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Introduction Military members and first responders may, at moment's notice, be asked to assist in incidents that may result in radiation exposure such as Operation Tomadachi in which the U.S. Navy provided significant relief for the Fukushima Daiichi Nuclear Reactor accident in Japan after an earthquake and tsunami in 2011. We are also currently facing potential threats from nuclear power plants in the Ukraine should a power disruption to a nuclear plant interfere with cooling or other safety measures. Exposure to high doses of radiation results in acute radiation syndrome (ARS) characterized by symptoms arising from hematopoietic, gastrointestinal, and neurovascular injuries. Although there are mitigators FDA approved to treat ARS, there are currently no FDA-approved prophylactic medical interventions to help protect persons who may need to respond to radiation emergencies. There is strong evidence that manganese (Mn) has radiation protective efficacy as a promising prophylactic countermeasure. Materials and Methods All animal procedures were approved by the Institutional Animal Care and Use Committee. Male and female B6D2F1J mice, 10 to 11 weeks old, were used for neurotoxicity studies and temporal effects of Mn. Four groups were evaluated: (1) vehicle injection, (2) dose of 4.5 mg/kg for 3 days, (3) dose of 13.5 mg/kg, and (4) sham. Irradiated mice were exposed to 9.5 Gy whole body Co60 γ-radiation. MRI was performed with a high dose of manganese chloride (MnCl2) (150 mg/kg) to assess the distribution of the MnCl2. Results The mice have promising survival curves (highest survival—13.5 mg/kg dose over 3 days of MnCl2 at 80% [87% female, 73% male] P  = 0.0004). The complete blood count (CBC) results demonstrated a typical hematopoietic response in all of the irradiated groups, followed by mildly accelerated recovery by day 28 in the treated groups. No difference between groups was measured by Rota Rod, DigiGait, and Y-maze. Histologic evaluation of the bone marrow sections in the group given 13.5 mg/kg dose over 3 days had the best return to cellularity at 80%. MRI showed a systemic distribution of MnCl2. Discussion The preliminary data suggest that a dose of 13.5 mg/kg of MnCl2 given over 3 days prior to exposure of radiation may have a protective benefit while not exhibiting the neurobehavioral problems. A countermeasure that can prophylactically protect emergency personnel entering an area contaminated with high levels of radiation is needed, especially in light that nuclear accidents are a continued global threat. There is a need for a protective agent with easy long-term storage, easy to transport, easy to administer, and low cost. Histologic evaluation supports the promising effect of MnCl2 in protecting tissue, especially the bone marrow using the dose given over 3 days (4.5 mg/kg per day) of MnCl2. Conclusions Initial experiments show that MnCl2 is a promising safe and effective prophylactic countermeasure against ARS. MRI data support the systemic distribution of MnCl2 which is needed in order to protect multiple tissues in the body. The pathology data in bone marrow and the brain support faster recovery from radiation exposure in the treated animals and decreased organ damage. [ABSTRACT FROM AUTHOR]

Introduction Exposure to high doses of ionizing radiation can result in hematopoietic acute radiation syndrome. Currently, there is no radiation medical countermeasure approved by the U.S. FDA which can be used before radiation exposure to protect exposed individuals. Here we aimed to evaluate the therapeutic potential of an aqueous suspension of synthetic genistein nanoparticles (BIO 300) as a radioprotectant in a pilot efficacy study using a nonhuman primate model of total body irradiation. Materials and Methods Eight rhesus macaques were divided into two groups; four received vehicle and four received BIO 300 Injectable Suspension 24 h before 5.8 Gy total-body irradiation. Survival, blood cell counts, blood chemistry, and clinical parameters were monitored over the 60 days of the study. Tissues were collected at necropsy 60 days post-irradiation or from animals that met unscheduled euthanasia criteria and subjected to histopathological analysis. Tissues analyzed included the duodenum, jejunum, ileum, sternum, lung, heart, liver, kidney, spleen, gut-associated lymphoid tissue, and urinary bladder. Results In this pilot study, all BIO 300 Injectable Suspension treated animals survived to day 60, while only 50% of the vehicle-treated animals survived. We found that BIO 300 Injectable Suspension did not mediate an improvement in blood cell counts (e.g. neutrophils, platelets, white blood cells). However, BIO 300 Injectable Suspension treated animals had a lower incidence of fever and febrile neutropenia, were able to better maintain their body weight post radiation exposure, and exhibited less anemia and faster recovery from anemia. Histopathological analysis revealed that BIO 300-treated animals had less irradiation-induced damage to the sternum and other tissues compared to vehicle controls. Conclusions BIO 300's mechanism of action is complex and protection against irradiation is attainable without much improvement in the complete blood count (CBC) profile. BIO 300's mechanism for radioprotection involves multiple biological pathways and systems. [ABSTRACT FROM AUTHOR]

Utilizing RBC or PLT-related parameters to establish rules for the PLT-O reflex test can assist laboratories in quickly identifying specimens with interfered PLT-I that require PLT-O retesting.Prospective PLT-I and PLT-O testing was performed on 6857 EDTA-anticoagulated whole blood samples, split randomly into training and validation cohorts at a 2:3 ratio. Reflex and non-reflex groups were distinguished based on the differences between PLT-I and PLT-O results. By comparing RBC and PLT parameter differences and flags in the training set, we pinpointed factors linked to PLT-O reflex testing. Utilizing Lasso regression, then refining through univariate and multivariate logistic regression, candidate parameters were selected. A predictive nomogram was constructed from these parameters and subsequently validated using the validation set. ROC curves were also plotted.Significant differences were observed between the reflex and non-reflex groups for 19 parameters including RBC, MCV, MCH, MCHC, RDW-CV, RDW-SD, Micro-RBC#, Micro-RBC%, Macro-RBC#, Macro-RBC%, MPV, PCT, P-LCC, P-LCR, PLR,“PLT clumps?” flag, “PLT abnormal histogram” flag, “IDA Anemia?” flag, and “RBC abnormal histogram” flag. After further analysis, Micro-RBC#, Macro-RBC%,“PLT clumps?”, and “PLT abnormal histogram” flag were identified as candidate parameters to develop a nomogram with an AUC of 0.636 (95 %CI: 0.622–0.650), sensitivity of 42.9 % (95 %CI: 37.8–48.1 %), and specificity of 90.5 % (95 %C1: 89.6–91.3 %).The established rules may help laboratories improve efficiency and increase accuracy in determining platelet counts as a supplement to ICSH41 guidelines. [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.)

Introduction: Stroke, a leading cause of death and disability worldwide, is primarily ischemic and linked to hypertension. Hypertension, characterized by systemic chronic inflammation, significantly increases stroke risk. This study explores the association of novel systemic inflammatory markers (SII, PIV, SIRI) with stroke prevalence in hypertensive U.S. adults using NHANES data. Methods: We analyzed data from hypertensive participants in the NHANES 1999-2020 survey, excluding those under 20, pregnant, or with missing data, resulting in 18,360 subjects. Systemic inflammatory markers (SII, PIV, SIRI) were calculated from blood counts. Hypertension and stroke status were determined by self-report and clinical measurements. Covariates included sociodemographic, lifestyle, and medical history factors. Weighted statistical analyses and multivariate logistic regression models were used to explore associations, with adjustments for various covariates. Ethical approval was obtained from the NCHS Ethics Review Board. Results: In a cohort of 18,360 hypertensive individuals (mean age 56.652  years), 7.25% had a stroke. Stroke patients were older, had lower PIR, and were more likely to be female, single, less educated, smokers, non-drinkers, physically inactive, and have diabetes and CHD. Multivariate logistic regression showed that SII was not significantly associated with stroke. However, PIV and SIRI were positively associated with stroke prevalence. Each unit increase in lnPIV increased stroke odds by 14% (OR = 1.140, p = 0.0022), and lnSIRI by 20.6% (OR = 1.206, p = 0.0144). RCS analyses confirmed J-shaped associations for lnPIV and lnSIRI with stroke. Stratified analyses identified gender and smoking as significant effect modifiers. Smoking was significantly associated with elevated PIV, SIRI, and SII levels, especially in current smokers. Conclusion: Elevated PIV and SIRI levels significantly increase stroke prevalence in hypertensive individuals, notably among males and smokers. A predictive model with PIV, SIRI, and sociodemographic factors offers strong clinical utility. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion The aim of this study was to assess the usefulness of routine hemoglobin testing following elective and urgent cesarean section (CS) in patients without primary postpartum hemorrhage (PPH).This retrospective cohort study included women who underwent vaginal delivery (VD), elective CS, and urgent CS at Carmel Medical Center from 2015 to 2020. Data were extracted from the obstetric database, excluding deliveries with PPH. Demographic and obstetric variables were recorded. Primary outcomes were the need for packed red blood cell transfusion.A total of 19 446 women were included, with five (0.3%) requiring a blood transfusion in the elective CS group, 27 (0.17%) in the VD group, and eight (0.4%) in the urgent CS group. Urgent CS was associated with a higher risk of blood transfusion, but there was no significant difference between elective CS and VD. Elective CS showed the lowest rates of post‐delivery hemoglobin below 7 g/dL 1 (0.1%) compared to VD 16 (0.6%) and urgent CS 13 (0.7%).Routine postoperative hemoglobin testing following elective CS in asymptomatic patients without PPH appears unnecessary. This study supports reconsidering routine hemoglobin testing following elective CS, aligning with the goal of optimizing resource utilization while maintaining patient quality. [ABSTRACT FROM AUTHOR]

Systemic inflammatory biomarkers recently studied in schizophrenia include neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR), systemic immune inflammation index (SII), and systemic inflammation response index (SIRI). SIRI, a novel inflammatory marker, has not been studied in different stages of schizophrenia. We aimed to compare NLR, MLR, PLR, SII, and SIRI values between psychotic exacerbation and remission values of the same patients with schizophrenia and a healthy control group. In this study, 86 patients with schizophrenia who were hospitalized due to psychotic relapse, the same patient group who were in remission after treatment, and 86 age-sex-matched healthy control subjects were analyzed. Inflammatory marker values of the patient group in both the psychotic exacerbation (PE) and the remission (R) period were analyzed and compared with healthy controls (HC). NLR, MLR, PLR, SII, and SIRI values were significantly higher in the schizophrenia-PE group than in the HC group. NLR, MLR, SII, and SIRI values were significantly higher in the schizophrenia-PE group than in the schizophrenia-R group. MLR values were significantly higher in the schizophrenia-R group than in the HC group. These findings may be interpreted as NLR, SII, and SIRI, which may be considered as state biomarkers, and MLR may be a trait marker for schizophrenia. [ABSTRACT FROM AUTHOR]

• Study shows ruptured endometriomas have higher pre-op biomarkers than non-ruptured cases. • Post-op MPV and NLR significantly higher in ruptured endometrioma patients. • Biomarkers in clinical management may improve diagnosis and treatment outcomes. To compare the outcomes between patients undergoing surgery for ruptured endometrioma versus non-ruptured endometrioma. The study was conducted at Health Sciences University, Etlik Zübeyde Hanım Training and Research Hospital Infertility Clinic. All patients who had a histopathology report of endometrioma between January 2014 and December 2020 were recruited. Patient files, surgery notes and laboratory values were extracted from the electronic recording system and patients with ruptured endometriomas (RE) or non-ruptured endometriomas (NRE) were compared. Overall, 181 patients were recruited to the study. No rupture was detected in 146 (80.7 %) patients while 35 patients (19.3 %) underwent surgery for RE. Pre-operative CRP, CA 125, CA 19–9, CA 15–3, CEA and mean platelet volume (MPV) values and postoperative MPV and neutrophil/lymphocyte ratio (NLR) values were statistically significantly higher (p < 0.01) in the RE group compared to the NRE group. Post-operative lymphocyte (p = 0.029) and eosinophyl (p = 0.015) values were significantly lower in the RE group compared to the NRE group. Among the preoperative biomarkers that are evaluated for prediction of rupture; MPV, CA 19–9 and CA-15.3 had a high specifity (>75 %) but a rather low sensitivity (<60 %), meanwhile CRP, CA-125 and CEA had high sensitivity but a low specifity. RE patients had significantly higher preoperative CRP, CA 125, CA 19–9, CA 15–3, CEA, and MPV values and postoperative MPV and NLR values while postoperative, lymphocyte and eosinophyl values were significantly lower compared with the NRE patients. Prospective studies with larger sample sizes are needed to determine biomarkers and parameters that can be used for non-invasive diagnosis of endometriosis and predict the possibility of endometrioma rupture. [ABSTRACT FROM AUTHOR]

The diagnosis of multiple myeloma requires detection of paraproteinemia and confirmation of monoclonal bone marrow infiltration, along with signs of end-organ damage. Despite the increasing prevalence, serum paraproteinemia is not routinely measured. We examined the relationship between alterations in routine hematological parameters and the development of paraproteinemia in a case-control study. Data was retrieved from a laboratory database in the capital region of Denmark between 01/01/2012 and 31/12/2022. Patients were included if they had a test for paraproteinemia (n = 134,740) and at least one prior hematological parameter (white blood cells, hemoglobin and platelet count) with a minimum follow-up of 1 year. Between 96,999 and 103,590 patients were included in each of the three hematological groups. We found white blood cell count and the presence of paraproteinemia followed an inverse J-shaped curve, with the highest presence below 3 × 109/L and above > 9 × 109/L. The adjusted OR below and above the nadir of 4 × 109/L was 1.61 (95% CI 1.25; 2.08, p < 0.0001) and 1.03 (95% CI 1.03; 1.04, p < 0.0001). Hemoglobin levels were inversely associated the presence of paraproteinemia, with the highest association below 6 mmol/L with an OR of 1.30 (95% CI 1.28; 1.32, p < 0.0001) adjusted for age and gender. Platelet count followed a U-shaped curve with the highest association at < 100 × 109/L. The adjusted OR below and above the nadir of 250 × 109/L was 1.13 (95% CI 1.10; 1.17, p < 0.0001) and 1.10 (95% CI 1.08; 1.12, p < 0.0001) respectively. In conclusion, all three parameters showed significant association with later paraproteinemia. [ABSTRACT FROM AUTHOR]

This study was performed to analyze fingertip capillary blood sampling in pediatric patients using microcapillary blood collection tubes and microhematocrit tubes and to compare the blood cell analysis results obtained via these two blood collection methods. Finger capillary blood was collected from 110 outpatients using microcapillary blood collection tubes and microhematocrit tubes and complete blood count analysis was performed with a Sysmex XS-900i hematology analyzer and manual microscopy for blood cell morphology. Paired data was evaluated for agreement and bias using the microhematocrit samples as the reference group and the samples from the microcapillary blood collection tubes as the observation group. The two blood collection methods demonstrated good agreement for measuring red blood cell (RBC) parameters (i.e., RBC, Hb, Hct, MCV, MCH and MCHC), wherein the relative bias was > allowable total error (TEa) in 0.91%, 1.82%, 11.82%, 1.82%, 0.91% and 8.18% of the parameter measures, respectively. According to industry requirements, the proportion of samples meeting the acceptable bias level should be > 80%. Additionally, the estimated biases at each medical decision level were within clinically acceptable levels for RBC, Hb, Hct, and MCV. However, the proportion of WBC and PLT counts with relative bias > TEa was 25.45% and 35.45%, respectively. Furthermore, the relative bias of the WBC count at the medical decision level of 0.5 × 109/L and that of the PLT counts at the medical decision levels of 10 × 109/L and 50 × 109/L were clinically significant. Bland–Altman analysis further showed a mean bias of 0.66 × 109/L (95% LoA, − 0.79 to 2.11) for the WBC count and 39 × 109/L (95% LoA, − 46 to 124) for the PLT count from the blood samples collected in the microcapillary blood collection tubes compared with the counts of those collected in the microhematocrit tubes. Neutrophil, monocyte, lymphocyte, eosinophil, and PLT counts increased significantly in the microcapillary blood collection tubes compared with those in the microhematocrit tubes, along with an elevated number of instrument false alarms (P < 0.05). The two capillary blood collection devices exhibit performance differences. Therefore, clinicians should pay attention to the variation in results caused by different blood collection methods. [ABSTRACT FROM AUTHOR]

Hydroxychloroquine (HCQ) is an immunomodulator used in dermatology and rheumatology. Side effects may be observed on routine monitoring studies before they become clinically apparent. The goal of this retrospective chart review was to assess laboratory abnormalities in dermatologic and rheumatologic patients taking HCQ. Medical records of patients prescribed HCQ were retrospectively reviewed. Demographics, reported side effects, and parameters on baseline and follow-up complete blood count (CBC) and comprehensive metabolic panel (CMP) were recorded and graded. Laboratory abnormalities were considered severe if they were grade 3 or greater according to Common Terminology Criteria for Adverse Events v3.0 and persistent if they continued beyond subsequent laboratory testing. Of 646 eligible charts, 289 had monitoring studies for review. There were 35 severe (grade 3 or 4, 35/289; 12%) adverse events that developed, as noted on CBC or CMP. Of these 35 severe adverse events, 25 self-corrected on subsequent testing, and 10 (10/289, 3%) across 9 patients were persistent, including glomerular filtration rate, alanine transferase, alkaline phosphatase, glucose, hemoglobin and lymphopenia abnormalities. Of these 10 abnormalities, 7/10 (70%) were unlikely due to hydroxychloroquine use according to the calculated Naranjo score for each patient. Severe laboratory abnormalities while taking hydroxychloroquine are rare, even in a population with a high rate of comorbidities. Among the abnormalities observed, the majority of them (70%) were likely due to disease progression or a medication other than hydroxychloroquine. CBC and CMP monitoring for the reason of observing abnormalities while on HCQ should be at the discretion of the prescribing physician. [ABSTRACT FROM AUTHOR]

The diagnosis of Myelodysplastic syndromes (MDS) is frequently challenging, especially in terms of the distinction from the other non-neoplastic causes of cytopenia. Currently, it is based on the presence of peripheral blood cytopenias, peripheral blood and bone marrow dysplasia/blasts, and clonal cytogenetic abnormalities, but MDS diagnostic features are polymorphic and non-specific. We investigated the utility of complete blood count (CBC) and research parameters (RUO) from the analyzer BC 6800 Plus (Mindray Diagnostics) to discriminate MDS-related cytopenia. Methods: 100 samples from healthy individuals were used to establish the values of research parameters in normal subjects. A retrospective study was conducted including 66 patients diagnosed with MDS, 90 cytopenic patients due to other diseases (cancer patients receiving therapy, aplastic anemia, other hematological malignancies) and 50 with macrocytic anemia. The Wilcoxon test was applied to detect statistical differences among the groups of patients, considering p < 0.05 significant. The diagnostic performance of the RUO parameters for discriminating MDS among cytopenias was evaluated using receiver operating characteristic (ROC) curve analysis. Amultivariable logistic regression model was performed to identify the potential predictors for having MDS. The area under curve (AUC) and the Hosmer–Lemeshow test of the model were assessed. The performance of the model was verified in a prospective study including 224 cytopenic patients (validation group). Results: In the MDS group, the mean cell volume (MCV), percentage of macrocytic red cells (MAC), red cell distribution width (RDW) and immature platelets fraction (IPF) had increased values compared to the cytopenic and normal patients, while platelets, red and white cell counts, Neu X (related to the cytoplasmic complexity of neutrophils), Neu Y (related to nucleic acid content) and Neu Z (related to cell size) were lower (p < 0.001). Neu X, Neu Y, and Neu Z showed higher AUC for detecting MDS > 0.80; MAC, RDW and IPF AUC > 0.76. The multivariable model demonstrated that Neu X and Neu Y could be used in the recognition of MDS, AUC 0.88. In the validation group, 89.0% of the MDS patients were well classified. Conclusion: MDS are common malignant disorders with a poor prognosis, and early diagnosis is warranted for optimal benefit from treatment. RUO gain insights to detect dysplasia of MDS and could be used in the differential diagnosis of MDS from cytopenias of other etiologies. [ABSTRACT FROM AUTHOR]

Hematologic toxicity is a common side effect of multimodal cancer therapy. Nearly all animal studies investigating the causes of radiotherapy-induced hematologic toxicity use inbred strains with limited genetic diversity and do not reflect the diverse responses observed in humans. We used the population-based Collaborative Cross (CC) mouse resource to investigate the genetic architecture of the acute and persistent immune response after radiation exposure by measuring 22 immune parameters in 1,720 CC mice representing 35 strains. We determined relative acute and persistent radiation resistance scores at the individual strain level considering contributions from all immune parameters. Genome-wide association analysis identified quantitative trait loci associated with baseline and radiation responses. A cross-species radiation resistance score predicted recurrence-free survival in medulloblastoma patients. We present a community resource of immune parameters and genome-wide association analyses before and after radiation exposure for future investigations of the contributions of host genetics on radiosensitivity.

Pediatric bronchopneumonia is a prevalent life-threatening disease, particularly in developing countries. Affordable and accessible blood biomarkers are needed to predict disease severity which can be based on the Duration of Hospitalization (DOH).

Abstract This study was performed to analyze fingertip capillary blood sampling in pediatric patients using microcapillary blood collection tubes and microhematocrit tubes and to compare the blood cell analysis results obtained via these two blood collection methods. Finger capillary blood was collected from 110 outpatients using microcapillary blood collection tubes and microhematocrit tubes and complete blood count analysis was performed with a Sysmex XS-900i hematology analyzer and manual microscopy for blood cell morphology. Paired data was evaluated for agreement and bias using the microhematocrit samples as the reference group and the samples from the microcapillary blood collection tubes as the observation group. The two blood collection methods demonstrated good agreement for measuring red blood cell (RBC) parameters (i.e., RBC, Hb, Hct, MCV, MCH and MCHC), wherein the relative bias was > allowable total error (TEa) in 0.91%, 1.82%, 11.82%, 1.82%, 0.91% and 8.18% of the parameter measures, respectively. According to industry requirements, the proportion of samples meeting the acceptable bias level should be > 80%. Additionally, the estimated biases at each medical decision level were within clinically acceptable levels for RBC, Hb, Hct, and MCV. However, the proportion of WBC and PLT counts with relative bias > TEa was 25.45% and 35.45%, respectively. Furthermore, the relative bias of the WBC count at the medical decision level of 0.5 × 109/L and that of the PLT counts at the medical decision levels of 10 × 109/L and 50 × 109/L were clinically significant. Bland–Altman analysis further showed a mean bias of 0.66 × 109/L (95% LoA, − 0.79 to 2.11) for the WBC count and 39 × 109/L (95% LoA, − 46 to 124) for the PLT count from the blood samples collected in the microcapillary blood collection tubes compared with the counts of those collected in the microhematocrit tubes. Neutrophil, monocyte, lymphocyte, eosinophil, and PLT counts increased significantly in the microcapillary blood collection tubes compared with those in the microhematocrit tubes, along with an elevated number of instrument false alarms (P

Abstract Background Dogs with congenital intrahepatic portosystemic shunt (IHPSS) are predisposed to gastrointestinal inflammation, ulceration, and bleeding, unlike dogs with congenital extrahepatic portosystemic shunt (EHPSS). Limited information is available about hematologic differences between dogs with IHPSS and dogs with EHPSS. Objective Compare hemogram variables between dogs with IHPSS and EHPSS. We hypothesized that hematologic variables would differ between the 2 populations, with a higher frequency and severity of anemia and microcytosis in dogs with IHPSS. Animals Twenty‐six client‐owned dogs with IHPSS and 35 client‐owned dogs with EHPSS. Methods Retrospective cross‐sectional study. Dogs were included if a CBC was performed before shunt attenuation. Contingency analysis was performed to determine if the frequency of clinical signs and of hematologic variables below the reference range differed between groups. Hematologic and selected biochemical variables were compared between groups using an analysis of covariance with age as a covariate. Results Gastrointestinal clinical signs (IHPSS, 81% vs EHPSS, 34%; P = .01), anemia (31% vs 6%; P = .01), microcytosis (77% vs 29%; P = .002), and hypochromia (77% vs 49%; P = .03) were more common in dogs with IHPSS than in dogs with EHPSS. Dogs with IHPSS had lower packed cell volume (34% vs 41%, P = .04), hemoglobin concentration (11.5 g/dL vs 13.7 g/dL, P = .03), mean corpuscular volume (57 fL vs 65 fL; P = .001), and mean corpuscular hemoglobin concentration (32 g/dL vs 33 g/dL; P = .04) than dogs with EHPSS. Conclusions and Clinical Importance Dogs with IHPSS had a higher frequency of anemia, microcytosis, and hypochromia and exhibited more gastrointestinal clinical signs.

Background: Little is known about how the COVID-19 pandemic altered laboratory testing efficiency in the State of Qatar. The aim of this study was to assess laboratory testing efficiency with respect to the total number and proportion of C-reactive protein (CRP), complete blood count (CBC), and comprehensive metabolic panel (CMP) tests completed on time in 2019–2021 in several ordinary and COVID-converted Primary Health Care Corporation (PHCC) health centers across Qatar. Methods: Secondary data from 2019 to 2021 were accessed from the PHCC-Clinical Information System center. Six randomly selected centers from three regions of Qatar (Northern, Central, and Western), two of which were COVID-converted, were analyzed. Results: A total of 404,316 laboratory tests were analyzed. There were decreasing, U-shaped, and inverted-U-shaped patterns in the numbers of tests conducted in different regions between 2019 and 2021 according to test type. The proportion of urgent (STAT) CBC and CMP tests increased from 2019 to 2021, and the proportion of tests completed by COVID-converted health centers increased for CRP and CBC and decreased for CMP between 2019 and 2021. Northern and Western regions in Qatar showed higher efficiency than the Central region with respect to the proportion of STAT tests completed on time in 2019–2021. COVID-converted centers completed fewer STAT CBC tests on time than ordinary centers. Conclusion: Pandemics such as COVID-19 shift the allocation of resources from routine tests to urgent tests, as exemplified by the increase in STAT test proportions in 2019 to 2021. High population densities, as noted in the Central region of Qatar, may require additional resources during pandemics to complete urgent tests more efficiently. The conversion of centers to COVID-converted centers may not necessarily translate into higher urgent test efficiency, as exemplified by the STAT CBC test results.

Background: The immune response dynamics in COVID-19 patients remain a subject of intense investigation due to their implications for disease severity and treatment outcomes. We examined changes in leukocyte levels, eosinophil activity, and cytokine profiles in patients hospitalized with COVID-19. Methods: Serum samples were collected within the first 10 days of hospitalization/confirmed infection and analyzed for eosinophil granule proteins (EGP) and cytokines. Information from medical records including comorbidities, clinical symptoms, medications, and complete blood counts were collected at the time of admission, during hospitalization and at follow up approximately 3 months later. Results: Serum levels of eotaxin, type 1 and type 2 cytokines, and alarmin cytokines were elevated in COVID-19 patients, highlighting the heightened immune response (p < 0.05). However, COVID-19 patients exhibited lower levels of eosinophils and eosinophil degranulation products compared to hospitalized controls (p < 0.05). Leukocyte counts increased consistently from admission to follow-up, indicative of recovery. Conclusion: Attenuated eosinophil activity alongside elevated chemokine and cytokine levels during active infection, highlights the complex interplay of immune mediators in the pathogenesis COVID-19 and underscores the need for further investigation into immune biomarkers and treatment strategies. [ABSTRACT FROM AUTHOR]

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

Background: Community-acquired pneumonia (CAP) is a type of lung infection that people can acquire outside of the hospital. One of the most serious complications of bacterial pneumonia is sepsis. It is a life-threatening condition caused by the body's response to an infection. The aim of this research is to find potential diagnostic and prognostic markers for community-acquired pneumonia and sepsis. Specifically, the study examined the diagnostic value of procalcitonin (PCT) and complete blood count (CBC) markers. Methods: One hundred twenty participants were selected and divided into 20 patients with sepsis due to CAP, 60 patients with bacterial CAP, and 40 control patients. All participants were between the ages of 23-95 years old. Blood samples were collected from both male and female patients. All samples were diagnosed by doctors specializing in respiratory and chest diseases and internal medicine. The study was conducted at Imam Al-Sadiq Hospital in Babylon Governorate and Imam Al-Hussein Medical City in Kerbela Governorate from December 2022 to June 2023. Results: The results showed significant differences in PCT, white blood cells (WBC), lymphocytes (LYM), monocyte, granulocyte (GRA), haematocrit, platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR). Haemoglobin also showed significant differences, except for platelets, which did not show significant differences. The study found that PCT, WBC, GRA, NLR, and PLR were valuable markers for diagnosing patients with CAP and sepsis due to CAP. Other CBC parameters were found to be less useful. Conclusion: The study highlights the importance of using PCT and CBC markers to diagnose and manage patients with community-acquired pneumonia and sepsis. [ABSTRACT FROM AUTHOR]

Background: Reference intervals are essential for the interpretation of clinical laboratory tests and patient management. This study aims to determine age and gender reference intervals of complete blood count (CBC) in the Moroccan population by using the indirect approach. Methods: The study used data of ostensibly healthy adults collected retrospectively using the laboratory information system (LIS) of the Laboratory for Research and Medical Analysis of the Fraternal Royal Gendarmerie in Rabat (Morocco), between January 2018 and February 2020. The study included 5,898 men and 10,172 women ranging in age from 18 to 90 years. The lower and upper reference limits of CBC parameters were calculated using the nonparametric technique, as suggested by the Clinical and Laboratory Standards Institute (CLSI). Results: All hematological parameters showed no clinically significant gender-related differences, except small differences in the values of hemoglobin (HB), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC). There were also no clinically significant agerelated differences for median values of all hematology analytes in both genders, except for platelet count (PLT) that continued to decline with increasing age in men and women, and Red blood cell count (RBC), Hematocrit (HCT), and hemoglobin (HB) that tended to increase with age but decrease in older age groups in men while they tended to increase with age in women. Conclusions: The indirect method can be used to establish reference intervals for CBC, with appropriate selection criteria and statistical tools. Our findings differed from the reference ranges provided in the textbook and also in other countries' reports. [ABSTRACT FROM AUTHOR]

Aim: This study investigates the association of complete blood count parameters and erythrocyte transfusions with retinopathy of prematurity (ROP) requiring treatment in infants born prematurely under 32 weeks of gestation. Materials and Methods: The single-center, retrospective, observational study included 130 patients with a gestational age between 24-32 weeks who were born in the same hospital and hospitalized in the neonatal intensive care unit of the hospital between 2016-2018. Results: Mean complete blood count parameters at postnatal 0-24 hours and postnatal 24-72 hours as well as erythrocyte transfusions were compared in terms of retinopathy of prematurity requiring treatment. Mean hemoglobin, hematocrit and red blood cell count at postnatal 24-72 hours were significantly lower in patients with ROP requiring treatment than in those without. Conclusion: The study suggests that low erythrocyte mass and an increased number of early erythrocyte transfusions are important risk factors for the development of ROP requiring treatment. [ABSTRACT FROM AUTHOR]

Background: Dogs with congenital intrahepatic portosystemic shunt (IHPSS) are predisposed to gastrointestinal inflammation, ulceration, and bleeding, unlike dogs with congenital extrahepatic portosystemic shunt (EHPSS). Limited information is available about hematologic differences between dogs with IHPSS and dogs with EHPSS. Objective: Compare hemogram variables between dogs with IHPSS and EHPSS. We hypothesized that hematologic variables would differ between the 2 populations, with a higher frequency and severity of anemia and microcytosis in dogs with IHPSS. Animals: Twenty‐six client‐owned dogs with IHPSS and 35 client‐owned dogs with EHPSS. Methods: Retrospective cross‐sectional study. Dogs were included if a CBC was performed before shunt attenuation. Contingency analysis was performed to determine if the frequency of clinical signs and of hematologic variables below the reference range differed between groups. Hematologic and selected biochemical variables were compared between groups using an analysis of covariance with age as a covariate. Results: Gastrointestinal clinical signs (IHPSS, 81% vs EHPSS, 34%; P =.01), anemia (31% vs 6%; P =.01), microcytosis (77% vs 29%; P =.002), and hypochromia (77% vs 49%; P =.03) were more common in dogs with IHPSS than in dogs with EHPSS. Dogs with IHPSS had lower packed cell volume (34% vs 41%, P =.04), hemoglobin concentration (11.5 g/dL vs 13.7 g/dL, P =.03), mean corpuscular volume (57 fL vs 65 fL; P =.001), and mean corpuscular hemoglobin concentration (32 g/dL vs 33 g/dL; P =.04) than dogs with EHPSS. Conclusions and Clinical Importance: Dogs with IHPSS had a higher frequency of anemia, microcytosis, and hypochromia and exhibited more gastrointestinal clinical signs. [ABSTRACT FROM AUTHOR]

Aim: This study evaluated the connection of periodontal status with the leukocyte profiles of maternal peripheral blood (MPB) and umbilical cord blood (UCB). Materials and Methods: Ninety‐nine pregnant females were recruited, and their data were collected via questionnaire and from medical records, including demographics, systemic conditions, complete blood count (CBC) and C‐reaction protein (CRP) level in MPB. Full‐mouth periodontal assessment was performed. CBC and CRP levels in UCB were measured after parturition. Results: All subjects and their neonates were generally healthy. 30.3% of the participants presented with periodontal health condition, whereas 69.7% had different severities of periodontal diseases. The counts/percentages of eosinophils and monocytes in UCB from the subjects with periodontal diseases elevated, and the percentage of neutrophils decreased referencing to that from the counterparts (p < 0.05). There were positive correlations for total leukocyte count, neutrophils and lymphocytes counts/percentages in MPB and UCB among the periodontally healthy subjects (r > 0.4, p < 0.05), but such findings did not exist in those with periodontal diseases. Moreover, periodontal diseases independently accounted for the counts/percentages of neutrophils and eosinophils in UCB after controlling confounders in four testing models (ANCOVA, p < 0.05). Conclusion: Maternal periodontal diseases could to some extent disturb the leukocyte profiles of umbilical cord blood. [ABSTRACT FROM AUTHOR]

Objective: The complete blood count (CBC) parameters and the ratios regarding these parameters have been demonstrated to be useful diagnostic biomarkers for many infectious diseases. Herein, we aimed to evaluate and compare the usefulness of the predictive role of the CBC in the differential diagnosis of pulmonary tuberculosis (TB) from community-acquired pneumonia (CAP) in children. We also compared serum electrolyte levels between the 2 diseases. Materials and Methods: In this retrospective study, we analyzed the efficacy of CBC parameters and neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), plateletto-lymphocyte ratio (PLR), neutrophil-to-monocyte-plus-lymphocyte ratio (NMLR), and serum electrolyte levels in the differential diagnosis of pulmonary TB from CAP in children. We also classified patients with TB into 2 groups according to the microbiologic confirmation. We investigated whether there is any difference regarding these parameters in patients with positive microbiologic results. Results: A total of 163 patients diagnosed with TB and CAP were included in this study. The WBC, neutrophil and monocyte counts, NLR, MLR, NMLR, mean platelet volume (MPV), and C-reactive protein (CRP) values were higher in CAP. There was statistical significance among serum sodium and phosphorus (P) levels between the 2 groups. Microbiologic confirmation was determined in 37 (35.5%) patients with the diagnosis of TB. The NLR, MLR, NMLR, CRP, and P values were significantly higher in patients with microbiologic confirmation. Conclusion: The results of the present study suggest that complete blood count parameters, NLR, MLR, NMLR, and CRP can be useful and cost-effective markers in differentiating pulmonary TB from CAP in the early stages of diagnosis. [ABSTRACT FROM AUTHOR]

Laboratory (lab) tests can assist diagnosis, treatment, and monitoring illness and health. Lab results are one of the most commonly accessible types of personal health information, yet they can be difficult for consumers (e.g., patients, laypeople, citizens) to understand. Consequently, many consumers turn to digital educational resources (e.g., websites, mobile applications) to make sense of their tests and results. In this study, we compared the understandability and readability of four different consumer targeted webpages with information about a commonly ordered blood test called the Complete Blood Count (CBC). The webpages varied in terms of understandability, and only one met the threshold. None of the web pages provided any information about how to respond to lab results. Although all four webpages were quite readable, some were much longer than others. The length of webpages may impact users’ attention, ability to locate information, and determine what is most important. Future work is warranted to better understand users’ information needs and the usability and user experience of these types of websites [ABSTRACT FROM AUTHOR]

Background: Cold agglutinins (CAs) in blood samples can cause a reversible agglutination of red blood cell (RBC) which result in an incorrect complete blood count (CBC). So, it is important to explore new simple and feasible treatment conditions for clinical work. Methods: The CAs group included 32 samples with CAs. The parameters of CBC at room temperature or after prewarming at 37°C or 41°C for different time periods were compared. The consistency and correlation of those parameters were analyzed. The morphology of erythrocytes in the CAs group was observed manually. The control group included 45 samples without CAs and prewarmed at 37°C or 41°C for different time periods. The differences were also analyzed. Results: CAs have a significant effect on CBC. After prewarming at 37°C or 41°C the interferences are all corrected. Consider prewarming at 37°C for 120 minutes as the standard procedure. The consistency and correlation analysis showed there was no statistical difference between the results of each subgroup and standard group, except the MCHC of group 41°C 10 minutes. The correlation of parameters between all subgroups and the standard group is satisfied. Microscopic examination showed no RBC aggregation or fragmentation after prewarming at 41°C or 37°C. According to the maximum bias requirements for expert performance in Validation, Verification, and Quality Assurance of Automated Hematology Analyzers, 2nd Edition (CLSI H26-A2), the differences in over-all results in control group are negligible. Conclusions: The 41°C 2 minutes prewarming method is a rapid and effective way for treating samples with CAs. It is an efficient way to obtain more reliable CBC results, without specific instruments. [ABSTRACT FROM AUTHOR]

Pseudothrombocytopenia is a condition in which platelets are seen in sufficient numbers and aggregated in the peripheral smear although the platelet count is low in the complete blood count analysis of the patient. One of the causes of pseudothrombocytopenia is the Ethylenediamine Tetraacetic acid (EDTA) anticoagulant used for routine complete blood count samples. EDTA has a calcium chelator effect and changes the structure of the GPIIb/IIIa integrin complex found in platelets. The hidden GPIIb epitope is revealed as a result of the change in the structure of the GPIIb/IIIa integrin complex, and antibodies are formed against this epitope. These antibodies cause platelet aggregation. Due to aggregation of platelets, complete blood count analysis may give erroneous results and may be confused with true thrombocytopenia. Pseudothrombocytopenia is not a bleeding diathesis, but patients may be subjected to unnecessary diagnostic procedures and treatments. This case report was prepared to emphasize the clinical picture of EDTA-induced pseudothrombocytopenia. In our case, thrombocytopenia was observed as a result of the analysis of the EDTA whole blood count sample taken from the patient who was admitted to the internal medicine outpatient clinic for routine controls. Complete blood count analysis over the past three years also observed thrombocytopenia. It was deemed appropriate to send a complete blood count sample from the patient in a citrate tube. In the analysis of the citrated complete blood count sample obtained from the patient, it was observed that the platelet count was normal. A simultaneous peripheral smear was reported as pseudothrombocytopenia. [ABSTRACT FROM AUTHOR]

Aim: To investigate the prognostic contribution of absolute neutrophil (ANC), lymphocyte (ALC), platelet count and their ratios, neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR), to thrombotic risk in patients with prefibrotic and overt fibrotic myelofibrosis (MF). Methods: We retrospectively analyzed a cohort of 256 patients with prefibrotic (85 patients) and overt fibrotic MF (171 patients) treated in six Croatian hematological centers. Results: Prefibrotic compared to overt fibrotic MF patients presented with significantly higher ALC, platelet count and PLR, and experienced longer time to thrombosis (TTT). Among prefibrotic patients, ANC > 8.33 × 109/L (HR 13.08, p = 0.036), ALC > 2.58 × 109/L (HR 20.63, p = 0.049) and platelet count > 752 × 109/L (HR 10.5, p = 0.043) remained independently associated with shorter TTT. Among overt fibrotic patients, ANC > 8.8 × 109/L (HR 4.49, p = 0.004), ALC ≤ 1.43 × 109/L (HR 4.15, p = 0.003), platelet count ≤ 385 × 109/L (HR 4.68, p = 0.004) and chronic kidney disease (HR 9.07, p < 0.001) remained independently associated with shorter TTT. Conclusions: Prognostic properties of ANC, ALC and platelet count are mutually independent and exceed those of NLR and PLR regarding thrombotic risk stratification. ALC and platelet count associate in opposite directions with thrombotic risk in prefibrotic and overt fibrotic MF patients. [ABSTRACT FROM AUTHOR]

Objectives National societies recommend against performing routine daily laboratory testing without a specific indication. Unnecessary testing can lead to patient harm, such as hospital-acquired anemia. The objective of this study was to reduce repeat complete blood counts (CBCs) after initial testing. Methods This was a quality improvement initiative implemented across 11 safety net hospitals in New York City. A best practice advisory (BPA) was implemented that asked the user to remove a CBC if the last 2 CBCs within 72 hours had normal white blood cell and platelet counts and unchanged hemoglobin levels. The outcome measure was the rate of CBCs per 1000 patient days preintervention (January 8, 2020, to December 22, 2020) to postintervention (December 23, 2020, to December 7, 2021). The process measure was the acceptance rate of the BPA, defined as the number of times the repeat CBC order was removed through the BPA divided by the total number of times the BPA triggered. Results Across 11 hospitals, repeat CBC testing decreased by 12.3% (73.05 to 64.04 per 1000 patient days, P <.001). Six of the 11 hospitals exhibited statistically significant decreases, ranging from a 10% to 48.9% decrease of repeat CBCs. The overall BPA action rate was 20.0% (24,029 of 119,944 repeat CBCs). Conclusions This low-effort, electronic health record–based intervention can effectively reduce unnecessary laboratory testing. [ABSTRACT FROM AUTHOR]

Introduction: Complete blood count (CBC) parameters change throughout pregnancy and are thought to be one of the factors affecting the pregnancy’s outcome. This study aims to report variations in CBC parameters throughout pregnancy and their association with maternal age and gravidity. Methods: This is a retrospective cohort study in which CBC data from 234 pregnancies with normal full-term delivery in 2020 were evaluated and grouped depending on maternal age and gravidity. Results: Hemoglobin levels decreased significantly from the first to the second trimester (P < 0.0001) and then slightly increased in the third trimester. Red blood cells decreased significantly from the first to the second trimester and remained unchanged in the third trimester (P < 0.0001). Packed cell volume decreased significantly from the first to the second trimester (P < 0.0001) and then increased in the third trimester (P = 0.0178). White blood cells (WBCs) increased significantly from the first to the second trimester (P < 0.0001) and then remained stable in the third trimester. Neutrophils and lymphocytes showed opposed tendencies, with neutrophils increasing significantly from the first to the second trimester (P < 0.0001) and then remaining stable in the third trimester (P = 0.42). Lymphocytes decreased significantly from the first to the second trimester (P < 0.0001) and continued to decrease in the third trimester (P < 0.0001). Monocytes increased significantly from the first to the third trimester (P = 0.0051). Platelets decreased significantly from the first to the third trimester (P < 0.0001). Gravidity showed a negative correlation with WBC count (r = −0.17, P = 0.01) and a positive correlation with eosinophil levels (r = 0.14, P = 0.0376). Spearman’s correlations revealed no significant differences in maternal age groups. Conclusions: Our findings provide useful insight for physicians and policymakers in assessing CBC during pregnancy and providing optimal care. Furthermore, the associations between gravidity and WBC (negative) and eosinophil levels (positive) point to a potential effect of reproductive history on immune function, necessitating additional research in this area. [ABSTRACT FROM AUTHOR]

Little is known about how the COVID-19 pandemic altered laboratory testing efficiency in the State of Qatar. The aim of this study was to assess laboratory testing efficiency with respect to the total number and proportion of C-reactive protein (CRP), complete blood count (CBC), and comprehensive metabolic panel (CMP) tests completed on time in 2019–2021 in several ordinary and COVID-converted Primary Health Care Corporation (PHCC) health centers across Qatar. Secondary data from 2019 to 2021 were accessed from the PHCC-Clinical Information System center. Six randomly selected centers from three regions of Qatar (Northern, Central, and Western), two of which were COVID-converted, were analyzed. A total of 404,316 laboratory tests were analyzed. There were decreasing, U-shaped, and inverted-U-shaped patterns in the numbers of tests conducted in different regions between 2019 and 2021 according to test type. The proportion of urgent (STAT) CBC and CMP tests increased from 2019 to 2021, and the proportion of tests completed by COVID-converted health centers increased for CRP and CBC and decreased for CMP between 2019 and 2021. Northern and Western regions in Qatar showed higher efficiency than the Central region with respect to the proportion of STAT tests completed on time in 2019–2021. COVID-converted centers completed fewer STAT CBC tests on time than ordinary centers. Pandemics such as COVID-19 shift the allocation of resources from routine tests to urgent tests, as exemplified by the increase in STAT test proportions in 2019 to 2021. High population densities, as noted in the Central region of Qatar, may require additional resources during pandemics to complete urgent tests more efficiently. The conversion of centers to COVID-converted centers may not necessarily translate into higher urgent test efficiency, as exemplified by the STAT CBC test results. [ABSTRACT FROM AUTHOR]

Modern automated laboratory haematology analysers use various methods to measure different haematological parameters. These parameters are useful in the diagnostic and clinical interpretation of patient symptoms. So, it is very important to compare the performance of different analysers measuring the same parameter. Hence, a comparison of complete blood counts analysed by Sysmex XN 3000 and Horiba Yumizen H2500 was performed. Total 296 EDTA anti-coagulated blood samples were processed in both the analysers in duplicate within 4 h of collection. The white blood cell count, red blood cell count, erythrocyte indices, differential leukocyte count, platelet count and platelet indices and reticulocyte count were compared. A good level of correlation and agreement between different parameters were obtained. A strong correlation was observed (r > 0.9) between Sysmex XN 3000 and Yumizen H2500 for WBC (0.997), RBC (0.997), Haemoglobin (0.999), haematocrit (0.974), MCV (0.902), MCH (0.99),, platelet count by impedance (0.989), mean platelet volume (0.954), plateletcrit (0.971), platelet distribution width (PDW) (0.916), neutrophils (0.997), lymphocytes (0.989), monocytes (0.943), and eosinophils (0.991) counts. A moderate correlation was observed for RDW-CV (0.75). The basophils count showed poor correlation (r < 0.5) possibly because of sample selection with mostly low basophils count. An acceptable bias was observed for most of the parameters like WBC, RBC, Haemoglobin, Haematocrit, platelet counts, neutrophils, lymphocytes, eosinophils and monocytes. The studied instruments ensured satisfactory interchangeability except for few parameters, thus facilitate substitution of one analyser by another without affecting the clinical decision making. [ABSTRACT FROM AUTHOR]

Excess levels of free radicals cause oxidative damage to cells. Taurine is a rare amino acid with antioxidant effects whose dietary deficiency increases oxidative damage to the cell membrane. To investigate the effects of dietary taurine supplementation on performance, blood hematology, oxidative stress, and jejunum morphology in broilers, 300 broilers (Ras 308, 1D of age) were randomly allocated into 4 groups with 5 replicates of 15 birds. The experimental treatments included basic diet (control treatment) and basic diet with 1, 3, and 6 g/kg taurine amino acid. During 1 to 45 days, the inclusion of taurine supplementation in diets improved the body weight gain (BWG), feed consumption (FC), and feed conversion ratio (FCR) of broilers (P < 0.05). In CBC tests, the experimental treatments were significantly different concerning the red blood cell (RBC) count, the average hemoglobin in the cell, the RBC width in the curve, and the hematocrit (P < 0.05). Despite the significance of oxidative stress among the treatments, the control and fourth treatments showed the highest and the lowest oxidative stress, respectively (P < 0.05). Also, in jejunum morphology, the fourth treatment showed the best performance in terms of villus length and width and the villus length to crypt depth (V/C) ratio (P < 0.05). Overall, 6 g/kg taurine addition to the diet reduced oxidative stress and positive features in the jejunum morphology while improving the functional traits of broilers. [ABSTRACT FROM AUTHOR]

Background: Despite the advanced laboratory technologies available today, blood culture is the gold standard method in the diagnosis of bloodstream infections. Automated blood culture devices give blood culture results for laboratories approximately in 2 - 3 days up to 7 days. Moreover, some microorganisms like nonreproducible bacteria, fungi or viruses cannot be produced in culture. Among all samples taken for blood culture on suspicion of infection approximately 10% are determined as positive whereas the false positive rate due to contamination is 5%. Especially in life-threatening severe conditions such as sepsis early diagnosis and prompt treatment are crucial. Based on this the aim of this study is to investigate complete blood count parameters as potential early markers in Escherichia coli, Staphylococcus aureus and Candida albicans bloodstream infections using an ex vivo whole blood model. Methods: Blood samples collected from healthy donors (n = 10) were treated with suspensions containing a certain concentration of microorganisms (107 CFU/mL for both E. coli ATCC 25922 and S. aureus ATCC 29213, 106 CFU/mL for C. albicans ATCC 14053). After bacteremia and candidemia were induced, complete blood count parameters were analyzed hourly in the samples until the end of the 4th hour with a Mindray BC-6800 hematology analyzer. Statistical analysis was performed by Tukey-Kramer post-hoc multiple comparison test and statistical significance was accepted as p < 0.05. Results: When platelet derived parameter baseline values were compared to hourly values in E. coli and S. aureus induced whole blood samples, it was found that the decrease in PLT, P-LCC and the increase in IPF% was significant from the first hour whereas the increase in IMG% was found to be significant only from the 3rd hour onward. In the experiments with C. albicans, it was observed that the increase in IPF% and IMG% was significant from the 2nd and 3rd hour onward, respectively. There was no relationship between MPV, P-LCR, and NLR baseline and hourly results in any microorganism induced model. Conclusions: IPF% can guide clinicians in the early diagnosis and management of treatment of infections caused by S. aureus, E. coli, and C. albicans. [ABSTRACT FROM AUTHOR]

Aim: To examine the relationship between complete blood count metrics and the severity of coronary artery disease (CAD) in patients undergoing coronary angiography. Methods: Patients diagnosed with stable angina pectoris or acute coronary syndrome by coronary angiography between October 2018 and February 2019 were included in the study. Based on their angiography results, patients were divided into two groups: one with severe CAD (n=258) and one with non-severe CAD (n=219). The initial clinical characteristics, along with data from laboratory tests and complete blood counts, were recorded and compared between the two groups. Results: The Wight Blood Cell (WBC) count, Neutrophil (NEU) count, Monocyte/Lymphocyte Ratio (MLR), Neutrophil/Lymphocyte Ratio (NLR), Monocyte/High-Density Lipoprotein Cholesterol Ratio (MHR), systemic immune inflammation index (SII) and systemic inflammation response index (SIRI) were each significantly higher in the group with severe CAD than in the group without severe CAD. The analysis utilized logistic regression, factoring in recognized CAD risk factors such as age, gender, diabetes mellitus (DM), hypertension (HT), hyperlipidemia (HL), and smoking, identified NLR, MHR, MLR, SII, and SIRI as notable and independent indicators of severe CAD. Conclusion: Our study showed that since it was an independent predictor of CAD, SII and SIRI could be utilized as a novel indicator for assessing the severity of CAD.

Frequent phlebotomies, even when only a small volume of blood is taken for diagnostic purposes, can lead to the development of iron deficiency with hematological and metabolic changes. The study aimed to determine the influence of frequent blood loss by phlebotomy on blood iron concentration (Fe), hematology, metabolic and endocrine parameters and their relationships. Blood samples were collected from 30 blood donor rams for 6 consecutive weeks, with approximately 10% of blood collected weekly. Such chronic blood loss resulted in a decrease in Fe. Indicators of iron transport in the bloodstream changed, so the value of total iron-binding capacity (TIBC) and unsaturated iron-binding capacity (UIBC) increased, while the value of transferrin saturation percentage (TS%) decreased. Hematological changes included a decrease in red blood cells, hemoglobin, mean red blood cell volume and hematocrit and a tendency for reticulocyte count and red cell distribution width to increase. Chronic blood loss resulted in a specific metabolic response that included the increase in glucose, cholesterol, triglycerides, aspartate-aminotransferase, and insulin resistance, while thyroxine, triiodothyronine and cortisol decreased and there was a tendency for lactate to increase and BHB to decrease. The mentioned blood parameters correlated with Fe and additionally showed greater changes when Fe was extrapolated to the level of clinical deficit (Fe=9μmol/L). These correlations suggest the need to monitor the metabolic and endocrine status during chronic blood loss, in addition to Fe and erythrocyte indices. Compared with previous results in other animal species, Fe may have a direct influence on metabolic processes in rams.

Abstract Background Liver fibrosis is an irreversible liver destruction. Apigenin (API) has different pharmacological properties as anticancer, anti-inflammatory, and antioxidant; however, API hepatoprotective and therapeutic effects are not often studied. This study assesses protective and therapeutic API effects on hepatic injuries produced by thioacetamide (TAA) in rats. Methods Forty-nine rats were sorted into seven groups (7 in each): negative control (G1), positive control (G2, TAA), API group (G3), TAA+API group (G4), TAA+SL group (G5), API+TAA group (G6), and SL+TAA group (G7). API and SL effects on TAA-induced hepatotoxicity were examined by determined body weights, liver weights, complete blood count picture (white blood cells, red blood cells, hemoglobin, hematocrit, and platelets counts), liver function tests (alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, gamma glutamyl transferase, alkaline phosphatase, total proteins, albumin, and globulin), and oxidative stress markers (malonaldehyde, catalase, superoxide dismutase, and reduced glutathione) in serum and liver histological was assessed. Results TAA decreased red blood cells, platelets, hemoglobin content, and hematocrit (p

Background: Hodgkin lymphoma (HL) is a rare malignancy characterized by a malignant proliferation of cells in the reticuloendothelial system, mainly lymph node, and the presence of Reed-Sternberg cells with a relatively good prognosis compared to other pediatric malignancies. This study aimed to produce epidemiologic and clinical data on HL for Albania, aiming for a better understanding of the disease presentation to diagnose it at an earlier stage with the result of a better outcome. Methods and Results: This single-center, retrospective study performed in the Mother Theresa University Hospital Center (Tirana, Albania) analyzed epidemiological and clinical data of pediatric patients under 14 years of age diagnosed with HL during a 10-year study period from 2012 to 2022. During the last 10 years, 25 children (ages 0-14) were diagnosed with HL at UHC "Mother Theresa," Tirana. From the demographic data of our study, most patients (68%) were in the age group of 10-14. The male-to-female ratio was 2.12:1. The first clinical presentation was mainly because of lymphadenopathy in 92% of patients, with the presence of B symptoms in 68%. In most cases, the CBC was not affected, yet 24% of patients had high platelets, and 12% had low RBCs, while WBCs increased in 16% of patients and decreased in 12%. Lymphopenia and monocytosis were found in more than half of cases. Around 68% of patients had high levels of LDH and CRP. ESR and ALP were high in 64% of patients, Ferritin was high in 32%, and fibrinogen level was high in 28%. According to the Ann Arbor system, most of our patients were at stage II (32%), followed closely by stage I (28%) and stage III (24%), and only 16% were at stage IV upon presentation. The most common histopathologic type was nodular sclerosis classical HL, presented in 44% of cases. Conclusion: HL is a relatively frequent pediatric malignancy in young adults, affecting mainly males, and is diagnosed at a relatively early stage in our country.

Aim To analyse changes in haematological values after plateletpheresis in donor population with regard to donor safety. Methods A retrospective study was conducted on first time and repeated healthy donors over a period of eight months in the Blood Transfusion Institute in the Federation of Bosnia and Herzegovina in Sarajevo. A total of 75 plateletpheresis procedures performed using Amicus continuous flow cell separator were evaluated. Various pre- and post-donation haematological values were measured in all donors: haemoglobin concentration (Hb), haematocrit (Hct), red blood cell count (RBC), platelet count (PLT), white blood cell count (WBC), mean platelet volume (MPV), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), and mean corpuscular haemoglobin concentration (MCHC). Results A significant decrease in post-donation Hb, Hct, RBC, PLT, MCHC (p

Abstract Background Multiple sclerosis (MS) is a disabling immune-mediated disease of the central nervous system. Ministry of Health and Population’s statistics show that MS comprise 1.4% of all neurological diseases, putting into consideration, current economic crisis; it is needed to predict disease severity with an acceptable cost-effective method. Complete blood count (CBC) parameters are supposed to be cheap, and simple markers for the systemic inflammatory state. This study aims at evaluating role of neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) in predicting the severity of MS. Therefore, this retrospective cohort study was done on 150 MS patients attending MS clinic during year 2022. All patients were subjected to complete medical history. Estimation of the disability was done through the extended disability status scale (EDSS) and analysis of different parameters of baseline CBC before starting therapy. Results A cutoff value of NLR ≥ 2.95 and PLR ≥ 201.5 could predict prognosis of MS. Risk factors of sever MS are high NLR, PLR, high body mass index and absence of disease-modifying therapy. Conclusions Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio are cheap valid useful predictors of increased relapse rate and severity in MS. Highlighting the role of both ratios at time of first diagnosis helps physicians to predict prognosis of patients in context of severity. Paying special attention to those with higher ratios can lead to improve patient outcome and reducing disease burden.

Introduction: Preterm birth is associated with high perinatal morbidity and mortality. Identifying women at risk for preterm labour early in pregnancy may improve pregnancy outcomes. Neutrophil-Lymphocyte Ratio (NLR) and Mean Platelet Volume (MPV) can be helpful in predicting preterm labour, as infection is an important factor in early preterm deliveries, with immunity playing a key role in preterm labour. Aim: To evaluate the predictive role of the NLR and MPV in preterm deliveries. Materials and Methods: This cross-sectional study was conducted in a tertiary care and research hospital from August 2022 to October 2023. Haematological and clinical data were retrieved for preterm deliveries (n=79, group I) and term deliveries (n=151, group II). The two groups were compared in terms of demographic characteristics, obstetric and laboratory findings, including maternal age, gravida, parity, birth weight, NLR, MPV, and haemoglobin levels. The data were analysed using Statistical Package for the Social Sciences (SPSS) version 29.0. One-way Analysis of Variance (ANOVA) was used to compare the mean values among different groups. Categorical values were evaluated with Pearson’s Chi-square test. Receiver Operating Characteristic (ROC) curve was used to assess the diagnostic properties of the tests. Results: The two groups showed no statistical difference in terms of demographic parameters such as the mother’s age (p-value=0.611), parity (p-value=0.798), and gravida (p-value=0.583). The NLR was higher in group I (5.8±5.01) compared to group II (4.3±1.75), and this difference was statistically significant with a p-value of

Dengue fever is a tropical mosquito-transmitted disease spread through the Aedes mosquito, where the human body works as the primary host. Each year, densely populated countries such as Bangladesh, Thailand, and India, particularly in the Southeast Asian region, experience the majority of dengue outbreaks worldwide. Notably, in 2023, Bangladesh endured an unprecedented dengue outbreak, registering the highest number of cases in over two decades since 2000. This research aims to facilitate early detection of dengue from patients’ complete blood count (CBC) medical laboratory reports collected from two hospitals in Dhaka, Bangladesh. The custom-built dataset, comprising 320 samples and 14 hematology features, is used to evaluate diverse artificial intelligence techniques. This dataset documents suspected dengue cases in Bangladesh from May 2023 to October 2023, reflecting a significant outbreak period, including a gender distribution ratio of 5:3 male to female patients. Various preprocessing steps, handling missing values and outliers, one-hot encoding, synthetic oversampling, and removing redundant features, are applied to the employed dataset. Five feature selection methods and diverse machine learning algorithms, along with ensemble learning and transformer-based models, are implemented. The stacking ensemble classifier achieved the highest performance, with an accuracy of 96.88% and an F1 score of 0.9646. The stacking technique has been built using the LightGBM meta-classifier and XGBoost, Logistic Regression, and Multilayer Perceptron base learners. The collected CBC dengue dataset and the implementation codes are available at: https://github.com/mritunjoychk17/Dengue-Prediction-in-Bangladesh-Using-Machine-Learning.

Myelodysplastic syndromes (MDS) are a heterogeneous group of clonal malignancies of the hematopoietic system, characterized by ineffective hematopoiesis with peripheral cytopenias. The aim of the study was to detect differences between automatic leukocyte separation and microscopic evaluation of a blood smear in a patient with MDS. A 68-year-old patient with a history of MDS pancytopenia and vascular bleeding diathesis was admitted to the Department of Internal Diseases and Endocrinology of the University Clinical Centre of the Medical University of Warsaw. The patient was diagnosed with metabolic alkalosis, renal failure and hyperparathyroidism. Morphological examinations showed persistent pancytopenia. The microscopic evaluation of the blood smear showed features of dysplasia, e.g. asynchrony of nucleus/cytoplasm maturation, hypogranulation of the granulocyte cytoplasm, unequal distribution of granules in the cytoplasm, and hyposegmentation in neutrophils. Complete blood count and blood smear were presented as percentages obtained from automatic leukocyte separation and microscopic smear evaluation of three consecutive patient examinations, respectively. The largest discrepancies were in the proportion of eosinophils (0.6%/1.3%/0% vs. 29.5%/26.0%/9.0%), neutrophils (49.7%/41.7%/32.4% vs 26.0%/13.6%/22.0%) and atypical lymphocytes (4.4%/2.9% vs 2.4%/5.0%). Microscopic analysis also showed the presence of eosinophils at various stages of maturation (eosinophilic myelocytes). Automatic blood smear analysis compared to manual analysis can show significantly different results. To diagnose diseases of the hematopoietic system, it is recommended to verify the results of the tests using the microscopic method. Bone marrow cytogenetic and molecular tests can also be performed as an auxiliary.

Introduction: Complete blood count (CBC) parameters change throughout pregnancy and are thought to be one of the factors affecting the pregnancy's outcome. This study aims to report variations in CBC parameters throughout pregnancy and their association with maternal age and gravidity. Methods: This is a retrospective cohort study in which CBC data from 234 pregnancies with normal full-term delivery in 2020 were evaluated and grouped depending on maternal age and gravidity. Results: Hemoglobin levels decreased significantly from the first to the second trimester (P < 0.0001) and then slightly increased in the third trimester. Red blood cells decreased significantly from the first to the second trimester and remained unchanged in the third trimester (P < 0.0001). Packed cell volume decreased significantly from the first to the second trimester (P < 0.0001) and then increased in the third trimester (P = 0.0178). White blood cells (WBCs) increased significantly from the first to the second trimester (P < 0.0001) and then remained stable in the third trimester. Neutrophils and lymphocytes showed opposed tendencies, with neutrophils increasing significantly from the first to the second trimester (P < 0.0001) and then remaining stable in the third trimester (P = 0.42). Lymphocytes decreased significantly from the first to the second trimester (P < 0.0001) and continued to decrease in the third trimester (P < 0.0001). Monocytes increased significantly from the first to the third trimester (P = 0.0051). Platelets decreased significantly from the first to the third trimester (P < 0.0001). Gravidity showed a negative correlation with WBC count (r = −0.17, P = 0.01) and a positive correlation with eosinophil levels (r = 0.14, P = 0.0376). Spearman's correlations revealed no significant differences in maternal age groups. Conclusions: Our findings provide useful insight for physicians and policymakers in assessing CBC during pregnancy and providing optimal care. Furthermore, the associations between gravidity and WBC (negative) and eosinophil levels (positive) point to a potential effect of reproductive history on immune function, necessitating additional research in this area.

Abstract Background One-third of veterans returning from the 1990–1991 Gulf War reported a myriad of symptoms including cognitive dysfunction, skin rashes, musculoskeletal discomfort, and fatigue. This symptom cluster is now referred to as Gulf War Illness (GWI). As the underlying mechanisms of GWI have yet to be fully elucidated, diagnosis and treatment are based on symptomatic presentation. One confounding factor tied to the illness is the high presence of post-traumatic stress disorder (PTSD). Previous research efforts have demonstrated that both GWI and PTSD are associated with immunological dysfunction. As such, this research endeavor aimed to provide insight into the complex relationship between GWI symptoms, cytokine presence, and immune cell populations to pinpoint the impact of PTSD on these measures in GWI. Methods Symptom measures were gathered through the Multidimensional fatigue inventory (MFI) and 36-item short form health survey (SF-36) scales and biological measures were obtained through cytokine & cytometry analysis. Subgrouping was conducted using Davidson Trauma Scale scores and the Structured Clinical Interview for Diagnostic and statistical manual of mental disorders (DSM)-5, into GWI with high probability of PTSD symptoms (GWIH) and GWI with low probability of PTSD symptoms (GWIL). Data was analyzed using Analysis of variance (ANOVA) statistical analysis along with correlation graph analysis. We mapped correlations between immune cells and cytokine signaling measures, hormones and GWI symptom measures to identify patterns in regulation between the GWIH, GWIL, and healthy control groups. Results GWI with comorbid PTSD symptoms resulted in poorer health outcomes compared with both Healthy control (HC) and the GWIL subgroup. Significant differences were found in basophil levels of GWI compared with HC at peak exercise regardless of PTSD symptom comorbidity (ANOVA F = 4.7, P = 0.01,) indicating its potential usage as a biomarker for general GWI from control. While the unique identification of GWI with PTSD symptoms was less clear, the GWIL subgroup was found to be delineated from both GWIH and HC on measures of IL-15 across an exercise challenge (ANOVA F > 3.75, P

Abstract Background Schizophrenia (SCZ) is a psychotic disorder with an unknown pathogenesis accompanied by varying degrees of cognitive deficits. Recent studies have shown that immune dysregulation plays an important role in developing symptoms and cognitive deficits in SCZ. This study aimed to determine the complete blood count (CBC), including white blood cells, neutrophils, monocytes, lymphocytes, platelets, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and monocyte-lymphocyte ratio (MLR), in patients with SCZ and explore their correlations with SCZ symptom dimensions and cognitive function. Methods Seventy-four patients with SCZ and 57 age- and sex-matched healthy controls with available demographic and clinical information were recruited for this study. Blood samples were collected, and symptom dimensions and cognitive function were evaluated using the Positive and Negative Syndrome Scale (PANSS) and MATRICS Consensus Cognitive Battery (MCCB) separately. Results Our results demonstrate that SCZ patients showed higher monocyte counts, PLR, MLR, and worse performance in the total MCCB than healthy controls. Neutrophil and lymphocyte counts and NLR were positively related to symptom severity and negatively related to depressive symptoms. White blood cell (WBC) count, monocyte count, and MLR were positively correlated with cognitive performance in patients with SCZ. Conclusion In summary, this study suggests that cognitive deficits and symptom severity in patients were associated with dysregulation of immunity. Moreover, we found that WBC could be used as a marker for symptom severity and cognitive deficits in SCZ and that neutrophils are more closely related to the former and monocytes to the latter. We hope that clinicians will pay more attention to dysregulated immunity in patients with SCZ in the future.