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Alarbid A, Salem SM, Alenezi T, Alenezzi A, Alali K, Ajrawi F, Alhajry F. Early predictors of Brucella epididymo-orchitis. Urol Ann 2023; 15:158-161. [PMID: 37304522 PMCID: PMC10252786 DOI: 10.4103/ua.ua_178_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 05/04/2022] [Indexed: 06/13/2023] Open
Abstract
Introduction Epididymo-orchitis (EO) is a common urological condition. In endemic areas, EO may be the presenting picture of brucellosis. Early suspicion and proper diagnosis is necessary for patient recovery. Objective The aim of our study is to identify early predictors of Brucella EO. Patients and Methods We retrospectively collected the data of all patients who were treated at the Urology Unit, Farwaniya Hospital, with acute EO above the age of 12 years between April 2017 and February 2019. Data from electronic and hardcopy files were gathered and analyzed. The diagnosis of acute EO was based on clinical, laboratory, and radiological findings. A total of 120 patients under the diagnosis of EO, epididymitis, and orchitis were reviewed. Thirty-one patients were tested for Brucella based on the history of animal contact, ingestion of unpasteurized dairy products, or persistent fever for more than 48 h. of those patients, 11 tested positive for Brucella orchitis. Results A comparison between Brucella-positive and Brucella-negative patients regarding age, presence of fever, complete blood count (CBC) parameters, pyuria, and abscess formation was made. In the Brucella group, 72% of the patients had a history of animal contact compared to 33% in non-Brucella group (P = 0.006). When comparing CBC parameters in the two groups, Brucella group had statistically significant lower total leukocytic count and neutrophil count (mean ± standard deviation [SD]) 13.07 ± 4.22, 6.4 ± 9.98 versus Brucella negative group 17.35 ± 5.28, 7.8 ± 10.53, and P values were 0.037 and 0.004, respectively. Brucella group showed lymphocytosis (mean ± SD) 25.95 ± 9.78 versus non-Brucella group 13.22 ± 8.05 and P < 0.01. Conclusion Brucella orchitis constituted 9% of the orchitis patients treated in our hospital. Patients with a history of animal contact, EO with lymphocytosis, and relative neutropenia should raise the suspicion for Brucella orchitis in endemic areas.
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Affiliation(s)
- Abdullah Alarbid
- Department of Urology, Farwaniya Hospital Kuwait, Al Farwaniyah, Egypt
| | | | - Turky Alenezi
- Department of Urology, Farwaniya Hospital Kuwait, Al Farwaniyah, Egypt
| | - Abdullah Alenezzi
- Department of Urology, Farwaniya Hospital Kuwait, Al Farwaniyah, Egypt
| | - Khaled Alali
- Department of Urology, Farwaniya Hospital Kuwait, Al Farwaniyah, Egypt
| | - Feras Ajrawi
- Department of Urology, Farwaniya Hospital Kuwait, Al Farwaniyah, Egypt
| | - Faisal Alhajry
- Department of Urology, Farwaniya Hospital Kuwait, Al Farwaniyah, Egypt
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Song J, Yu T, Yan Q, Zhang Q, Wang L. Association of Hemoglobin to Red Blood Cell Distribution Width-Standard Deviation (RDW-SD) Ratio and 3-Month Readmission in Elderly Chinese Patients with Heart Failure: A Retrospective Cohort Study. Int J Gen Med 2023; 16:303-315. [PMID: 36718147 PMCID: PMC9883988 DOI: 10.2147/ijgm.s396805] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/20/2023] [Indexed: 01/25/2023] Open
Abstract
Purpose Hemoglobin (Hb) and red blood cell distribution width-standard deviation (RDW-SD) have clinical significance in the prognosis of heart failure (HF). Little is known regarding the prognostic value of the Hb/RDW-SD ratio in patients with HF. This study sought to investigate the association between Hb/RDW-SD ratio and HF 3-month readmission in Chinese elderly patients. Patients and Methods The present study was a retrospective cohort study. A total of 1816 HF patients were extracted from the Chinese HF database. A generalized linear model was used to explore the association between Hb/RDW-SD and 3-month readmission in HF. The generalized additive model was used to explore the nonlinear relationship, and a two-piecewise linear regression model was used to find the inflection point. Subgroup analysis explored interactions and whether each subgroup was consistent with the primary outcome direction. Results Result showed Hb/RDW-SD was negatively associated with HF 3-month readmission (OR = 0.70, 95% CI: 0.55 to 0.89, P = 0.0031). A non-linear relationship was detected between Hb/RDW-SD and HF 3-month readmission with two inflection points (1.78 and 2.17). Both Hb/RDW-SD < 1.78 and Hb/RDW-SD > 2.17 showed a significant correlation between them, with corresponding effect values of (OR = 0.38, 95% CI: 0.17 to 0.87, P = 0.0209) and (OR = 0.44, 95% CI: 0.27 to 0.71, P = 0.0007), respectively. Conclusion Hb/RDW-SD is negatively associated with HF 3-month readmission. The relationship between Hb/RDW-SD and HF 3-month readmission is also non-linear. Both Hb/RDW-SD < 1.78 and Hb/RDW-SD > 2.17 were strong negatively associated with HF 3-month readmission.
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Affiliation(s)
- Jikai Song
- Zhejiang Provincial People’s Hospital, Qingdao University, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Tianhang Yu
- North China University of Science and Technology, Tangshan, Hebei Province, People’s Republic of China
| | - Qiqi Yan
- Zhejiang Provincial People’s Hospital, Qingdao University, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Qinggang Zhang
- Zhejiang Provincial People’s Hospital, Qingdao University, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Lihong Wang
- Zhejiang Provincial People’s Hospital, Qingdao University, Hangzhou, Zhejiang Province, People’s Republic of China,Correspondence: Lihong Wang, Zhejiang Provincial People’s Hospital, Hangzhou, People’s Republic of China, Tel +86 13666690598, Email
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Lan S, Guo Z, He Y, Liu W, Guo H. Brucella prostatic abscess: a retrospective study of eight cases and a literature review. J Int Med Res 2021; 49:3000605211027442. [PMID: 34586877 PMCID: PMC8485306 DOI: 10.1177/03000605211027442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE To present the clinical characteristics, diagnostics, and treatments for Brucella prostatic abscess (BPA). METHODS We retrospectively analyzed eight BPA patients according to their vocations, age, clinical manifestations, laboratory test results, magnetic resonance imaging (MRI) findings, and treatments. RESULTS The median age was 59 years. The most common clinical symptom was fever, followed by dysuria, erectile dysfunction, frequent urination, and urodynia. C-reactive protein (CRP) concentrations were significantly elevated in all patients, and in all by one patient, the erythrocyte sedimentation rate (ESR) was high. Prostate enlargement occurred in 87.5% of the patients. Lesions were located in the prostate peripheral (87.5%) and central zones (100%), with homogenous signals on T1-weighted imaging (T1WI) and a hyperintense signal on short tau inversion recovery (STIR). Patients had a small nodule or multiple nodules, with slight hyperintense to hyperintense signals on T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI). Three patients had pelvic effusion, and seminal vesicle (37.5%), epididymis (12.5%), and bladder (12.5%) infections occurred. All patients received rifampicin and doxycycline with levofloxacin; all lesions had resolved at follow-up ultrasonography. CONCLUSION Even in epidemic areas, the incidence of BPA is relatively rare. Our findings may increase the understanding of BPA and reduce misdiagnosis and mistreatment.
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Affiliation(s)
- Siqin Lan
- Xinjiang Medical University Affiliated First Hospital, Medical Imaging Center, Urumqi, P.R. China
| | - Zhaoxing Guo
- Beijing Capital Medical University, Beijing, P.R. China
| | - Yuanlin He
- Xinjiang Medical University Affiliated First Hospital, Medical Imaging Center, Urumqi, P.R. China
| | - Wenya Liu
- Xinjiang Medical University Affiliated First Hospital, Medical Imaging Center, Urumqi, P.R. China
| | - Hui Guo
- Xinjiang Medical University Affiliated First Hospital, Medical Imaging Center, Urumqi, P.R. China
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Qu J, Zhou T, Xue M, Sun H, Shen Y, Chen Y, Tang L, Qian L, You J, Yang R, Liu Y. Correlation Analysis of Hemoglobin-to-Red Blood Cell Distribution Width Ratio and Frailty in Elderly Patients With Coronary Heart Disease. Front Cardiovasc Med 2021; 8:728800. [PMID: 34513961 PMCID: PMC8429811 DOI: 10.3389/fcvm.2021.728800] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/04/2021] [Indexed: 12/16/2022] Open
Abstract
Background: Coronary heart disease (CHD) is a common chronic disease in the elderly. Frailty can accelerate the development of CHD and lead to adverse health outcomes. Risk prediction and decision-making for frailty are crucial. The peripheral hemoglobin-to-red blood cell distribution width ratio (HRR) is a novel biomarker of inflammation. Our purpose was to explore the correlation between HRR and frailty in elderly patients with CHD. Methods: This cross-sectional study evaluated 245 Chinese hospitalized patients with CHD. Blood parameters measured upon admission were obtained via the hospital electronic information medical record system. The Fried Frailty Phenotype Scale was used to evaluate the frailty status of the participants. The Receiver operating characteristic curve was used to determine the optimal cut-off values of HRR. We used univariate analysis to examine the potential factors affecting frailty. Kendall's tau-b grade correlation was used to analyze the correlation between HRR and frailty. The ordered logistic regression model was used to analyze the relationship between HRR and frailty. Results: A total of 233 elderly patients with CHD were included in our study. Among the patients, 33.48% (78) were in a state of frailty. The optimal cut-off values of HRR was 9.76. The area under the curve (AUC) for HRR in the frailty patients was 0.652, exceed Hb (AUC = 0.618) and RDW (AUC = 0.650). Kendall's tau-b grade correlation analysis showed that HRR (K = −0.296, P < 0.001) was negatively correlated with frailty. The ordered logistic regression analysis determined that lower HRR was associated with frailty (P < 0.05) after adjusted for age, body mass index, number of drugs, comorbidity index, heart failure, red blood cells, albumin, total cholesterol, triglyceride, high density lipoprotein cholesterol, and low density lipoprotein cholesterol. Conclusion: Lower HRR is an independent risk factor for frailty in elderly hospitalized patients with CHD. HRR was a more powerful prognostic indicator for frailty than either Hb or RDW alone. Clinicians should focus on timely identification of the risk of frailty in order to improve patient quality of life and to reduce the risk of complications.
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Affiliation(s)
- Jiling Qu
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Ting Zhou
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Mengxin Xue
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Huiping Sun
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yijing Shen
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yuhui Chen
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Lei Tang
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Lin Qian
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Jiachun You
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Ruohan Yang
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yongbing Liu
- School of Nursing, Yangzhou University, Yangzhou, China
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Yu J, Li S, Wang L, Dong Z, Si L, Bao L, Wu L. Pathogenesis of Brucella epididymoorchitis-game of Brucella death. Crit Rev Microbiol 2021; 48:96-120. [PMID: 34214000 DOI: 10.1080/1040841x.2021.1944055] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Brucellosis is a worldwide zoonotic disease caused by Brucella spp. Human infection often results from direct contact with tissues from infected animals or by consumption of undercooked meat and unpasteurised dairy products, causing serious economic losses and public health problems. The male genitourinary system is a common involved system in patients with brucellosis. Among them, unilateral orchitis and epididymitis are the most common. Although the clinical and imaging aspect of orchi-epididymitis caused by brucellosis have been widely described, the cellular and molecular mechanisms involved in the damage and the immune response in testis and epididymis have not been fully elucidated. In this review, we first summarised the clinical characteristics of Brucella epididymo-orchitis and the composition of testicular and epididymal immune system. Secondly, with regard to the mechanism of Brucella epididymoorchitis, we mainly discussed the process of Brucella invading testis and epididymis in temporal and spatial order, including i) Brucella evades innate immune recognition of testicular PRRs;ii) Brucella overcomes the immune storm triggered by the invasion of testis through bacterial lipoproteins and virulence factors, and changes the secretion mode of cytokines; iii) Brucella breaks through the blood-testis barrier with the help of macrophages, and inflammatory cytokines promote the oxidative stress of Sertoli cells, damaging the integrity of BTB; iv) Brucella inhibits apoptosis of testicular phagocytes. Finally, we revealed the structure and sequence of testis invaded by Brucella at the tissue level. This review will enable us to better understand the pathogenesis of orchi-epididymitis caused by brucellosis and shed light on the development of new treatment strategies for the treatment of brucellosis and the prevention of transition to chronic form. Facing the testicle with immunity privilege, Brucella is like Bruce Lee in the movie Game of Death, winning is survival while losing is death.HIGHLIGHTSWe summarized the clinical features and pathological changes of Brucellaepididymoorchitis.Our research reveals the pathogenesis of Brucella epididymoorchitis, which mainly includes the subversion of testicular immune privilege by Brucella and a series of destructive reactions derived from it.As a basic framework and valuable resource, this study can promote the exploration of the pathogenesis of Brucella and provide reference for determining new therapeutic targets for brucellosis in the future.
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Affiliation(s)
- Jiuwang Yu
- Mongolian Medicine School, Inner Mongolia Medical University, Hohhot, China
| | - Sha Li
- Department of Pharmacy, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Lu Wang
- Department of Pharmacy, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Zhiheng Dong
- Department of Pharmacy, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Lengge Si
- Mongolian Medicine School, Inner Mongolia Medical University, Hohhot, China
| | - Lidao Bao
- Department of Pharmacy, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Lan Wu
- Mongolian Medicine School, Inner Mongolia Medical University, Hohhot, China
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Zhou Y, Xie S, Zheng R, Dai Q, Xu Z, Zuo W, Ding J, Zhang Y. Brucellar reproductive system injury: A retrospective study of 22 cases and review of the literature. J Int Med Res 2021; 48:300060520924548. [PMID: 32552113 PMCID: PMC7303501 DOI: 10.1177/0300060520924548] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Objective We aimed to describe the clinical characteristics and prognosis of 22
patients with Brucella-induced reproductive system
injury. Methods We assessed 22 patients with reproductive system injury between 2010 and 2018
at The First Affiliated Hospital of Xinjiang Medical University. Results The disease is predominant in men. Male patients had orchitis, erectile
dysfunction, prostatitis, and urethral stricture, while female patients had
vaginitis and cervicitis. Some patients had laboratory abnormalities and
liver injury. Patients received combination therapy of rifampicin and
doxycycline. Doxycycline combined with levofloxacin or moxifloxacin was
administered to patients with rifampicin intolerance. All patients had
received antibiotic therapy for at least 6 weeks. One patient was lost to
follow-up, one patient relapsed because of osteoarthropathy, and one patient
had dysuria resulting from chronic prostatitis. The clinical symptoms
resolved in the other patients, and the overall patient prognosis was
good. Conclusion Clinicians should pay attention to brucellosis-induced reproductive system
damage. The two-drug regimen of rifampicin+doxycycline is recommended for
these patients. Doxycycline combined with levofloxacin or moxifloxacin
should be used in patients with brucellosis-induced reproductive system
damage who have rifampicin intolerance. The treatment course should be at
least 6 weeks.
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Affiliation(s)
- Yan Zhou
- Department of Infection Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Songsong Xie
- The First Hospital of Shihezi University, Shihezi, Xinjiang, China
| | - Rongjiong Zheng
- Department of Infection Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Qinqi Dai
- Department of Infection Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Zheng Xu
- Department of Infection Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Weize Zuo
- The First Hospital of Shihezi University, Shihezi, Xinjiang, China
| | - Jianbing Ding
- Department of Immunology, Basic Medical College, Xinjiang Medical University, Urumqi, China
| | - Yuexin Zhang
- Department of Infection Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.,Department of Immunology, Basic Medical College, Xinjiang Medical University, Urumqi, China
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Akya A, Bozorgomid A, Ghadiri K, Ahmadi M, Elahi A, Mozafari H, Almasi A, Namadi P, Chegenelorestani R. Usefulness of Blood Parameters for Preliminary Diagnosis of Brucellosis. J Blood Med 2020; 11:107-113. [PMID: 32280292 PMCID: PMC7125307 DOI: 10.2147/jbm.s245513] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 03/17/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Human brucellosis is a multisystem disease with a wide range of clinical signs which often leads to misdiagnosis and treatment delay. Early diagnosis of this disease can prevent the serious complications and mismanagements. This study aimed to evaluate the hematological parameters with predictive value for the diagnosis of brucellosis. METHODS In this prospective case-control study which was done during 2015-2017 in Imam Reza Hospital, Kermanshah Province, west Iran, 100 patients with a confirmed diagnosis of brucellosis (brucellosis group) and 100 healthy individuals (control group) were studied. The hematological parameters, including hemoglobin (Hb), red blood cell (RBC), white blood cell (WBC) count, lymphocyte count, neutrophil count, platelet count (PLTs), mean platelet volume (MPV), platelet distribution width (PDW), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) of both groups were recorded. The data were statistically compared between the brucellosis and the control groups. RESULTS The mean age of patients and healthy groups was 44.04 ± 23.11 and 37.92 ± 24.80, respectively (P = 0.062). The WBC, CRP and neutrophil counts were significantly higher in the brucellosis group (P < 0.05). Based on the receiver operating characteristic (ROC) analysis, the sensitivity and specificity were 54% and 66% for the WBC, 45% and 71% for the neutrophil and 65% and 72% for the CRP, respectively. There was no statistically significant difference between the two groups in terms of Hb, RBC, WBC, lymphocyte and platelet count, MPV, PDW and ESR (P > 0.05). CONCLUSION The results of this study indicate that WBC, CRP and neutrophil count can be used as valuable markers in the preliminary diagnosis of brucellosis. However, further researches are required to standardize these parameters for various forms of brucellosis.
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Affiliation(s)
- Alisha Akya
- Infectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Arezoo Bozorgomid
- Infectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Kayghobad Ghadiri
- Infectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mahnaz Ahmadi
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Azam Elahi
- Infectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hadi Mozafari
- Fertility and Infertility Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Afshin Almasi
- Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Parvin Namadi
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Roya Chegenelorestani
- Infectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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