Comparative assessment of umbilical cord blood with peripheral venous blood using hematological scoring system as an early predictive screening method for the detection of early-onset neonatal sepsis in the tertiary care center of Central India

Background: Sepsis is one of the major causes of neonatal morbidity and mortality. Early recognition and diagnosis of early-onset neonatal sepsis (EONS) is difficult because of the variable and non-specific clinical presentation of this condition. Hence, there is a need for early predictive screening method for EONS. Aims and Objectives: To compare the umbilical cord blood Haematological Scoring System (HSS) with peripheral venous blood as an early predictive screening method for detection of EONS. Materials and Methods: 100 inborn neonates with two or more risk factors for EONS, chosen by sequential sampling method were included in this prospective analytical study. Blood samples were collected from the umbilical cord and peripheral vein analyzed for hematological parameters, sepsis screen, and peripheral smear for HSS of Rodwell et al., send for blood culture. Blood cultures were performed as gold standard for diagnosing neonatal sepsis and sepsis screen was done to corroborate the diagnosis of neonatal sepsis. Results: Of 100 neonates, 21 belongs to sepsis; 14 to probable sepsis; 65 to no sepsis. HSS in umbilical cord blood (UCB) had Sensitivity-74.28%, Specificity-92.30%, PPV-83.87%, NPV-86.95% and HSS in PVB had Sensitivity-62.85%, Specificity- 87.69%, PPV-75.86%, NPV-81.69%. Conclusion: HSS score in UCB can be used as a simple, quick, cost-effective, and readily available screening test with decent sensitivity and high specificity, for the detection of EONS.

Use of umbilical cord blood culture in the diagnosis of early onset neonatal sepsis among high risk mothers

Background: Early onset neonatal sepsis (EONS) is one of the important causes of morbidity and mortality in neonates. Its early diagnosis and prompt treatment is essential and any delay in the diagnosis can have serious consequences including neonatal death. Blood culture is the gold standard test for diagnosis of neonatal sepsis. Umbilical cord blood culture (UCBC) is a painless procedure and technically less challenging. We conducted this study to evaluate use of UCBC for the diagnosis of EONS and compared it with the results of peripheral venous blood culture (PVBC) reports. Aims and Objectives: The aim of the study was to evaluate UCBC for the diagnosis of EONS and compared it with the results of PVBC reports. Materials and Methods: This was a hospital-based prospective cohort study consisting of 100 neonates who were at risk of EONS. The study was conducted in the Department of Pediatrics Sikkim Manipal Institute of Medical Sciences Gangtok between January 2018 and December 2019. Neonates found to be at risk of development of EONS were included in this study on the basis of a predefined inclusion and exclusion criteria. Immediately after birth blood samples were collected from both umbilical cord and peripheral vein and were sent to bacteriology lab. Sensitivity, specificity, positive predictive value, and negative predictive value of both the samples were analyzed. Results: Out of 100 neonates in 32 (32%) EONS could be confirmed with positive sepsis screening results and/or demonstration of organisms on blood culture. Among the 32 neonates with EONS, 17 were found to be premature. The mean gestational age of newborns with EONS was found to be 35.2 weeks. The umbilical blood culture was found to have sensitivity and specificity of 100% and 74.4%, respectively, whereas peripheral vein blood culture was found to have sensitivity and specificity of 77.7% and 72.5%, respectively. The most common organism grown in our study was Escherichia coli. Conclusion: UCBC is painless and technically less challenging method of blood sampling. It has been found to have a higher sensitivity as well specificity for the diagnosis of EONS as compared to peripheral venous blood sample.

Study Results of the 2,3-Diphosphoglycerate Content in Erythrocytes of Patients with Malignant Neoplasm Anemia in Genitourinary Organs Cancer

Every year, more than 6 million people are diagnosed with and more than 4 million people die from cancer all over the world, which is approximately 10% of the total mortality. The incidence of cancer in Ukraine shows a gradual increase, with the number of newly diagnosed patients 304-308 per 100 thousand people. Bladder cancer ranks second in the world among oncological diseases of the urinary system after prostate cancer. In the later stages of diseases, their course may be associated with malignant neoplasm anemia. The purpose of the study was to study the content of 2,3-diphosphoglycerate in erythrocytes of peripheral venous blood of patients with malignant neoplasm anemia with urothelial bladder cancer and prostate cancer, depending on the severity of anemia; to evaluate the possible diagnostic and prognostic value of the studied indicator. Materials and methods. 96 patients (64 men and 32 women) with urothelial bladder cancer were examined. There were 39 patients (28 men and 11 women) among them, the course of their underlying disease was not accompanied by the presence of anemia (first (I) observation group) and 57 patients (36 men and 21 women), the course of their underlying disease was aggravated by malignant neoplasm anemia (second (II) observation group). Also, 48 men with prostate cancer whose course of the disease was not aggravated by malignant neoplasm anemia (19 men) (third (III) observation group) and 29 men (fourth (IV) observation group) were diagnosed with malignant neoplasm anemia. The age of the patients under the survey was from 22 to 79 years old. All patients were examined after verifying the diagnosis and before starting any treatment. The content of 2,3-diphosphoglycerate in erythrocytes of peripheral venous blood was determined by the method of I. S. Luganova, M. N. Blinov (1975). Results and discussion. The content of 2,3-diphosphoglycerate in peripheral venous erythrocytes of patients with malignant neoplasm anemia due to urothelial bladder cancer and prostate cancer has been studied. It was found that malignant neoplasm anemia in patients with urothelial bladder cancer and prostate cancer is associated with an increase in the studied indicator (p<0.05). The article discusses the possible causes and pathogenetic mechanisms of the identified changes. Conclusion. Patients with urothelial bladder cancer and prostate cancer have an imbalance of energy metabolism that occurs in erythrocytes. This process is manifested by an increase in the amount of 2,3-diphosphoglycerate

EVALUATION OF CORD BLOOD CULTURE AS AN EARLY PREDICTOR FOR THE DETECTION OF EARLY ONSET NEONATAL SEPSIS IN TERTIARY CENTRE OF CENTRAL INDIA.

BACKGROUND : Neonatal sepsis is one of the major causes of neonatal morbidity and mortality. Peripheral venous blood culture and sensitivity is gold standard for the diagnosis of neonatal sepsis. Low sensitivity of blood culture in newborn is due to small volume of blood sample collected from neonates & antibiotics given before sampling. AIM : To evaluate the utility & compare the Umblical cord blood culture(UCBC) with Peripheral venous blood culture(PVBC) for detection of Early Onset Neonatal Sepsis(EONS) METHOD : 100 inborn neonates with two or more risk factors for EONS, chosen by sequential sampling method were included in this prospective analytical study. Blood samples were collected from umbilical cord and peripheral vein for culture. Sepsis screen was done to corroborate the diagnosis of neonatal sepsis. RESULT : Out of 100 neonates, 21 belongs to sepsis; 14 to probable sepsis; 65 to no sepsis. UCBC had Sensitivity-65.71% , Specicity-93.84%, PPV-85.18% , NPV-83.56% & PVBC had Sensitivity-60% , Specicity-95.38% , PPV-87.5% , NPV-81.57%. CONCLUSION : UCBC is simple and convenient method for the diagnosis of EONS compared to PVBC. Organisms grown are comparable to PVBC sample.

Intercellular Interactions in Peripheral Venous Blood in Practically Healthy Residents of High Latitudes

The paper presents the results of studying the immunological parameters of 369 people who were practically healthy at the time of the survey, 298 women and 71 men, of which 216 people are living in the European North of the Russian Federation (173 women and 43 men) and 153 are residents of the Arctic (125 women and 28 men). The study was carried out in the morning (08:00–10:00 am). The study included the determination of the aggregation of erythrocytes, platelets, neutrophilic granulocytes, lymphocytes, hemogram study, hematological analysis, enzyme immunoassay, and flow cytometry. Statistical processing of the obtained data was carried out using the Statistica 7.0 software package (StatSoft, USA). It was found that the activity of aggregation of cells of peripheral venous blood in Arctic residents is 1.5–1.7 times higher than that in people living in more favourable climatic conditions. The frequency of registration of aggregation of erythrocytes and platelets is actually 2 times higher than the aggregation of leukocytes. Aggregation of erythrocytes is associated with an increase in the concentrations of transferrin and receptors for this transport protein. The frequency of detection of platelet aggregation is accompanied by an increase in transferrin concentrations; in cases of aggregation of nonnuclear blood cells, the content of NO2 in the blood serum is increased. Aggregation of neutrophilic granulocytes and lymphocytes is associated with an increase in the content of free adhesion molecules. Aggregation of erythrocytes and platelets is in evidence when it is necessary to trigger reactions of changes in the hemodynamics of microcirculation to increase the efficiency of oxygen and trophic supply of tissues. The adhesion of leukocytes to the endothelium determines the secretion of biologically active substances that contribute to a change in microcirculation and an increase in the migration of leukocytes into tissues for the implementation of phagocytic and cytolytic functions.

Impact of Midregional N‐Terminal Pro–Atrial Natriuretic Peptide and Soluble Suppression of Tumorigenicity 2 Levels on Heart Rhythm in Patients Treated With Catheter Ablation for Atrial Fibrillation: The Biorhythm Study

Background We assessed the impact of preprocedural plasma levels of MRproANP (midregional N‐terminal pro–atrial natriuretic peptide) and sST2 (soluble suppression of tumorigenicity 2) on recurrence of atrial fibrillation (AF) at 1 year after catheter ablation of AF. Methods and Results This was a prospective, multicenter, observational study including patients undergoing catheter ablation of AF. MRproANP and sST2 were measured in a peripheral venous blood preprocedure, and MRproANP was assessed in the right and left atrial blood during ablation. The primary end point was recurrent AF between 3 and 12 months postablation, defined as a documented (>30 seconds) episode of AF, flutter, or atrial tachycardia. We included 106 patients from December 2017 to March 2019; 105 had complete follow‐up, and the mean age was 63 years with 74.2% males. Overall, 34 patients (32.1%) had recurrent AF. In peripheral venous blood, MRproANP was significantly higher in patients with recurrent AF (median, 192.2; [quartile 1–quartile 3, 155.9–263.9] versus 97.1 [60.9–150.7] pmol/L; P <0.0001), as was sST2 (median, 30.3 [quartile 1–quartile 3, 23.3–39.3] versus 23.4 [95% CI, 17.4–33.0] ng/mL; P =0.0033). In the atria, MRproANP was significantly higher than in peripheral blood and was higher during AF than during sinus rhythm. Receiver operating characteristic curve analysis identified a threshold of MRproANP>107.9 pmol/L to predict AF recurrence at 1 year and a threshold of >26.7 ng/mL for sST2. By multivariate analysis, MRproANP>107.9 pmol/L was the only independent predictor of recurrent AF (OR, 24.27; 95% CI, 4.23–139.18). MRproANP<107.9 pmol/L identified subjects at very low risk of recurrence (negative predictive value >95%). Conclusions Elevated MRproANP level independently predicts recurrent AF, whereas sST2 levels do not appear to have any prognostic value in assessing the risk of recurrence of AF up to 1 year after catheter ablation. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03351816.

Transcriptome analysis of arterial and venous circulating miRNAs during hypertension

Most current circulating miRNA biomarkers are derived from peripheral venous blood, whereas miRNA deregulation in arterial blood in disease conditions has been largely ignored. To explore whether peripheral venous blood miRNAs could represent a bona fide specific miRNA deregulation pattern, we selected hypertension, a disease that is particularly associated with vessels, as the model. Circulating miRNA profiles of arterial and venous blood from spontaneously hypertensive (SHR) rats and their corresponding controls (i.e., WKY rats) were investigated by next-generation miRNA sequencing. Little miRNAs were observed between arterial and venous circulating miRNAs in WKY rats. Interestingly, this number was enhanced in SHR hypertensive rats. Bioinformatical analysis of disease association, enriched target genes and the regulatory transcription factors of these differentially expressed miRNAs implied a potential functional link with cardiovascular disease-related functions. Comparisons between arterial and venous miRNAs in hypertension-versus-control conditions also revealed prominent disease association of circulating miRNAs and their target genes in arteries but not in veins. Moreover, a young non-hypertensive animal model in SHR background (i.e. JSHR) was used as a second control for SHR. Additional transcriptomic analysis and droplet digital PCR validation of arterial and venous deregulated miRNAs among SHR and its two controls (WKY, JSHR) revealed a noticeable consensus of artery-deregulated miRNAs in hypertension and two novel arterial circulating signatures (miR-455-3p and miR-140-3p) of hypertension. These results suggest the necessity of re-evaluating the efficacy of certain venous miRNAs identified in previous studies as potential biomarkers in cardiovascular diseases or a wider disease spectrum.

A case of hemolytic anemia associated with interstitial lung disease, arthralgia and fever caused by Mycoplasma pneumoniae

Pulmonary interstitiopathies have become the most diagnosed forms of pneumonia in 2020 due to the COVID-19 pandemic. The spectrum of interstitiopathies is broad and includes idiopathic diseases and secondary forms. In April 2020, a 36-year-old man admitted to our department for arthralgias, fever, asthenia, cough, and dyspnea. In January 2020 fever, cough, arthralgias and asthenia appeared. In April, his general condition worsened with development of macrohematuria, malaise, and intense asthenia. On admission, the patient presented pale, asthenic and symptomatic for dyspnea and arthralgias. There was objective joint pain in the small joints of the hands, elbow, and knees with morning stiffness and decreased strength. CT of the chest documented ground-glass opacities in both lung fields. He performed 2 swabs for SARS-CoV2, which were negative. On hematochemical examination: IgM 332 mg/dL and ferritin 700.2 ng/ml. At venous blood smear peripheral venous blood, agglutination of erythrocytes. The serology (IgM) for M. Pneumoniae was positive with agglutinins in the serum; Doxaciclina was started. There was a progressive normalization of hemoglobin levels and cold agglutinins were gradually reduced and were no longer detected at 15 days after the start of treatment. At one month after discharge, pulmonary function had fully recovered and the picture of hemolytic anemia was resolved.

Association Study between miR-181b rs322931 Polymorphism and Risk of Gastric Cancer

Objective: To explore the relationship between miR-181b rs322931 polymorphism and the risk of gastric cancer. Methods: The peripheral venous blood of 172 patients with gastric cancer and 224 healthy controls were collected. The miR-181b rs322931 was typed by TaqMan probe method, and correlation between miR-181b rs322931 and the risk of gastric cancer was evaluated using SPSS software. Results: The frequencies of miR-181b rs322931 CC, CT, TT genotype, C, and T allele were 61.6, 33.7, 4.7, 78.5, and 21.5% in gastric cancer, and 74.1, 23.7, 2.2, 85.9, and 14.1% in controls, respectively. After the ?2 test and correction for age and gender, the risk of gastric cancer in carriers of CT and CT/TT genotypes increased by 1.71 and 1.79 times, respectively (CT vs. CC: 95% CI, 1.10-2.67, P=0.02; CT /TT compared with CC: 95%CI, 1.16-2.74, P=0.008). Moreover, compared with alleles, the risk of gastric cancer in T allele carriers increased by 1.69 times (95%CI, 1.16-2.44, P=0.006). Conclusion: miR-181b rs322931 polymorphism may be one of the susceptibility genes of gastric cancer in the Chinese Han nationality.