Pediatric chronic kidney disease: blood cell count indexes as inflammation markers / Doença renal crônica pediátrica: índices de contagem de células sanguíneas como marcadores de inflamação

Abstract Introduction: Chronic kidney disease (CKD) is defined as a progressive decline of kidney functions. In childhood, the main triggering factors are congenital anomalies of the kidneys and urinary tract (CAKUT) and glomerulopathies. Inflammatory responses present challenges for diagnosis and staging, which justifies studies on biomarkers/indexes. Aim: To define blood cell count indexes and verify their association with pediatric CKD etiology and staging. The included indexes were: Neutrophil-Lymphocyte Ratio (NLR), Derived Neutrophil-Lymphocyte Ratio (dNLR), Lymphocyte-Monocyte Ratio (LMR), Systemic Inflammation Response Index (SIRI), Aggregate Index of Systemic Inflammation (AISI), and Systemic Immune-Inflammation Index (SII). Methods: We determined the indexes in 52 pediatric CKD patients and 33 healthy controls by mathematical calculation. CKD patients were separated in five groups based on the etiology and staging: Group IA: glomerulopathies at stage 1 or 2; IB: glomerulopathies at stage 3 or 4; IIA: CAKUT at stage 1 or 2; IIB: CAKUT at stage 3 or 4; and III: stages 3 or 4 of other etiologies. In addition, we combined all patients with CKD in one group (IV). Group V was a healthy control group. Results: Lower values of LMR were observed for groups IB and IIB compared to group V (p = 0.047, p = 0.031, respectively). Increased values of SIRI were found for group III versus group V (p = 0.030). There was no difference for other indexes when the groups were compared two by two. Conclusion: The LMR and SIRI indexes showed promising results in the evaluation of inflammation, as they correlated with CKD etiologies and specially staging in these patients.

Resumo Introdução: Doença renal crônica (DRC) é definida como um declínio progressivo das funções renais. Na infância, os principais fatores desencadeantes são anomalias congênitas dos rins e trato urinário (CAKUT) e glomerulopatias. Respostas inflamatórias apresentam desafios para diagnóstico e estadiamento, o que justifica estudos sobre biomarcadores/índices. Objetivo: Definir índices de contagem de células sanguíneas e verificar sua associação com etiologia e estadiamento da DRC pediátrica. Os índices incluídos foram: Razão Neutrófilo-Linfócito (NLR), Razão Neutrófilo-Linfócito Derivada (dNLR), Razão Linfócito-Monócito (LMR), Índice de Resposta à Inflamação Sistêmica (SIRI), Índice Agregado de Inflamação Sistêmica (AISI) e Índice de Inflamação Imune Sistêmica (SII). Métodos: Determinamos índices em 52 pacientes pediátricos com DRC e 33 controles saudáveis por cálculo matemático. Pacientes com DRC foram separados em cinco grupos conforme etiologia e estadiamento: Grupo IA: glomerulopatias em estágio 1 ou 2; IB: glomerulopatias em estágio 3 ou 4; IIA: CAKUT em estágio 1 ou 2; IIB: CAKUT em estágio 3 ou 4; e III: estágios 3 ou 4 de outras etiologias. Além disso, combinamos todos os pacientes com DRC em um grupo (IV). Grupo V foi um grupo controle saudável. Resultados: Observamos valores menores de LMR nos grupos IB e IIB comparados ao grupo V (p=0,047; p=0,031, respectivamente). Encontramos valores maiores de SIRI para o grupo III versus grupo V (p=0,030). Não houve diferença para outros índices quando os grupos foram comparados dois a dois. Conclusão: Os índices LMR e SIRI apresentaram resultados promissores na avaliação da inflamação, pois correlacionaram-se com as etiologias da DRC e, principalmente, com o estadiamento desses pacientes.

Analysis of the correlation between smoking, white blood cell counts and serum bilirubin levels in male radiation workers / 公共卫生与预防医学

Objective To investigate the correlation between smoking, white blood cell counts, and serum bilirubin levels in male radiation workers, and to explore the role of systemic inflammatory response in the changes of serum bilirubin level induced by smoking. Methods Occupational health examination data of 1 320 male radiation workers in a medical institution was collected. Linear regression analysis method was used to analyze the correlations between smoking and white blood cell counts, between smoking and serum bilirubin levels, and between white blood cell counts and serum bilirubin levels. Results There was a significant positive correlation between smoking and white blood cell counts (P 0.05). By dividing white blood cell counts into two groups, an inverse correlation was found between smoking and serum bilirubin levels in the high white blood cell count group (P < 0.05). Conclusion Serum bilirubin may be an effective indicator of early health damage caused by smoking in male radiation workers. Smoking may induce inflammatory reaction, thus deplete serum bilirubin and cause its levels to drop.

Effects of transrectal medicinal ozone in horses - clinical and laboratory aspects / Efeitos do ozônio medicinal transretal em cavalos - aspectos clínicos e laboratoriais

Ozone (O3) therapy has been used for medical procedures for centuries; however, there are no extensive studies on its utilization in horses. This study aimed to evaluate the application of transrectal O3 on horses by physical and laboratorial evaluation, and production of reactive oxygen species (ROS). Sixteen healthy horses were separated in two groups: a control group (CG) and a group treated with O3 (TG). The TG animals received 1L of an oxygen and O3 mixture transrectally. The initial dose was 10µg/ml for the first two applications, 15µg/ml for the following two applications, and 20µg/ml for the next six applications. The CG animals received 1L of oxygen transrectally. In TG animals no variations in the physical examination were detected; furthermore, TG animals did not exhibit changes in biochemical evaluation results, fibrinogen concentrations, or ROS production. TG animals had increased red blood cell counts, hemoglobin concentrations, and packet cell volume values in comparison to the baseline and CG values. We could infer that O3 affected the red blood cell counts and improved rhetological properties of the blood. The transrectal application of O3 in horses is safe and can indirectly improve the oxygenation and metabolism of tissues.(AU)

A utilização medicinal do ozônio (O3) é secular, contudo não existem estudos expressivos de sua utilização em equinos. O objetivo deste estudo foi avaliar o efeito da aplicação transretal de O3 em equinos por meio da avaliação física, laboratorial, e produção de espécies reativas de oxigênio (EROs). Dezesseis equinos hígidos foram separados em dois grupos: grupo controle (GC) e grupo tratado com O3 (GT). O GT recebeu por via retal 1L da mistura de oxigênio e ozônio, sendo a dose inicial de 10µg/ml por duas aplicações, 15µg/ml por mais duas aplicações e 20µg/ml por seis aplicações. O GC recebeu 1L de oxigênio via transretal. No GT não foram observadas alterações no exame físico, bem como não foram observadas alterações na avaliação bioquímica, concentração de fibrinogênio e produção de EROs. O GT apresentou aumento no número de hemácias, na concentração de hemoglobina, e nos valores de hematócrito em relação aos valores basais e GC. Podemos inferir que o O3 alterou os valores de eritrócitos e melhorou as propriedades reológicas do sangue. Conclui-se que a aplicação transretal de 03 em equinos é segura e pode melhorar indiretamente a oxigenação e metabolismo dos tecidos.(AU)

Is there an association between platelet and blood inflammatory indices and the risk of gestational diabetes mellitus?

OBJECTIVE: Gestational diabetes mellitus (GDM) is the most prevalent medical complication in pregnancy. Early diagnosis of GDM can influence maternal/neonatal outcomes. To assess the association between platelet and blood inflammatory indices and the risk of GDM occurrence using the complete blood count (CBC) test. We also aimed to determine the sensitivity of each parameter for an early screening of this disorder during pregnancy.METHODS: This case-control study included 2 groups of 110 pregnant women with and without GDM. The women in each group were compared after the routine screening for GDM and after the CBC test at 24–28 weeks' gestation after being matched according to the inclusion criteria. Data were analyzed using SPSS version 16 and Medcalc version 14.8.1 software.RESULTS: There were statistically significant intergroup differences in white blood cell (WBC) count, platelet count, mean platelet volume (MPV), plateletcrit (PCT), MPV to platelet ratio, platelet to lymphocyte ratio, and Rh values. The values of lymphocyte count, neutrophil count, neutrophil to lymphocyte ratio, and blood group were not significantly different between groups. The logistic regression analysis showed the predictive values of WBC, platelet, MPV, and PCT in GDM. According to the receiver operating characteristic curve for all 3 variables, the level below the PCT chart was more than that of the others.CONCLUSION: Increasing platelet and inflammatory indices on the CBC test in the second trimester of pregnancy seemed to be associated with the probability of GDM occurrence.

Analysis of hematologic parameters of donors, patients, and granulocyte concentrates to predict successful granulocyte transfusion

BACKGROUND: Granulocyte transfusion (GTx) is performed as a supportive therapy in severe neutropenic patients caused by various conditions. The study aimed to analyze the hematologic parameters of donors, patients, and granulocyte concentrates to predict successful GTx. METHODS: This study was performed in 281 donors, with their granulocyte concentrates being collected through apheresis, and in 54 severe neutropenic patients who had various hematologic diseases. Complete blood cell counts of donors pre- and post-apheresis, granulocyte concentrates, and patients pre- and post-GTx were analyzed. Patients were divided into two groups according to survival at discharge (Group S, survival; Group D, dead) to compare various factors including age, infection status, pre- and post-GTx total white blood cell counts (TWBCC) and absolute neutrophil counts (ANC), total number of GTx, infused TWBCC and ANC per weight, and use of G-CSF during therapy. RESULTS: Overall data of patients showed that both TWBCC and ANC were significantly increased after GTx (median values at pre-GTx, TWBCC=0.40×109/L, ANC=0.14×109/L; post-GTx, TWBCC=0.57×109/L, ANC=0.29×109/L, both P<0.0001). After GTx, Group S (N=25) showed significantly higher TWBCC and ANC than Group D (N=29) (P=0.01 and P=0.04, respectively). Using different cutoff levels, post-GTx TWBCC greater than 0.5×109/L showed statistically significant difference between the two groups (P<0.01). None of the other factors showed statistically significant differences. CONCLUSION: The TWBCC and ANC after GTx were significant factors to predict patients' outcome. Therefore, follow-up of those two parameters may be helpful to select or consider other therapeutic modalities including additional GTx.

Analyzing micronucleus test in patients with occupational chronic benzene poisoning / 中国职业医学

OBJECTIVE: To analyze chromosome damage and its possible influencing factors in patients with occupational chronic benzene poisoning. METHODS: Fifty patients with occupational chronic benzene poisoning were selected as chronic benzene poisoning group,and 53 workers without occupational exposure to benzene and other toxic substances were chosen as control group by using convenience sampling method. Questionnaire and routine blood test were conducted on all study subjects. Micronucleus rate test was performed by micronucleus blocking cytokinesis assay. RESULTS: Peripheral blood tests of chronic benzene poisoning group showed significantly reduced hemoglobin level,counts of red blood cells,white blood cells,platelets,lymphocytes and neutrophils( P < 0. 01),and higher lymphocyte micronucleus rates compared to control group( !: 6. 26‰ vs 3. 91‰,P < 0. 01). The proportion of increased lymphocyte micronucleus rate in chromic benzene poisoning group was also higher than that in control group( 46. 0% vs 5. 7%,P < 0. 01). The multivariate Poisson analysis results indicated that the time after disengagement from benzene exposure was the influencing factor of micronucleus rate in chronic benzene poisoning group( P < 0. 05),after adjusting the confounding factors of gender,age,smoking status,alcohol drinking status and working age of benzene exposure. CONCLUSION: Occupational chronic benzene poisoning leads to increase of chromosome damage in lymphocytes of patients. The time after disengagement from benzene exposure was positively correlated with chromosome damage.

Effect of Carica papaya (L) Leaves on Haematological Parameters in Ccl4-induced Wistar Albino Rats.

Aims: To investigate the effect of Carica papaya leaves on some haematological parameters (PCV, RBC, Hb, WBC and differential blood counts) were investigated. Place and Duration of Study: Department of Medical Biochemistry, Faculty of Basic Medical Sciences, College of Health Sciences, Niger Delta University, Wilberforce Island, Amassoma, Bayelsa-State, Nigeria, between. Methods: Thirty male albino rats were randomly allotted to five groups of six rats per group. Haemoglobin (Hb) was determined spectrophotometrically by the cyanomethaemoglobin method, Red blood cells (RBC), was estimated by haemocytometer, using adopted standard procedure. Group1 (negative control) were fed with 100% rat feed. Groups 2- 4 were pretreated with 10, 30 and 50% C. papaya L respectively, while Group 5 (normal control) received 100% rat feed. Rats in groups (1-4), were injected with CCl4 (0.5 ml/kg body weight in 0.5 ml olive oil) on the 29th day while rats in group 5 were not administered with CCl4 (normal control). Results: The results were statistically analyzed using one-way analysis of variance (ANOVA). There were significant increases (p≤ 0.05) in the levels of Hb, PCV, RBC, lymphocytes and decreased WBC and neutrophils in rats in group 5 (normal control) as against the negative control (group 1). Rats groups pretreated with 10, 30 and 50% Carica papaya (groups 2, 3 and 4 respectively), showed significant increased (p≤ 0.05) PCV, RBC and Hb levels, when compared with untreated rats (group 1). Rats that were administered with CCl4 only (negative control), showed significant increases (p≤ 0.05) in the levels of WBC and neutrophils. However, incorporation of 10, 30 and 50% Carica papaya in groups 2, 3 and 4 respectively, significantly decreased the levels of WBC and neutrophils, when compared with rats in untreated group 1. Monocytes levels significantly increased (p≤ 0.05) in rats pre-treated with 30% and 50% Carica papaya (groups 3 and 4 respectively). While, there was zero level of basophils in all the groups. Conclusion: Carica papaya L, may therefore possess and confer erythropoietic properties on rats pretreated groups as evident in the increased levels of Hb, PCV, RBC and lymphocytes.

Evaluation of COBIO XS automated urine sediment analyzer in screening urinary tract infection / 国际检验医学杂志

Objective To evaluate the clinical application of COBIO XS automated urine sediment analyzer for screening urinary tract infection(UTI) .Methods Midstream urine samples were collected from 182 patients with suspected UTI .White blood cell counts(WBC) and bacteria counts(BACT) were determined by COBIO XS automated urine sediment analyzer .By comparing with quantitative urine culture as the golden standard of UTI .The area under the ROC curve(AUC) was constructed to evaluate the dis‐criminative power of variables to predict UTI .Results The positive rate of urine culture was 30 .8% .The isolated rate of Esche‐richia coli ,Enterococcus species and proteus species were 53 .6% ,16 .1% ,10 .7% ,respectively .ROC curve analysis showed that AUC was 0 .808(95% CI 0 .710-0 .867) for WBC and 0 .899(95% CI 0 .797 -0 .923) for BACT .The best cutoff value for WBC was 50/μL ,sensitivity was 89 .0% ,specificity was 83 .8% ,positive predictive value was 86 .3% and negative predictive value was 93 .7% .The best cutoff value for BACT was 110/μL ,sensitivity was 82 .5% ,specificity was 85 .6% ,positive predictive value was 78 .5% and negative predictive value was 88 .0% .Conclusion COBIO XS analyzer is adopted to conduct rapid and reliable a screen‐ing tool for UTI .

Response of EDAG knockout mice to low-dose radiation-induced damage / 军事医学

Objective To generate the erythroid differentiation associated gene(EDAG) knockout mice and analyze their sensitivity to low dose radiation-induced damage.Methods Zinc finger nuclease technology ( ZFNs ) was used to produce the EDAG knockout mice.The low dose radiation-induced damage was evaluated by peripheral blood cell counts, DNA damage and colony formation of bone marrow cells.Wild-type and EDAG knockout mice were irradiated with 0.31 Gy/min X-ray, one minute per day for seven consecutive days, and the cumulative radiation dose was 2.17 Gy(n=7).The blood cell counts were measured by an automated hemocytometer.DNA damage was detected by immunofluorescence assay with a DNA damage marker p-H2A.x antibody (n=3).The colony formation ability of bone marrow cells was evaluated with a semi-solid culture medium(n=3).Results A model of EDAG knockout mice was established.Compared to wide type mice, white blood cell counts of EDAG knockout mice decreased significantly while the DNA damage marker p-H2A.x expression was increased on the third day after X-ray irradiation.The ability of colony-forming was reduced after 7 days of X-ray irradiation.Conclusion Our present study found that EDAG knockout mice are more sensitive to low dose radiation-induced damage as shown by decreased peripheral blood cells counts, reduced colony-forming ability of bone marrow cells, and increased DNA damage.These results suggest that EDAG knockout mice can serve as a powerful tool for evaluation of the biological effects of low-dose radiation damage.

Diffuse Hypermetabolism at Bone Marrow in F-18 FDG PET/CT: Correlation with Bone Marrow Biopsy and Complete Blood Cell Counts / 핵의학분자영상

PURPOSE: Increased FDG uptake in the bone marrow has been reported in patients taking erythropoietin or granulocyte-colony stimulating factor (G-CSF). The aim of this study is to investigate the correlation between F-18 FDG uptake in the bone marrow and bone marrow finding, hematological parameters. MATERIALS AND METHODS: Twenty patients who had diffuse FDG uptake at the bone marrow and received hematological examinations, bone marrow biopsy within 10 days before or after PET/CT were enrolled in this study. Among them, 11 patients were excluded; 4 patients received G-CSF or erythropoietin before PET/CT. Seven patients showed definite pathology in a bone marrow biopsy. The parameters included the measurement of WBC, hemoglobin, platelet and cellularity of the bone marrow. RESULTS: Bone marrow FDG uptake was correlated with a low hemoglobin but not WBC, platelet. Histopathologic findings in marrow biopsies were various: normal finding (n=3), hyperplasia of granulocytic cells (n=2), eosinophilic hyperplasia (n=1), reactive lymphoid nodules (n=1), hypercelluar marrow (n=1), hypocelluar marrow (n=1). All patients except two, showed normal marrow celluarity. CONCLUSION: FDG uptake by bone marrow correlated with anemia but not WBC, platelet, bone marrow cellularity.

Factors Related to the Thrombocytosis in Children with Iron Deficiency Anemia / 대한소아혈액종양학회지

PURPOSE: We investigated to identify factors related to thrombocytosis and clinical data for thrombopoiesis in children with iron deficiency anemia (IDA). METHODS: We retrospectively analyzed clinical and laboratory data for 85 children admitted for acute infection or inflammation. Seventy patients of 85 children were diagnosed as IDA. The others were clinically suspected as IDA but they were not diagnosed. We divided three groups: group 1 included severe anemia below hemoglobin (Hb) 8.0 g/dL, group 2 mild to moderate anemia (Hb: 8.0~10.0 g/dL), and group 3 (control) were clinically suspected but without IDA. RESULTS: There are no differences among groups except age at diagnosis. The age at diagnosis in group 1 are higher than other groups. In control group, there are not any factors correlated with thrombocytosis. In group 1, the white blood cell and lymphocyte counts are significantly related to the platelet counts. However, serum iron level is only correlated with platelets in group 2. In multiple regression analysis, we found significantly correlation between white blood cell counts and serum iron level and thrombocytosis in IDA including group 1 and 2. CONCLUSION: We suggest that white blood cell counts and serum iron level in IDA may be related with increased platelet counts, as a reactive thrombocytosis. We need further study for correlation between acute phase reactants and thrombocytosis in IDA.

Umbilical Nucleated Red Blood Cell Counts and Perinatal Outcome According to Doppler End-Diastolic Velocity in Severe Preeclampsia / 대한산부인과학회잡지

OBJECTIVE: To assess the umbilical nucleated red blood cell counts and perinatal outcomes according to umbilical artery Doppler end diastolic velocity in severe preeclampsia. MATERIALS AND METHODS: A prospective case-control study comparing 42 severe preeclampsia patients who had present umbilical artery end diastolic velocity with 7 severe preeclampsia patients who absent end diastolic velocity for umbilical nucleated red blood cell counts and perinatal outcomes. RESULTS: Those with absent end diastolic velocity did not have significantly greater nucleated red blood cell counts, but they had increased hemoglobin, hematocrit. These newborn had significantly lower birth weight, increased Cesarean section rate for fetal distress and been more frequently admitted to the neonatal intensive care unit. These newborn also had significantly increased intracranial hemorrhage,assisted ventilation and longer hospital days. CONCLUSION: No correlation with nucleated red blood cell counts and chronic fetal hypoxia were presented. However further study with more expanded cases for the role of nucleated red blood cell counts as a marker of fetal hypoxia will be needed.

Clinical Analysis of Patients with Acute Appendicitis Operated on during

PURPOSE: During the night time decision making on patients suspicious of appendicitis is often difficult because diagnosis and timing for operation are frequently delayed. Therefore, we analyzed above cases and solution is suggested. METHODS: This retrospective study included 360 patients who underwent laparotomies for suspected appendicitis at Hanil Hospital during one year, from March 1998 to Feb. 1999. They were divided into two groups according to presenting time to physician (Day time: 6 a.m. to 6 p.m., Night time: 6 p.m. to 6 a.m.). Sex & age distribution, time of presentation to physician, duration of symptoms, symptoms & physical findings, white blood cell counts, interval from presentation to operation, hospital stay, and pathologic diagnosis were compared. RESULTS: There were no significant differences in sex & age distribution, duration of symptoms, symptoms & physical findings, white blood cell counts, pathologic diagnosis between the two groups. However, during the night time, the interval from presentation to operation was longer than that of the day time (9.15 hours versus 4.83 hours, p<0.001), the rate of delayed appendectomy during the night was 58.0%, the rate of negative laparotomy increased when appendectomy was delayed for more than 12 hours compared with less than 12 hours (28.1% vs 11.7%, p<0.01), and in the cases with perforated appendicitis, delayed appendectomy for more than 12 hours had longer hospital stay compared with less than 12 hours (12 days vs 9.44 days, p<0.01). Factors causing delayed appendectomy were related to the physician (42.5%), lack of anesthetic & nursing supports (19.5%), failure to structure the operation team (20.7%), and patient itself (17.3%). When white blood cell counts were rechecked in the next morning, levels above 10,000 cells/mm3 were highly associated with appendicitis in contrast to that below 10,000 cells/mm3 (91.7% vs 43.5%, p<0.002).

Hematotoxic Effect of Formaldehyde in Mice / 环境与健康杂志

Objective To study hematotoxic effect of formaldehyde in mice.Methods Sixty healthy KM mice were randomly divided into a control group and three formaldehyde treated groups named a low level group,a moderate level group and high level group.Themice in the experimental groups were exposed to formaldehyde by intraperitoneal injection,once a day,for three weeks at the dose of 0.2,2.0 and 20 mg/kg bw respectively.Five mice were sacrificed at the 1st,2nd,3rd week of formaldehyde treatment and the blood samples were collected.The red blood cell counts,white blood cell counts and the hemoglobin content in the blood in mice were determined.Results During the experimental period,the body weight of mice in low level group at the 1st and 3rd week decreased significantly compared with the control group.The organ coefficient of the kidney in the moderate level group,high level group at the 1st week were higher than that of control group.The organ coefficient of the spleen in moderate level group at the 2nd week,in all three formaldehyde treated groups at the 3rd week was lower than that of control group.The organ coefficient of the heart in high level group at the 3rd week also decreased markedly in comparison to that of control group.The hemoglobin content in high level group at the 3rd week was lower than that of the control group.The red blood cell counts in three experiment groups at the 1st week and in high level group at the 2nd week decreased markedly compared with the control group.The white blood cell counts were seen much lower in low level group at the first two weeks,in moderate level group at the 1st week and in high level group in the experimental period compared with the control group.Conclusion Formaldehyde exposure has some hematotoxic effects in mice.