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1.
Eur Rev Med Pharmacol Sci ; 26(8): 2775-2781, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-35503622

RESUMEN

OBJECTIVE: To our knowledge, there are no studies that investigated the relationship between diabetes mellitus type 2 (T2D) and some novel indexes, such as monocyte/granulocyte to lymphocyte ratio (M/GLR), derived neutrophil to lymphocyte ratio (dNLR), and platelets to neutrophil ratio (PNR). The aim of this study was to examine the association between these novel indexes and glycated hemoglobin (HbA1c) in patients with prediabetes and T2D. PATIENTS AND METHODS: A total of 827 participants were consecutively recruited. According to the American Diabetes Association (ADA) criteria, participants were divided into control, prediabetes, and T2D group. RESULTS: White blood cell count (WBC), neutrophil count, NLR, dNLR, and M/GLR were higher in T2D patients than in the other two groups, whereas PNR was the lowest in T2D group. Lymphocyte count was higher in prediabetes and T2D patients than in control group. Multivariable ordinal regression analysis showed that WBC, neutrophil count, lymphocyte count, NLR, dNLR, and M/GLR were positively associated [OR (95% CI) 1.287 (1.191-1.390), p<0.001; 1.427 (1.275-1.594), p<0.001; 1.347 (1.130- 1.606), p=0.001; 1.350 (1.090-1.670), p=0.006; 1.662 (1.189-2.326), p=0.003; 1.275 (1.057-1.540), p=0.012, respectively] with HbA1c. However, PNR was negatively associated with HbA1c [0.987 (0.981-0.993), p<0.001]. CONCLUSIONS: Novel, modified NLR indexes, such as dNLR and M/GLR were independently correlated with HbA1c. Also, PNR showed superiority over platelets (PLT) in relation to HbA1c. These novel indexes might give a significant contribution to the timely recognition of disturbances of glucose homeostasis in patients with prediabetes and overt diabetes.


Asunto(s)
Diabetes Mellitus Tipo 2 , Estado Prediabético , Plaquetas , Diabetes Mellitus Tipo 2/complicaciones , Hemoglobina A Glucada/análisis , Humanos , Recuento de Leucocitos , Linfocitos , Estado Prediabético/complicaciones
2.
Eur Rev Med Pharmacol Sci ; 26(8): 2900-2905, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-35503633

RESUMEN

OBJECTIVE: Inflammation forms the basis of cancer development and progression. It causes changes in complete blood count parameters, such as neutrophil counts. Low albumin levels are associated with poor prognosis in cancer patients. We aimed to investigate the association between neutrophil to albumin ratio (NAR) and the stage of non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: 257 NSCLC patients (24 females and 198 males) were included in the study. Patients were divided into two groups. Group 1 (n=61) included patients with early stage cancer (stage 1 and 2), while group 2  (n=196) included those with advanced stage cancer (stage 3 and 4). Demographic data, neutrophil, lymphocyte, platelet, white blood cell counts (WBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), ferritin and albumin levels at the time of diagnosis were recorded. The NAR of 2 groups were compared. RESULTS: There were no significant differences between the lymphocyte count (2.0 vs. 2.0 103/mm3) and platelet count (291 vs. 311 103/mm3) of the two groups (p > 0.05). ESR (38.8 vs. 57.5 mm/h), CRP (158 vs. 57 mg/l), ferritin (85 vs. 261 ng/ml), WBC count (8.6 vs. 10.6 103/mm3), neutrophil count (5.6 vs. 7.5 103/mm3), albumin values (2.9 vs. 3.7 gr/dl), and (p < 0.05) NAR levels (1.6 vs. 2.3) (p < 0.05) were significantly higher in group 2. CONCLUSIONS: NAR can be used in predicting the stage of NSCLC.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas , Neoplasias Pulmonares , Albúminas , Proteína C-Reactiva/análisis , Carcinoma de Pulmón de Células no Pequeñas/diagnóstico , Femenino , Ferritinas , Humanos , Recuento de Leucocitos , Neoplasias Pulmonares/diagnóstico , Recuento de Linfocitos , Linfocitos , Masculino , Neutrófilos , Estudios Retrospectivos
3.
Clin Lab ; 68(5)2022 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-35536089

RESUMEN

BACKGROUND: Acute appendicitis is one of the most common abdominal emergencies worldwide. Biomarkers and imaging are valuable adjuncts to history and examination. Differentiating complicated and uncomplicated appendicitis is essential. Our aim is to investigate whether serum I-FABP could be a suitable diagnostic biomarker in diagnosing acute appendicitis in which inflammation and ischemia play a role in the pathophysiology. METHODS: Sixty-six patients with histopathologically confirmed acute appendicitis were included in the study. Blood samples were taken from the patient and control groups to examine serum I-FABP, white blood cell (WBC) counts, C-reactive protein (CRP), and procalcitonin (PCT) levels. RESULTS: Twenty-six patients (39.3%) had complicated appendicitis. When the patient and control groups were compared in terms of I-FABP, WBC, neutrophil-lymphocyte ratio, (NLR) CRP, and PCT values, a significant difference was found in all biochemical parameters (p < 0.001). We compared the levels of patients with uncomplicated and complicated appendicitis in terms of serum I-FABP, WBC, NLR, CRP, and PCT levels and found that only the I-FABP level was significantly different (p < 0.001), and the diagnostic sensitivity was higher in patients with complicated appendicitis compared with uncomplicated patients (AUC; 0.89 for I-FABP, 0.55, 0.57, 0.61, and 0.59 for WBC, NLR, CRP, and PCT respectively). CONCLUSIONS: I-FABP has no diagnostic advantage over WBC, CRP, and PCT to diagnose acute appendicitis. However, it is more sensitive than other biomarkers in differentiating complicated from uncomplicated appendicitis.


Asunto(s)
Apendicitis , Proteínas de Unión a Ácidos Grasos/sangre , Enfermedad Aguda , Apendicitis/diagnóstico , Biomarcadores , Proteína C-Reactiva/análisis , Humanos , Recuento de Leucocitos , Polipéptido alfa Relacionado con Calcitonina , Estudios Retrospectivos
4.
An Acad Bras Cienc ; 94(2): e20201947, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35507979

RESUMEN

The diagnostic role of serum cytokines depends on the etiology and pathogenesis of acute appendicitis but the clinical significance of these cytokines in the differential diagnosis of complicated acute appendicitis remains unclear. To investigate the prediction of progression and diagnostic values of interleukin-6, interleukin-1 beta, and tumor necrosis factor-alpha in complicated acute appendicitis. This study was conducted in 100 patients with a definitive diagnosis of acute appendicitis and 20 individuals assigned for the control group. Venous blood was collected to assess biochemical tests, as well as interleukin-6, interleukin-1ß, and tumor necrosis factor-α levels. Serum levels of all parameters were dramatically higher in the complicated group compared with uncomplicated. Duration of hospitalization, rates of postoperative infection, intraabdominal abscess, and re-hospitalization were higher in complicated group. Cut-off points of WBC, CRP, NLR, interleukin-6, interleukin-1ß and tumor necrosis factor-α were 13.5x103/µL, 1.92 mg/dL, 6.09, 23.4 pg/mL, 5.6 pg/mL and 24 pg/mL (p=0.0014, p<0.001, p=0.009, respectively and p<0.001 for the rest). AUC of interleukin-6 was larger than AUCs of all other parameters, suggesting the highest predicting power of interleukin-6 among other parameters. Serum interleukin-6, interleukin-1ß, and tumor necrosis factor-α levels are valuable diagnostic parameters to predict a complicated acute appendicitis.


Asunto(s)
Apendicitis , Enfermedad Aguda , Apendicitis/complicaciones , Apendicitis/diagnóstico , Apendicitis/cirugía , Biomarcadores , Citocinas , Humanos , Interleucina-1beta , Interleucina-6 , Recuento de Leucocitos , Factor de Necrosis Tumoral alfa
5.
Eur J Gen Pract ; 28(1): 95-101, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-35535699

RESUMEN

BACKGROUND: The diagnostic value of C-reactive protein (CRP) for appendicitis in children has not been evaluated in primary care. As biochemical responses and differential diagnoses vary with age, separate evaluation in children and adults is needed. OBJECTIVES: To determine whether adding CRP to symptoms and signs improves the diagnosis of appendicitis in children with acute abdominal pain in primary care. METHODS: A retrospective cohort study in Dutch general practice. Data was collected from the Integrated Primary Care Information database between 2010 and 2016. We included children aged 4-18 years, with no history of appendicitis, presenting with acute abdominal pain, and having a CRP test. Initial CRP levels were related to the specialist's diagnosis of appendicitis, and the test's characteristics were calculated for multiple cut-offs. The value of adding CRP to signs and symptoms was analysed by logistic regression. RESULTS: We identified 1076 eligible children, among whom 203 were referred for specialist evaluation and 70 had appendicitis. The sensitivity and specificity of a CRP cut-off ≥10 mg/L were 0.87 (95%CI, 0.77-0.94) and 0.77 (95%CI, 0.74-0.79), respectively. When symptoms lasted > 48 h, this sensitivity increased to 1.00. Positive predictive values for CRP alone were low (0.18-0.38) for all cut-off values (6-100 mg/L). Adding CRP increased the area under the curve from 0.82 (95%CI, 0.78-0.87) to 0.88 (95%CI, 0.84-0.91), and decision curve analysis confirmed that its addition provided the highest net benefit. CONCLUSION: CRP adds value to history and physical examination when diagnosing appendicitis in children presenting acute abdominal pain in primary care. Appendicitis is least likely if the CRP value is < 10 mg/L and symptoms have been present for > 48 h.


Asunto(s)
Apendicitis , Proteína C-Reactiva , Dolor Abdominal/diagnóstico , Dolor Abdominal/etiología , Enfermedad Aguda , Adolescente , Apendicitis/diagnóstico , Proteína C-Reactiva/análisis , Niño , Preescolar , Humanos , Recuento de Leucocitos , Estudios Retrospectivos , Sensibilidad y Especificidad
6.
PLoS One ; 17(4): e0267638, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35476704

RESUMEN

BACKGROUND: The Sysmex DI-60 digital morphology analyzer is a fully automated, cell-locating image analysis system. This study aimed to evaluate the analytical performance of DI-60. METHODS: A total of 822 peripheral blood smears were used. The diagnostic performance of DI-60 in terms of red blood cell (RBC) morphology characterization, white blood cell (WBC) differentials, and the total assay time including hands-on time was evaluated. RESULTS: In comparison with manual slide review, DI-60 demonstrated acceptable accuracy in recognizing polychromasia, target cells, and ovalocytes. However, for schistocytes, DI-60 demonstrated low specificity (10.4%) despite the high sensitivity (97.2%). In the precision analysis of RBC morphology characterization, borderline samples harboring specific RBCs showed inconsistencies in the positive results among 20 replicates. Particularly, 6 of 10 samples showed inconsistencies in the precision for schistocytes. For WBC differentials, the overall agreement between pre-classification results and user-verified results was 89.4%. Except for basophils, normal WBCs showed a good correlation between DI-60 (after user verification) and manual counts. The sensitivities in detecting immature granulocytes, blasts, atypical lymphocytes, and normoblasts were 85.9%, 92.0%, 37.5%, and 77.6%, respectively. Although the total assay time of DI-60 was longer than that of manual review, the hands-on time was considerably shorter with a difference of 144.1 s/slide for abnormal samples. CONCLUSION: DI-60 demonstrated acceptable performance for normal samples. However, for abnormal WBC differentials and RBC morphology characterization, it should be utilized carefully. DI-60 may contribute to an improvement in laboratory efficiency with increased feasibility.


Asunto(s)
Pruebas Hematológicas , Leucocitos , Recuento de Células Sanguíneas/métodos , Recuento de Eritrocitos , Recuento de Leucocitos
7.
Front Immunol ; 13: 861459, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35464477

RESUMEN

Introduction: The specific pathogenesis of ankylosing spondylitis (AS) remains unclear, and our study aimed to investigate the possible pathogenesis of AS. Materials and Methods: Two datasets were downloaded from the GEO database to perform differentially expressed gene analysis, GO enrichment analysis, KEGG pathway analysis, DO enrichment analysis, GSEA analysis of differentially expressed genes, and construction of diagnostic genes using SVM and WGCNA along with Hypoxia-related genes. Also, drug sensitivity analysis was performed on diagnostic genes. To identify the differentially expressed immune genes in the AS and control groups, we analyzed the composition of immune cells between them. Then, we examined differentially expressed genes in three AS interspinous ligament specimens and three Degenerative lumbar spine specimens using high-throughput sequencing while the immune cells were examined using the neutrophil count data from routine blood tests of 1770 HLA-B27-positive samples and 7939 HLA-B27-negative samples. To assess the relationship between ANXA3 and SORL1 and disease activity, we took the neutrophil counts of the first 50 patients with above-average BASDAI scores and the last 50 patients with below-average BASDAI scores for statistical analysis. We used immunohistochemistry to verify the expression of ANXA3 and SORL1 in AS and in controls. Results: ANXA3 and SORL1 were identified as new diagnostic genes for AS. These two genes showed a significant differential expression between AS and controls, along with showing a significant positive correlation with the neutrophil count. The results of high-throughput sequencing verified that these two gene deletions were indeed differentially expressed in AS versus controls. Data from a total of 9707 routine blood tests showed that the neutrophil count was significantly higher in AS patients than in controls (p < 0.001). Patients with AS with a high BASDAI score had a much higher neutrophil count than those with a low score, and the difference was statistically significant (p < 0.001). The results of immunohistochemistry showed that the expression of ANXA3 and SORL1 in AS was significantly higher than that in the control group. Conclusion: Upregulated of ANXA3, SORL1, and neutrophils may be a key factor in the progression of Ankylosing spondylitis.


Asunto(s)
Espondilitis Anquilosante , Anexina A3/metabolismo , Antígeno HLA-B27/genética , Humanos , Proteínas Relacionadas con Receptor de LDL , Recuento de Leucocitos , Proteínas de Transporte de Membrana , Neutrófilos/metabolismo , Espondilitis Anquilosante/diagnóstico
8.
Biochem Med (Zagreb) ; 32(2): 020801, 2022 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-35464744

RESUMEN

The internalization of apoptotic cells by non-phagocytic cells has been observed in different tissues and could be an important mechanism for the elimination of dying cells. Here, we describe a probable event of phagocytosis of apoptotic cells mediated by urothelial cells in urinary sediment. A 90-years-old male patient was admitted unconscious to the hospital, visible signs included: pale skin and dry mucous membranes, presumptively diagnosed as dehydration. Blood test revealed anaemia (haemoglobin 130 g/L) and hyperglycaemia (glucose 7.8 mmol/L), urinalysis showed a picture of urinary tract infection (leukocyturia and bacteriuria). The microscopic analysis of urinary sediment revealed the presence of urothelial cells and leukocytes internalized in urothelial cells. Anti-CD68 (membrane marker of macrophages) was tested by immunocytochemistry and a negative result was observed. Based on the findings phagocytosis of apoptotic cells mediated by urothelial cells was identified. This phenomenon can be observed in urinary sediment and should not be confused with a neoplastic process since it is a physiological event of cell elimination.


Asunto(s)
Bacteriuria , Infecciones Urinarias , Anciano de 80 o más Años , Bacteriuria/diagnóstico , Femenino , Humanos , Recuento de Leucocitos , Leucocitos , Masculino , Urinálisis , Infecciones Urinarias/diagnóstico
9.
Comput Math Methods Med ; 2022: 5708326, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35465013

RESUMEN

Background: A relevant study found that allergic rhinitis (AR) may be related to the imbalance of nasal flora. Therefore, if the nasal flora of AR patients can be detected quickly, it is of great significance to study the distribution law of nasal flora in AR patients and explore its correlation with AR. Objective: To design a new and convenient nano-DNA sensor for quick screening of nasal flora in allergic rhinitis (AR) patients, so as to provide experimental basis for the prevention and treatment of AR. Methods: We create a synthesized nanostructured DNA biosensor called Nano-TiO2-DNA sensor which can be combined with samples from nasal mucosa or secretion with high efficiency and detect certain flora in situ without DNA extraction or RNA sequencing. In a physical property test, firstly, we tested the permeability, solubility, and storage temperature of nano-TiO2, so as to provide experimental basis for the synthesis of Nano-TiO2-DNA sensor. Subsequently, the permeability of Nano-TiO2-DNA sensor in Staphylococcus aureus was further tested. In a clinical experiment, we selected 60 AR patients treated in our hospital from September 2020 to September 2021 as the AR group and 60 healthy people who underwent physical examination at the same time as the control group. The Nano-TiO2-DNA sensor was used to detect typical nasal flora in AR patients, and Pearson's correlation analysis was used to explore the correlation between nasal flora with serum IgE and eosinophils. Results: As for physicochemical characteristics, this sensor can permeate into certain bacteria directly and specifically. It has high affinity ability with a target, and the combination can be detected by evaluating the released fluorescence qualitatively and quantitatively. It can be stored at -20°C in ethyl alcohol stably. By this sensor, we have successfully detected Staphylococcus aureus, Klebsiella pneumoniae, and viridans streptococci in AR patients compared with healthy people, which will help these patients in the prevention of acute sinusitis and acute or subacute pneumonia. Furthermore, we found Proteus had the strongest positive correlation with AR while Actinomyces had the biggest negative correlation. Conclusion: The Nano-TiO2-DNA sensor will help an outpatient doctor more for quick screening certain nasal flora in AR patients and improve the prevention of AR-related complications.


Asunto(s)
Rinitis Alérgica , ADN , Humanos , Recuento de Leucocitos , Mucosa Nasal , Rinitis Alérgica/diagnóstico , Titanio
11.
Mayo Clin Proc ; 97(4): 805, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-35379427
12.
J Clin Invest ; 132(7)2022 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-35362477

RESUMEN

Although the memory capacity of innate immune cells, termed trained immunity (TI), is a conserved evolutionary trait, the cellular and molecular mechanisms involved are incompletely understood. One fundamental question is whether the induction of TI generates a homogeneous or heterogeneous population of trained cells. In this issue of the JCI, Zhang, Moorlag, and colleagues tackle this question by combining an in vitro model system of TI with single-cell RNA sequencing. The induction of TI in human monocytes resulted in three populations with distinct transcriptomic profiles. Interestingly, the presence of lymphocytes in the microenvironment of monocytes substantially impacted TI. The authors also identified a similar population of monocytes in various human diseases or in individuals vaccinated with bacillus Calmette-Guérin. These insights warrant in-depth analysis of TI in responsive versus nonresponsive immune cells and suggest that modulating TI may provide a strategy for treating infections and inflammatory diseases.


Asunto(s)
Inmunidad Innata , Mycobacterium bovis , Humanos , Recuento de Leucocitos , Macrófagos , Monocitos
13.
Medicina (Kaunas) ; 58(4)2022 Apr 12.
Artículo en Inglés | MEDLINE | ID: mdl-35454373

RESUMEN

Background and Objectives: In women of reproductive age, leukocytosis is a risk factor that bridges low-grade chronic inflammation (metabolic inflammation), metabolic changes, and polycystic ovary syndrome (PCOS) and is a potential early predictor of PCOS. This study aims to explore the predictive role of quantitative changes in white blood cells (WBCs) and neutrophils in PCOS-associated metabolic changes. Materials and Methods: A total number of 176 blood samples were obtained from age-matched women of the reproductive period, comprising 88 PCOS cases and 88 healthy controls. Hematological, metabolic, and anthropometric indices and ultrasonic assessment were recorded. Results: Elevated levels of luteinizing hormone, testosterone, and lipid parameters except HDL-C levels, and the prevalence of metabolic syndrome in PCOS were statistically significant (p < 0.001). The neutrophil count and neutrophil-lymphocyte ratio (NLR) in PCOS patients were significantly higher (p < 0.001) than their counterparts. The predictive ability of the neutrophil count and neutrophil-lymphocyte ratio (NLR) for PCOS, and possibly its associating subclinical inflammation at optimum cut-off values for the neutrophil count and NLR of >46.62% (sensitivity 94.32% and specificity 74.42%) and >1.23 (sensitivity 71.59% and specificity 100%), respectively. With regard to the areas under the curve (AUC) and Youden indices, they constituted 0.922 and 0.697 for neutrophil count and 0.926 and 0.716 for NLR, respectively. The comparative ROC z-statistic value was 2.222 and a p = 0.026. The multiple linear regression analysis revealed no significant influence for hormonal and metabolic independent variables on the neutrophil count in PCOS cases, but, as can be expected, revealed a significant negative relationship with the other components of WBCs. Conclusion: In conclusion, relative neutrophilia and elevated NLR are potential cost-effective, sensitive, and specific predictors of PCOS that may also shed light on the mechanism of chronic low-grade inflammation that is characteristic of the disease.


Asunto(s)
Síndrome del Ovario Poliquístico , Estudios de Casos y Controles , Femenino , Humanos , Inflamación , Recuento de Leucocitos , Linfocitos , Neutrófilos , Síndrome del Ovario Poliquístico/complicaciones
14.
STAR Protoc ; 3(2): 101280, 2022 Jun 17.
Artículo en Inglés | MEDLINE | ID: mdl-35434655

RESUMEN

Granulocytes encompass diverse roles, from fighting off pathogens to regulating inflammatory processes in allergies. These roles are represented by distinct cellular phenotypes that we captured with mass cytometry (CyTOF). Our protocol enables simultaneous evaluation of human basophils, eosinophils, and neutrophils under homeostasis and upon immune activation by anti-Immunoglobulin E (anti-IgE) or interleukin-3 (IL-3). Granulocyte integrity and detection of protein markers were optimized so that rare granulocyte populations could be deeply characterized by single cell mass cytometry. For complete details on the use and execution of this protocol, please refer to Vivanco Gonzalez et al. (2020).


Asunto(s)
Eosinófilos , Neutrófilos , Basófilos , Eosinófilos/metabolismo , Citometría de Flujo/métodos , Humanos , Recuento de Leucocitos
15.
Ann Clin Lab Sci ; 52(2): 314-322, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35414510

RESUMEN

OBJECTIVE: The aim of this study was to investigate the correlation between instrumental and morphological cell differential methods in body fluid (BF) samples. METHODS: Forty ascitic (AF) and forty cerebrospinal (CSF) fluid samples were measured with Sysmex XN1000 and XN2000 instruments in BF mode. Flow cytometry (FC) was carried out with FACS Canto II. From the centrifuged cytospin preparations mononuclear (MN%) and polymorphonuclear (PMN%) cell percentages were determined using optical microscopy (OM) and a digital cell morphology system CellaVision (CV). RESULTS: Both Passing-Bablok and Bland-Altman analysis showed strong correlation between the hematology analyzers for total cell count (TC), white blood cell count (WBC), MN%, and PMN% in BFs. With slightly inferior results, all other WBC differential methods showed acceptable correlation. Passing-Bablok regression analysis yielded a slope encompassing 1.0 in all method comparisons except for three scenarios in CSF. The bias calculated with Bland-Altman plots was comprised between -6.05% and 6.05%. Strong correlations were found when comparing XN1000, XN2000, and CV to OM and FC method with linear regression analysis (r values between 0.905 and 0.984). CONCLUSION: We found strong correlation between instrumental and manual morphological WBC differential methods when testing BF samples containing no tumor cells.


Asunto(s)
Líquidos Corporales , Hematología , Citometría de Flujo/métodos , Hematología/métodos , Humanos , Recuento de Leucocitos , Microscopía/métodos , Reproducibilidad de los Resultados
16.
Hosp Pediatr ; 12(5): 481-490, 2022 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-35373285

RESUMEN

OBJECTIVES: Infectious meningitis (IM) in US children is increasingly rare and new rapid multiplex PCR-based testing is increasingly available. We evaluated the added value of cerebrospinal fluid (CSF) protein and glucose tests to predict IM when compared with information provided by CSF white blood cell count (WBC) and multiplex polymerase chain reaction (PCR). METHODS: We retrospectively reviewed CSF results from October 2015 to August 2017 in patients 0 to 18 years at a US children's hospital. Noninfectious evaluations were excluded. Test characteristics were calculated for CSF WBC, protein, and glucose in isolation and in parallel for prediction of microbiologically confirmed IM. Chart review was performed to identify consideration of protein and glucose in medical decision-making (MDM). RESULTS: We identified 735 patients including 446 <2 months; 45 (6.1%) had microbiologically-confirmed IM, including 23 (5.2%) age <2 months. Multiplex PCR and/or CSF WBC identified all IM patients. When added to CSF WBC, measurement of glucose made no contribution to sensitivity, specificity, positive predictive value (PPV) or negative predictive value (NPV), and protein had no impact on sensitivity and decreased the specificity, PPV, and NPV compared with CSF WBC alone. Abnormal protein was documented in MDM in 6 (0.8%) patients, all of whom had elevated WBC counts also cited. Glucose was not mentioned in MDM. CONCLUSIONS: Multiplex PCR testing and WBC may be sufficient to predict meningitis in children in low incidence settings. Protein and glucose did not contribute significant additional information. More intentional use of protein and glucose testing in patients with suspected IM may achieve higher value care.


Asunto(s)
Meningitis Bacterianas , Meningitis , Niño , Glucosa/líquido cefalorraquídeo , Humanos , Lactante , Recuento de Leucocitos , Meningitis Bacterianas/líquido cefalorraquídeo , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Sensibilidad y Especificidad
17.
BMC Med Imaging ; 22(1): 77, 2022 04 26.
Artículo en Inglés | MEDLINE | ID: mdl-35473495

RESUMEN

BACKGROUND: Image segmentation is the process of partitioning an image into separate objects or regions. It is an essential step in image processing to segment the regions of interest for further processing. We propose a method for segmenting the nuclei and cytoplasms from white blood cells (WBCs). METHODS: Initially, the method computes an initial value based on the minimum and maximum values of the input image. Then, a histogram of the input image is computed and approximated to obtain function values. The method searches for the first local maximum and local minimum from the approximated function values in the order of increasing of knots sequence. We approximate the required threshold from the first local minimum and the computed initial value based on defined conditions. The threshold is applied to the input image to binarize it, and then post-processing is performed to obtain the final segmented nucleus. We segment the whole WBC before segmenting the cytoplasm depending on the complexity of the objects in the image. For WBCs that are well separated from red blood cells (RBCs), n thresholds are generated and then produce n thresholded images. Then, a standard Otsu method is used to binarize the average of the produced images. Morphological operations are applied on the binarized image, and then a single-pixel point from the segmented nucleus is used to segment the WBC. For images in which RBCs touch the WBCs, we segment the whole WBC using SLIC and watershed methods. The cytoplasm is obtained by subtracting the segmented nucleus from the segmented WBC. RESULTS: The method is tested on two different public data sets and the results are compared to the state of art methods. The performance analysis shows that the proposed method segments the nucleus and cytoplasm well. CONCLUSION: We propose a method for nucleus and cytoplasm segmentation based on the local minima of the approximated function values from the image's histogram. The method has demonstrated its utility in segmenting nuclei, WBCs, and cytoplasm, and the results are satisfactory.


Asunto(s)
Algoritmos , Núcleo Celular , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Recuento de Leucocitos , Leucocitos
18.
BMC Cardiovasc Disord ; 22(1): 146, 2022 04 02.
Artículo en Inglés | MEDLINE | ID: mdl-35366817

RESUMEN

BACKGROUND: Eosinophils are pro-inflammatory cells involved in thrombosis and have been proposed as a prognosis marker in acute ischemic stroke and ST-elevation myocardial Infarction. Here, we sought to clarify the prognostic value of eosinophil percentage (EOS%) in patients with acute type A aortic dissection (AAAD). METHODS: We examined 183 consecutive AAAD patients. Based on the optimum cut-off value of EOS% determined by X-tile software, patients were classified into the low EOS% (EOS% ≤ 0.1) and high EOS% groups (EOS% > 0.1). We performed multivariate regression analysis and Kaplan-Meier (KM) survival curves to assess the association between EOS% and mortality. Eosinophil accumulation in aortic dissection intraluminal thrombus was confirmed using hematoxylin-eosin (H&E) staining. An external cohort from Medical Information Mart for Intensive Care IV was performed to validate the results. RESULTS: Relative to surviving patients, those who died during hospitalization had significantly lower EOS% (p = 0.001) but significantly higher WBC (p = 0.002) and neutrophil (p = 0.001) counts. Multivariate regression analysis identified EOS% as an independent predictor of in-hospital and 1-year mortality. KM curves revealed that 1-year cumulative mortality was significantly higher in the low EOS% group, although it was mainly attributed to the higher 30-day mortality. H&E staining revealed massive infiltration of eosinophils in all 20 thrombus specimens. The external validation confirmed that relative to survivors, patients with in-hospital mortality (p = 0.010) had significantly lower EOS%. Moreover, multivariate regression analyses identified that decreased EOS% was independently significantly associated with in-hospital mortality. CONCLUSIONS: Low EOS% is significantly related to increased mortality rates in AAAD patients.


Asunto(s)
Aneurisma Disecante , Accidente Cerebrovascular Isquémico , Aneurisma Disecante/diagnóstico por imagen , Eosinófilos , Humanos , Recuento de Leucocitos , Pronóstico
19.
Ulus Travma Acil Cerrahi Derg ; 28(3): 375-381, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35485560

RESUMEN

BACKGROUND: Acute appendicitis (AA) is the most common reason for pediatric abdominal surgery in the world. Despite ad-vances in science and technology, diagnosing AA is still difficult today, and complications are common as a result. The early prediction of complicated appendicitis is of great importance for the surgical planning, further treatments, and predicting the course of disease. The immature granulocyte (IG) is a new and more effective marker in predicting the severity of inflammation than traditional markers. Our aim is to determine the effectiveness of IG% in the diagnosis and severity of AA. METHODS: Eighty-eight patients diagnosed with AA and a control group of fifty-eight healthy children were included in this prospec-tive study. Patients with pathologically confirmed AA were divided into two subgroups: acute simple appendicitis (ASA) and acute perforated appendicitis (APA). The demographic characteristics, white blood cell (WBC) count, neutrophil-to-lymphocyte ratio (NLR), mean platelet volume (MPV), IG%, and C-reactive protein (CRP) values were analyzed. Receiver operating characteristics (ROC) anal-ysis was used to compare the diagnostic accuracies and predictive performances. RESULTS: Patients with AA had higher IG%, WBC count, NLR, and MPV value than control group (p=0.28, p=0.22, p<0.001, p=0.001, respectively). Only IG% showed statistically significant difference from other inflammatory markers evaluated in ASA and APA patients (p<0.001). ROC analysis showed that IG% is a good predictor for the presence of APA at an optimal cut-off for IG being 0.2% (sensitivity 81.8%, specificity 85.2%, area under the ROC curve 0.83). CONCLUSION: In the present study, we demonstrated that AA patients with higher IG levels might be more likely to develop perforation. The IG values combined with a physical examination, imaging studies, and other laboratory tests may help clinicians to identify high-risk AA patients in the pediatric emergency department.


Asunto(s)
Apendicitis , Enfermedad Aguda , Apendicitis/diagnóstico , Apendicitis/cirugía , Biomarcadores , Niño , Granulocitos , Humanos , Recuento de Leucocitos , Neutrófilos , Estudios Retrospectivos
20.
Ulus Travma Acil Cerrahi Derg ; 28(3): 390-394, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35485562

RESUMEN

BACKGROUND: Acute appendicitis (AA) is a common disease that includes all age groups and both genders in societies and is one of the most common causes of acute abdomen. It is important to distinguish between complicated and non-complicated appendicitis before surgery. This study aims to determine laboratory parameters that can be used to determine whether the disease is complicated or non-complicated in patients admitted to the emergency department with AA. METHODS: Female and male patients admitted to the Emergency General Surgery Department between May 2019 and November 2020 and diagnosed with appendicitis were included in the study. Demographic data (age, gender, and protocol numbers), complete blood counts (Delta neutrophil index [DNI], hemoglobin, monocyte, neutrophil, eosinophil, basophil, platelet, platelet distribution width, mean platelet volume, reticulocyte distribution width), biochemical parameters (amylase, direct bilirubin, indirect bilirubin, albumin, calcium, and lactate dehydrogenase), and examination information were obtained from the hospital automation system and recorded via SPSS software. Parameters of patients were divided into two groups as complicated and non-complicated appendicitis groups were compared. RESULTS: White blood cell (WBC), monocyte, neutrophil, DNI, total bilirubin, and direct bilirubin values were found to be statisti-cally significantly higher in the complicated appendicitis group compared to the non-complicated appendicitis group (p-values; <0.001, 0.003, <0.001, <0.001 and 0.008, respectively). CONCLUSION: DNI, bilirubin values, WBC, monocyte, neutrophil, and eosinophil can be used as laboratory parameters to distin-guish between complicated and non-complicated AA.


Asunto(s)
Apendicitis , Apendicitis/complicaciones , Apendicitis/diagnóstico , Apendicitis/cirugía , Bilirrubina , Femenino , Humanos , Recuento de Leucocitos , Masculino , Neutrófilos , Estudios Retrospectivos
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