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Kim H, Hur M, Yi JH, Lee GH, Lee S, Moon HW, Yun YM. Detection of blasts using flags and cell population data rules on Beckman Coulter DxH 900 hematology analyzer in patients with hematologic diseases. Clin Chem Lab Med 2024; 62:958-966. [PMID: 38000045 DOI: 10.1515/cclm-2023-0932] [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: 08/24/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023]
Abstract
OBJECTIVES White blood cell (WBC)-related flags are essential for detecting abnormal cells including blasts in automated hematology analyzers (AHAs). Cell population data (CPD) may characterize each WBC population, and customized CPD rules can be also useful for detecting blasts. We evaluated the performance of WBC-related flags, customized CPD rules, and their combination for detecting blasts on the Beckman Coulter DxH 900 AHA (DxH 900, Beckman Coulter, Miami, Florida, USA). METHODS In a total of 239 samples from patients with hematologic diseases, complete blood count on DxH 900 and manual slide review (MSR) were conducted. The sensitivity, specificity, and efficiency of the five WBC-related flags, nine customized CPD rules, and their combination were evaluated for detecting blasts, in comparison with MSR. RESULTS Blasts were detected by MSR in 40 out of 239 (16.7 %) samples. The combination of flags and CPD rules showed the highest sensitivity compared with each of flags and CPD rules for detecting blasts (97.5 vs. 72.5 % vs. 92.5 %). Compared with any flag, the combination of flags and CPD rules significantly reduced false-negative samples from 11 to one for detecting blasts (27.5 vs. 2.5 %, p=0.002). CONCLUSIONS This is the first study that evaluated the performance of both flags and CPD rules on DxH 900. The customized CPD rules as well as the combination of flags and CPD rules outperformed WBC-related flags for detecting blasts on DxH 900. The customized CPD rules can play a complementary role for improving the capability of blast detection on DxH 900.
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Affiliation(s)
- Hanah Kim
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Mina Hur
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Jong-Ho Yi
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Gun-Hyuk Lee
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Seungho Lee
- Department of Preventive Medicine, College of Medicine, Dong-A University, Busan, Korea
| | - Hee-Won Moon
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Yeo-Min Yun
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea
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Cho HJ, Israilov S, Tsega S, Alaiev D, Talledo J, Chandra K, Alarcon Manchego P, Zaurova M, Petrilli CM, Krouss M. Initiative to reduce unnecessary routine daily testing of complete blood counts across 11 safety net hospitals. Am J Clin Pathol 2024; 161:388-392. [PMID: 38041859 DOI: 10.1093/ajcp/aqad159] [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: 07/14/2023] [Accepted: 10/16/2023] [Indexed: 12/04/2023] Open
Abstract
OBJECTIVES National societies recommend against performing routine daily laboratory testing without a specific indication. Unnecessary testing can lead to patient harm, such as hospital-acquired anemia. The objective of this study was to reduce repeat complete blood counts (CBCs) after initial testing. METHODS This was a quality improvement initiative implemented across 11 safety net hospitals in New York City. A best practice advisory (BPA) was implemented that asked the user to remove a CBC if the last 2 CBCs within 72 hours had normal white blood cell and platelet counts and unchanged hemoglobin levels. The outcome measure was the rate of CBCs per 1000 patient days preintervention (January 8, 2020, to December 22, 2020) to postintervention (December 23, 2020, to December 7, 2021). The process measure was the acceptance rate of the BPA, defined as the number of times the repeat CBC order was removed through the BPA divided by the total number of times the BPA triggered. RESULTS Across 11 hospitals, repeat CBC testing decreased by 12.3% (73.05 to 64.04 per 1000 patient days, P < .001). Six of the 11 hospitals exhibited statistically significant decreases, ranging from a 10% to 48.9% decrease of repeat CBCs. The overall BPA action rate was 20.0% (24,029 of 119,944 repeat CBCs). CONCLUSIONS This low-effort, electronic health record-based intervention can effectively reduce unnecessary laboratory testing.
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Affiliation(s)
- Hyung J Cho
- Department of Quality, Brigham and Women's Hospital, Boston, MA, US
| | - Sigal Israilov
- Department of Anesthesia, Icahn School of Medicine, New York, NY, US
| | - Surafel Tsega
- Department of Quality and Safety, NYC Health + Hospitals, New York, NY, US
| | - Dan Alaiev
- Department of Quality and Safety, NYC Health + Hospitals, New York, NY, US
| | - Joseph Talledo
- Department of Quality and Safety, NYC Health + Hospitals, New York, NY, US
| | - Komal Chandra
- Department of Quality and Safety, NYC Health + Hospitals, New York, NY, US
| | | | - Milana Zaurova
- Department of Quality and Safety, NYC Health + Hospitals, New York, NY, US
| | - Christopher M Petrilli
- Department of Medicine, NYU Grossman School of Medicine, New York, NY, US
- Cost of Care, Inc, Boston, MA, US
| | - Mona Krouss
- Department of Quality and Safety, NYC Health + Hospitals, New York, NY, US
- Department of Medicine, Icahn School of Medicine, New York, NY, US
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Mustafa MI, Ali IA, Mohammed MA, Taha EH, Awad KM, Musa OA. Reference intervals of complete blood count parameters in the adult western Sudanese population. BMC Res Notes 2024; 17:99. [PMID: 38566261 PMCID: PMC10988930 DOI: 10.1186/s13104-024-06754-3] [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: 12/19/2023] [Accepted: 03/25/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND A complete blood count (CBC) analysis is one of the most common conventional blood tests that physicians frequently prescribe. THE OBJECTIVE of this study was to determine the reference intervals (RIs) of CBC parameters in the population of healthy adults living in the western Sudan region. METHODS A cross-sectional study of healthy people residing in the western area of Sudan was carried out. We assessed the CBC RIs in samples taken from 153 individuals using an automated haematology analyser (Sysmex KX-21) and a modified Box-Cox transformation procedure to transform the data into a Gaussian distribution after eliminating outliers using the Dixon method. IBM SPSS Statistics version 25 was used to analyse the data, and t tests were employed to examine variations in the mean CBC parameters according to sex and age. P was considered significant at ≤ 0.05. RESULTS Beyond all the other measured values, the only CBC parameters that significantly differed between the sexes were haemoglobin (HGB) and white blood cell (WBC) counts. Women were found to experience more WBC counts than men did. However, they have less HGB RIs.The male participants in our study exhibited lower WBC count RIs, a significantly lower limit, and a greater upper limit of platelet RIs than did the individuals from other nations. CONCLUSIONS Compared with males, females had higher platelet and WBC counts and lower HGB.
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Affiliation(s)
- Malak Ibrahim Mustafa
- Department of Physiology, Faculty of Medicine, The National Ribat University, Khartoum, Sudan
| | - Ibrahim Abdelrhim Ali
- Department of Physiology, Faculty of Medicine, The National Ribat University, Khartoum, Sudan
| | - Muaath Ahmed Mohammed
- Department of Physiology, Faculty of Medicine, The National Ribat University, Khartoum, Sudan.
| | - Elmutaz Hussien Taha
- Department of Physiology, Faculty of Medicine, University of Dongola, Dongola, Sudan
| | - Kamal Mohamed Awad
- Department of Physiology, Faculty of Medicine, University of Gadarif, Elgadarif, Sudan
| | - Omer Abdelaziz Musa
- Department of Physiology, Faculty of Medicine, The National Ribat University, Khartoum, Sudan
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Ignak S, Unay-Demirel O, Yuksel M. Early Prediction of Bloodstream Infection with Complete Blood Count Parameters: an Ex-Vivo Human Whole Blood Model. Clin Lab 2024; 70. [PMID: 38623664 DOI: 10.7754/clin.lab.2023.231013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
BACKGROUND Despite the advanced laboratory technologies available today, blood culture is the gold standard method in the diagnosis of bloodstream infections. Automated blood culture devices give blood culture results for laboratories approximately in 2 - 3 days up to 7 days. Moreover, some microorganisms like nonreproducible bacteria, fungi or viruses cannot be produced in culture. Among all samples taken for blood culture on suspicion of infection approximately 10% are determined as positive whereas the false positive rate due to contamination is 5%. Especially in life-threatening severe conditions such as sepsis early diagnosis and prompt treatment are crucial. Based on this the aim of this study is to investigate complete blood count parameters as potential early markers in Escherichia coli, Staphylococcus aureus and Candida albicans bloodstream infections using an ex vivo whole blood model. METHODS Blood samples collected from healthy donors (n = 10) were treated with suspensions containing a certain concentration of microorganisms (107 CFU/mL for both E. coli ATCC 25922 and S. aureus ATCC 29213, 106 CFU/mL for C. albicans ATCC 14053). After bacteremia and candidemia were induced, complete blood count parameters were analyzed hourly in the samples until the end of the 4th hour with a Mindray BC-6800 hematology analyzer. Statistical analysis was performed by Tukey-Kramer post-hoc multiple comparison test and statistical significance was accepted as p < 0.05. RESULTS When platelet derived parameter baseline values were compared to hourly values in E. coli and S. aureus induced whole blood samples, it was found that the decrease in PLT, P-LCC and the increase in IPF% was significant from the first hour whereas the increase in IMG% was found to be significant only from the 3rd hour onward. In the experiments with C. albicans, it was observed that the increase in IPF% and IMG% was significant from the 2nd and 3rd hour onward, respectively. There was no relationship between MPV, P-LCR, and NLR baseline and hourly results in any microorganism induced model. CONCLUSIONS IPF% can guide clinicians in the early diagnosis and management of treatment of infections caused by S. aureus, E. coli, and C. albicans.
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Thoral E, García-Díaz CC, Persson E, Chamkha I, Elmér E, Ruuskanen S, Nord A. The relationship between mitochondrial respiration, resting metabolic rate and blood cell count in great tits. Biol Open 2024; 13:bio060302. [PMID: 38385271 PMCID: PMC10958200 DOI: 10.1242/bio.060302] [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: 01/11/2024] [Accepted: 02/19/2024] [Indexed: 02/23/2024] Open
Abstract
Although mitochondrial respiration is believed to explain a substantial part of the variation in resting metabolic rate (RMR), few studies have empirically studied the relationship between organismal and cellular metabolism. We therefore investigated the relationship between RMR and mitochondrial respiration of permeabilized blood cells in wild great tits (Parus major L.). We also studied the correlation between mitochondrial respiration traits and blood cell count, as normalizing mitochondrial respiration by the cell count is a method commonly used to study blood metabolism. In contrast to previous studies, our results show that there was no relationship between RMR and mitochondrial respiration in intact blood cells (i.e. with the ROUTINE respiration). However, when cells were permeabilized and interrelation re-assessed under saturating substrate availability, we found that RMR was positively related to phosphorylating respiration rates through complexes I and II (i.e. OXPHOS respiration) and to the mitochondrial efficiency to produce energy (i.e. net phosphorylation efficiency), though variation explained by the models was low (i.e. linear model: R2=0.14 to 0.21). However, unlike studies in mammals, LEAK respiration without [i.e. L(n)] and with [i.e. L(Omy)] adenylates was not significantly related to RMR. These results suggest that phosphorylating respiration in blood cells can potentially be used to predict RMR in wild birds, but that this relationship may have to be addressed in standardized conditions (permeabilized cells) and that the prediction risks being imprecise. We also showed that, in our conditions, there was no relationship between any mitochondrial respiration trait and blood cell count. Hence, we caution against normalising respiration rates using this parameter as is sometimes done. Future work should address the functional explanations for the observed relationships, and determine why these appear labile across space, time, taxon, and physiological state.
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Affiliation(s)
- Elisa Thoral
- Lund University, Department of Biology, Section for Evolutionary Ecology, Sölvegatan 37, SE-223 62 Lund, Sweden
| | - Carmen C. García-Díaz
- Lund University, Department of Biology, Section for Evolutionary Ecology, Sölvegatan 37, SE-223 62 Lund, Sweden
| | - Elin Persson
- Lund University, Department of Biology, Section for Evolutionary Ecology, Sölvegatan 37, SE-223 62 Lund, Sweden
| | - Imen Chamkha
- Lund University, Department of Clinical Sciences, Mitochondrial Medicine, Sölvegatan 17, SE-221 84, Lund, Sweden
| | - Eskil Elmér
- Lund University, Department of Clinical Sciences, Mitochondrial Medicine, Sölvegatan 17, SE-221 84, Lund, Sweden
| | - Suvi Ruuskanen
- Department of Biological and Environmental Science, University of Jyväskylä, FI-40014 Jyväskylä, Finland
| | - Andreas Nord
- Lund University, Department of Biology, Section for Evolutionary Ecology, Sölvegatan 37, SE-223 62 Lund, Sweden
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Tsalta-Mladenov ME, Andonova SP. Peripheral blood cell count ratios as a predictor of poor functional outcome in patients with acute ischemic stroke. Neurol Res 2024; 46:213-219. [PMID: 37846878 DOI: 10.1080/01616412.2023.2270336] [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: 06/22/2023] [Accepted: 10/08/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND AND AIMS Acute ischemic stroke (AIS) is a leading cause of death and long-term disability worldwide. Thromboinflammation plays an important role in the pathophysiology of stroke. The peripheral blood cell count ratios (PBCCR): neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR), are global inflammatory indicators with prognostic value for the clinical outcome after stroke. We aimed to determine the relationship between NLR, PLR, or LMR and the functional outcome three months post-stroke. METHODS A prospective, hospital-based study, including 141 participants with AIS, was conducted at a referral stroke center in North-Eastern Bulgaria. The PBCCRs were obtained during the first 24 hours after stroke onset. Stroke severity was measured using the NIHSS scale, and functional outcome was assessed with the modified Rankin Scale (mRS) at discharge and 3 months post-stroke. RESULTS We found significantly lower total lymphocyte counts, and higher NLR, PLR, and C-reactive protein in the poor-outcome group (mRS>3) three months post-stroke. A positive correlation was found between the NIHSS score and mRS score on discharge, NLR, and PLR with the worse outcome on the third month. The receiver operating characteristic (ROC) curves showed the predictability of NLR (AUC, 0.626, 95%CI: 0.524-0.724, p = 0.018), and for PLR- (AUC, 0.613, 95%CI: 0.510-0.716, p = 0.031). The optimal cutoff value for NLR was 2.68 (sensitivity 77.8% and specificity 60.4%), and for PLR - 122.6 (sensitivity 77.8% and specificity 61.5%). CONCLUSION Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are simple, widely available, and cost-effective biomarkers with high prognostic value for the clinical outcome three months post-stroke.
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Affiliation(s)
- Mihael Emilov Tsalta-Mladenov
- Department of Neurology and Neuroscience, Faculty of Medicine, Medical University "Prof. Paraskev Stoyanov", Varna, Bulgaria
- Second Clinic of Neurology with ICU and Stroke unit, University Hospital "Sveta Marina", Varna, Bulgaria
| | - Silva Peteva Andonova
- Department of Neurology and Neuroscience, Faculty of Medicine, Medical University "Prof. Paraskev Stoyanov", Varna, Bulgaria
- Second Clinic of Neurology with ICU and Stroke unit, University Hospital "Sveta Marina", Varna, Bulgaria
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Zhang XJ, Zhao H, Zhang D, Ye DD, Qin J, Zhou YR, Zhang YZ. Blood cell count-derived inflammation indices as predictors of the osteoporotic risk of postmenopausal women. Eur Rev Med Pharmacol Sci 2024; 28:2207-2216. [PMID: 38567584 DOI: 10.26355/eurrev_202403_35725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
OBJECTIVE We investigated the associations between osteoporosis (OP) and systemic immune inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) in postmenopausal women. PATIENTS AND METHODS This retrospective study included 966 postmenopausal women. Logistic regression and receiver operating characteristic curve (ROC) analyses were applied to explore the relationships between SII, NLR, MLR, and PLR with the bone mineral density (BMD) and risk of OP. RESULTS Logistic regression analyses showed that SII, PLR, NLR, and MLR had independent negative associations with the OP risk. The ROC curve analysis showed that SII, NLR, and MLR predicted a low BMD, with NLR having the highest predictive value (area under the curve = 0.624). SII > 504.09, PLR > 131.87, NLR > 2.02, and MLR > 0.12 correlated with a particularly high OP risk. CONCLUSIONS High levels of SII, PLR, NLR, and MLR were associated with a high OP risk. In particular, NLR > 2.02 strongly predicted the risk of OP, thereby representing a valuable and convenient inflammatory marker of the OP risk.
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Affiliation(s)
- X-J Zhang
- Department of Endocrinology, Hebei Medical University Third Hospital, Shijiazhuang, China.
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Farooq F, Smith ER, Pan Q, Glass Baumann S, Akelo V, Jehan F, Kasaro M, Nisar I, Ouma G, Vwalika B, Spelke MB, Price JT, Hoodbhoy Z. Comparison of Masimo Total Hemoglobin SpHb® continuous non-invasive hemoglobin monitoring device with laboratory complete blood count measurement using venous sample: Protocol for an observational substudy of the Pregnancy Risk and Infant Surveillance and Measurement Alliance Maternal and Newborn Health (PRISMA MNH) study. Gates Open Res 2024; 7:50. [PMID: 37868333 PMCID: PMC10587393 DOI: 10.12688/gatesopenres.14499.1] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2024] [Indexed: 10/24/2023] Open
Abstract
Background The Masimo Total Hemoglobin SpHb® is a continuous and non-invasive handheld device to measure hemoglobin levels. Previous research has found that SpHb is able to accurately detect hemoglobin levels in adult patients with a similar degree of bias and standard deviation to point-of-care invasive method measurements. Generally, limited clinical evidence, lack of validation of Masimo at higher than and lower than hemoglobin threshold values, and scientific consensus supporting the use of Masimo for accurate hemoglobin testing for the diagnosis of anemia during pregnancy calls for further research. Methods and analysis The proposed prospective cohort will be nested within the ongoing Pregnancy Risk and Infant Surveillance and Measurement Alliance (PRISMA) Maternal and Newborn Health (MNH) study. Three study sites (located in Zambia, Kenya, and Pakistan) will participate and collect hemoglobin data at five time points (<20 weeks, 20 weeks, 28 weeks, 36 weeks' gestation, and six weeks postpartum). We will measure hemoglobin using a venous blood sample via hematology auto-analyzer complete blood count (gold standard) and the non-invasive device. The primary objective is to assess agreement between Masimo total hemoglobin and complete blood count and on a continuous scale using Intraclass Correlation Coefficient and Bland-Altman Analysis. The second objective is to assess agreement between the two measures on a binary scale using Positive Percentage Agreement and Negative Percentage Agreement, Cohen's Kappa, and McNemar Test. On an ordinal scale, agreement will be measured using Weighted Cohen's Kappa and Harrel's Concordance Index. Lastly, we will assess factors that might affect the accuracy of Masimo total hemoglobin using linear mixed models. Conclusions The primary aim of this study is to assess the validity of the non-invasive Masimo device compared to the gold standard method of invasive hemoglobin measurements during pregnancy and postpartum periods for the diagnosis of anemia.
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Affiliation(s)
- Fouzia Farooq
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, 20052, USA
| | - Emily R. Smith
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, 20052, USA
| | - Qing Pan
- Department of Statistics, Columbian College of Arts & Sciences, George Washington University, Washington, DC, 20052, USA
| | - Sasha Glass Baumann
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, 20052, USA
| | - Victor Akelo
- Centers for Disease Controls and Prevention - Kenya, Kisumu, Kenya
| | - Fyezah Jehan
- Aga Khan University Hospital, Karachi, Karachi, Sindh, Pakistan
| | - Margaret Kasaro
- UNC Global Projects Zambia, Lusaka, Zambia
- School of Medicine, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Imran Nisar
- Aga Khan University Hospital, Karachi, Karachi, Sindh, Pakistan
| | - Gregory Ouma
- Centre for Global Health Research (CGHR), Kenya Medical Research Institute, Kisumu, Kenya
| | | | - M. Bridget Spelke
- UNC Global Projects Zambia, Lusaka, Zambia
- School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, NC 27599, USA
| | - Joan T. Price
- UNC Global Projects Zambia, Lusaka, Zambia
- School of Medicine, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Zahra Hoodbhoy
- Aga Khan University Hospital, Karachi, Karachi, Sindh, Pakistan
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Tang TT, Zawaski JA, Sabek OM, Gaber MW. High variability in short and long-term recovery kinetic of blood cell count and blood chemistry in a partial body irradiation mouse model. Int J Radiat Biol 2024; 100:565-572. [PMID: 38306486 DOI: 10.1080/09553002.2024.2304833] [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: 09/12/2023] [Accepted: 12/28/2023] [Indexed: 02/04/2024]
Abstract
PURPOSE In the aftermath of a nuclear disaster or accident, survivors will suffer from radiation-induced normal tissue damage. Recovery after radiation exposure is dictated by several factors, one of which is degree of shielding at time of exposure. This study aims to characterize the short and late term changes in kinetics and magnitude of pancytopenia and blood chemistry in a model of heterogeneous radiation exposure, or partial body irradiation (PBI), compared to whole body irradiation (WBI). MATERIALS AND METHODS Male C57BL/6 mice, 8-10 weeks of age, were WBI at 6 different doses (6, 6.1. 6.15, 6.2, 6.5, and 7.5 Gy) to establish the LD50. To determine the effect of shielding on blood cell counts and chemistry, animals were either WBI at 6 Gy (LD2230) or 6 Gy PBI with one leg shielding (LD030). Complete blood counts and chemistry were measured at 1, 5-, 10-, 20-, 30- and 120-days post-irradiation. RESULTS AND CONCLUSIONS Irradiated animals had significant depletion of white blood cells, red blood cells and platelets up to 10 days post-irradiation. Separation between PBI and WBI were observed at 10- and 20-days post-irradiation at which point PBI animals showed sign of recovery while overall cell count remains depleted in WBI animals up to 30 days post-irradiation. In addition, significant changes were found in parameters indicative of hematopoietic injury including hemoglobin count, hematocrit count and white blood cell population. Significant changes were observed in kidney function with changes to blood urea nitrogen and calcium concentration at 5-days post-irradiation. At 10-days post-irradiation. liver function changes differentiated WBI from PBI animals. Long-term, irradiated animal's chemistry values and many blood counts were not significantly different from Sham. In conclusion, partial shielding ensured complete survival and demonstrated a different recovery kinetics of blood and chemistry parameters after irradiation compared to survivors of whole body irradiation and no single hemopoietic parameter was able to consistently differentiate irradiated from Sham animals. This seems to indicate that there is no single robust hemopoietic parameter to differentiate those exposed from those who were not due to the inherent variability in individual responses. Furthermore, there were no significant long-term effects on these blood parameters between survivors of WBI and PBI except that shielding accelerated recovery.
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Affiliation(s)
- Tien T Tang
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Janice A Zawaski
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Omaima M Sabek
- Department of Surgery, Methodist Hospital Research Institute, Houston, TX, USA
| | - M Waleed Gaber
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
- Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, USA
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Khodadadi R, Eghbal M, Ofoghi H, Balaei A, Tamayol A, Abrinia K, Sanati-Nezhad A, Samandari M. An integrated centrifugal microfluidic strategy for point-of-care complete blood counting. Biosens Bioelectron 2024; 245:115789. [PMID: 37979545 DOI: 10.1016/j.bios.2023.115789] [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: 07/13/2023] [Revised: 09/26/2023] [Accepted: 10/24/2023] [Indexed: 11/20/2023]
Abstract
Centrifugal microfluidics holds the potential to revolutionize point-of-care (POC) testing by simplifying laboratory tests through automating fluid and cell manipulation within microfluidic channels. This technology can facilitate blood testing, the most frequent clinical test, at the POC. However, an integrated centrifugal microfluidic device for complete blood counting (CBC) has not yet been fully realized. To address this, we propose an integrated portable system comprising a centrifuge and a hybrid microfluidic disc specifically designed for CBC analysis at the POC. The disc enables the implementation of various spin profiles in different stages of CBC to facilitate in-situ cell separation, solution metering and mixing, and differential cell counting. Furthermore, our system is coupled with a custom script that automates the process and ensures precise quantification of cells using light and fluorescent images captured from the detection chamber of the disc. We demonstrate a close correlation between the proposed method and the hematology analyzer, considered the gold standard, for quantifying hematocrit (R2 = 0.99), white blood cell count (R2 = 0.98), white blood cell differential count (granulocyte/agranulocyte; R2 = 0.89), red blood cell count (R2 = 0.97), and mean corpuscular volume (R2 = 0.94). The integration of our portable system offers significant advantages, enabling more accessible and affordable CBC testing at the POC. Considering the simplicity, affordability (∼$250 capital cost and <$2 operational cost per test), as well as low power consumption (>100 tests using a typical 24 V/10 Ah battery), this system has the potential to enhance healthcare delivery, particularly in resource-limited settings and remote areas where access to traditional laboratory facilities is limited.
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Affiliation(s)
- Reza Khodadadi
- School of Mechanical Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - Manouchehr Eghbal
- Biotechnology Department, Iranian Research Organization for Science and Technology, Tehran, Iran
| | - Hamideh Ofoghi
- Biotechnology Department, Iranian Research Organization for Science and Technology, Tehran, Iran
| | - Alireza Balaei
- Biotechnology Department, Iranian Research Organization for Science and Technology, Tehran, Iran
| | - Ali Tamayol
- Department of Biomedical Engineering, University of Connecticut Health Center, Farmington, CT, 06030, USA
| | - Karen Abrinia
- School of Mechanical Engineering, College of Engineering, University of Tehran, Tehran, Iran.
| | - Amir Sanati-Nezhad
- Department of Biomedical Engineering, University of Calgary, Calgary, Alberta, T2N 1N4, Canada.
| | - Mohamadmahdi Samandari
- Department of Biomedical Engineering, University of Connecticut Health Center, Farmington, CT, 06030, USA.
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de Fréminville A, Saad M, Sage E, Pricopi C, Fischler M, Trillat B, Salze B, Pascreau T, Vasse M, Vallée A, Guen ML, Fessler J. Relationship Between Preoperative Inflammation Ratios Derived From Preoperative Blood Cell Count and Postoperative Pulmonary Complications in Patients Undergoing Lobectomy: A Single-Center Observational Study. J Cardiothorac Vasc Anesth 2024; 38:482-489. [PMID: 38016820 DOI: 10.1053/j.jvca.2023.11.001] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/19/2023] [Accepted: 11/01/2023] [Indexed: 11/30/2023]
Abstract
OBJECTIVE Evaluation of the association of inflammatory cell ratios, especially neutrophil-to-lymphocyte ratio (NLR), based on preoperative complete blood counts, with postoperative complications in lobectomy surgery. DESIGN This was a retrospective monocentric cohort study. SETTING The study was conducted at Foch University Hospital in Suresnes, France. PARTICIPANTS Patients having undergone a scheduled lobectomy from January 2018 to September 2021. INTERVENTIONS There were no interventions. MEASUREMENTS AND MAIN RESULTS The authors studied 208 consecutive patients. Preoperative NLR, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic inflammation index, systemic inflammation response index, and aggregate inflammation systemic index were calculated. Median and (IQR) of NLR was 2.67 (1.92-3.69). No statistically significant association was observed between any index and the occurrence of at least one major postoperative complication, which occurred in 37% of the patients. Median postoperative length of stay was 7 (5-10) days. None of the ratios was associated with prolonged length of stay (LOS), defined as a LOS above the 75th percentile. CONCLUSIONS The results suggested that simple available inflammatory ratios are not useful for the preoperative identification of patients at risk of postoperative major complications in elective lobectomy surgery.
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Affiliation(s)
- Amaury de Fréminville
- Department of Anesthesiology, Hôpital Foch, Suresnes, France, and Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Mary Saad
- Department of Anesthesia, Institut Curie, PSL Research University, Saint Cloud, France, and PSL Research University, INSERM, Institut Curies, Saint Cloud, France
| | - Edouard Sage
- Department of Thoracic Surgery and Lung Transplantation, Hôpital Foch, Suresnes, France, and Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Ciprian Pricopi
- Department of Thoracic Surgery and Lung Transplantation, Hôpital Foch, Suresnes, France, and Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Marc Fischler
- Department of Anesthesiology, Hôpital Foch, Suresnes, France, and Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France.
| | - Bernard Trillat
- Department of Information Systems, Hôpital Foch, Suresnes, France
| | - Benjamin Salze
- Department of Anesthesiology, Hôpital Foch, Suresnes, France, and Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Tiffany Pascreau
- Department of Clinical Biology, Hôpital Foch, Suresnes, France, and Department of Epidemiology-Data-Biostatistics, Delegation of Clinical Research and Innovation, Hôpital Foch, Suresnes, France
| | - Marc Vasse
- Department of Clinical Biology, Hôpital Foch, Suresnes, France, and Department of Epidemiology-Data-Biostatistics, Delegation of Clinical Research and Innovation, Hôpital Foch, Suresnes, France
| | - Alexandre Vallée
- Department of Epidemiology and Public Health, Hôpital Foch, Suresnes, France
| | - Morgan Le Guen
- Department of Anesthesiology, Hôpital Foch, Suresnes, France, and Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Julien Fessler
- Department of Anesthesiology, Hôpital Foch, Suresnes, France, and Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
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12
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Sui J, Lin Z, Azizpour S, Chen F, Gaur S, Keene K, Soleimani F, Bhowmick T, Rafique Z, Javanmard M. Clinical evaluation of a fully electronic microfluidic white blood cell analyzer. PLoS One 2024; 19:e0296344. [PMID: 38236796 PMCID: PMC10796056 DOI: 10.1371/journal.pone.0296344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 11/11/2023] [Indexed: 01/22/2024] Open
Abstract
The White Blood Cell (WBC) count is one of the key parameters signaling the health of the immune system. Abnormal WBC counts often signal a systemic insult to the body such as an underlying infection or an adverse side effect to medication. Typically, the blood collected is sent to a central lab for testing, and results come back within hours, which is often inconvenient and may delay time-sensitive diagnosis or treatment. Here, we present the CytoTracker, a fully electronic, microfluidic based instant WBC analyzer with the potential to be used at point-of-care. The CytoTracker is a lightweight, portable, affordable platform capable of quantifying WBCs within minutes using only 50 μl of blood (approximately one drop of blood). In this study, we clinically evaluated the accuracy and performance of CytoTracker in measuring WBC and granulocyte counts. A total of 210 adult patients were recruited in the study. We validated the CytoTracker against a standard benchtop analyzer (Horiba Point of Care Hematology Analyzer, ABX Micros 60). Linear dynamic ranges of 2.5 k/μl- 35 k/μl and 0.6 k/μl- 26 k/μl were achieved for total WBC count and granulocyte count with correlation coefficients of 0.97 and 0.98. In addition, we verified CytoTracker's capability of identifying abnormal blood counts with above 90% sensitivity and specificity. The promising results of this clinical validation study demonstrate the potential for the use of the CytoTracker as a reliable and accurate point-of-care WBC analyzer.
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Affiliation(s)
- Jianye Sui
- RizLab Health, Inc., Princeton, New Jersey, United States of America
| | - Zhongtian Lin
- RizLab Health, Inc., Princeton, New Jersey, United States of America
| | - Shahriar Azizpour
- RizLab Health, Inc., Princeton, New Jersey, United States of America
| | - Fei Chen
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States of America
| | - Sunanda Gaur
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States of America
| | - Kelly Keene
- Department of Emergency Medicine, Baylor College of Medicine, Houston, Texas, United States of America
| | - Farzad Soleimani
- Department of Emergency Medicine, Baylor College of Medicine, Houston, Texas, United States of America
| | - Tanaya Bhowmick
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States of America
| | - Zubaid Rafique
- Department of Emergency Medicine, Baylor College of Medicine, Houston, Texas, United States of America
| | - Mehdi Javanmard
- RizLab Health, Inc., Princeton, New Jersey, United States of America
- Department of Electrical and Computer Engineering, Rutgers University, Piscataway, New Jersey, United States of America
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13
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Schwanke D, Valente M, Ostheim P, Schüle S, Bobyk L, Drouet M, Riccobono D, Magné N, Daguenet E, Stewart SJ, Muhtadi R, Port M, Abend M. Validation of genes for H-ARS severity prediction in leukemia patients - interspecies comparison, challenges, and promises. Int J Radiat Biol 2024; 100:527-540. [PMID: 38227483 DOI: 10.1080/09553002.2023.2295295] [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: 05/08/2023] [Accepted: 10/04/2023] [Indexed: 01/17/2024]
Abstract
PURPOSE In a previous baboon-study, a total of 29 genes were identified for clinical outcome prediction of the hematologic, acute, radiation, syndrome (H-ARS) severity. Among them, four genes (FDXR, DDB2, POU2AF1, WNT3) appeared promising and were validated in five leukemia patients. Within this study, we sought further in-vivo validation in a larger number of whole-body irradiated patients. MATERIAL AND METHODS Peripheral blood was drawn from 10 leukemia patients before and up to 3 days during a fractionated (2 Gy/day) total-body irradiation (TBI) with 2-12Gy. After RNA-isolation, gene expression (GE) was evaluated on 31 genes widely used in biodosimetry and H-ARS prediction employing qRT-PCR. A customized low-density-array (LDA) allowed simultanously analyzing all genes, the 96-well format further examined the four most promising genes. Fold-changes (FC) in GE relative to pre-irradiation were calculated. RESULTS Five patients suffering from acute-lymphoblastic-leukemia (ALL) respectively non-Hodgkin-lymphoma (NHL) revealed sufficient RNA-amounts and corresponding lymphocyte and neutrophile counts for running qRT-PCR, while acute-myeloid-leukemia (AML) and one myelofibrosis patient could not supply enough RNA. Generally, 1-2µg total RNA was isolated, whereas up to 10-fold differences in RNA-quantities (associated suppressed GE-changes) were identified among pre-exposure and exposure samples. From 31 genes, 23 were expressed in at least one of the pre-exposure samples. Relative to pre-exposure, the number of expressed genes could halve at 48 and 72h after irradiation. Using the LDA, 13 genes were validated in human samples. The four most promising genes (vid. sup.) were either undetermined or too close to pre-exposure. However, they were measured using the more sensitive 96-well format, except WNT3, which wasn´t detectable. As in previous studies, an opposite regulation in GE for FDXR in leukemia patients (up-regulated) relative to baboons (down-regulated) was reconfirmed. Radiation-induced GE-changes of DDB2 (up-regulated) and POU2AF1 (down-regulated) behaved similarly in both species. Hence, 16 out of 23 genes of two species showed GE-changes in the same direction, and up-regulated FDXR as in human studies were revalidated. CONCLUSION Identified genes for H-ARS severity prediction, previously detected in baboons, were validated in ALL but not in AML patients. Limitations related to leukemia type, associated reduced RNA amounts, suppressed GE changes, and methodological challenges must be considered as factors negatively affecting the total number of validated genes. Based on that, we propose additional controls including blood cell counts and preferably fluorescence-based RNA quantity measurements for selecting promising samples and using a more sensitive 96-well format for candidate genes with low baseline copy numbers.
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Affiliation(s)
| | - Marco Valente
- Department of Radiation Biological Effects, Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
| | | | - Simone Schüle
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - Laure Bobyk
- Department of Radiation Biological Effects, Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
| | - Michel Drouet
- Department of Radiation Biological Effects, Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
| | - Diane Riccobono
- Department of Radiation Biological Effects, Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
| | - Nicolas Magné
- Cellular and Molecular Radiobiology Laboratory, Lyon-Sud Medical School, UMR CNRS5822/IP2I, Univ Lyon, Lyon 1 University, Oullins, France
- Department of Radiotherapy, Lucien Neuwirth Institute, Saint Priest en Jarez, France
- Department of Radiotherapy, Bergonié Institute, Bordeaux, France
| | | | | | - Razan Muhtadi
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - Matthias Port
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - Michael Abend
- Bundeswehr Institute of Radiobiology, Munich, Germany
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14
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Zhou L, Ma X, Wang W. Immune dysregulation is associated with symptom dimensions and cognitive deficits in schizophrenia: accessible evidence from complete blood count. BMC Psychiatry 2024; 24:48. [PMID: 38216897 PMCID: PMC10785466 DOI: 10.1186/s12888-023-05430-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/01/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Schizophrenia (SCZ) is a psychotic disorder with an unknown pathogenesis accompanied by varying degrees of cognitive deficits. Recent studies have shown that immune dysregulation plays an important role in developing symptoms and cognitive deficits in SCZ. This study aimed to determine the complete blood count (CBC), including white blood cells, neutrophils, monocytes, lymphocytes, platelets, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and monocyte-lymphocyte ratio (MLR), in patients with SCZ and explore their correlations with SCZ symptom dimensions and cognitive function. METHODS Seventy-four patients with SCZ and 57 age- and sex-matched healthy controls with available demographic and clinical information were recruited for this study. Blood samples were collected, and symptom dimensions and cognitive function were evaluated using the Positive and Negative Syndrome Scale (PANSS) and MATRICS Consensus Cognitive Battery (MCCB) separately. RESULTS Our results demonstrate that SCZ patients showed higher monocyte counts, PLR, MLR, and worse performance in the total MCCB than healthy controls. Neutrophil and lymphocyte counts and NLR were positively related to symptom severity and negatively related to depressive symptoms. White blood cell (WBC) count, monocyte count, and MLR were positively correlated with cognitive performance in patients with SCZ. CONCLUSION In summary, this study suggests that cognitive deficits and symptom severity in patients were associated with dysregulation of immunity. Moreover, we found that WBC could be used as a marker for symptom severity and cognitive deficits in SCZ and that neutrophils are more closely related to the former and monocytes to the latter. We hope that clinicians will pay more attention to dysregulated immunity in patients with SCZ in the future.
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Affiliation(s)
- Lina Zhou
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, P.R. China
| | - Xiancang Ma
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, P.R. China
| | - Wei Wang
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, P.R. China.
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15
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Tahir A, Asghar K, Shafiq W, Batool H, Khan D, Chughtai O, Chaudhary SU. Fingerprinting hyperglycemia using predictive modelling approach based on low-cost routine CBC and CRP diagnostics. Sci Rep 2024; 14:1090. [PMID: 38212326 PMCID: PMC10784542 DOI: 10.1038/s41598-023-44623-4] [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: 03/11/2023] [Accepted: 10/10/2023] [Indexed: 01/13/2024] Open
Abstract
Hyperglycemia is an outcome of dysregulated glucose homeostasis in the human body and may induce chronic elevation of blood glucose levels. Lifestyle factors such as overnutrition, physical inactivity, and psychosocials coupled with systemic low-grade inflammation have a strong negative impact on glucose homeostasis, in particular, insulin sensitivity. Together, these factors contribute to the pathophysiology of diabetes (DM) and expanding landscape of its prevalence regionally and globally. The rapid rise in the prevalence of type 2 diabetes, therefore, underscores the need for its early diagnosis and treatment. In this work, we have evaluated the discriminatory capacity of different diagnostic markers including inflammatory biomolecules and RBC (Red Blood Cell) indices in predicting the risk of hyperglycemia and borderline hyperglycemia. For that, 208,137 clinical diagnostic entries obtained over five years from Chugtai Labs, Pakistan, were retrospectively evaluated. The dataset included HbA1c (n = 142,011), complete blood count (CBC, n = 84,263), fasting blood glucose (FBG, n = 35,363), and C-reactive protein (CRP, n = 9035) tests. Our results provide four glycemic predictive models for two cohorts HbA1c and FBG) each having an overall predictive accuracy of more than 80% (p-value < 0.0001). Next, multivariate analysis (MANOVA) followed by univariate analysis (ANOVA) was employed to identify predictors with significant discriminatory capacity for different levels of glycemia. We show that the interplay between inflammation, hyperglycemic-induced derangements in RBC indices, and altered glucose homeostasis could be employed for prognosticating hyperglycemic outcomes. Our results then conclude a glycemic predictor with high sensitivity and specificity, employing inflammatory markers coupled with RBC indices, to predict glycemic outcomes (ROC p-value < 0.0001). Taken together, this study outlines a predictor of glycemic outcomes which could assist as a prophylactic intervention in predicting the early onset of hyperglycemia and borderline hyperglycemia.
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Affiliation(s)
- Amna Tahir
- Biomedical Informatics and Engineering Research Laboratory, Department of Life Sciences, Syed Babar Ali School of Science and Engineering, Lahore University of Management Sciences, Lahore, Pakistan
| | - Kashif Asghar
- Basic Science Department, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Waqas Shafiq
- Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Hijab Batool
- Chughtai Institute of Pathology, Lahore, Pakistan
| | - Dilawar Khan
- Chughtai Institute of Pathology, Lahore, Pakistan
| | | | - Safee Ullah Chaudhary
- Biomedical Informatics and Engineering Research Laboratory, Department of Life Sciences, Syed Babar Ali School of Science and Engineering, Lahore University of Management Sciences, Lahore, Pakistan.
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16
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Kim M, Kym D, Park J, Yoon J, Cho YS, Hur J, Chun W, Yoon D. Big data insights into the diagnostic values of CBC parameters for sepsis and septic shock in burn patients: a retrospective study. Sci Rep 2024; 14:800. [PMID: 38191787 PMCID: PMC10774327 DOI: 10.1038/s41598-023-50695-z] [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: 08/17/2023] [Accepted: 12/22/2023] [Indexed: 01/10/2024] Open
Abstract
Sepsis and septic shock are prevalent and life-threatening complications in burn patients. Despite their severity, existing diagnostic methods are limited. This study aims to evaluate the efficacy of Complete Blood Count (CBC) and CBC ratio markers in diagnosing sepsis and septic shock, and in predicting mortality among burn patients. A cohort of 2757 burn patients was examined to ascertain the correlation between various CBC parameters, their ratios, and the incidence of sepsis and related mortality. Key markers analyzed included Red Cell Distribution Width (RDW), Mean Platelet Volume (MPV), Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Mean Platelet Volume-to-Platelet Ratio (MPVPR). Our findings indicate that 65.5% of the patients developed sepsis, and 24.3% succumbed to their conditions. The CBC parameters RDW, MPV, NLR, MPVPR, and MPV-to-Lymphocyte Ratio (MPVLR) were significantly associated with sepsis and mortality. These markers showed considerable temporal variation and yielded an Area Under the Curve (AUC) of over 0.65 in an unadjusted Generalized Estimating Equations (GEE) model. This study underscores the potential of RDW, MPV, NLR, MPVPR, and MPVLR as vital prognostic tools for diagnosing sepsis, septic shock, and predicting mortality in burn patients. Although based on a single-center dataset, our results contribute to the enhancement of sepsis management by facilitating earlier, more precise diagnosis and treatment strategies. Further multi-center research is necessary to confirm these findings and broaden their applicability, establishing a solid base for future explorations in this crucial field.
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Affiliation(s)
- Myongjin Kim
- Department of Surgery and Critical Care, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-Ro 7-Gil, Youngdeungpo-Gu, 07247, Seoul, South Korea
| | - Dohern Kym
- Department of Surgery and Critical Care, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-Ro 7-Gil, Youngdeungpo-Gu, 07247, Seoul, South Korea.
- Burn Institutes, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-Ro 7-Gil, Youngdeungpo-Gu, 07247, Seoul, South Korea.
| | - Jongsoo Park
- Department of Surgery and Critical Care, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-Ro 7-Gil, Youngdeungpo-Gu, 07247, Seoul, South Korea
| | - Jaechul Yoon
- Department of Surgery and Critical Care, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-Ro 7-Gil, Youngdeungpo-Gu, 07247, Seoul, South Korea
| | - Yong Suk Cho
- Department of Surgery and Critical Care, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-Ro 7-Gil, Youngdeungpo-Gu, 07247, Seoul, South Korea
- Burn Institutes, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-Ro 7-Gil, Youngdeungpo-Gu, 07247, Seoul, South Korea
| | - Jun Hur
- Department of Surgery and Critical Care, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-Ro 7-Gil, Youngdeungpo-Gu, 07247, Seoul, South Korea.
- Burn Institutes, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-Ro 7-Gil, Youngdeungpo-Gu, 07247, Seoul, South Korea.
| | - Wook Chun
- Department of Surgery and Critical Care, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-Ro 7-Gil, Youngdeungpo-Gu, 07247, Seoul, South Korea
- Burn Institutes, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-Ro 7-Gil, Youngdeungpo-Gu, 07247, Seoul, South Korea
| | - Dogeon Yoon
- Burn Institutes, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-Ro 7-Gil, Youngdeungpo-Gu, 07247, Seoul, South Korea
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17
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Park J, Kym D, Kim M, Cho YS, Hur J, Chun W, Yoon D, Yoon J. Pioneering predictions of AKI and AKIN severity in burn patients: a comprehensive CBC approach. Sci Rep 2024; 14:675. [PMID: 38182863 PMCID: PMC10770361 DOI: 10.1038/s41598-024-51253-x] [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: 07/11/2023] [Accepted: 01/02/2024] [Indexed: 01/07/2024] Open
Abstract
This study aims to evaluate the utility of complete blood count (CBC) markers, in conjunction with the acute kidney injury network (AKIN) criteria, for the early detection, severity assessment, and prediction of mortality outcomes of acute kidney injury (AKI) in burn patients. The research seeks to fill existing gaps in knowledge and validate the cost-effectiveness of using CBC as a routine diagnostic tool for better management of AKI. The study was conducted at Hangang Sacred Heart Hospital. We performed a large-scale retrospective analysis of 2758 adult patients admitted to the burn intensive care unit over a 12-year period. Among these patients, AKI occurred in 1554 patients (56.3%). Based on the AKIN stage classification, 794 patients (28.8%) were categorized as AKIN 1, 494 patients (17.9%) as AKIN 2, and 266 patients (9.6%) as AKIN 3. We defined several ratio markers, including the Neutrophil-to-lymphocyte ratio (NLR), Platelet-to-lymphocyte ratio (PLR), Monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), and various mean platelet volume (MPV) ratios. Our statistical analyses, conducted using the R programming language, revealed significant correlations between these markers and AKI severity. The AUC values for neutrophil count and WBC count were 0.790 and 0.793, respectively, followed by immature granulocyte count with an AUC of 0.727. For red blood cell (RBC)-related parameters, the AUC values for hematocrit (Hct), hemoglobin (Hb), and RBC count were 0.725, 0.713, and 0.713, respectively. Among the platelet-related parameters, only platelet distribution width (PDW) had an AUC of 0.677. Among the ratio markers, the NLR had the highest AUC at 0.772, followed by MPVNR and SII with AUC values of 0.700 and 0.680, respectively. The findings underscore the potential of CBC as an economical, routine test for AKI, thereby paving the way for enhanced patient outcomes. Our study suggests the utility of routine CBC tests, specifically WBC count and PLR, for predicting AKI and platelet, MPV, and NLR for mortality assessment in burn patients. These findings underscore the potential of easily accessible CBC tests in enhancing AKI management. However, further multicenter studies are needed for validation.
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Affiliation(s)
- Jongsoo Park
- Department of Surgery and Critical Care, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-ro 7-gil, Youngdeungpo-gu, Seoul, 07247, South Korea
| | - Dohern Kym
- Department of Surgery and Critical Care, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-ro 7-gil, Youngdeungpo-gu, Seoul, 07247, South Korea.
- Burn Institutes, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-ro 7-gil, Youngdeungpo-gu, Seoul, 07247, South Korea.
| | - Myongjin Kim
- Department of Surgery and Critical Care, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-ro 7-gil, Youngdeungpo-gu, Seoul, 07247, South Korea
| | - Yong Suk Cho
- Department of Surgery and Critical Care, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-ro 7-gil, Youngdeungpo-gu, Seoul, 07247, South Korea
- Burn Institutes, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-ro 7-gil, Youngdeungpo-gu, Seoul, 07247, South Korea
| | - Jun Hur
- Department of Surgery and Critical Care, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-ro 7-gil, Youngdeungpo-gu, Seoul, 07247, South Korea
- Burn Institutes, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-ro 7-gil, Youngdeungpo-gu, Seoul, 07247, South Korea
| | - Wook Chun
- Department of Surgery and Critical Care, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-ro 7-gil, Youngdeungpo-gu, Seoul, 07247, South Korea
- Burn Institutes, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-ro 7-gil, Youngdeungpo-gu, Seoul, 07247, South Korea
| | - Dogeon Yoon
- Burn Institutes, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-ro 7-gil, Youngdeungpo-gu, Seoul, 07247, South Korea
| | - Jaechul Yoon
- Department of Surgery and Critical Care, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-ro 7-gil, Youngdeungpo-gu, Seoul, 07247, South Korea
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18
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Karakurt G, Guven O, Aynaci E, Kerget B, Senkardesler G, Duger M. Evaluation of Hemogram Parameters in the Diagnosis of Pulmonary Embolism: Immature Granulocytes and Other New Tips. Clin Appl Thromb Hemost 2024; 30:10760296241227212. [PMID: 38348584 PMCID: PMC10865945 DOI: 10.1177/10760296241227212] [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: 10/09/2023] [Revised: 12/03/2023] [Accepted: 01/04/2024] [Indexed: 02/15/2024] Open
Abstract
Pulmonary embolism (PE) is an important cause of sudden death and is difficult to diagnose. Therefore unnecessary radiological investigations are often resorted to. Although some inflammatory parameters in the hemogram have been found to play a role in the diagnosis of PE, many parameters have not been adequately investigated. We aimed to evaluate potential inflammatory parameters in hemogram in the diagnosis of PE and to determine the parameters with the highest diagnostic value. This single-center, retrospective study was performed by evaluating 114 cases with suspected PE admitted to the emergency department between January 2017 and June 2022. Among 114 cases, 62 cases with a definitive diagnosis of PE by pulmonary computed tomography angiography served as the PE group and 52 cases without PE served as the control group. Admission hemogram parameters of both groups were recorded. Potential chronic diseases and acute conditions affecting hemogram were excluded from the study. In the multivariate model; immature granulocyte (IG), neutrophil/lymphocyte ratio (NLR), monocyte % and platelet large cell ratio (P-LCR) were found to be significantly and independently effective in differentiating cases with and without PE (P˂.05). Our findings suggest that high IG, high NLR, high monocyte %, and low P-LCR values have diagnostic value in cases with suspected PE. However the usability of IGs in the diagnosis of PE is a new finding. Hemogram is cheap, easily accessible, and potential inflammatory biomarkers in hemograms may increase physicians' awareness in the diagnosis of PE.
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Affiliation(s)
- Gokhan Karakurt
- Chest Diseases Department, Kirklareli Training and Research Hospital, Kirklareli, Turkey
| | - Oya Guven
- Emergency Medicine Department, Kirklareli University, Kirklareli, Turkey
| | - Engin Aynaci
- Chest Diseases Department, Beykent University, Istanbul, Turkey
| | - Bugra Kerget
- Chest Diseases Department, Ataturk University, Erzurum, Turkey
| | - Gizem Senkardesler
- Chest Diseases Department, Kirklareli Training and Research Hospital, Kirklareli, Turkey
| | - Mustafa Duger
- Chest Diseases Department, Medipol University, Istanbul, Turkey
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19
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Cho O. Post-Radiotherapy Exosomal Non-Coding RNA and Hemograms for Early Death Prediction in Patients with Cervical Cancer. Int J Mol Sci 2023; 25:126. [PMID: 38203297 PMCID: PMC10778718 DOI: 10.3390/ijms25010126] [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: 10/24/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Concurrent chemo-radiotherapy (CCRT) is linked with accelerated disease progression and early death (ED) in various cancers. This study aimed to assess the association of plasma levels of exosomal non-coding ribonucleic acid (RNA) (ncRNA) and blood cell dynamics with ED prediction in patients with cervical cancer undergoing CCRT. Using propensity score matching, a comparison of complete blood counts (CBCs) was performed among 370 CCRT-treated patients. Differences in ncRNA and messenger RNA (mRNA) expression before and after CCRT in 84 samples from 42 patients (cohort 2) were represented as logarithmic fold change (log2FC). Networks were constructed to link the CBCs to the RNAs whose expression correlated with ED. From the key RNAs selected using multiple regression of all RNA combinations in the network, CBC dynamics-associated ncRNAs were functionally characterized using an enrichment analysis. Cohort 1 (120 patients) exhibited a correlation between elevated absolute neutrophil counts (ANC) and ED. Cohort 2 exhibited a prevalence of microRNA (miR)-574-3p and long intergenic non-protein coding (LINC)01003 ncRNA, whose expression correlated with ANC and hemoglobin values, respectively. Conversely, acyl-coenzyme A thioesterase 9 (ACOT9) mRNA was relevant to all CBC components. An integrative analysis of post-CCRT ncRNA levels and CBC values revealed that the patients with miR-574-3p-LINC01003-ACOT9 log2FC) < 0 had a better prospect of 30-month disease-specific survival. These findings indicate that miR-574-3p and LINC01003 could serve as ED prognostic biomarkers.
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Affiliation(s)
- Oyeon Cho
- Gynecologic Cancer Center, Department of Radiation Oncology, Ajou University School of Medicine, Suwon 16499, Republic of Korea
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20
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Morawiec R, Matuszewska-Brycht O, Maeser P, Kośny M, Krejca M, Drożdż J. Are in-hospital mortality predictors based on complete blood count useful in patients with infective endocarditis? A retrospective tertiary center perspective (2015-2022). Pol Arch Intern Med 2023; 133:16617. [PMID: 38051080 DOI: 10.20452/pamw.16617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Affiliation(s)
- Robert Morawiec
- Second Department of Cardiology, Medical University of Lodz, Łódź, Poland.
| | | | - Paweł Maeser
- Second Department of Cardiology, Medical University of Lodz, Łódź, Poland
| | - Michał Kośny
- Second Department of Cardiology, Medical University of Lodz, Łódź, Poland
| | - Michał Krejca
- Department of Cardiac Surgery, Medical University of Lodz, Łódź, Poland
| | - Jarosław Drożdż
- Second Department of Cardiology, Medical University of Lodz, Łódź, Poland
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21
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Zhang M, Zhao C, Cheng Q, Xu J, Xu N, Yu L, Feng W. A score-based method of immune status evaluation for healthy individuals with complete blood cell counts. BMC Bioinformatics 2023; 24:467. [PMID: 38082403 PMCID: PMC10714576 DOI: 10.1186/s12859-023-05603-7] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 12/05/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND With the COVID-19 outbreak, an increasing number of individuals are concerned about their health, particularly their immune status. However, as of now, there is no available algorithm that effectively assesses the immune status of normal, healthy individuals. In response to this, a new score-based method is proposed that utilizes complete blood cell counts (CBC) to provide early warning of disease risks, such as COVID-19. METHODS First, data on immune-related CBC measurements from 16,715 healthy individuals were collected. Then, a three-platform model was developed to normalize the data, and a Gaussian mixture model was optimized with expectation maximization (EM-GMM) to cluster the immune status of healthy individuals. Based on the results, Random Forest (RF), Light Gradient Boosting Machine (LightGBM) and Extreme Gradient Boosting (XGBoost) were used to determine the correlation of each CBC index with the immune status. Consequently, a weighted sum model was constructed to calculate a continuous immunity score, enabling the evaluation of immune status. RESULTS The results demonstrated a significant negative correlation between the immunity score and the age of healthy individuals, thereby validating the effectiveness of the proposed method. In addition, a nonlinear polynomial regression model was developed to depict this trend. By comparing an individual's immune status with the reference value corresponding to their age, their immune status can be evaluated. CONCLUSION In summary, this study has established a novel model for evaluating the immune status of healthy individuals, providing a good approach for early detection of abnormal immune status in healthy individuals. It is helpful in early warning of the risk of infectious diseases and of significant importance.
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Affiliation(s)
- Min Zhang
- College of Intelligent Systems Science and Engineering, Harbin Engineering University, Harbin, China
| | - Chengkui Zhao
- College of Intelligent Systems Science and Engineering, Harbin Engineering University, Harbin, China
| | - Qi Cheng
- College of Intelligent Systems Science and Engineering, Harbin Engineering University, Harbin, China
| | - Jiayu Xu
- College of Intelligent Systems Science and Engineering, Harbin Engineering University, Harbin, China
| | - Nan Xu
- Institute of Biomedical Engineering and Technology, Shanghai Engineering Research Center of Molecular Therapeutics and New Drug Development, School of Chemistry and Molecular Engineering, East China Normal University, Shanghai, China
- Shanghai Unicar-Therapy Bio-Medicine Technology Co., Ltd, Shanghai, China
| | - Lei Yu
- Institute of Biomedical Engineering and Technology, Shanghai Engineering Research Center of Molecular Therapeutics and New Drug Development, School of Chemistry and Molecular Engineering, East China Normal University, Shanghai, China.
- Shanghai Unicar-Therapy Bio-Medicine Technology Co., Ltd, Shanghai, China.
| | - Weixing Feng
- College of Intelligent Systems Science and Engineering, Harbin Engineering University, Harbin, China.
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22
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Wong BPK, Lam RPK, Ip CYT, Chan HC, Zhao L, Lau MCK, Tsang TC, Tsui MSH, Rainer TH. Applying artificial neural network in predicting sepsis mortality in the emergency department based on clinical features and complete blood count parameters. Sci Rep 2023; 13:21463. [PMID: 38052864 PMCID: PMC10698015 DOI: 10.1038/s41598-023-48797-9] [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: 10/04/2023] [Accepted: 11/30/2023] [Indexed: 12/07/2023] Open
Abstract
A complete blood count (CBC) is routinely ordered for emergency department (ED) patients with infections. Certain parameters, such as the neutrophil-to-lymphocyte ratio (NLR), might have prognostic value. We aimed to evaluate the prognostic value of the presenting CBC parameters combined with clinical variables in predicting 30-day mortality in adult ED patients with infections using an artificial neural network (ANN). We conducted a retrospective study of ED patients with infections between 17 December 2021 and 16 February 2022. Clinical variables and CBC parameters were collected from patient records, with NLR, monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) calculated. We determined the discriminatory performance using the area under the receiver operating characteristic curve (AUROC) and performed a 70/30 random data split and supervised ANN machine learning. We analyzed 558 patients, of whom 144 (25.8%) had sepsis and 60 (10.8%) died at 30 days. The AUROCs of NLR, MLR, PLR, and their sum were 0.644 (95% CI 0.573-0.716), 0.555 (95% CI 0.482-0.628), 0.606 (95% CI 0.529-0.682), and 0.610 (95% CI 0.534-0.686), respectively. The ANN model based on twelve variables including clinical variables, hemoglobin, red cell distribution width, NLR, and PLR achieved an AUROC of 0.811 in the testing dataset.
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Affiliation(s)
- Beata Pui Kwan Wong
- Department of Emergency Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Rex Pui Kin Lam
- Department of Emergency Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
| | - Carrie Yuen Ting Ip
- Department of Emergency Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Ho Ching Chan
- Department of Emergency Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Lingyun Zhao
- Department of Emergency Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Michael Chun Kai Lau
- Department of Emergency Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Tat Chi Tsang
- Accident and Emergency Department, Queen Mary Hospital, Hospital Authority, Hong Kong Special Administrative Region, China
| | - Matthew Sik Hon Tsui
- Accident and Emergency Department, Queen Mary Hospital, Hospital Authority, Hong Kong Special Administrative Region, China
| | - Timothy Hudson Rainer
- Department of Emergency Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
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23
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Gearhart A, Esteso P, Sperotto F, Elia EG, Michelson KA, Lipsitz S, Sun M, Knoll C, Vanderpluym C. Nucleated Red Blood Cells Are Predictive of In-Hospital Mortality for Pediatric Patients. Pediatr Emerg Care 2023; 39:907-912. [PMID: 37246140 PMCID: PMC10981975 DOI: 10.1097/pec.0000000000002980] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
PURPOSE We sought to establish whether nucleated red blood cells (NRBCs) are predictive of disposition, morbidity, and mortality for pediatric patients presenting to the emergency department (ED). METHODS A single-center retrospective cohort study examining all ED encounters from patients aged younger than 19 years between January 2016 and March 2020, during which a complete blood count was obtained. Univariate analysis and multivariable logistic regression were used to test the presence of NRBCs as an independent predictor of patient-related outcomes. RESULTS The prevalence of NRBCs was 8.9% (4195/46,991 patient encounters). Patient with NRBCs were younger (median age 4.58 vs 8.23 years; P < 0.001). Those with NRBCs had higher rates of in-hospital mortality (30/2465 [1.22%] vs 65/21,741 [0.30%]; P < 0.001), sepsis (19% vs 12%; P < 0.001), shock (7% vs 4%; P < 0.001), and cardiopulmonary resuscitation (CPR) (0.62% vs 0.09%; P < 0.001). They were more likely to be admitted (59% vs 51%; P < 0.001), have longer median hospital length of stay {1.3 (interquartile range [IQR], 0.22-4.14) vs 0.8 days (IQR, 0.23-2.64); P < 0.001}, and median intensive care unit (ICU) length of stay (3.9 [IQR, 1.87-8.72] vs 2.6 days [IQR, 1.27-5.83]; P < 0.001). Multivariable regression revealed presence of NRBCs as an independent predictor for in-hospital mortality (adjusted odds ratio [aOR], 2.21; 95% confidence interval [CI], 1.38-3.53; P < 0.001), ICU admission (aOR, 1.30; 95% CI, 1.11-1.51; P < 0.001), CPR (aOR, 3.83; 95% CI, 2.33-6.30; P < 0.001), and 30-day return to the ED (aOR, 1.15; 95% CI, 1.15-1.26; P < 0.001). CONCLUSIONS The presence of NRBCs is an independent predictor for mortality, including in-hospital mortality, ICU admission, CPR, and readmission within 30 days for children presenting to the ED.
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Affiliation(s)
- Addison Gearhart
- Department of Cardiology, Boston Children’s Hospital, Boston, MA, 02115, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, 02115, USA
| | - Paul Esteso
- Department of Cardiology, Boston Children’s Hospital, Boston, MA, 02115, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, 02115, USA
| | - Francesca Sperotto
- Department of Cardiology, Boston Children’s Hospital, Boston, MA, 02115, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, 02115, USA
| | - Eleni G. Elia
- Department of Cardiology, Boston Children’s Hospital, Boston, MA, 02115, USA
| | - Kenneth A. Michelson
- Department of Pediatrics, Harvard Medical School, Boston, MA, 02115, USA
- Division of Emergency Medicine, Boston Children’s Hospital, Boston, MA, 02115, USA
| | - Stu Lipsitz
- Department of Cardiology, Boston Children’s Hospital, Boston, MA, 02115, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, 02115, USA
| | - Mingwei Sun
- Clinical Research Informatics Team, Department of Pediatrics, Boston Children’s Hospital, Boston, MA, 02115, USA
| | - Christopher Knoll
- Department of Cardiology, Phoenix Children’s Hospital, Phoenix, AZ, 85016, USA
| | - Christina Vanderpluym
- Department of Cardiology, Boston Children’s Hospital, Boston, MA, 02115, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, 02115, USA
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24
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Barakauskas VE, Bohn MK, Branch E, Boutin A, Albert A, Luke S, Dittrick M, Higgins V, Adeli K, Vallance H, Jung B, Dooley K, Dahlgren-Scott L, Chan WS. Mining the Gap: Deriving Pregnancy Reference Intervals for Hematology Parameters Using Clinical Datasets. Clin Chem 2023; 69:1374-1384. [PMID: 37947280 DOI: 10.1093/clinchem/hvad167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/27/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Physiological changes during pregnancy invalidate use of general population reference intervals (RIs) for pregnant people. The complete blood count (CBC) is commonly ordered during pregnancy, but few studies have established pregnancy RIs suitable for contemporary Canadian mothers. Prospective RI studies are challenging to perform during pregnancy while retrospective techniques fall short as pregnancy and health status are not readily available in the laboratory information system (LIS). This study derived pregnancy RIs retrospectively using LIS data linked to provincial perinatal registry data. METHODS A 5-year healthy pregnancy cohort was defined from the British Columbia Perinatal Data Registry and linked to laboratory data from two laboratories. CBC and differential RIs were calculated using direct and indirect approaches. Impacts of maternal and pregnancy characteristics, such as age, body mass index, and ethnicity, on laboratory values were also assessed. RESULTS The cohort contained 143 106 unique term singleton pregnancies, linked to >972 000 CBC results. RIs were calculated by trimester and gestational week. Result trends throughout gestation aligned with previous reports in the literature, although differences in exact RI limits were seen for many tests. Trimester-specific bins may not be appropriate for several CBC parameters that change rapidly within trimesters, including red blood cells (RBCs), some leukocyte parameters, and platelet counts. CONCLUSIONS Combining information from comprehensive clinical databases with LIS data provides a robust and reliable means for deriving pregnancy RIs. The present analysis also illustrates limitations of using conventional trimester bins during pregnancy, supporting use of gestational age or empirically derived bins for defining CBC normal values during pregnancy.
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Affiliation(s)
- Vilte E Barakauskas
- Department of Pathology and Laboratory Medicine, BC Children's and Women's Hospital, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Mary Kathryn Bohn
- Clinical Biochemistry, Pediatric Laboratory Medicine, The Hospital for Sick Children and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Emma Branch
- Women's Health Research Institute, BC Women's Hospital, Vancouver, BC, Canada
| | - Amelie Boutin
- Department of Pediatrics, Université Laval, and Reproduction, Mother and Youth Health Unit, CHU de Quebec-Université Laval Research Center, Quebec City, QC, Canada
| | - Arianne Albert
- Women's Health Research Institute, BC Women's Hospital, Vancouver, BC, Canada
| | - Sabrina Luke
- Women's Health Research Institute, BC Women's Hospital, Vancouver, BC, Canada
- Research and Surveillance Group, Perinatal Services British Columbia, Vancouver, BC, Canada
| | - Michelle Dittrick
- Department of Pathology and Laboratory Medicine, BC Children's and Women's Hospital, Vancouver, BC, Canada
| | - Victoria Higgins
- Clinical Biochemistry, DynaLIFE Medical Labs and Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | - Khosrow Adeli
- Clinical Biochemistry, Pediatric Laboratory Medicine, The Hospital for Sick Children and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Hilary Vallance
- Department of Pathology and Laboratory Medicine, BC Children's and Women's Hospital, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Benjamin Jung
- Clinical Biochemistry, Pediatric Laboratory Medicine, The Hospital for Sick Children and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Kent Dooley
- Clinical Biochemistry, LifeLabs Medical Laboratories, Victoria, BC, Canada
| | - Leanne Dahlgren-Scott
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
| | - Wee-Shian Chan
- Department of Medicine, BC Women's Hospital and Division of General Internal Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
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Xie J, Guo Z, Zhu Y, Ma M, Jia G. Peripheral blood inflammatory indexes in breast cancer: A review. Medicine (Baltimore) 2023; 102:e36315. [PMID: 38050296 PMCID: PMC10695498 DOI: 10.1097/md.0000000000036315] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 11/03/2023] [Indexed: 12/06/2023] Open
Abstract
Immune and inflammatory responses play an important role in tumorigenesis and metastasis. Inflammation is an important component of the tumor microenvironment, and the changes in inflammatory cells may affect the occurrence and development of tumors. Complete blood count at the time of diagnosis and treatment can reflect the inflammatory status within the tumor. Studies have shown that the number of certain inflammatory cells in peripheral blood and their ratios are important prognostic factors for many malignancies, including neutrophil, lymphocyte, monocyte, and platelet counts, as well as neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, systemic immune-inflammation index, systemic inflammation response index and pan-immune-inflammation-value. The value of peripheral blood inflammation indexes in predicting the efficacy and prognosis of breast cancer neoadjuvant therapy is worth recognizing. This review details the application of peripheral blood inflammation indexes in the evaluation of efficacy and prediction of prognosis in neoadjuvant therapy for breast cancer, aiming to provide a more comprehensive reference for the comprehensive diagnosis and treatment of breast cancer.
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Affiliation(s)
- Jiaqiang Xie
- Department of Breast and Thyroid Surgery, Huaihe Hospital of Henan University, Kaifeng, Henan, China
- School of Clinical Medicine, Henan University, Kaifeng, Henan, China
| | - Zhenxi Guo
- Department of Breast and Thyroid Surgery, Huaihe Hospital of Henan University, Kaifeng, Henan, China
- School of Clinical Medicine, Henan University, Kaifeng, Henan, China
| | - Yijing Zhu
- Department of Breast and Thyroid Surgery, Huaihe Hospital of Henan University, Kaifeng, Henan, China
- School of Clinical Medicine, Henan University, Kaifeng, Henan, China
| | - Mingde Ma
- Department of Breast and Thyroid Surgery, Huaihe Hospital of Henan University, Kaifeng, Henan, China
| | - Guangwei Jia
- Department of Thyroid and Breast Surgery, Nanyang First People’s Hospital Affiliated to Henan University, Nanyang, Henan, China
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Mohammadi M, Ghazizadeh H, Mohammadi-Bajgiran M, Kathryn Bohn M, Yaghooti-Khorasani M, Kamel Khodabandeh A, Steele S, Torabzadeh Khorasani N, Ferns GA, Boskabadi H, Esmaily H, Adeli K, Assaran Darban R, Ghayour-Mobarhan M. Pediatric reference intervals for hematology parameters in healthy infants and young children in Iran. Int J Lab Hematol 2023; 45:845-852. [PMID: 37442636 DOI: 10.1111/ijlh.14132] [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: 03/11/2023] [Accepted: 06/16/2023] [Indexed: 07/15/2023]
Abstract
INTRODUCTION Defining accurate age- and sex-specific reference intervals (RIs) for hematology parameters, especially for the pediatric population, is important for making an appropriate clinical diagnosis. To address gaps, we established age-specific RIs for 11 hematologic parameters in Iranian children younger than 30 months for the first time. METHODS Fresh whole blood samples collected from a total of 344 participants (males: 158 and females: 186) ages 3 days to 30 months, with a mean age of 12.91 ± 7.15 months, were recruited from healthcare centers in Mashhad, Iran. Hematologic parameters, including complete blood count (CBC), were analyzed on the Sysmex auto-analyzer system (KX-21 N). RIs were calculated with 90% confidence intervals using the direct method based on CLSI Ep28-A3 and C28-A3 guidelines. RESULTS None of the CBC parameters required sex partitioning. Of 11 CBC parameters, six required age partitions of 3 days-<4 months, 4-<10, 10-<15, and 4-<30 months. Five parameters (i.e., white blood cell count, mean corpuscular hemoglobin concentration, mean platelet volume, red cell distribution width, and platelet distribution width) did not demonstrate age-specific changes. RIs of red blood cell count and hematocrit, as well as hemoglobin, increased with age, while mean corpuscular volume, mean corpuscular hemoglobin, and platelet count, decreased with age. CONCLUSION In this study, we established RIs for 11 hematology parameters in young children. Age partitioning was required for six parameters demonstrating marked changes during the early period of growth and development and necessitating the use of pediatric-specific reference standards.
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Affiliation(s)
- Maliheh Mohammadi
- Department of Biology, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Hamideh Ghazizadeh
- CALIPER Program, Division of Clinical Biochemistry, Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Mohammadi-Bajgiran
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mary Kathryn Bohn
- CALIPER Program, Division of Clinical Biochemistry, Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada
- Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Canada
| | - Mahdiyeh Yaghooti-Khorasani
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Atieh Kamel Khodabandeh
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shannon Steele
- CALIPER Program, Division of Clinical Biochemistry, Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada
- Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Canada
| | | | - Gordon A Ferns
- Division of Medical Education, Falmer, Brighton & Sussex Medical School, Brighton, UK
| | - Hassan Boskabadi
- Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaily
- Social Determinants of Health Research Center, Mashhad University of Medical sciences, Mashhad, Iran
| | - Khosrow Adeli
- CALIPER Program, Division of Clinical Biochemistry, Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada
- Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Canada
| | - Reza Assaran Darban
- Department of Biology, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
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27
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Zini G, Mancini F, Rossi E, Landucci S, d'Onofrio G. Artificial intelligence and the blood film: Performance of the MC-80 digital morphology analyzer in samples with neoplastic and reactive cell types. Int J Lab Hematol 2023; 45:881-889. [PMID: 37641457 DOI: 10.1111/ijlh.14160] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 03/21/2023] [Accepted: 08/06/2023] [Indexed: 08/31/2023]
Abstract
INTRODUCTION Implementing artificial intelligence-based instruments in hematology laboratories requires evidence of efficiency in classifying pathological cells. In two-Universities, we assessed the performance of the Mindray® MC-80 for hematology patients with frequent leukemic and dysplastic cells. METHODS The Mindray MC-80® locates and pre-classifies cells in blood films. In a two-university study, four films were prepared from 591 samples, two each for the analyser MC-80 and the microscope reference method, using reagents from two different manufacturers. We used Microsoft Excel® statistics for imprecision and distributional inaccuracy and a matrix table model (H20-A2 CLSI standard) for sensitivity, specificity and predictive value for atypical cells. RESULTS The results indicate minimal within-run imprecision (ICSH method) and good intra-method consistency even on duplicate analysis of 413 samples with a high incidence of hematological abnormalities (r = 0.942 or more, except for basophils, r = 0.841, and reactive lymphocytes, r = 0.847). Distributional inaccuracy was also very low compared to the microscope reference, with a pass rate higher than 80% for pathological cells (except 75.1% for reactive lymphocytes). The primary causes of discrepancy were bizarre shapes of dysplastic neutrophils and inconsistent nomenclature for lymphoma cells. Sensitivity for critical samples containing cells typically absent in circulating blood (immature or malignant) was 98.8% for immature granulocytes, 83.8% for all types of neoplastic cells, 93.6% for reactive lymphocytes and 97.5% for nucleated red blood cells. The negative predictive values of MC-80 were 98.8% for immature granulocytes, 88.4% for the different types of neoplastic cells, 97.8% for reactive lymphocytes, and 96.9% for nucleated red blood cells. CONCLUSION Our study highlights the outstanding diagnostic performance of this artificial intelligence-based blood film analyzer for hematology patients with circulating abnormal cells. We appreciated the morphological harmonization of cells observed on the screen and those seen in the microscope.
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Affiliation(s)
- Gina Zini
- Catholic University of Sacred Heart, Hematology Service, Rome, Italy
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Francesca Mancini
- Dipartimento di Medicina Traslazionale e di Precisione, Divisione di Ematologia, Università La Sapienza, Rome, Italy
| | - Elena Rossi
- Catholic University of Sacred Heart, Hematology Service, Rome, Italy
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Stefania Landucci
- Dipartimento di Medicina Traslazionale e di Precisione, Divisione di Ematologia, Università La Sapienza, Rome, Italy
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He S, Wu S, Chen T, Cao C. Using complete blood count, serum immunoglobulins G/A/M and complement C3/C4 levels to predict the risk of COPD acute exacerbation: 2-year follow-up in a single-center prospective cohort study. Clin Exp Med 2023; 23:5161-5176. [PMID: 37328656 DOI: 10.1007/s10238-023-01117-x] [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: 04/20/2023] [Accepted: 06/07/2023] [Indexed: 06/18/2023]
Abstract
Autoimmunity is present in patients with stable chronic obstructive pulmonary disease (COPD), playing a role in indirect and direct ways. We aimed to explore whether autoimmunity could play a role in COPD exacerbations and construct autoimmunity-related prediction models. This prospective, longitudinal, observational cohort study enrolled 155 patients with acute COPD exacerbations (AECOPD) followed for at least two years. The laboratory parameters, including complete blood count, serum immunoglobulins G/A/M and complement C3/C4 levels, were collected at enrollment. We studied the demographic characteristics, clinical characteristics and laboratory parameters to identify independent risk factors and build predictive models. The results showed that lower lymphocyte count was associated with noninvasive ventilation (NIV) in patients with AECOPD (the odds ratio [OR] 0.25, the 95% confidence interval [CI]: 0.08-0.81, P = 0.02). Lymphocyte count performed well with an area under the curves (AUC) of 0.75 (P < 0.0001, sensitivity: 78.1%, specificity: 62.3%, cutoff value [Cov] ≤ 1.1). The C index, calibration plot, decision curve analysis (DCA) and bootstrap repetitions indicated that this clinical prediction model based on lymphocyte count for NIV in patients with AECOPD performed well. Having prior home oxygen therapy (OR: 2.82, 95% CI: 1.25-6.36, P = 0.013) and higher COPD Assessment Test (CAT) scores (OR: 1.14, 95% CI: 1.03-1.25, P = 0.011) were associated with the increased risk for respiratory failure. For predicting respiratory failure, CAT scores and home oxygen therapy combined had an AUC-ROC of 0.73 (P < 0.0001). This clinical prediction model based on lymphocyte count may help to assist in treatment decisions for NIV in patients with AECOPD. Lower complement C3 seems to be associated with worse outcomes in patients with AECOPD.
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Affiliation(s)
- Shiyi He
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Ningbo University, 59 Liuting Road, Ningbo, 315010, China
- Health Science Center, Ningbo University, Ningbo, China
| | - Shiyu Wu
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Ningbo University, 59 Liuting Road, Ningbo, 315010, China
| | - Tianwei Chen
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Ningbo University, 59 Liuting Road, Ningbo, 315010, China
- Zhejiang University School of Medicine, Hangzhou, China
| | - Chao Cao
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Ningbo University, 59 Liuting Road, Ningbo, 315010, China.
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Henderson AD, Prospero Ponce CM, Lee AG, Van Stavern GP. Should Routine Complete Blood Count and Electrolytes Be Sent as Part of the Initial Diagnostic Workup for Idiopathic Intracranial Hypertension? J Neuroophthalmol 2023; 43:569-574. [PMID: 37358915 DOI: 10.1097/wno.0000000000001905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Affiliation(s)
- Amanda D Henderson
- Wilmer Eye Institute (ADH), Johns Hopkins University School of Medicine, Baltimore, Maryland; Neuro-Ophthalmology and Ocular Pathology (CMPP), Departments of Surgery and Neurology, Texas Tech University Health Sciences Center El Paso, Paul L. Foster School of Medicine, El Paso, Texas; Blanton Eye Institute (AGL), Houston Methodist Hospital, Houston, Texas; and Department of Ophthalmology and Visual Sciences (GPVS), Washington University in St. Louis School of Medicine, St. Louis, Missouri
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Rosetti M, Olivieri M, Polli V, Massari E, Monti M, Clementoni A, Libri V, Poletti G, Fasano T. Effects of the presence of fibrin strands on complete blood count parameters. Scand J Clin Lab Invest 2023; 83:620-621. [PMID: 38090770 DOI: 10.1080/00365513.2023.2292601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 12/05/2023] [Indexed: 01/25/2024]
Affiliation(s)
- Marco Rosetti
- Clinical Pathology Unit, Hub Laboratory, AUSL della Romagna, Cesena, Italy
| | - Melania Olivieri
- Clinical Pathology Unit, Hub Laboratory, AUSL della Romagna, Cesena, Italy
| | - Valentina Polli
- Clinical Pathology Unit, Hub Laboratory, AUSL della Romagna, Cesena, Italy
| | - Evita Massari
- Clinical Pathology Unit, Hub Laboratory, AUSL della Romagna, Cesena, Italy
| | - Marta Monti
- Clinical Pathology Unit, Hub Laboratory, AUSL della Romagna, Cesena, Italy
| | - Alice Clementoni
- Clinical Pathology Unit, Hub Laboratory, AUSL della Romagna, Cesena, Italy
| | - Virginia Libri
- Clinical Pathology Unit, Hub Laboratory, AUSL della Romagna, Cesena, Italy
| | - Giovanni Poletti
- Clinical Pathology Unit, Hub Laboratory, AUSL della Romagna, Cesena, Italy
| | - Tommaso Fasano
- Clinical Pathology Unit, Hub Laboratory, AUSL della Romagna, Cesena, Italy
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Demir AN, Kara Z, Sulu C, Uysal S, Zulfaliyeva G, Atar OA, Valikhanova N, Ozturk T, Ozkaya HM, Damci T, Gonen MS. The effect of radioiodine therapy on blood cell count in patients with differentiated thyroid cancer. Hormones (Athens) 2023; 22:595-602. [PMID: 37603221 DOI: 10.1007/s42000-023-00479-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 08/08/2023] [Indexed: 08/22/2023]
Abstract
PURPOSE This study aimed to investigate the long-term effects of radioiodine treatment (RAI) on blood cell counts in patients with differentiated thyroid cancer (DTC) and to describe the characteristics of patients at high risk for blood cell count abnormalities. METHODS The study included patients with DTC who underwent RAI treatment between 2007 and 2017. Patients with regular complete blood counts for at least 5 years were included, while those with diseases or treatments that could influence blood count parameters were excluded. Blood cell count abnormalities were defined according to the Common Terminology Criteria for Adverse Events version 5.0, and factors influencing these abnormalities were examined. RESULTS A total of 225 patients were analyzed. The mean age at diagnosis was 45.8 ± 13.9 years, and 76.5% of patients were female. In the first year after RAI, leukocyte, neutrophil, and lymphocyte counts were significantly reduced compared with baseline values. The leukocyte and neutrophil counts returned to baseline values by the third year, while the decrease in lymphocytes continued until the fifth year. Blood cell count abnormalities developed in 16 patients (7.1%) within the first year after RAI. Risk factors for blood cell count abnormalities within the first year after RAI included male sex, older age, T4, N1, and M1 disease, as well as higher RAI doses. In logistic regression analysis, only RAI dose remained independently associated with blood cell count abnormalities. CONCLUSION These results suggest an association between RAI dose and blood cell count abnormalities, characterized by mild lymphopenia, and indicate that the risk of mild lymphopenia persists over time. Careful consideration should be given when planning high-dose RAI for patients at a high risk of blood cell count abnormalities, such as males with metastatic disease and of advanced age.
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Affiliation(s)
- Ahmet Numan Demir
- Department of Endocrinology, Metabolism, and Diabetes, Istanbul University-Cerrahpasa, Istanbul, 34098, Turkey
| | - Zehra Kara
- Department of Endocrinology, Metabolism, and Diabetes, Istanbul University-Cerrahpasa, Istanbul, 34098, Turkey
| | - Cem Sulu
- Department of Endocrinology, Metabolism, and Diabetes, Istanbul University-Cerrahpasa, Istanbul, 34098, Turkey
| | - Serhat Uysal
- Department of Endocrinology, Metabolism, and Diabetes, Istanbul University-Cerrahpasa, Istanbul, 34098, Turkey
| | - Guldana Zulfaliyeva
- Department of Internal Medicine, Istanbul University-Cerrahpasa, 34098, Istanbul, Turkey
| | - Oznur Aydin Atar
- Department of Internal Medicine, Istanbul University-Cerrahpasa, 34098, Istanbul, Turkey
| | - Nahida Valikhanova
- Department of Internal Medicine, Istanbul University-Cerrahpasa, 34098, Istanbul, Turkey
| | - Tulin Ozturk
- Department of Medical Pathology, Istanbul University-Cerrahpasa, 34098, Istanbul, Turkey
| | - Hande Mefkure Ozkaya
- Department of Endocrinology, Metabolism, and Diabetes, Istanbul University-Cerrahpasa, Istanbul, 34098, Turkey
| | - Taner Damci
- Department of Endocrinology, Metabolism, and Diabetes, Istanbul University-Cerrahpasa, Istanbul, 34098, Turkey
| | - Mustafa Sait Gonen
- Department of Endocrinology, Metabolism, and Diabetes, Istanbul University-Cerrahpasa, Istanbul, 34098, Turkey.
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Verdier H, Thomas P, Batista J, Kempster C, McKinney H, Gleadall N, Danesh J, Mumford A, Heemskerk JWM, Ouwehand WH, Downes K, Astle WJ, Turro E. A signature of platelet reactivity in CBC scattergrams reveals genetic predictors of thrombotic disease risk. Blood 2023; 142:1895-1908. [PMID: 37647652 PMCID: PMC10733829 DOI: 10.1182/blood.2023021100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/27/2023] [Accepted: 08/18/2023] [Indexed: 09/01/2023] Open
Abstract
Genetic studies of platelet reactivity (PR) phenotypes may identify novel antiplatelet drug targets. However, such studies have been limited by small sample sizes (n < 5000) because of the complexity of measuring PR. We trained a model to predict PR from complete blood count (CBC) scattergrams. A genome-wide association study of this phenotype in 29 806 blood donors identified 21 distinct associations implicating 20 genes, of which 6 have been identified previously. The effect size estimates were significantly correlated with estimates from a study of flow cytometry-measured PR and a study of a phenotype of in vitro thrombus formation. A genetic score of PR built from the 21 variants was associated with the incidence rates of myocardial infarction and pulmonary embolism. Mendelian randomization analyses showed that PR was causally associated with the risks of coronary artery disease, stroke, and venous thromboembolism. Our approach provides a blueprint for using phenotype imputation to study the determinants of hard-to-measure but biologically important hematological traits.
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Affiliation(s)
- Hippolyte Verdier
- Institut Pasteur, CNRS UMR 3751, Decision and Bayesian Computation, Université Paris Cité, Paris, France
| | - Patrick Thomas
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Joana Batista
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Carly Kempster
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Institute for Cardiovascular and Metabolic Research, School of Biological Sciences, University of Reading, Reading, United Kingdom
| | - Harriet McKinney
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Nicholas Gleadall
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
- National Health Service Blood and Transplant, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - John Danesh
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom
- British Heart Foundation Centre of Research Excellence, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, United Kingdom
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, United Kingdom
| | - Andrew Mumford
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, United Kingdom
- South West National Health Service Genomic Medicine Service Alliance, Bristol, United Kingdom
| | | | - Willem H. Ouwehand
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
- National Health Service Blood and Transplant, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Kate Downes
- Cambridge Genomics Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - William J. Astle
- National Health Service Blood and Transplant, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Medical Research Council Biostatistics Unit, Cambridge Biomedical Campus, University of Cambridge, Cambridge, United Kingdom
- National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, United Kingdom
| | - Ernest Turro
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY
- Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY
- Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
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Pham HN, Huynh NX, Pham PNH, Dang DNY, Cao LT, Huynh DM, Thoi HTT, Le OH, Beaupha SMC. Reference intervals of complete blood count and coagulation tests in Vietnamese pregnant women. BMC Pregnancy Childbirth 2023; 23:788. [PMID: 37951881 PMCID: PMC10638750 DOI: 10.1186/s12884-023-06106-2] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 11/03/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Pregnancy has major effects that make hematology parameters outside of normal reference ranges. Therefore, we conducted this study to establish reference intervals for Vietnamese pregnant women. METHODS From June 2023 to Augst 2023, blood samples from 879 eligible pregnant women were run on DxH 900 hematology analyzer and ACL TOP 550 coagulation analyzer. The tested parameters are prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), white blood cell (WBC) and its differentials (neutrophils, lymphocytes, monocytes, eosinophils and basophils), red blood cell (RBC), hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), RBC distribution width (RDW), RBC distribution width standard deviation (RDW-SD), platelet count (PLT), mean platelet volume (MPV). A non-parametric method was used to establish the 2.5th and 97.5th percentile reference intervals. RESULTS PT, APTT decrease but fibrinogen increases during pregnancy. Physiological adaptations of pregnancy result in a decrease in RBC count, but an increase in WBC count and no changes in platelet count. The reference intervals for PT (seconds), APTT (seconds), fibrinogen (mg/dL), in the first trimester were 10.30-12.88, 25.40-35.46, 280.28-559.00, in the second trimester were 9.80-11.66, 24.05-33.23, 347.75-593.35, in the third trimester were 9.60-11.40, 23.40-31.80, 330.28-628.56, respectively. The reference intervals for main hematology parameters which are WBC (× 109/L), RBC (× 1012/L), HGB (g/dL), HCT (%), PLT (× 109/L) in the first trimester were 6.33-15.24, 3.73-5.32, 10.33-13.95, 32.22-42.29, 169.66-413.88, in the second trimester were 6.99-15.55, 3.33-4.98, 9.71-13.17, 30.26-40.07, 172.34-372.19, in the third trimester were 6.22-14.14, 3.54-4.98, 9.80-13.97, 31.11-42.70, 151.30-417.14, respectively. CONCLUSIONS Most established referenced intervals from each trimester differ from other trimesters. These trimester-specific reference ranges for Vietnamese pregnant women will aid clinicians in entepreting parameters and help other laboratories adopt these ranges after validating. TRIAL REGISTRATION This study is registered at www. CLINICALTRIALS gov as NCT05929326.
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Affiliation(s)
| | | | | | | | | | | | | | - Oanh Hoang Le
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Suzanne Monivong Cheanh Beaupha
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Cho Ray Hospital, Ho Chi Minh City, Vietnam
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Yan J, Li XY, Geng YL, Liang YF, Chen C, Han ZW, Zhou R. [A preliminary prediction model of depression based on whole blood cell count by machine learning method]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:1862-1868. [PMID: 38008578 DOI: 10.3760/cma.j.cn112150-20221202-01169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/28/2023]
Abstract
This study used machine learning techniques combined with routine blood cell analysis parameters to build preliminary prediction models, helping differentiate patients with depression from healthy controls, or patients with anxiety. A multicenter study was performed by collecting blood cell analysis data of Beijing Chaoyang Hospital and the First Hospital of Hebei Medical University from 2020 to 2021. Machine learning techniques, including support vector machine, decision tree, naïve Bayes, random forest and multi-layer perceptron were explored to establish a prediction model of depression. The results showed that based on the blood cell analysis results of healthy controls and depression group, the accuracy of prediction model reached as high as 0.99, F1 was 0.975. Receiver operating characteristic curve area and average accuracy were 0.985 and 0.967, respectively. Platelet parameters contributed mostly to depression prediction model. While, to random forest differential diagnosis model based on the data from depression and anxiety groups, prediction accuracy reached 0.68 and AUC 0.622. Age, platelet parameters, and average volume of red blood cells contributed the most to the model. In conclusion, the study researched on the prediction model of depression by exploring blood cell analysis parameters, revealing that machine learning models were more objective in the evaluation of mental illness.
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Affiliation(s)
- J Yan
- Department of Laboratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - X Y Li
- Department of Laboratory Medicine, the First Hospital of Hebei Medical University, Shijiazhuang 050031, China
| | - Y L Geng
- Department of Laboratory Medicine, the First Hospital of Hebei Medical University, Shijiazhuang 050031, China
| | - Y F Liang
- Department of Laboratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - C Chen
- Beijing Jinfeng Yitong Technology Co., Ltd, Beijing 100020, China
| | - Z W Han
- Beijing Jinfeng Yitong Technology Co., Ltd, Beijing 100020, China
| | - R Zhou
- Department of Laboratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
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Lv S, Sun Y, Zhang J, Jin T, Hu X. Application of the FMEA Method in Improving the Quality Management of Emergency Complete Blood Count Testing. Lab Med 2023; 54:574-581. [PMID: 36864558 DOI: 10.1093/labmed/lmad002] [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] [Indexed: 03/04/2023] Open
Abstract
OBJECTIVE Failure mode and effects analysis (FMEA) was used to identify factors that contribute to quality management deficiencies in laboratory testing of emergency complete blood count (CBC). METHODS Improvements included instrument updates, personnel training, and laboratory information system optimization. We used operational data from January 2021 (control group) and January 2022 (FMEA group) to compare the risk priority number (RPN) of FMEA, emergency CBC laboratory turnaround time (TAT), error report rate, and specimen failure rate. RESULTS After the implementation of FMEA, the average RPN dropped from 36.24 ± 9.68 to 9.45 ± 2.25, (t = 20.89, P < .05). Additionally, the median TAT for emergency CBCs decreased from 23 min to 11 min as did the interquartile distance (17-34 min to 8-16 min) (P < .05). The rate of emergency CBC error reports decreased from 1.39% to 0.71% (P < .05), and the specimen failure rate decreased from 0.95% to 0.32% (P < .05). Patient satisfaction also increased from 43% to 74% (P < .05), and the technician-performed morphology assessment pass rate increased from 16.7% to 100% (P < .05). CONCLUSION Improving the emergency CBC testing process with FMEA can shorten emergency CBC laboratory TAT and reduce specimen failure rates and reporting error rates. The FMEA can be used to improve quality management in emergency CBC laboratories.
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Affiliation(s)
- Shuangshuang Lv
- Clinical Laboratory, DongYang People's Hospital, Dongyang, China
| | - Yingqian Sun
- Clinical Laboratory, DongYang People's Hospital, Dongyang, China
| | - Jian Zhang
- Clinical Laboratory, DongYang People's Hospital, Dongyang, China
| | - Tingting Jin
- Clinical Laboratory, DongYang People's Hospital, Dongyang, China
| | - Xiaxuan Hu
- Clinical Laboratory, DongYang People's Hospital, Dongyang, China
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Maynard RD, Funk T, Harrill W, Jin J, Smith D, Smith G, Korpi-Steiner N. Analytical Performance Evaluation of Three Point-of-Care CBC Analyzers for Management of Clozapine Therapy in Ambulatory Psychiatry Clinics. J Appl Lab Med 2023; 8:1028-1041. [PMID: 37608429 DOI: 10.1093/jalm/jfad050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/09/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND Clozapine is a first-line therapy and the only FDA-approved drug for patients with treatment-resistant schizophrenia (TRS). However, frequent measurement of absolute neutrophil count (ANC) is required to monitor for potential adverse severe neutropenia from clozapine therapy. We evaluated 3 point-of-care (POC) instruments that perform the complete blood count (CBC) with differential to assess their analytical performance and potential to meet the clinical need for clozapine therapy management. METHODS A CBC with differential was performed on 104 residual whole blood specimens using 3 CBC analyzers (Sight OLO, PixCell HemoScreen, and Sysmex pocH-100i) to assess analytical precision, linearity, and accuracy vs the ADVIA 2120i and manual differential reference methods. Clinical concordance of ANC between POC devices and manual differential at medical decision points for mild, moderate, or severe neutropenia, and the threshold for clozapine therapy discontinuation (1.0 × 109/L) were determined. RESULTS For CBC parameters, a CV ≤ 6.4% was observed on the OLO, CV ≤ 6.2% for the HemoScreen, and CV ≤ 5.1% with the pocH-100i. Each device accurately identified ANC with the greatest mean bias ±0.42 × 109/L using the pocH-100i vs manual differential. For results near the medical decision points (ANC <1.5 × 109/L), clinical concordance of ANC results was 55.6% for the OLO, 89.5% for the HemoScreen, and 82.4% for the pocH-100i. CONCLUSIONS The HemoScreen device demonstrated the best clinical concordance in ANC values at medical decision thresholds for clozapine therapy management.
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Affiliation(s)
- Robert D Maynard
- Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Tony Funk
- McLendon Clinical Laboratories, UNC Health, Chapel Hill, NC, United States
| | - William Harrill
- McLendon Clinical Laboratories, UNC Health, Chapel Hill, NC, United States
| | - Jenny Jin
- McLendon Clinical Laboratories, UNC Health, Chapel Hill, NC, United States
| | - Dawn Smith
- McLendon Clinical Laboratories, UNC Health, Chapel Hill, NC, United States
| | - Gina Smith
- McLendon Clinical Laboratories, UNC Health, Chapel Hill, NC, United States
| | - Nichole Korpi-Steiner
- Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, NC, United States
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37
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Khalid N, Umer M. Utilization Of The Complete Blood Count In Diagnosing Endemic Diseases In Pakistan. J PAK MED ASSOC 2023; 73:2219-2225. [PMID: 38013532 DOI: 10.47391/jpma.8459] [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] [Indexed: 11/29/2023]
Abstract
Numerous infectious diseases, including enteric fever, malaria, dengue fever, and, most recently, coronavirus disease-2019, are prevalent in Pakistan. All these diseases have overlapping clinical symptoms and can present a diagnostic challenge for the general practitioner. Since definitive testing for these disorders is time-consuming and expensive, basic clinical testing, such as a complete blood count, should be utilised to supplement clinical diagnosis, when possible. The current narrative review was planned to present specific alterations in haematological parameters for each of these disorders. The review was intended as a guide for practising physicians in their decision-making.
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Affiliation(s)
- Noor Khalid
- Department of Medicine, Benazir Bhutto Hospital, Rawalpindi, Pakistan
| | - Muhammad Umer
- Department of Medicine, Combined Military Hospital, Rawalpindi, Pakistan
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McGuirk JP, Metheny L, Pineiro L, Litzow M, Rowley SD, Avni B, Tamari R, Lazarus HM, Rowe JM, Sheleg M, Rothenstein D, Halevy N, Zuckerman T. Placental expanded mesenchymal-like cells (PLX-R18) for poor graft function after hematopoietic cell transplantation: A phase I study. Bone Marrow Transplant 2023; 58:1189-1196. [PMID: 37553467 PMCID: PMC10622312 DOI: 10.1038/s41409-023-02068-3] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 07/12/2023] [Accepted: 07/21/2023] [Indexed: 08/10/2023]
Abstract
Persistent cytopenia in the post-hematopoietic cell transplantation (HCT) setting can occur despite adequate engraftment of donor cells. PLX-R18, a placental-derived mesenchymal-like cell product, is expanded ex vivo in a 3-dimensional environment. PLX-R18 cells secrete a large array of hematopoietic factors, which promote regeneration, maturation, and differentiation of hematopoietic cells and stimulate their migration to peripheral blood. This phase 1, first-in-human study (NCT03002519), included 21 patients with incomplete hematopoietic recovery post-HCT. Patients were treated with escalating doses of PLX-R18: 3 patients received 1 million cells/kg, 6 received 2 million cells/kg, and 12 received 4 million cells/kg via multiple intramuscular injections. While patients received only two administrations of cells during the first week, peripheral blood counts continued to increase for months, peaking at 6 months for hemoglobin (Hb, p = 0.002), lymphocytes (p = 0.008), and neutrophils (ANC, p = 0.063), and at 9 months for platelets (p < 0.001) and was maintained until 12 months for all but ANC. The need for platelet transfusions was reduced from 5.09 units/month at baseline to 0.55 at month 12 (p = 0.05). Likewise, red blood cell transfusions decreased from 2.91 units/month at baseline to 0 at month 12 (p = 0.0005). PLX-R18 was safe and well tolerated and shows promise in improving incomplete hematopoietic recovery post-HCT.
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Affiliation(s)
- Joseph P McGuirk
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Leland Metheny
- Case Western Reserve University, Cleveland, OH, USA
- University Hospitals Seidman Cancer Center, Cleveland, OH, USA
| | - Luis Pineiro
- Apheresis and Marrow Processing Laboratories, Baylor University Medical Center, Dallas, TX, USA
| | - Mark Litzow
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Scott D Rowley
- Stem Cell Transplantation and Cellular Therapy Program, John Theurer Cancer Center, Hackensack, NJ, USA
| | - Batia Avni
- Hadassah University Medical Center, Jerusalem, Israel
| | - Roni Tamari
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Hillard M Lazarus
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Jacob M Rowe
- Department of Hematology, Shaare Zedek Medical Center, Jerusalem, Israel
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
- Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel
| | | | | | | | - Tsila Zuckerman
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
- Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel
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Deng S, Lv M, Long X. Correlation between pulmonary embolism and blood cell count changes. Cell Mol Biol (Noisy-le-grand) 2023; 69:63-66. [PMID: 37953584 DOI: 10.14715/cmb/2023.69.10.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Indexed: 11/14/2023]
Abstract
Pulmonary embolism is one of the acute diseases of the respiratory system. This study investigates changes in red blood cell counts in pulmonary embolisms confirmed by scintigraphy. Counting red blood cells is essential in diseases, especially pulmonary embolism, because of the vital role of these cells. In this study, 25 patients with pulmonary embolism were selected. A group of 25 healthy volunteers was also considered as a control. At zero, 30, 60 minutes, 24, 48, and 72 hours, blood samples were taken from both control and patient groups, and red blood cells were counted according to the standard method. After extracting technetium-99m from the molybdenum generator, this substance was added to the MAA drug kit under particular conditions. After preparation, radiopharmaceutical 99mTC-MAA with 1.5 millicuries was injected intravenously into both groups. In this study, a significant increase in the red blood cell count of the patient group was observed on the first and second days of the disease. On the third day, this count returned to normal. These changes indicate the functioning of the body's defense system and a response to reduce the complications caused by pulmonary embolism. Therefore, paying more attention to counting red blood cells in pulmonary embolism, along with other care, is recommended due to their particular function.
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Affiliation(s)
- Shuling Deng
- Department of Internal Medicine ICU, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning116001, China.
| | - Mingyi Lv
- Department of Internal Medicine ICU, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning116001, China.
| | - Xiaofeng Long
- Department of Internal Medicine ICU, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning116001, China.
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Yilmaz S, Dağ M, Kizilarslanoğlu MC, Baştürk A. Can Pseudothrombocytopenia be recognised at first look? Medicine (Baltimore) 2023; 102:e35395. [PMID: 37832120 PMCID: PMC10578760 DOI: 10.1097/md.0000000000035395] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 09/05/2023] [Indexed: 10/15/2023] Open
Abstract
Our aim was to determine the laboratory parameters that distinguish pseudothrombocytopenia from true thrombocytopenia. A total of 107 patients who were referred to the adult hematology outpatient clinic with thrombocytopenia and subsequently diagnosed with acute myeloid leukaemia, immune thrombocytopenia and pseudothrombocytopenia were included in our study. Hemogram parameters on admission, platelet value in the control hemogram and peripheral smear findings were recorded. Forty three (40.2%) males and 64 (59.8%) females, were included in our study. There were 25 patients in the leukaemia group, 39 in the immune thrombocytopenia group and 43 in the pseudothrombocytopenia group. Control platelet value and red cell distribution width/platelet ratio were found to be statistically significantly different between the 3 groups. Receiver operating characteristic analysis based on platelet values showed that platelet value ≤ 38,000/µL (86% sensitivity, 78.1% specificity, P < .001), difference between 2 consecutively measured platelet levels ≤ 11. 000/µL (79.1% sensitivity, 79.7% specificity, P < .001), red cell distribution width/platelet ratio ≥ 0.413 (90.7% sensitivity, 78.1% specificity, P < .001) were found to be in favor of true thrombocytopenia. In the differentiation of pseudothrombocytopenia and true thrombocytopenia, the difference between the hemogram parameters at the time of admission and the platelet count in the control blood count may be guiding. This result may reduce patient and physician anxiety and prevent patient referral.
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Affiliation(s)
- Seda Yilmaz
- Department of Internal Medicine, Clinic of Hematology, Konya City Hospital, Konya, Turkey
| | - Mikail Dağ
- Department of Internal Medicine, Şanliurfa Training and Research Hospital, Şanliurfa, Turkey
| | - Muhammet Cemal Kizilarslanoğlu
- Department of Internal Medicine, Division of Geriatrics, University of Health Sciences, Konya City Hospital, Konya, Turkey
| | - Abdulkadir Baştürk
- Department of Internal Medicine, Clinic of Hematology, Konya City Hospital, Konya, Turkey
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41
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Juchnowicz D, Dzikowski M, Rog J, Waszkiewicz N, Karakuła KH, Zalewska A, Maciejczyk M, Karakula-Juchnowicz H. The usefulness of a complete blood count in the prediction of the first episode of schizophrenia diagnosis and its relationship with oxidative stress. PLoS One 2023; 18:e0292756. [PMID: 37824542 PMCID: PMC10569548 DOI: 10.1371/journal.pone.0292756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 09/27/2023] [Indexed: 10/14/2023] Open
Abstract
A complete blood count (CBC) is a routinely performed blood examination. Only a few studies assess the relationship between CBC and oxidative stress (OS) in schizophrenia (SZ). The aim of the study was to assess the utility of CBC in the prediction of SZ diagnosis, and the relationship between CBC and OS. The study included: 47 individuals with the first episode of psychosis (26 drug-naive: FEP-nt; 21 patients under antipsychotic treatment: FEP-t) and 30 healthy persons (control group, HC). CBC and oxidative stress-related parameters were assessed in blood samples. The FEP group had higher levels of WBC, MCHC, NEU, MONO, EOZ, BASO, and %EOZ compared to HC (p<0.05). Various relationships between OS and CBC were found, and this connection was significantly different between healthy individuals and patients. The most promising C&RT model for discriminating FEP from HC was combining monocytes, eosinophils, and neutrophils (accuracy: 77%, 95%CI = 0.67-0.87). The analysis singled out WBC and HT (accuracy: 74%, 95%CI = 0.64-0.90) as the most promising to distinguish FEP-nt from HC; WBC and %Neu to allocate to FEP-t or HC group (accuracy: 87%, 95%CI = 0.64-0.90); RDW-SD and LYMPH (accuracy: 86%, 95% CI = 0.75-97) for distinguishing FEP-nt from FEP-t. CBC could be a promising, cheap tool to determine abnormalities related to schizophrenia. However, more studies with larger sample sizes are required.
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Affiliation(s)
- Dariusz Juchnowicz
- Department of Psychiatric Nursing, Medical University of Lublin, Lublin, Poland
| | - Michał Dzikowski
- 1st Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Lublin, Poland
| | - Joanna Rog
- Laboratory of Human Metabolism Research, Department of Dietetics, Warsaw University of Life Sciences, Warsaw, Poland
| | | | - Kaja Hanna Karakuła
- 1st Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Lublin, Poland
| | - Anna Zalewska
- Department of Restorative Dentistry and Experimental Dentistry Laboratory, Medical University of Bialystok, Bialystok, Poland
| | - Mateusz Maciejczyk
- Department of Hygiene, Epidemiology and Ergonomics, Medical University of Bialystok, Bialystok, Poland
| | - Hanna Karakula-Juchnowicz
- 1st Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Lublin, Poland
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Poottasane N, Phornprasitsaeng P, Onthong Y, Sinthana T, Limvorapitak W. Predictive Score for Dengue Infection with Complete Blood Count Parameters, Including the Monocyte Distribution Width: A Retrospective Single-Center Derivation and Validation Study. Am J Trop Med Hyg 2023; 109:926-932. [PMID: 37640293 PMCID: PMC10551065 DOI: 10.4269/ajtmh.23-0104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 07/19/2023] [Indexed: 08/31/2023] Open
Abstract
Early detection of dengue virus infection will lead to proper management and reduction in morbidity/mortality. Monocyte distribution width (MDW) was recently approved for use in the early detection of sepsis. Because monocytes are involved in the innate immune system against viral infection, we sought to determine changes in MDW to develop and validate a new predictive score for dengue viral infection. This study included patients who presented with symptoms or signs related to dengue infection and who had a complete blood count and dengue investigation performed during September 2019 to May 2020. The proportion of dengue infection was 29.5% in the current study. The MDW was significantly higher in dengue infection (median, 29.7 versus 24.2; P < 0.001). We then randomly separated patients into training and validation cohorts. Independent predictive factors of dengue infection were white blood cells < 4 × 109/L (score 1), platelets < 100 × 109/L (score 1), and MDW > 24 (score 1). Clinical features were not significantly predictive of dengue infection. The areas under the receiver operating characteristic curve (95% CI) of the prognostic score were 0.839 (0.779-0.899) in the training cohort and 0.742 (0.674-0.811) in the validation cohort. With a cutoff score ≥ 1, the sensitivity and specificity of the scores were 92.2% and 40.8% in the training cohort and 88.9% and 44.1% in the validation cohort, respectively. We concluded that MDW increases with dengue infection and MDW could easily be incorporated in the predictive scores for dengue infection.
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Affiliation(s)
- Naiyana Poottasane
- Hematology Unit Medical Technology Laboratory, Thammasat University Hospital, Khlong Luang, Pathumthani, Thailand
| | - Pharkchawis Phornprasitsaeng
- Hematology Unit Medical Technology Laboratory, Thammasat University Hospital, Khlong Luang, Pathumthani, Thailand
| | - Yupapin Onthong
- Hematology Unit Medical Technology Laboratory, Thammasat University Hospital, Khlong Luang, Pathumthani, Thailand
| | - Thurdsak Sinthana
- Hematology Unit Medical Technology Laboratory, Thammasat University Hospital, Khlong Luang, Pathumthani, Thailand
| | - Wasithep Limvorapitak
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Khlong Luang, Pathumthani, Thailand
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Chopra S, Karandikar NJ, Holman CJ. Systematic Evaluation of Hematologic Parameters and Blood Smear Findings in Patients With SARS-CoV-2 vs Other Viral Respiratory Infections. Am J Clin Pathol 2023; 160:331-334. [PMID: 37289433 DOI: 10.1093/ajcp/aqad061] [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: 02/27/2023] [Accepted: 05/02/2023] [Indexed: 06/09/2023] Open
Abstract
OBJECTIVES We evaluated and compared the peripheral blood findings in patients with acute COVID-19 vs other viral respiratory infections. METHODS We retrospectively reviewed peripheral blood counts and smear morphology in patients with a positive viral respiratory panel (VRP) or SARS-CoV-2 test. RESULTS A total of 97 peripheral blood samples (COVID-19 infection, 53; VRP positive, 44) from 50 patients (mean [SD] age, 45.8 [20.8] years; females 52%) were reviewed. There were no statistically significant differences in the demographic characteristics between the 2 groups. The most common peripheral blood abnormalities were anemia, thrombocytopenia, absolute lymphopenia, and reactive lymphocytes. The following peripheral blood findings were significantly associated with other viral respiratory infections compared with COVID-19 infection: low red blood cell count, low hematocrit, high mean corpuscular volume, thrombocytopenia, low mean platelet volume, high red cell distribution width, band neutrophilia, and toxic granulation in neutrophils. CONCLUSIONS Our study showed that there are several peripheral blood count and morphologic abnormalities seen in patients with COVID-19, but most of these findings lack specificity as they are also seen in the other viral respiratory infections.
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Affiliation(s)
- Saurav Chopra
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, US
| | - Nitin J Karandikar
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, US
| | - Carol J Holman
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, US
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Liao H, Xu Y, Meng Q, Mao Z, Qiao Y, Liu Y, Zheng Q. A convolutional neural network-based, quantitative complete blood count scattergram-mapping framework promptly screens acute promyelocytic leukemia with high sensitivity. Cancer 2023; 129:2986-2998. [PMID: 37254628 DOI: 10.1002/cncr.34890] [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: 01/31/2023] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Acute promyelocytic leukemia (APL) is a subtype of acute myeloid leukemia (AML) characterized by its rapidly progressive and fatal clinical course if untreated, although it is curable if treated in a timely manner. Promptly screening patients who have results that are suspicious for APL is vital to overcome early death. METHODS The authors developed an innovative framework consisting of ResNet-18, a convolutional neural network architecture, with the objective of quantitatively mapping a complete blood count (CBC) scattergram to quickly and robustly indicate a probable susceptibility to APL. Three hundred and twenty scattergrams of the white blood cell differential channel from 51 patients with APL, 510 scattergrams from 105 patients who had non-APL AML, and 320 scattergrams from 320 healthy controls were randomly stratified at a ratio of 4:1 and split into training and testing data sets to accomplish five-fold cross-validation. RESULTS Both the area under the curve and the average precision of >0.99 were achieved in each fold. Three hundred four of the 320 APL scattergrams (95%) were correctly flagged by the model, which outcompeted the CBC review rules recommended by the International Society of Laboratory Hematology (all p < .001). External validation based on an independent testing data set that included 56 scattergrams from 31 patients with APL, 56 scattergrams from 55 patients with non-APL AML, and 64 scattergrams from 64 healthy controls also confirmed the sensitivity and specificity of the framework. CONCLUSIONS To the authors' knowledge, their convolutional neural network-based framework is the first to use scattergram output from routine CBC analysis to map suspicious APL early with outstanding sensitivity, specificity, and precision. The authors also describe a new CBC workflow incorporating this framework upstream of the morphologic review, which would provide the earliest flag for APL. PLAIN LANGUAGE SUMMARY The authors propose an innovative way to visualize complete blood counts (CBCs) by mapping the difference in white blood cell counts using automated CBC analysis to identify potential acute promyelocytic leukemia (APL) using a convolutional neural network (CNN), which can eliminate the potential pitfalls of manual observation. Analyses of an unprecedented, realistic data set validated that the quantitative relationship between the CBC scattergram and an APL abnormality is highly consistent. This is the first study to date focusing on screening for APL using scattergrams of the difference in white blood cell counts from routine CBC tests and has significant clinical relevance. The authors recommend using this method even before analyzing cell images, which could provide the earliest way to screen for APL in a sensitive and accurate way.
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Affiliation(s)
- Hongyan Liao
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Yuanxin Xu
- College of Electrical Engineering, Sichuan University, Chengdu, China
| | - Qiang Meng
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Zhigang Mao
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Yifan Qiao
- College of Computer Science, Sichuan University, Chengdu, China
| | - Yan Liu
- College of Electrical Engineering, Sichuan University, Chengdu, China
| | - Qin Zheng
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
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Kilpeläinen L, Nikkilä A, Lohi O. Pre-harvest CD34 + cell counts predicted peripheral blood stem cell collection yields. Acta Paediatr 2023; 112:2189-2190. [PMID: 37332113 DOI: 10.1111/apa.16879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/13/2023] [Accepted: 06/15/2023] [Indexed: 06/20/2023]
Affiliation(s)
- Laura Kilpeläinen
- TamCAM - Tampere Center for Child, Adolescent and Maternal Health Research, Faculty of Health Sciences and Medicine, Tampere University, Tampere, Finland
| | - Atte Nikkilä
- TamCAM - Tampere Center for Child, Adolescent and Maternal Health Research, Faculty of Health Sciences and Medicine, Tampere University, Tampere, Finland
- Kanta-Häme Central Hospital, Hämeenlinna, Finland
| | - Olli Lohi
- TamCAM - Tampere Center for Child, Adolescent and Maternal Health Research, Faculty of Health Sciences and Medicine, Tampere University, Tampere, Finland
- Tays Cancer Center and Department of Pediatrics, Tampere University Hospital, Tampere, Finland
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46
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da Silva AJ, dos Santos Lopes AC, Mota APL, Silva ACSE, Dusse LMS, Alpoim PN. Pediatric chronic kidney disease: blood cell count indexes as inflammation markers. J Bras Nefrol 2023; 45:458-469. [PMID: 37948452 PMCID: PMC10726671 DOI: 10.1590/2175-8239-jbn-2022-0190en] [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: 02/01/2023] [Accepted: 06/11/2023] [Indexed: 11/12/2023] Open
Abstract
INTRODUCTION Chronic kidney disease (CKD) is defined as a progressive decline of kidney functions. In childhood, the main triggering factors are congenital anomalies of the kidneys and urinary tract (CAKUT) and glomerulopathies. Inflammatory responses present challenges for diagnosis and staging, which justifies studies on biomarkers/indexes. AIM To define blood cell count indexes and verify their association with pediatric CKD etiology and staging. The included indexes were: Neutrophil-Lymphocyte Ratio (NLR), Derived Neutrophil-Lymphocyte Ratio (dNLR), Lymphocyte-Monocyte Ratio (LMR), Systemic Inflammation Response Index (SIRI), Aggregate Index of Systemic Inflammation (AISI), and Systemic Immune-Inflammation Index (SII). METHODS We determined the indexes in 52 pediatric CKD patients and 33 healthy controls by mathematical calculation. CKD patients were separated in five groups based on the etiology and staging: Group IA: glomerulopathies at stage 1 or 2; IB: glomerulopathies at stage 3 or 4; IIA: CAKUT at stage 1 or 2; IIB: CAKUT at stage 3 or 4; and III: stages 3 or 4 of other etiologies. In addition, we combined all patients with CKD in one group (IV). Group V was a healthy control group. RESULTS Lower values of LMR were observed for groups IB and IIB compared to group V (p = 0.047, p = 0.031, respectively). Increased values of SIRI were found for group III versus group V (p = 0.030). There was no difference for other indexes when the groups were compared two by two. CONCLUSION The LMR and SIRI indexes showed promising results in the evaluation of inflammation, as they correlated with CKD etiologies and specially staging in these patients.
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Affiliation(s)
- Aislander Junio da Silva
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Belo Horizonte, MG, Brazil
| | - Ana Cristina dos Santos Lopes
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Belo Horizonte, MG, Brazil
| | - Ana Paula Lucas Mota
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Belo Horizonte, MG, Brazil
| | - Ana Cristina Simões e Silva
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Pediatria, Belo Horizonte, MG, Brazil
| | - Luci Maria Sant’Ana Dusse
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Belo Horizonte, MG, Brazil
| | - Patrícia Nessralla Alpoim
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Belo Horizonte, MG, Brazil
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Gao MY, Ge ML, Huo JL, Li XX, Shao YQ, Huang JB, Ren X, Zhang J, Wang M, Nie N, Jin P, Zheng YZ. [Melatonin-Mediated Inhibitory Effect on Hyperimmune Status of Acquired Aplastic Anemia]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2023; 31:1462-1468. [PMID: 37846701 DOI: 10.19746/j.cnki.issn.1009-2137.2023.05.033] [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] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
OBJECTIVE To evaluate the expression level of melatonin and its effects on immune function in aplastic anemia (AA) patients. METHODS The enzyme-linked immunosorbent assay (ELISA) was used to detect the plasma levels of melatonin in AA patients, and the correlation between melatonin levels and laboratory indexs was analyzed. The activation, proliferation, and apoptosis of T cells from AA patients were analyzed by flow cytometry with or without melatonin in vitro. RESULTS The plasma levels of melatonin in AA patients were significantly lower compared with healthy controls (HC) (12.23 pg/ml vs 20.04 pg/ml, P < 0.01), while the plasma melatonin levels of AA patients in remission group after immunosuppressive therapy (IST) were significantly higher than those in non-remission group (29.16 pg/ml vs 11.73 pg/ml, P =0.04). Moreover, the melatonin levels were positively correlated with platelets (r =0.49), the absolute reticulocyte count (r =0.45), and the percentage of neutrophils (r =0.43). Meanwhile, there was a negative correlation between melatonin levels and the percentages of lymphocytes (r =-0.45). The expressions of CD25 and CD69 in both CD4+ and CD8+ T cells from AA patients were remarkably inhibited by melatonin in vitro (all P < 0.05). When cultured with melatonin, the proliferation rates of both CD4+ and CD8+ T cells from AA patients were markedly suppressed (P =0.01 andP < 0.01). CONCLUSION The plasma levels of melatonin were decreased in AA patients, which might play an important role in the mechanism of immunological abnormalities. The hyperimmune status of AA patients could be partially ameliorated by melatonin in vitro.
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Affiliation(s)
- Meng-Ying Gao
- Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Tianjin 300020, China
| | - Mei-Li Ge
- Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Tianjin 300020, China.E-mail:
| | - Jia-Li Huo
- Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Tianjin 300020, China
| | - Xing-Xin Li
- Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Tianjin 300020, China
| | - Ying-Qi Shao
- Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Tianjin 300020, China
| | - Jin-Bo Huang
- Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Tianjin 300020, China
| | - Xiang Ren
- Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Tianjin 300020, China
| | - Jing Zhang
- Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Tianjin 300020, China
| | - Min Wang
- Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Tianjin 300020, China
| | - Neng Nie
- Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Tianjin 300020, China
| | - Peng Jin
- Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Tianjin 300020, China
| | - Yi-Zhou Zheng
- Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Tianjin 300020, China.E-mail:
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48
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Gauthier N. [Blood count in adults and children: indications and interpretation]. Rev Prat 2023; 73:909-914. [PMID: 38354018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Affiliation(s)
- Nicolas Gauthier
- Service d'hématologie clinique, hôpital de La Pitié-Salpêtrière,AP-HP, Paris
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49
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Loo E, Rodrigues Simoes NJ, Browne LJ, Mindiola Romero AE, Kaur P. Hematology lab waste reduction through implementation of peripheral smear review criteria. Int J Lab Hematol 2023; 45:813-815. [PMID: 37211976 DOI: 10.1111/ijlh.14103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 05/03/2023] [Indexed: 05/23/2023]
Affiliation(s)
- Eric Loo
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Health, Lebanon, New Hampshire, USA
| | - Nathalie J Rodrigues Simoes
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Health, Lebanon, New Hampshire, USA
| | - Leslie J Browne
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Health, Lebanon, New Hampshire, USA
| | - Andres E Mindiola Romero
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Health, Lebanon, New Hampshire, USA
| | - Prabhjot Kaur
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Health, Lebanon, New Hampshire, USA
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Golcuk Y, Ergözen S, Golcuk BK. Beyond Complete Blood Cell Count Parameters: Factors Predicting Severity in Children With Carbon Monoxide Poisoning. Pediatr Emerg Care 2023; 39:e72. [PMID: 37665973 DOI: 10.1097/pec.0000000000003047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
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