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Tian J, Miao M. How Does Altering the Volume-Load of Plyometric Exercises Affect the Inflammatory Response, Oxidative Stress, and Muscle Damage in Male Soccer Players? J Sports Sci Med 2024; 23:97-106. [PMID: 38455429 PMCID: PMC10915621 DOI: 10.52082/jssm.2024.97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 12/30/2023] [Indexed: 03/09/2024]
Abstract
Incorporating plyometric exercises (PE) into soccer players' conditioning routines is vital for boosting their performance. Nevertheless, the effects of PE sessions with diverse volume loads on inflammation, oxidative stress, and muscle damage are not yet clearly understood. This study aimed to examine the effects of altering the volume-loads of PE on indicators of oxidative muscle damage and inflammation. The study involved forty young male soccer players who were randomly assigned to three different volume-loads of PE (Low volume-load [100 jumps]: LVL, n = 10; Moderate volume-load [150 jumps]: MVL, n = 10; and High volume-load [200 jumps]: HVL, n = 10) and a control group (CON = 10). The levels of various biomarkers including delayed onset muscle soreness (DOMS), serum lactate dehydrogenase (LDH), creatine kinase (CK), 8-hydroxy-2-deoxyguanosine (8-OHdG), malondialdehyde (MDA), protein carbonyl (PC), leukocytes, neutrophils, interleukin-6 (IL-6), and C-reactive protein (CRP) were measured at different time points. These measurements were taken at rest, immediately after completion of PE, and 24-, 48-, and 72-hours post-PE. The CK, LDH, DOMS, 8-OHdG, MDA, and PC levels were significantly increased (p < 0.05) after the PE protocol, reaching their peak values between 24 to 48 hours post-PE for all the volume-loaded groups. The levels of leukocytes, neutrophils, and IL-6 also increased after the PE session but returned to resting values within 24 hours post-PE. On the other hand, CRP levels increased at 24 hours post-PE for all the treatment groups (p < 0.05). The changes observed in the indicators of muscle damage and inflammation in response to different volume-loads of PE was not significant. However, the HVL and MVL indicated significant differences compared to LVL in the 8-OHdG (at 48-hour) and MDA (at 72-hour). Athletes engaging in higher volume-loads demonstrated more pronounced responses in terms of biochemical variables (specifically, LVL < MVL < HVL); however, these changes were not statistically significant (except 8-OHdG and MDA).
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Affiliation(s)
- Jian Tian
- School of Physical Education, Henan University, Kaifeng, China
| | - Miao Miao
- School of Physical Education, Henan University, Kaifeng, China
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Bruins A, Keeley J, Uhley V, Anyadike K, Kemp K. White Blood Cell and C-Reactive Protein Levels Are Similar in Obese Hispanic White Women Reporting Adherence to a Healthy Plant, Unhealthy Plant, or Animal-Based Diet, unlike in Obese Non-Hispanic White Women. Nutrients 2024; 16:556. [PMID: 38398880 PMCID: PMC10891662 DOI: 10.3390/nu16040556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
While modifying dietary patterns can reduce the effects of inflammation in obesity, less is known about the impact of dietary patterns on inflammation levels in women of different ethnicities. This study investigated the link between dietary patterns and mediators associated with inflammation, such as C-reactive protein (CRP) and white blood cells (WBCs), among obese Hispanic and Non-Hispanic White women. CRP and WBC counts were extracted from the National Health and Nutrition Examination Survey conducted between 2003 and 2010. Based on their recorded responses to two 24 h recall interviews, individuals were grouped into one of three dietary patterns: healthy plant-based, less healthy plant-based, or animal-based. Comparisons were run between obese Hispanic and Non-Hispanic women assigned to the same dietary pattern groups and between dietary pattern groups within ethnic groups. CRP and WBCs increased in obese Non-Hispanics as dietary patterns moved from healthy plant-based to animal-based (pCRP = 0.002 and pWBC = 0.017). Regardless of the dietary pattern, CRP and WBC expression were similar in Hispanic women. In addition, WBCs were higher in Hispanics compared to Non-Hispanics when both populations adhered to healthy plant and less healthy plant dietary patterns. The results indicate that dietary patterns may influence Hispanics' inflammation differently than Non-Hispanics.
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Affiliation(s)
- Anna Bruins
- Trinity Health Grand Rapids Family Medicine Residency, 200 Jefferson Ave SE, Grand Rapids, MI 49503, USA;
| | - Jacob Keeley
- Department of Research, Oakland University William Beaumont School of Medicine, 586 Pioneer Dr, Rochester, MI 48309, USA;
| | - Virginia Uhley
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, 586 Pioneer Dr, Rochester, MI 48309, USA;
- Department of Family Medicine and Community Health, Oakland University William Beaumont School of Medicine, Rochester, MI 48309, USA
| | - Kimberly Anyadike
- Oakland University William Beaumont School of Medicine, 586 Pioneer Dr, Rochester, MI 48309, USA;
| | - Kyeorda Kemp
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, 586 Pioneer Dr, Rochester, MI 48309, USA;
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Lo HC, Hsu SC. Suggested Flowchart Through Integrated C-Reactive Protein and White Blood Cell Count Analysis for Screening for Early Complications After Gastric Bypass: a Single-Center Retrospective Study. Obes Surg 2023; 33:3517-3526. [PMID: 37801238 DOI: 10.1007/s11695-023-06864-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/07/2023]
Abstract
INTRODUCTION Early leakage detection following bariatric procedures is crucial, but a standardized evaluation method is lacking. The aim was to validate the potential benefits of postoperative day 1 (POD1) C-reactive protein (CRP) levels and white blood cell (WBC) counts in distinguishing at-risk patients following Roux-en-Y gastric bypass (RYGB) while considering the impact of obesity-related chronic inflammation. METHODS Retrospective analysis of 261 consecutive patients aged 18-65 years with a body mass index (BMI) of 32.5-50 kg/m2 who underwent primary RYGB between 2017 and 2022. Sequential changes in CRP levels and WBC counts measured 48 h preoperatively and on POD1 morning were collected and compared between patients with/without complications and in patients without complications stratified by preoperative CRP levels. RESULTS Female patients and those with a higher BMI tended to have higher baseline CRP levels, which were positively related to postoperative CRP. Patients experiencing complications had higher WBC counts and a higher prevalence of WBC counts >14,000/μl (77.8% vs. 25.4%; p<0.001) than those without complications. Baseline CRP ≥ 0.3 mg/dl, a longer operative time, and blood loss >10 ml were significantly more common with WBC counts above 14,000/μl; a reasonable range of change in WBC count (∆WBC) derived from its positive correlation to postoperative WBC count (r=0.6695) may serve as a useful complementary indicator. CONCLUSION An individualized CRP threshold setting and integrated interpretation of the WBC count can be more appropriate than using static criteria for differentiating at-risk patients after RYGB. Further studies are needed to validate these findings and determine their generalizability.
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Affiliation(s)
- Hung-Chieh Lo
- Division of Trauma and Emergency Surgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
- Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, No. 111, Sec. 3, Xinglong Rd., Wenshan Dist., Taipei, Taiwan.
- TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Shih-Chang Hsu
- Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Emergency Department, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
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Zhang W, Zhang Y, Jin C, Fang R, Hua R, Zang X, Zhang H. The indicative role of inflammatory index in the progression of periodontal attachment loss. Eur J Med Res 2023; 28:287. [PMID: 37592356 PMCID: PMC10433564 DOI: 10.1186/s40001-023-01247-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/26/2023] [Indexed: 08/19/2023] Open
Abstract
OBJECTIVE To explore the forewarning immunological indicators during periodontal attachment loss progression in American adults. METHODS A total of 5744 participants with periodontal attachment loss were enrolled from the National Health and Nutrition Examination Surveys (NHANES) 2009-2014. In which, dependent variable was the counts of teeth with severe attachment loss (depth of periodontal probing was above 5 mm). Independent variables were circulatory immunological indexes, including counts of white blood cells (WBC), Lymphocytes, Monocytes, Neutrophils, Eosinophils, and Basophils. The association among variables was examined using multivariable linear regression models, fitting with smoothing curves, and generalizing additive models. RESULTS Based on the indicators of 5744 subjects, we found that severe attachment loss tended to occur in the elderly or males and was accompanied by higher WBC, Monocytes, and Neutrophils, as well as lower poverty-income ratio and educational qualification. WBC (above the inflection point: 6200 cells/µL) and Neutrophils (above the inflection point: 3300 cells/µL) counts were positively associated with attachment loss progression in each multivariable linear regression model. On subgroup analyses, stratified by sex and race, the positive correlation of WBC or Neutrophils with severe attachment loss was stable in both men and women, as well as in all races except blacks (WBC β = - 0.0576, 95% CI - 0.1945 to 0.0793, Neutrophils β = - 0.0527, 95% CI - 0.2285 to 0.1231). CONCLUSION Increasing WBC (above 6200 cells/µL) and Neutrophils (above 3300 cells/µL) counts were risk indicators of severe periodontal attachment loss among all races, except in blacks.
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Affiliation(s)
- Wenhao Zhang
- Key Laboratory of Oral Diseases Research of Anhui Province, College & Hospital of Stomatology, Anhui Medical University, Hefei, 230032, China
| | - Yulong Zhang
- Key Laboratory of Oral Diseases Research of Anhui Province, College & Hospital of Stomatology, Anhui Medical University, Hefei, 230032, China
| | - Cong Jin
- Key Laboratory of Oral Diseases Research of Anhui Province, College & Hospital of Stomatology, Anhui Medical University, Hefei, 230032, China
| | - Ruihan Fang
- Key Laboratory of Oral Diseases Research of Anhui Province, College & Hospital of Stomatology, Anhui Medical University, Hefei, 230032, China
| | - Ruixue Hua
- Key Laboratory of Oral Diseases Research of Anhui Province, College & Hospital of Stomatology, Anhui Medical University, Hefei, 230032, China
| | - Xiaodong Zang
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230032, China.
| | - Hengguo Zhang
- Key Laboratory of Oral Diseases Research of Anhui Province, College & Hospital of Stomatology, Anhui Medical University, Hefei, 230032, China.
- Department of Dental Implantology, College & Hospital of Stomatology, Anhui Medical University, Hefei, 230032, China.
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Feigin E, Levinson T, Witztum T, Adler A, Goldiner I, Egoz E, Rogowski O, Meilik A, Zeltser D, Shapira I, Shenhar-Tsarfaty S, Berliner S, Wasserman A. Early signaling of bacteremia in patients who present to the Department of Emergency Medicine with relatively low C-Reactive Protein (CRP) concentrations. Clin Chim Acta 2023:117451. [PMID: 37336422 DOI: 10.1016/j.cca.2023.117451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/14/2023] [Accepted: 06/16/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVES Examiningthe usefulness of C-reactive protein velocity (CRPv) as an early biomarker for the presence of bacteraemia in patients presenting to the Department of Emergency Medicine with acute infection/inflammation and suspected bacteraemia. METHODS A retrospective study examining a cohort of patients who presented to the E.R and in whom blood cultures were taken. CRPv was calculated as the difference in mg/hour/litter between two consecutive CRP tests performed within 12 hours. RESULTS 256 patients were included in the cohort. Using CRPv in patients who at first presented with a relatively low (17.9≤mg/L 1stquartile) CRP concentration, we found an AUC of 0.808±0.038 (p<0.001) for the presence of positive versus negative blood cultures (what is AUC?). This was better than the AUC that was obtained when the WBC for the same purpose. CONCLUSIONS CRPv may be a useful biomarker in the identification of patients with suspected bacteremiaand a low CRP-a challenging situation for clinicians who may underestimate the severity of illness in this patient group.
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Affiliation(s)
- Eugene Feigin
- Department of Internal Medicine "C", "D", & "E", Tel Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel.
| | - Tal Levinson
- Department of Internal Medicine "C", "D", & "E", Tel Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel; Infectious Diseases Unit, Tel Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel.
| | - Tamar Witztum
- Department of Internal Medicine "C", "D", & "E", Tel Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel.
| | - Amos Adler
- Microbiology Laboratory, Tel Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel.
| | - Ilana Goldiner
- Laboratory Medicine, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 64239, Israel.
| | - Eyal Egoz
- I-Medata AI Center, Tel-Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel.
| | - Ori Rogowski
- Department of Internal Medicine "C", "D", & "E", Tel Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel.
| | - Ahuva Meilik
- I-Medata AI Center, Tel-Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel.
| | - David Zeltser
- Department of Emergency medicine, Tel Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel.
| | - Itzhak Shapira
- Department of Internal Medicine "C", "D", & "E", Tel Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel.
| | - Shani Shenhar-Tsarfaty
- Department of Internal Medicine "C", "D", & "E", Tel Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel.
| | - Shlomo Berliner
- Department of Internal Medicine "C", "D", & "E", Tel Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel.
| | - Asaf Wasserman
- Department of Internal Medicine "C", "D", & "E", Tel Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel.
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AL kafhage FA, Abbas AN, Al-Masaoodi RA, Hassan S, Al-Shemery MK. The relationship between hormonal levels and hematological parameters in cystic ovarian syndrome. J Med Life 2023; 16:937-940. [PMID: 37675180 PMCID: PMC10478661 DOI: 10.25122/jml-2022-0315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 03/30/2023] [Indexed: 09/08/2023] Open
Abstract
Polycystic ovarian syndrome (PCOS) is characterized by the abnormal production of ovarian androgens resulting in elevated levels of male sex hormones in women. This condition is often marked by the development of a group of small cysts, fluid-filled sacs (cysts) in the ovaries. This study aimed to analyze serum levels of prolactin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and specific hematological parameters in women with PCOS. In total, 70 women were enrolled, of which 50 were diagnosed with PCOS at an obstetrics institution in Karbala from February and May 2022, and 20 were excluded. Participant selection was based on the Rotterdam 2003 criteria, and we excluded postmenopausal women, those with hyperprolactinemia, and those with overt thyroid dysfunction. The control group included 20 fertile women with normal hormone levels, regular menstrual cycles, and no signs of hyperandrogenism, as verified by ultrasonography. Ages 15 to 46 were similar with regard to the frequency of illness, with those under 36 having a higher incidence. Data were collected via questionnaires, hormone level assessments, and complete blood count (CBC) tests. There was a significant increase in hormone levels (LH, FSH, prolactin, TSH) and CBC values (WBC, Hb, and Plt) in the PCOS group compared to the control group. We observed that women between 26 and 35 were more susceptible to PCOS. Furthermore, women who were overweight demonstrated a higher susceptibility to the syndrome.
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Affiliation(s)
| | | | | | - Saif Hassan
- Department of Pharmacy, Al-Zahrawi University College, Kerbala, Iraq
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Olayah F, Senan EM, Ahmed IA, Awaji B. Blood Slide Image Analysis to Classify WBC Types for Prediction Haematology Based on a Hybrid Model of CNN and Handcrafted Features. Diagnostics (Basel) 2023; 13:diagnostics13111899. [PMID: 37296753 DOI: 10.3390/diagnostics13111899] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/24/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
White blood cells (WBCs) are one of the main components of blood produced by the bone marrow. WBCs are part of the immune system that protects the body from infectious diseases and an increase or decrease in the amount of any type that causes a particular disease. Thus, recognizing the WBC types is essential for diagnosing the patient's health and identifying the disease. Analyzing blood samples to determine the amount and WBC types requires experienced doctors. Artificial intelligence techniques were applied to analyze blood samples and classify their types to help doctors distinguish between types of infectious diseases due to increased or decreased WBC amounts. This study developed strategies for analyzing blood slide images to classify WBC types. The first strategy is to classify WBC types by the SVM-CNN technique. The second strategy for classifying WBC types is by SVM based on hybrid CNN features, which are called VGG19-ResNet101-SVM, ResNet101-MobileNet-SVM, and VGG19-ResNet101-MobileNet-SVM techniques. The third strategy for classifying WBC types by FFNN is based on a hybrid model of CNN and handcrafted features. With MobileNet and handcrafted features, FFNN achieved an AUC of 99.43%, accuracy of 99.80%, precision of 99.75%, specificity of 99.75%, and sensitivity of 99.68%.
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Affiliation(s)
- Fekry Olayah
- Department of Information System, Faculty Computer Science and information System, Najran University, Najran 66462, Saudi Arabia
| | - Ebrahim Mohammed Senan
- Department of Artificial Intelligence, Faculty of Computer Science and Information Technology, Alrazi University, Sana'a, Yemen
| | | | - Bakri Awaji
- Department of Computer Science, Faculty of Computer Science and Information System, Najran University, Najran 66462, Saudi Arabia
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Bianconi V, Mannarino MR, Ramondino F, Fusaro J, Giglioni F, Braca M, Ricciutelli F, Lombardini R, Paltriccia R, Greco A, Lega IC, Pirro M. Lipoprotein(a) Does Not Predict Thrombotic Events and In-Hospital Outcomes in Patients with COVID-19. J Clin Med 2023; 12:jcm12103543. [PMID: 37240653 DOI: 10.3390/jcm12103543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/10/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
The prothrombotic and proinflammatory properties of lipoprotein(a) (Lp(a)) have been hypothesized to play a role in the pathogenesis of severe COVID-19; however, the prognostic impact of Lp(a) on the clinical course of COVID-19 remains controversial. This study aimed to investigate whether Lp(a) may be associated with biomarkers of thrombo-inflammation and the occurrence of thrombotic events or adverse clinical outcomes in patients hospitalized for COVID-19. We consecutively enrolled a cohort of patients hospitalized for COVID-19 and collected blood samples for Lp(a) assessment at hospital admission. A prothrombotic state was evaluated through D-dimer levels, whereas a proinflammatory state was evaluated through C-reactive protein (CRP), procalcitonin, and white blood cell (WBC) levels. Thrombotic events were marked by the diagnosis of deep or superficial vein thrombosis (DVT or SVT), pulmonary embolism (PE), stroke, transient ischemic attack (TIA), acute coronary syndrome (ACS), and critical limb ischemia (CLI). The composite clinical end point of intensive care unit (ICU) admission/in-hospital death was used to evaluate adverse clinical outcomes. Among 564 patients (290 (51%) men, mean age of 74 ± 17 years) the median Lp(a) value at hospital admission was 13 (10-27) mg/dL. During hospitalization, 64 (11%) patients were diagnosed with at least one thrombotic event and 83 (15%) patients met the composite clinical end point. Lp(a), as either a continuous or categorical variable, was not associated with D-dimer, CRP, procalcitonin, and WBC levels (p > 0.05 for all correlation analyses). In addition, Lp(a) was not associated with a risk of thrombotic events (p > 0.05 for multi-adjusted odds ratios) nor with a risk of adverse clinical outcomes (p > 0.05 for multi-adjusted hazard ratios). In conclusion, Lp(a) does not influence biomarkers of plasma thrombotic activity and systemic inflammation nor has any impact on thrombotic events and adverse clinical outcomes in patients hospitalized for COVID-19.
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Affiliation(s)
- Vanessa Bianconi
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
| | - Massimo R Mannarino
- Women's College Research Institute, Women's College Hospital, Toronto, ON M5G 1N8, Canada
| | - Federica Ramondino
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
| | - Jessica Fusaro
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
| | - Francesco Giglioni
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
| | - Marco Braca
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
| | - Federica Ricciutelli
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
| | - Rita Lombardini
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
| | - Rita Paltriccia
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
| | - Alessia Greco
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
| | - Iliana C Lega
- Women's College Research Institute, Women's College Hospital, Toronto, ON M5G 1N8, Canada
| | - Matteo Pirro
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
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Meletis G, Tychala A, Ntritsos G, Verrou E, Savvidou F, Dermitzakis I, Chatzidimitriou A, Gkeka I, Fyntanidou B, Gkarmiri S, Tzallas AT, Protonotariou E, Makedou K, Tsalikakis DG, Skoura L. Variant-Related Differences in Laboratory Biomarkers among Patients Affected with Alpha, Delta and Omicron: A Retrospective Whole Viral Genome Sequencing and Hospital-Setting Cohort Study. Biomedicines 2023; 11:biomedicines11041143. [PMID: 37189760 DOI: 10.3390/biomedicines11041143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/04/2023] [Accepted: 04/07/2023] [Indexed: 05/17/2023] Open
Abstract
During the COVID-19 pandemic, different SARS-CoV-2 variants of concern (VOC) with specific characteristics have emerged and spread worldwide. At the same time, clinicians routinely evaluate the results of certain blood tests upon patient admission as well as during hospitalization to assess disease severity and the overall patient status. In the present study, we searched for significant cell blood count and biomarker differences among patients affected with the Alpha, Delta and Omicron VOCs at admission. Data from 330 patients were retrieved regarding age, gender, VOC, cell blood count results (WBC, Neut%, Lymph%, Ig%, PLT), common biomarkers (D-dimers, urea, creatinine, SGOT, SGPT, CRP, IL-6, suPAR), ICU admission and death. Statistical analyses were performed using ANOVA, the Kruskal-Wallis test, two-way ANOVA, Chi-square, T-test, the Mann-Whitney test and logistic regression was performed where appropriate using SPSS v.28 and STATA 14. Age and VOC were significantly associated with hospitalization, whereas significant differences among VOC groups were found for WBC, PLT, Neut%, IL-6, creatinine, CRP, D-dimers and suPAR. Our analyses showed that throughout the current pandemic, not only the SARS-CoV-2 VOCs but also the laboratory parameters that are used to evaluate the patient's status at admission are subject to changes.
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Affiliation(s)
- Georgios Meletis
- Department of Microbiology, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Areti Tychala
- Department of Microbiology, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Georgios Ntritsos
- Department of Informatics and Telecommunications, School of Informatics and Telecommunications, University of Ioannina, 47100 Arta, Greece
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, 45110 Ioannina, Greece
| | - Eleni Verrou
- School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Filio Savvidou
- School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Iasonas Dermitzakis
- School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Anastasia Chatzidimitriou
- Institute of Applied Bioscience, Centre for Research and Technology Hellas, 6th km Charilaou-Thermi Rd., Thermi, 57001 Thessaloniki, Greece
| | - Ioanna Gkeka
- Department of Microbiology, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Barbara Fyntanidou
- Department of Emergency Medicine, AHEPA University Hospital, 54636 Thessaloniki, Greece
| | - Sofia Gkarmiri
- Department of Emergency Medicine, AHEPA University Hospital, 54636 Thessaloniki, Greece
| | - Alexandros T Tzallas
- Department of Informatics and Telecommunications, School of Informatics and Telecommunications, University of Ioannina, 47100 Arta, Greece
| | - Efthymia Protonotariou
- Department of Microbiology, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Kali Makedou
- Laboratory of Biochemistry, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Dimitrios G Tsalikakis
- Department of Electrical and Computer Engineering, University of Western Macedonia, 50131 Kozani, Greece
| | - Lemonia Skoura
- Department of Microbiology, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
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Storniolo JL, Chaulan M, Esposti R, Cavallari P. A single session of whole-body cryotherapy boosts maximal cycling performance and enhances vagal drive at rest. Exp Brain Res 2023; 241:383-93. [PMID: 36544016 DOI: 10.1007/s00221-022-06528-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022]
Abstract
Whole-body cryotherapy (WBC) has been reported to maximize physical recovery after exercise and reduce the ensuing muscle damage. In addition, WBC triggers cardiovascular responses leading to an increased vagal drive. Here we tested whether WBC may boost exercise performance as well as post-exercise recovery. Moreover, we compared the effects of WBC and exercise on sympathovagal balance and tested whether these two factors may interact. ECG was recorded in 28 healthy adults who underwent rest, all-out effort on a cycloergometer, 5 min recovery and again rest. After 3-5 days, WBC (3 min exposure to - 150 °C air) was applied and the whole procedure repeated. Total exercise duration was split into the time needed to reach peak power output (tPEAK) and the time to exhaustion (tEXH). The post-exercise exponential decay of HR was characterized by its delay from exercise cessation (tDELAY) and by its time constant (τOFF). Sympathovagal balance was evaluated by measuring HR variability power in the low (LF) and high (HF) frequency bands, both before exercise and after recovery from it. Sympathetic vs. vagal predominance was assessed by the sympathovagal index LFnu. Paired t-tests indicated that WBC increased tEXH and reduced tDELAY, speeding up the HR recovery. These results suggest that WBC may be exploited to boost exercise performance by about 12-14%. ANOVA on HR variability confirmed that exercise shifted the sympathovagal balance towards sympathetic predominance, but it also highlighted that WBC enhanced vagal drive at rest, both before exercise and after full recovery, covering ~ 70% of the exercise effect.
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11
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Tarján D, Hegyi P. Acute Pancreatitis Severity Prediction: It Is Time to Use Artificial Intelligence. J Clin Med 2022; 12:jcm12010290. [PMID: 36615090 PMCID: PMC9821076 DOI: 10.3390/jcm12010290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 12/26/2022] [Indexed: 12/31/2022] Open
Abstract
The clinical course of acute pancreatitis (AP) can be variable depending on the severity of the disease, and it is crucial to predict the probability of organ failure to initiate early adequate treatment and management. Therefore, possible high-risk patients should be admitted to a high-dependence unit. For risk assessment, we have three options: (1) There are univariate biochemical markers for predicting severe AP. One of their main characteristics is that the absence or excess of these factors affects the outcome of AP in a dose-dependent manner. Unfortunately, all of these parameters have low accuracy; therefore, they cannot be used in clinical settings. (2) Score systems have been developed to prognosticate severity by using 4-25 factors. They usually require multiple parameters that are not measured on a daily basis, and they often require more than 24 h for completion, resulting in the loss of valuable time. However, these scores can foresee specific organ failure or severity, but they only use dichotomous parameters, resulting in information loss. Therefore, their use in clinical settings is limited. (3) Artificial intelligence can detect the complex nonlinear relationships between multiple biochemical parameters and disease outcomes. We have recently developed the very first easy-to-use tool, EASY-APP, which uses multiple continuous variables that are available at the time of admission. The web-based application does not require all of the parameters for prediction, allowing early and easy use on admission. In the future, prognostic scores should be developed with the help of artificial intelligence to avoid information loss and to provide a more individualized risk assessment.
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Affiliation(s)
- Dorottya Tarján
- Heart and Vascular Center, Division of Pancreatic Diseases, Semmelweis University, 1083 Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, 7623 Pécs, Hungary
| | - Péter Hegyi
- Heart and Vascular Center, Division of Pancreatic Diseases, Semmelweis University, 1083 Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, 7623 Pécs, Hungary
- Translational Pancreatology Research Group, Interdisciplinary Centre of Excellence for Research Development and Innovation University of Szeged, 6725 Szeged, Hungary
- Correspondence: ; Tel.: +36-703751031
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12
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Martín-Cuervo M, Gracia-Calvo LA, Macías-García B, Ezquerra LJ, Barrera R. Evaluation of Eosinopenia as a SIRS Biomarker in Critically Ill Horses. Animals (Basel) 2022; 12:ani12243547. [PMID: 36552467 PMCID: PMC9774166 DOI: 10.3390/ani12243547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/05/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022] Open
Abstract
Systemic inflammatory response syndrome (SIRS) is a very common finding in critically ill patients. To accurately identify patients with SIRS and those who need intensive care, several markers have been evaluated, including cortisol, WBC or lactate. It is widely known that a stress leukogram includes eosinopenia as one of its main markers (neutrophilia, eosinopenia, lymphopenia and mild monocytes). It is known that cortisol concentration in plasma is the main stress biomarker and is strongly correlated with the severity of disease in horses. However, it is not possible to measure this parameter routinely in clinical conditions. Hence, in this study it was hypothesized that the eosinophil count could be a reliable parameter to identify critically ill horses. Horses included in this study were divided into three groups: Group A (sick horses received at the Emergency Unit which did not fulfil the criteria for SIRS), Group B (horses that meet two or more criteria for inclusion in the definition of SIRS) and a control group of healthy horses. In this study, horses with SIRS showed lower eosinophil counts than healthy horses. Moreover, non-surviving horses exhibited lower eosinophil counts than survivors. Eosinopenia could be used to identify horses with SIRS and can be useful as a prognostic marker.
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Affiliation(s)
- María Martín-Cuervo
- Grupo MECIAN, Departamento de Medicina Animal, Facultad de Veterinaria, Campus de Cáceres, Universidad de Extremadura, 10003 Cáceres, Spain
- Correspondence:
| | | | - Beatriz Macías-García
- Grupo MINVET, Departamento de Medicina Animal, Facultad de Veterinaria, Campus de Cáceres, Universidad de Extremadura, 10003 Cáceres, Spain
| | - Luis Javier Ezquerra
- Grupo MECIAN, Departamento de Medicina Animal, Facultad de Veterinaria, Campus de Cáceres, Universidad de Extremadura, 10003 Cáceres, Spain
| | - Rafael Barrera
- Grupo MINVET, Departamento de Medicina Animal, Facultad de Veterinaria, Campus de Cáceres, Universidad de Extremadura, 10003 Cáceres, Spain
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Xie S, Chen P, Wang D, Jiang X, Wu Z, Liao K, Liu M, Zhang S, Chen Y. Application of Procalcitonin for the Rapid Diagnosis of Clostridioides difficile Infection in Patients with Inflammatory Bowel Disease. Diagnostics (Basel) 2022; 12. [PMID: 36553115 DOI: 10.3390/diagnostics12123108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/27/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
Background: The incidence of Clostridioides difficile infection (CDI) has increased in recent years in patients with inflammatory bowel disease (IBD). C. difficile is a toxin-producing bacterium, and CDI results in the worsening of underlying IBD, increasing the risk of IBD treatment failure, surgery, and hospitalization. Because the symptoms of CDI overlap with those of IBD, it is challenging to make a differential diagnosis. Therefore, early, rapid, and reliable diagnostic tools that can identify CDI in IBD patients would be valuable to clinicians. Methods: This study retrospectively collected 135 patients with IBD. Among them, 44 patients were diagnosed with CDI, and 42 patients were diagnosed with viral or fungal infections. A total of 49 patients without infections were defined as the control group. The diagnostic values of procalcitonin (PCT), C-reactive protein (CRP), and white blood cell (WBC) count in the peripheral blood were examined. Results: In this study, PCT levels were significantly higher in patients with CDI than in non-CDI patients (including patients with viral/fungal infections and the control group; p < 0.001 and p < 0.05, respectively). CRP levels were significantly higher in patients with CDI than in non-CDI patients (p < 0.05). The area under the curve (AUC) of PCT and WBC count were compared using DeLong’s test: the AUCs of PCT vs. CRP for the detection of the IBD−CDI group and the control group was 0.826 [95% confidence interval (CI) 0.743−0.909] vs. 0.663 [95% confidence interval (CI) 0.551−0.774] (p < 0.05), respectively. WBC count was inferior as a diagnostic tool for CDI. The sensitivity was 59.09% (95% CI: 43.2% to 73.7%), the specificity was 89.80% (95% CI: 77.8% to 96.6%), and the positive likelihood ratio LR (+) was 5.79 for PCT for the diagnosis of CDI. Conclusions: The present study demonstrates the superiority of PCT over CRP and WBC count for the rapid diagnosis of CDI in IBD patients.
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Vo NN, Tran HT, Nguyen THP, Vu DD, Vo TS, Nguyen TH. Determination of the Assigned Values of Blood Cells by an Impedance Method for Hematological Reference Samples Used in Hematology External Quality Assessment (EQA) Programs. Biomedicines 2022; 10:biomedicines10123169. [PMID: 36551923 PMCID: PMC9775971 DOI: 10.3390/biomedicines10123169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/01/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
The research into and production of hematological reference samples used to implement an external quality assessment (EQA) to check the quality of hematology tests are necessary for hematology laboratories in Vietnam. In this research, the study team determined the assessment values of blood cell count (human RBCs, pseudo-leucocytes, and pseudo-platelets) by the impedance method used in hematology EQA programs. The hematological reference samples were controlled at three concentration levels: low, normal, and high. Determination of the assigned value (mean ± 2SD) was performed for the following hematology analyzer series by impedance method: ABX Micros 60, Celldyn 1700, and Mindray BC 2000. Each device was sent to 10 different laboratories for evaluation. Research results for assigned values of each model (ABX Micros 60, Celldyn 1700, and Mindray BC 2000) were determined at the three concentrations. For the ABX Micros 60 and Celldyn 1700 series, 80% of laboratories had analytical results within assigned values. For the Mindray BC 2000 series, 100% of laboratories had analytical results within assigned values. The measurement results for the number of human RBCs, pseudo-leucocytes, and pseudo-platelets on each analyzer were similar between the 10 laboratories; the results of the three hematology analyzer series using the impedance method were different and the difference was statistically significant (p < 0.05). Thus, hematological reference samples for measuring the number of blood cells meeting the standards so that they can evaluate the results of laboratories using the impedance method: ABX, Celldyn 1700, Mindray BC 2000.
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Affiliation(s)
- Ngoc Nguyen Vo
- Department of Biotechnology, Faculty of Chemical Engineering, Ho Chi Minh City University of Technology (HCMUT), 268 Ly Thuong Kiet Street, District 10, Ho Chi Minh City 700000, Vietnam
- Vietnam National University Ho Chi Minh City, Linh Trung Ward, Thu Duc District, Ho Chi Minh City 700000, Vietnam
- Correspondence: (N.N.V.); (H.T.T.)
| | - Huu Tam Tran
- Center for Standardization and Quality Control in Medical Lab of HCMC, 75A Cao Thang Street, District 3, Ho Chi Minh City 700000, Vietnam
- Correspondence: (N.N.V.); (H.T.T.)
| | - Thi Hong Phuong Nguyen
- Center for Standardization and Quality Control in Medical Lab of HCMC, 75A Cao Thang Street, District 3, Ho Chi Minh City 700000, Vietnam
| | - Dinh Dung Vu
- Center for Standardization and Quality Control in Medical Lab of HCMC, 75A Cao Thang Street, District 3, Ho Chi Minh City 700000, Vietnam
| | - Thanh Sang Vo
- Institute of Applied Technology and Sustainable Development, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam
| | - Thuy Huong Nguyen
- Department of Biotechnology, Faculty of Chemical Engineering, Ho Chi Minh City University of Technology (HCMUT), 268 Ly Thuong Kiet Street, District 10, Ho Chi Minh City 700000, Vietnam
- Vietnam National University Ho Chi Minh City, Linh Trung Ward, Thu Duc District, Ho Chi Minh City 700000, Vietnam
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Zhang X, He D, Xiang Y, Wang C, Liang B, Li B, Qi D, Deng Q, Yu H, Lu Z, Zheng F. DYSF promotes monocyte activation in atherosclerotic cardiovascular disease as a DNA methylation-driven gene. Transl Res 2022; 247:19-38. [PMID: 35460889 DOI: 10.1016/j.trsl.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 04/10/2022] [Accepted: 04/12/2022] [Indexed: 10/18/2022]
Abstract
Dysferlin (DYSF) has drawn much attention due to its involvement in dysferlinopathy and was reported to affect monocyte functions in recent studies. However, the role of DYSF in the pathogenesis of atherosclerotic cardiovascular diseases (ASCVD) and the regulation mechanism of DYSF expression have not been fully studied. In this study, Gene Expression Omnibus (GEO) database and epigenome-wide association study (EWAS) literatures were searched to find the DNA methylation-driven genes (including DYSF) of ASCVD. The hub genes related to DYSF were also identified through weighted correlation network analysis (WGCNA). Regulation of DYSF expression through its promoter methylation status was verified using peripheral blood leucocytes (PBLs) from ASCVD patients and normal controls, and experiments on THP1 cells and Apoe-/- mice. Similarly, the expressions of DYSF related hub genes, mainly contained SELL, STAT3 and TMX1, were also validated. DYSF functions were then evaluated by phagocytosis, transwell and adhesion assays in DYSF knock-down and overexpressed THP1 cells. The results showed that DYSF promoter hypermethylation up-regulated its expression in clinical samples, THP1 cells and Apoe-/- mice, confirming DYSF as a DNA methylation-driven gene. The combination of DYSF expression and methylation status in PBLs had a considerable prediction value for ASCVD. Besides, DYSF could enhance the phagocytosis, migration and adhesion ability of THP1 cells. Among DYSF related hub genes, SELL was proven to be the downstream target of DYSF by wet experiments. In conclusion, DYSF promoter hypermethylation upregulated its expression and promoted monocytes activation, which further participated in the pathogenesis of ASCVD.
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Affiliation(s)
- Xiaokang Zhang
- Center for Gene Diagnosis and Department of Clinical Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Dingdong He
- Department of Clinical Laboratory Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China; Center for Gene Diagnosis and Department of Clinical Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Yang Xiang
- Center for Gene Diagnosis and Department of Clinical Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Chen Wang
- Center for Gene Diagnosis and Department of Clinical Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Bin Liang
- Center for Gene Diagnosis and Department of Clinical Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Boyu Li
- Center for Gene Diagnosis and Department of Clinical Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Daoxi Qi
- Center for Gene Diagnosis and Department of Clinical Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Qianyun Deng
- Laboratory Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510000, China
| | - Hong Yu
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan University School of Basic Medical Sciences, Wuhan, 430071, China
| | - Zhibing Lu
- Institute of Myocardial Injury and Repair, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Fang Zheng
- Center for Gene Diagnosis and Department of Clinical Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
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Khury F, Oltmanns M, Fuchs M, Leiprecht J, Reichel H, Faschingbauer M. Against the Norm: Do Not Rely on Serum C-Reactive Protein and White Blood Cell Count Only When Assessing Eradication of Periprosthetic Joint Infection. Antibiotics (Basel) 2022; 11:antibiotics11091174. [PMID: 36139954 PMCID: PMC9495056 DOI: 10.3390/antibiotics11091174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/20/2022] [Accepted: 08/27/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction: Periprosthetic joint infections (PJI) following primary arthroplasty continue to be a serious complication, despite advances in diagnostics and treatment. Two-stage revision arthroplasty has been commonly used as the gold standard for the treatment of PJI. However, much discussion persists regarding the interim of the two-stage procedure and the optimal timing of reimplantation. Serology markers have been proposed as defining parameters for a successful reimplantation. The objective of this matched-pair analysis was to assess the role of serum C-reactive protein (CRP) and white blood cell count (WBC) in determining infection eradication and proper timing of reimplantation. We investigated the delta (∆) change in CRP and WBC values prior to both stages of two-stage revision arthroplasty as a useful marker of infection eradication. Methods: We analyzed 39 patients and 39 controls, matched by propensity score matching (BMI, age, ASA-classification), with a minimum follow-up of 24 months and treated with a two-stage revision THA or TKA in our institution. Data of serum CRP and WBC values were gathered at two selected time points: prior to the explantation of the implant (preexplantation) and following the completion of antibiotic treatment regimen, both systemic and with a drug-eluting cement spacer (prereimplantation). Patient records were reviewed electronically for preexisting comorbidities, overall health status, synovial fluid cultures, inflammatory serologies, revision surgeries, and recurrent or persistent infection based on the modified Musculoskeletal Infection Society criteria. Patient demographics, ∆CRP, ∆WBC, and time interval to reimplantation were statistically analyzed using receiver operator curves (ROC), Pearson’s correlation coefficient, Levene’s test, and Student’s t-test. Results: Infection-free patients exhibited higher mean CRP and WBC than did patients who were reinfected at both time points. When comparing preexplantation with prereimplantation values, the median ∆CRP was 9.48 mg/L (interquartile range (IQR) 2.3−36.6 mg/L) for patients who did not develop a reinfection versus 2.74 mg/L (IQR 1.4−14.2 mg/L) for patients who developed reinfection (p = 0.069). The median ∆WBC was 1.5 × 109/L (IQR 0.6−4.0 × 109/L) for patients who remained infection-free versus 1.2 × 109/L (IQR 0.8−2.2 109/L) for patients who developed reinfection (p = 0.072). Analysis of areas under the curve (AUC) using ROC demonstrated poor prediction of persistent infection by ∆CRP (AUC = 0.654) and ∆WBC (AUC = 0.573). Although a highly significant correlation was found between the interim interval and infection persistence (r = 0.655, p < 0.01), analysis using ROC failed to result in a specific threshold time to reimplantation above which patients are at significantly higher risk for reinfection (AUC = 0.507). Conclusion: No association could be determined between the delta change in serum CRP and WBC before and after two-stage revision arthroplasty for PJI and reinfection risk. Even though inflammatory serologies demonstrate a downtrending pattern prior to reimplantation, the role of CRP and WBC in determining the optimal timing of reimplantation seems to be dispensable. Planning a second-stage reimplantation requires assessing multiple variables rather than relying on specific numeric changes in these inflammatory marker values.
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Affiliation(s)
- Farouk Khury
- Department of Orthopedic Surgery, University of Ulm, Oberer Eselsberg 45, 89081 Ulm, Germany
- Division of Orthopedic Surgery, Rambam Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, HaAliya HaShniya St 8, Haifa 3109601, Israel
| | - Moritz Oltmanns
- Department of Orthopedic Surgery, University of Ulm, Oberer Eselsberg 45, 89081 Ulm, Germany
| | - Michael Fuchs
- Department of Orthopedic Surgery, University of Ulm, Oberer Eselsberg 45, 89081 Ulm, Germany
| | - Janina Leiprecht
- Department of Orthopedic Surgery, University of Ulm, Oberer Eselsberg 45, 89081 Ulm, Germany
| | - Heiko Reichel
- Department of Orthopedic Surgery, University of Ulm, Oberer Eselsberg 45, 89081 Ulm, Germany
| | - Martin Faschingbauer
- Department of Orthopedic Surgery, University of Ulm, Oberer Eselsberg 45, 89081 Ulm, Germany
- Correspondence: or
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Werner NL, Cralley A, Lawless R, Platnick KB, Cohen MJ, Coleman JJ, Hoehn M, Campion E, Pieracci FM, Burlew CC. Time to Look for Another Infectious Source? White Blood Cell Trends during Ventilator-Associated Pneumonia. Surg Infect (Larchmt) 2022; 23:656-660. [PMID: 35930247 DOI: 10.1089/sur.2022.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Ventilator-associated pneumonia (VAP) continues to plague patients in intensive care units (ICUs) throughout the world. Persistent leukocytosis despite antibiotic treatment for VAP can have many etiologies including normal inflammatory response, inadequate VAP antimicrobial therapy, and the presence of additional infectious diagnoses. Hypothesis: Surgical patients with VAP and a second infectious source have a different white blood cell count (WBC) trend than patients with VAP alone. Patients and Methods: Retrospective, single-center study of surgical ICU patients diagnosed with VAP (>104 CFU/mL on semi-quantitative culture) between January 2019 and June 2020. Chart review identified additional infections diagnosed during VAP treatment. White blood cell count values were compared between patients treated for VAP alone (VAP-alone) and those with additional infections (VAP-plus) using a Wilcoxon test. Univariable analysis compared admission type, surgeries, and steroid use between cohorts. Results: Eighty-eight VAPs were included for analysis; 61 (69%) were VAP-alone and 27 (31%) VAP-plus. Average age was 47.1 ± 16.7 years, 78% were male, and 93% were trauma admissions. Median hospital day of VAP diagnosis was six (interquartile range [IQR], 4-10). Nearly all patients (99%) were started on initial antibiotic agents to which the VAP organism was sensitive. Daily WBC was higher for VAP-plus compared with VAP-alone on days five, six, and seven of treatment. The maximum WBC was higher for VAP-plus (21.6 k/mcL vs. 16.1 k/mcL; p = 0.02). There were no differences in admission types, number of surgeries, or steroid use between groups. Conclusions: Providers should have increased suspicion for additional sources of infection when ICU patients with a VAP continue to have elevated WBC despite appropriate antibiotic therapy.
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Affiliation(s)
| | - Alexis Cralley
- University of Colorado School of Medicine, Denver, Colorado, USA
| | - Ryan Lawless
- Denver Health Medical Center, Denver, Colorado, USA
| | | | - Mitchell J Cohen
- University of Colorado School of Medicine, Denver, Colorado, USA
| | | | - Melanie Hoehn
- UCHealth Medical Center of the Rockies, Loveland, Colorado, USA
| | - Eric Campion
- Denver Health Medical Center, Denver, Colorado, USA
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18
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Talukdar K, Bora K, Mahanta LB, Das AK. A comparative assessment of deep object detection models for blood smear analysis. Tissue Cell 2022; 76:101761. [PMID: 35219070 DOI: 10.1016/j.tice.2022.101761] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/21/2022] [Accepted: 02/18/2022] [Indexed: 10/19/2022]
Abstract
A blood smear is a common type of blood test where blood sample is taken from a patient, smear is made from the sample followed by observation of red blood cells, white blood cells and platelets. A pathologist carefully observes the sample and manually counts the number of RBC, WBC and platelets. This entire process from creating a smear to manually counting each element is tedious and susceptible to human errors. That is why, with the advancement of deep learning, various object detection techniques have become useful for automating the process and mitigating human errors in blood smear analysis. This work presents a comparative assessment of three different object detection models namely Faster R-CNN, EfficientDet D3 and CenterNet Hourglass, and presents their respective inference results. The three models have been compared using the COCO evaluation metrics to identify the best model performance for the given task. It is observed that out of the three models, the Faster R-CNN model performs the best in detecting WBCs and platelets in microscopic blood smear images with an average precision of 99.4%. Critical tasks like medical image processing require accurate predictions to prevent unintended ramifications. Therefore, while slower in terms of inference time, Faster R-CNN is the go-to model where accuracy is the priority. The work is also compared with the existing work in this domain to prove its efficiency.
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Affiliation(s)
- Kabyanil Talukdar
- Department of Computer Science & IT, Cotton University, Guwahati, 781001, Assam, India.
| | - Kangkana Bora
- Department of Computer Science & IT, Cotton University, Guwahati, 781001, Assam, India.
| | - Lipi B Mahanta
- MCSD Division, Institute of Advanced Study in Science and Technology, Guwahati, 781038, Assam, India.
| | - Anup K Das
- Arya Wellness Centre, Guwahati, 781032, Assam, India.
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Dobielewski M, Hauser J, Beck O, Stemme G, Roxhed N. Blood cell quantification on dry blood samples: toward patient-centric complete blood counts. Bioanalysis 2022; 14:693-701. [PMID: 35593738 DOI: 10.4155/bio-2022-0029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Performing complete blood counts from patients' homes could have a transformative impact on e-based healthcare. Blood microsampling and sample drying are enabling elements for patient-centric healthcare. The aim of this study was to investigate the potential of dry blood samples for image-based cell quantification of red and white blood cells. Methods: A manual sample preparation method was developed and tested for image-based red and white blood cell counting. Results & conclusion: Dry blood samples enable image-based cell counting of red and white blood cells with a good correlation to gold standard hematology analyzer data (average coefficient of variation <6.5%; R2 >0.8) and resolve the basic morphology of white blood cell nuclei. The presented proof-of-principle study is a first step toward patient-centric complete blood counts.
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20
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Y Al-Taee SM, Al-Allaff RGM, E Alnajafy L. The Effect of Leptin on the Regulation of Immune Responses in Women with Polycystic Ovary Syndrome. Pak J Biol Sci 2022; 25:715-724. [PMID: 36098197 DOI: 10.3923/pjbs.2022.715.724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
<b>Background and Objective:</b> Leptin is a hormone produced by fat cells in adipose tissue that plays a biological role in metabolism, immune system control and energy flow regulation. The study's objective was to investigate serum leptin levels in PCOS females and determine how they are related to immunological and hormonal parameters. <b>Materials and Methods:</b> Thirty PCOS women were chosen for the study and compared to thirty healthy women as control samples, with both case and normal samples ranging in age from 18-36 years. WBC count, absolute numbers of neutrophils, lymphocytes, monocytes, eosinophils, leptin, Prolactin and serum IgA levels were measured. <b>Results:</b> The results showed the mean WBC, lymphocytes and eosinophil absolute numbers in PCOS women were significantly different. However, there was no significant difference in the absolute numbers of neutrophils and monocytes. The findings also revealed a significant increase in BMI, IgA, leptin and prolactin levels in PCOS when compared to controls. The results showed strong positive correlation coefficients between BMI and IgA (1.000**), WBC with neutrophils, lymphocytes and monocytes (0.797**, 0.790**, 0.712**), respectively and finally leptin and prolactin (0.474**). The same test, on the other hand, revealed an inverse correlation coefficient between BMI, IgA and prolactin (-0.376*, -0.376*, respectively with p<u><</u>0.05). <b>Conclusion:</b> A rise in the levels of the hormones leptin and prolactin, which were positively associated with the body mass index in women with PCOS, was found in the current study. The findings revealed that the hormones leptin and prolactin have an effect on some immune parameters in women with PCOS.
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Ghasemi SZ, Memarzia A, Behrouz S, Gholamnezhad Z, Boskabady MH. Comparative effects of Curcuma longa and curcumin on paraquat-induced systemic and lung oxidative stress and inflammation in rats. Avicenna J Phytomed 2022; 12:414-424. [PMID: 35782772 PMCID: PMC9121257 DOI: 10.22038/ajp.2022.19713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/10/2022] [Accepted: 02/12/2022] [Indexed: 11/22/2022]
Abstract
Objective Comparative effect of Curcuma longa (C. longa) ethanolic extract and curcumin on paraquat (PQ)-induced systemic and lung oxidative stress and inflammation were evaluated in the present study. Materials and Methods Control animals were exposed to normal saline and PQ group to 54 mg/m3 PQ aerosols (8 times, each time for 30 min). Treatment groups were exposed to PQ and treated with 150 and 600 mg/kg/day C. longa, or 30 and 120 mg/kg/day curcumin after PQ exposure period for 16 days. Total and differential white blood cells (WBC) and oxidative markers were measured both in bronchoalveolar lavage (BALF) and blood at the end of the study. Results Total and differential WBC counts as well as malondialdehyde (MDA) level were significantly increased but total thiol content and the activities of catalase (CAT) and superoxide dismutase (SOD) were reduced in both the BALF and blood of the PQ group in comparison with the control group (p<0.05 to p<0.001). Both doses of C. longa and curcumin diminished MDA level, total and differential WBC counts in the blood and BALF but increased CAT and SOD activities in both of them compared to PQ group (p<0.05 to p<0.001). The effects of C. longa and curcumin high dose on most variables were markedly more than low dose (p<0.05 to p<0.001). Furthermore, the effects of curcumin on some variables were markedly more than C. longa (p<0.05 to p<0.001). Conclusion Both C. longa and curcumin improved PQ-induced systemic and lung inflammation and oxidative stress, but the effect of curcumin was more prominent.
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Affiliation(s)
- Seyedeh Zahra Ghasemi
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran,Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Arghavan Memarzia
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran,Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran,Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sepideh Behrouz
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran,Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Gholamnezhad
- Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Hossein Boskabady
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran,Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran,Corresponding Author: Tel: +98-5138828565, Fax: +98-5138828564,
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Hu ZB, Lu ZX, Zhu F, Jiang CQ, Zhang WS, Pan J, Jin YL, Xu L, Thomas GN, Cheng K, Lam T. Higher total white blood cell and neutrophil counts are associated with an increased risk of fatal stroke occurrence: the Guangzhou biobank cohort study. BMC Neurol 2021; 21:470. [PMID: 34856939 PMCID: PMC8638334 DOI: 10.1186/s12883-021-02495-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 11/16/2021] [Indexed: 12/05/2022] Open
Abstract
Background Chronic inflammatory diseases are linked to an increased risk of stroke events. The white blood cell (WBC) count is a common marker of the inflammatory response. However, it is unclear whether the WBC count, its subpopulations and their dynamic changes are related to the risk of fatal stroke in relatively healthy elderly population. Methods In total, 27,811 participants without a stroke history at baseline were included and followed up for a mean of 11.5 (standard deviation = 2.3) years. After review of available records, 503 stroke deaths (ischaemic 227, haemorrhagic 172 and unclassified 104) were recorded. Cox proportional hazards regression was used to assess the associations between the WBC count, its subpopulations and their dynamic changes (two-phase examination from baseline to the 1st follow-up) and the risk of fatal all stroke, fatal ischaemic stroke and fatal haemorrhagic stroke. Results (i) Regarding the WBC count in relation to the risk of fatal stroke, restricted cubic splines showed an atypically U-curved association between the WBC count and the risk of fatal all stroke occurrence. Compared with those in the lowest WBC count quartile (< 5.3*10^9/L), the participants with the highest WBC count (> 7.2*10^9/L) had a 53 and 67% increased risk for fatal all stroke (adjusted hazard ratio [aHR] = 1.53, 95% confidence interval (CI) 1.16–2.02, P = 0.003) and fatal haemorrhagic stroke (aHR = 1.67, 95% CI 1.10–2.67, P = 0.03), respectively; compared with those in the lowest quartile (< 3.0*10^9/L), the participants with the highest NEUT count (> 4.5*10^9/L) had a 45 and 65% increased risk for fatal all stroke (aHR = 1.45, 95% CI 1.10–1.89, P = 0.008) and fatal ischaemic stroke (aHR = 1.65, 95%CI 1.10–2.47 P = 0.02), respectively. With the additional adjustment for C-reactive protein, the same results as those for all stroke and ischaemic stroke, but not haemorrhagic stroke, were obtained for the WBC count (4 ~ 10*10^9/L) and the NEUT count (the NEUT counts in the top 1% and bottom 1% at baseline were excluded). (ii) Regarding dynamic changes in the WBC count in relation to the risk of fatal stroke, compared with the stable group (− 25% ~ 25%, dynamic changes from two phases of examination (baseline, from September 1st, 2003 to February 28th, 2008; 1st follow-up, from March 31st 2008 to December 31st 2012)), the groups with a 25% increase in the WBC count and NEUT count respectively had a 60% (aHR = 1.60, 95% CI 1.07–2.40, P = 0.02) and 45% (aHR = 1.45, 95% CI1.02–2.05, P = 0.04) increased risk of fatal all stroke occurrence. Conclusions The WBC count, especially the NEUT count, was associated with an increased risk of fatal all stroke occurrence. Longitudinal changes in the WBC count and NEUT count increase in excess of 25% were also associated with an increased risk of fatal all stroke occurrence in the elderly population. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-021-02495-z.
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Affiliation(s)
- Zhi-Bing Hu
- Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Ze-Xiong Lu
- Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Feng Zhu
- Guangzhou Twelfth People's Hospital, Guangzhou, China.
| | | | - Wei-Sen Zhang
- Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Jin Pan
- Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Ya-Li Jin
- Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Lin Xu
- School of Public Health, the University of Hong Kong, Pokfulam, Hong Kong.,School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - G Neil Thomas
- Institute of Applied Health Research, University of Birmingham, Sun Yat-sen University, Birmingham, UK
| | - Karkeung Cheng
- Institute of Applied Health Research, University of Birmingham, Sun Yat-sen University, Birmingham, UK
| | - Taihing Lam
- Guangzhou Twelfth People's Hospital, Guangzhou, China.,School of Public Health, the University of Hong Kong, Pokfulam, Hong Kong.,School of Public Health, Sun Yat-sen University, Guangzhou, China
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Drałus G, Mazur D, Czmil A. Automatic Detection and Counting of Blood Cells in Smear Images Using RetinaNet. Entropy (Basel) 2021; 23:1522. [PMID: 34828220 DOI: 10.3390/e23111522] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 01/06/2023]
Abstract
A complete blood count is one of the significant clinical tests that evaluates overall human health and provides relevant information for disease diagnosis. The conventional strategies of blood cell counting include manual counting as well as counting using the hemocytometer and are tedious and time-consuming tasks. This research-based paper proposes an automatic software-based alternative method to count blood cells accurately using the RetinaNet deep learning network, which is used to recognize and classify objects in microscopic images. After training, the network automatically recognizes and counts red blood cells, white blood cells, and platelets. We tested a model trained on smear images and found that the trained model has generalized capabilities. We assessed the quality of detection and cell counting using performance measures, such as accuracy, sensitivity, precision, and F1-score. Moreover, we studied the dependence of the confidence thresholds and the number of learning epochs on the obtained results of recognition and counting. We compared the performance of the proposed approach with those obtained by other authors who dealt with the subject of cell counting and show that object detection and labeling can be an additional advantage in the task of counting objects.
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Koch SPR, Thomasen IN, Nielsen JØ, Philipsen JP, Smith J. Interchangeability of multiple Sysmex XN10 and XN20 modules for six types of leukocytes. Int J Lab Hematol 2021; 44:273-280. [PMID: 34726344 DOI: 10.1111/ijlh.13748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/20/2021] [Accepted: 10/08/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Differential counts of leukocytes are frequent, and often several automated blood cell counters are needed in contemporary laboratories. However, these modules are often individually quality assured. Our aim was therefore to validate the interchangeability of five hematology modules in a large modern laboratory and to compare them with our gold standard (GS) manual white blood cell differential count. METHODS At Copenhagen University Hospital, we compared five Sysmex XN-modules for neutrophils, lymphocytes, monocytes, eosinophils, basophils, and immature granulocytes (IG). We analyzed control samples in three levels to evaluate intra- and intermodular precision. Bias between modules was evaluated by analyzing 93 random patient samples within reference intervals. XN-modules' mean counts were compared with GS. RESULTS We found acceptable intramodular CV% (0.92%-8.76%), only neutrophils and eosinophils exceeded state-of-the-art imprecision or desirable specifications for medium control levels. Intermodular CV% showed significance difference for only monocytes (ANOVA, P < .0001). For patient samples, there were significant differences between XN-modules regarding four WBC types (ANOVA); however, proportional bias ranged from 1.7% to 3.8%, being within desirable specifications except basophils and IG (bias = 13.3% and 24.9%, respectively). Comparisons with GS, XN-modules exceeded desirable bias for basophils (lower than GS); monocytes and IG (higher than GS). CONCLUSION This multimodule comparison shows acceptable intermodular imprecision and bias for clinical purposes, which is important for patient safety. Similar multimodule study should be performed with samples out of reference range in large-scale laboratories to confirm the interchangeability.
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Affiliation(s)
- Sheila Perez Rovsing Koch
- Department of Clinical Biochemistry, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Isa Neimann Thomasen
- Department of Technology, Faculty of Health, University College Copenhagen, Copenhagen, Denmark
| | - Jesper Østrup Nielsen
- Department of Clinical Biochemistry, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | | | - Julie Smith
- Department of Technology, Faculty of Health, University College Copenhagen, Copenhagen, Denmark
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Magee CD, Parsons AS, Millard AS, Torre D. Lessons in clinical reasoning ‒ pitfalls, myths, and pearls: a case of confusion, disequilibrium, and "picking at the air". Diagnosis (Berl) 2021; 9:127-132. [PMID: 34455730 DOI: 10.1515/dx-2020-0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 07/30/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Defects in human cognition commonly result in clinical reasoning failures that can lead to diagnostic errors. CASE PRESENTATION A 43-year-old female was brought to the emergency department with 4-5 days of confusion, disequilibrium resulting in several falls, and hallucinations. Further investigation revealed tachycardia, diaphoresis, mydriatic pupils, incomprehensible speech and she was seen picking at the air. Given multiple recent medication changes, there was initial concern for serotonin syndrome vs. an anticholinergic toxidrome. She then developed a fever, marked leukocytosis, and worsening encephalopathy. She underwent lumbar puncture and aspiration of an identified left ankle effusion. Methicillin sensitive staph aureus (MSSA) grew from blood, joint, and cerebrospinal fluid cultures within 18 h. She improved with antibiotics and incision, drainage, and washout of her ankle by orthopedic surgery. CONCLUSIONS Through integrated commentary on the diagnostic reasoning process from clinical reasoning experts, this case underscores how multiple cognitive biases can cascade sequentially, skewing clinical reasoning toward erroneous conclusions and driving potentially inappropriate testing and treatment. A fishbone diagram is provided to visually demonstrate the major factors that contributed to the diagnostic error. A case discussant describes the importance of structured reflection, a tool to promote metacognitive analysis, and the application of knowledge organization tools such as illness scripts to navigate these cognitive biases.
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Affiliation(s)
- Charles D Magee
- Department of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Andrew S Parsons
- Department of Medicine, University of Virginia, Charlottesville, VA, USA
| | | | - Dario Torre
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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Mukherjee AP. Hypothesis: Immunotherapy by Selective Convalescent Blood Engineering to Stifle Diseases like COVID-19. Int J Med Sci 2021; 18:3389-3394. [PMID: 34522165 PMCID: PMC8436102 DOI: 10.7150/ijms.46363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 12/18/2020] [Indexed: 11/13/2022] Open
Abstract
Current standard vaccine testing protocols take approximately 10-24 months of testing before a vaccine can be declared successful. Sometimes by the time a successful vaccine is out for public use, the outbreak may already be over. With no vaccine or antiviral drug available to treat the infected, we are left with the age-old methods of isolation, quarantine, and rest, to arrest such a viral outbreak. Convalescent blood therapy and covalent plasma therapy have often proved effective in reducing mortality, however, the role of innate and adaptive immune cells in these therapies have been overlooked. Antigen presenting cells (APCs), CD4+ T memory cells, CD8+ T memory cells, and memory B-Cells all play a vital role in sustainable defense and subsequent recovery. This report incorporates all these aspects by suggesting a novel treatment therapy called selective convalescent leukapheresis and transfusion (SCLT) and also highlights its potential in vaccination. The anticipated advantages of the proposed technique outweigh the cost, time, and efficiency of other available transfusion and vaccination processes. It is envisioned that in the future this new approach could serve as a rapid emergency response to subdue a pathogen outbreak and to stop it from becoming an epidemic, or pandemic.
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Affiliation(s)
- Arka Prava Mukherjee
- Greka Engineering and Technology, 28 Landmark Plaza, Outer Ring Road 1, CBD, Zhengzhou, 450000, China
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Grzebisz-Zatońska N, Poprzęcki S, Pokora I, Mikołajec K, Kamiński T. Effect of Seasonal Variation during Annual Cyclist Training on Somatic Function, White Blood Cells Composition, Immunological System, Selected Hormones and Their Interaction with Irisin. J Clin Med 2021; 10:3299. [PMID: 34362082 DOI: 10.3390/jcm10153299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/19/2021] [Accepted: 07/22/2021] [Indexed: 12/02/2022] Open
Abstract
The aim of this study was to evaluate somatic, hormonal and immunological changes during the macrocycle of cyclists (9 well-trained men, age 25.6 ± 5.2 years and body weight 72.4 ± 7.35 kg). During the training macrocycle, four exercise control tests were carried out, and biochemical markers were measured in the laboratory. Seasonal training changes did not significantly disturb resting somatic and functional parameters, physical capacity (VO2max), body weight, the number of leukocytes and selected hormones. The secretory system of the organism did not respond significantly to the exercise stress in the training process, even with the increasing share of anaerobic processes in the subsequent periods of the macrocycle. Irisin and other parameters globally did not correlate with training volume. Irisin showed a significant correlation only with cortisol in the first period and human growth hormone in the second, and it showed a weak correlation in the third period with body mass and BMI. The lack of interactions between irisin level and other variables practically excludes its use in monitoring cyclist training. Future research would be complemented by the assessment of stress and postexercise changes in the cyclists’ macrocycle and expanding the research group to other athletes, including women.
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Butrimavičienė L, Nalivaikienė R, Kalcienė V, Rybakovas A. Impact of copper and zinc mixture on haematological parameters of rainbow trout (Oncorhynchus mykiss): acute exposure and recovery. Ecotoxicology 2021; 30:873-884. [PMID: 33851333 DOI: 10.1007/s10646-021-02404-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/26/2021] [Indexed: 06/12/2023]
Abstract
Significant changes in composition of rainbow trout Oncorhynchus mykiss blood cells types were induced after 4-days exposure with mixture of Cu2+ and Zn2+ at 0.25, 0.125 and 0.06 parts of LC50 in comparison to control group. The highest concentration of metal mixture (0.25 of LC50) significantly induced elevation of the number of monocytes and poly-segmented neutrophils. Treatment with 0.125 parts of LC50 concentration increased the number of thrombocytes, monocytes and non-segmented neutrophils. The most diluted mixture resulted in significant induction of thrombocytes, monocytes, non- and poly segmented neutrophils. Analysis of leucocyte cell types in the O. mykiss blood samples after 4-days of exposure at all applied mixture parts showed signs of monocytosis and neutrophilia. Comparison of different types of leucocytes' percentages (leukogram) in fish after 4-days exposure to metal mixture and after 4, 8, and 12-days recovery periods showed that, values of neutrophils even after the 12-days recovery period at all tested parts of LC50, and monocytes after exposure with the highest (0.25) used part of LC50 were not restored to control group levels. Depuration and recovery processes in treated fish are concentration and recovery period dependent.
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Affiliation(s)
- Laura Butrimavičienė
- Nature Research Centre, Institute of Ecology, Akademijos Str. 2, LT-08412, Vilnius, Lithuania.
| | - Reda Nalivaikienė
- Nature Research Centre, Institute of Ecology, Akademijos Str. 2, LT-08412, Vilnius, Lithuania
| | - Virginija Kalcienė
- Vilnius University, Life Sciences Center, Institute of Biosciences, Saulėtekio av. 7, LT-10257, Vilnius, Lithuania
| | - Aleksandras Rybakovas
- Nature Research Centre, Institute of Ecology, Akademijos Str. 2, LT-08412, Vilnius, Lithuania
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Seliger G, Bergner M, Haase R, Stepan H, Schleußner E, Zöllkau J, Seeger S, Kraus FB, Hiller GGR, Wienke A, Tchirikov M. Daily monitoring of vaginal interleukin 6 as a predictor of intraamniotic inflammation after preterm premature rupture of membranes - a new method of sampling studied in a prospective multicenter trial. J Perinat Med 2021; 49:572-582. [PMID: 33629573 DOI: 10.1515/jpm-2020-0406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 01/04/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVES (A) To introduce a new technique for vaginal fluid sampling (biocompatible synthetic fiber sponge) and (B) evaluate the collected vaginal fluid interleukine-6 (IL-6vag)-concentration as a new diagnostic tool for daily monitoring of intrauterine inflammation after preterm premature rupture of membranes (PPROM). Secondary objectives were to compare the potential to predict an intrauterine inflammation with established inflammation parameters (e.g., maternal white blood cell count). METHODS This prospective clinical case-control diagnostic accuracy multicenter study was performed with women after PPROM (gestational age 24.0/7 - 34.0/7 weeks). Sampling of vaginal fluid was performed once daily. IL-6vag was determined by electrochemiluminescence-immunoassay-kit. Neonatal outcome and placental histology results were used to retrospectively allocate the cohort into two subgroups: 1) inflammation and 2) no inflammation (controls). RESULTS A total of 37 cases were included in the final analysis. (A): Measurement of IL-6 was successful in 86% of 172 vaginal fluid samples. (B): Median concentration of IL-6vag in the last vaginal fluid sample before delivery was significantly higher within the inflammation group (17,085 pg/mL) compared to the controls (1,888 pg/mL; p=0.01). By Youden's index an optimal cut-off for prediction an intrauterine inflammation was: 6,417 pg/mL. Two days before delivery, in contrast to all other parameters IL-6vag remained the only parameter with a sufficient AUC of 0.877, p<0.001, 95%CI [0.670-1.000]. CONCLUSIONS This study established a new technique for vaginal fluid sampling, which permits assessment of IL-6vag concentration noninvasively in clinical daily routine monitoring.
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Affiliation(s)
- Gregor Seliger
- Department of Obstetrics and Prenatal Medicine, Center of Fetal Surgery, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Michael Bergner
- Department of Obstetrics and Prenatal Medicine, Center of Fetal Surgery, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Roland Haase
- Department of Pediatrics, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Holger Stepan
- Department of Obstetrics and Gynecology, University of Leipzig, Leipzig, Germany
| | | | - Janine Zöllkau
- Department of Obstetrics and Gynecology, University Hospital, Jena, Germany
| | - Sven Seeger
- Department of Gynaecology and Obstetrics, Perinatal Centre, Halle (Saale), Germany
| | - Frank Bernhard Kraus
- Central Laboratory, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Grit Gesine Ruth Hiller
- Institute for Pathology, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Andreas Wienke
- Interdisciplinary Center for Health Sciences, Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Michael Tchirikov
- Department of Obstetrics and Prenatal Medicine, Center of Fetal Surgery, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
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Krzystanek M, Romańczyk M, Surma S, Koźmin-Burzyńska A. Whole Body Cryotherapy and Hyperbaric Oxygen Treatment: New Biological Treatment of Depression? A Systematic Review. Pharmaceuticals (Basel) 2021; 14:ph14060595. [PMID: 34205729 PMCID: PMC8235744 DOI: 10.3390/ph14060595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/18/2021] [Accepted: 06/19/2021] [Indexed: 11/16/2022] Open
Abstract
Treatment with antidepressants is often insufficiently effective, especially in treatment-resistant depression. In such a situation, it is possible to change the drug, add a second antidepressant, or use pharmacological and non-pharmacological methods of augmenting the effect of pharmacotherapy. New methods that may fall into the scope of multi-module depression treatment as an augmentation of depression treatment are whole body cryotherapy (WBC) and hyperbaric oxygen treatment (HBOT). 545 records were selected and analyzed for these two treatments and finally three clinical trials were selected for analysis. The review also includes data on the possibility of using WBC and HBOT in somatic indications and in organic mental syndromes. Despite the small number of studies on the effectiveness of WBC or HBOT in depression, the current data show that both methods may be effective in the treatment of depression. WBC may be effective in the augmentation of antidepressants, and additionally, it is a method in which a quick antidepressant effect is obtained. HBOT may be effective in endogenous depression, just as it is effective in the treatment of somatic depression symptoms. The results are very preliminary, but if confirmed in subsequent studies, both WBC and HBOT may become new treatment options in treating depression. The authors point to the need and directions for further research into these treatment methods as an augmentation strategy for pharmacological treatment of depression.
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Affiliation(s)
- Marek Krzystanek
- Clinic of Psychiatric Rehabilitation, Department of Psychiatry and Psychotherapy, Faculty of Medical Sciences, Medical University of Silesia in Katowice, Ziołowa 45/47, 40-635 Katowice, Poland; (M.R.); (S.S.)
- Correspondence: or ; Tel.: +48-322059260 or +48-693281021; Fax: +48-322059260
| | - Monika Romańczyk
- Clinic of Psychiatric Rehabilitation, Department of Psychiatry and Psychotherapy, Faculty of Medical Sciences, Medical University of Silesia in Katowice, Ziołowa 45/47, 40-635 Katowice, Poland; (M.R.); (S.S.)
| | - Stanisław Surma
- Clinic of Psychiatric Rehabilitation, Department of Psychiatry and Psychotherapy, Faculty of Medical Sciences, Medical University of Silesia in Katowice, Ziołowa 45/47, 40-635 Katowice, Poland; (M.R.); (S.S.)
| | - Agnieszka Koźmin-Burzyńska
- Clinic of Psychiatric Rehabilitation, Leszek Giec Upper-Silesian Medical Centre of the Medical University of Silesia in Katowice, Ziołowa 45/47, 40-635 Katowice, Poland;
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Wen J, Xu F, Zhou Q, Hu H, Liu Y, Su J, Zhang Y, Qu W, Shi L. Dynamic changes and multiplication rate of white blood cell count may direct the timing of cytoreduction chemotherapy during induction treatment in newly diagnosed acute promyelocytic leukemia with low-intermediate risk. Mol Clin Oncol 2021; 14:112. [PMID: 33903818 PMCID: PMC8060852 DOI: 10.3892/mco.2021.2274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 03/12/2021] [Indexed: 11/23/2022] Open
Abstract
In order to explore the optimal timing for initiating cytoreduction chemotherapy following all-trans retinoic acid plus arsenic trioxide administration, 58 newly diagnosed patients with acute promyelocytic leukemia (APL) with low-intermediate mortality risk were retrospectively analyzed. During induction treatment, white blood cell (WBC) count >4x109/l and multiplication rate of WBC <3 days were defined as rapid WBC multiplication. Patients were divided into two groups: With or without rapid WBC multiplication. Comparison between the two groups revealed that the incidence of differentiation syndrome (DS) (48.1% vs. 6.5%; P<0.001), grade 3-4 bleeding (34.8% vs. 6.5%; P=0.022) and peak WBC count (30.4±20.0x109/l vs. 8.67±5.4x109/l; P<0.001) were significantly higher in the group with rapid WBC multiplication compared with in the group without rapid WBC multiplication. No significant differences were observed in bone marrow depression, infection, complete remission (CR) rate, time to achieve CR and early mortality rate between the two groups. Multivariate analysis revealed that WBC count at chemotherapy initiation was an independent risk factor for the occurrence of DS (P=0.040). Peak WBC count and rapid WBC multiplication were significantly associated with grade 3-4 bleeding (P=0.019 and P=0.002, respectively). Hence, WBC count at chemotherapy initiation along with its multiplication rate may direct the timing of cytoreduction chemotherapy during induction treatment in newly diagnosed APL with low-intermediate risk.
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Affiliation(s)
- Jingjing Wen
- Department of Hematology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan 621000, P.R. China
| | - Fang Xu
- Department of Hematology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan 621000, P.R. China
| | - Qiaolin Zhou
- Department of Hematology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan 621000, P.R. China
| | - Hong Hu
- Department of Hematology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan 621000, P.R. China
| | - Yiping Liu
- Department of Hematology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan 621000, P.R. China
| | - Jing Su
- Department of Hematology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan 621000, P.R. China
| | - Ya Zhang
- Department of Hematology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan 621000, P.R. China
| | - Wen Qu
- Department of Hematology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan 621000, P.R. China
| | - Lin Shi
- Department of Hematology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan 621000, P.R. China
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Tosounidis TH, Holton C, Giannoudis VP, Kanakaris NK, West RM, Giannoudis PV. Can CRP Levels Predict Infection in Presumptive Aseptic Long Bone Non-Unions? A Prospective Cohort Study. J Clin Med 2021; 10:425. [PMID: 33499272 DOI: 10.3390/jcm10030425] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/16/2021] [Accepted: 01/20/2021] [Indexed: 01/10/2023] Open
Abstract
Nonunion remains a major complication of the management of long bone fractures. The primary aim of the present study was to investigate whether raised levels of C-reactive protein (CRP) and white blood cell count (WBC), in the absence of clinical signs, are correlated with positive intraoperative tissue cultures in presumptive aseptic long-bone nonunions. Infection was classified as positive if any significant growth of microorganisms was observed from bone/tissue samples sent from the theater at the time of revision surgery. Preoperatively all patients were investigated with full blood count, white blood count differential as well as C-reactive protein (CRP). A total of 105 consecutive patients (59 males) were included in the study, with an average age of 46.76 years (range 16-92 years) at the time of nonunion diagnosis. The vast majority were femoral (56) and tibial (37) nonunions. The median time from the index surgical procedure to the time of nonunion diagnosis was 10 months (range 9 months to 10 years). Positive cultures revealed a mixed growth of microorganisms, with coagulase-negative Staphylococcus (56.4%) being the most prevalent microorganism, followed by Staphylococcusaureus (20.5%). Pseudomonas, Methicillin-Resistant Staphylococcus aureus (MRSA), coliforms and micrococcus were present in the remainder of the cases (23.1%). Overall, the risk of infection with normal CRP levels (<10 mg/L) was 21/80 = 0.26. Elevated CRP levels (≥10 mg/L) increased the risk of infection to 0.72. The relative risk given a positive CRP test was RR = 0.72/0.26 = 2.74. Overall, the WBC count was found to be an unreliable marker to predict infection. Solid union was achieved in all cases after an average of 6.5 months (3-24 months) from revision surgery. In patients with presumed aseptic long bone nonunion and normal CRP levels, the risk of underlying low-grade indolent infection can be as high as 26%. Patients should be made aware of this finding, which can complicate their treatment course and outcomes.
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Goldberg I, Shalmon D, Shteinvil R, Wasserman A, Berliner S, Levinson T, Shapira I, Shenhar-Tsarfaty S, Meilik A, Goldiner I, Ziv-Baran T, Sprecher E, Ritter O, Rogowski O. The superiority of 72 h leukocyte descent over CRP for mortality prediction in patients with sepsis. Clin Chim Acta 2021; 514:34-9. [PMID: 33333041 DOI: 10.1016/j.cca.2020.12.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/27/2020] [Accepted: 12/09/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Detection of an eventful course in the early days of sepsis treatment is clinically relevant. The white blood cell count (WBCC) and C-reactive protein (CRP) are used in daily practice to monitor the intensity of the inflammatory response associated with sepsis. It is not entirely clear which of the two might better discriminate the outcomes of patients with sepsis. METHODS 30-day mortality was assessed in a cohort of patients who were hospitalized with sepsis in the departments of Internal Medicine in a tertiary medical center. Admission and 72-hour time points were analyzed to discriminate between patients with increased versus decreased 30 days mortality risk. RESULTS The study included 195 patients. Higher 72 h CRP, WBCC, neutrophil counts and neutrophils to lymphocyte ratio were associated with increased mortality (p < 0.02). Baseline WBCC and CRP failed to discriminate between patients who died and those who survived (AUC = 0.551, 0.479). In multivariate analysis of the 72 h tests, higher WBCC count (OR = 1.12, 95%CI 1.05-1.20, p = 0.001), was associated with increased mortality whereas CRP was not (OR = 1.004, 95%CI 0.998-1.01, p = 0.146). CONCLUSION Patients who presented a 72-hour leukocyte descent had a better outcome and in this regard, WBCC was superior to 72-hour CRP in predicting 30 days mortality.
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Fan Y, Chen X, Li H. Clinical value of serum biomarkers CA153, CEA, and white blood cells in predicting sentinel lymph node metastasis of breast cancer. Int J Clin Exp Pathol 2020; 13:2889-2894. [PMID: 33284901 PMCID: PMC7716139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 09/14/2020] [Indexed: 06/12/2023]
Abstract
We retrospectively analyzed preoperative serum CA153, carcinoembryonic antigen (CEA) and white blood cells (WBC) in 121 breast cancer patients who underwent breast-conserving therapy and sentinel lymph node biopsy (SLNB) between June 2017 and April 2019 in our institution. The receiver operating characteristic curve (ROC curve) was used to determine the optional cut-offs of these biomarkers for predicting SLN metastasis. The relationship between the parameters to SLN metastasis of breast cancer was assessed by univariate analysis and multivariate logistic regression models. We finally enrolled 121 breast cancer patients who all underwent SLNB, of whom 56 were confirmed as positive SLN by histopathology. ROC curve analysis calculated an ideal CA153 cutoff value of 7.85 U/ml in prediction of SLN metastasis, with a sensitivity of 73.2%, and specificity of 67.7%. The ideal cutoff value for CEA to predict SLN metastasis was 1.66 ng/ml (sensitivity 67.9%, specificity 73.8%). CA153 combined with CEA showed specificity 78.6% and specificity 76.9%. CA153 and CEA combined with WBC presented sensitivity 80.4% and specificity 78.5%. In the multivariate logistic regression analysis, CA153 (odds ratio (OR): 1.165, 95% confidence interval (CI) 1.061-1.279, P<0.001) and CEA (OR: 3.440, 95% CI: 1.859-6.366, P<0.001) were independent predictive factors of SLN metastasis in patients with breast cancer.
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Affiliation(s)
- Yuan Fan
- Department of Breast Surgery, West China Hospital of Sichuan University Chengdu, Sichuan, China
| | - Xiuyuan Chen
- Department of Breast Surgery, West China Hospital of Sichuan University Chengdu, Sichuan, China
| | - Hongjiang Li
- Department of Breast Surgery, West China Hospital of Sichuan University Chengdu, Sichuan, China
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Ferrari D, Motta A, Strollo M, Banfi G, Locatelli M. Routine blood tests as a potential diagnostic tool for COVID-19. Clin Chem Lab Med 2020; 58:1095-1099. [PMID: 32301746 DOI: 10.1515/cclm-2020-0398] [Citation(s) in RCA: 140] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 04/06/2020] [Indexed: 01/19/2023]
Abstract
Objectives The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to date, the epidemic has gradually spread to 209 countries worldwide with more than 1.5 million infected people and 100,000 deaths. Amplification of viral RNA by rRT-PCR serves as the gold standard for confirmation of infection, yet it needs a long turnaround time (3-4 h to generate results) and shows false-negative rates as large as 15%-20%. In addition, the need of certified laboratories, expensive equipment and trained personnel led many countries to limit the rRT-PCR tests only to individuals with pronounced respiratory syndrome symptoms. Thus, there is a need for alternative, less expensive and more accessible tests. Methods We analyzed the plasma levels of white blood cells (WBCs), platelets, C-reactive protein (CRP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyl transpeptidase (GGT), alkaline phosphatase and lactate dehydrogenase (LDH) of 207 patients who, after being admitted to the emergency room of the San Raffaele Hospital (Milan, Italy) with COVID-19 symptoms, were rRT-PCR tested. Of them, 105 tested positive, whereas 102 tested negative. Results Statistically significant differences were observed for WBC, CRP, AST, ALT and LDH. Empirical thresholds for AST and LDH allowed the identification of 70% of either COVID-19-positive or -negative patients on the basis of routine blood test results. Conclusions Combining appropriate cutoffs for certain hematological parameters could help in identifying false-positive/negative rRT-PCR tests. Blood test analysis might be used as an alternative to rRT-PCR for identifying COVID-19-positive patients in those countries which suffer from a large shortage of rRT-PCR reagents and/or specialized laboratory.
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Affiliation(s)
- Davide Ferrari
- SCVSA Department, University of Parma, Parma, Italy.,Laboratory Medicine Service, San Raffaele Hospital, Milan, Italy, Phone: +39 0521 906633, Fax: +39 0521 905151
| | - Andrea Motta
- Laboratory Medicine Service, San Raffaele Hospital, Milan, Italy
| | - Marta Strollo
- Laboratory Medicine Service, San Raffaele Hospital, Milan, Italy
| | - Giuseppe Banfi
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Vita-Salute University, San Raffaele, Milan, Italy
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Prasad P, Sarkar N, Sinha D. Effect of low- and high-level groundwater arsenic on peripheral blood and lung function of exposed rural women. Regul Toxicol Pharmacol 2020; 115:104684. [PMID: 32454235 DOI: 10.1016/j.yrtph.2020.104684] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 05/01/2020] [Accepted: 05/03/2020] [Indexed: 11/16/2022]
Abstract
The World Health Organization (WHO) recommended maximum contaminant level (MCL) of arsenic (As) in drinking water at 10 μg/L. Many Asian countries still have their MCL for As at 50 μg/L. The current cross sectional study was conducted on asymptomatic females (without As related skin lesions) selected from rural areas of West Bengal, Baruipur and Dhamakhali [low As 11-50 μg/L; N,93]; Kamardanga & Sibhati [high As>50 μg/L; N,70] and Boria [Control; As<10 μg/L N,118] of West Bengal, India. The study was designed to compare the status of peripheral blood and lung function due to prolonged As exposure. The lung function parameters were considered according to Miller's prediction quadrant - FVC less than 80% indicated restrictive lung, FEV1/FVC less than 70% showed obstructive lung and both FVC and FEV1/FVC less than predicted percentage exhibited combined lung function decrement. The study showed that groundwater As concentration [22.5 ± 19.2 (low), 67.8 ± 26.9 (high) and 1.02 ± 2.3 μg/L (control)] was correlated with nail As content of the enrolled women. Linear regression depicted that nail As content influenced reduction of haemoglobin (β: 0.43; 95%CI: 0.02 to -0.006; p = 0.0001) and CD56+ NK cells (β: 0.53; 95%CI: 0.07 to -0.03; p = 0.0001) per 1 μg/g increase in As in nails. Multivariate logistic regression exhibited that nail As content was associated with reduction of lung function parameters [FEV1 (Exp B:1.04; 95%CI: 1.022 to 1.055; p = 0.0001) and FVC (Exp B:1.05; 95%CI: 1.03 to 1.07; p = 0.0001) per 1 μg/g increase in As in nails. Hence the study may be indicative of the fact that even in asymptomatic women, increase in chronic As exposure may weaken immune surveillance and provoke respiratory ailments.
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Affiliation(s)
- Priyanka Prasad
- Department of Receptor Biology and Tumor Metastasis, Chittaranjan National Cancer Institute, 37, S.P. Mukherjee Road, Kolkata 700026, India
| | - Nivedita Sarkar
- Department of Receptor Biology and Tumor Metastasis, Chittaranjan National Cancer Institute, 37, S.P. Mukherjee Road, Kolkata 700026, India
| | - Dona Sinha
- Department of Receptor Biology and Tumor Metastasis, Chittaranjan National Cancer Institute, 37, S.P. Mukherjee Road, Kolkata 700026, India.
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Kim EM, Jeong HJ, Lim ST, Sohn MH. Analysis of Cell Fraction of <sup>99</sup>mTc-HMPAO Radiolabeled Leukocytes. Curr Radiopharm 2020; 13:142-148. [PMID: 32386504 DOI: 10.2174/1874471013666200510015742] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 03/05/2020] [Accepted: 03/06/2020] [Indexed: 11/22/2022]
Abstract
PURPOSE 99mTc-HMPAO radiolabeled autologous leukocyte scintigraphy is routinely used clinically for infection imaging. Leukocytes are mostly separated via sedimentation. It is unknown whether leukocytes are clearly separated by sedimentation or selectively labeled. Therefore, in this study, the blood cell numbers were investigated after leukocyte radiolabeling to identify the cells strongly radiolabeled by 99mTc-HMPAO. METHODS This study was performed with leftover blood samples of the patients who underwent 99mTc-HMPAO scintigraphy at Chonbuk National University Hospital (2018-2019). The blood of 22 patients was drawn for 99mTc-HMPAO scintigraphy. WBCs were separated via conventional sedimentation at our clinic and radiolabeled. The concentration of cell components was determined using an automatic hematology analyzer. The cells in the final sample injectate sample were separated using Histopaque and counted with a dose calibrator. RESULTS The average numbers of RBCs, WBCs, and PLTs in the final injection sample were 79 ± 33, 23.26 ± 11.95, and 229.5 ± 206.57 x 103/μL, respectively. The PLT number was almost 10-fold the number of WBCs. The number of RBCs was nearly 3-fold higher than WBCs [RBC/WBC ratio = 4.67 ± 3.58, and PLT/WBC ratio = 10.65 ± 12.46]. Following Histopaque separation, the activity of each layer showed 99mTc-HMPAO labeling of WBC > RBC > PLT in order. The total activity/cell numbers of WBCs, RBCs and PLTs were 0.016 ± 0.010, 0.005 ± 0.005 and 0.003 ± 0.002, respectively (p > 0.05). CONCLUSION Although the numbers of RBCs and PLTs were highly increased after sedimentation, their individual cellular activity was lower than that of WBCs. 99mTc-HMPAO was more selective to WBCs than RBCs or PLTs. In conclusion, a higher number of WBCs were radiolabeled compared with RBCs and PLTs.
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Affiliation(s)
- Eun-Mi Kim
- Department of Nuclear Medicine, Molecular Imaging and Therapeutic Medicine Research Center, Research Institute of Clinical Medicine of Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Jeonbuk, Korea
| | - Hwan-Jeong Jeong
- Department of Nuclear Medicine, Molecular Imaging and Therapeutic Medicine Research Center, Research Institute of Clinical Medicine of Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Jeonbuk, Korea
| | - Seok-Tae Lim
- Department of Nuclear Medicine, Molecular Imaging and Therapeutic Medicine Research Center, Research Institute of Clinical Medicine of Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Jeonbuk, Korea
| | - Myung-Hee Sohn
- Department of Nuclear Medicine, Molecular Imaging and Therapeutic Medicine Research Center, Research Institute of Clinical Medicine of Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Jeonbuk, Korea
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Kim MJ, Lee EB, Song YW, Park JK. Profile of common inflammatory markers in treatment-naïve patients with systemic rheumatic diseases. Clin Rheumatol 2020; 39:2899-906. [PMID: 32314175 DOI: 10.1007/s10067-020-05049-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/12/2020] [Accepted: 03/18/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To evaluate and compare the clinical implications of common inflammatory markers in systemic rheumatic diseases (SRDs). METHOD We investigated the profiles of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and white blood cell (WBC) count in treatment-naïve patients with SRDs, osteoarthritis and pneumonia diagnosed at Seoul National University Hospital during 2004-2016. SRDs included rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), ankylosing spondylitis (AS), systemic sclerosis (SSc), idiopathic inflammatory myopathy (IIM) and adult-onset Still's disease (AOSD). Associations between inflammatory markers were evaluated using Pearson's correlation and regression analysis. ROC curve analysis was performed to examine the predictive value of inflammatory markers for SRD diagnosis. RESULTS We identified a total of 1191 patients. Leukocytosis was present in < 20% SRD patients. There was marked variability in ESR and CRP levels among different SRDs. The highest mean CRP levels (mean ± SD, mg/dL) were observed in AOSD (11.3 ± 7.9), followed by RA (2.0 ± 3.3), IIM (1.8 ± 3.5), SLE (1.5 ± 3.1), SSc (0.6 ± 1.3) and AS (0.08 ± 0.1). Mean ESR (mm/h) was also highest in AOSD (71.2 ± 31.0), followed by SLE (47.3 ± 34.2), RA (45.5 ± 30.6), IIM (40.8 ± 24.8) and SSc (27.8 ± 26.0). All SRDs showed significant positive correlations between ESR and CRP: greatest in RA (r = 0.53, p < 0.001) and weakest in SLE (r = 0.20, p = 0.03). WBC correlated weakly with CRP but not with ESR in most SRDs. While the AUC for WBC count was less than that of ESR or CRP, the AUC for ESR and CRP were similar in SRD. The optimal cuff-off values for inflammatory markers predicting SRD were within or slightly above the normal limit. CONCLUSIONS ESR, CRP and WBC are not always elevated in treatment-naïve patients with SRD. Individual SRDs have a unique profile of inflammatory markers. However, routine inflammatory markers should still be interpreted with caution when diagnosing and assessing disease activity in those with SRD. Key Points •Leukocytosis and elevation of ESR and CRP are not always present in all systemic rheumatic diseases. •Inflammatory markers are often dissociated and they are not specific for disease diagnosis. •Better biomarkers, which measure disease-specific local and systemic inflammation, are needed.
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Salman A, Lapidot I, Shufan E, Agbaria AH, Porat Katz BS, Mordechai S. Potential of infrared microscopy to differentiate between dementia with Lewy bodies and Alzheimer's diseases using peripheral blood samples and machine learning algorithms. J Biomed Opt 2020; 25:1-15. [PMID: 32329265 PMCID: PMC7177186 DOI: 10.1117/1.jbo.25.4.046501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 04/09/2020] [Indexed: 06/11/2023]
Abstract
SIGNIFICANCE Accurate and objective identification of Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) is of major clinical importance due to the current lack of low-cost and noninvasive diagnostic tools to differentiate between the two. Developing an approach for such identification can have a great impact in the field of dementia diseases as it would offer physicians a routine objective test to support their diagnoses. The problem is especially acute because these two dementias have some common symptoms and characteristics, which can lead to misdiagnosis of DLB as AD and vice versa, mainly at their early stages. AIM The aim is to evaluate the potential of mid-infrared (IR) spectroscopy in tandem with machine learning algorithms as a sensitive method to detect minor changes in the biochemical structures that accompany the development of AD and DLB based on a simple peripheral blood test, thus improving the diagnostic accuracy of differentiation between DLB and AD. APPROACH IR microspectroscopy was used to examine white blood cells and plasma isolated from 56 individuals: 26 controls, 20 AD patients, and 10 DLB patients. The measured spectra were analyzed via machine learning. RESULTS Our encouraging results show that it is possible to differentiate between dementia (AD and DLB) and controls with an ∼86 % success rate and between DLB and AD patients with a success rate of better than 93%. CONCLUSIONS The success of this method makes it possible to suggest a new, simple, and powerful tool for the mental health professional, with the potential to improve the reliability and objectivity of diagnoses of both AD and DLB.
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Affiliation(s)
- Ahmad Salman
- Shamoon College of Engineering, Department of Physics, Beer-Sheva, Israel
| | - Itshak Lapidot
- Afeka Tel-Aviv Academic College of Engineering, Afeka Center for Language Processing, Department of Electrical and Electronics Engineering, Tel-Aviv, Israel
| | - Elad Shufan
- Shamoon College of Engineering, Department of Physics, Beer-Sheva, Israel
| | - Adam H. Agbaria
- Ben-Gurion University of the Negev, Department of Physics, Faculty of Natural Sciences, Beer-Sheva, Israel
| | - Bat-Sheva Porat Katz
- The Hebrew University of Jerusalem, School of Nutritional Sciences, The Robert H. Smith Faculty of Agriculture, Food, and Environment, Rehovot, Israel
- Kaplan Medical Center, Rehovot, Israel
| | - Shaul Mordechai
- Ben-Gurion University of the Negev, Department of Physics, Faculty of Natural Sciences, Beer-Sheva, Israel
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Tripon F, Iancu M, Trifa A, Crauciuc GA, Boglis A, Dima D, Lazar E, Bănescu C. Modelling the Effects of MCM7 Variants, Somatic Mutations, and Clinical Features on Acute Myeloid Leukemia Susceptibility and Prognosis. J Clin Med 2020; 9:E158. [PMID: 31936215 DOI: 10.3390/jcm9010158] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 12/21/2019] [Accepted: 01/06/2020] [Indexed: 12/13/2022] Open
Abstract
The main objective of the study was to evaluate the associations between MCM7 rs2070215, rs1527423, and rs1534309 single nucleotide polymorphisms (SNPs) and acute myeloid leukemia (AML) risk and prognosis. The secondary objectives were to assess if any relationships existed between the mentioned SNPs and FLT3, DNMT3A, NPM1 mutations with clinical outcomes and overall survival (OS) in AML patients. We investigated 281 AML cases and 405 healthy subjects. The results showed a significant association between a variant allele of rs2070215 (p = 0.007), CAT haplotype (p = 0.012), and AML susceptibility. No significant association was found between MCM7 variant genotypes and overall survival of AML patients (p > 0.05), while several associations between somatic mutations, clinical and biological features, and poor OS were noticed. Lactate dehydrogenase (LDH) level ≥ 600 IU/L had a significant effect on the hazard of death (p = 0.004, HR = 1.49, 95% CI: 1.13–1.95). Our study showed that the variant allele of rs2070215, in the allelic model, and CAT haplotype were associated with AML susceptibility. The investigated FLT3, DNMT3A, and NPM1 mutations were associated with the clinical and biological features and poor OS. LDH level ≥ 600 IU/L was associated with an increased hazard of death and this association remained significant when quantifying for effect modification by FLT3 mutation status.
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Abstract
The S100 family proteins possess a variety of intracellular and extracellular functions. They interact with multiple receptors and signal transducers to regulate pathways that govern inflammation, cell differentiation, proliferation, energy metabolism, apoptosis, calcium homeostasis, cell cytoskeleton and microbial resistance. S100 proteins are also emerging as novel diagnostic markers for identifying and monitoring various diseases. Strategies aimed at targeting S100-mediated signaling pathways hold a great potential in developing novel therapeutics for multiple diseases. In this chapter, we aim to summarize the current knowledge about the role of S100 family proteins in health and disease with a major focus on their role in inflammatory conditions.
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Affiliation(s)
| | - Michelle C Flynn
- Division of Immunometabolism, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Mallikarjun Patil
- Department of Biomedical Engineering, Schools of Medicine and Engineering, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Prasanna Krishnamurthy
- Department of Biomedical Engineering, Schools of Medicine and Engineering, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Andrew J Murphy
- Division of Immunometabolism, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia; Department of Immunology, Monash University, Melbourne, VIC, Australia
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TSUBOKURA M, NABESHIMA Y, MURAKAMI M, NEMOTO T, KAMBE T, NONAKA S, SHIMADA Y, KOBASHI Y, OZAKI A, OIKAWA T. Usefulness of the whole-body counter for infants and small children (BABYSCAN) as a risk communication tool after the Fukushima Daiichi nuclear power plant incident. Proc Jpn Acad Ser B Phys Biol Sci 2020; 96:70-78. [PMID: 32037370 PMCID: PMC7030972 DOI: 10.2183/pjab.96.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Responding to the radiation-related concerns of parents/guardians with infants/small children is an important public health issue for regional recovery after radioactive contamination. This study summarizes the results of a systematic internal contamination screening of infants/small children, aged 0-6 years, using BABYSCAN and individual counselling sessions with physicians about radiation concerns from 2014 to 2018 in Minamisoma City. Of 3,114 participants, no one was found to have internal contamination with radioactive caesium with a detection limit of 50 Bq/body. The questionnaire survey showed a decreasing trend of concerns about food contamination and playing outside as possible causes of internal contamination over time. Because people's concerns were diverse in counselling sessions, individual responses are required. This study showed that examinations using BABYSCAN provide an opportunity for direct dialogue between the parents/guardians of infants/small children and experts. This can be considered a model case for risk communication conducted by the local government after a radioactive contamination incident.
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Affiliation(s)
- Masaharu TSUBOKURA
- Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
- Ionizing Radiation Epidemiology Laboratory, Institute for Radiological Protection and Nuclear Safety, Fontenay-aux-Roses, France
- Correspondence should be addressed: M. Tsubokura, Research Center for Community Health, Minamisoma Municipal General Hospital, 2-54-6 Takami-cho, Haramachi-ku, Minamisoma, Fukushima 975-0033, Japan (e-mail: )
| | - Yuko NABESHIMA
- Kawauchi Village National Health Insurance Clinic, Kawauchi, Fukushima, Japan
| | - Michio MURAKAMI
- Department of Health Risk Communication, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tsuyoshi NEMOTO
- Department of Surgery, Kashima Kosei Hospital, Minamisoma, Fukushima, Japan
| | - Toshiyuki KAMBE
- Department of Internal Medicine, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
| | - Saori NONAKA
- Department of Internal Medicine, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
| | - Yuki SHIMADA
- Department of Neurosurgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
| | - Yurie KOBASHI
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Akihiko OZAKI
- Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
- Department of Breast Surgery, Jyoban Hospital, Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Tomoyoshi OIKAWA
- Department of Neurosurgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
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Fancourt D, Steptoe A. The longitudinal relationship between changes in wellbeing and inflammatory markers: Are associations independent of depression? Brain Behav Immun 2020; 83:146-152. [PMID: 31604140 PMCID: PMC6928572 DOI: 10.1016/j.bbi.2019.10.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 09/30/2019] [Accepted: 10/03/2019] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES There is a large literature linking inflammation with mental ill health, but a much smaller literature focusing on mental wellbeing. Specifically, it remains unclear whether mental wellbeing is longitudinally and independently associated with inflammation or only via associated changes in mental ill health. METHODS This study used data from 8780 adults aged 50+ in the English Longitudinal Study of Ageing. Hedonic wellbeing (both positive affect and life satisfaction) and eudemonic wellbeing (self-realisation and control-autonomy) were measured at data collection waves 2 (2004/05), 4 (2008/09) and 6 (20012/13), along with measures of C-reactive protein (CRP), fibrinogen and white blood cells (WBC). Fixed effects modelling was performed to identify the longitudinal relationship between wellbeing and inflammation, adjusting for time-varying mental ill health and other identified confounders. RESULTS Both measured aspects of hedonic wellbeing were associated with lower WBC count, independent of mental ill health. For life satisfaction, this relationship was explained by confounders, whilst for positive affect it persisted. Both measured aspects of eudemonic wellbeing were associated with lower CRP, fibrinogen and WBC, independent of mental ill health. For control-autonomy, this relationship was explained by confounders, whilst for self-realisation it persisted. Results were present in both men and women, although more strongly in men, and were robust to a range of sensitivity analyses. CONCLUSIONS This study builds on the strong literature showing a relationship between mental ill health and inflammation by showing that there is also an apparently independent relationship between mental wellbeing, in particular eudemonic wellbeing, and inflammation that is unexplained by socio-economic or other time-constant factors and in some instances persists independent of time-varying confounders.
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Affiliation(s)
- Daisy Fancourt
- Department of Behavioural Science and Health, University College London, United Kingdom.
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Jung GH, Hwang HK, Lee WJ, Kang CM. Extremely high white blood cell counts on postoperative day 1 do not predict severe complications following distal pancreatectomy. Ann Hepatobiliary Pancreat Surg 2019; 23:377-384. [PMID: 31825005 PMCID: PMC6893049 DOI: 10.14701/ahbps.2019.23.4.377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 07/14/2019] [Accepted: 07/25/2019] [Indexed: 11/17/2022] Open
Abstract
Backgrounds/Aims Distal pancreatectomy(DP) is associated with high morbidity. In clinical practice, postoperative white blood cell(WBC) counts are useful indicators of infection complications. The aim of this study was to determine the relevance of extremely high postoperative day (POD)1 WBC counts after DP and their relationship to perioperative outcomes. Methods From December 2005 to December 2016, data from patients who had open or minimally invasive DP surgery (robot or laparoscopy, MIS) for benign or borderline malignant tumors were retrospectively reviewed. Patients were divided into groups based on POD1 WBC count (>20K, High and <20K, Low) for comparisons. Results Twelve patients (4.6%) were categorized into the High group. There were significant differences in age (p=0.019), BMI (p=0.010), and spleen-preserving rate (p=0.002) between the High and Low groups. In binary logistic regression analysis, the risk factors for severe complication was age (p=0.032) and open DP (p=0.005), not POD1 WBC count. Conclusions Extremely high WBC count after POD1 after DP was not associated with severe complications, but was associated with splenectomy. Surgical methods and age were associated with severe complications.
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Affiliation(s)
- Gun Hee Jung
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Ho Kyoung Hwang
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.,Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.,Pancreatobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, Korea
| | - Woo Jung Lee
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.,Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.,Pancreatobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, Korea
| | - Chang Moo Kang
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.,Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.,Pancreatobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, Korea
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Sollini M, Lauri C, Boni R, Lazzeri E, Erba PA, Signore A. Current Status of Molecular Imaging in Infections. Curr Pharm Des 2019; 24:754-771. [PMID: 29318965 DOI: 10.2174/1381612824666180110103348] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 10/01/2017] [Accepted: 11/01/2017] [Indexed: 11/22/2022]
Abstract
There is an increased need to find non-invasive tools for early diagnosis and follow-up of infections. Nuclear medicine techniques may be used to diagnose, localize and evaluate the severity and the extent of infections before the occurrence of anatomical abnormalities. This review focuses on different approaches based on radiolabelled cells, peptides and antibodies or [18F]FDG to image infective diseases in agreement with what is being jointly evaluated by the European Association of Nuclear Medicine (EANM). This is particularly relevant, since the EANM has strated a wide program of collaboration with other European clinical societies to define common diagnostic flow-charts in many of these infective diseases. It emerges the role of radiolabelled WBC by SPECT/CT for prosthetic joint infections and of FDG by PET/CT for spondylodiscitis. Comparable values of accuracy have been described for WBC and FDG in the diagnosis of vascular fgraft infections, diabetic gfoot, endocarditis and peripheral bone osteomyelitis, with some exceptions.
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Affiliation(s)
- Martina Sollini
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Chiara Lauri
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Roberto Boni
- Nuclear Medicine Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Elena Lazzeri
- Regional Center of Nuclear Medicine, Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - Paola Anna Erba
- Regional Center of Nuclear Medicine, Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - Alberto Signore
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy
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Picharski GL, Andrade DP, Fabro ALMR, Lenzi L, Tonin FS, Ribeiro RC, Figueiredo BC. The Impact of Flt3 Gene Mutations in Acute Promyelocytic Leukemia: A Meta-Analysis. Cancers (Basel) 2019; 11:E1311. [PMID: 31492033 DOI: 10.3390/cancers11091311] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 08/29/2019] [Accepted: 08/30/2019] [Indexed: 12/21/2022] Open
Abstract
The association of FLT3 mutations with white blood cell (WBC) counts at diagnosis and early death was studied in patients with acute promyelocytic leukemia (APL). Publications indexed in databases of biomedical literature were analyzed. Potential publication bias was evaluated by analyzing the standard error in funnel plots using the estimated relative risk (RR). Mixed-effect models were used to obtain the consolidated RR. All analyses were conducted using the R statistical software package. We used 24 publications in the final meta-analysis. Of 1005 males and 1376 females included in these 24 publications, 645 had FLT3-ITD (internal tandem duplication) mutations. Information on FLT3-D835 mutations was available in 10 publications for 175 patients. Concurrent occurrence of the two mutations was rare. WBC count at diagnosis was ≥10 × 109/L in 351 patients. For patients with the FLT3-ITD mutation, RR was 0.59 for overall survival (OS) and 1.62 for death during induction. For those with FLT3-D835 mutations, the RR was 0.50 for OS and 1.77 for death during induction. RR for WBC count ≥10 × 109/L was 3.29 and 1.48 for patients with FLT3-ITD and FLT3-D835, respectively. APL patients with FLT3-ITD or FLT3-D835 are more likely to present with elevated WBC counts and poorer prognosis than those without these mutations.
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Kaur A, Sandhu A, Kaur T, Bhullar RS, Dhawan A, Kaur J. Correlation Between Clinical Course and Biochemical Analysis in Odontogenic Space Infections. J Maxillofac Oral Surg 2019; 18:203-209. [PMID: 30996539 PMCID: PMC6441441 DOI: 10.1007/s12663-018-1132-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 06/15/2018] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE To correlate the clinical course and biochemical analysis in odontogenic space infections. METHODS A randomized prospective study was undertaken in 50 patients presenting with infections of odontogenic origin. The data were subjected to statistical analysis to co-relate the values of CRP, WBC count and ESR with the clinical course of odontogenic infections. The statistical analysis was carried out using SPSS Version 17.0 clinical parameters included pain, swelling, mouth opening, dyspnea, dysphagia, hoarseness, body temperature, active discharge, length of hospital stay and number of fascial spaces involved. RESULTS There was a significant correlation between all the clinical parameters and biochemical markers preoperatively as well as on various postoperative days. CONCLUSION According to the percentage rate of fall, CRP was considered as the best indicator of clinical course/recovery of the patient, followed by WBC count and ESR, respectively.
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Affiliation(s)
- Amreen Kaur
- Department of Oral and Maxillofacial Surgery, Sri Guru Ram Das Institute of Dental Sciences and Research, Mall Mandi, Amritsar, Punjab 143006 India
| | - Amneet Sandhu
- Department of Oral and Maxillofacial Surgery, Sri Guru Ram Das Institute of Dental Sciences and Research, Mall Mandi, Amritsar, Punjab 143006 India
| | - Tejinder Kaur
- Department of Oral and Maxillofacial Surgery, Sri Guru Ram Das Institute of Dental Sciences and Research, Mall Mandi, Amritsar, Punjab 143006 India
| | - Ramandeep Singh Bhullar
- Department of Oral and Maxillofacial Surgery, Sri Guru Ram Das Institute of Dental Sciences and Research, Mall Mandi, Amritsar, Punjab 143006 India
| | - Amit Dhawan
- Department of Oral and Maxillofacial Surgery, Sri Guru Ram Das Institute of Dental Sciences and Research, Mall Mandi, Amritsar, Punjab 143006 India
| | - Jasmine Kaur
- Department of Oral and Maxillofacial Surgery, Sri Guru Ram Das Institute of Dental Sciences and Research, Mall Mandi, Amritsar, Punjab 143006 India
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Zhang Y, Zhou S, Zhou J, Wang D, Zhou T. Regulation of NF-κB/MAPK signaling pathway attenuates the acute lung inflammation in Klebsiella pneumonia rats by mollugin treatment. Microb Pathog 2019; 132:369-373. [PMID: 31075430 DOI: 10.1016/j.micpath.2019.05.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 05/02/2019] [Accepted: 05/06/2019] [Indexed: 11/27/2022]
Abstract
Present study evaluates the protective effect of mollugin against Klebsiella pneumonia (KP) and also postulates the possible mechanism of its action. Klebsiella pneumoniae (2.4 × 108 CFU/ml) was used for the induction of KP. PMNs and WBC count was determined in the blood and bronchoalveolar lavage fluid (BALF) of Klebsiella pneumonia rat. Level of inflammatory cytokines in the blood of Klebsiella pneumonia rat was determined by ELISA methods. Moreover effect of mollugin was estimated by Western blot assay and RT-PCR method. Result of the study suggests that water content in lung was reduced in the mollugin treated group compared to pneumonia control group of rats. Count of PMNs and WBC were found to be reduced in mollugin treated group compared to pneumonia control group of rats. Level of inflammatory cytokines was also found to be reduced in the blood of mollugin treated group than pneumonia control group. Moreover treatment with mollugin attenuates the altered expression of p-MAPK, p-JNK and p-ERK protein and mRNA expression of NF-κB in the lung tissues of Klebsiella pneumonia rat. In conclusion, data of the study reveals that treatment with mollugin ameliorates Klebsiella pneumonia rat by reducing the lung inflammation. Inflammation of lung tissue was reduced by regulating the NF-κB/MAPK signaling pathway in mollugin treated group.
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Affiliation(s)
- Yuedan Zhang
- Department of Emergency, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Changzhou, 213003, Jiangsu, People's Republic of China
| | - Shujun Zhou
- Department of Critical Care Medicine, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Changzhou, 213003, Jiangsu, People's Republic of China
| | - Jun Zhou
- Department of Respiratory Medicine, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Changzhou, 213003, Jiangsu, People's Republic of China
| | - Daming Wang
- Department of Emergency, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Changzhou, 213003, Jiangsu, People's Republic of China
| | - Ti Zhou
- Department of Respiratory Medicine, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Changzhou, 213003, Jiangsu, People's Republic of China.
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Davis S, Shesser R, Authelet K, Pourmand A. "Bandemia" without leukocytosis: A potential Emergency Department diagnostic pitfall. Am J Emerg Med 2019; 37:1970-1. [PMID: 30955925 DOI: 10.1016/j.ajem.2019.03.050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 03/28/2019] [Indexed: 11/21/2022] Open
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Berky AJ, Ryde IT, Feingold B, Ortiz EJ, Wyatt LH, Weinhouse C, Hsu-Kim H, Meyer JN, Pan WK. Predictors of mitochondrial DNA copy number and damage in a mercury-exposed rural Peruvian population near artisanal and small-scale gold mining: An exploratory study. Environ Mol Mutagen 2019; 60:197-210. [PMID: 30289587 PMCID: PMC6452630 DOI: 10.1002/em.22244] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 07/22/2018] [Accepted: 07/31/2018] [Indexed: 05/22/2023]
Abstract
Mitochondrial DNA (mtDNA) copy number (CN) and damage in circulating white blood cells have been proposed as effect biomarkers for pollutant exposures. Studies have shown that mercury accumulates in mitochondria and affects mitochondrial function and integrity; however, these data are derived largely from experiments in model systems, rather than human population studies that evaluate the potential utility of mitochondrial exposure biomarkers. We measured mtDNA CN and damage in white blood cells (WBCs) from 83 residents of nine communities in the Madre de Dios region of the Peruvian Amazon that vary in proximity to artisanal and small-scale gold mining. Prior research from this region reported high levels of mercury in fish and a significant association between food consumption and human total hair mercury level of residents. We observed that mtDNA CN and damage were both associated with consumption of fruit and vegetables, higher diversity of fruit consumed, residential location, and health characteristics, suggesting common environmental drivers. Surprisingly, we observed negative associations of mtDNA damage with both obesity and age. We did not observe any association between total hair mercury or, in contrast to previous results, age, with either mtDNA damage or CN. The results of this exploratory study highlight the importance of combining epidemiological and laboratory research in studying the effects of stressors on mitochondria, suggesting that future work should incorporate nutritional and social characteristics, and caution should be taken when applying conclusions from epidemiological studies conducted in the developed world to other regions, as results may not be easily translated. Environ. Mol. Mutagen. 60: 197-210, 2019. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Axel J. Berky
- Nicholas School of the Environment, Box 90328, Duke University, Durham, NC 27708, USA
| | - Ian T. Ryde
- Nicholas School of the Environment, Box 90328, Duke University, Durham, NC 27708, USA
| | - Beth Feingold
- University of Albany, School of Public Health, Rensselaer, NY 12144, USA
| | - Ernesto J. Ortiz
- Duke Global Health Institute, Duke University, 310 Trent Dr, Durham, NC 27710, USA
| | - Lauren H. Wyatt
- Nicholas School of the Environment, Box 90328, Duke University, Durham, NC 27708, USA
| | - Caren Weinhouse
- Duke Global Health Institute, Duke University, 310 Trent Dr, Durham, NC 27710, USA
| | - Heileen Hsu-Kim
- Department of Civil and Engineering, Box 90287, Duke University, Durham, NC 27708, USA
| | - Joel N. Meyer
- Nicholas School of the Environment, Box 90328, Duke University, Durham, NC 27708, USA
- Corresponding authors: William Pan, Duke Global Health Institute, 310 Trent Drive, Campus Box 90519, Durham, NC 27708, fax 681-7748, , Joel N. Meyer, Nicholas School of the Environment, Box 90328, Duke University, Durham, NC 27708, USA,
| | - William K. Pan
- Nicholas School of the Environment, Box 90328, Duke University, Durham, NC 27708, USA
- Duke Global Health Institute, Duke University, 310 Trent Dr, Durham, NC 27710, USA
- Corresponding authors: William Pan, Duke Global Health Institute, 310 Trent Drive, Campus Box 90519, Durham, NC 27708, fax 681-7748, , Joel N. Meyer, Nicholas School of the Environment, Box 90328, Duke University, Durham, NC 27708, USA,
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