Hematological and Serum Biochemical Changes and Their Prognostic Value in Horses Spontaneously Poisoned by Crotalaria spectabilis

Determining the prognosis of poisoning by plants containing pyrrolizidine alkaloids is usually challenging. This study aimed to identify important prognostic parameters that can determine the severity of spontaneous poisoning by Crotalaria spectabilis in horses. Blood samples from 42 horses spontaneously poisoned by oats contaminated with C. spectabilis seeds were evaluated. Complete blood counts (CBC) and serum biochemical tests [urea, creatinine, total protein, albumin, total and direct bilirubin concentrations, aspartate aminotransferase (AST), γ-glutamyl transferase (GGT), and creatine kinase (CK) activities] were performed. Horses were followed up for 12 months to determine the long-term survival rate; after 12 months, they were divided into two groups: survivors (n = 30) and non-survivors (n = 12). Horses spontaneously poisoned with C. spectabilis had higher levels of urea, globulin, bilirubin (total, direct, and indirect), AST, GGT, and CK than the reference values. Non-survivor horses showed significantly higher (p < 0.05) values of hemoglobin, GGT, and direct bilirubin than the survivor horses. Horses with serum GGT activity higher than 95 U/l had 14.0 times the risk of death compared to animals showing activities equal to or lower than this value, whereas horses with serum direct bilirubin concentration higher than 0.6 mg/dl (10.26 μmol/L) had 5.78 times the risk of death compared to the others. In summary, serum GGT activity and direct bilirubin concentration may be useful prognostic indicators for assessing the severity of C. spectabilis-poisoned horses.

Hematology and blood biochemistry profile of the freshwater stingray Potamotrygon magdalenae as a tool for population assessment in artificial environments

Hematological and blood biochemical reference information is important to establish physiological status of freshwater stingray populations and improve care and management protocols in artificial environments. Here, we used a commercial freshwater stingray with high mortality rates in the market (Potamotrygon magdalenae), as an example to understand how artificial environments and handling protocols influence physiological status of captive freshwater stingrays. To this purpose, blood from five adult males and six adult females was collected to perform complete blood counts and blood chemistry analyses. All sampled animals showed good body condition with no differences between sexes. Differences between sexes were only found for the differential count of lymphocytes. Red blood results were consistent with previously studied potamotrygonids while white blood results showed higher values of leukocytes, thrombocytes, heterophils and lymphocytes in P. magdalenae compared to other Potamotrygonids. All types of leukocytes described for elasmobranchs were found except neutrophils and basophils. Blood metabolites showed an influence of ex situ diet in total protein, triglycerides and cholesterol. Glucose results were consistent while urea showed lower levels than those recorded for other freshwater stingrays. These results highlight the importance of physical, physiological and health analysis in freshwater stingrays as a part of welfare assessment to improve monitoring protocols and survival rates in public or private aquaria.

Prolonged neutrophilia is associated with worse outcomes after Esophagectomy

Neutrophilia is a potential biomarker for postoperative complications and oncologic outcomes. There is a paucity of data regarding neutrophilia in patients with esophageal adenocarcinoma. Our Institutional Database was queried for esophageal adenocarcinoma patients who underwent esophagectomy from 2006 to 2019. Complete blood counts (CBC), demographic characteristics, perioperative and oncologic outcomes were evaluated. Two groups were created based on the presence of prolonged neutrophilia (PN, >7,000 absolute neutrophils 90 days after surgery). Univariate, multivariable, and survival analysis were performed (P-value < 0.05). We identified 686 patients with complete CBC data: 565 in the no prolonged neutrophilia (NPN) and 121 in the PN groups (17.6%). The mean age was 54 versus 48 years in the NPN and PN groups (P = 0.01). There was no difference in height, weight, gender, race, tumor size, histology, pTNM, PS, ASA, salvage procedure, neoadjuvant treatment and comorbidities. On multivariable analysis, the PN group had increased transfusions (19.8% vs. 11.9%; P = 0.02), aspiration (13.2% vs. 2.5%; P = 0.002), pulmonary embolus (3.3% vs. 0.4%; P = 0.02), cardiac arrest (5% vs. 0.4%; P = 0.02) and hematologic complications (23.1% vs. 12.6%; P = 0.01). After controlling for any postoperative complication, PN had increased distant recurrence (24% vs. 12.7%; hazard ration [HR]: 2.3, 95% confidence interval [CI] 1.42–3.9; P = 0.001) and decreased OS (33.8% vs. 49.7%, HR: 1.83, 95% CI: 1.19–2.81; P = 0.006); median follow up 77 months (46–109). PN was predictive of distant recurrence and decreased overall survival. Further work investigating these neutrophil populations represents a potential area for biomarker research, immunomodulation, and may guide postoperative surveillance strategies.

Dose–response relationships between polycyclic aromatic hydrocarbon exposure and blood cell counts among coke oven workers: a sex-stratified analysis

ObjectivesTo explore sex differences and dose–response relationships between nine urinary polycyclic aromatic hydrocarbon (PAH) metabolites and neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR) and complete blood counts among coke oven workers.Design and settingA cross-sectional study with stratified sex was conducted in Shanxi, China.ParticipantsA total of 458 male workers and 226 female workers were selected.Primary and secondary outcome measuresGeneral linear models, p values for trend tests and natural cubic spline models were used to explore the dose–response relationships between nine urinary PAH metabolites and NLR, PLR and complete blood counts.ResultCompared with male workers, female workers had lower exposure level of PAH (0.95 ng/mL vs 1.38 ng/mL). Only among female workers did we observe that a 1-unit increase in lg(1-OHPyr) was related to a 0.149 (95% CI: 0.055 to 0.242; p for trend=0.041) and 0.103 (95% CI: 0.025 to 0.181; p for trend=0.007) increase in lg(NLR) and lg(PLR), and a 0.116 (95% CI: −0.179 to –0.054; p for trend=0.007) decrease in lg(lymphocyte counts (LYMs)). A 1-unit increase in lg(2-OHNap) was related to a 0.045 (95% CI: 0.003 to 0.086; p for trend=0.037) increase in lg(PLR) and a 0.029 (95% CI: −0.056 to –0.002; p for trend=0.030) and 0.016 (95% CI: −0.029 to –0.003; p for trend=0.010) decrease in lg(white blood cell counts (WBCs)) and lg(haemoglobin (HGB)).ConclusionFemale workers’ NLR, PLR, WBCs, HGB and LYMs may be more susceptible than those of male workers when affected by PAH.

Stranded beluga (Delphinapterus leucas) calf response and care: reports of two cases with different outcomes

Given the remote, rugged areas belugas typically inhabit and the low rehabilitation success rate with any cetacean, it is rare to have the opportunity to rescue a live-stranded beluga. The Alaska SeaLife Center cared for two stranded beluga calves with two different outcomes. In 2012, a neonatal male beluga calf (DL1202) stranded following intense storms in Bristol Bay. In 2017, a helicopter pilot discovered a stranded male beluga calf (DL1705) during a flight over Cook Inlet. The Alaska SeaLife Center transported both calves for rehabilitation and utilized supportive care plans based on those for other species of stranded cetaceans and care of neonatal belugas at zoological facilities. Diagnostics included complete blood counts, serum chemistries, microbial cultures, hearing tests, imaging and morphometric measurements to monitor systemic health. Treatments included in-pool flotation support; antimicrobials; gastrointestinal support; and close monitoring of respirations, urination, defecation and behaviour. After three weeks of supportive care, the Bristol Bay calf (DL1202) succumbed to sepsis secondary to a possible prematurity-related lack of passive transfer of antibodies. After seven weeks, the Cook Inlet calf (DL1705) recovered and all medications were discontinued. Unable to survive on his own, he was declared non-releasable and placed in long-term care at a zoological facility, to live with other belugas. Aspects and details from successful cases of cetacean critical care become important references especially vital for the survival of essential animals in small, endangered populations.

Hematological changes in patients with malaria in a tertiary care hospital, Multan, Punjab, Pakistan

Background: Malaria is one of the most common human infections and continues to cause significant morbidity and mortality all over the world. To assess and compare the hematological changes in common types of malaria in our patients.Methods: This observational study included 100 diagnosed malaria patients of Multan Medical and Dental college, Multan both from out patient department (OPD) and in-patient department, between March 2020 and March 2021. The diagnosis of malaria was confirmed by thick and thin film stained with Geimsa’s staining for malaria parasite and plasmodium species and the parasite index (MPI) in some cases. Complete blood counts (CBCs) were performed and WBC differential was done on all cases.Results: The most common type of malarial parasite was Plasmodium vivax followed by Plasmodium falciparum and 89% of the patient had thrombocytopenia, 70 % anemia, 23% had leukopenia and 10% had raised WBC count. The mean parasite load was 1.275±0.629%, 20 % of the cases showed neutropenia, 40 % had lymphopenia and 40 % showed monocytopenia. Of all the cases 15 % had neutrophilia, 8 % had lymphocytosis and 5 % had eosinophilia. Thrombocytopenia was slightly more in P. falciparum (58.69%) than P. vivax (30.18%) cases, p>0.05, whereas there was no significant difference in the incidence of anemia in two groups (34.68% vs 33.82%) with p>0.05.Conclusions: P. vivax is the common malarial parasite in our population. Both P. vivax and P. falciparum can cause marked hematological changes including thrombocytopenia, anemia, lymphopenia and monocytopenia.

Remediation of ABCG5-Linked Macrothrombocytopenia With Ezetimibe Therapy

To investigate refractory hypercholesterolemia, a female patient and relatives were subjected to whole-genome sequencing. The proband was found to have compound heterozygous substitutions p. Arg446Gln and c.1118+3G>T in ABCG5, one of two genes causing sitosterolemia. When tracing these variants in the full pedigree, all maternally related heterozygotes for the intronic ABCG5 variant exhibited large platelets (over 30 fl), which segregated in an autosomal dominant manner, consistent with macrothrombocytopenia, or large platelet syndrome which may be associated with a bleeding tendency. In vitro cell-line and in vivo rat model experiments supported a pathogenic role for the variant and the macrothrombocytopenia was recapitulated in heterozygous rats and human cell lines exhibiting that single variant. Ezetimibe treatment successfully ameliorated all the symptoms of the proband with sitosterolemia and resolved the macrothrombocytopenia of the treated heterozygote relatives. Subsequently, in follow up these observations, platelet size, and size distribution were measured in 1,180 individuals; 30 were found to be clinically abnormal, three of which carried a single known pathogenic ABCG5 variant (p.Arg446Ter) and two individuals carried novel ABCG5 variants of uncertain significance. In this study, we discovered that identification of large platelets and therefore a possible macrothrombocytopenia diagnosis could easily be inadvertently missed in clinical practice due to variable instrument settings. These findings suggest that ABCG5 heterozygosity may cause macrothrombocytopenia, that Ezetimibe treatment may resolve macrothrombocytopenia in such individuals, and that increased attention to platelet size on complete blood counts can aid in the identification of candidates for ABCG5 genetic testing who might benefit from Ezetimibe treatment.

SARS-CoV-2 Infection in One Cat and Three Dogs Living in COVID-19-Positive Households in Madrid, Spain

In this study, we describe SARS-CoV-2 infection dynamics in one cat and three dogs from households with confirmed human cases of COVID-19 living in the Madrid Community (Spain) at the time of expansion (December 2020 through June 2021) of the alpha variant (lineage B.1.1.7). A thorough physical exam and nasopharyngeal, oropharyngeal, and rectal swabs were collected for real-time reverse-transcription PCR (RT-qPCR) SARS-CoV-2 testing on day 0 and in successive samplings on days 7, 14, 21, and 47 during monitoring. Blood was also drawn to determine complete blood counts, biochemical profiles, and serology of the IgG response against SARS-CoV-2. On day 0, the cat case 1 presented with dyspnea and fever associated with a mild bronchoalveolar pattern. The dog cases 2, 3, and 4 were healthy, but case 2 presented with coughing, dyspnea, and weakness, and case 4 exhibited coughing and bilateral nasal discharge 3 and 6 days before the clinical exam. Case 3 (from the same household as case 2) remained asymptomatic. SARS-CoV-2 detection by RT-qPCR showed that the cat case 1 and the dog case 2 exhibited the lowest cycle threshold (Ct) (Ct < 30) when they presented clinical signs. Viral detection failed in successive samplings. Serological analyses revealed a positive IgG response in cat case 1 and dog cases 3 and 4 shortly after or simultaneously to virus shedding. Dog case 2 was seronegative, but seroconverted 21 days after SARS-CoV-2 detection. SARS-CoV-2 genome sequencing was attempted, and genomes were classified as belonging to the B.1.1.7 lineage.

Diagnostic and prognostic value of peripheral blood leucocyte ratios in sick cats

The objective of this study was to assess the diagnostic and prognostic utility of feline neutrophil-to-lymphocyte (NLR) and lymphocyte-to-monocyte ratios (LMR) in a variety of underlying diseases. Five-year medical records from cats presenting to the internal medicine unit of a veterinary teaching hospital were retrospectively reviewed. Cats were considered for inclusion based on complete medical records. ADVIA 120 was used for the complete blood counts; the NLR and LMR were calculated by dividing the absolute numbers of the respective leucocytes. Two hundred and nineteen sick and 20 healthy cats were included in the study. The median NLR and LMR were significantly (P < 0.05) elevated and decreased, respectively, in cats with infectious, neoplastic and chronic kidney diseases compared to controls. Additionally, cats with neoplasia had significantly higher median NLR compared to cats with urinary tract and gastrointestinal diseases. Non-survivors had significantly higher NLR and lower LMR compared to survivors. Both ratios had suboptimal prognostic performance for the outcome of sick cats (NLR sensitivity: 37.9%, specificity: 86.4%; LMR sensitivity: 69.0%, specificity: 61.0%). Many different disease categories were associated with increased NLR and decreased LMR compared to controls, but the overall prognostic performance of the two leucocyte ratios was suboptimal.