The Importance of hematological parameters in the prognosis of patients with severe COVID-19, A single-center retrospective study.

Background: Inflammation biomarkers known as acute phase reactants (APRs) show significant variations in serum concentrations during inflammation brought on by both viral and noninfectious diseases. The erythrocyte sedimentation rate (ESR), the C-reactive protein (CRP), the lactate dehydrogenase (LDH), the ferritin, the fibrinogen, the procalcitonin, the D-dimer, and the troponin I are all significant APRs. During inflammation, the serum levels of each of these positive APRs rise. The sensitivity and specificity of hematologic parameters and indices are as high as the inflammatory biomarkers mentioned above for monitoring disease severity and treatment response. Aim: We aimed to evaluate the differences in hematological parameters and indices, and to reveal their treatment and prognostic values, especially in deceased patients with COVID-19. Materials and Methods: The hemogram parameters of 169 critical patients with COVID-19 (125 males and 44 females) who received inpatient treatment at ….between 1 March 2020 and 31 December 2021 were analyzed retrospectively. The patients were divided into two groups-deceased (77) and surviving (92)-noting demographic data such as age and gender. All analyses were performed using SPSS 25.0. Results: Analyses of the hematological parameters used during the treatment processes revealed statistically significant differences between the two patient groups. White blood cell (WBC), neutrophil, and neutrophil-to-lymphocyte ratio (NLR) values were significantly higher (P = 0.019, P = 0.000 and P = 0.000, respectively) for deceased subjects, while lymphocyte, platelet and plateletcrit (PCT) values were significantly lower (for all values, P = 0.000). Platelet volume (MPV) and platelet distribution width (PDW), as well as MPV/PLT, PDW/PLT, MPV/PCT, and PDW/PCT, levels were significantly higher in deceased subjects (P = 0.000). Particularly in our deceased cases, receiver operating characteristic analyses were performed to reveal the importance of such analyses in prognostic status evaluation in COVID-19 since the hematological parameters are quite different. Cut-off values were determined for each parameter, and sensitivity and specificity ratios were calculated. While the sensitivities of MPV/PLT, PDW/PLT, MPV/PCT, and PDW/PCT indices are over 80%, neutrophil and white blood cell sensitivities were found to be lower (74%, 68.8%, respectively). Conclusion: In addition to NLR, which is an important biomarker, the hematological indices MPV/PLT, PDW/PLT, MPV/PCT, and PDW/PCT can be used to determine the risk of death in patients with severe COVID-19.

The effect of smoking on neutrophil/lymphocyte and platelet/lymphocyte ratio and platelet indices: a retrospective study.

OBJECTIVE: Smoking commonly leads to death. Although the neutrophil/lymphocyte Ratio, platelet/lymphocyte ratio and platelet indices have been shown to be important for the diagnosis, prognosis and severity of some diseases, the smoking status of patients in these studies has not been well defined. In this study, we compared ratios derived from complete blood count and platelet indices to smoking status and length in smokers and non-smokers. PATIENTS AND METHODS: The data of healthy males and females aged between 18-60 years who presented to our institute for a routine check-up were collected, and subjects were divided in two groups - smokers and non-smokers. The presence of medical history or laboratory results which could affect inflammatory response, formed our exclusion criteria. All complete blood count results were noted and persons' smoking habits were calculated as pack/years. RESULTS: White blood cell, neutrophil, basophil and eosinophil counts; mean corpuscular volume, red cell distribution width and neutrophil/lymphocyte ratio were significantly higher in smokers when compared to non-smokers (p<0.05). When smokers were grouped according to smoking habits; positive linear correlations were detected between pack/year and Neutrophil/lymphocyte ratio and also pack/year and plateletcrit in smokers (p<0.05). CONCLUSIONS: Neutrophil/lymphocyte ratio increases in correlation with pack/year while platelet/lymphocyte ratio is not affected and platelet distribution width is increased in smokers. If smokers are not excluded from studies evaluating neutrophil/lymphocyte ratio and platelet distribution width, the relationship between smoking status as well as pack/year must be determined and reported.

Interactions of thyroid hormones; insulin-like growth factor-1 (IGF-1), IGF binding proteins, and nutritional anthropometric parameters in school children with goiter detected by palpation.

AIM: In the present study we evaluated anthropometric indices, serum thyroid hormones, insulin-like growth factor-1 (IGF-1) and IGF- binding proteins (IGFBPs) levels, in children who has palpable goiter at endemic population. We aimed to 1) compare children with palpable goiter with healthy peers, 2) detect interaction of anthropometric indices, serum thyroid hormones, IGF-1 and IGFBPs parameters in both groups 3) evaluate the effects of their nutritional status to these parameters. SUBJECTS AND METHODS: We performed goiter palpation to 1 018 child and found goiter at 81 child. Seventy-three pubertal children were included in this study. Seventy-five healthy children were defined as the control group. Weight and height of all children were measured. Thyroid hormone levels, IGF-1, IGFBP-3, and IGFBP-1 were assessed in both groups. RESULTS: Height and weight SDS were significantly lower in children who had goiter by palpation than healthy peers (p<0.05). Free T4 (FT4) levels were significantly higher in control group than children with palpable goiter (p<0.05). IGF-1 level and IGF-1 SDS were significantly lower in children with palpable goiter (p<0.001), IGFBP3 and IGFBP1 levels were not significantly different between the two groups (p>0.05). Serum IGF-1 and IGFBP-3 levels were significantly lower (p<0.05) in underweight children with goiter than normal weight group. In the presence of goiter, IGF-1 levels were lower (B: 0.97, 95% CI: 0.96-0.98, p<0.001). CONCLUSION: In endemic areas, children with palpable goiter were shorter and thinner than the healthy peers. Thyroid hormones were between the reference ranges. In children with palpable goiter, IGF-1 levels were lower and IGFBP-3 and IGFBP-1 levels were not different from the healthy control group. However, at the presence of goiter IGF-1 levels decrease. This decrease can be the result of insufficient nutrition and result in short stature and weakness than their healthy peers.

Recreational and master athletic activity does not affect free and total prostate-specific antigen levels but lowers the free-to-total prostate-specific antigen ratio.

Prostate-specific antigen (PSA) and the ratio of free-to-total PSA are widely used tumour markers, but the effect of exercise on these parameters is unclear. We aimed to determine whether long-term physical training was associated with changes in serum PSA by comparing PSA concentrations in middle-aged master athletes (n = 12), recreational athletes (n = 12) and sedentary controls (n = 12). Serum total PSA and free PSA concentrations were assessed using an electrochemiluminescence immunoassay; there were no significant differences among the groups. The free-to-total PSA ratio was significantly lower statistically in master athletes compared with recreational athletes, but this is not clinically significant as both values (0.22 versus 0.31, respectively) were within the normal range. These results indicate that the free-to-total PSA ratio may be affected by long-term athletic training, and could be important when evaluating athletes with prostate-related disorders.

The protective mechanisms of defibrotide on liver ischaemia-reperfusion injury.

During some surgical interventions, temporary occlusion of the hepatic blood supply may cause ischaemia-reperfusion (I/R) injury and hepatic dysfunction. In this study the protective effect of defibrotide (DEF) was evaluated in a rat model of liver I/R injury. Four groups of rats were subjected to the following protocols: saline infusion without ischaemia, DEF infusion without ischaemia, DEF infusion with hepatic I/R, and saline infusion with hepatic I/R. After a midline laporatomy, liver ischaemia was induced by 45 min of portal occlusion. DEF 175 mg/kg(-1) was infused before ischaemia in 10 ml of saline. The same volume of saline was infused into the control animals. At the end of the 45-min reperfusion interval, the animals were sacrified. Superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) enzyme activities were determined in haemolysates, and malondialdehyde (MDA) level in the liver tissue was measured. Tissue MDA levels were significantly higher in the I/R plus saline group compared to the sham operation control groups (p < 0.01 and p < 0.05, respectively). Tissue MDA levels decreased in the DEF plus I/R group compared to the I/R plus saline group (p < 0.05), but DEF could not reduce tissue lipid peroxidation to the levels of the control sham operation groups. SOD and GSH-Px enzyme activities were significantly higher in DEF-treated animals than in the other groups (p < 0.05). These results suggest that DEF protects liver against I/R injury by increasing the antioxidant enzyme levels.

The acute effects of cilazapril on pulmonary function tests and arterial blood gas changes in patients with pulmonary hypertension.

The aim of the present study was to evaluate pulmonary function tests and arterial oxygen transport in patients with pulmonary hypertension due to congestive heart failure before and after cilazapril treatment. Thirty patients (16 men and 14 women, mean age, 65 +/- 18 years) with congestive heart failure and 30 healthy volunteers (20 men and 10 women, mean age 59 +/- 12 years, p > 0.05) were included in the study. All patients underwent evaluation of pulmonary function by spirometry and arterial blood gas analysis. Arterial oxygen saturation and arterial oxygen transport changed significantly after treatment (81 +/- 7 to 87 +/- 8 and 317 +/- 74 to 392 +/- 8, respectively). Forced expiration volume in 1 second, vital capacity and total lung capacity were increased after cilazapril treatment (2.55 +/- 0.7 to 2.61 +/- 0.8, 3.2 +/- 0.9 to 3.3 +/- 1.0 and 3.6 +/- 0.9 to 4.1 +/- 1.1, respectively, p < 0.05). In conclusion, short-term cilazapril administration improved pulmonary function and arterial oxygen transport because it increased cardiac output, produced pulmonary vasodilatation, improved the pulmonary hemodynamics and removed interstitial fluid.

The acute effect of orlistat on endothelial function in young obese women.

Recent studies indicate that abdominal fat accumulation is related to impaired endothelial function in young healthy volunteers. The aim of this study was to determine the acute effect of gastrointestinal lipase inhibitor on brachial flow-mediated vasodilatation and hemodynamic parameters in young obese women. The study population was composed of 42 female obese patients (mean age 29 +/- 4 years, age range between 18 and 34 years). Flow-mediated endothelial-dependent vasodilatation was assessed in the brachial artery in response to reactive hyperemia using high-resolution ultrasound. Brachial artery diameter (3.46 +/- 0.72 mm to 3.82 +/- 0.84 mm) and flow-mediated vasodilation (7.6 +/- 0.8% to 9.8 +/- 1.6%) changed significantly after 12 weeks of therapy (p < 0.001). Brachial artery flow was not changed (124 +/- 92 ml/min to 148 +/- 14 ml/min, p > 0.05). The results of this study demonstrate that orlistat improved endothelial function, weight, body mass index and systolic and diastolic blood pressure in young women.

Clomiphene citrate does not adversely affect endometrial leukemia inhibitory factor levels.

The aim of this study was to compare endometrial leukemia inhibitory factor (LIF) levels in spontaneous and clomiphene citrate (CC)-induced cycles of patients with unexplained infertility. The patients were followed in two consecutive cycles. Endometrial samples were obtained 7 days after ultrasonographic evidence that ovulation has occurred during the spontaneous cycle, then the patients were induced with CC from day 5 to day 9 during the subsequent cycle with 50 mg/day, and ovulation monitoring and endometrial biopsy were performed in the same manner. The samples were obtained using a Pipelle biopsy device without using local anesthesia, and kept in formaldehyde solution until the day of measurement. Then they were homogenized in phosphate buffered distilled water, and LIF levels were detected in the homogenized fluid by ELISA method. Endometrial LIF levels were 470 +/- 52 and 501 +/- 45 pg/1 gram wet tissue in spontaneous and CC-induced cycles respectively, revealing no significant difference. Ovulation induction with CC did not adversely affect endometrial LIF levels.

Testosterone and nonverbal intelligence in right-handed men with successful and unsuccessful educational levels.

The relationship between serum total testosterone (T) concentration and fluid intelligence (nonverbal, spatial) was studied in consistently right-handed men with successful (S) or unsuccessful educational levels (NS). Hand preference was assessed by the Edinburgh Handedness Inventory. Nonverbal intelligence was measured by Cattell's Culture Fair Intelligence Test. Serum T level was determined using chemiluminescence enzyme-immunoassay on hormone autoanalyzer. There was no significant difference between the mean T levels of the S subjects and NS subjects, although S-men tended to have higher T levels than NS-men. The mean IQ was found to be significantly higher in S-men than NS-men. In the total sample (S + NS men), the correlation between T to IQ was best described by a polynomial regression (3rd order), exhibiting an inverse U-shaped regression. In S-men, the relationship between T and IQ was best described by a polynomial regression equation of the 3rd order; however, the relationship was not U-shaped, but rather a positive correlation (low T: low IQ and high T high IQ). In NS-men, there was an inverse U-shaped correlation between T and IQ (low and very high T: low IQ and moderate T: high IQ). The present data suggest that (i) very low and very high serum T concentrations may be disadvantageous, (ii) moderate T levels may be advantageous for general fluid intelligence, and (iii) a prewired cerebral organization may be essential for the T effects on cognitive abilities.

Immunolocalization of transforming growth factor-beta 3 in pregnant human myometrium.

BACKGROUND: Transforming growth factor-beta 3 is a cytokine which is involved in cell growth regulation and differentiation, stimulation of extracellular matrix and modulation of immune responses. The goal of this study was to detect the presence of this cytokine in the myometrium of preterm and term, nonlaboring and laboring patients, and to measure serum levels of interleukin-1 beta (IL-1 beta), IL-6 and IL-8 before cesarean section. METHODS: In this prospective study, we obtained samples of myometrium from the lower uterine segment during elective and emergency cesarean sections (term non-laboring, n=8; term laboring, n=7; preterm non-laboring, n=3; and preterm laboring, n=19) and stained for transforming growth factor-beta 3. Blood was also sampled from the same patients to determine IL-1 beta, IL-6 and IL-8 levels. RESULTS: Different intensities of staining were detected in preterm laboring, term nonlaboring and term laboring groups, but there was no staining in preterm nonlaboring group. We also found a statistically significant difference in IL-6 levels between laboring and nonlaboring groups (p=0.028). CONCLUSION: Different intensities of TGF-beta 3 which appeared in different stages of myometrium made us consider that TGF-beta 3 might prepare myometrium to labor, and IL-6 was more important than the other interleukins in initiation of labor.

Low levels of high density lipoprotein cholesterol in Turkish children: an important risk factor.

In Turkish adults, the incidence of coronary artery disease (CAD) has been found to be high. However, no detailed lipid, or lipoprotein data of children are available from Turkey. The present study was designed to define the borderline lipid and lipoprotein levels of sera in 397 healthy children (aged 5-14 years; 206 boys and 191 girls). Mean levels of total cholesterol (TC), triglyceride (TG), high- and low-density lipoprotein cholesterol (HDL-C and LDL-C, respectively) were found to be 150, 79, 46.7, and 87.6 mg/dL, respectively, for boys, and 152, 77.5, 46.3 and 90.5 mg/dL, respectively, for girls. Lipids and lipoproteins did not show any significant correlation with age and body mass index (BMI), except for TG in boys in whom TG levels were positively correlated with age and BMI. There were no significant differences in lipid and lipoprotein levels between boys and girls. As in the Turkish adult population, serum HDL-C levels of Turkish children were profoundly low on international comparison. Twenty-three (53%) of 43 children with low HDL-C level (< or = 35 mg/dL) had abnormal ratios of TC/HDL-C (> or = 5) and/or LDL-C/HDL-C (> or = 4.5), whereas only 13 (3.7%) of the remaining 354 children with a HDL-C level less than 35 mg/dL had abnormal ratios of TC/HDL-C (> or = 5) and/or LDL-C/HDL-C (> or = 4.5). The low levels of HDL-C in Turkish children may be associated with the high incidence of CAD in the Turkish adult population.

Effect of long-term alcohol abuse on male sexual function and serum gonadal hormone levels.

PURPOSE: The relationship between chronic alcohol abuse and male sexual dysfunction and pituitary gonadal function abnormalities remains uncertain. The purpose of this study was to assess the effect of chronic alcoholism on sexual functions and serum hormone levels. MATERIALS AND METHODS: Forty-five chronically alcoholic men and a control group of thirty healthy non-alcoholic volunteers were enrolled in the study. Each of the men in the study and control group were interviewed according to a sexual dysfunction questionnaire by an urologist. Blood samples were collected for evaluation of hormone levels. Sera were stored at -70 degrees C for analysis. RESULTS: The sexual desire and erection scores of alcoholic men were not statistically different from those of the control group. Fourteen out of the 45 alcoholic men complained of loss of erection during sexual activity. No significant difference in hormone levels between groups was found except for FSH. CONCLUSION: In the absence of hepatic and gonadal failure in chronically alcoholic men, there is no significant difference in serum hormonal levels, sexual dysfunction form, and sexual functions between alcoholics and normal healthy non-alcoholic men.

Beneficial effects of testosterone undecanoate on the lipoprotein profiles in healthy elderly men. A placebo controlled study.

BACKGROUND AND METHODS: In order to assess the effects of testosterone undecanoate (TU; 120 mg/d orally for 2 months) on serum lipid, lipoprotein, and apolipoprotein levels in healthy elderly men, the placebo (PL) controlled study was performed on 37 elderly men, aged between 53 and 89 years. In all subjects venous blood samples were taken after an overnight (10 hours) fast and sera were stored -70 degrees C until analysis. RESULTS: In PL group, neither hormonal data nor lipid, lipoprotein, and apolipoprotein levels showed significant changes. After TU supplementation, serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and estradiol (E2) levels decreased from 198 +/- 30.7 mg/dl to 174 +/- 41.9 mg/dl (p < 0.05), from 111 +/- 18.14 mg/dl to 87.9 +/- 29.4 mg/dl (p < 0.01), and from 86.2 +/- 16.9 pmol/l to 70.5 +/- 18 pmol/l (p < 0.01), respectively. Statistically significant differences were not observed in the serum triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and apolipoprotein (apo) A-1 and apo B levels after TU treatment. The mean ratios TC/HDL-C and LDL-C/HDL-C as coronary risk factor criteria decreased significantly in the TU but not in the PL group. No obvious side effect was observed in those who took TU except for reported pyrosis in 2 of 17 elderly men. CONCLUSIONS: These data indicate that the increased serum levels of total testosterone (TT) produced by administration of TU, 120 mg/d orally for 2 months lead to suppressed levels of TC and LDL-C and E2 but not significantly changed levels of TC, HDL-C, apo A-1 and apo B. Thus, we conclude that TU may be an effective drug for protecting coronary heart disease in healthy elderly men with lowered TT and FT levels. It may also have beneficial effects for sexual function and behavior.

Increased lipoprotein (a) and its relationships with other parameters of lipoprotein metabolism in chronic renal failure treated by hemodialysis.

BACKGROUND: Studies have shown that patients with chronic renal failure have a high frequency of cardiovascular atheromatous disease. METHODS: We examined serum lipoprotein (a) [Lp(a)], very-low density lipoprotein cholesterol (VLDL-C), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), apolipoprotein A1 (apo A1) and B (apo B), triglyceride (TG) and total cholesterol (TC) levels as possible risk factors for atherosclerosis in 45 patients with chronic renal failure (CRF) treated by hemodialysis (HD) and in 15 CRF patients who were not on HD. A control group of 20 healthy subjects was also studied. RESULTS: The proportion of smokers and body mass indexes were similar between the groups. In both patient groups, higher TG, TC and Lp(a) and lower apo A1 and HDL-C levels in serum were found than in those of controls. Serum apo B and LDL-C were similar in the patients treated by HD and the controls. Serum VLDL-C and LDL-C were similar in the CRF patients who were not on HD and the controls. The highest ratios of apo B/apo A1 and LDL-C/HDL-C were found in HD patients. The highest ratio of TC/HDL-C was found in the other patient group. We found significant correlations between Lp(a) and other parameters of lipoprotein metabolism in CRF patients, both those who were and those who were not on HD. CONCLUSIONS: Our results indicate that CRF patients who both were and were not on HD show atherogenic changes in the lipoprotein pattern, and that the increase in Lp(a) during the CRF phase is basically related to the loss of renal function and may also depend on the resultant alterations which are produced in other lipoprotein variables.

Increased serum copper and decreased serum zinc levels in children with iron deficiency anemia.

In order to evaluate serum copper and zinc status in children with iron deficiency anemia (IDA), 60 children with IDA aged 1-14 yr and 64 healthy children as controls aged 1-14 yr were included the study. Serum copper levels were higher in children with IDA (189 +/- 49 micrograms/dL) than those of controls (163 +/- 37 micrograms/dL) (p = 0.001). Serum zinc levels were lower in the patient group (109 +/- 59 micrograms/dL) than those of control subjects (135 +/- 56 micrograms/dL) (p = 0.017). In addition, there were statistically significant negative correlations between hematological parameters and serum copper levels in the patient group, but not in controls. No correlation between hematological parameters and serum zinc levels were found in both patient and control groups, except positive correlation between mean corpuscular volume (MCV) and serum zinc level in patients. It was concluded that at the time of managing children with IDA, zinc deficiency must be borne in mind and if necessary treatment should be initiated with zinc.

Effects of passive exposure to tobacco, socioeconomic status and a family history of essential hypertension on lipid profiles in children.

There is abundant evidence that the atherosclerotic process begins in childhood. Dyslipidemia is a major risk factor for atherosclerosis in adults and children. In the present study, we measured serum lipoprotein concentrations in 194 healthy children aged between 4 to 14 years. Children were grouped according to the socioeconomic status of the families, family history of essential hypertension and passive tobacco exposure. The values of total cholesterol, low density lipoprotein cholesterol and the ratio of total cholesterol/high density lipoprotein cholesterol in the low socioeconomic group were found to be significantly higher than the values obtained for the middle-high socioeconomic group. The values of total cholesterol, low density lipoprotein cholesterol, the ratio of total cholesterol/high density lipoprotein cholesterol and low density lipoprotein cholesterol/high density lipoprotein cholesterol in the passive smoker group were found to be significantly higher than those of the nonsmoker group. But, the socioeconomic level in the passive smoker group was found to be significantly lower than that of the nonsmoker group, and therefore, the impact of passive smoking on the serum lipids in children was related to socioeconomic status. A significant difference in terms of blood lipid fractions between the groups with and that without a family history of essential hypertension was not found. These results suggest that passive smoking and lower socioeconomic status are important risk factors for cardiovascular heart disease, while a positive family history of essential hypertension is not an important risk factor.

The influence of calcium infusion on serum prolactin in hyperprolactinemic women.

This study investigated the influence of calcium on serum prolactin (PRL) in hyperprolactinemic and healthy women. Previous studies have shown an inhibitory effect of Ca2+ on serum PRL, related to the degree of hypercalcemia. Serum PRL levels were measured by immunoradiometric assay (IRMA) in subjects before and one hour after 1375 mg Ca2+ injection. Serum PRL level was significantly decreased by calcium injection in hyperprolactinemic women (89.2 +/- 29.1 and 63.3 +/- 35.8 ng/ml; p < 0.01) while it was not significant (p > 0.05) in women with normal PRL levels (12.6 +/- 5.1 ng/ml and 11.3 +/- 4.0 ng/ml). These results indicate that acute alterations in serum calcium levels affect PRL secretion in hyperprolactinemic women.