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Background/purpose Our previous study found significantly lower serum hematinic levels and higher serum homocysteine level as well as higher frequencies of serum hematinic deficiencies and hyperhomocysteinemia in oral leukoplakia (OL) patients than in healthy control subjects. This study evaluated whether carcinoembryonic antigen (CEA)-positive or squamous cell carcinoma-antigen (SCC–Ag)-positive OL patients had significantly lower serum hematinic levels and higher serum homocysteine level as well as significantly higher frequencies of hematinic deficiencies and hyperhomocysteinemia than CEA-negative or SCC-Ag-negative OL patients or healthy control subjects. Methods The complete blood count, serum iron, vitamin B12, folic acid, and homocysteine levels in 184 OL patients including 85 CEA-positive, 99 CEA-negative, 25 SCC-Ag-positive, and 159 SCC-Ag-negative OL patients and in 184 age- and sex-matched healthy control subjects were measured and compared. Results We found that the 85 CEA-positive or 25 SCC-Ag-positive OL patients had a significantly lower mean serum folic acid level and a significantly higher mean serum homocysteine level as well as significantly higher frequencies of serum folic acid deficiency and hyperhomocysteinemia than 184 healthy control subjects. Moreover, the 25 SCC-Ag-positive OL patients had a significantly higher mean serum homocysteine level than the 159 SCC-Ag-negative OL patients. The 85 CEA-positive OL patients had a higher mean serum homocysteine level and a higher frequency of hyperhomocysteinemia than 99 CEA-negative OL patients (marginally significant, P = 0.060). Conclusion CEA-positive or SCC-Ag-positive OL patients tend to have a higher mean serum homocysteine level and a higher frequency of hyperhomocysteinemia than CEA-negative or SCC-Ag-negative OL patients, respectively.

Background/Purpose: Lacto-vegetarians (LVs) tend to have vitamin B12 deficiency (B12D). This study assessed whether 140 female LVs, including 16 B12D/LVs and 124 non-B12D/LVs, had significantly higher frequencies of microcytosis, macrocytosis, and of blood hemoglobin (Hb), red blood cell (RBC), and serum vitamin B12 deficiencies than 140 healthy control subjects (HCSs). Methods: The complete blood count and serum vitamin B12 level in 140 female LVs and 140 female HCSs were measured and compared. Results: We found that 8.6%, 4.3%, 22.9%, 20.0%, and 11.4% of 140 LVs had microcytosis, macrocytosis, and blood Hb, RBC, and serum vitamin B12 deficiencies, respectively. The 140 LVs, 16 B12D/LVs, and 124 non-B12D/LVs had significantly higher frequencies of microcytosis as well as blood Hb and RBC deficiencies than 140 HCSs (all P-values

Objective: To address the lack of information about clinical sequelae of coronavirus disease 2019 (COVID-19). Patients and Methods: Previously hospitalized COVID-19 patients who were attending the outpatient clinic for post–COVID-19 patients (ASST Ovest Milanese, Magenta, Italy) were included in this retrospective study. They underwent blood draw for complete blood count, C-reactive protein, ferritin, D-dimer, and arterial blood gas analysis and chest high-resolution computed tomography (HRCT) scan. The primary endpoint was the assessment of blood gas exchanges after 3 months. Other endpoints included the assessment of symptoms and chest HRCT scan abnormalities and changes in inflammatory biomarkers after 3 months from hospital admission. Results: Eighty-eight patients (n = 65 men; 73.9%) were included. Admission arterial blood gas analysis showed hypoxia and hypocapnia and an arterial partial pressure of oxygen/fractional inspired oxygen ratio of 271.4 (interquartile range [IQR]: 238-304.7) mm Hg that greatly improved after 3 months (426.19 [IQR: 395.2-461.9] mm Hg, P

Background: Identifying areas of excess cost for shoulder arthroplasty patients can play a role in effective health care spending. The purpose of this study was to assess the utility of postoperative complete blood count (CBC) testing after total shoulder arthroplasty (TSA) and identify which patients benefit from routine CBC testing. Methods: We performed a retrospective review of a cohort of patients who underwent primary TSA from January 2018 through January 2019. All patients in this cohort received tranexamic acid. Patient demographic characteristics and patient-specific risk factors such as American Society of Anesthesiologists score, Elixhauser index, body mass index, smoking status, and coagulopathy history were obtained. Perioperative values including length of surgery, preoperative and postoperative hemoglobin (Hgb) levels, and need for transfusion were also obtained. Results: This study included 387 TSA patients in the final analysis. Comparison between the cohort requiring transfusion and the cohort undergoing no intervention revealed no statistically significant differences in age, sex, body mass index, American Society of Anesthesiologists score, or Elixhauser index. The group receiving transfusions was found to have significantly lower levels of preoperative Hgb (11.3 g/dL) and postoperative Hgb (8.1 g/dL) (P < .0001). Additionally, the percentages of patients with abnormal preoperative Hgb levels ( 12 mg/dL and first postoperative Hgb levels > 9 mg/dL. This translates to potential health care cost savings and improves current evidence-based perioperative management in shoulder arthroplasty.

Purpose: To determine the effects of blood flow restriction (BFR) exercise on CD34+ cells, platelets, white blood cells, neutrophils, lymphocytes, lactate, and glucose. Methods: Healthy participants aged 20 to 39 years who were able to perform the exercise sessions were recruited. Participants underwent an experimental (EXP) occluded testing session and a control (CON) session using the Delfi Personalized Tourniquet System. Blood draws were performed prior to testing and immediately after the exercise session. Blood analysis consisted of a complete blood count as well as flow cytometry to measure peripheral CD34+ counts as a marker for hematopoietic progenitor cells. Results: Fourteen men (aged 30.8 ± 3.9 years) volunteered. There was a significant increase in average CD34+ counts immediately after the EXP session only (3.1 ± 1.2 cells ⋅ μL–1 vs 5.2 ± 2.9 cells ⋅ μL–1, P = .012). Platelet counts were significantly elevated after both sessions, with the average increase being higher after the EXP session (mean difference [MD], 34,200/μL; P < .002) than after the CON session (MD, 11,600/μL; P < .002). White blood cell counts significantly increased after both the EXP (8,400 ± 2,200/μL vs 6,300 ± 1,600/μL; P < .001) and CON (MD, 900/μL; P < .001) sessions. There was a significant increase from baseline to immediately after exercise in the average number of lymphocytes (MD, 6.3%; P < .001) and, conversely, a significant decrease in the average neutrophil count (MD, 6.5%; P < .001) in the EXP session only. Lactate levels significantly increased in the EXP (MD, 6.1 mmol ⋅ L–1; P = .001) and CON (MD, 3.6 mmol ⋅ L–1; P = .001) groups. No changes in glucose levels were observed. Conclusions: Exercise with BFR causes a significant post-exercise increase in peripheral hematopoietic progenitor cells and platelets, beyond that of standard resistance training. Clinical Relevance: BFR can be considered a way to manipulate point-of-care blood products such as platelet-rich plasma to increase product yield.

Background: Previous studies have indicated that inflammation plays an important role in the occurrence and development of bronchopulmonary dysplasia (BPD); however, there were rare researches about the changes of neutrophils and their influence on the prognosis of BPD. Hence, we aimed to explore the changes in the number of peripheral blood neutrophils (PBNs), and the relationship between these changes and susceptibility to pulmonary infection among children with BPD. Methods: Firstly, the gene expression of lung tissues and the number of PBNs were respectively detected by RNA sequencing and complete blood count in the 85% O2-induced BPD model rats. Then it was analyzed the number of PBNs after birth and the incidence of pneumonia within 6 months of corrected age (CA) after discharge among full-term infants (FTIs: gestational age [GA] between 370/7 and 416/7 weeks, n = 88), preterm infants with (PTIs-BPD: GA 0.05). Although the peripheral blood neutrophils decreased overall after birth in both PTIs-nBPD and PTIs-BPD groups, only the reduction in the PTIs-BPD group was significant (p

Objective: This study aimed to separately evaluate the prevalence of anemia and iron deficiency in nulliparous and multiparous women. Materials and methods: We retrospectively examined data of women who delivered in our clinic from January 2016 to December 2018. Inclusion criteria were delivery occurring at ≥36 weeks and singleton pregnancy. Pregnant women with severe medical disorders were excluded. We estimated complete blood count (CBC) and serum ferritin (SF) in the first trimester and only CBC in the late second trimester. Data of nulliparas and multiparas were analyzed separately. Statistically significance was set at p

Introduction The thyroid gland has a very important role in hematopoiesis, blood disorders are frequently seen in patients with thyroid disorders. Thyroid hormones have direct effect on blood parameters by stimulating erythrocytes precursors and indirectly by enhancing erythropoietin production. Patients and methods This is a case-control study which included 300 subjects who were grouped to 3 equal groups as a control, hypothyroidism, and hyperthyroidism groups. Patients with inherited or acquired red cell abnormalities, those receiving treatment for thyroid disorder or anemia, patient with chronic diseases, aged, Highlights • The thyroid gland has a very important role in hematopoiesis. • Females are more affected by thyroid disorders than males. • Thyroid hormones directly stimulate erythrocytes precursors and indirectly by enhancing erythropoietin production.

Background Secondary pulmonary hypertension (PH) is emerging as a significant cause of mortality and morbidity in patients with thalassemia. Tricuspid Regurgitant Jet Velocity (TRJV) can identify patients at risk for PH. Aim of the work To study the effect of the L-arginine and Sildenafil on patients with β -thalassemia complicated by increased Tricuspid Regurgitant Jet Velocity. Patients and methods A randomized controlled clinical trial was carried out on 60 children with β-thalassemia major, selected with high TRJV (TRJV>2.5 m/s). The children were selected from Hematology Unit, Pediatric Departments, Tanta University Hospital. They were classified into 3 groups: Group (I): Twenty children received L-arginine, group (II): Twenty children received Sildenafil therapy and group (III): Twenty children did not receive either L-arginine or sildenafil therapy as a control group. All Patients were matched in ethnicity, age and sex distribution. They underwent to full history taking and complete clinical examination. Investigations include; complete blood count, aspartate transaminase (AST), alanine transaminase (ALT), serum ferritin and Color Doppler Echocardiography to measure TRJV. Results: There was no statistically significant difference between three groups as regard platelet count, serum ferritin, serum ALT, AST. There was a significant decrease of TRJV after Sildenafil therapy and/or L-arginine therapy, with no statistically significant differences between group (I) and group (II) as regard to TRJV after treatment. Conclusion Pediatric patients with thalassemia complicated by PH can get benefit from therapy with Sildenafil and/or arginine therapy.

Background/purpose: Granulocyte colony-stimulating factor (G-CSF) is widely used for prophylaxis and treatment of neutropenia in cancer patients and also for peripheral blood stem cells (PBSC) mobilization. The aim of this study is to evaluate the possible changes of platelet surface antigens after G-CSF injection in PBSC donors compared with healthy control. Methods: Between January 1st and December 31st, 2014, 48 healthy voluntary PBSC donors were eligible for this study. Donors received G-CSF (Filgrastim) subcutaneously for five days, and then their whole blood was collected for complete blood count. Analysis of platelet antigens was performed by flow cytometry. Sixteen healthy controls were also included for comparison. Results: Lower platelet counts were found in PBSC donors after G-CSF use and in comparison with health controls. The platelet size evaluated by forward scattering (FSC) showed smaller platelets in PBSC donors after G-CSF use compared with healthy controls (39.3 vs 46.7 mean fluorescence intensity, P = 0.015). CD31 were higher in PBSC donor (203.2 vs. 120.7, P

Background/Purpose: Our previous study found 284 gastric parietal cell antibody (GPCA)-positive atrophic glossitis (AG) patients (so-called GPCA+AG patients in this study) in a group of 1064 AG patients. This study evaluated whether high-titer (GPCA titer ≥ 160) GPCA+AG patients had greater frequencies of anemia, vitamin B12 deficiency, macrocytosis, and hyperhomocysteinemia than low-titer (GPCA titer

The use of additives such as ractopamine (Rac) in pregnant sows during early-mid pregnancy is an alternative to increase foetal and progeny growth and development. However, Rac supplementation in finishing pigs can lead to behavioural and physiological changes similar to the typical stress responses. The objective of this study was to evaluate the effects of dietary supplementation with Rac in pregnant sows from day 25 to 50 of gestation (pre-hyperplastic stage) on piglet's vitality, blood parameters, number, diameter and perimeter of muscle fibres in semitendinosus muscle and developmental characteristics of piglets at birth to weaning. Forty-one hybrid sows were divided into three dietary treatments: (1) control diet without Rac (control), (2) addition of 10 mg/kg of Rac (Rac10) and (3) addition of 20 mg/kg of Rac (Rac20). Higher numbers of low-vitality piglets (P

Summary Background The potential effects of SARS-CoV-2 and Plasmodium falciparum co-infection on host susceptibility and pathogenesis remain unknown. We aimed to establish the prevalence of malaria and describe the clinical characteristics of SARS-CoV-2 and P falciparum co-infection in a high-burden malaria setting. Methods This was an exploratory prospective, cohort study of patients with COVID-19 who were admitted to hospital in Uganda. Patients of all ages with a PCR-confirmed diagnosis of SARS-CoV-2 infection who had provided informed consent or assent were consecutively enrolled from treatment centres in eight hospitals across the country and followed up until discharge or death. Clinical assessments and blood sampling were done at admission for all patients. Malaria diagnosis in all patients was done by rapid diagnostic tests, microscopy, and molecular methods. Previous P falciparum exposure was determined with serological responses to a panel of P falciparum antigens assessed using a multiplex bead assay. Additional evaluations included complete blood count, markers of inflammation, and serum biochemistries. The main outcome was overall prevalence of malaria infection and malaria prevalence by age (including age categories of 0–20 years, 21–40 years, 41–60 years, and >60 years). The frequency of symptoms was compared between patients with COVID-19 with P falciparum infection versus those without P falciparum infection. The frequency of comorbidities and COVID-19 clinical severity and outcomes was compared between patients with low previous exposure to P falciparum versus those with high previous exposure to P falciparum. The effect of previous exposure to P falciparum on COVID-19 clinical severity and outcomes was also assessed among patients with and those without comorbidities. Findings Of 600 people with PCR-confirmed SARS-CoV-2 infection enrolled from April 15, to Oct 30, 2020, 597 (>99%) had complete information and were included in our analyses. The majority (502 [84%] of 597) were male individuals with a median age of 36 years (IQR 28–47). Overall prevalence of P falciparum infection was 12% (95% CI 9·4–14·6; 70 of 597 participants), with highest prevalence in the age groups of 0–20 years (22%, 8·7–44·8; five of 23 patients) and older than 60 years (20%, 10·2–34·1; nine of 46 patients). Confusion (four [6%] of 70 patients vs eight [2%] of 527 patients; p=0·040) and vomiting (four [6%] of 70 patients vs five [1%] of 527 patients; p=0·014] were more frequent among patients with P falciparum infection than those without. Patients with low versus those with high previous P falciparum exposure had a increased frequency of severe or critical COVID-19 clinical presentation (16 [30%] of 53 patients vs three [5%] of 56 patients; p=0·0010) and a higher burden of comorbidities, including diabetes (12 [23%] of 53 patients vs two [4%] of 56 patients; p=0·0010) and heart disease (seven [13%] of 53 patients vs zero [0%] of 56 patients; p=0·0030). Among patients with no comorbidities, those with low previous P falciparum exposure still had a higher proportion of cases of severe or critical COVID-19 than did those with high P falciparum exposure (six [18%] of 33 patients vs one [2%] of 49 patients; p=0·015). Multivariate analysis showed higher odds of unfavourable outcomes in patients who were older than 60 years (adjusted OR 8·7, 95% CI 1·0–75·5; p=0·049). Interpretation Although patients with COVID-19 with P falciparum co-infection had a higher frequency of confusion and vomiting, co-infection did not seem deleterious. The association between low previous malaria exposure and severe or critical COVID-19 and other adverse outcomes will require further study. These preliminary descriptive observations highlight the importance of understanding the potential clinical and therapeutic implications of overlapping co-infections. Funding Malaria Consortium (USA).

Background Coronavirus disease (COVID-19) is an infectious disease caused by a recently discovered coronavirus. Blood test including complete blood count is crucial in diagnosing of several viral and bacterial infection. Aims This study aimed to assess the association between lymphocyte ratio and other WBC types and severity of COVID-19 pneumonia. Methods The design of this study was a cross-sectional study. A complete blood count and erythrocyte sedimentation rate (ESR) was done for one hundred twenty-six COVID-19 patients (76 males and 50 females; aged 20–70 years). Patients were randomly recruited from multicenter in Al-Najaf Governorate, Iraq. Results The study had revealed an inverse correlation between severity of COVID-19 infection and both lymphocytes and monocytes ratio even in patients with normal WBC count. Additionally, there was a direct correlation between platelets and leukocyte count. The relation between leukocyte count and ESR level was significant in a patient with elevated WBC only. Conclusion Lymphocytes and monocyte ratios inpatient with COVID-19 infection can be used as predictors for the severity of infection. Increased leukocyte count resulted in increases in platelets inpatient with COVID-19., Coronavirus; Lymphocytes; Monocytes; White blood cells.

Objective Polycythemia is a rare condition in which an increase in erythrocyte mass is observed. It can be primary or secondary. Primary polycythemia occurs as a result of congenital or acquired mutations that regulate erythroid development. Although secondary polycythemia is mostly seen secondary to hypoxia due to cardiac/pulmonary reasons, it also develops as a result of congenital mutations. Globin gene mutations that increase the affinity of hemoglobin for oxygen are one of these rare causes. Materials and Methods We present a male case who was referred to us for polycythemia. Results A 15-year-old male patient with no known disease was referred to us after his school screening revealed high hemoglobin (18 g/dL). In complete blood count, other series were normal (wbc 5.8 × 103/µL neu 3.3 × 103/µL plt 174 × 103/µL), bilirubins and liver functions were within normal limits. On physical examination, conjunctiva and hands were pletoric, there was no hepatosplenomegaly, intermittent headaches were present, and neurological examination was normal. The patient was examined for the etiology of polycythemia. Hyperchromic erythrocytes were found in peripheral smear, no signs of hemolysis were observed. EPO level (8 mIU/ml) was in the normal range and JAK2 (V617F) mutation was negative. The patient's cardiac and pulmonary functions were within normal limits. Hemoglobin electrophoresis was sent from the patient. HbA was determined as 59.2, HbA2 2.8, Variant Hb 38. c.435G>T mutation was detected in the HBB genetic analysis, and this was considered to be compatible with Hemoglobin Andrew-Minneapolis. It was learned that the patient's mother and her cousins had similar findings, and some of them had undergone phlebotomy. Phlebotomy was planned in the presence of the patient's hemoglobin value > 18 g/dL and clinical findings. Phlebotomy was performed 3 times, aspirin was not started because there was no history of thromboembolism. In our 1-year follow-up, the hemoglobin value was 17-17.5 g/dL. Conclusion More than a hundred globin gene mutations associated with erythrocytosis have been described. Hemoglobin Andrew-Minneapolis mutation is one of them. Hemoglobin's affinity for oxygen has increased and EPO level is normal/increased. Due to the low number of cases, treatment recommendations were prepared based on polycythemia vera guidelines. Patients should be closely monitored in terms of hyperviscosity and thromboembolism, aspirin prophylaxis and phlebotomy are recommended according to symptoms. While investigating the etiology of polycythemia, hemoglobin electrophoresis is necessary, although it is very rare.

Introduction: Covid-19 is an infectious disease with systemic involvement, which causes intense changes in the blood system, such as neutrophilia and lymphopenia, as well as changes in coagulation function and the concentration of acute phase proteins. Infected patients require laboratory follow-up to assist in clinical and therapeutic management. It is important to define efficient parameters to predict the clinical course of the disease, especially when the overall symptoms are becoming worse, in an attempt to anticipate therapeutic measures and to ensure the most appropriate assistance. Purpose: To correlate neutrophil and lymphocyte counts and their subtypes with the severity and outcome of patients with Covid-19. Materials and methods: Patients hospitalized for severe Covid-19, of both genders and without evidence of bacterial pneumonia, seen at the CHC-UFPR between April and June 2020, were included. Lymphocyte subpopulation analysis was performed by multiparametric flow cytometry (MFC) on whole blood sample using antibodies against CD45, CD3, CD4, CD8 and CD19. A BD FACSCanto™ II cytometer and Infinicyt™ 2.0 analysis software were used. ROC curve and other statistical relationships were performed with IBM SPSS™ v. 25 software. Results: Patients were divided as moderate (not intubated, n = 41) and severe (intubated, n = 35). From the median total leukocyte, neutrophil and lymphocyte counts and their subsets, we define the cutoff values with the highest correlation with hospital discharge. Patients with lymphocyte counts higher than 489/μL, CD4 counts higher than 326 and CD8 counts higher than 121 had a greater chance of evolving with a better prognosis (p < 0.001). Patients who had neutrophil-to-lymphocyte ratio (NLR) higher than 15.2 showed greater correlation with worse prognosis. Patients with lymphopenia below cutoff values are 40 to 55% more likely to be intubated and 50 to 63% to progress to death. Patients with NLR higher than 15.2 have 53.1% more chances of being intubated and 78.1% of evolving to death. Discussion: Laboratory evaluation is essential in the follow-up of patients with Covid-19. In addition to routinely used biochemical markers, cellular analysis can provide valuable information about the clinic and its progression. Lymphopenia and neutrophilia are common parameters in patients with severe disease, so NLR analysis presents itself as an objective scale for stratification of infected patients with a high correlation with possible outcomes. Associated with this, assessment of the immune profile with low levels of T-cells and especially low levels of positive CD4 cells has been associated with worse prognosis in patients with severe Covid-19. Conclusion: We conclude that analysis of the neutrophil/lymphocyte ratio routinely obtained from the complete blood count may provide relevant prognostic information for patients with Covid-19. In addition, flow cytometry analysis of CD4 and CD8 T-lymphocytes can complement the screening of patients with Covid-19 by providing information on the immune profile of the disease.

Background Diabetes mellitus (DM) is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. The most common type is type II diabetes and is characterized by insulin resistance or relative insulin deficiency. Objectives This study was performed to discover whether Complte blood count is a suitable indicator for development of type II diabetes complications. Methods 137 type II diabetic patients with high blood glucose level were included in this study and their complete blood count was recorded. Demographic and laboratory data were also noted. Result WBC, Hb, Hematocrit, MCH had abnormal values. As the results of this study show, higher leukocyte counts was correlated with uncontrolled diabetes. Accompanied by other markers, chronic inflammation that can be shown by this factor could be related to pathogenesis and the progression of these diabetes-related complications. Conclusion Complete blood count test could be considered as an appropriate clinical examination for early diagnosis and prevention of microvascular and macrovascular complications thus reducing morbidity and mortality from diabetes mellitus.

Background The combination of visceral leishmaniasis (VL) and macrophage activation syndrome (MAS) makes the diagnosis difficult due to their similar clinical presentation, with a poor prognosis especially since the treatment is still poorly codified. We report the case of a 17-month-old female patient from Berkane, presenting for a 3 months history of anarchic fever with anemic syndrome made up of pallor and hemorrhagic syndrome made up of epistaxis. Physical examination revealed a temperature of 39 ° C, lower limbsedema, paleness of skin and mucous membranes, gingival petechiae, bleached hair, and hepatosplenomegaly. Case presentation The complete blood count showed pancytopenia with deep aregenerative normochromic normocytic anemia at 3 g/dL, leukocytes were at 4860/mm 3 with neutropenia at 680/mm 3 and thrombocytopenia at 12.000/mm3, the blood smear was without abnormality. These anomalies were associated with a hypoalbunemia, hypertriglyceridemia, hyperferritinemia, lactate dehydrogenase (LDH) level was at 337 IU/L, low prothrombin time (PT) at 56 % and fibrinogen level at 1 g/L. The direct Coombs test was positive. Examination of the myelogram revealed the presence of leishmania bodies and figures of hemophagocytosis. A diagnosis of visceral leishmaniasis associated with MAS was made. The patient was put on liposomal amphotericin B and corticosteroid therapy with good clinical and biological evolution and good therapeutic tolerance. Conclusion The association of VL and MAS remains rare and should be evoked even in non-endemic areas since late diagnosis worsens the prognosis and may even be responsible for the death of patients despite an aggressive treatment.

Background Helicobacter pylori infection represents a major gastrointestinal complaint associated with gastritis, gastric ulcer and stomach tumors. It is present in 90 % of developing countries population. H. pylori diagnosis in these countries, where resources are limited, is accomplished with simple non-invasive tests such as stool antigen and serum antibody tests. The aim of this study was to evaluate the serum antibody test in the diagnosis of current H. pylori infection. Subject and methods A total of 117 patients were included in this prospective diagnosis accuracy testing study, who clinically presented with dyspepsia, heartburn, abdominal pain, diarrhea, or halitosis. A stool sample was collected from each patient and tested for H. pylori antigen using immunochromatographic method. Blood sample was also collected, half of which was EDTA-sampled and analyzed for complete blood count, while the remaining half was left to clot, the separated serum was tested for antibodies against H. pylori with immunochromatographic cassette. Results About 35 % of sixty six patients who were positive for stool antigen test gave a negative for serum antibodies test. Meanwhile, the non-consistent results within 51 negative stool antigen test patients was exhibited by 47 % of them. The discrepancies were not affected by age or disease duration. The calculated sensitivity, specificity, positive predictive value and negative predictive values were 50 %, 65 %, 65 % and 50 % respectively. Conclusion The serum antibody test is not reliable in the diagnosis of current H. pylori infection. In developing countries, with limited facilities and primary care units, stool antigen test diagnosis is useful for diagnosis.

Introduction Low blood-brain barrier (BBB) penetration and hematopoietic side effects limit the therapeutic development of erythropoietin (EPO) for Alzheimer's disease (AD). A fusion protein of EPO and a chimeric monoclonal antibody targeting the mouse transferrin receptor (cTfRMAb) has been engineered. The latter drives EPO into the brain via receptor-mediated transcytosis across the BBB and increases its peripheral clearance to reduce hematopoietic side effects of EPO. Our previous work shows the protective effects of this BBB-penetrating EPO in AD mice but hematologic effects have not been studied. Herein, we investigate the hematologic safety and therapeutic effects of chronic cTfRMAb-EPO dosing, in comparison to recombinant human EPO (rhu-EPO), in AD mice. Methods Male APPswe PSEN1dE9 (APP/PS1) mice (9.5 months) were treated with saline (n = 11), and equimolar doses of cTfRMAb-EPO (3 mg/kg, n = 7), or rhu-EPO (0.6 mg/kg, n = 9) 2 days/week subcutaneously for 6 weeks, compared to saline-treated wild-type mice (n = 10). At 6 weeks, exploration and memory were assessed, and mice were sacrificed at 8 weeks. Spleens were weighed, and brains were evaluated for amyloid beta (Aβ) load and synaptophysin. Blood was collected at 4, 6 and 8 weeks for a complete blood count and white blood cells differential. Results cTfRMAb-EPO transiently increased reticulocyte counts after 4 weeks, followed by normalization of reticulocytes at 6 and 8 weeks. rhu-EPO transiently increased red blood cell count, hemoglobin and hematocrit, and significantly decreased mean corpuscular volume and reticulocytes at 4 weeks, which remained low at 6 weeks. At 8 weeks, a significant decline in red blood cell indices was observed with rhu-EPO treatment. Exploration and cognitive deficits were significantly worse in APP/PS1-rhu-EPO mice. Both cTfRMAb-EPO and rhu-EPO decreased 6E10-positive brain Aβ load; however, cTfRMAb-EPO and not rhu-EPO selectively reduced brain Aβ1-42 and elevated synaptophysin expression. Discussion Chronic treatment with cTfRMAb-EPO results in better hematologic safety, behavioral, and therapeutic indices compared with rhu-EPO, supporting the development of this BBB-penetrable EPO analog for AD., Highlights • Chimeric monoclonal antibody against the mouse TfR (cTfRMAb)-erythropoietin (EPO) is a brain-penetrating IgG-EPO fusion protein. • Chronic treatment with cTfRMAb-EPO does not alter hematology indices in APP/PS1 mice. • Equimolar dose of recombinant human EPO significantly alters hematologic indices in APP/PS1 mice. • Both cTfRMAb-EPO and recombinant human EPO reduce amyloid beta load in APP/PS1 mice. • cTfRMAb-EPO selectively reduces amyloid beta (1–42) and increases synaptophysin in APP/PS1 mice.

Background: No previous studies have explored emergency medical care for children with chronic neuromuscular disorders (NMDs). We aimed to determine the major reasons for the emergency room (ER) readmission of pediatric patients with NMDs and suggest changes to the care plan to decrease readmissions. Methods: Children with chronic NMDs (aged

Objective To study the potential role of miRNA34a gene expression and its relationship with P53 gene expression, fate, stage, metastasis and overall survival of colorectal cancer. Patients and methods This study was carried out 30 patients with colon adenocarcinoma, 30 patients with benign colon polyp and 30 apparently healthy persons served as controls. All participants were subjected to full history taking, general clinical examination. Complete blood count, liver and kidney function, determination of serum tumor markers were done. Estimation of microRNA 34a and P53 Gene expression by real-time PCR were done. Results There was a significant negative relationship between serum tumor markers and micro RNA 34a gene expression in cancer patients. Also, there was a statistically significant positive relationship between miRNA34a gene expression and P53 gene expression in both patients groups. The diagnostic accuracy of miRNA34a gene expression was both sensitive and specific for colon cancer. MiRNA34a and P53 gene expression had statistically significant relation with tumor stage and presence of metastases. Conclusion It can be concluded that the level of miRNA34a can be used to differentiate between colon cancers and begin adenomas. MiRNA34a can be used as a prognostic marker in colon cancer., Highlights • MiRNA34a has an important role in colon cancer. • Presence of correlation between P53 and miRNA34a gene expression. • MiRNA34a can be used as a prognostic marker in colon cancer. • MiRNA34a can be used to differentiate between colon cancer and benign adenoma.

Purpose: To analyze the cellular response and chemokine profiles following exercise using cooling and blood flow restriction on the Vasper system. Methods: Healthy male patients between the ages of 20 and 39 years were recruited. Testing was performed on the Vasper system, a NuStep cross-trainer with concomitant 4-limb venous compression with proximal arm cuffs at 40 mm Hg and proximal leg cuffs at 65 mm Hg. A cooling vest and cooling mat (8.3°C) were used. A 7-minute warm-up followed by alternating 30- and 60-second sprints with 1.5 and 2 minutes of active recovery, respectively, between each sprint. Peripheral blood was drawn before exercise, immediately following exercise (T20), 10 minutes after the first post-exercise blood draw (T30), and then every 30 minutes (T60, T90, T120, T150, T180). A blood draw occurred at 24 hours’ postexercise. Complete blood count, monoclonal flow cytometry for CD34+, and enzyme-linked immunosorbent assay were used to analyze the samples. Results: Sixteen healthy male patients (29.5 ± 4.5years, 1.78 ± 0.05m, 83.7 ± 11.4 kg) were enrolled. There was an immediate, temporary increase in white blood cell counts, marked by an increase in lymphocyte differential (38.3 ± 6.5 to 44.3 ± 9.0%, P = .001), decrease in neutrophil differential (47.8 ± 6.6 to 42.0 ± 9.1%, P < .001), and platelets (239.5 ± 57.2 to 268.6 ± 86.3 K⋅μL–1, P = .01). Monocytes significantly decreased from PRE to T90 (9.8 ± 1.1 to 8.9 ± 1.1K/μL, P < .001) and T120 (8.9 ± 1.1 K/μL, P < .0001). There was a significant increase in CD34+ cells (3.9 ± 2.0 to 5.3 ± 2.8 cells⋅μL–1, P < .001). No detectable differences in measured cytokine levels of interleukin (IL)-10, IL-6, granulocyte-macrophage colony-stimulating factor , IL-1ra, tumor necrosis factor-α, or IL-2 were observed. Conclusions: A significant elevation of peripheral blood CD34+ and platelet levels immediately following the exercise session was observed; however, there was no effect on peripheral circulation of IL-10, IL-6, IL-1ra, tumor necrosis factor-α, or IL-2. Clinical Relevance: Exercise can be considered as a way to manipulate point-of-care blood products like platelet-rich plasma and may increase product yield.

Brucellosis is the most prevalent bacterial zoonosis worldwide. The WHO estimates that the infection is responsible for more than 500 000 cases per year across the world [1]. Hematological complications like mild anemia and leukopenia have been frequently associated with acute brucellosis, but pancytopenia and thrombocytopenia are less frequently encountered [2]. We are reporting the case of a 73 year old male patient, with pancytopenia that revealed acute brucellosis. Following 6 weeks of antibiotic therapy, our patient showed favorable clinical outcome, and the complete blood count returned to normal. Acute brucellosis should be highly suspected in patients with pancytopenia.

Highlights • Isolated of COVID-19 infection. • Atypical presentations of COVID-19 are likely thrombocytopenia can be a rare presentation to go undiagnosed or misdiagnosed. • Physicians should be familiar with atypical presentations of COVID-19 Infection. • Hematological involvement in COVID-19 infection can be diverse., COVID-19 is known to cause serious respiratory symptoms and involvement of other body systems such as hematopoietic, neurological and the immune system. In this report, we described a case of a COVID-19 patient who presented with no pulmonary involvement but severe thrombocytopenia. She suffered from headache and malaise with no respiratory symptoms, fever or chills. Chest radiological imaging was unremarkable but, the laboratory results showed significant thrombocytopenia associated with relatively decreased lymphocytes. Based on her high-risk work environment, a reverse transcription polymerase chain reaction (RT-PCR) test was performed and SARS-CoV-2 RNA was detected in the nasopharyngeal swab. Complete blood count (CBC) of patient was re-checked during admission and platelet count showed rising trend up to normal levels. A narrow diagnostic approach where only febrile patients with pulmonary symptoms are evaluated for a COVID-19 diagnosis will result in many missed diagnoses; so it is important that physicians are familiar with atypical and rare presentations of COVID-19, such as isolated thrombocytopenia.

Background Non Hodgkin lymphoma (NHL) is one of the immune system cancers. The occurrence and progression of malignant lymphomas depends on cellular pathways deregulation. Understanding the relationship between the immune system at the genetic level and malignant transformation is critical to reach its etiology. Objective The aim of this work is to evaluate the expression of five immune related genes (PD-1, FOXP3, GrA, GrB and CD11c) in patients with diffuse large B cell non Hodgkin lymphoma (DLBCL). Materials and methods This study was conducted on fifty patients with DLBCL and fifty sex and age matched apparently healthy subjects. The participants were subjected to these laboratory investigations: complete blood count, serum lactate dehydrogenase and β2microglobulin (β2M) levels and determination of PD-1, FOXP3, GrA, GrB and CD11c gene expressions. Results The results of this study revealed that PD-1, FOXP3, GrA, GrB and CD11c gene expressions were significantly increased in DLBCL patients. Conclusion Patients with DLBCL have variablePD-1, FOXP3,GrA, GrB and CD11cgene expressions levels, which are correlated with the overall survival (OS) indicating that they can be good predictors of outcome in these patients., Highlights • The gene expression of immunity related genes are important indicators of lymphoma overall survival and prognosis. • Patients with DLBCL is usually accompanied by increased PD-1, and FOXP3 gene expression. • GrA and GrB genes expression decrease in DLBCL. • CD11c gene expression level is variable.

The complete blood count and white blood cell (WBC) differential provide valuable information regarding the main cellular components of the peripheral blood: red blood cells (RBCs), WBCs, and platelets. Typical parameters reported include the RBC and platelet counts and indices, the WBC count, and absolute counts and/or proportions of each WBC subtype, including neutrophils, lymphocytes, monocytes, eosinophils, and basophils. Laboratory techniques utilized include impedance, conductivity measurements, light scatter, and fluorescence. Abnormal results can lead to alerts, also known as flags, and such results often warrant examination of a peripheral blood smear.

Background Hospital acquired infection (HAI) and multiple organ dysfunctions (MODS) remain a leading cause of death in pediatric intensive care unit (PICU) despite the great efforts to control it. Objective Our objective was to assess the mRNA of TNFα and BCL2 for prediction of HAI and/or MODS in our community. Patients and methods Fifty children, admitted to PICU, were included in the study after exclusion of cases of end-stage renal failure, end-stage liver failure and congenital immune deficiency. Serial Blood samples were collected for complete blood count (CBC) and other routine investigations. Gene expression of (TNFα and BCL2) was quantified using quantitative real time PCR (qRT-PCR). Centers of disease control (CDC) criteria were used to detect HAI, and organ failure index (OFI). Pediatric logistic organ dysfunction (PELOD) and pediatric risk of mortality (PRISM) scores were used for follow up. The results were compared between the group who acquired HAI and who didn't. Gene expression was tested with a ROC curve to detect its ability to predict HAI. Main results The overall complication (HAI and/or MODS) rate was 52%, Complicated cases had a significantly longer duration of stay in PICU (0.002) and in overall hospital stay (p = 0.013) and a higher death rate (p = 0.000). On day1; TNFα, BCL2 and lymphocytic count were lower in patients who developed complications (p = 0.02, p = 0.000 and p = 0.04, respectively), all had the ability to predict the complications with AUC (0.7, 0.8 and 0.67 respectively). On day 4: TNFα and BCL2 returned to normal levels while the lymphocytic count still lower in complicated cases, p = 0.001 and AUC = 0.73. Conclusions TNFα and BCL2 on admission can predict HAI and MODS (AUC = 0.7 and AUC = 0.8), but were of no use in the follow-up, however, the lymphocytic count is a rapid, easy and cheap test to assess the immune state with a good predictive and follow up values., Highlights • To our knowledge, our work is the 1st to show mRNA biomarkers in acquired immunosuppressed critically ill Egyptian children. • The current study provides a new evidence that immune suppression can be measured and opens the way for further studies. • We mainly found that TNFα and BCL2 can predict HAI and MODS on admission but they were of no use in the follow-up. • Lymphocytic count, a rapid, easy and cheap test, can assess the immune state with a good predictive and follow up values.

Background: The precise mechanisms of the increased incidence of hemostatic abnormalities in congenital heart disease (CHD) have not been determined. The aim of the study was to evaluate some indicators of activation of platelets and vascular endothelial cells in patients with CHD, evaluation of bleeding liability of these patients, and correlation with the clinical presentation of these patients. Methods: This work was carried out on 20 patients with cyanotic congenital heart diseases (CCHD), 20 patients with acyanotic congenital heart diseases (ACHD), and 20 healthy children who served as the control group, aged between 1 and 10 years. All were subjected to full clinical examination, complete blood count, oxygen saturation, echocardiography, bleeding and coagulation times, PT, PTT, FDPs, plasma soluble P-selectin, E-selectin, and platelet factor 4 (PF4). Results: There was significant prolongation of PT and PTT, and there was a significant lowering of platelet counts. These results were obtained in CCHD and ACHD, but were more significant in CCHD patients. There was a significant elevation in PF4 (55.0 ± 25.5 ng/mL), P-selectin (128.9 ± 42.44 ng/dL), and E-selectin (9461.5 ± 1701.24 pg/mL) levels in children with CCHD as compared to those with ACHD (PF4, 21 ± 7.94 ng/mL; P-selectin, 80.1 ± 13.2 ng/mL; E-selectin, 7969.6 ± 2127.5 pg/mL), and significant increase in both groups when compared to the control group (PF4, 8.1 ± 4.7 ng/mL; P-selectin, 27.83 ± 9.73 ng/mL; E-selectin, 6750.00 ± 3204.00 pg/mL). There was a significant negative correlation between oxygen saturation, plasma P-selectin (r = −0.865), E-selectin (r = −0.401), and PF4 (r = −0.792) in patients with CCHD. Conclusion: Patients with CHD—both cyanotic and acyanotic—have variable degrees of increased liability for both thrombosis and hemorrhage that represents some sort of adaptation to preserve hemostasis and to protect these patients against the clinical presentation of both thrombosis and bleeding. This is to say that CHD patients have their own point of balance between thrombogenicity and bleeding liability. Wide-scale studies are needed to detect the normal levels of different thrombohemorrhagic parameters of these patients. Keywords: CHD, Endothelial, PF4, Platelet, Selectins

Graphical abstract, Highlights • Body weight, complete blood count and studied serum parameters remained unaffected upon Ti 6 A l 4 V alloy powder exposure. • Short tern exposure to Ti 6Al 4V powder drastically affected neuromuscular coordination in male mice during rota rod test. • Reduced novel object recognition ability in female mice exposed to Ti 6Al 4V alloy powder. • Disturbed antioxidant metabolites in vital organs of mice treated with Ti 6Al 4V alloy powder., Titanium, Aluminum and Vanadium (Ti 6Al 4V) alloy are frequently used as surgical implant but regarding their compatibility in living systems is limited. Ti 6Al 4V was prepared from high purity constituents and Ti 6Al 4V alloy powder (25 mg/ml solvent/Kg body weight) was gavaged to albino mice for 8 days. A saline treated control group was maintained in parallel. A series of behavioral (rota rod, light and dark box, open field and novel object) test performance, complete blood count, selected serum (HDL cholesterol, LDL cholesterol, creatinine, cholesterol and triglycerides) parameters, antioxidant metabolites from vital organs (superoxide dismutase, catalase and lipid peroxidation) from vital organs and body weight were determined in both treatments. It was observed that rota rod test performance in male (P = 0.05) and novel object recognition capability in female mice (P = 0.04) were significantly reduced as compared to their respective control groups. Body weight, complete blood count and studied serum parameters remained unaffected when compared between two treatments of both genders. Concentration of superoxide dismutase in liver (P = 0.008), heart (P = 0.01) and lungs (P = 0.05) was significantly elevated while catalase concentration in liver (P = 0.001) was significantly decreased in female albino mice that were exposed to 25 mg/ml solvent/kg body weight of Ti 6 A l 4 V alloy powder. In case of male albino mice, superoxide dismutase concentration in lungs was reduced (P = 0.05) in mice exposed to Ti 6 A l 4 V alloy powder. In conclusion, our results indicated that short term exposure to 25 mg/ml solvent/Kg body weight of Ti-6Al-4V alloy powder supplementation had adversely affected selected aspects of behavior of albino mice in a gender specific manner. Analysis of antioxidant parameters in vital organs has demonstrated that the applied dose of Ti-6Al-4V alloy powder can disturb the H₂O₂ associated metabolic pathways in albino mice, especially in female mice. As this alloy is part of surgical implants, so we recommend that their effects in living systems must be extensively explored under variable dose and exposure time conditions to know more about their biocompatibility.

Objectives: To study the prognostic value of abnormalities in baseline complete blood count in patients with oropharyngeal cancer (OPC) treated with (chemo) radiation. Methods and materials: The prognostic value of baseline complete blood count on outcome in 234 patients with OPC treated between 2010 and 2015 was examined in multivariate analysis together with other conventional prognostic variables including HPV-status, tumor stage, tumor and nodal size. Results: The 3-year overall survival (OS), disease-free survival (DFS), locoregional control (LRC), and distant control (DC) of the whole group were 74%, 64%, 79%, and 88%, respectively. Leukocytosis and HPV-status were the only significant prognosticators for OS and DFS at the multivariate analysis. Patients without leukocytosis had a significantly better DC compared to those with leukocytosis (92% and 70%, respectively, p