1
|
Torrungruang K, Vathesatogkit P, Mahanonda R, Thienpramuk L. Periodontitis and hypertension are linked through systemic inflammation: A 5-year longitudinal study. J Clin Periodontol 2024; 51:536-546. [PMID: 38196116 DOI: 10.1111/jcpe.13942] [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: 09/28/2023] [Accepted: 12/17/2023] [Indexed: 01/11/2024]
Abstract
AIM To investigate the associations between periodontitis and hypertension and potential mediation via systemic inflammation through a 5-year longitudinal study. MATERIALS AND METHODS The severity and extent of periodontitis were determined using probing depth (PD). Oral hygiene was assessed using plaque scores. The associations between periodontal variables and 5-year blood pressure changes or incident hypertension were analysed using linear or Poisson regression, adjusting for potential confounders. Mediation analysis of two systemic inflammatory biomarkers, namely white blood cell count (WBC) and C-reactive protein (CRP) levels, was performed. RESULTS The study population included 901 hypertension-free participants, aged 50-73 years. Greater mean PD, higher percentage of sites with PD ≥ 6 mm and poor oral hygiene were associated with elevated systolic blood pressure and increased hypertension risk (relative risks = 1.17 [95% confidence interval [CI]: 1.02-1.34], 1.13 [95% CI: 1.02-1.26] and 1.08 [95% CI: 1.03-1.13], respectively). Periodontitis and poor oral hygiene were associated with higher WBC and CRP levels (p < .05), which, in turn, were associated with increased hypertension risk (p < .05). WBC and CRP jointly mediated 14.1%-26.9% of the associations between periodontal variables and incident hypertension. CONCLUSIONS Periodontitis and poor oral hygiene were associated with increased hypertension risk, and systemic inflammation was, in part, a mediator of these associations.
Collapse
Affiliation(s)
- Kitti Torrungruang
- Department of Microbiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Prin Vathesatogkit
- Department of Internal Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Rangsini Mahanonda
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Lalitsara Thienpramuk
- Dental Clinic Department, Medical and Health Division, Electricity Generating Authority of Thailand, Nonthaburi, Thailand
| |
Collapse
|
2
|
Bambo GM, Asmelash D, Alemayehu E, Gedefie A, Duguma T, Kebede SS. Changes in selected hematological parameters in patients with type 1 and type 2 diabetes: a systematic review and meta-analysis. Front Med (Lausanne) 2024; 11:1294290. [PMID: 38444411 PMCID: PMC10912516 DOI: 10.3389/fmed.2024.1294290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/29/2024] [Indexed: 03/07/2024] Open
Abstract
Background Diabetes mellitus is a chronic metabolic disorder that causes hyperglycemia and various life-threatening health problems. Although hematological parameters play a significant role in the progression and pathogenesis of diabetes, many studies have explored contradictory findings. Therefore, this evidence-based study aimed to determine the pooled mean difference of white blood cell and red blood cell parameters in diabetic patients in order to investigate hematological dysfunctions in type 1 and type 2 diabetes mellitus. Methods Articles were extensively searched in bibliographic databases (PubMed, Cochrane library, Scopus, Web of Science, PsycINFO, Embase, online archives and university repositories) using appropriate entry terms. For studies meeting the eligibility criteria, the first author's name, year of publication, study design and area, type of diabetes mellitus, sample size, and mean and standard deviation of hematological parameters were extracted using Microsoft Excel and exported to Stata 11 for meta-analysis. The pooled standardized mean difference (SMD) was determined using the random effects model, and heterogeneity was quantified using Higgins' I2 statistics. Egger's test and funnel plot were performed to measure bias. Furthermore, a sensitivity analysis was performed to determine the small study effect. Results Initially 39, 222 articles were identified. After screening of the entire methodology, 22 articles with 14,041 study participants (6,146 T2DM, 416 T1DM patients and 7,479 healthy controls) were included in this study. The pooled SMD in TLC (109/L) was 0.66 and -0.21, in T2DM and T1DM, respectively. Differences in absolute differential WBC counts for neutrophils, eosinophils, basophils, lymphocytes and monocytes in T2DM were 0.84, -1.59, 3.20, 0.36 and 0.26, respectively. The differences in relative differential counts (%) in T2DM were as follows: neutrophils: 1.31, eosinophils: -0.99, basophils: 0.34, lymphocytes: -0.19 and monocyte: -0.64. The SMD of differential counts of WBC (109/L) parameters; neutrophils, lymphocytes, monocytes and basophils in T1DM were -0.10, -0.69, 0.19, and -0.32, respectively. The pooled SMD in RBC parameters in T2DM were as follows: RBC: -0.57 (106/μL), Hb: -0.73 g/dL and HCT: -1.22%, Where as in T1DM RBC, Hb and HCT were -1.23 (106/μL), -0.80 g/dL and -0.29%, respectively. Conclusion Patients with T2DM had significantly increased TLC counts, absolute neutrophil, basophil, lymphocyte, monocyte counts and relative counts of neutrophils and basophils in comparison to controls. On the contrary, the absolute eosinophil count and relative lymphocyte, eosinophil and monocyte counts were decreased. In T1DM, WBC parameters were significantly decreased except monocytes. RBC parameters were found to be significantly decreased in T2DM patients. In T1DM, Hb and HCT were significantly decreased. However, there is no significant difference in RBC as compared with non-diabetic controls. The findings indicated a significant alteration of WBC and RBC parameters in both diabetic patients suggesting the considerable metabolic effect of diabetes on hematologic parameters. Systematic review registration https://www.crd.york.ac.uk/prospero/export_details_pdf.php, identifier [CRD42023413486].
Collapse
Affiliation(s)
- Getachew Mesfin Bambo
- Department of Medical Laboratory Sciences, College of Health Sciences, Mizan-Tepi University, Mīzan, Ethiopia
| | - Daniel Asmelash
- Department of Medical Laboratory Sciences, College of Health Sciences, Mizan-Tepi University, Mīzan, Ethiopia
| | - Ermiyas Alemayehu
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Alemu Gedefie
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Tadesse Duguma
- Department of Medical Laboratory Sciences, College of Health Sciences, Mizan-Tepi University, Mīzan, Ethiopia
| | - Samuel Sahile Kebede
- Department of Medical Laboratory Sciences, College of Health Sciences, Mizan-Tepi University, Mīzan, Ethiopia
| |
Collapse
|
3
|
Gasbarrino K, Zheng H, Daskalopoulou SS. Circulating Sex-Specific Markers of Plaque Instability in Women and Men With Severe Carotid Atherosclerosis. Stroke 2024; 55:269-277. [PMID: 38252755 DOI: 10.1161/strokeaha.123.044840] [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: 08/15/2023] [Accepted: 12/15/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND Sex-specific differences in plaque composition and instability underscore the need to explore circulating markers for better prediction of high-risk plaques. This cross-sectional study aims to (1) investigate differences in lipid, immune, and adipokine circulating profiles between men and women with stable versus unstable plaques and (2) identify circulating markers that can better classify men and women according to plaque instability. METHODS Preoperative blood samples and plaque specimens were collected from consecutive men and women with carotid artery stenosis ≥50% and who underwent a carotid endarterectomy between 2009 and 2018. Adipokine, lipid, and immune profiling was conducted. Plaque stability was determined by gold-standard histological classifications. Statistical analyses, including χ2, ANOVA, Kruskal-Wallis, and logistic regression, assessed differences in plaque features and blood parameters between men and women with stable and unstable plaques. RESULTS Of 470 recruited patients (aged 70.8±9.2 years), the final study analyses included 317 men and 143 women (aged 71.0±9.0 years). Men exhibited more unstable plaques (P<0.001), characterized by increased plaque hemorrhage, larger lipid core, and inflammation (P<0.001), along with less favorable circulating profiles. Antagonistic interactions between sex and white blood cell (WBC) counts, basophil-to-WBC ratio, and platelet counts influenced plaque instability. In men, low WBC counts, high monocyte-to-WBC ratio, low basophil-to-WBC ratio, and high LDL-C (low-density lipoprotein cholesterol) levels were associated with greater plaque instability (odds ratio, 0.827 [95% CI, 0.713-0.926], 1.158 [95% CI, 1.027-1.305], 0.495 [95% CI, 0.281-0.871], and 1.564 [95% CI, 1.001-2.443], respectively) and more unstable features (ie, inflammation, foam cells, and neovascularization). In women, a high basophil-to-WBC ratio was associated with greater plaque instability (3.142 [95% CI, 1.220-8.093]), hemorrhage, and thrombosis, while a high molecular weight-to-total adiponectin ratio was associated with decreased instability (0.014 [95% CI, 0.000-0.646]) and inflammation. CONCLUSIONS Our findings demonstrated sex-specific differences, with women displaying more stable plaque phenotypes and favorable circulating profiles compared with men. This proof-of-concept study was also designed as the key first step in exploring novel sex-specific associations between circulating lipid, immune, and adipokine profiles and carotid plaque instability.
Collapse
Affiliation(s)
- Karina Gasbarrino
- Division of Experimental Medicine, Research Institute of McGill University Health Centre (K.G., H.Z., S.S.D.), Department of Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Huaien Zheng
- Division of Experimental Medicine, Research Institute of McGill University Health Centre (K.G., H.Z., S.S.D.), Department of Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Stella S Daskalopoulou
- Division of Experimental Medicine, Research Institute of McGill University Health Centre (K.G., H.Z., S.S.D.), Department of Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Division of Internal Medicine, McGill University Health Centre (S.S.D.), Department of Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada
| |
Collapse
|
4
|
Krychtiuk KA, Bräu K, Schauer S, Sator A, Galli L, Baierl A, Hengstenberg C, Gangl C, Lang IM, Roth C, Berger R, Speidl WS. Association of Periprocedural Inflammatory Activation With Increased Risk for Early Coronary Stent Thrombosis. J Am Heart Assoc 2024; 13:e032300. [PMID: 38214300 PMCID: PMC10926812 DOI: 10.1161/jaha.122.032300] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/14/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Stent thrombosis is a rare but deleterious event. Routine coronary angiography with percutaneous coronary intervention (PCI) is often deferred in the presence of laboratory markers of acute inflammation to prevent complications. The aim of this study was to investigate whether an acute inflammatory state is associated with an increased risk of early stent thrombosis. METHODS AND RESULTS Within a prospective single-center registry, the association between preprocedural acute inflammatory activation, defined as C-reactive protein plasma levels >50 mg/L or a leukocyte count >12 g/L, and occurrence of early (≤30 days) stent thrombosis was evaluated. In total, 11 327 patients underwent PCI and of those, 6880 patients had laboratory results available. 49.6% of the study population received PCI for an acute coronary syndrome and 50.4% for stable ischemic heart disease. In patients with signs of acute inflammatory activation (24.9%), PCI was associated with a significantly increased risk for stent thrombosis (hazard ratio, 2.89; P<0.00001), independent of age, sex, kidney function, number and type of stents, presence of multivessel disease, choice of P2Y12 inhibitor, and clinical presentation. Elevated laboratory markers of acute inflammation were associated with the occurrence of stent thrombosis in both patients with acute coronary syndrome (hazard ratio, 2.63; P<0.001) and in patients with stable ischemic heart disease (hazard ratio, 3.57; P<0.001). CONCLUSIONS An acute inflammatory state at the time of PCI was associated with a significantly increased risk of early stent thrombosis. Evidence of acute inflammation should result in deferred PCI in elective patients, while future studies are needed for patients with acute coronary syndrome.
Collapse
Affiliation(s)
- Konstantin A. Krychtiuk
- Department of Internal Medicine II–Division of CardiologyMedical University of ViennaViennaAustria
- Ludwig Boltzmann Institute for Cardiovascular ResearchViennaAustria
| | - Konstantin Bräu
- Department of Internal Medicine II–Division of CardiologyMedical University of ViennaViennaAustria
| | - Stephanie Schauer
- Department of Internal Medicine II–Division of CardiologyMedical University of ViennaViennaAustria
| | - Alexander Sator
- Department of Internal Medicine II–Division of CardiologyMedical University of ViennaViennaAustria
| | - Lukas Galli
- Department of Internal Medicine II–Division of CardiologyMedical University of ViennaViennaAustria
- Ludwig Boltzmann Institute for Cardiovascular ResearchViennaAustria
| | - Andreas Baierl
- Department of Statistics and Operations ResearchUniversity of ViennaViennaAustria
| | - Christian Hengstenberg
- Department of Internal Medicine II–Division of CardiologyMedical University of ViennaViennaAustria
| | - Clemens Gangl
- Department of Internal Medicine II–Division of CardiologyMedical University of ViennaViennaAustria
| | - Irene M. Lang
- Department of Internal Medicine II–Division of CardiologyMedical University of ViennaViennaAustria
| | - Christian Roth
- Department of Internal Medicine II–Division of CardiologyMedical University of ViennaViennaAustria
| | - Rudolf Berger
- Department of Internal Medicine ICardiology and Nephrology, Hospital of St. John of GodEisenstadtAustria
| | - Walter S. Speidl
- Department of Internal Medicine II–Division of CardiologyMedical University of ViennaViennaAustria
- Ludwig Boltzmann Institute for Cardiovascular ResearchViennaAustria
| |
Collapse
|
5
|
Balasundaram P, Al-Mulaabed SW, Roger K. Unraveling Leukocyte Profile Shifts and Platelet Dynamics Following Leukoreduced Packed Red Cell Transfusions in Very Low Birth Weight Preterm Neonates. Cureus 2023; 15:e44900. [PMID: 37814753 PMCID: PMC10560488 DOI: 10.7759/cureus.44900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2023] [Indexed: 10/11/2023] Open
Abstract
Background Packed red blood cell (PRBC) transfusions are routine in neonatal care and the most common blood product administered to sick neonates. However, their impact on leukocyte and platelet profiles in very low birth weight (VLBW) preterm infants remains largely unexplored. This study examines leukocyte profile shifts and platelet dynamics following leukoreduced PRBC transfusions in VLBW preterm infants, offering insights to improve neonatal care and reduce unnecessary interventions. Methods The study utilized a retrospective cohort design within a single center, focusing on VLBW preterm infants who received PRBC transfusions at a level 3 NICU between January 2014 and June 2019. Data collection encompassed white blood cell (WBC) and platelet count measurements taken 24 hours before and up to 72 hours after PRBC transfusion. Neonates lacking complete blood count (CBC) data within the 72-hour post-transfusion window were excluded. A subgroup analysis distinguished the outcome between the initial PRBC transfusion and subsequent ones. The statistical significance of pre- and post-transfusion laboratory data was determined using the Wilcoxon signed ranks test and paired T-test. Results A cohort of 108 VLBW preterm infants who underwent a total of 402 PRBC transfusions was included in the analysis. The subjects exhibited a mean gestational age of 27.2 ± 2.5 weeks and a mean birth weight of 913 ± 264 grams. Analysis of pre- and post-transfusion data revealed no significant differences in total white blood cell count (WBC), absolute neutrophil count (ANC), absolute monocyte count (AMC), absolute eosinophil count, and absolute lymphocyte count. Notably, the platelet count was significantly decreased in the post-transfusion group (p < 0.001). In a subset analysis limited to the first-time transfusions among the 108 infants, a statistically significant increase was observed in total WBC, AMC, and ANC following transfusion. Conclusions The findings of this study highlight that PRBC transfusions can prompt an increase in neutrophils, monocytes, and eosinophils, coupled with a decline in platelet counts, all within a 72-hour window post-transfusion. Notably, these changes were predominantly discernible after the initial transfusion, with subsequent transfusions demonstrating consistency, except for the observed platelet count reduction. Recognizing these patterns could prove instrumental in averting undue investigations for suspected sepsis, particularly following the initial transfusion event. However, further in-depth investigations are necessary to uncover the underlying factors responsible for the shifts in leukocyte and platelet profiles triggered by PRBC transfusions.
Collapse
Affiliation(s)
- Palanikumar Balasundaram
- Division of Neonatology, Department of Pediatrics, Javon Bea Hospital, Mercy Health, Rockford, USA
| | | | - Kim Roger
- Division of Neonatology, Brookdale University Hospital Medical Center, Brooklyn, USA
| |
Collapse
|
6
|
Altuntaş G, Altuntaş M, Imamoğlu M, Çolakoğlu MK, Uydu HA, Bedir R. Diagnostic value of serum signal peptide-CUB-EGF-like domain-containing protein 1 levels in patients with acute appendicitis. Rev Assoc Med Bras (1992) 2023; 69:e20230076. [PMID: 37585982 PMCID: PMC10427172 DOI: 10.1590/1806-9282.20230076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 05/27/2023] [Indexed: 08/18/2023]
Abstract
OBJECTIVE Acute appendicitis is one of the most common surgical causes of an acute abdomen among patients admitted to the emergency room due to abdominal pain. The clinical diagnosis of acute appendicitis is usually difficult and is made by evaluating the clinical, laboratory, and radiological findings together. The aim of this study was to investigate the diagnostic potential of signal peptide-CUB-EGF-like domain-containing protein 1 as a biomarker for acute appendicitis. METHODS A total of 67 adult patients without any comorbidities who presented to the emergency department with abdominal pain and were clinically diagnosed with acute appendicitis were included in the case group. The patients included in the study were classified into the negative appendectomy group and the acute appendicitis group according to their histopathological final diagnosis. In addition, 48 healthy volunteers without comorbidities were included in the control group. Signal peptide-CUB-EGF-like domain-containing protein 1 levels of patients and the control group were measured. RESULTS According to postoperative histopathological examinations of the patients, 7 (10.4%) patients were diagnosed with negative appendectomy, and 60 (89.6%) patients were diagnosed with acute appendicitis. Signal peptide-CUB-EGF-like domain-containing protein 1 levels were higher in the patients with acute appendicitis than in negative appendectomy patients (p=0.012). Signal peptide-CUB-EGF-like domain-containing protein 1 levels were also higher in the case group compared to the control group (p=0.001). CONCLUSION The admission signal peptide-CUB-EGF-like domain-containing protein 1 level was significantly higher in adults with acute appendicitis. The SCUBE1 level is a novel but promising biomarker that aids in the diagnosis of acute appendicitis.
Collapse
Affiliation(s)
- Gürkan Altuntaş
- Recep Tayyip Erdogan University, Faculty of Medicine, Department of Emergency Medicine – Rize, Turkey
| | - Mehmet Altuntaş
- Recep Tayyip Erdogan University, Faculty of Medicine, Department of Emergency Medicine – Rize, Turkey
| | - Melih Imamoğlu
- Karadeniz Technical University, Faculty of Medicine, Department of Emergency Medicine – Trabzon, Turkey
| | - Muhammet Kadri Çolakoğlu
- Health Sciences University, Ankara City Hospital, Department of Gastrointestinal Surgery – Ankara, Turkey
| | - Hüseyin Avni Uydu
- Recep Tayyip Erdogan University, Faculty of Medicine, Department of Medical Biochemistry – Rize, Turkey
| | - Recep Bedir
- Recep Tayyip Erdogan University, Faculty of Medicine, Department of Pathology – Rize, Turkey
| |
Collapse
|
7
|
Oymaci E, Kahramansoy N, Tan S, Aydogan S, Yildirim M. The diagnostic role of preoperative blood tests in complicated appendicitis: A feasible approach to surgical decision. Niger J Clin Pract 2023; 26:1005-1010. [PMID: 37635587 DOI: 10.4103/njcp.njcp_906_22] [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: 08/29/2023]
Abstract
Background An accurate diagnosis and timely surgical intervention have significant importance in noncomplicated appendicitis (NCA) and complicated appendicitis (CA). Therefore, any factor that helps in the prediction of CA also contributes to suitable treatment options. Aim This retrospective study aimed to identify any relationship between acute appendicitis (AA) and preoperative blood test levels and whether these parameters can differentiate between NCA and CA patients. Patients and Methods A database of 201 appendectomies and 100 control healthy patients was analyzed between 2019 and 2022. Patients were divided into three groups: NCA without peritonitis or phlegmonous appendicitis as group 1; CA with perforated, necrotizing appendicitis with peritonitis as group 2; and the healthy control group (CG) as group 3. White blood cell (WBC), platelet distribution width (PDW), mean platelet volume (MPV), red cell distribution width (RDW), creatine kinase (CK), and bilirubin levels were collected from the patients and compared statistically between the groups. Results Age, WBC, and PDW levels were set as predictive in the differential diagnosis of CA as a result of receiver operating characteristic (ROC) analysis. The multivariate analysis demonstrated that age (OR: 1.023; 95% CI: 1.000-1.045; P = 0.04), male sex (OR: 3.718; 95% CI: 1.501-9.213; P = 0.005), WBC levels (OR: 1.000; 95% CI: 1.000-1.000; P = 0.002), and PDW levels (OR: 2.129; 95% CI: 1.301-3.484; P = 0.003) were independently associated with CA. Conclusion Age, higher WBC count, and PDW levels are valuable in differentiating the diagnosis of CA from NCA, and this could be a feasible approach for surgical decisions.
Collapse
Affiliation(s)
- E Oymaci
- Department of General Surgery, Health Sciences University, Izmir Bozyaka Education and Research Hospital, Turkey
| | - N Kahramansoy
- Department of General Surgery, Health Sciences University, Izmir Bozyaka Education and Research Hospital, Turkey
| | - S Tan
- Department of General Surgery, Health Sciences University, Izmir Bozyaka Education and Research Hospital, Turkey
| | - S Aydogan
- Department of General Surgery, Health Sciences University, Izmir Bozyaka Education and Research Hospital, Turkey
| | - M Yildirim
- Department of General Surgery, Health Sciences University, Izmir Bozyaka Education and Research Hospital, Turkey
| |
Collapse
|
8
|
Wu B, Zhou Y, Yang Y, Zhou D. Risk factors and a new nomogram for predicting brain metastasis from lung cancer: a retrospective study. Front Oncol 2023; 13:1092721. [PMID: 37404749 PMCID: PMC10316021 DOI: 10.3389/fonc.2023.1092721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 05/31/2023] [Indexed: 07/06/2023] Open
Abstract
Objective This study aims to establish and validate a new nomogram for predicting brain metastasis from lung cancer by integrating data. Methods 266 patients diagnosed as lung cancer between 2016 and 2018 were collected from Guangdong Academy of Medical Sciences. The first 70% of patients were designated as the primary cohort and the remaining patients were identified as the internal validation cohort. Univariate and multivariable logistics regression were applied to analyze the risk factors. Independent risk factors were used to construct nomogram. C-index was used to evaluate the prediction effect of nomogram.100 patients diagnosed as lung cancer between 2018 and 2019 were collected for external validation cohorts. The evaluation of nomogram was carried out through the distinction and calibration in the internal validation cohort and external validation cohort. Results 166 patients were diagnosed with brain metastasis among the 266 patients. The gender, pathological type (PAT), leukocyte count (LCC) and Fibrinogen stage (FibS) were independent risk factors of brain metastasis. A novel nomogram has been developed in this study showed an effective discriminative ability to predict the probability of lung cancer patients with brain metastasis, the C-index was 0.811. Conclusion Our research provides a novel model that can be used for predicting brain metastasis of lung cancer patients, thus providing more credible evidence for clinical decision-making.
Collapse
Affiliation(s)
- Bo Wu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Neurosurgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| | - Yujun Zhou
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Neurosurgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| | - Yong Yang
- Department of Neurosurgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| | - Dong Zhou
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Neurosurgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| |
Collapse
|
9
|
Wakabayashi I, Daimon T. Hematometabolic Index as a New Discriminator of Cardiometabolic Risk in Middle-Aged Men with Polycythemia and High Leukocyte Count in Peripheral Blood. Metab Syndr Relat Disord 2023. [PMID: 37196206 DOI: 10.1089/met.2023.0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023] Open
Abstract
Background: Both polycythemia and high leukocyte count are associated with the risk of cardiovascular disease. However, it remains to be determined whether polycythemia and high leukocyte count show synergistic increasing effects on cardiometabolic risk. Methods: Cardiometabolic risk was evaluated by cardiometabolic index (CMI) and metabolic syndrome in a cohort of middle-aged men (n = 11,140) who underwent annual health check-up examinations. The subjects were divided into three tertile groups by hemoglobin concentration or leukocyte count in peripheral blood, and their relations with CMI and metabolic syndrome were investigated. A new index, named hematometabolic index (HMI), was defined as the product of hemoglobin concentration (g/dL)-minus-13.0 and leukocyte count (/μL)-minus-3000. Results: When the subjects were further classified by tertiles for hemoglobin concentration and leukocyte count into nine groups, the odds ratios for high CMI and metabolic syndrome of the group categorized in the highest (third) tertiles for both hemoglobin concentration and leukocyte count versus the group of the lowest (first) tertiles for both of them were highest among the nine groups. In receiver-operating characteristic (ROC) analysis for relationships of HMI with high CMI and metabolic syndrome, areas under the ROC curves (AUCs) were significantly larger than the reference level and tended to be smaller with an increase in age. In subjects from 30 to 39 years of age, the AUC for the relationship between HMI and metabolic syndrome was 0.707 (0.663-0.751) and the cutoff of HMI was 9850. Conclusions: HMI, reflecting hemoglobin concentration and leukocyte count, is thought to be a possible marker for discriminating cardiometabolic risk.
Collapse
Affiliation(s)
- Ichiro Wakabayashi
- Department of Environmental and Preventive Medicine and School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Takashi Daimon
- Department of Biostatistics, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| |
Collapse
|
10
|
Pamulapati V, Cuda CM, Smith TL, Jung J, Xiong L, Swaminathan S, Ho KJ. Inflammatory Cell Dynamics after Murine Femoral Artery Wire Injury: A Multi-Parameter Flow Cytometry-Based Analysis. Cells 2023; 12:689. [PMID: 36899827 PMCID: PMC10000449 DOI: 10.3390/cells12050689] [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: 11/11/2022] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
An acute inflammatory response following arterial surgery for atherosclerosis, such as balloon angioplasty, stenting, and surgical bypass, is an important driver of neointimal hyperplasia after arterial injury, which leads to recurrent ischemia. However, a comprehensive understanding of the dynamics of the inflammatory infiltrate in the remodeling artery is difficult to attain due to the shortcomings of conventional methods such as immunofluorescence. We developed a 15-parameter flow cytometry method to quantitate leukocytes and 13 leukocyte subtypes in murine arteries at 4 time points after femoral artery wire injury. Live leukocyte numbers peaked at 7 days, which preceded the peak neointimal hyperplasia lesion at 28 days. Neutrophils were the most abundant early infiltrate, followed by monocytes and macrophages. Eosinophils were elevated after 1 day, while natural killer and dendritic cells gradually infiltrated over the first 7 days; all decreased between 7 and 14 days. Lymphocytes began accumulating at 3 days and peaked at 7 days. Immunofluorescence of arterial sections demonstrated similar temporal trends of CD45+ and F4/80+ cells. This method allows for the simultaneous quantitation of multiple leukocyte subtypes from small tissue samples of injured murine arteries and identifies the CD64+Tim4+ macrophage phenotype as being potentially important in the first 7 days post-injury.
Collapse
Affiliation(s)
- Vivek Pamulapati
- Division of Vascular Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Carla M. Cuda
- Division of Rheumatology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Tracy L. Smith
- Division of Vascular Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Jonathan Jung
- Division of Vascular Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Liqun Xiong
- Division of Vascular Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Suchitra Swaminathan
- Division of Rheumatology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Karen J. Ho
- Division of Vascular Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| |
Collapse
|
11
|
Choi KY, Kim DH, Jin KN, Lee HJ, Park TY, Ryu B, Lee JK, Heo EY, Kim DK, Lee HW. Different treatment response to systemic corticosteroids according to white blood cell counts in severe COVID-19 patients. Ann Med 2022; 54:2998-3006. [PMID: 36453635 PMCID: PMC9721443 DOI: 10.1080/07853890.2022.2137736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Limited data are available in COVID-19 patients on the prediction of treatment response to systemic corticosteroid therapy based on systemic inflammatory markers. There is a concern whether the response to systemic corticosteroid is different according to white blood cell (WBC) counts in COVID-19 patients. We aimed to assess whether WBC count is related with the clinical outcomes after treatment with systemic corticosteroids in severe COVID-19. METHODS We conducted a retrospective cohort study and analysed the patients hospitalised for severe COVID-19 and received systemic corticosteroids between July 2020 and June 2021. The primary endpoint was to compare the composite poor outcome of mechanical ventilation, extracorporeal membrane oxygenation, and mortality among the patients with different WBC counts. RESULTS Of the 585 COVID-19 patients who required oxygen supplementation and systemic corticosteroids, 145 (24.8%) belonged to the leukopoenia group, 375 (64.1%) belonged to the normal WBC group, and 65 (11.1%) belonged to the leukocytosis group. In Kaplan-Meier curve, the composite poor outcome was significantly reduced in leukopoenia group compared to leukocytosis group (log-rank p-value < 0.001). In the multivariable Cox regression analysis, leukopoenia group was significantly associated with a lower risk of the composite poor outcome compared to normal WBC group (adjusted hazard ratio [aHR] = 0.32, 95% CI 0.14-0.76, p-value = 0.009) and leukocytosis group (aHR = 0.30, 95% CI = 0.12-0.78, p-value = 0.013). There was no significant difference in aHR for composite poor outcome between leukocytosis and normal WBC group. CONCLUSION Leukopoenia may be related with a better response to systemic corticosteroid therapy in COVID-19 patients requiring oxygen supplementation.KEY MESSAGESIn severe COVID-19 treated with systemic corticosteroids, patients with leukopoenia showed a lower hazard for composite poor outcome compared to patients with normal white blood cell counts or leukocytosis.Leukopoenia may be a potential biomarker for better response to systemic corticosteroid therapy in COVID-19 pneumonia.
Collapse
Affiliation(s)
- Kwang Yong Choi
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Dong Hyun Kim
- Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Kwang Nam Jin
- Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Hyo Jin Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Tae Yun Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Borim Ryu
- Biomedical Research Institute, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Jung-Kyu Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Eun Young Heo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Deog Kyeom Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Hyun Woo Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| |
Collapse
|
12
|
Woodford EP, Woodford HM, Hort AR, Pang TC, Lam VWT, Nahm CB. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio use in detecting bowel ischaemia in adhesional small bowel obstruction. ANZ J Surg 2022; 92:2915-2920. [PMID: 36197308 DOI: 10.1111/ans.18073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 09/08/2022] [Accepted: 09/12/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Bowel ischaemia significantly increases morbidity and mortality from adhesional small bowel obstruction. Current biomarkers and clinical parameters have poor predictive value for ischaemia. Our study investigated whether neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) could be used to predict bowel ischaemia in adhesional small bowel obstruction. METHODS This single-centre retrospective study collected clinical, biochemical and radiological data from patients with adhesional small bowel obstruction between 2017 and 2020 who underwent operative management. The presence or absence of bowel ischaemia/infarction was used to distinguish two populations. Biochemical markers on admission and immediately prior to operation were collected to give platelet-lymphocyte ratio (PLR0 and PLRPRE-OP , respectively) and neutrophil-lymphocyte ratio (NLR0 and NLRPRE-OP , respectively). SAS 9.4 (SAS Institute Inc., Cary, NC) software was used for data analysis with Mann-Whitney U testing for continuous variables and Pearson Chi-square test for categorical variables. Sensitivity and specificity for PLR and NLR were calculated by means of receiver operating characteristic (ROC) curve analysis. RESULTS Twenty-seven patients had intra-operative bowel ischaemia whilst the remaining 73 had no evidence of bowel ischaemia. Both median PLRPRE-OP and NLRPRE-OP were significantly higher in patients with bowel ischaemia compared to those without (PLRPRE-OP 272 [IQR 224-433] and 231 [IQR 146-295] respectively, P = 0.027; NLRPRE-OP 12.5 [IQR 8.6-21.3] v. 5.5 [IQR 3.5-10.2] respectively, P ≤ 0.001). Area under the receiver operator characteristic curve (AUC) was 0.762 for NLRPRE-OP , with a sensitivity of 85.1% and specificity of 63% for NLR 7.4. CONCLUSION Raised NLR is predictive of bowel ischaemia in patients with adhesional small bowel obstruction.
Collapse
Affiliation(s)
| | - Hannah Mercy Woodford
- Department of Radiology, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Amy Rose Hort
- Acute Surgical Unit, Westmead Hospital, Sydney, New South Wales, Australia.,Western Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Tony Chun Pang
- Acute Surgical Unit, Westmead Hospital, Sydney, New South Wales, Australia.,Western Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Surgical Innovations Unit, Westmead Hospital, Sydney, New South Wales, Australia.,South West Sydney Clinical School, University of New South Wales, Liverpool, New South Wales, Australia
| | - Vincent Wai To Lam
- Acute Surgical Unit, Westmead Hospital, Sydney, New South Wales, Australia.,Macquarie Medical School, Macquarie University, Sydney, New South Wales, Australia
| | - Christopher Bahdah Nahm
- Acute Surgical Unit, Westmead Hospital, Sydney, New South Wales, Australia.,Western Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Surgical Innovations Unit, Westmead Hospital, Sydney, New South Wales, Australia
| |
Collapse
|
13
|
Yi Y, Qu T, Shi A, Pang Z, Zhao Y, Li P, Xie J, Zhi X, Zhu Y, Zhu H. Relationship between inflammatory cells level and longer duration of hypertension in Chinese community residents. Clin Exp Hypertens 2022; 44:619-626. [PMID: 35838365 DOI: 10.1080/10641963.2022.2100411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND To explore the relationship between duration of hypertension and inflammatory cell levels and to assess whether long duration might aggravate these inflammatory cells among Chinese urban community residents. METHODS A cross-sectional study of 5199 hypertensive and 2675 no-hypertensive participants who registered in community health service centers for physical examination was performed in Tianjin, China. Data of blood pressure and inflammatory cells were collected. Binary logistic regression was performed to assess the effect of hypertensive duration on the level of inflammatory cells before and after adjustment for the potential confounding factors. RESULTS Individuals with hypertension had significantly higher level of leukocyte count, neutrophil proportion, neutrophil-to-lymphocyte ratio (NLR), and lower level of lymphocyte proportion than those without hypertension. Two-way ANOVA showed that hypertension duration, rather than blood pressure control or their interaction, had significant influence on the levels of neutrophil proportion, lymphocyte proportion, and NLR. With the prolongation of the duration of hypertension, the level of neutrophil proportion and NLR increased, and the level of lymphocyte proportion decreased. Long hypertension duration (>10 years) was significantly associated with high level of neutrophil proportion (OR = 1.48, 95% CI: 1.25, 1.75), high level of NLR (OR = 1.53, 95% CI: 1.29, 1.81), and low level of lymphocyte proportion (OR = 1.54, 95% CI: 1.30, 1.82) in comparison with short duration (<5 years) after adjustment for confounding factors. CONCLUSION Hypertensive patients had higher level of leukocyte count, neutrophil proportion, NLR, and lower level of lymphocyte proportion than normotensive ones. Long duration of hypertension was associated with aggravated inflammatory biomarkers.
Collapse
Affiliation(s)
- Yue Yi
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition & Public Health, Tianjin, China
| | - Ting Qu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition & Public Health, Tianjin, China
| | - Aibin Shi
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition & Public Health, Tianjin, China
| | - Zhixin Pang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition & Public Health, Tianjin, China
| | - Yuxin Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition & Public Health, Tianjin, China
| | - Pengcheng Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition & Public Health, Tianjin, China
| | - Juan Xie
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition & Public Health, Tianjin, China
| | - Xinyue Zhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition & Public Health, Tianjin, China
| | - Yun Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition & Public Health, Tianjin, China
| | - Hong Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition & Public Health, Tianjin, China
| |
Collapse
|
14
|
Ahmad Mir S, Din Wani M. Shabir's "SMART-LAB" score for predicting complicated appendicitis-a prospective study. Turk J Surg 2022; 38:140-148. [PMID: 36483176 PMCID: PMC9714658 DOI: 10.47717/turkjsurg.2022.5383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 05/12/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Complicated appendicitis needs an aggressive and urgent management, hence there is need of an efficient scoring system for predicting complicated appendicitis. With this in mind, the author developed the present scoring system for predicting complicated acute appendicitis. The study aimed to assess the suitability of this novel (Shabir's SMART-LAB) score for predicting diagnosis of complicated appendicitis. MATERIAL AND METHODS In this prospective study, a novel score designated as "SMART-LAB" SCORE, proposed by the author (Shabir) based on his previous observations was calculated in all patients. This score includes sonography (S), migratory right iliac fossa pain (M), anorexia (A), rebound tenderness (R), tenderness (T), leukocytosis (L), Acute phase protein-CRP (A), and serum bilirubin (B). RESULTS Of a total of 150 patients included in this study, 52 cases turned out to be perforated and/or gangrenous appendicitis on intraoperative/histopathologic examination. The most commonly affected age group was 10-19 years. SMART-LAB score of >9 was present in significantly higher number of patients in complicated (perforated and gangrenous) appendicitis than uncomplicated appendicitis (p value<0.001 i.e., highly significant). Hence, high likelihood of complicated appendicitis is reflected by a score >9 (with a sensitivity= 80.7%, specificity= 92.9%, PPV= 85.7%, NPV= 90.1%, and accuracy= 88.7%), while a score 7-9 needs further confirmation to reach a conclusion, and for a score of <7, there is low likelihood of complicated appendicitis. CONCLUSION It seems that this novel score (Shabir's SMART-LAB score) is a reasonably good tool to predict the diagnosis of complicated appendicitis. Early diagnosis of appendiceal perforation is important to limit the associated abdominal sepsis.
Collapse
Affiliation(s)
- Shabir Ahmad Mir
- Department of Surgery, Government Medical College Srinagar, Kashmir, India
| | - Mumtaz Din Wani
- Department of Surgery, Government Medical College Srinagar, Kashmir, India
| |
Collapse
|
15
|
Podgórski T, Kryściak J, Pluta B, Adrian J, Marynowicz J, Krzykała M, Konefał M, Chmura P, Chmura J, Andrzejewski M. A Practical Approach to Monitoring Biomarkers of Inflammation and Muscle Damage in Youth Soccer Players During a 6-Month Training Cycle. J Hum Kinet 2021; 80:185-97. [PMID: 34868428 DOI: 10.2478/hukin-2021-0093] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The aim of the study was to determine the effects of a 6-month training cycle on muscle damage and inflammatory markers in youth male soccer players. Twenty-one soccer players were tested four times: at the beginning (T1) and immediately after the pre-season period (T2), in the middle (T3) and at the end of the competitive period (T4). Muscle damage and inflammatory markers were determined in blood taken 36 hours after the match. Throughout the training cycle significant increases (p < 0.05) of creatine kinase (T1: 254.4 U·L-1; T4: 304.2 U·L-1) and lactate dehydrogenase (T1: 382.8 U·L-1; T4: 453.2 U·L-1) activities were observed. Significant changes (p < 0.05) in platelet count (T1: 210.5·109·L-1; T4: 234.2·109·L-1), percentage of lymphocyte (T1: 39.80%; T4: 42.97%), monocyte (T1: 6.88%; T4: 9.99%) and granulocyte (T1: 53.32%; T4: 47.05%) as well as in granulocyte-to-lymphocyte (T1: 1.41; T4: 1.17) and lymphocyte-to-monocyte (T1: 6.21; T4: 4.46) ratios were noted. The correlation analysis revealed statistically significant relationships (p < 0.05) between: myoglobin and the percentage of leukocyte subpopulations and the granulocyte to lymphocyte ratio; lactate dehydrogenase and the percentage of monocyte; lactate and leukocyte count. In conclusion, the reported muscle damage and inflammatory markers in T3 and T4 indicate the need for fatigue status monitoring in youth soccer players, especially in the competitive period. Moreover granulocyte to lymphocyte and lymphocyte to monocyte ratios proved to be sensitive to fatigue changes and therefore can provide coaches and sport scientists with a broader perspective on the biochemical monitoring of training status in soccer players.
Collapse
|
16
|
Sigmund IK, Puchner SE, Windhager R. Serum Inflammatory Biomarkers in the Diagnosis of Periprosthetic Joint Infections. Biomedicines 2021; 9:biomedicines9091128. [PMID: 34572314 PMCID: PMC8467465 DOI: 10.3390/biomedicines9091128] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/16/2021] [Accepted: 08/21/2021] [Indexed: 11/23/2022] Open
Abstract
Accurate preoperative diagnosis of periprosthetic joint infections (PJIs) can be very challenging, especially in patients with chronic PJI caused by low-virulence microorganisms. Serum parameters, such as serum C-reactive protein (CRP) or the erythrocyte sedimentation rate (ESR), are—among other diagnostic test methods—widely used to distinguish septic from aseptic failure after total hip or knee arthroplasty and are recommended by the AAOS in the preoperative setting. However, they are systemic parameters, and therefore, unspecific. Nevertheless, they may be the first and occasionally the only preoperative indication, especially when clinical symptoms are lacking. They are easy to obtain, cheap, and are available worldwide. In the last decade, different novel serum biomarkers (percentage of neutrophils, neutrophils to lymphocytes ratio, platelet count to mean platelet volume ratio, fibrinogen, D-Dimer, Il-6, PCT) were investigated to find a more specific and accurate serum parameter in the diagnosis of PJI. This article reviews the diagnostic value of established (serum CRP, ESR, WBC) and ‘novel’ serum inflammatory biomarkers (fibrinogen, D-dimer, interleukin-6 (IL-6), procalcitonin, percentage of neutrophils (%N), neutrophils to lymphocytes ratio (NLR), platelet count to mean platelet volume ratio (PC/mPV)) for the preoperative diagnosis of periprosthetic joint infections.
Collapse
|
17
|
Solano-Suárez G, Caixeta LS, Masic A, Manríquez D, Hatamoto-Zervoudakis L, Paudyal S, Velasquez-Munoz A, Velez J, Pinedo PJ. Effect of peripartal administration of mycobacterium cell wall fraction on health and fertility of Holstein cows under organic-certified management. J Anim Sci 2021; 99:6360969. [PMID: 34468760 DOI: 10.1093/jas/skab191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 06/11/2021] [Indexed: 01/07/2023] Open
Abstract
The main objective of this study was to evaluate the effect of peripartal administration of a commercially available nonspecific immune stimulant (mycobacterium cell wall fraction; MCWF [Amplimune, NovaVive Inc., Napanee, ON, Canada]) on the incidence of disease during early lactation and subsequent fertility of dairy cows. A second objective was to characterize the dynamics of circulating white blood cells (WBC) and metabolic markers following treatment administration. Cows in an United States Department of Agriculture (USDA) organic-certified dairy herd were blocked by parity and, based on sequential calving dates, randomly assigned to receive two injections (5 mL s.c.) of either a placebo (saline solution) as a control (CON; n = 71) or MCWF (n = 65) at enrollment (7 d before expected calving) and within 24 h after calving. Blood samples were collected from a subsample of the study population (MCWF = 16; CON = 18) for WBC count at enrollment, at day 2 post enrollment, and at days 1, 3, 7, and 14 after calving. Serum fatty acids, beta-hydroxybutyrate, and Ca concentrations were determined at days 1 and 7 postpartum (MCWF = 21; CON = 21). Main outcome variables included incidence risk of peripartal and early lactation health disorders and pregnancy at first artificial insemination (AI), at 100, and at 150 days in milk (DIM). In addition, the average daily milk yield up to 90 DIM and death and live culling before 305 DIM were compared. Treatment effects were assessed using multivariable logistic regression, time-to-event analyses, and repeated measures analysis of variance (ANOVA). A treatment effect on the incidence risk of some of the health disorders in the study was established. Incidence risk of metritis and clinical mastitis <28 DIM was smaller in MCWF than in CON cows (36.9% vs. 50.7% and 6.3% vs. 19.7%, respectively). On the contrary, the incidence risk of respiratory disease <28 DIM was smaller in CON (0%) than in MCWF (7.7%). Reproductive performance of multiparous cows was affected by MCWF administration: pregnancy at first AI and pregnancy at 100 and 150 DIM were greater in MCWF than in CON (35.6% vs. 19.2%; 51.1% vs. 25.0%; and 64.4% vs. 40.4%, respectively). Overall, median intervals from calving to pregnancy were 90 vs. 121 d in MCWF and CON cows, respectively. No treatment effects on the dynamics of circulating WBC or in postpartum metabolic status were established. No differences for milk yield or for the proportion of cows that survived up to 305 DIM were determined, although cows in MCWF left the herd earlier than cows in CON. In conclusion, incidence risks of metritis and mastitis in early lactation were smaller in cows receiving MCWF, whereas the incidence risk of respiratory disease was smaller in CON. Fertility significantly improved in MCWF compared with CON cows. As this study was performed in an organic-certified dairy, specific health and reproductive management practices may affect the external validity of the current findings.
Collapse
Affiliation(s)
- Gilberto Solano-Suárez
- Department of Animal Sciences, College of Agricultural Sciences, Colorado State University, Fort Collins, CO 80521, USA
| | - Luciano S Caixeta
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St Paul, MN 55108, USA
| | | | - Diego Manríquez
- Department of Animal Sciences, College of Agricultural Sciences, Colorado State University, Fort Collins, CO 80521, USA
| | - Luciana Hatamoto-Zervoudakis
- Department of Animal Sciences, College of Agricultural Sciences, Colorado State University, Fort Collins, CO 80521, USA
| | - Sushil Paudyal
- Department of Animal Sciences, College of Agriculture and Life Sciences, Texas A&M University, College Station, TX 77843, USA
| | - Ana Velasquez-Munoz
- Department of Animal Sciences, College of Agricultural Sciences, Colorado State University, Fort Collins, CO 80521, USA
| | - Juan Velez
- Aurora Organic Farms, Platteville, CO 80651, USA
| | - Pablo J Pinedo
- Department of Animal Sciences, College of Agricultural Sciences, Colorado State University, Fort Collins, CO 80521, USA
| |
Collapse
|
18
|
Huang R, Li T, Li MX, Ye ST, Nie N, Liang Y. [Systematic review and Meta-analysis on chemotherapy-induced bone marrow suppression treated with acupuncture]. Zhongguo Zhen Jiu 2021; 41:557-62. [PMID: 34002574 DOI: 10.13703/j.0255-2930.20200618-k0005] [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: 11/06/2022]
Abstract
OBJECTIVE To review systematically the effectiveness of acupuncture in treatment of chemotherapy-induced bone marrow suppression. METHODS From the date of database establishment to April 1, 2020, the articles on randomized controlled trials of chemotherapy-induced bone marrow suppression were retrieved by computer from the following databases, i.e. PubMed, Cochrane central register of controlled trials (CENTRAL), EMbase, cumulative index to nursing & allied health literature (CINAHL), JBI database of systematic reviews and implementation reports, CNKI, Wanfang, VIP and SinoMed. Using RevMan5.3, Meta-analysis was conducted. With GRADEpro GDT, the evidence quality was evaluated. RESULTS A total of 12 articles were included, 10 articles of which were analyzed by quantitative Meta-analysis. Compared with the control group, the improvements in the decrease of post-chemotherapy leukocyte (P<0.01, MD=0.88, 95%CI=[0.71, 1.05]) and platelet (P<0.01, MD=25.91, 95%CI=[16.86, 34.97]) were better in the observation group. The difference in reducing hemoglobin was not significant between the two groups (P>0.05, MD=2.19, 95%CI=[-1.22, 5.61]). Regarding the improvement in the decrease of post-chemotherapy neutrophile granulocyte (P=0.03, MD=0.40, 95%CI=[0.04, 0.77]) and erythrocyte (P=0.03,MD=0.15,95%CI=[0.01, 0.28]), Karnofsky score (P<0.01, MD=4.19, 95%CI=[3.40, 4.98]) and quality of life (QOL) score (P<0.01, MD=5.01,95%CI=[1.61, 8.42]), the effects in the observation group were better than those in the control group. CONCLUSION Acupuncture alleviates the decrease of leukocyte, platelet, neutrophile granulocyte and erythrocyte counts and improves the survival quality of patients with chemotherapy-induced bone marrow suppression.
Collapse
Affiliation(s)
- Rui Huang
- Third Clinical Medical College, Zhejiang Chinese Medicine University, Hangzhou 310053, China
| | - Tong Li
- Third Clinical Medical College, Zhejiang Chinese Medicine University, Hangzhou 310053, China
| | - Mei-Xia Li
- Third Clinical Medical College, Zhejiang Chinese Medicine University, Hangzhou 310053, China
| | - Si-Ting Ye
- Third Clinical Medical College, Zhejiang Chinese Medicine University, Hangzhou 310053, China
| | - Na Nie
- Department of Acupuncture and Moxibustion, Third Affiliated Hospital of Zhejiang Chinese Medicine University, Hangzhou 310005
| | - Yi Liang
- Third Clinical Medical College, Zhejiang Chinese Medicine University, Hangzhou 310053, China; Department of Acupuncture and Moxibustion, Third Affiliated Hospital of Zhejiang Chinese Medicine University, Hangzhou 310005
| |
Collapse
|
19
|
Peyton MA, Kouo T, Scott J, Yanek LR, Ngo TL. Use of white cell count, age, and presence of other injuries in stratifying risk of intracranial injury in pediatric trauma. J Investig Med 2021; 69:408-410. [PMID: 33443054 DOI: 10.1136/jim-2020-001509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2020] [Indexed: 11/04/2022]
Abstract
The Pediatric Emergency Care Applied Research Network (PECARN) Head Injury/Trauma Algorithm is a well-validated decision rule used to identify patients at low risk of clinically important traumatic brain injuries who may not need head CT. In adult patients with mild head trauma, elevated serum glucose and white cell count (WCC) have been associated with abnormal head CT findings. Currently, glucose or WCC is not considered in pediatric patients. The objective of this study was to determine if elevations in glucose or WCC could be used as additional tools to risk-stratify pediatric trauma patients for intracranial injury (ICI). Data were abstracted from the Maryland Trauma Registry and from electronic medical records for patients at the Johns Hopkins Children's Center from 2017 to 2020. We evaluated 145 encounters that met the inclusion criteria. There were 33 cases of ICI on CT. In addition to higher median glucose and WCC, we found that patients with ICI had a younger median age and were less likely to have other clinically significant injuries than patients without ICI. Following multiple logistic regression analysis, WCC (OR 1.113, 95% CI 1.02 to 1.21), younger age (OR 0.89, 95% CI 0.8 to 0.98), and absence of other injuries (OR 0.41, 95% CI 0.23 to 0.73) were found to be associated with risk of ICI. The area under the curve for our model was 0.79. When used with the PECARN algorithm, our model could help determine which patients may avoid head CT or undergo a shorter observation period.
Collapse
Affiliation(s)
- Margo A Peyton
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Theodore Kouo
- Division of Pediatric Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jennifer Scott
- Division of Pediatric Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Lisa R Yanek
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Thuy L Ngo
- Division of Pediatric Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| |
Collapse
|
20
|
Kheradmand M, Ranjbaran H, Alizadeh-Navaei R, Yakhkeshi R, Moosazadeh M. Association between White Blood Cells Count and Diabetes Mellitus in Tabari Cohort Study: A Case-Control Study. Int J Prev Med 2021; 12:121. [PMID: 34760132 PMCID: PMC8551773 DOI: 10.4103/ijpvm.ijpvm_336_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 09/20/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND White Blood Cells (WBC) can be a useful marker to predict diabetes. In this study, we aimed to investigate the association between WBC count with type 2 diabetes in a large-scaled population-based cohort study. METHODS In the present study we used a subset of data collected in enrolment phase of Tabari cohort study. Participants with fasting blood glucose ≥126 or those who report as having diabetes or taking glucose-lowering medications were selected as case group (1765 participants) and control group included participants who did not report as having diabetes (1765 participants) and they randomly selected from the baseline population. Hematology indices were measured for all participants using Celltac Alpha MEK-6510 K. Chi-squared and independent t-test were used to compare categorical and continuous variables, respectively. RESULTS The mean of WBC in diabetic patients and control group was 6.89 ± 1.67 and 6.37 ± 1.49 respectively (P ≤ 0.001). The odds of diabetes based on WBC count in crud model was 1.23 [CI 95% 1.181.28] and after adjustment for all possible confounding factor was 1.17 [CI 95% 1.111.23]. CONCLUSIONS Results of the present study showed a significant association between WBC count and diabetes. This association remained significant after adjustment for all possible confounders.
Collapse
Affiliation(s)
- Motahareh Kheradmand
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hossein Ranjbaran
- Immunogenetic Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Yakhkeshi
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Address for correspondence: Dr. Mahmood Moosazadeh, Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran. E-mail:
| |
Collapse
|
21
|
Harsløf M, Pedersen KM, Nordestgaard BG, Afzal S. Low High-Density Lipoprotein Cholesterol and High White Blood Cell Counts: A Mendelian Randomization Study. Arterioscler Thromb Vasc Biol 2020; 41:976-987. [PMID: 33327746 DOI: 10.1161/atvbaha.120.314983] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Animal studies suggest that HDL (high-density lipoprotein) regulates proliferation and differentiation of hematopoietic stem cells. Using a Mendelian randomization approach, we tested the hypothesis that low HDL cholesterol is associated with high white blood cell counts. Approach and Results: We included 107 952 individuals aged 20 to 100 years from the Copenhagen General Population Study with information on HDL cholesterol, white blood cell counts, and 9 genetic variants associated with HDL cholesterol. In multivariable-adjusted observational analyses, HDL cholesterol was inversely associated with white blood cell counts. On a continuous scale, a 1-mmol/L (39 mg/dL) lower HDL cholesterol was associated with 5.1% (95% CI, 4.7%-5.4%) higher leukocytes, 4.5% (95% CI, 4.0%-4.9%) higher neutrophils, 5.7% (95% CI, 5.3%-6.1%) higher lymphocytes, 5.7% (95% CI, 5.3%-6.2%) higher monocytes, 14.8% (95% CI, 13.9%-15.8%) higher eosinophils, and 3.9% (95% CI, 3.1%-4.7%) higher basophils. In age- and sex-adjusted genetic analyses using the inverse-variance weighted analysis, a 1-mmol/L (39 mg/dL) genetically determined lower HDL cholesterol was associated with 2.2% (95% CI, 0.3%-4.1%) higher leukocytes, 4.3% (95% CI, 1.6%-7.1%) higher lymphocytes, 4.3% (95% CI, 2.6%-6.1%) higher monocytes, and 4.8% (95% CI, 1.2%-8.5%) higher eosinophils. Overall, the genetic associations were robust across sensitivity analyses and replicated using summary statistics from the UK Biobank with up to 350 470 individuals. CONCLUSIONS Genetic and hence lifelong low HDL cholesterol was associated with high peripheral blood leukocytes, including high lymphocytes, monocytes, and eosinophils. The concordance between observational and genetic estimates and independent replication suggest a potential causal relationship.
Collapse
Affiliation(s)
- Mads Harsløf
- The Copenhagen General Population Study at the Department of Clinical Biochemistry (M.H., K.M.P., B.G.N., S.A.), Copenhagen University Hospital, Herlev and Gentofte Hospital, Denmark
| | - Kasper M Pedersen
- The Copenhagen General Population Study at the Department of Clinical Biochemistry (M.H., K.M.P., B.G.N., S.A.), Copenhagen University Hospital, Herlev and Gentofte Hospital, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (K.M.P., B.G.N., S.A.)
| | - Børge G Nordestgaard
- The Copenhagen General Population Study at the Department of Clinical Biochemistry (M.H., K.M.P., B.G.N., S.A.), Copenhagen University Hospital, Herlev and Gentofte Hospital, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (K.M.P., B.G.N., S.A.)
| | - Shoaib Afzal
- The Copenhagen General Population Study at the Department of Clinical Biochemistry (M.H., K.M.P., B.G.N., S.A.), Copenhagen University Hospital, Herlev and Gentofte Hospital, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (K.M.P., B.G.N., S.A.)
| |
Collapse
|
22
|
Alkhaldy HY, A. Awan Z, Abouzaid AA, Elbahaie HM, Al Amoudi SM, Andarawi M, F Shehata S. The Prevalence of Isolated Neutropenia at High Altitude in Southern Saudi Arabia: Does Altitude Affect Leucocyte Count? Int J Gen Med 2020; 13:1373-1379. [PMID: 33299343 PMCID: PMC7721288 DOI: 10.2147/ijgm.s284133] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 11/09/2020] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Isolated neutropenia is a common problem in hematology practice. Benign ethnic neutropenia (BEN) is the common form of neutropenia worldwide and it affects mainly African and Middle Eastern ethnicities. Most cases of isolated mild and moderate neutropenia are benign and associated with no clinical significance. The aim of this study was to estimate the prevalence of isolated neutropenia at high-altitude southern Saudi Arabia. METHODS A large dataset of complete blood counts (CBCs) was analyzed for walk-in patients of both genders, of age ranges from 12 to 60 years doing blood tests at a commercial lab for high altitude - 2,270 meters above sea level - (HA) group, and from sea level SL group. Abnormal biochemical or CBC results were excluded before analysis. RESULTS For HA group, 3123 CBCs were analyzed and for SL group 18,427 CBCs were analyzed. The prevalence of mild neutropenia, defined as absolute neutrophil count (ANC) in the range of 1.0-.5× 109/L, was 12.4% (n=399) versus 5.6% (n=1025), while moderate neutropenia, defined as ANC of 0.5-1 × 109/L, was present 6% (n=191) versus 1.45% (n=269) in the high altitude and sea level groups, respectively. Severe neutropenia, defined as neutrophil count less than 0.5-1 × 109/L, was rare in both groups. CONCLUSION Isolated neutropenia is common in Saudis living at high altitude. While benign ethnic neutropenia (BEN) is thought to be the major contributing factor to this high prevalence, other factors including environmental factors and altitude are possible contributing factors along with underlying ethnic neutropenia.
Collapse
Affiliation(s)
- Husain Y Alkhaldy
- Department of Internal Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
- Research Center for Advanced Materials Science, King Khalid University, Abha, Saudi Arabia
| | - Zuhier A. Awan
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Clinical Pathology, Al-Borg Medical Laboratories, Jeddah, Saudi Arabia
| | - Ahmed A Abouzaid
- Department of Clinical Pathology, Al-Borg Medical Laboratories, Jeddah, Saudi Arabia
- Department of Medical Biochemistry, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Hossameldin M Elbahaie
- Department of Clinical Pathology, Al-Borg Medical Laboratories, Jeddah, Saudi Arabia
- Clinical Pathology Department, Suez Canal University, Ismailia, Egypt
| | - Saeed M Al Amoudi
- Department of Clinical Pathology, Al-Borg Medical Laboratories, Jeddah, Saudi Arabia
| | - Mohamed Andarawi
- Department of Pathology, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Shehata F Shehata
- Department of Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
- High Institute of Public Health, Alexandria University, Alexandria, Egypt
| |
Collapse
|
23
|
Meyer MM, Brandenburg L, Hudel H, Agné A, Padberg W, Erdogan A, Nef H, Amati AL, Dörr O, Witte B, Grau V. Who Is Afraid of CRP? Elevated Preoperative CRP Levels Might Attenuate the Increase in Inflammatory Parameters in Response to Lung Cancer Surgery. J Clin Med 2020; 9:E3340. [PMID: 33080990 DOI: 10.3390/jcm9103340] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/07/2020] [Accepted: 10/15/2020] [Indexed: 12/26/2022] Open
Abstract
During surgery, ATP from damaged cells induces the release of interleukin-1β, a potent pro-inflammatory cytokine that contributes to the development of postoperative systemic inflammation, sepsis and multi-organ damage. We recently demonstrated that C-reactive protein (CRP) inhibits the ATP-induced release of monocytic interleukin-1β, although high CRP levels are deemed to be a poor prognostic marker. Here, we retrospectively investigated if preoperative CRP levels correlate with postoperative CRP, leukocyte counts and fever in the context of anatomical lung resection and systematic lymph node dissection as first line lung cancer therapy. No correlation was found in the overall results. In men, however, preoperative CRP and leukocyte counts positively correlated on postoperative days one to two, and a negative correlation of CRP and fever was seen in women. These correlations were more pronounced in men taking statins and in statin-naïve women. Accordingly, the inhibitory effect of CRP on the ATP-induced interleukin-1β release was blunted in monocytes from coronary heart disease patients treated with atorvastatin compared to monocytes obtained before medication. Hence, the common notion that elevated CRP levels predict more severe postoperative inflammation should be questioned. We rather hypothesize that in women and statin-naïve patients, high CRP levels attenuate trauma-induced increases in inflammatory markers.
Collapse
|
24
|
Cho HJ, Kim WY, Park SM, Lee JH, Shin HJ, Jang GY, Ha KS. The Risk Prediction of Coronary Artery Lesions through the Novel Hematological Z-Values in 4 Chronological Age Subgroups of Kawasaki Disease. ACTA ACUST UNITED AC 2020; 56:E466. [PMID: 32932823 DOI: 10.3390/medicina56090466] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 09/05/2020] [Accepted: 09/10/2020] [Indexed: 12/19/2022]
Abstract
Background and Objectives: Most cases of Kawasaki disease (KD) occur between the ages of 6 months and 5 years. Differences in immunological reaction and CAL (coronary artery lesion) by the age subgroups classified according to the prevalence of KD and those particularly in the earlier life of KD should be investigated. Materials and Methods: The laboratory data of 223 infantile and 681 non-infantile KD cases from 2003 to 2018 at Korea University Hospital were retrospectively analyzed. Patients with KD were divided into infants and non-infants and further subdivided into four subgroups by age. The age-adjusted Z-values were compared among the subgroups. Febrile controls were identified as patients with fever for >5 days and who showed some of the KD symptoms. Results: IVIG (intravenous immunoglobulin) resistance at the age of 6 months or less was significantly lower than that at the ages of 7–12 months and 13–60 months (respectively, p < 0.05). The significant risk factors for CAL in total KD patients were age, incomplete KD, post-IVIG fever, IVIG resistance, convalescent Z-eosinophil, and subacute platelet (p < 0.05). The significant risk factors for CAL at the age of 6 months or less were IVIG resistance, acute Z-neutrophil, subacute Z-neutrophil, subacute NLR (neutrophil to lymphocyte ratio), and subacute platelet (respectively, p < 0.05). Conclusion: Younger age and incomplete presentation in KD can be independent risk factors for CAL. The immune reactions of KD at a younger age are more tolerated compared with those at older ages during the acute phase. The immune response at the age of 6 months or less showed immune tolerance in terms of incomplete presentation and IVIG responsiveness. The risk factors such as IVIG resistance, subacute platelet, subacute NLR, and acute or subacute Z-neutrophil at the age of 6 months or less can be very useful parameters to predict CAL in young, incomplete KD.
Collapse
|
25
|
Abstract
BACKGROUND Total and differential white blood cell counts are important for the diagnostic evaluation of suspected diseases. To facilitate the interpretation of total and differential white blood cell counts in pediatric patients, the present study investigated age-dependent changes in total and differential white blood cell counts in healthy reference children. METHODS Data were obtained from the Pediatric Reference Intervals in China study (PRINCE), which aims to establish and verify pediatric reference intervals for Chinese children based on a nationwide multicenter cross-sectional study from January 2017 to December 2018. Quantile curves were calculated using the generalized additive models for location, shape, and scale method. The 2.5th, 50th, and 97.5th quantile curves were calculated for both total and differential white blood counts. Percents of stacked area charts were used to demonstrate the proportions of differential white blood cells. All statistical analyses were performed using R software. RESULTS Both 50th and 97.5th quantiles of total white blood cell count and monocyte count were highest at birth, then rapidly decreased in the first 6 months of life; relatively slow reduction continued until 2 years of age. The lymphocyte count was low during infancy and increased to its highest level at 6 months of age; it then exhibited moderate and continuous reduction until approximately 9 years of age. The pattern of neutrophil count changed with age in a manner opposite to that of lymphocyte count. Besides, there were two inter-sections of lymphocyte count and neutrophil count during infancy and at approximately 5 years of age, based on locally weighted regression (LOESS) analysis. There were no apparent age-related changes in eosinophil or basophil counts. CONCLUSION These data regarding age-related changes in total and differential white blood cell counts can be used to assess the health of pediatric patients and guide clinical decisions.
Collapse
Affiliation(s)
- Kun Li
- Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children Health, Beijing 100045, China
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Ya-Guang Peng
- Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children Health, Beijing 100045, China
| | - Ruo-Hua Yan
- Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children Health, Beijing 100045, China
| | - Wen-Qi Song
- Department of Clinical Laboratory Center, Beijing Children's Hospital, Capital Medical University, National Center for Children Health, Beijing 100045, China
| | - Xiao-Xia Peng
- Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children Health, Beijing 100045, China
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Xin Ni
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck, Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children Health, Beijing 100045, China
| |
Collapse
|
26
|
Javanian M, Bayani M, Shokri M, Sadeghi-Haddad-Zavareh M, Babazadeh A, Yeganeh B, Mohseni S, Mehraeen R, Sepidarkish M, Bijani A, Rostami A, Shahbazi M, Tabari AM, Shabani A, Masrour-Roudsari J, Hasanpour AH, Gholinejad HE, Ghorbani H, Ebrahimpour S. Clinical and laboratory findings from patients with COVID-19 pneumonia in Babol North of Iran: a retrospective cohort study. ACTA ACUST UNITED AC 2020; 58:161-7. [PMID: 32396143 DOI: 10.2478/rjim-2020-0013] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND In December 2019, China has experienced an outbreak of novel coronavirus disease 2019 (COVID-19). Coronavirus has now spread to all of the continents. We aimed to consider clinical characteristics, laboratory data of COVID-19 that provided more information for the research of this novel virus. METHODS We performed a retrospective cohort study on the clinical symptoms and laboratory findings of a series of the 100 confirmed patients with COVID-19. These patients were admitted to the hospitals affiliated to Babol University of Medical Sciences (Ayatollah Rohani, Shahid Beheshti and Yahyanejad hospitals) form 25 February 2020 to 12 March 2020. RESULTS Nineteen patients died during hospitalization and 81 were discharged. Non-survivor patients had a significantly higher C-reactive protein (CRP) (MD: 46.37, 95% CI: 20.84, 71.90; P = 0.001), white blood cells (WBCs) (MD: 3.10, 95% CI: 1.53, 4.67; P < 0.001) and lower lymphocyte (MD: -8.75, 95% CI: -12.62, -4.87; P < 0.001) compared to survivor patients Data analysis showed that comorbid conditions (aRR: 2.99, 95% CI: 1.09, 8.21, P = 0.034), higher CRP levels (aRR: 1.02, 95% CI: 1.01, 1.03, P = 0.044), and lower lymphocyte (aRR: 0.82, 95% CI: 0.73, 0.93, P = 0.003) were associated with increased risk of death. CONCLUSIONS Based on our findings, most non-survivors are elderly with comorbidities. Lymphopenia and increased levels of WBCs along with elevated CRP were associated with increased risk of death. Therefore, it is best to be regularly assessed these markers during treatment of COVID-19 patients.
Collapse
|
27
|
Golding CN, Schaltz-Buchholzer F, Sanca L, Clipet-Jensen C, Benn CS, Au N, Chipperfield K, Kollmann TR, Amenyogbe NA. Feasibility of manual white blood cell counts as a predictor of neonatal sepsis in a low-resource setting. Trans R Soc Trop Med Hyg 2020; 114:566-574. [PMID: 32333010 DOI: 10.1093/trstmh/traa023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 02/17/2020] [Accepted: 03/13/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Manual white blood cell (WBC) differential counts as a predictor for neonatal sepsis development in a low-resource setting have not been thoroughly evaluated. We hypothesized that manual differentiation (specifically immature:total [I:T] neutrophil ratios) would be feasible and useful as an adjunct to predict early-onset neonatal sepsis (EONS). Secondarily, we hypothesized that vaccination with bacillus Calmette-Guérin (BCG) and oral polio vaccine (OPV) could alter WBC differential counts and thus might reduce its predictive performance. METHODS We performed a prospective cohort study within a randomized trial, randomizing healthy, high-risk newborns admitted to the nursery at the national hospital in Guinea-Bissau 1:1 to BCG+OPV at admission or at discharge (usual practice). Thin capillary blood films were prepared at 2 d of age in a subset of 268 neonates. WBC counts were assessed by microscopy and neonates were followed up for sepsis development within 2 weeks. RESULTS Ninety-eight percent (264/268) of smears provided interpretable reads. Of the 264 children, 136 had been randomized to receive BCG+OPV prior to sampling; the remaining 128 were vaccinated at discharge. The I:T ratio (average 0.017) was lower among children who did not develop clinical sepsis but did not predict sepsis (p=0.70). Only three children had an I:T ratio >0.2 (associated with a higher probability of clinical sepsis in previous studies) but did not develop sepsis. Immunization did not alter WBC composition. CONCLUSIONS Manual WBC differentials are feasible in low-resource settings. WBC differentials are not affected by standard newborn immunization. However, the I:T ratio had no value in predicting subsequent development of sepsis.
Collapse
Affiliation(s)
- Christian N Golding
- Bandim Health Project, Indepth Network, Apartado 861, Bissau 1004, Guinea-Bissau
- Institute of Health, Aarhus University, Nordre Ringgade 1, Aarhus C 8000, Denmark
- Research Center for Vitamins and Vaccines, Statens Serum Institut, Artillerivej 5, Copenhagen S 2300, Denmark
| | - Frederik Schaltz-Buchholzer
- Bandim Health Project, Indepth Network, Apartado 861, Bissau 1004, Guinea-Bissau
- Research Center for Vitamins and Vaccines, Statens Serum Institut, Artillerivej 5, Copenhagen S 2300, Denmark
- OPEN, Department of Clinical Research, University of Southern Denmark, and Odense University Hospital, J.B. Winsløws Vej 9A, Odense C 5000, Denmark
| | - Lilica Sanca
- Bandim Health Project, Indepth Network, Apartado 861, Bissau 1004, Guinea-Bissau
| | - Clara Clipet-Jensen
- Research Center for Vitamins and Vaccines, Statens Serum Institut, Artillerivej 5, Copenhagen S 2300, Denmark
| | - Christine S Benn
- Bandim Health Project, Indepth Network, Apartado 861, Bissau 1004, Guinea-Bissau
- Research Center for Vitamins and Vaccines, Statens Serum Institut, Artillerivej 5, Copenhagen S 2300, Denmark
- OPEN, Department of Clinical Research, University of Southern Denmark, and Odense University Hospital, J.B. Winsløws Vej 9A, Odense C 5000, Denmark
| | - Nicholas Au
- Department of Pathology and Laboratory Medicine, University of British Columbia, Rm. G227-2211 Wesbrook Mall, Vancouver, BC Canada V6T 2B5
| | - Kate Chipperfield
- Department of Pathology and Laboratory Medicine, University of British Columbia, Rm. G227-2211 Wesbrook Mall, Vancouver, BC Canada V6T 2B5
| | - Tobias R Kollmann
- Department of Pediatrics, University of British Columbia, Rm 2D19, 4480 Oak Street, Vancouver, BC Canada V6H 3V4
| | - Nelly A Amenyogbe
- Department of Experimental Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC Canada V5Z 1M9
| |
Collapse
|
28
|
Rodríguez RX, Villarroel LA, Meza RA, Peña JI, Musalem C, Kattan J, Urzúa S. Infection profile in neonatal patients during extracorporeal membrane oxygenation. Int J Artif Organs 2020; 43:391398820911379. [PMID: 32195608 DOI: 10.1177/0391398820911379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To describe risk factors for acquired infection during neonatal extracorporeal membrane oxygenation and to examine the predictive value of inflammatory markers in the diagnosis of infection. METHODS A retrospective study was conducted with data for patients under 30 days supported with extracorporeal membrane oxygenation from 2003 to April 2016, in a neonatal intensive care unit. RESULTS Our study included 160 neonatal patients, the average age of connection was 8.5 days and the duration of extracorporeal membrane oxygenation support was 9.7 days. The incidence of confirmed infection was 23%. Patients with confirmed infection present more frequently: vaginal delivery, lower birth weight, female sex, diagnosis of congenital diaphragmatic hernia, and longer duration of extracorporeal membrane oxygenation. When comparing the group of patients with confirmed infection and suspicion of infection, there were no significant differences in the inflammatory markers. When calculating the slope for each one, the difference in white blood cell count slope 72 h before the infection is significant; in patients with confirmed infection, the count of white blood cell increases (slope: 0.25), versus the group of patients with suspected infection in whom the count decreases (slope: -0.39). No differences were found in other variables. CONCLUSION Our study describes that the factors that increase the risk of infection are lower birth weight, vaginal birth, duration of extracorporeal membrane oxygenation, and a positive trend of white blood cell 72 h prior to infection/suspicion. Further studies are necessary to include or definitively rule out the use of these factors and the biomarkers as predictors of infection in neonatal patients supported with extracorporeal membrane oxygenation.
Collapse
Affiliation(s)
| | - Luis A Villarroel
- Department of Public Health, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rodrigo A Meza
- Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Javier I Peña
- Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudia Musalem
- Department of Statistics, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Javier Kattan
- Department of Neonatology, Division of Pediatrics, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Soledad Urzúa
- Department of Neonatology, Division of Pediatrics, Pontificia Universidad Católica de Chile, Santiago, Chile
| |
Collapse
|
29
|
Abstract
INTRODUCTION: Organophosphorus poisoning (OPP) is a major public health problem in developing countries like India. Leukocyte count is a simple and inexpensive test, and elevated count is associated with acute inflammation and increased oxidative stress-like OPP. This study was done to correlate the severity of acute OPP with leukocyte count and also to assess the prognosis. MATERIALS AND METHODS: A prospective, observational clinical study was done on 80 patients suspected of OPP of age >15 years admitted to emergency unit at a tertiary rural teaching health-care center of Central India. Serum cholinesterase level and leukocyte count were estimated at the time of admission in all patients and severity of OPP was assessed according to Peradeniya organophosphorus poisoning (POP) scale. RESULTS: The mean age of the patients was 33.52 years (standard deviation [SD] 11.62) in males and 27.30 years (SD 7.33) in females. Among them, 57 (71.25%) were males and 23 (28.75%) were females. The severity of poisoning was directly correlated with serum cholinesterase level (P = 0.0001). Leukocyte count had a sensitivity of 60%, specificity of 76%, and negative predictive value of 85% if counts were more than 12,000 and 30% sensitivity, 95% specificity, and 80% negative predictive value if counts were more than 15,000 in predicting mortality in patients with OPP. CONCLUSION: Leukocyte count levels on admission can be used a prognostic marker in patients with OP poisoning.
Collapse
Affiliation(s)
- Sunil Kumar
- Department of Medicine, Jawaharlal Nehru Medical College, DMIMSU, Wardha, Maharashtra, India
| | - Sachin Agrawal
- Department of Medicine, Jawaharlal Nehru Medical College, DMIMSU, Wardha, Maharashtra, India
| | - Nitin Raisinghani
- Department of Medicine, Jawaharlal Nehru Medical College, DMIMSU, Wardha, Maharashtra, India
| | - Shameem Khan
- Department of Medicine, Jawaharlal Nehru Medical College, DMIMSU, Wardha, Maharashtra, India
| |
Collapse
|
30
|
Nasu T, Satoh M, Ohmomo H, Shiwa Y, Komaki S, Ono K, Shimizu A, Taguchi S, Takahashi Y, Osaki T, Morino Y, Sobue K, Sasaki M. Epigenome-Wide Association Study Identifies a Novel DNA Methylation in Patients With Severe Aortic Valve Stenosis. Circ Genom Precis Med 2020; 13:e002649. [PMID: 31928219 DOI: 10.1161/circgen.119.002649] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Takahito Nasu
- Division of Cardiology, Department of Internal Medicine (T.N. S.T., Y.T., T.O., Y.M.), Iwate Medical University, Japan
| | - Mamoru Satoh
- Division of Biomedical Information Analysis, Institute for Biomedical Sciences (M. Satoh), Iwate Medical University, Japan
| | - Hideki Ohmomo
- Division of Biomedical Information Analysis, Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center (H.O., Y.S., S.K., K.O., A.S.), Iwate Medical University, Japan
| | - Yuh Shiwa
- Division of Biomedical Information Analysis, Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center (H.O., Y.S., S.K., K.O., A.S.), Iwate Medical University, Japan
| | - Shohei Komaki
- Division of Biomedical Information Analysis, Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center (H.O., Y.S., S.K., K.O., A.S.), Iwate Medical University, Japan
| | - Kanako Ono
- Division of Biomedical Information Analysis, Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center (H.O., Y.S., S.K., K.O., A.S.), Iwate Medical University, Japan
| | - Atsushi Shimizu
- Division of Biomedical Information Analysis, Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center (H.O., Y.S., S.K., K.O., A.S.), Iwate Medical University, Japan
| | - Satoru Taguchi
- Division of Cardiology, Department of Internal Medicine (T.N. S.T., Y.T., T.O., Y.M.), Iwate Medical University, Japan
| | - Yuji Takahashi
- Division of Cardiology, Department of Internal Medicine (T.N. S.T., Y.T., T.O., Y.M.), Iwate Medical University, Japan
| | - Takuya Osaki
- Division of Cardiology, Department of Internal Medicine (T.N. S.T., Y.T., T.O., Y.M.), Iwate Medical University, Japan
| | - Yoshihiro Morino
- Division of Cardiology, Department of Internal Medicine (T.N. S.T., Y.T., T.O., Y.M.), Iwate Medical University, Japan
| | - Kenji Sobue
- Department of Neuroscience, Institute for Biomedical Sciences (K.S.), Iwate Medical University, Japan
| | - Makoto Sasaki
- Executive Director, Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center (M. Sasaki), Iwate Medical University, Japan.,Division of Ultrahigh Field MRI, Institute for Biomedical Sciences (M. Sasaki), Iwate Medical University, Japan
| |
Collapse
|
31
|
Quan K, Wang A, Zhang X, Wang Y. Leukocyte Count and Adverse Clinical Outcomes in Acute Ischemic Stroke Patients. Front Neurol 2019; 10:1240. [PMID: 32038447 PMCID: PMC6988785 DOI: 10.3389/fneur.2019.01240] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 11/07/2019] [Indexed: 12/23/2022] Open
Abstract
Background: Post-ischemic inflammatory response might be affected by many factors. We chose leukocyte count as a marker of inflammatory response and investigated whether the effects of leukocyte count on the clinical outcomes in acute ischemic stroke patients are different according to different factors. Methods: We derived data from the China National Stroke Registry II. Patients with ischemic stroke were classified into four groups by leukocyte count quartiles within the first 24 h after admission. Adverse clinical outcomes were defined as recurrent stroke, all-cause death, and poor functional outcomes (3 ≤ mRS ≤ 5) at 3-months and 1-year follow-up. The subgroup factors were age, sex, history of hypertension, history of diabetes, history of previous stroke, or transient ischemic attack and smoking status. We assessed the association between leukocyte count and adverse clinical outcomes and evaluated this association in different subgroups. Results: A total of 14,678 patients were included. Patients in higher quartiles were likely to be younger, male, smokers, and drinkers, and to have a shorter time from symptom onset to arrival, a more proportion of history of diabetes, atrial fibrillation, and hypertension, and a higher severity of stroke. Higher quartiles were associated with elevated risk of adverse clinical outcomes at 3-months and 1-year follow-up. Leukocyte count had a moderate accuracy to predict clinical outcomes. There was no difference in the relationship between leukocyte count and adverse clinical outcomes across subgroups such as age, sex, history of hypertension, and smoking. The effect of leukocyte count on all-cause death was pronounced among patients with previous stroke or transient ischemic attack, and the effect of leukocyte count on short-term poor functional outcomes was also pronounced among patients without diabetes. Conclusions: Leukocyte count is associated with short-term and long-term clinical outcomes of acute ischemic stroke and may have predictive value, especially in patients with certain specific characteristics.
Collapse
Affiliation(s)
- Kehua Quan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Xiaoli Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| |
Collapse
|
32
|
Zhang B, Hao Y, Zhang Y, Yang N, Li H, Liang J. Kawasaki disease manifesting as bilateral facial nerve palsy and meningitis: a case report and literature review. J Int Med Res 2019; 47:4014-4018. [PMID: 31364426 PMCID: PMC6726819 DOI: 10.1177/0300060519854287] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Kawasaki disease (KD) is an acute multisystem vasculitic syndrome that predominantly affects infants and young children. Neurological complications are rare in patients with KD and the diagnosis is challenging. We report a case of KD that manifested as bilateral facial nerve palsy and meningitis. Case report A 6-month-old boy presented with a 10-day history of fever. Four days before admission, the patient developed a rash, conjunctival injection, perioral and perianal excoriation, and bilateral facial nerve palsy. Brain magnetic resonance imaging was normal. Echocardiography showed dilated coronary arteries and coronary artery aneurysms. A cerebrospinal fluid examination showed an elevated leukocyte count. A diagnosis of KD was made, and the patient was treated with gamma globulin and aspirin. The patient’s fever subsided on the following day and the right-sided facial nerve palsy was relieved 1 month later. An 18-month follow-up showed that the left-sided facial nerve palsy persisted and the patient’s condition remained stable. Conclusion KD manifesting as bilateral facial nerve palsy and meningitis is extremely rare. Clinicians should be aware of this condition, and early diagnosis and appropriate treatment should be emphasized.
Collapse
Affiliation(s)
- Bo Zhang
- 1 Department of Pediatric Neurology, the First Hospital of Jilin University, Changchun, Jilin, China
| | - Yunpeng Hao
- 1 Department of Pediatric Neurology, the First Hospital of Jilin University, Changchun, Jilin, China
| | - Yanfeng Zhang
- 1 Department of Pediatric Neurology, the First Hospital of Jilin University, Changchun, Jilin, China
| | - Nuo Yang
- 1 Department of Pediatric Neurology, the First Hospital of Jilin University, Changchun, Jilin, China
| | - Hang Li
- 2 Department of Hepatobiliary Pancreatic Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Jianmin Liang
- 1 Department of Pediatric Neurology, the First Hospital of Jilin University, Changchun, Jilin, China
| |
Collapse
|
33
|
Hanprathet N, Lertmaharit S, Lohsoonthorn V, Rattananupong T, Ammaranond P, Jiamjarasrangsi W. Shift Work and Leukocyte Count Changes among Workers in Bangkok. Ann Work Expo Health 2019; 63:689-700. [PMID: 31211837 DOI: 10.1093/annweh/wxz039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 03/13/2019] [Accepted: 05/03/2019] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVES Previous epidemiological evidence for the association of shift work exposure and increased leukocyte count is cross-sectional in nature, thus limiting cause-effect inference. We therefore used a longitudinal design to: (i) compare leukocyte counts at baseline between shift and day workers and (ii) examine the time trend of leukocyte counts over the follow-up period for these workers. METHODS A retrospective cohort study was conducted among 6737 workers aged <60 years at two large organizations (a humanitarian organization and a university) in Bangkok, Thailand who had participated in at least two annual health check-ups during the period 2005-2016. Shift work exposure history was assessed by a self-administered questionnaire and categorized into day, former, and current shift workers. Data on leukocyte count were collected annually as part of worksite health screening during the observation period. Association of shift work exposure and increased leukocyte count was then examined cross-sectionally and longitudinally by using multiple linear regression and multilevel analysis of repeated measures data, respectively. In addition, trends for leukocyte count over the follow-up period and work years were examined using LOWESS smooth curves. RESULTS Compared to day work, the current shift work was associated with increased leukocyte counts. The magnitude of percentage increase was the highest for basophil counts, followed by eosinophil and lymphocyte counts. Both cross-sectional and longitudinal evidence revealed this association, although it was less pronounced longitudinally. For total leukocyte count, the magnitude of difference was constant across the 11-year follow-up period. However, for lymphocyte and basophil counts, these discrepancies tapered over the work years until they no longer differed (for lymphocyte count) or even differed in the opposite direction (for basophil count) in later work years. CONCLUSION This study confirmed previous cross-sectional evidence that shift work exposure-increased leukocyte counts and that this was reversible. Whether this increase in immune cell count also results in an increased immune cell activity and serves as the intermediary in the association between shift work exposure and subsequent chronic disease development needs further investigation.
Collapse
Affiliation(s)
- Nitt Hanprathet
- Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Pathumwan, Bangkok, Thailand
| | - Somrat Lertmaharit
- Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Pathumwan, Bangkok, Thailand
| | - Vitool Lohsoonthorn
- Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Pathumwan, Bangkok, Thailand.,Department of Preventive and Social Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross, Bangkok, Thailand
| | - Thanapoom Rattananupong
- Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Pathumwan, Bangkok, Thailand
| | - Palanee Ammaranond
- Department of Transfusion Medicine, Faculty of Allied Health Sciences, Chulalongkorn University, Pathumwan, Bangkok, Thailand
| | - Wiroj Jiamjarasrangsi
- Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Pathumwan, Bangkok, Thailand.,Department of Preventive and Social Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross, Bangkok, Thailand
| |
Collapse
|
34
|
李 旭, 高 云, 尹 焯, 杨 金. [Clinical features of testicular torsion and its misdiagnosis:analysis of 274 cases]. Nan Fang Yi Ke Da Xue Xue Bao 2019; 39:490-494. [PMID: 31068295 PMCID: PMC6744001 DOI: 10.12122/j.issn.1673-4254.2019.04.17] [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] [Received: 01/15/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To summarize the clinical characteristics of testicular torsion and explore the relationship between its incidence and temperature, the value of supplementary examinations, and the factors causing misdiagnosis and testicular lesions. METHODS We retrospectively analyzed the clinical data of the patients with testicular torsion diagnosed in 9 hospitals in Hunan Province from May 1, 2009 to November 1, 2018. The temperature at onset and WBC value after onset were analyzed. The misdiagnosis rate and testicular lesion rate in the first-visit hospitals were compared between the large general hospitals and local hospitals. The factors that affected the diagnosis and treatment of testicular torsion were analyzed. RESULTS A total of 274 cases were included in this study, and misdiagnoses occurred in 151 cases (61.9%). The initial diagnosis was made in large general hospitals in 59 cases; misdiagnosis occurred in 30.5% of the cases and the rate of testicular lesions was 57.6%. Of the 215 cases first diagnosed in local hospitals, only 82 cases were diagnosed correctly, and the misdiagnosis rate was as high as 61.9%; the rate of testicular lesion was 85.6% in these cases. There were significant differences in the misdiagnosis rate and testicular lesion rate between the two groups (P < 0.05). CONCLUSIONS The first-visit misdiagnosis rate of testicular torsion is much lower and the probability of testicle preservation is significantly higher in large general hospitals than in the local hospitals, suggesting the importance of health education for testicular torsion, enhancing the awareness of this condition and training of the surgeons in primary hospitals.
Collapse
Affiliation(s)
- 旭睿 李
- />中南大学湘雅二医院泌尿外科, 湖南 长沙 410011Department of Urology, Second Hospital of Central South University, Changsha 410011, China
| | - 云亮 高
- />中南大学湘雅二医院泌尿外科, 湖南 长沙 410011Department of Urology, Second Hospital of Central South University, Changsha 410011, China
| | - 焯 尹
- />中南大学湘雅二医院泌尿外科, 湖南 长沙 410011Department of Urology, Second Hospital of Central South University, Changsha 410011, China
| | - 金瑞 杨
- />中南大学湘雅二医院泌尿外科, 湖南 长沙 410011Department of Urology, Second Hospital of Central South University, Changsha 410011, China
| |
Collapse
|
35
|
Choi WJ, Lee JW, Cho AR, Lee YJ. Dose-Dependent Toxic Effect of Cotinine-Verified Tobacco Smoking on Systemic Inflammation in Apparently Healthy Men and Women: A Nationwide Population-Based Study. Int J Environ Res Public Health 2019; 16:E503. [PMID: 30754720 PMCID: PMC6388378 DOI: 10.3390/ijerph16030503] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 02/01/2019] [Accepted: 02/04/2019] [Indexed: 12/17/2022]
Abstract
Chronic exposure to tobacco smoke leads to chronic low-grade systemic inflammation; however, little is known about the dose-dependent toxic effect of objective tobacco smoking on systemic inflammation. We examined the dose-dependent toxic effect of cotinine-verified tobacco smoking on leukocyte count in a representative sample of Korean adults, including 8655 men and 10,432 women aged 19⁻65 years from the Korean National Health and Nutrition Examination Survey. The participants were categorized into five groups by the level of urine cotinine (Ucot) as follows: A non-smoker group (<50.00 ng/mL) and four quartile groups for smokers for both men and women. The odds ratios (ORs) and 95% confidence intervals (CIs) for sex-specific high leukocyte count (≥75th percentile) were calculated across five groups of Ucot concentrations using multiple logistic regression analyses. The mean values of leukocyte count gradually increased according to the grade of Ucot concentration in both sexes. The ORs (95% CIs) for high leukocyte count in the 4th Ucot quartile concentrations versus the non-smokers were 4.09 (3.39⁻4.94) for men and 3.91 (2.82⁻5.41) for women after adjusting for confounding variables. The present study confirmed the dose-response toxic effect of tobacco smoking on chronic low-grade systemic inflammation.
Collapse
Affiliation(s)
- Won-Jun Choi
- Department of Family Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemoon-gu, Seoul 06273, Korea.
- Department of Medicine, Graduate School, Yonsei University, 50-1 Yonsei-ro, Seodaemoon-gu, Seoul 03722, Korea.
| | - Ji-Won Lee
- Department of Family Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemoon-gu, Seoul 06273, Korea.
| | - A Ra Cho
- Department of Family Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemoon-gu, Seoul 06273, Korea.
| | - Yong-Jae Lee
- Department of Family Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemoon-gu, Seoul 06273, Korea.
| |
Collapse
|
36
|
Bauer TW, Bedair H, Creech JD, Deirmengian C, Eriksson H, Fillingham Y, Grigoryan G, Hickok N, Krenn V, Krenn V, Lazarinis S, Lidgren L, Lonner J, Odum S, Shah J, Shahi A, Shohat N, Tarabichi M, W-Dahl A, Wongworawat MD. Hip and Knee Section, Diagnosis, Laboratory Tests: Proceedings of International Consensus on Orthopedic Infections. J Arthroplasty 2019; 34:S351-S359. [PMID: 30343973 DOI: 10.1016/j.arth.2018.09.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
|
37
|
Dos Reis NA, Tavares DMDS, Gonçalves JRL, Amaro EDA, Virtuoso Júnior JS. Frailty Screening: Inflammatory Markers Assessment and Identification of Adverse Health Factors in Hospitalized Older Adults. J Nurs Meas 2018; 26:512-522. [PMID: 30593575 DOI: 10.1891/1061-3749.26.3.512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE The detection of older individuals who are most vulnerable to adverse health effects (AHE) may be useful for practitioners in managing health care resources. The purpose of this study was to analyze the prevalence and identify AHE after hospital discharge (HD). METHODS This cohort study included 135 hospitalized older individuals. Fragility was assessed by changes in the plasma concentrations of C-reactive protein and / or leukocytes. RESULTS Fragile individuals had a higher risk of rehospitalization, consumption of drugs, functional impairment and mortality within 30 days post-HD, and higher risk of functional disability at 180 days post-HD. CONCLUSION More than one-third of hospitalized older individuals are fragile and require more attention in the first 30 days because of the associated AHE.
Collapse
|
38
|
Yucel C, Ozlem Ilbey Y. Predictive value of hematological parameters in testicular torsion: retrospective investigation of data from a high-volume tertiary care center. J Int Med Res 2018; 47:730-737. [PMID: 30453814 PMCID: PMC6381455 DOI: 10.1177/0300060518809778] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objective To investigate the use of hematological parameters in the differential diagnosis of testis torsion and epididymo-orchitis, and to determine the predictive value of these parameters in the diagnosis of testis torsion. Methods This study retrospectively reviewed the medical data of patients who presented to our institute with the complaint of acute scrotal pain. Eighty-five patients who had undergone orchiectomy or surgical detorsion due to testis torsion and 72 patients with epididymo-orchitis were included in the study. The control group comprised 78 healthy males. The groups were compared with respect to age, hematological parameters, neutrophil to lymphocyte ratio (NLR), monocyte to eosinophil ratio (MER), and platelet to lymphocyte ratio (PLR). Results The monocyte count significantly differed between testis torsion and epididymo-orchitis, and was useful in the differential diagnosis. The mean neutrophil, platelet, and white blood cell counts, and the NLR, MER, and PLR values in the control group were significantly lower than those in the torsion and epididymo-orchitis groups. Conclusion The sensitivity and specificity of NLR in predicting testis torsion were as high as the sensitivity and specificity of doppler ultrasonography, suggesting the possible use of this parameter in the diagnosis of testis torsion.
Collapse
Affiliation(s)
- Cem Yucel
- Department of Urology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Yusuf Ozlem Ilbey
- Department of Urology, Tepecik Training and Research Hospital, Izmir, Turkey
| |
Collapse
|
39
|
Ackland GL, Abbott TEF, Cain D, Edwards MR, Sultan P, Karmali SN, Fowler AJ, Whittle JR, MacDonald NJ, Reyes A, Paredes LG, Stephens RCM, Del Arroyo AG, Woldman S, Archbold RA, Wragg A, Kam E, Ahmad T, Khan AW, Niebrzegowska E, Pearse RM. Preoperative systemic inflammation and perioperative myocardial injury: prospective observational multicentre cohort study of patients undergoing non-cardiac surgery. Br J Anaesth 2019; 122:180-7. [PMID: 30686303 DOI: 10.1016/j.bja.2018.09.002] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/26/2018] [Accepted: 09/03/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Systemic inflammation is pivotal in the pathogenesis of cardiovascular disease. As inflammation can directly cause cardiomyocyte injury, we hypothesised that established systemic inflammation, as reflected by elevated preoperative neutrophil-lymphocyte ratio (NLR) >4, predisposes patients to perioperative myocardial injury. METHODS We prospectively recruited 1652 patients aged ≥45 yr who underwent non-cardiac surgery in two UK centres. Serum high sensitivity troponin T (hsTnT) concentrations were measured on the first three postoperative days. Clinicians and investigators were blinded to the troponin results. The primary outcome was perioperative myocardial injury, defined as hsTnT≥14 ng L-1 within 3 days after surgery. We assessed whether myocardial injury was associated with preoperative NLR>4, activated reactive oxygen species (ROS) generation in circulating monocytes, or both. Multivariable logistic regression analysis explored associations between age, sex, NLR, Revised Cardiac Risk Index, individual leukocyte subsets, and myocardial injury. Flow cytometric quantification of ROS was done in 21 patients. Data are presented as n (%) or odds ratio (OR) with 95% confidence intervals. RESULTS Preoperative NLR>4 was present in 239/1652 (14.5%) patients. Myocardial injury occurred in 405/1652 (24.5%) patients and was more common in patients with preoperative NLR>4 [OR: 2.56 (1.92-3.41); P<0.0001]. Myocardial injury was independently associated with lower absolute preoperative lymphocyte count [OR 1.80 (1.50-2.17); P<0.0001] and higher absolute preoperative monocyte count [OR 1.93 (1.12-3.30); P=0.017]. Monocyte ROS generation correlated with NLR (r=0.47; P=0.03). CONCLUSIONS Preoperative NLR>4 is associated with perioperative myocardial injury, independent of conventional risk factors. Systemic inflammation may contribute to the development of perioperative myocardial injury. CLINICAL TRIAL REGISTRATION NCT01842568.
Collapse
|
40
|
Abstract
OBJECTIVE The inverse associations of testosterone and sex hormone-binding globulin (SHBG) levels with cardiometabolic diseases are well established and are increasingly viewed as inflammatory diseases. This study aimed to examine the associations of testosterone and SHBG levels with leukocyte count in 451 Korean men aged ≥50 years. METHODS Serum testosterone and SHBG levels were categorized into tertiles. High leukocyte count was defined as ≥7340 cells/μl, which corresponded to the 75th percentile of the current sample. The odds ratios (ORs) and 95% confidence intervals (95% CIs) for high leukocyte count were calculated across testosterone and SHBG tertiles using multiple logistic regression analysis. RESULTS The mean leukocyte counts significantly decreased with increasing testosterone and SHBG tertiles. The ORs (95% CIs) of high leukocyte count for the first tertile of testosterone and SHBG were 3.27 (1.34-7.95) and 2.38 (1.05-5.96), respectively, compared with the referent third tertile, after adjusting for age, smoking status, alcohol drinking, regular exercise, body mass index, blood pressure, fasting plasma glucose, triglyceride, and high-density lipoprotein (HDL) cholesterol level. CONCLUSION We found inversely graded associations of low testosterone and SHBG levels with leukocyte count. These findings suggest that low testosterone and SHBG levels may be interpreted as a state of low-grade inflammation.
Collapse
Affiliation(s)
- Byoungjin Park
- a Department of Family Medicine, Yonsei University College of Medicine , Seoul , Korea
- b Department of Medicine, Graduate School of Medicine , Yonsei University, Seoul , Korea
| | - Yong-Jae Lee
- a Department of Family Medicine, Yonsei University College of Medicine , Seoul , Korea
| |
Collapse
|
41
|
Welsh C, Welsh P, Mark PB, Celis-Morales CA, Lewsey J, Gray SR, Lyall DM, Iliodromiti S, Gill JMR, Pell J, Jhund PS, Sattar N. Association of Total and Differential Leukocyte Counts With Cardiovascular Disease and Mortality in the UK Biobank. Arterioscler Thromb Vasc Biol 2018; 38:1415-1423. [PMID: 29699973 DOI: 10.1161/atvbaha.118.310945] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 04/09/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Elevated white blood cell count is associated with a higher risk of cardiovascular disease (CVD). We aimed to investigate whether specific leukocyte subpopulations, which may more closely indicate a specific inflammatory pathway, are specifically associated with CVD. APPROACH AND RESULTS Participants (478 259) from UK Biobank with data for white blood cell count were included. Death because of CVD (n=1377) and non-CVD causes (n=8987) occurred during median follow-up time of 7.0 years (interquartile range, 6.3-7.6). In Cox models, deciles of leukocyte counts (lymphocytes, monocytes, neutrophils, eosinophils, and basophils) were examined using the fifth decile as the referent group. Models were stratified by sex and adjusted for a range of classical risk factors. A sensitivity analysis excluded participants with baseline comorbidites and the first 2 years of follow-up. Men (hazard ratio [HR], 1.59; 95% confidence interval, 1.22-2.08) and women (HR, 2.15; 95% confidence interval, 1.38-3.35) in the highest decile of neutrophil count were at higher risk of CVD mortality and nonfatal CVD (men HR, 1.28; 95% confidence interval, 1.16-1.42 and women HR, 1.21; 95% confidence interval, 1.06-1.38). In the sensitivity analysis, the power to investigate CVD mortality was limited, but for both sexes combined, the linear HRs for a 1×109/L cell count increase in white blood cell count and neutrophils, respectively, was 1.05 (1.03-1.07) and 1.07 (1.04-1.11). CONCLUSIONS Among circulating leukocyte subpopulations, neutrophil count in men was most consistently associated with fatal and nonfatal CVD. Further studies of interventions that lower circulating neutrophils, such as canakinumab, are required to investigate causality.
Collapse
Affiliation(s)
- Claire Welsh
- From the Institute of Cardiovascular and Medical Sciences (P.W., C.W., P.B.M., C.A.C.-M., S.R.G., S.I., J.M.R.G., P.S.J., N.S.)
| | - Paul Welsh
- From the Institute of Cardiovascular and Medical Sciences (P.W., C.W., P.B.M., C.A.C.-M., S.R.G., S.I., J.M.R.G., P.S.J., N.S.)
| | - Patrick B Mark
- From the Institute of Cardiovascular and Medical Sciences (P.W., C.W., P.B.M., C.A.C.-M., S.R.G., S.I., J.M.R.G., P.S.J., N.S.)
| | - Carlos A Celis-Morales
- From the Institute of Cardiovascular and Medical Sciences (P.W., C.W., P.B.M., C.A.C.-M., S.R.G., S.I., J.M.R.G., P.S.J., N.S.)
| | - James Lewsey
- Institute of Health and Wellbeing (J.L., D.M.L., J.P.), University of Glasgow, Scotland
| | - Stuart R Gray
- From the Institute of Cardiovascular and Medical Sciences (P.W., C.W., P.B.M., C.A.C.-M., S.R.G., S.I., J.M.R.G., P.S.J., N.S.)
| | - Donald M Lyall
- Institute of Health and Wellbeing (J.L., D.M.L., J.P.), University of Glasgow, Scotland
| | - Stamatina Iliodromiti
- From the Institute of Cardiovascular and Medical Sciences (P.W., C.W., P.B.M., C.A.C.-M., S.R.G., S.I., J.M.R.G., P.S.J., N.S.)
| | - Jason M R Gill
- From the Institute of Cardiovascular and Medical Sciences (P.W., C.W., P.B.M., C.A.C.-M., S.R.G., S.I., J.M.R.G., P.S.J., N.S.)
| | - Jill Pell
- Institute of Health and Wellbeing (J.L., D.M.L., J.P.), University of Glasgow, Scotland
| | - Pardeep S Jhund
- From the Institute of Cardiovascular and Medical Sciences (P.W., C.W., P.B.M., C.A.C.-M., S.R.G., S.I., J.M.R.G., P.S.J., N.S.)
| | - Naveed Sattar
- From the Institute of Cardiovascular and Medical Sciences (P.W., C.W., P.B.M., C.A.C.-M., S.R.G., S.I., J.M.R.G., P.S.J., N.S.)
| |
Collapse
|
42
|
|
43
|
Chmielewski PP, Strzelec B. Elevated leukocyte count as a harbinger of systemic inflammation, disease progression, and poor prognosis: a review. Folia Morphol (Warsz) 2017; 77:171-178. [PMID: 29064542 DOI: 10.5603/fm.a2017.0101] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Revised: 09/08/2017] [Accepted: 09/11/2017] [Indexed: 01/27/2023]
Abstract
Total leukocyte count increases significantly in response to infection, trauma, inflammation, and certain diseases. Factors affecting leukocyte count in healthy adults include sex, hormonal milieu, genetic inheritance, stress level, diet, nutrition, and lifestyle (e.g. tobacco-induced inflammatory changes, chronic psychological stress, etc.). To date, numerous studies have reported that high but normal leukocyte counts at baseline predict increased cardiovascular and noncardiovascular mortality in older adults. Recent findings suggest that elevated leukocyte count within the normal range, but especially neutrophil and monocyte counts, may be a harbinger of increased systemic inflammation and subclinical disease. Moreover, elderly people who tend to have high but normal leukocyte counts are at greater risk of cancer, cardiovascular disease, type 2 diabetes, some other age-related conditions, and they also have increased all-cause mortality. These results indicate that strong and reliable inflammatory markers, such as leukocyte count, may reflect the rate of ageing and therefore can predict long-term survival in the elderly. Remarkably, leukocyte count correlates positively with genuine markers of systemic inflammation like C-reactive protein and interleukin 6. Interestingly, some authors conclude that leukocyte counts have a stronger prognostic ability with regard to total and cardiovascular mortality than total cholesterol or low-density lipoproteins. The fact that these inflammatory markers are clinically useful predictors of long-term survival in the elderly is quite remarkable as these blood parameters are included in routine medical check-ups. Therefore, they can be used as simple and reliable morphological indicators of chronic systemic inflammation, disease progression, and poor prognosis, especially among individuals who are likely to develop age-related conditions. Nevertheless, the pathomechanism that links elevated but normal leukocyte counts to increased mortality remains poorly understood. This review summarises the most important findings on the links between leukocyte count, chronic systemic inflammation, and health outcomes in older adults. (Folia Morphol 2018; 77, 2: 171-178).
Collapse
Affiliation(s)
- P P Chmielewski
- Division of Anatomy, Department of Human Morphology and Embryology, Faculty of Medicine, Wroclaw Medical University, 6a Chałubińskiego Street, 50-368 Wrocław, Poland.
| | | |
Collapse
|
44
|
Bauer ME, Price LK, MacEachern MP, Housey M, Langen ES, Bauer ST. Maternal leukocytosis after antenatal corticosteroid administration: a systematic review and meta-analysis . J OBSTET GYNAECOL 2017; 38:210-216. [PMID: 28903611 DOI: 10.1080/01443615.2017.1342614] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Although it is known that corticosteroid administration causes leukocytosis, the magnitude and length of time this leukocytosis persists is unknown during pregnancy. This study aimed to establish the expected range of maternal leukocytosis in healthy pregnant women at risk for preterm delivery after antenatal corticosteroid administration. PubMed, Embase and ClinicalTrials.gov were searched to identify the studies in healthy women at risk for preterm delivery without signs of clinical infection that reported white blood cell values preceding and after antenatal corticosteroid administration. The inverse variance weighting technique was used to calculate the weighted means and the standard deviation from the mean for each time period. Six studies met inclusion criteria and included 524 patients and 1406 observations. Mean ± standard deviation maternal white blood cell count values prior to antenatal corticosteroid administration and up to 24, 48, 72 and 96 hours after corticosteroid administration were 10.4 ± 2.4, 13.6 ± 3.6, 12.1 ± 3.0, 11.5 ± 2.9 and 11.1 ± 2.5 × 109/L, respectively. Leukocytosis in healthy, non-infected women is expected to peak 24 hours after antenatal corticosteroid administration and the magnitude of increase is small. Impact statement What is already known on this subject: While it is well known that administration of antenatal corticosteroids causes leukocytosis, it is currently unknown the magnitude and length of time the leukocytosis persists. What the results of this study add: This study establishes the expected range and the temporal progression and regression with antenatal corticosteroid administration in healthy pregnant women at risk for preterm delivery without clinical signs of infection. What the implications are of these findings for clinical practice and/or further research: Clinicians may wish to consider further investigation into the clinical cause, whether infectious or non-infectious, for absolute values and changes outside this range.
Collapse
Affiliation(s)
- Melissa E Bauer
- a Department of Anesthesiology , University of Michigan , Ann Arbor , MI , USA
| | - Laura K Price
- b Department of Obstetrics and Gynecology , Oakland University William Beaumont School of Medicine , Royal Oak , MI , USA
| | - Mark P MacEachern
- c Taubman Health Sciences Library , University of Michigan , Ann Arbor , MI , USA
| | - Michelle Housey
- a Department of Anesthesiology , University of Michigan , Ann Arbor , MI , USA
| | - Elizabeth S Langen
- d Department of Obstetrics and Gynecology , University of Michigan , Ann Arbor , MI , USA
| | - Samuel T Bauer
- b Department of Obstetrics and Gynecology , Oakland University William Beaumont School of Medicine , Royal Oak , MI , USA
| |
Collapse
|
45
|
Kwon YJ, Lee HS, Shim JY, Lee YJ. Serum carcinoembryonic antigen is positively associated with leukocyte count in Korean adults. J Clin Lab Anal 2017; 32. [PMID: 28653772 DOI: 10.1002/jcla.22291] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 06/05/2017] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Emerging evidence shows that serum carcinoembryonic antigen (CEA) levels may modestly be increased in non-neoplastic conditions such as cardiometabolic diseases, which are increasingly being seen as inflammatory diseases. Leukocyte count is widely evaluated marker of inflammation in clinical practice and a useful predictor of cardiometabolic disease. In this study, we aimed to determine the relationship between serum CEA levels and leukocyte counts in Korean adults. METHODS This cross-sectional study included a total of 19 834 individuals enrolled from a health promotion center between November 2006 and July 2010. Multiple linear regression analysis was performed to investigate the association between serum CEA levels and leukocyte counts after adjusting for confounding variables. RESULTS According to both stepwise-method and enter-method multiple linear regression analyses, serum CEA levels were positively and independently associated with leukocyte counts (P<.001) after adjusting for age, sex, body mass index, systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, HDL-cholesterol, cigarette smoking, alcohol ingestion, physical activity, diabetes mellitus, and anti-inflammatory drugs. CONCLUSIONS We demonstrate a positive relationship between serum CEA levels and leukocyte counts in Korean adults. Our results suggested that an elevated serum CEA level may reflect chronic inflammation state.
Collapse
Affiliation(s)
- Yu-Jin Kwon
- Department of Family Medicine, Yong-in Severance Hospital, Yonsei University College of Medicine, Yong-in, Korea.,Department of Medicine, Gradauate School of Yonsei University College of Medicine, Seoul, Korea
| | - Hye-Sun Lee
- Biostatistics Collaboration Units, Department of Research Affairs, Yonsei University College of Medicine, Seoul, Korea
| | - Jae-Yong Shim
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yong-Jae Lee
- Department of Family Medicine, Gangam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| |
Collapse
|
46
|
Shiyovich A, Gilutz H, Plakht Y. White Blood Cell Subtypes Are Associated with a Greater Long-Term Risk of Death after Acute Myocardial Infarction. Tex Heart Inst J 2017; 44:176-188. [PMID: 28761398 DOI: 10.14503/thij-16-5768] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
We evaluated the association between white blood cell counts and long-term mortality rates in 2,129 patients (mean age, 65.3 ± 13.5 yr; 69% men) who had survived acute myocardial infarction. We obtained white blood cell counts and differential counts of white blood cell subtypes within the first 72 hours of hospital admission. The primary outcome was all-cause death at 1, 5, and 10 years after acute myocardial infarction. In regard to death in the long term, we found significant negative linear associations (lymphocytes), positive linear associations (neutrophils and the neutrophil-to-lymphocyte ratio), and nonlinear U-shaped associations (basophils, eosinophils, monocytes, and total white blood cell count). After multivariate adjustment for the Soroka Acute Myocardial Infarction risk score, lymphocytes (strongest association), neutrophil-to-lymphocyte ratio, and eosinophils were independently associated with death for up to 10 years after hospital discharge. The independent associations weakened over time. We conclude that lymphocyte count, neutrophil-to-lymphocyte ratio, and eosinophil count are independently and incrementally associated with death in the long term after acute myocardial infarction.
Collapse
|
47
|
McIntosh AG, Li T, Ito T, Mannion J, Dziemianowicz M, Waingankar N, Haseebuddin M, Chen DYT, Greenberg RE, Viterbo R, Kutikov A, Uzzo RG, Smaldone MC, Abbosh PH. WBC Associates with Readmission Following Cystectomy. Bladder Cancer 2017; 3:95-103. [PMID: 28516154 PMCID: PMC5409152 DOI: 10.3233/blc-160088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Radical cystectomy is associated with perioperative complication rates exceeding 50% in some series. Readmission rates are increasingly used as a surgical quality metric. White blood cell count is a crude surrogate for physiologic processes which may reflect postoperative complications leading to readmission. Objective: We assessed the association between final white blood cell count at discharge and risk of readmission following radical cystectomy. Methods: Records on 477 patients undergoing radical cystectomy from 2006-2013 were reviewed. Final white blood cell count was defined as the last documented value during index admission. Univariate analysis was performed using Fisher's exact, Wilcoxon rank sum test, and Spearman's coefficient tests where appropriate. Multivariable logistic regression models were used to test the associations between final white blood cell count and readmission. Results: 34% of patients were readmitted within 90 days of surgery. Amongst this cohort, a cutoff final white blood cell count of 9000/mm3 was identified, with a significantly higher proportion of patients with values >9000/mm3 experiencing readmission than those with values≤9000/mm3 (42% vs 28%, p = 0.004). Other perioperative variables associated with an increased readmission rate included initial hospital length of stay≤10 days, and receipt of a continent diversion. Following adjustment, final white blood cell count >9000/mm3 was associated with increased risk of readmission (OR 2.09, 95% CI 1.23-3.53, p = 0.006). Conclusions: Final white blood cell count is associated with hospital readmission following radical cystectomy. This metric may provide important guidance in discharge algorithms.
Collapse
Affiliation(s)
| | - Tianyu Li
- Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Timothy Ito
- Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Jason Mannion
- Temple University Health System, Philadelphia, PA, USA
| | | | | | | | | | | | | | | | - Robert G Uzzo
- Fox Chase Cancer Center, Philadelphia, PA, USA.,Albert Einstein Medical Center, Philadelphia, PA, USA
| | | | - Philip H Abbosh
- Fox Chase Cancer Center, Philadelphia, PA, USA.,Albert Einstein Medical Center, Philadelphia, PA, USA
| |
Collapse
|
48
|
Ferrari JP, Lueneberg ME, da Silva RL, Fattah T, Gottschall CAM, Moreira DM. Correlation between leukocyte count and infarct size in ST segment elevation myocardial infarction. Arch Med Sci Atheroscler Dis 2016; 1:e44-e48. [PMID: 28905018 PMCID: PMC5421522 DOI: 10.5114/amsad.2016.60759] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 06/13/2016] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Regarding the inflammatory mechanisms involved in ischemic heart disease, currently the leukocyte count is the subject of studies related to its association with the prognosis and mortality of ST segment elevation myocardial infarction (STEMI). Our aim is correlate the leukocyte count rise with the size of STEMI, evaluated with the area under the curve (AUC) and the peak of necrosis markers release. MATERIAL AND METHODS This study is a sub-analysis of the TETHYS trial, a clinical trial that evaluated the effects of methotrexate in STEMI. We evaluated the correlation between quantitative variables with Pearson's correlation, and the variables that did not follow a normal distribution were subjected to logarithmic transformation to base 10. The value of p < 0.05 indicated statistical significance. RESULTS Males accounted for 73% of the participants, who had an average age of 59 years. A total of 58% were hypertensive and 53% smokers. The leukocyte count at hospital admission was significantly correlated with the AUC creatine kinase (CK) (r = 0.256, p = 0.021), troponin AUC (r = 0.247, p = 0.026), peak CK (r = 0.270, p = 0.015) and troponin peak (r = 0.233, p = 0.037). The leukocyte count at 72 h was significantly correlated with CK AUC (r = 0.238, p = 0.032), AUC of MB portion of CK (r = 0.240, p = 0.031) and peak CK (r = 0.224, p = 0.045). CONCLUSIONS White blood cell count correlates with STEMI size assessed by serial cardiac biomarker levels.
Collapse
Affiliation(s)
| | | | | | - Tammuz Fattah
- Instituto de Cardiologia de Santa Catarina – ICSC, São José, Brazil
| | | | | |
Collapse
|
49
|
Abstract
BACKGROUND The diagnosis of acute appendicitis is made using clinical findings and investigations. Recent studies have suggested that serum bilirubin, a cheap and simple biochemical test, is a positive predictor in the diagnosis of appendiceal perforation and may be more specific than C-reactive protein (CRP) and white cell count (WCC). The aim of this study was to investigate the utility of the serum bilirubin level in patients with suspected acute but non-perforative appendicitis. METHODS A retrospective chart review of 213 patients who presented with suspected appendicitis in a 6-month period to Nambour General Hospital was performed. Serum bilirubin, WCC and CRP were recorded and analysed as to their utility in relation to the final diagnosis. RESULTS A total of 196 patients underwent an appendicectomy and 41 of these were negative. The specificity of hyperbilirubinaemia for appendicitis overall was 0.83 with a positive predictive value (PPV) of 0.86, compared with CRP (specificity 0.40, PPV 0.75) and WCC (specificity 0.67, PPV 0.85). The area under the receiver operating characteristic curve for bilirubin was 0.6289 compared to 0.6171 for CRP and 0.7219 for WCC. A subgroup analysis of those with complicated appendicitis demonstrated a PPV for bilirubin of 0.66 compared to 0.58 for WCC and 0.34 for CRP in agreement with the literature. Subgroup analysis of hyperbilirubinaemia in simple appendicitis demonstrated a PPV of 0.81 compared to CRP (0.71) and WCC (0.82). CONCLUSION Bilirubin had a higher specificity than CRP and WCC overall in patients with appendicitis. Hyperbilirubinaemia had a high PPV in patients with simple appendicitis.
Collapse
Affiliation(s)
- Anna Sandstrom
- Department of Surgery, Nambour General Hospital, Nambour, Queensland, Australia
| | - David A Grieve
- Department of Surgery, Nambour General Hospital, Nambour, Queensland, Australia
| |
Collapse
|
50
|
Dharma S, Hapsari R, Siswanto BB, van der Laarse A, Jukema JW. Blood Leukocyte Count on Admission Predicts Cardiovascular Events in Patients with Acute Non-ST Elevation Myocardial Infarction. Int J Angiol 2015; 24:127-32. [PMID: 26060384 DOI: 10.1055/s-0035-1544178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
We aim to test the hypothesis that blood leukocyte count adds prognostic information in patients with acute non-ST-elevation myocardial infarction (non-STEMI). A total of 585 patients with acute non-STEMI (thrombolysis in myocardial infarction risk score ≥ 3) were enrolled in this cohort retrospective study. Blood leukocyte count was measured immediately after admission in the emergency department. The composite of death, reinfarction, urgent revascularization, and stroke during hospitalization were defined as the primary end point of the study. The mean age of the patients was 61 ± 9.6 years and most of them were male (79%). Using multivariate Cox regression analysis involving seven variables (history of smoking, hypertension, heart rate > 100 beats/minute, serum creatinine level > 1.5 mg/dL, blood leukocyte count > 11,000/µL, use of β-blocker, and use of angiotensin-converting enzyme inhibitor), leukocyte count > 11,000/µL demonstrated to be a strong predictor of the primary end point (hazard ratio = 3.028; 95% confidence interval = 1.69-5.40, p < 0.001). The high blood leukocyte count on admission is an independent predictor of cardiovascular events in patients with acute non-STEMI.
Collapse
Affiliation(s)
- Surya Dharma
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
| | - Rosmarini Hapsari
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
| | - Bambang B Siswanto
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
| | - Arnoud van der Laarse
- Department of Cardiology and Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| |
Collapse
|