What is the role of inflammatory markers in predicting spontaneous ureteral stone passage?

Purpose: To investigate the role of inflammatory markers in predicting the spontaneous passage of ureteral stones. Methods: We retrospectively reviewed 279 patients with ureteral stones sized 4–10 mm that were managed conservatively. The patients were divided into two groups: Group 1 consisted of 137 patients who passed the stone spontaneously; Group 2 comprised 142 patients without spontaneous stone passage. The groups were compared using the Mann-Whitney U and chi-square tests. In addition, univariate and multivariate analyses were performed to identify the significance of the parameters. Results: The mean age of the patients was 41.2 years. The patients in Group 1 had a significantly lower mean stone size, white blood cell count and neutrophil count. In addition, stone location, presence of hydronephrosis and history of urolithiasis were significantly different between the groups. Neutrophil percentage, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were insignificantly lower in Group 1. In a multivariate analysis, stone size, distal location and hydronephrosis status significantly predicted the spontaneous stone passage. However, inflammatory markers including white blood cell count, neutrophil count and neutrophil-to-lymphocyte ratio could not determine the likelihood of spontaneous stone passage. Conclusion: Our results suggest that inflammatory markers are no meaningful parameters for the prediction of spontaneous stone passage.

To Analyze the Influencing Factors of Senile Coronary Heart Disease Patients Complicated with Frailty Syndrome

To analyze the influencing factors of senile coronary heart disease patients complicated with frailty syndrome. A total of 80 elderly patients with coronary heart disease admitted to our hospital from March 2020 to March 2021 were selected as the research subjects. The Fried Frailty Symptom Scale was used to evaluate whether the 80 patients were complicated with frailty syndrome. According to the evaluation results, the patients were divided into a nonfrailty syndrome group (52 cases in total) and frailty syndrome group (28 cases in total). Clinical data of two groups of patients were collected, and multivariate logistic regression was used to analyze the influencing factors of senile coronary heart disease patients complicated with frailty syndrome. Among 80 patients, the incidence of frailty syndrome was 35.00% (28/80), including 18 cases in early frailty and 10 cases in frailty stage. Univariate analysis showed that age, body mass (BMI), diabetes mellitus, congestive heart failure, chronic renal insufficiency, chronic obstructive pulmonary disease (COPD), tumor, high uric acid hematic disease, arrhythmia, interleukin-6 (IL-6), c-reactive protein (CRP), fibrinogen (FIB), brain natriuretic peptide (BNP), uric acid (UA), serum creatinine (Scr), serum protein (ALB), white blood cell count (WBC), and neutrophil count were the possible risk factors for senile coronary heart disease complicated with frailty syndrome ( P < 0.05). Multivariate logistic regression analysis showed that combined COPD, combined tumor, IL-6, BNP, UA, SCR, ALB, and neutrophil count were independent risk factors for senile CHD complicated with frailty syndrome ( P < 0.05). Combined with COPD, combined with tumor, IL-6, BNP, UA, SCR, ALB, and neutron cell count are the influencing factors for senile coronary heart disease patients complicated with frailty syndrome. These factors can be used as the basis for the diagnosis of frailty syndrome and guide the clinical development of targeted diagnosis and treatment plan.

Predictors of Venous Thromboembolism in COVID-19 Patients: Results of the COVID-19 Brazilian Registry

Background Previous studies that assessed risk factors for venous thromboembolism (VTE) in COVID-19 patients have shown inconsistent results. Our aim was to investigate VTE predictors by both logistic regression (LR) and machine learning (ML) approaches, due to their potential complementarity. Methods This substudy of a large Brazilian COVID-19 Registry included COVID-19 adult patients from 16 hospitals. Symptomatic VTE was confirmed by objective imaging. LR analysis, tree-based boosting and bagging were used to investigate the association of variables upon hospital presentation with VTE. Results Among 4,120 patients (55·5% men, 39·3% critical patients), VTE was confirmed in 6·7%. In multivariate LR analysis, obesity (OR 1·50, 95%CI 1·11-2·02); being an ex-smoker (OR 1·44, 95%CI 1·03-2·01); surgery ≤ 90 days (OR 2·20, 95%CI 1·14-4·23); axillary temperature (OR 1·41, 95%CI 1·22-1·63); D-dimer ≥ 4 times above the upper limit of reference value (OR 2·16, 95%CI 1·26-3·67), lactate (OR 1·10, 95%CI 1·02-1·19), C-reactive protein levels (CRP, OR 1·09, 95% CI 1·01-1·18); and neutrophil count (OR 1·04, 95%CI 1·005-1·075) were independent predictors of VTE. Atrial fibrillation, peripheral oxygen saturation/inspired oxygen fraction (SF) ratio and prophylactic use of anticoagulants were protective. Temperature at admission, SF ratio, neutrophil count, D-dimer, CRP and lactate levels were also identified as predictors by ML methods. Conclusion By using ML and LR analyse, we showed that D-dimer, axillary temperature, neutrophil count, CRP and lactate levels are risk factors for VTE in COVID-19 patients.

Plinabulin and Pegfilgrastim in Combination for the Prevention of Chemotherapy-Induced Neutropenia in Patients with Breast Cancer (PROTECTIVE-2): A Randomized Trial

PurposePlinabulin is a non-granulocyte colony-stimulating factor (G-CSF) novel small molecule with both anticancer and myeloprotective effects. Single-agent plinabulin is myeloprotective in the first week of the chemotherapy cycle, and pegfilgrastim in the second week. We assessed the efficacy and safety of the combination of plinabulin and pegfilgrastim for the prevention of chemotherapy-induced neutropenia (CIN) following chemotherapy.MethodsThis randomized, open-label, Phase 2 trial enrolled patients with breast cancer. All received docetaxel 75 mg/m2, doxorubicin 50 mg/m2, and cyclophosphamide 500 mg/m2 on Day 1. In the combined therapy cohort, patients received plinabulin 20 mg/m2 on Day 1 and 1.5, 3, or 6 mg pegfilgrastim on Day 2. The primary objective was to establish the recommended Phase 3 dose (RP3D). Secondary endpoints included absolute neutrophil count (ANC) nadir, relative dose intensity (RDI), and incidence of adverse events including neutropenia and bone pain.ResultsIn total, 115 patients were randomized and evaluated. The combination therapy at the RP3D (plinabulin 20 mg/m2 and pegfilgrastim 6 mg) was well-tolerated and had superior CIN prevention in terms of Grade 4 and Grade 3/4 neutropenia frequency, absolute neutrophil count (ANC) nadir, higher relative dose intensity (RDI), less bone pain, and less toxicity burden when compared with pegfilgrastim 6 mg alone.ConclusionPlinabulin combined with pegfilgrastim at the RP3D (plinabulin 20 mg/m2 Day 1 and pegfilgrastim 6 mg Day 2) had more favorable efficacy, safety, and tolerability profiles and lower bone pain incidence than did pegfilgrastim alone.Trial information Clinical Trial Registration: ClinicalTrials.gov NCT04227990Date registered: January 14, 2020 Retrospectively registered

Plasma Neutrophil Gelatinase-associated Lipocalin and Leukocyte Differential Count in Children with Febrile Urinary Tract Infection

Purpose: We aimed to study the association of plasma neutrophil gelatinase-associated lipocalin (pNGAL) and leukocyte differential count in children with febrile urinary tract infection (UTI).Methods: Medical records of 154 children aged 1 month to 13 years with febrile UTI who were hospitalized were retrospectively reviewed. Associations between pNGAL levels and blood leukocyte differential count at admission and after 48 hours of treatment were investigated in children with or without acute pyelonephritis (APN).Results: The APN group (n=82) showed higher pNGAL levels, neutrophil count, monocyte count, and neutrophil-to-lymphocyte ratio (NLR), compared to the non-APN group (n=72) (all P<0.05). After adjustment for age and sex, pNGAL showed positive correlations with neutrophil count and NLR in both groups (all P<0.05). Additionally, it was correlated with the monocyte-to-lymphocyte ratio (MLR) only in the APN group (P<0.05). Before and after treatment, pNGAL was positively correlated with neutrophil count, NLR, and MLR in patients with APN while it was related with neutrophil count and NLR in those without APN (all P<0.05). Areas under the receiver operating curve of pNGAL, neutrophil count, NLR, and MLR for predicting APN were 0.804, 0.760, 0.730, and 0.636, respectively (all P<0.05). Only pNGAL was independently associated with the presence of APN in a multivariable logistic regression analysis (P<0.05).Conclusion: In children with febrile UTIs, pNGAL might be associated with leukocyte differential count and the presence of APN.

Risks of Cardiovascular Events in Patients with Inflammatory Bowel Disease in China: A Retrospective Multicenter Cohort Study

Background Inflammatory bowel disease (IBD) is a complex chronic disorder characterized by systemic inflammation, which may cause abnormal state of coagulation, resulting in cardiac events. This study aimed to investigate the incidences and risks of cardiac events in patients with IBD in China. Methods A retrospective cohort study was performed comprising 1,435 patients with IBD from 12 IBD centers in China. Cases were matched with 1,588 eligible participants without IBD from 12 medical centers according to age, sex, and laboratory parameters. Results Patients with IBD in China exhibited significantly higher incidences of ischemic heart disease (IHD) (coronary heart disease included) but lower frequencies of right bundle branch block and premature contraction than those of matched controls. The risk of IHD increased in patients with IBD, peaking at the age of 18−35 years. Female patients with IBD were more likely to experience IHD than male patients. C-reactive protein (CRP) levels and neutrophil count in the peripheral blood were positively related with the risk of IHD among patients with Crohn’s disease (CD), whereas plasma fibrinogen levels were negatively related with the risk of IHD both in patients with CD and UC. Conclusions The risk of IHD is increased in patients with IBD, especially in young female patients with IBD when compared to matched non-IBD subjects. CRP and plasma fibrinogen levels and neutrophil count in the peripheral blood may be potential predictors associated with the occurrence of IHD in patients with IBD. The study’s findings have significant implications for the management and prevention of cardiac events in patients with IBD.

The effect of Cisplatin on Complete blood count among chemotherapy Sudanese patients at Taiba Cancers Center in Khartoum state 2021

Background: Cisplatin is one of therapy used as anticancer activity in a variety of tumors. Among many chemotherapy drugs that are widely used for cancer, Cisplatin is one of the most compelling ones. Material and methods: This study was Analytical cross sectional study conducted at Taiba Cancer Center, Khartoum, Sudan, during the period July 2021 to November 2021 and aimed to estimate the complete blood count among chemotherapy Sudanese patients treated with Cisplatin. 50 cancer patients treated with cisplatin as chemotherapy selected as a case group and 50 apparently health donor were selected as control group. Three ml of the venous blood was collected in EDTA container. Six sample collected from each patient before each dose of cisplatin. Complete blood count was done by using Sysmex Automated Hematology Analyzer KX 21N.Result: When compared the base line of case value of RBCs, Hb, WBCs, neutrophils, and platelets with control there were insignificant differences (P. value ≥ 0.05). But when compared RBCs, Hb, WBCs, neutrophils, and platelets between the case (baseline) and the cases in cycle 1, 2,3,4 and 5 there was significant decreased among progression of doses (P. value ≤ 0.05). There was insignificant correlation in the duration of the cancer and WBCs, neutrophil count, HGB and platelets count (P. value ≥ 0.05), significant correlation with RBCs in baseline and cycle 2 (P. value < 0.05). When correlate the anatomical location of cancer with WBCs, neutrophil count there was insignificant correlation, and significant correlation with RBC and HGB in cycle 5 and platelets count cycle 2 and cycle 3 Conclusion: The study observed that Cisplatin with combination of drug can effect on the hematological parameters also the chemotherapy was induced anemia, neutropenia and thrombocytopenia.

Application of a complete blood count to screening lethargic and anorectic cats for pancreatitis

Background Feline pancreatitis (FP) is an important health problem of cats. Its diagnostics is based on the combination of quantification of serum pancreatic lipase immunoreactivity (fPLI) and abdominal ultrasonography (AUS). These modalities allow for establishing highly specific diagnosis, however they are relatively expensive and time-consuming. On the other hand, a screening test of high sensitivity which would allow to rule out FP on the first visit without a considerable increase of costs would be clinically useful. To evaluate accuracy of nonspecific inflammatory biomarkers based on complete blood count (CBC) in diagnosing FP 73 client-owned cats with signs of lethargy and reduced appetite lasting for at least 2 days before presentation were enrolled in the cross-sectional study. They were examined with fPLI assay and AUS and classified as cats with very low risk of FP when fPLI ≤3.5 μg/L and AUS negative for FP, or as cats with increased risk of FP in the case of any other combination of results. Then, 7 various CBC measurements were measured in each cat and linked to the risk of FP using the multivariable logistic regression. Results Five CBC measurements turned out to be significantly associated with the risk of FP – total leukocyte count (WBC; crude odds ratio(ORcrude) = 12.2; CI 95%: 1.52, 98.5), total neutrophil count (ORcrude = 5.84; CI 95%: 1.22, 27.9), band neutrophil count (BNC; ORcrude = 6.67; CI 95%: 1.98, 22.4), neutrophil-to-lymphocyte ratio (ORcrude = 3.68; CI 95%: 1.25, 10.9), and eosinophil count (EC; ORcrude = 0.34; CI 95%: 0.12, 0.96). The model based on WBC, BNC, and EC proved to have at least fair diagnostic potential (area under ROC curve 82.7%; CI 95%: 72.8%, 92.5%). When WBC < 18 G/L, BNC < 0.27 G/L, and EC > 0.3 G/L was considered as a negative result, and any other combination as the positive result, the CBC model had high sensitivity (91.8%; CI 95%: 80.8%, 96.8%) at a relatively low specificity (58.3%; CI 95%: 38.8%, 75.5%). Conclusion The combination of three CBC measurements is an immediately available and fairly accurate screening method for identification of lethargic and anorectic cats with increased risk of FP.