Preoperative erythrocyte sedimentation rate in patients with rheumatoid arthritis predicts deep vein thrombosis following total knee arthroplasty

PURPOSE: To thoroughly evaluate preoperative risk factors for deep venous thrombosis (DVT) in patients with knee rheumatoid arthritis (RA) undergoing unilateral total knee arthroplasty (TKA). METHODS: Clinical data of 106 patients with knee RA who underwent unilateral TKA from August 2014 to October 2020 were collected. All patients received ultrasonic examination of the veins of both lower extremities on the third day after TKA and were divided into DVT and non-DVT groups. The associations between age, gender, body mass index (BMI), history of diabetes/hypertension, common serum lipid levels, indicators related to coagulation function, blood viscosity, erythrocyte sedimentation rate (ESR) and postoperative DVT were statistically compared and analyzed. RESULTS: ESR was significantly correlated with DVT risk after TKA (OR = 1.844, 95% CI = 1.022–2.981, P = 0.019). Receiver operating characteristic (ROC) curve analysis showed the optimal cut-off point of ESR for predicting DVT was 42 mm/h with a sensitivity of 95.5% and specificity of 66.7% . CONCLUSION: An increased preoperative ESR value is a risk factor for DVT in patients with knee RA following unilateral TKA. Pre-surgery control of ESR level and prevention of postoperative DVT in these patients are worthy of attention.

A Descriptive Study on Hematological Changes in Brucellosis Infected Individuals

Background: Brucellosis is a zoonotic organism that causes diseases in both animals and humans. Human contact with infected domestic animals is often a transmission route of Brucellosis infection. This infection affects hematological parameters of the patients. We carried this study to determine the changes in various hematological parameters in our study subjects. Patients and Methodology: This study was carried out in Nangarhar regional hospital and safi medical complex on 45 Afghani people from December 2018 up to December 2020. The study design was prospective. A total of 45 patients (Cases) with confirmed diagnosis of Brucellosis on the basis of serology enrolled in the study. Complete blood count and Erythrocyte sedimentation rate studies are also performed. Considered hematological parameters includes Hemoglobin (Hb), White Blood Cell count (WBC), Platelet count (PLT) and ESR. As well interview was done with each patient and a questionnaire was used. The collected data was analyzed with Microsoft excel program Autosum statistics. Results. A total of 45 patients were enrolled. The mean age±SD of the patients under the study were (28.74±15.22) years. The most common hematological changes observed were; anemia (57.7%), thrombocytopenia (24%), leucocytosis (13.3%), pancytopenia (24.4%), lymphocytopenia (31.1%), lymphocytosis (55.5%) & leucopenia (40%). Erythrocyte sedimentation rate were elevated in about 66% of patients. Fever and headache were the most common presenting symptoms (73%) and (82%) respectively. Night sweats in (40%), joint pain (53%), muscle pain (53%) and lymphadenopathy in 46% of patients. Conclusion: This result of this study shows that Brucellosis commonly affects people of low socioeconomical states, female sex, uneducated, those consuming contaminated dairy products, peoples living in rural areas and those having consuming or contact with animal. Salmonella typhi causes changes in the hematological parameters due to involvement of bone marrow.

Estimation of Variations in the Erythrocyte Sedimentation Rate in COVID-19 Recovered Patients

Background: A cluster of patients with pneumonia and severe acute respiratory syndrome developed in Wuhan, China in December 2019, and infection with a novel coronavirus virus called COVID -19 was later verified. Although fever and cough were the most common early signs and symptoms of COVID -19, extrapulmonary symptoms have also been reported. Many studies demonstrate that called COVID -19 swiftly progresses to acute respiratory distress syndrome and even multiple organ dysfunction. Aim:The study aims to evaluate the erythrocyte sedimentation rate count in COVID -19 recovered individuals and compare it with healthy controls. Materials & Methods: A cross-sectional pilot study in 5 healthy COVID -19 uninfected and 5 COVID -19 recovered individuals was conducted, the blood samples were collected and the erythrocyte sedimentation rate was calculated for each set of controls and samples. Statistical analysis was performed using SPSS software. An independent t-test was done to compare the results. Results: The mean value of the control participants was found to be 8.08 ± 4.38 and the mean value of COVID -19 recovered patients was 20.60 ± 1.81. The difference in Erythrocyte Sedimentation Rate (ESR) values between control individuals and COVID -19 recovered patients was statistically significant with p value of less than 0.005. Conclusion: Within the limitations of the study, we conclude that the COVID -19 recovered patients has higher ESR values compared to the healthy uninfected individuals.

Comparison of K2 and K3 EDTA Anticoagulant on Complete Blood Count and Erythrocyte Sedimentation Rate

The use of anticoagulants is one of the important pre-analytic factors in hematological tests. Both dipotassium (K2) andtripotassium (K3) Ethylene Diamine Tetraacetic Acid (EDTA) are widely used anticoagulants. International CouncilStandardization of Hematology (ICSH) and several researchers recommend the use of K2 EDTA due to its less hyperosmolareffect on blood cells compared to K3 EDTA. This study aimed to compare the results of Complete Blood Count (CBC) andErythrocyte Sedimentation Rate (ESR) using anticoagulant K2 EDTA and K3 EDTA. This study was an analytic observationalstudy with a cross-sectional design conducted from April to December 2018. The subject of the study were 103 healthyadults selected by consecutive sampling. Blood samples were collected in both anticoagulant tubes with a volume of 3 mLeach. Samples were tested twice, in the first 0 hours and the next 6 hours using Sysmex XN 1000 and Alifax Roller 20 LC.Kolmogorov-Smirnov test, paired T-test and Wilcoxon rank test were used for statistical analysis. The agreement testbetween both anticoagulants was carried out using the Bland Altman plot for parameters with a significant difference. Therewas a significant difference between both anticoagulants for the parameters of hemoglobin, hematocrit MCV, MCHC, RDW,PDW, MPV, PLC-R, and erythrocyte sedimentation rate in both the first and second tests. The agreement test using the BlandAltman plot showed that the difference in these parameters was within the Limit of Agreement (LOA) range of 95%. Thisstudy showed that there were differences in some parameters of complete blood count and erythrocyte sedimentation ratebetween the two anticoagulants (K2 K3 EDTA), but these differences were within the LOA range.

CHANGES IN HEMATOLOGICAL PARAMETERS IN HENS DURING SHORT-TERM INFLUENCE OF NEGATIVE ENVIRONMENTAL FACTORS

Comparative analysis of changes in hematological parameters of hens under short-term exposure to various negative environmental factors was performed. For this purpose in the conditions of a modern complex on production of food eggs 3 groups of hens were formed, each of which was kept in a separate cage-analogue on the area and the equipment. In particular, the hens of the 2nd group were deprived of fodder, the 3rd group – of light, and the 4th group – were kept with a significant overcrowding. Exposure to the factor in all groups was 24 hours, after which hematological parameters were determined. Differences in the response of the blood system of hens to short-term exposure to adverse environmental factors depending on their nature were found. The smallest changes in the blood system of hens were observed under the influence of the lack of food, namely an increase, within the physiological norm, the content of leukocytes and ESR, decreased hemoglobin, hematocrit, erythrocytes, platelets, as well as violation of the ratio of different forms of leukocytes – an increase in the concentration of heterophiles (3.3% > normal) on the background of a decrease in the concentration of monocytes (1.6% < normal), lymphocytes and basophils. Whereas under the influence of the factor of lack of light, a higher content of leukocytes in the blood by 10.6%, a lower concentration of hemoglobin by 22.4%, hematocrit – by 4.2%, platelets – by 9.8%, as well as higher erythrocyte sedimentation rate by 9.8%, higher concentration of heterophiles by 5.9% and lower concentration of lymphocytes – by 4.6%, compared with the lack of food. The most significant changes in the blood system were observed under the influence of a factor of significant overcrowding of hens, namely higher blood leukocytes by 17.1 and 5.9%, lower hemoglobin concentration by 29.6 and 9.2%, hematocrit – by 5.9 and 1.7%, erythrocytes – by 10.3%, platelets – by 35.8 and 28.8%, as well as higher erythrocyte sedimentation rate by 4.9%, higher concentration of heterophiles by 11.3 and 5.4% and lower concentration monocytes – by 0.8 and 0.4%, lymphocytes – by 9.4 and 4.8% and eosinophils – by 0.7%, compared with the factor of lack of food and lack of light, respectively.

Profile of several autoantibodies, complement and vitamin D levels in Brazilian patients with Chikungunya infection

Introduction. Chikungunya virus infection (CKV) may lead to chronic arthritis in up to 40% of the patients. There are previous data regarding positive auto antibodies in CKV. Objective is to systematically evaluate the prevalence of auto antibodies in CKV patients. Methods. All study participants had clinical manifestations being CKV positive at least serologally or by RT-PCR data. The following autoantibodies were assessed: antinuclear antibodies (ANA), anti-dsDNA, anti-Sm, anti-Ro/SS-A, anti-La/SS-B, anti-U1RNP, IgG and IgM anticardiolipin, anticyclic citrullinated peptide (antiCCP), rheumatoid factor (RF), antiribosomal P protein, lupus anticoagulant, anti-Jo-1 and anti-Scl-70. CH100, C3 and C4 complement components, serum levels of immunoglobulins, C-reactive protein, erythrocyte sedimentation rate, alpha1-acid glycoprotein, antithyroglobulin, antithyroperoxidase, TRAb, 25 hydroxyvitamin D (25OHD), dengue and zika IgG and IgM antibodies were also measured. Results. 30 CKV patients were included. Mean age was 59.1±15.7 years, 85% females and 77% Caucasian subjects. Disease duration comprised 4.9±4.0 months. Oligoarthritis was observed in 93% cases. Mean C-reactive protein levels were 10.1±6.8 ng/dL, erythrocyte sedimentation rate — 34.2±19.9 mm/1st hour and alpha1-acid glycoprotein 115.5±52.6 mg/dL. Intramuscular betamethasone depot single dose injection was administered in 54%, prednisone — in 15% and methotrexate — in 23% cases. Importantly, 1/30 (3.3%) cases was positive for ANA, 4/30 (13.3%) — for RF and none was positive for anti-CCP or any other autoantibodies. Complement and immunoglobulin levels were all within the normal range. Low levels of 25OHD were observed in 88% cases.

258. D-Dimer, Erythrocyte Sedimentation Rate, and C-Reactive Protein Sensitivity for PJI Diagnosis

Background Consensus criteria for the diagnosis of acute PJI now include D-dimer. Additionally, Erythrocyte Sedimentation Rate (ESR) is of questionable use in the diagnosis of acute PJI. There is scarce and contradicting evidence on the diagnostic value for these biomarkers, and further studies on larger cohorts are needed for validation. We sought to quantify the sensitivities of D-dimer and ESR compared to C-Reactive Protein (CRP) in the diagnosis of acute PJI at a tertiary referral center. Sensitivity Table for D-Dimer and ESR Methods An institutional database was queried for patients undergoing revision procedures for PJI after total hip arthroplasty (THA) and total knee arthroplasty (TKA) from 2014 to present. Patients were included if they had a PJI diagnosis code with subsequent revision procedure CPT codes and PICC line placement within 21 days of revision surgery. Patients with inflammatory arthropathies were excluded. Diagnostic labs, including CRP, ESR, and D-dimer, were collected within 90 days pre- and post-operatively and sensitivities for the diagnosis of PJI were calculated. Cutoff values included CRP &gt;1 mg/dL, ESR &gt;30 mm/hr and &gt;50 mm/hr, and D-dimer &gt;860 ng/mL. Results In total, 961 PJI patients were identified. Of those, 904 had ESR and CRP values collected, and 123 had ESR, CRP, and D-dimer collected. In the cohort of patients with ESR and CRP, 603 patients had elevated CRP, 554 had ESR &gt;30 mm/hr, and 379 had ESR &gt;50 mm/hr, corresponding to sensitivities of 66.7%, 61.3%, and 41.9%, respectively. In the cohort of patients with all three biomarkers, 113 had an elevated D-dimer, corresponding to a sensitivity of 91.9%. Conclusion In this cohort, CRP and ESR were of comparable sensitivity in diagnosing PJI. D-dimer was the most sensitive, but further pooled studies are needed to confirm this. Providers should continue to use this information in the context of other data and MSIS criteria to inform decision-making. Disclosures Thorsten Seyler, MD/PhD, Depuy Synthes (Other Financial or Material Support, Resident Educational Support)Extrel Therapeutics (Board Member, Shareholder)Heraeus Medical (Consultant)MiCare Path (Board Member, Shareholder)OREF (Grant/Research Support)Pattern health (Board Member)Restor3D (Other Financial or Material Support, Royalties)Smith+Nephew, Inc. (Grant/Research Support, Speaker’s Bureau)Stryker (Other Financial or Material Support, Resident Educational Support)Total Joint Orthopedics, Inc. (Consultant)Wolters Kluwer Health (Other Financial or Material Support, Royalties)Zimmer Biomet (Grant/Research Support) William Jiranek, MD, Depuy Synthes (Other Financial or Material Support, Royalty/Licensing)