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2021 ◽  
Vol 16 ◽  
Author(s):  
Laura Díaz-Chirón ◽  
Luis Negral ◽  
Laura Megido ◽  
Beatriz Suárez-Peña ◽  
Alberto Domínguez-Rodríguez ◽  
...  

Aims: To analyse the relationship among air pollutants, markers of inflammation and infarct size in patients with acute coronary syndrome (ACS). Methods: This was a prospective analysis of consecutive patients admitted to hospital because of ACS. Cardiac biomarkers were drawn. The daily mean values of the air pollutants from the day before until 7 days before admission were analysed. The study population was stratified according to infarct size, based on median peak troponin value. Results: Patients were divided into two groups of 108 subjects each, according to median peak troponin value. Patients with extensive MIs had a higher neutrophil:lymphocyte ratio and leukocyte and neutrophil counts than patients with smaller MIs. In addition, they were exposed to higher concentrations of sulphur dioxide (9.7 ± 4.1 versus 8.4 ± 3.1 μg/m3; p=0.009) and lower concentrations of ozone (33.8 ± 13.7 versus 38.6 ± 14.5 μg/m3; p=0.014). Multivariate analysis showed that sulphur dioxide levels (OR 1.12; 95% CI [1.031–1.21]; p=0.007) and neutrophil/lymphocyte ratio (OR 1.08; 95% CI [1.011–1.17]; p=0.024) were independent predictors of infarct size. Conclusion: Patients with extensive MIs had higher white cell inflammatory levels and had been exposed to higher sulphur dioxide concentrations in the ambient air.


2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Ozhin Karadakhy ◽  
Emma Poynton-Smith ◽  
Ian Beckingham

Abstract Background Temporary elevation of white cell count (WCC) and platelets are commonly observed after splenectomy and can therefore make it difficult for the surgeon to distinguish a normal physiological response from potential infection. Clinicians are often misled by elevated post-operative WCC after splenectomy, resulting in delayed discharges and prolonged unnecessary hospital stays for patients. The aim of this study was to establish what constitutes a normal rise in WCC and platelets after splenectomy. Methods All 127 patients who had undergone a splenectomy between July 2016 and January 2021 were identified from a search of our centre's hospital episode statistics data.  WCC and platelet count on post-operative days one to seven as well as at least one long-term follow-up result count were identified from electronic hospital records. Hospital records were searched for data on pre-operative steroid administration and peri-operative infections. These cohort data were retrospectively analysed in SPSS using stepwise logistic regression, correlation analysis, and T-tests, as well as descriptive statistics. Results 86 (68%) patients underwent an elective splenectomy and 41 (32%) an emergency splenectomy. 35 (27.6%) patients developed infections post-operatively, while 92 (72.4%) did not. Logistic regression suggested that a raised WCC (above 17.5x109/L) at day 3 post-op was a significant predictor of infection (p < 0.001): average WCC at day 3 for patients with infection was 20.00x109/L (SD = 6.23x109/L) compared to 14.86x109/L (SD = 4.01x109/L) for those without. Infective outcomes were not influenced by whether the surgery was emergency or elective. Overall, average WCCs were 9.63x109/L pre-operatively and 15.07x109/L long-term post-operatively. Even in the absence of infection, splenectomy led to a long-term rise in WCC of 3.8x109/L from baseline, to an average of 13.0x109/L [SD = 5.41x109/L): a T-test on the 56 patients without infection and with both pre-op and long-term WCCs showed a mean rise of 3.76x109/L, p < 0.0001). Platelet count was not correlated with infection, though platelet counts rose from a mean of 261 × 109/L (SD = 103.4x109/L) pre-operatively to 581 × 109/L (SD = 236.3x109/L) at 7-day and 619 × 109/L (SD = 293.5x109/L) at long-term follow up across all patients – an average increase of 357 × 109/L, which did not significantly differ between patients with and without infective complications. Conclusions A rise in WCC and platelet count is normal post-splenectomy.  A rise in WCC>17.5x109/L on day 3 post-splenectomy is strongly correlated with infection (regardless of trauma or platelet count). Long-term follow up suggests that while much of the WCC increase is transient, WCC remains higher than pre-operatively, as does platelet count, in post-splenectomy patients. A raised WCC or platelet count without signs of infection should not preclude timely discharge in otherwise well patients.


2021 ◽  
Vol 267 ◽  
pp. 342-349
Author(s):  
Jiepei Zhu ◽  
J. Travis Parsons ◽  
Yang Yang ◽  
Erika Martin ◽  
Donald F. Brophy ◽  
...  

2021 ◽  
Vol 5 (4) ◽  
pp. 1-8
Author(s):  
Paul F. Cotter

The aim is to demonstrate a variety of apoptotic heterophils (equivalents of mammalian neutrophils) occurring in hemograms of 50 apparently healthy pullets housed in cages. These atypical cells are found in blood with normal total white cell levels (TWBC, ~20K) and in those ranging up to 100(K) a leukocytosis/leukemoid reaction level. Conversely heterophil/lymphocyte (H/L) ratios in all hens ranged between 0.14 – 0.50 (homeostasis). The Arneth index (a heterophil age measure) of 1.8 computed using only intact heterophils indicated a “left-shift”, suggesting inflammation even in the context of a normal hemogram.


2021 ◽  
Author(s):  
Brendan Mulcahy ◽  
Daniel Rolnik ◽  
Alexia Matheson ◽  
Yizhen Liu ◽  
Kirsten Palmer ◽  
...  

Background: Community lockdowns during the COVID-19 pandemic may influence preterm birth rates, but mechanisms are unclear. Methods: We compared neonatal outcomes of preterm infants born to mothers exposed to community lockdowns in 2020 (exposed group) to those born in 2019 (control group). Main outcome studied was composite of significant neonatal morbidity or death. Results: Median gestational age was 35+4 weeks (295 infants, exposed group) vs. 35+0 weeks (347 infants, control group) (p = 0.108). The main outcome occurred in 36/295 (12.2%) infants in exposed group vs. 46/347 (13.3%) in control group (p = 0.69). Continuous positive airway pressure (CPAP) use, jaundice requiring phototherapy, hypoglycaemia requiring treatment, early neonatal white cell and neutrophil counts were significantly reduced in the exposed group. Conclusions: COVID-19 community lockdowns did not alter composite neonatal outcomes in preterm infants, but reduced rates of some common outcomes, and early white cell and neutrophil counts.


2021 ◽  
pp. 130995
Author(s):  
Ligang Shao ◽  
Jiajin Chen ◽  
Kunyang Wang ◽  
Jiaoxu Mei ◽  
Tu Tan ◽  
...  

2021 ◽  
Vol 33 (3) ◽  
pp. 169-177
Author(s):  
Bartholomew Chukwu ◽  
Lyra Menezes ◽  
Thiago Fukuda ◽  
Jamary Filho ◽  
Marilda Goncalves

BackgroundDetection of abnormal TAMMV with transcranial Doppler is fundamental in primary stroke prevention in children with sickle cell disease (SCD). The study aimed at evaluating TAMMV and correlating it with clinical and hematological profiles of children and adolescent with SCD. MethodsTranscranial Doppler was performed on subjects aged 2-16 years, using a 2 MHz probe placed over the transtemporal windows. Pulse oximetry was used to determine the peripheral oxygen saturation while clinical and hematological profiles were retrieved from their medical records.Results One hundred and thirty five patients were recruited. The mean TAMMV was 125cm/s. Patients with HbSS had a significantly higher TAMMV (131cm/s) than those with HbSC (107cm/s). Only one (0.74%) patient had abnormal TAMMV. TAMMV correlated inversely with oxygen saturation, Hct and patient’s age, and positively with white cell and platelet counts. Previous history of acute chest syndrome (ACS) and recurrent painful crises increased the risk of development of abnormal and conditional velocity.Conclusion Frequency of abnormal TAMMV in this study was low. Younger children and those with HbSS had higher TAMMV. Age, oxygen saturation and haematocrit correlated negatively while white cell and platelet counts correlated positively with TAMMV. Previous history of ACS and recurrent bone pain were associated with increased risk of having abnormal and conditional TAMMV.


Author(s):  
Roberto Céspedes López ◽  
Elena Amutio ◽  
Xabier Martín Martitegui ◽  
Amaia Balerdi Malcorra ◽  
Lucia Insunza Oleaga ◽  
...  

Thymomas are tumours frequently associated with autoinmune manifestations or immunodeficiencies like Good syndrome. In rare cases, pure white cells aplasia (PWCA) has been described in association with thymomas. PWCA is characterized by agranulocytosis of autoinmune background primary refractory to granulocyte colony-stimulating factor (G-CSF). It is necessary to use inmunosupressor drugs.


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