Unique characteristics of new complete blood count parameters, the Immature Platelet Fraction and the Immature Platelet Fraction Count, in dengue patients

The advanced platelet parameters Immature Platelet Fraction and Immature Platelet Fraction Count have been implemented in clinical practice as measures of thrombopoietic activity, mainly in hematologic disorders that cause thrombocytopenia. The purpose of this observational study was to examine thrombopoiesis as reflected by these 2 new CBC parameters in patients infected with dengue. The study was conducted in infectious disease referral hospital in Metro Manila, the Philippines. We enrolled hospitalized patients at admission who were diagnosed with acute dengue or community acquired bacterial infection (CABI). Immature Platelet Fraction (IPF) and Immature Platelet Fraction Count were evaluated at admission and during hospitalization. A total of 606 patients were enrolled from May 1, 2017 to June 1, 2018. The participants consisted of 152 patients with dengue infection, 180 confirmed CABI, and 274 suspected CABI patients. At admission, the percent IPF (IPF%) of the patients with dengue was significantly higher than that of the confirmed CABI patients (median 3.7% versus 1.9%; p <0.001). In a time course evaluation, there was no significant difference of IPF% between the patients with dengue infection and the confirmed CABI patients in the febrile phase (median 1.9% versus 2.4%; p = 0.488), however, the IPF% of the patients with dengue infection increased to be significantly higher than that of the confirmed CABI patients in the critical phase (median 5.2% versus 2.2%; p <0.001). Our study elucidated the unique characteristics and time-course trends of IPF percent and number (IPF#) in the patients with dengue infection. IPF% and IPF# are potentially valuable parameters in dengue and further investigation is required for the optimal use in clinical practice.

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Time-course evaluation of survival and treatment in FIRE-3 (AIO KRK0306, first-line therapy of KRAS wild-type metastatic colorectal cancer with FOLFIRI plus cetuximab or bevacizumab).

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.4_suppl.617 ◽

2016 ◽

Vol 34 (4_suppl) ◽

pp. 617-617

Author(s):

Dominik Paul Modest ◽

Sebastian Stintzing ◽

Ludwig Fischer von Weikersthal ◽

Alberto F. Sobrero ◽

Thomas Decker ◽

...

Keyword(s):

Overall Survival ◽

Time Course ◽

Course Evaluation ◽

Time Interval ◽

Wild Type ◽

Time Intervals ◽

Number Of Patients ◽

Significant Difference ◽

Time Frames ◽

In Fire

617 Background: FIRE-3 reported overall survival (OS) difference in favour of arm A (FOLFIRI plus cetuximab, N= 297 pts.) compared to arm B (FOLFIRI plus bevacizumab, N= 295 pts.) in the absence of significant differences in progression-free survival and response rate. Methods: We subdivided the study into six-month time intervals, starting at the time point of randomisation and evaluated OS in a time-wise fashion. Within each interval, OS was analyzed by Cox regression. Furthermore, systemic treatment and local interventions were investigated in the respective time-frames. Results: The time-course hazard ratios of OS are summarized in the Table. Pronounced differences in overall survival by time-interval analysis are observed between 24 and 30 months and between 30 and 36 months. Within the interval of 24-30 months, 24.6% (73/297) of pts in arm A and 25.1% (74/295) of pts in arm B received systemic therapy (any treatment-line). In the subsequent interval of 30-36 months, systemic anti-tumor treatment decreased to 18.9% (56/297) of pts in arm A and 16.3% (48/295) of pts in arm B. Median time on treatment was less than 2 months in the intervals of 24-30 months and 30-36 months. Updated data including RAS wild-type population will be presented at the meeting. Conclusions: The differences in OS observed in FIRE-3 are pronounced in time intervals between 24-30 months as well as 30-36 months after randomisation into the study. A small number of patients received rather short courses of anti-tumor therapy in these observation units. The significant difference in OS that manifests in time-frames between 24 and 30 months as well as between 30 and 36 months suggests that underlying effects on OS in FIRE-3 may include multiple factors and cannot be explained by the number of patients on active treatment alone. Clinical trial information: NCT00433927. [Table: see text]

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Time Course of Simulator Sickness in Asian Military Pilots

Aerospace Medicine and Human Performance ◽

10.3357/amhp.5674.2020 ◽

2020 ◽

Vol 91 (11) ◽

pp. 892-896

Author(s):

Janine En Qi Loi ◽

Magdalene Li Ling Lee ◽

Benjamin Boon Chuan Tan ◽

Brian See

Keyword(s):

Air Force ◽

Time Course ◽

Simulator Training ◽

Simulator Sickness ◽

Time Points ◽

True Prevalence ◽

Subjective Scale ◽

Significant Difference ◽

Simulator Sickness Questionnaire ◽

Military Pilots

INTRODUCTION: This study sought to determine the incidence, severity, and time-course of simulator sickness (SS) among Asian military pilots following flight simulator training.METHODS: A survey was conducted on Republic of Singapore Air Force pilots undergoing simulator training. Each subject completed a questionnaire immediately after (0H), and at the 3-h (3H) and 6-h (6H) marks. The questionnaire included the simulator sickness questionnaire (SSQ) and a subjective scale to rate their confidence to fly.RESULTS: In this study, 258 pilots with a median age of 31.50 yr (range, 2155 yr) and mean age of 32.61 6.56 yr participated. The prevalence of SS was 48.1% at 0H, 30.8% at 3H, and 16.4% at 6H. Based on a threshold of an SSQ score >10, the prevalence of operationally significant SS was 33.3% at 0H, 13.2% at 3H, and 8.1% at 6H. The most frequent symptoms were fatigue (38.1%), eye strain (29.0%), and fullness of head (19.9%). There was no significant difference in mean scores between rotary and fixed wing pilots. Older, more experienced pilots had greater scores at 0H, but this association did not persist. A correlation was found between SSQ score and self-reported confidence.DISCUSSION: To our knowledge, this study is the first to report the prevalence of operationally significant SS in Asian military pilots over serial time points. Most pilots with SS are able to subjectively judge their fitness to fly. Sensitivity analysis suggests the true prevalence of SS symptoms at 3H and 6H to be closer to 23.8% and 12.0%, respectively.Loi JEQ, Lee MLL, Tan BBC, See B. Time course of simulator sickness in Asian military pilots. Aerosp Med Hum Perform. 2020; 91(11):892896.

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Executive summary of the 2020 clinical practice guidelines for the management of hypertension in the Philippines

Journal of Clinical Hypertension ◽

10.1111/jch.14335 ◽

2021 ◽

Author(s):

Deborah Ignacia D. Ona ◽

Cecilia A. Jimeno ◽

Gabriel V. Jasul ◽

Ma. Lourdes E. Bunyi ◽

Raymond Oliva ◽

...

Keyword(s):

Clinical Practice ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

The Philippines ◽

Executive Summary

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Rheumatologist perspective of the Brazilian consensus for detection of auto antibodies in HEp-2 CELLS

Advances in Rheumatology ◽

10.1186/s42358-021-00190-8 ◽

2021 ◽

Vol 61 (1) ◽

Author(s):

Isadora Carvalho Medeiros Francescantonio ◽

Leandro Augusto Rodrigues dos Santos ◽

Paulo Luiz Carvalho Francescantonio ◽

Luiz Eduardo Coelho Andrade ◽

Wilson de Melo Cruvinel

Keyword(s):

Clinical Practice ◽

Immunofluorescence Assay ◽

Chi Square ◽

Dichotomous Data ◽

Level Of Satisfaction ◽

Significant Difference ◽

Chi Square Test ◽

Geographic Regions ◽

Relevant Pattern ◽

Structured Questionnaire

Abstract Objective To evaluate the perception of rheumatologists regarding the recommendations of the Brazilian Consensus for detection of Autoantibodies (BCA) on HEp-2 Cells by Indirect Immunofluorescence assay (IFA) and how BCA recommendations help in clinical practice. Methodology A structured questionnaire regarding the BCA recommendations for detection and interpretations of autoantibodies in HEp-2 cells was applied to randomly selected rheumatologists. The results were tabulated using the Microsoft® Excel program, expressed as a simple percentage and the dichotomous data were analyzed using the Chi-square test and the Epi Info® program. Results Four hundred fuorteen rheumatologists participated in the study: 70% of them considered their knowledge of the HEp-2 IFA test satisfactory or excellent, and 43% said they knew the BCA recommendations in general, without distinguishing the edition of the BCA to which they refer. The Revista Brasileira de Rheumatologia/Advances in Rheumatology was the means of dissemination most consulted by specialists (50%). According to the rheumatologists’ opinion, the most relevant pattern was the homogeneous nuclear (78%) and 65% stated they were satisfied with the BCA recommendations at a level of satisfaction greater than or equal to 80%. There was no significant difference in the perception of rheumatologists from the several Brazilian geographic regions. Conclusion Brazilian rheumatologists are aware of the BCA guidelines and most are satisfied with the content published, considering that the BCA recommendations assist positively in the clinical practice. Most rheumatologists recognize the patterns associated with rheumatic autoimmune diseases and have used BCA recommendations to interpret the results of the HEp-2 IFA test.

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Quality of life assessments in clinical practice using either the EORTC-QLQ-C30 or the SEIOQL-DW: a randomized study

Journal of Patient-Reported Outcomes ◽

10.1186/s41687-021-00315-z ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Åsa Kettis ◽

Hanna Fagerlind ◽

Jan-Erik Frödin ◽

Bengt Glimelius ◽

Lena Ring

Keyword(s):

Quality Of Life ◽

Clinical Practice ◽

Significant Difference ◽

Patient Reported ◽

Health Related Qol ◽

Health Related ◽

Secondary Outcomes ◽

The Impact ◽

Over Time

Abstract Background Effective patient-physician communication can improve patient understanding, agreement on treatment and adherence. This may, in turn, impact on clinical outcomes and patient quality of life (QoL). One way to improve communication is by using patient-reported outcome measures (PROMs). Heretofore, studies of the impact of using PROMs in clinical practice have mostly evaluated the use of standardized PROMs. However, there is reason to believe that individualized instruments may be more appropriate for this purpose. The aim of this study is to compare the effectiveness of the standardized QoL-instrument, the European Organization for Research and Treatment of Cancer Quality of Life C-30 (EORTC-QOL-C30) and the individualized QoL instrument, the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW), in clinical practice. Methods In a prospective, open-label, controlled intervention study at two hospital out-patient clinics, 390 patients with gastrointestinal cancer were randomly assigned either to complete the EORTC-QOL-C30 or the SEIQoL-DW immediately before the consultation, with their responses being shared with their physician. This was repeated in 3–5 consultations over a period of 4–6 months. The primary outcome measure was patients’ health-related QoL, as measured by FACIT-G. Patients’ satisfaction with the consultation and survival were secondary outcomes. Results There was no significant difference between the groups with regard to study outcomes. Neither intervention instrument resulted in any significant changes in health-related QoL, or in any of the secondary outcomes, over time. This may reflect either a genuine lack of effect or sub-optimization of the intervention. Since there was no comparison to standard care an effect in terms of lack of deterioration over time cannot be excluded. Conclusions Future studies should focus on the implementation process, including the training of physicians to use the instruments and their motivation for doing so. The effects of situational use of standardized or individualized instruments should also be explored. The effectiveness of the different approaches may depend on contextual factors including physician and patient preferences.

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Computing infection distributions and longitudinal evolution patterns in lung CT images

BMC Medical Imaging ◽

10.1186/s12880-021-00588-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Dongdong Gu ◽

Liyun Chen ◽

Fei Shan ◽

Liming Xia ◽

Jun Liu ◽

...

Keyword(s):

Time Course ◽

Lower Lobe ◽

Ground Truth ◽

Distribution Patterns ◽

Lung Infection ◽

Ct Images ◽

Community Acquired Pneumonia ◽

Disease Course ◽

Distribution Maps ◽

Significant Difference

Abstract Background Spatial and temporal lung infection distributions of coronavirus disease 2019 (COVID-19) and their changes could reveal important patterns to better understand the disease and its time course. This paper presents a pipeline to analyze statistically these patterns by automatically segmenting the infection regions and registering them onto a common template. Methods A VB-Net is designed to automatically segment infection regions in CT images. After training and validating the model, we segmented all the CT images in the study. The segmentation results are then warped onto a pre-defined template CT image using deformable registration based on lung fields. Then, the spatial distributions of infection regions and those during the course of the disease are calculated at the voxel level. Visualization and quantitative comparison can be performed between different groups. We compared the distribution maps between COVID-19 and community acquired pneumonia (CAP), between severe and critical COVID-19, and across the time course of the disease. Results For the performance of infection segmentation, comparing the segmentation results with manually annotated ground-truth, the average Dice is 91.6% ± 10.0%, which is close to the inter-rater difference between two radiologists (the Dice is 96.1% ± 3.5%). The distribution map of infection regions shows that high probability regions are in the peripheral subpleural (up to 35.1% in probability). COVID-19 GGO lesions are more widely spread than consolidations, and the latter are located more peripherally. Onset images of severe COVID-19 (inpatients) show similar lesion distributions but with smaller areas of significant difference in the right lower lobe compared to critical COVID-19 (intensive care unit patients). About the disease course, critical COVID-19 patients showed four subsequent patterns (progression, absorption, enlargement, and further absorption) in our collected dataset, with remarkable concurrent HU patterns for GGO and consolidations. Conclusions By segmenting the infection regions with a VB-Net and registering all the CT images and the segmentation results onto a template, spatial distribution patterns of infections can be computed automatically. The algorithm provides an effective tool to visualize and quantify the spatial patterns of lung infection diseases and their changes during the disease course. Our results demonstrate different patterns between COVID-19 and CAP, between severe and critical COVID-19, as well as four subsequent disease course patterns of the severe COVID-19 patients studied, with remarkable concurrent HU patterns for GGO and consolidations.

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Effect of Resonant Frequency Vibration on Delayed Onset Muscle Soreness and Resulting Stiffness as Measured by Shear-Wave Elastography

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18157853 ◽

2021 ◽

Vol 18 (15) ◽

pp. 7853

Author(s):

Garrett C. Jones ◽

Jonathan D. Blotter ◽

Cameron D. Smallwood ◽

Dennis L. Eggett ◽

Darryl J. Cochrane ◽

...

Keyword(s):

Resonant Frequency ◽

Shear Wave ◽

Time Course ◽

Biceps Brachii ◽

Shear Wave Elastography ◽

Upper Body ◽

Maximum Voluntary Isometric Contraction ◽

Post Exercise ◽

Significant Difference ◽

Pain Ratings

This study utilized resonant frequency vibration to the upper body to determine changes in pain, stiffness and isometric strength of the biceps brachii after eccentric damage. Thirty-one participants without recent resistance training were randomized into three groups: a Control (C) group and two eccentric exercise groups (No vibration (NV) and Vibration (V)). After muscle damage, participants in the V group received upper body vibration (UBV) therapy for 5 min on days 1–4. All participants completed a visual analog scale (VAS), maximum voluntary isometric contraction (MVIC), and shear wave elastography (SWE) of the bicep at baseline (pre-exercise), 24 h, 48 h, and 1-week post exercise. There was a significant difference between V and NV at 24 h for VAS (p = 0.0051), at 24 h and 1-week for MVIC (p = 0.0017 and p = 0.0016, respectively). There was a significant decrease in SWE for the V group from 24–48 h (p = 0.0003), while there was no significant change in the NV group (p = 0.9341). The use of UBV resonant vibration decreased MVIC decrement and reduced VAS pain ratings at 24 h post eccentric damage. SWE was strongly negatively correlated with MVIC and may function as a predictor of intrinsic muscle state in the time course of recovery of the biceps brachii.

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Comparison of hematological parameters and perinatal outcomes between COVID-19 pregnancies and healthy pregnancy cohort

Journal of Perinatal Medicine ◽

10.1515/jpm-2020-0403 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Esin Merve Erol Koç ◽

Rahime Bedir Fındık ◽

Hatice Akkaya ◽

Işılay Karadağ ◽

Eda Özden Tokalıoğlu ◽

...

Keyword(s):

Complete Blood Count ◽

Perinatal Outcomes ◽

Control Group ◽

Strong Positive Correlation ◽

Monocyte Count ◽

Distribution Width ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Significant Difference ◽

Adverse Perinatal Outcomes

AbstractObjectivesTo evaluate the relationship between Coronavirus Disease 2019 (COVID-19) in pregnancy and adverse perinatal outcomes. The secondary aim is to analyze the diagnostic value of hematologic parameters in COVID-19 complicated pregnancies.MethodsThe current study is conducted in a high volume tertiary obstetrics center burdened by COVID-19 pandemics, in Turkey. In this cohort study, perinatal outcomes and complete blood count indices performed at the time of admission of 39 pregnancies (Study group) complicated by COVID-19 were compared with 69 uncomplicated pregnancies (Control group).ResultsThere was no significant difference between the obstetric and neonatal outcomes of pregnancies with COVID-19 compared to data of healthy pregnancies, except the increased C-section rate (p=0.026). Monocyte count, red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR), and monocyte/lymphocyte ratio (MLR) were significantly increased (p<0.0001, p=0.009, p=0.043, p<0.0001, respectively) whereas the MPV and plateletcrit were significantly decreased (p=0.001, p=0.008) in pregnants with COVID-19. ROC analysis revealed that the optimal cut-off value for MLR was 0.354 which indicated 96.7% specificity and 59.5% sensitivity in diagnosis of pregnant women with COVID-19. A strong positive correlation was found between the MLR and the presence of cough symptom (r=41.4, p=<0.0001).ConclusionsThe study revealed that, pregnancies complicated by COVID-19 is not related with adverse perinatal outcomes. MLR may serve as a supportive diagnostic parameter together with the Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) in assessment of COVID-19 in pregnant cohort.

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Can Hematological Parameters Play a Role in the Differential Diagnosis of Adrenal Tumors?

Uro ◽

10.3390/uro1020006 ◽

2021 ◽

Vol 1 (2) ◽

pp. 39-44

Author(s):

Mehmet Gürkan Arıkan ◽

Göktan Altuğ Öz ◽

Nur Gülce İşkan ◽

Necdet Süt ◽

İlkan Yüksel ◽

...

Keyword(s):

Differential Diagnosis ◽

Inflammatory Markers ◽

Blood Count ◽

Complete Blood Count ◽

Low Cost ◽

Easy Access ◽

Adrenal Tumors ◽

Tumor Diameter ◽

Lymphocyte Ratio ◽

Significant Difference

There have been few studies reported with conflicting results in the use of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), redcell-distribution-width (RDW), etc. for predicting prognosis and differential diagnosis of adrenal tumors. The aim of this study is to investigate the role of inflammatory markers through a complete blood count, which is an easy access low-cost method, for the differential diagnosis of adrenocortical adenoma (ACA), adrenocortical carcinoma (ACC), and pheochromocytoma. The data of patients who underwent adrenalectomy between the years of 2010–2020 were retrospectively analyzed. Systemic hematologic inflammatory markers based on a complete blood count such as neutrophil ratio (NR), lymphocyte ratio (LR), NLR, PLR, RDW, mean platelet volume (MPV), and maximum tumor diameter (MTD) were compared between the groups. A statistically significant difference was found between the three groups in terms of PLR, RDW, and MTD. With post-hoc tests, a statistically significant difference was found in PLR and MTD between the ACA and ACC groups. A statistically significant difference was found between the ACA and pheochromocytoma groups in PLR and RDW values. In conclusion, it could be possible to plan a more accurate medical and surgical approach using PLR and RDW, which are easily calculated through an easy access low-cost method such as a complete blood count, together with MTD in the differential diagnosis of ACC, ACA, and pheochromocytoma.

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