognosis. [ABSTRACT FROM AUTHOR]

Copyright of Zagazig University Medical Journal is the property of Association of Arab Universities 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.)

Objective: This study was to examine the association between inflammation‐related indexes SII (systemic immune‐inflammation index), NLR (neutrophil‐to‐lymphocyte ratio), PPN (product of platelet count and neutrophil count), and PLR (platelet‐to‐lymphocyte ratio), and the occurrence of vertebral fractures in older Americans. Methods: Patients ⩾60 years of age from the 2013–2014 NHANES database were selected for this study. Restricted cubic spline models and weighted logistic regression models were used to assess the association between inflammation‐related indexes and the occurrence of vertebral fractures in older Americans. The predictive value of the inflammation‐related indexes on the occurrence of vertebral fractures was assessed using receiver operating characteristic curves (ROC). To examine the robustness of the main findings, a sensitivity analysis was conducted. Results: A total of 1281 patients were included in the analysis, of whole 120 suffered vertebral fractures. Fully adjusted logistic regression showed a significant linear relationship between NLR and the occurrence of vertebral fracture in older Americans (p <.05), but no relationship was found between SII, PLR, and the occurrence of vertebral fracture in older Americans. Meanwhile, NLR was slightly better than other indicators in predicting vertebral fracture. Conclusions: This study found that NLR, as a novel inflammatory marker, can predict the risk of vertebral fracture in older Americans, which is of clinical significance for the prevention and treatment of vertebral fracture in older adults. [ABSTRACT FROM AUTHOR]

Objective: This study explored the utility of NLR (neutrophil-to-lymphocyte ratio) as a marker to predict Lower Extremity Peripheral Artery Disease (PAD) in the Chinese population, as well as to assess its consistency and diagnostic value with digital subtraction angiography. Methods: Patients were distributed into three groups according to the angiography in lower limb arterial: group L1, plaque with no stenosis; group L2, plaque with luminal stenosis and group L3, total vascular occlusion. Changes in the neutrophil-to-lymphocyte ratio were documented and compared among groups. Results: Compared to group L1, NLR was significantly increased in L2 (1.76 vs 2.35, p=0.037) and L3 (1.76 vs 3.60, p<0.001), with a gradual decrease in ABI (Ankle-Brachial Index, 1.11 vs 1.02 vs 0.94, p<0.001). Those older patients with higher prevalence of hypertension (p=0.002), obesity (p=0.032), or reduced high-density lipoprotein cholesterol (p=0.020) were more likely to develop PAD; higher glycosylated hemoglobin (p=0.045), low-density lipoprotein cholesterol (p=0.006), and systolic blood pressure (p<0.001) levels led to a greater tendency to suffer stenosis or even occlusion; the probability of severe stenosis (>70%) increased to 2.075 times for every 1 increase in NLR, while it was 46.8% for every 0.1 increase in ABI. The optimal NLR cut-off value to predict severe stenosis in PAD was 2.73. Receiver operating characteristic curve analysis of the inflammatory biomarkers and severe stenosis prediction displayed an area under the curve of 0.81. Conclusion: NLR could serve as a new noninvasive and accurate marker in predicting PAD. [ABSTRACT FROM AUTHOR]

Objective: We conducted this study to summarize the results of studies reporting the role of NLR (neutrophil to lymphocyte ratio) in PSCC (penile squamous cell carcinoma). Methods: This meta-analysis was conducted using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria. A systematic search was conducted on PubMed, Scopus, and web of science up to March 10, 2023. Fourteen studies were included in the review. The NOS (Newcastle–Ottawa Scale) was used to determine the quality of the included studies. This meta-analysis was conducted on the studies reporting the relationship between NLR and survival using HR (hazard ratio) and 95% CI (confidence interval). Results: There was a significant association between NLR levels and the prognosis, nodal stage, and anatomical tumor stage of PSCC patients. In the meta-analysis of the association of NLR with survival, NLR level was significantly associated with lower cancer-specific survival (HR = 3.51, 95% CI = 2.07–5.98, p < 0.001) and lower disease-free survival (HR = 2.88, 95% CI = 1.60–5.20, p < 0.001). However, NLR was found to have no association with the stage, grade, location, and size of the tumor. Conclusion: NLR has a significant diagnostic and prognostic value in PSCC. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the relationship of different chronic diseases with immunonutritional markers in the senior population. Methods: this study included 1190 hospitalized geriatric patients. The criteria to participate were ability to communicate, given consent and C-reactive protein (CRP) lower than 6 mg/dL. Results: the mean age of the study population was 81.7 ± 7.6 years. NLR (neutrophil-to-lymphocyte ratio), LMR (lymphocyte-to-monocyte ratio), MWR (monocyte-to-white blood cell ratio), SII (systemic immune–inflammation index), PNI (prognostic nutritional index) and CAR (C-reactive protein-to-albumin ratio) were related to age. NLR and MWR were higher, while LMR, PLR (platelet-to-lymphocyte ratio and SII were lower in men. All markers were related to BMI. NLR, LMR, LCR (lymphocyte-to-CRP ratio), MWR, PNI and CAR were related to several concomitant chronic diseases. In multivariate analyses, age and BMI were selected as independent predictors of all studied immunonutritional markers. Atrial fibrillation, diabetes mellitus and dementia appear most often in the models. PNI presented the most consistent statistical association with age, BMI and concomitant chronic diseases. Conclusions: this study reveals the pivotal role of aging and BMI in inflammatory marker levels and the association of immunonutritional markers with different chronic diseases. Atrial fibrillation seems to have the most dominant connection to the immunonutritional markers. [ABSTRACT FROM AUTHOR]

Immunosuppression and malnutrition play pivotal roles in the complications of intracerebral hemorrhage (ICH) and are intricately linked to the development of stroke-associated pneumonia (SAP). Inflammatory markers, including NLR (neutrophil-to-lymphocyte ratio), SII (systemic immune inflammation index), SIRI (systemic inflammatory response index), and SIS (systemic inflammation score), along with nutritional indexes such as CONUT (controlling nutritional status) and PNI (prognostic nutritional index), are crucial indicators influencing the inflammatory state following ICH. In this study, our objective was to compare the predictive efficacy of inflammatory and nutritional indices for SAP in ICH patients, aiming to determine and explore their clinical utility in early pneumonia detection. Patients with severe ICH requiring ICU admission were screened from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. The outcomes included the occurrence of SAP and in-hospital death. Receiver operating characteristic (ROC) analysis, multivariate logistic regression, smooth curve analysis, and stratified analysis were employed to investigate the relationship between the CONUT index and the clinical outcomes of patients with severe ICH. A total of 348 patients were enrolled in the study. The incidence of SAP was 21.3%, and the in-hospital mortality rate was 17.0%. Among these indicators, multiple regression analysis revealed that CONUT, PNI, and SIRI were independently associated with SAP. Further ROC curve analysis demonstrated that CONUT (AUC 0.6743, 95% CI 0.6079–0.7408) exhibited the most robust predictive ability for SAP in patients with ICH. Threshold analysis revealed that when CONUT < 6, an increase of 1 point in CONUT was associated with a 1.39 times higher risk of SAP. Similarly, our findings indicate that CONUT has the potential to predict the prognosis of patients with ICH. Among the inflammatory and nutritional markers, CONUT stands out as the most reliable predictor of SAP in patients with ICH. Additionally, it proves to be a valuable indicator for assessing the prognosis of patients with ICH. [ABSTRACT FROM AUTHOR]

The analysis of hematological parameters in premature infants with clinical signs of perinatal pathology is important and allows to assess the adaptive response of the body, especially under the conditions of negative effects of hypoxia. Almost half of all preterm births are caused by inflammatory processes in the mother leading to rupture of membranes with or without chorioamnionitis. Due to the functional immaturity of organ systems and regulatory mechanisms, preterm infants have certain problems of adaptation in the neonatal period. Disruption of a balanced adaptive response to changing environmental conditions due to dysregulation of immune defense and immunosuppression is the basis for the initiation of pathophysiological mechanisms of hypoxic stress and damage to the body, starting from the subcellular level. This causes severe dysmetabolic changes with the formation of serious diseases with a high risk of mortality and the formation of long-term consequences of pathology in survivors, reducing the quality of life of patients in later years. Materials and methods. We studied 68 infants with a gestational age of 32 to 33/6 weeks who had clinical signs of perinatal pathology (main study group). Subgroup A included 35 newborns with severe disease, and subgroup B included 33 children whose general condition was considered moderate. The comparison group consisted of 31 infants with a gestational age of 34 to 36/6 weeks (control group). Inclusion criteria were confirmed clinical signs of moderate and severe perinatal pathology; exclusion criteria were gestational age at birth less than 32 weeks and 37 weeks or more, congenital malformations. A comprehensive clinical and laboratory examination of newborns was performed, considering the main and concomitant pathology. Based on the results of the complete blood count, the ratio of indicators was calculated: NLR (neutrophil to lymphocyte ratio), PLR (platelet to lymphocyte ratio), MLR (monocyte to lymphocyte ratio); as well as SII (systemic immune inflammation index); SIRI (systemic inflammation response index); PIV (platelet, neutrophil, monocyte and lymphocyte index). Taking into account the data obtained, the risk of deterioration of newborns’ condition in relation to perinatal risk factors was identified, the limits of indicators and indices of systemic hypoxic inflammation in relation to moderate and severe pathology were determined. Scientific research was conducted in accordance with the basic provisions of GCP (1996), the Convention of the Council of Europe on Human Rights and Biomedicine (April 4, 1997), the Declaration of Helsinki of the World Medical Association on the Ethical Principles for Research on Human Subjects (1964-2008), Order of the Ministry of Health of Ukraine No. 690 dated September 23, 2009 (as amended by Order of the Ministry of Health of Ukraine No. 523 dated July 12, 2012). Protocol of scientific research of the Biomedical Ethics Commission of BSMU dated September 12, 2015. Considering the complex subject of the research work, the informed consent of the parents of newborns was obtained after familiarization with the purpose, objectives and planned methods of laboratory and functional studies. Statistical processing of results was performed using STATISTICA software (StatSoft Inc., USA, version 10). Comparison of quantitative indicators with normal distribution was performed using Student’s t-test, and the probability of differences was considered statistically significant at p<0.001. Results of the study. The results of the study showed that in order to determine the severity of the general condition in premature infants, along with the assessment of clinical signs of pathology, it is advisable to conduct a detailed analysis of the results of a complete blood count with the study of the ratio of individual indicators and the determination of systemic inflammation indices. This allows to improve the approaches to differential diagnosis of the severity of neonatal diseases by using a low-cost conventional method, while obtaining more correct conclusions. The indicators of complete blood count in newborns confirm the presence of compensatory activation of erythroid, myeloid and granulocytic hematopoiesis in response to hypoxia in the early neonatal period. The obtained data showed significant differences from the control values, which correlated with the severity of the newborns’ condition. Reserves for improving the effectiveness of medical care for IPA should include the improvement of diagnostic measures to clarify the pathophysiological mechanisms of hypoxic inflammation in order to reduce mortality and prevent the development of long-term consequences of the pathology, while maintaining the health and quality of life of patients. Conclusions: 1. Determination of the ratio of GBT and systemic inflammatory indices can be a qualitative adjunct to diagnosis to clarify the pathophysiological mechanisms of hypoxic damage to the body and to objectify approaches to assessing the severity of the condition of newborns with various forms of perinatal pathology. 2. The risk of worsening in children with development of moderate pathology should be predicted at the following limits of the ratio of indicators: an increase in NLR from 0.295 to 0.343, a decrease in PLR from 7.982 to 7.290 and MLR from 0.096 to 0.093; an increase in systemic inflammation indices: SII – from 66.546 to 76.386, SIRI – from 0.802 to 0.975, PIV – from 180.825 to 225.130. 3. Severe course of diseases in newborns is predicted on the basis of ratio of indicators: NLR – up to 0.238, PLR – up to 5.923, MLR – up to 0.086 and the presence of systemic inflammation indices: SII – up to 51.230, SIRI – up to 0.745 and PIV – up to 160.310. [ABSTRACT FROM AUTHOR]

1Correlation between CA125 levels and severity of diverticulitis: A simple versus complicated diverticulitis; B CA125 levels according to the modified Hinchey classification. AUC, area under the curve; CRP, C-reactive protein; NLR, neutrophil to lymphocyte ratio; WBC, white blood count The original article has been corrected. [Extracted from the article]

In our study, we investigated the prognostic significance of hematological markers—NLR (Neutrophil-to-Lymphocyte Ratio), PLR (Platelet-to-Lymphocyte Ratio), and RDW-CV (Red Blood Cell Distribution Width—Coefficient of Variation)—in 117 glioblastoma patients. The data collected from January 2016 to December 2018 included demographics, clinical scores, and treatment regimens. Unlike previous research, which often examined these markers solely before surgery, our unique approach analyzed them at multiple stages: preoperative, postoperative, and before adjuvant therapies. We correlated these markers with the overall survival (OS) and progression-free survival (PFS) using statistical tools, including ANOVA, Cox regression, and Kaplan–Meier survival analyses, employing SPSS version 29.0. Our findings revealed notable variations in the NLR, PLR, and RDW-CV across different treatment stages. The NLR and PLR decreased after surgery, with some stabilization post-STUPP phase (NLR: p = 0.007, η2p = 0.06; PLR: p = 0.001, η2p = 0.23), while the RDW-CV increased post-surgery and during subsequent treatments (RDW-CV: p < 0.001, η2p = 0.67). Importantly, we observed significant differences between the preoperative phase and other treatment phases. Additionally, a higher NLR and RDW-CV at the second-line treatment and disease progression were associated with an increased risk of death (NLR at 2nd line: HR = 1.03, p = 0.029; RDW-CV at progression: HR = 1.14, p = 0.004). We proposed specific marker cut-offs that demonstrated significant associations with survival outcomes when applied to Kaplan–Meier survival curves (NLR at 2nd line < 5: p < 0.017; RDW-CV at progression < 15: p = 0.007). An elevated NLR and RDW-CV at later treatment stages correlated with poorer OS and PFS. No significant preoperative differences were detected. These biomarkers may serve as non-invasive tools for glioblastoma management. [ABSTRACT FROM AUTHOR]

Background: The spleen plays an important role in systemic antitumor immune response, but whether spleen imaging features have predictive effect for prognosis and immune status was unknown. The aim of this study was to investigate computed tomography (CT)‐based spleen radiomics to predict the prognosis of patients with esophageal squamous cell carcinoma (ESCC) underwent definitive radiotherapy (dRT) and to try to find its association with systemic immunity. Methods: This retrospective study included 201 ESCC patients who received dRT. Patients were randomly divided into training (n = 142) and validation (n = 59) groups. The pre‐ and delta‐radiomic features were extracted from enhanced CT images. LASSO‐Cox regression was used to select the radiomics signatures most associated with progression‐free survival (PFS) and overall survival (OS). Independent prognostic factors were identified by univariate and multivariate Cox analyses. The ROC curve and C‐index were used to evaluate the predictive performance. Finally, the correlation between spleen radiomics and immune‐related hematological parameters was analyzed by spearman correlation analysis. Results: Independent prognostic factors involved TNM stage, treatment regimen, tumor location, pre‐ or delta‐Rad‐score. The AUC of the delta‐radiomics combined model was better than other models in the training and validation groups in predicting PFS (0.829 and 0.875, respectively) and OS (0.857 and 0.835, respectively). Furthermore, some spleen delta‐radiomic features are significantly correlated with delta‐ALC (absolute lymphocyte count) and delta‐NLR (neutrophil‐to‐lymphocyte ratio). Conclusions: Spleen radiomics is expected to be a useful noninvasive tool for predicting the prognosis and evaluating systemic immune status for ESCC patients underwent dRT. [ABSTRACT FROM AUTHOR]

Cancer cachexia is a disorder that affects patient outcomes. The present study prospectively evaluated the prognostic value of the cachexia index (CXI) in elderly patients with non-Hodgkin's lymphoma (NHL). We prospectively analyzed 51 elderly patients who were diagnosed with NHL at our institution. CXI was calculated as follows: CXI = SMI × Alb/NLR (SMI: skeletal muscle index, Alb: serum albumin, NLR: neutrophil-to-lymphocyte ratio). SMI was measured by a bioelectrical impedance analysis (BIA) using the InBody 720. We determined the sex-specific cutoff values of the CXI by a receiver operating characteristic curve analysis and divided all patients into low- and high-CXI groups. The median age at the diagnosis was 78 years (60–93 years), and 28 (55%) were male. The histologic subtypes were B-cell lymphoma in 49 patients and T-cell lymphoma in 2. Twenty-eight (55%) patients were categorized into the high-CXI group, and 23 (45%) were categorized into the low-CXI group. The overall survival (OS) in the low-CXI group was significantly shorter than that in the high-CXI group (3-year OS, 70.4% vs. 95.7%, p = 0.007). Among 23 patients with DLBCL, patients with low-CXI had shorter OS than those with high-CXI (3-year OS, 55.6% vs. 92.9%, p = 0.008). On the other hand, sarcopenia had less impact on the clinical outcome of DLBCL patients. Low-CXI was associated with poor outcomes in elderly NHL and the CXI may be a clinical useful index for predicting prognosis. Further large prospective studies are needed to verify this conclusion. [ABSTRACT FROM AUTHOR]

(1) Background: Acute pulmonary embolism (PE) is a significant public health concern that requires efficient risk estimation to optimize patient care and resource allocation. The purpose of this retrospective study was to show the correlation of NLR (neutrophil-to-lymphocyte ratio) and PESI (pulmonary embolism severity index)/sPESI (simplified PESI) in determining the risk of in-hospital mortality in patients with pulmonary thromboembolism. (2) Methods: A total of 160 patients admitted at the County Clinical Emergency Hospital of Sibiu from 2019 to 2022 were included and their hospital records were analyzed. (3) Results: Elevated NLR values were significantly correlated with increased in-hospital mortality. Furthermore, elevated NLR was associated with PESI and sPESI scores and their categories, as well as the individual components of these parameters, namely increasing age, hypotension, hypoxemia, and altered mental status. We leveraged the advantages of machine learning algorithms to integrate elevated NLR into PE risk stratification. Utilizing two-step cluster analysis and CART (classification and regression trees), several distinct patient subgroups emerged with varying in-hospital mortality rates based on combinations of previously validated score categories or their defining elements and elevated NLR, WBC (white blood cell) count, or the presence COVID-19 infection. (4) Conclusion: The findings suggest that integrating these parameters in risk stratification can aid in improving predictive accuracy of estimating the in-hospital mortality of PE patients. [ABSTRACT FROM AUTHOR]

Background: In this study, we aimed to explore the association between baseline and early changes in the neutrophil-to-lymphocyte ratio (NLR) and the 30-day mortality rate in patients having anti-melanoma differentiation-associated gene 5 (MDA5)-positive dermatomyositis with interstitial lung disease (DM-ILD). Methods: Overall, 263 patients with anti-MDA5 DM-ILD from four centers in China were analyzed. Multivariate logistic regression analysis was used to evaluate the impact of baseline NLR on the 30-day mortality rate in patients with anti-MDA5-positive DM-ILD. Furthermore, a generalized additive mixed model (GAMM) was applied to compare the NLR variations over time between 30-day survival group and non-survival group. Results: Two hundred sixty-three patients with anti-MDA5-positive DM-ILD were divided into different groups based on their NLR and whether they survived or not within 30 days. The multivariate logistic regression analysis, accounting for confounding factors, identified an elevated baseline NLR as a prognostic indicator for 30-day mortality in patients with anti-MDA5-positive DM-ILD (hazard ratio 2.68, 95% confidence interval [CI] 1.18,6.00, P = 0.019). Furthermore, the GAMM results indicated that the NLR gradually increased more in the non-survival group compared with the survival group within 14 days of admission, with a daily average increase of 1.03 (β = 1.03; 95% CI, 0.75–1.31; P < 0.001). Conclusions: We found that an elevated baseline NLR and its progressive increase are associated with 30-day mortality in patients with anti-MDA5-positive DM-ILD. [ABSTRACT FROM AUTHOR]

Background: COVID-19 pneumonia is associated with SIRS and hypercatabolism. The aim of this study was to determine muscle loss during the acute phase of COVID-19 pneumonia and evaluate long-term sequelae in discharged patients. Methods: A total of 16 patients with COVID-19 pneumonia and respiratory insufficiency were included in the study. Selected parameters (weight, BMI, LBM = lean body mass, albumin, CRP, NLR = neutrophil-to-lymphocyte ratio, ultrasound measured thickness of rectus femoris muscle = US RF and rectus femoris + vastus intermedius = US RF + VI, handgrip strength, quality of life = EQ-5D questionnaire, and activities of daily living = Barthel's ADLs) were recorded on admission, discharge, and 1, 3, and 6 months after discharge. Results: The most significant changes were between hospital admission and discharge: US RF and RF + VI (−1.28 ± 1.97 mm, p = 0.046; −1.76 ± 2.94 mm, p = 0.05), EQ-5D score (14.6 ± 19.2, p = 0.02), and ADLs (17.1 ± 22.6; p = 0.02). There was a significant positive correlation between US RF + VI and handgrip strength (p = 0.014) and a negative correlation between weight and Barthel index (p = 0.012). There was an association between muscle function with an EQ-5D score and ADLs during outpatient check-ups, most noticeably between handgrip strength, US RF+VI, and ADLs (p = 0.08; p = 0.1, respectively). Conclusions: In patients with COVID-19 pneumonia, there is a significant reduction of health-related quality of life, impaired even 6 months after hospital discharge, influenced mainly by muscle loss. During the hospital stay, there was a significant muscle mass reduction. Ultrasound measurement of thigh muscle thickness may be a useful method to monitor muscle loss. [ABSTRACT FROM AUTHOR]