RESUMO

PURPOSE: To determine the predictive value of maternal White Blood Cells (WBC), neutrophils, and C-Reactive Protein (CRP) for diagnosing Histological Chorioamnionitis (HCA) among women with Preterm Premature Rupture of Membranes (PPROM) who underwent cervical cerclage. METHODS: A retrospective cross-sectional study was conducted among women with singleton pregnancy and PPROM, who underwent cervical cerclage during 2018-2020. RESULTS: A total of 55 eligible women were included in the final analysis, including 36 (61.02%) cases with HCA and 19 (38.98%) without HCA. Women with HCA had higher WBC count (12.31 ± 2.80) × 109/L and neutrophil count (9.67 ± 2.90)×109/L than those without HCA (10.35 ± 2.53) × 109/L and 7.82 ± 2.82 × 109/L, respectively) (both p < 0.05). The cut-off value of WBC count at 10.15×109/L was found to be the most effective in identifying HCA, with an Area Under Curve (AUC) of 0.707 (95% CI: 0.56-0.86; p = 0.012), sensitivity of 86.11%, specificity of 57.90%, Positive Predictive Value (PPV) of 79.49%, Negative Predictive Value (NPV) of 68.75%, and Youden index of 0.44. The combination of WBC + neutrophil had a slightly higher (AUC = 0.711, 95% CI: 0.57-0.86; p = 0.011), specificity (68.42%), and PPV (81.25%), but lower sensitivity (72.22%), than the WBC count alone. A cut-off value of neutrophil at 7.46 × 109/L was effective in identifying HCA, with an AUC of 0.689 (95% CI: 0.53-0.84; p = 0.022). DISCUSSION: Combination use of WBC+neutrophil was found to be the most accurate predictor of HCA among women with PPROM after surgery of cervical cerclage.

Assuntos

Cerclagem Cervical , Corioamnionite , Nascimento Prematuro , Gravidez , Recém-Nascido , Feminino , Humanos , Corioamnionite/diagnóstico , Estudos Retrospectivos , Estudos Transversais , Biomarcadores

RESUMO

Acute leukemia is usually diagnosed when a test of peripheral blood shows at least 20% of abnormal immature cells (blasts), a figure even lower in case of recurrent cytogenetic abnormalities. Blast identification is crucial for white blood cell (WBC) counting, which depends on both identifying the cell type and characterizing the cellular morphology, processes susceptible of inter- and intraobserver variability. The present work introduces an image combined-descriptor to detect blasts and determine their probable lineage. This strategy uses an intra-nucleus mosaic pattern (InMop) descriptor that captures subtle nuclei differences within WBCs, and Haralick's statistics which quantify the local structure of both nucleus and cytoplasm. The InMop captures WBC inner-nucleus structure by applying a multiscale Shearlet decomposition over a repetitive pattern (mosaic) of automatically-segmented nuclei. As a complement, Haralick's statistics characterize the local structure of the whole cell from an intensity co-occurrence matrix representation. Both InMoP and Haralick-based descriptors are calculated using the b-channel from Lab color-space. The combined-descriptor is assessed by differentiating blasts from nonleukemic cells with support vector machine (SVM) classifiers and different transformation kernels, in two public and independent databases. The first database-D1 (n = 260) is composed of healthy and acute lymphoid leukemia (ALL) single cell images, and second database-D2 contains acute myeloid leukemia (AML) blasts (n = 3294) and nonblast (n = 15,071) cell images. In a first experiment, blasts versus nonblast differentiation is performed by training with a subset of D2 (n = 6588) and testing in D1 (n = 260), obtaining a training AUC of 0.991 ± 0.002 and AUC = 0.782 for the independent validation. A second experiment automatically differentiates AML blasts (260 images from D2) from ALL blasts (260 images from D1), with an AUC of 0.93. In a third experiment, state-of-the-art strategies, VGG16 and RESNEXT convolutional neural networks (CNN), separate blast from nonblast cells in both databases. The VGG16 showed an AUC of 0.673 and the RESNEXT of 0.75. Reported metrics for all the experiments are area under the ROC curve (AUC), accuracy and F1-score.

Assuntos

Leucemia Mieloide Aguda , Humanos , Leucemia Mieloide Aguda/diagnóstico , Leucócitos , Contagem de Leucócitos , Citoplasma

RESUMO

ABSTRACT Purpose: To determine the predictive value of maternal White Blood Cells (WBC), neutrophils, and C-Reactive Protein (CRP) for diagnosing Histological Chorioamnionitis (HCA) among women with Preterm Premature Rupture of Membranes (PPROM) who underwent cervical cerclage. Methods: A retrospective cross-sectional study was conducted among women with singleton pregnancy and PPROM, who underwent cervical cerclage during 2018-2020. Results: A total of 55 eligible women were included in the final analysis, including 36 (61.02%) cases with HCA and 19 (38.98%) without HCA. Women with HCA had higher WBC count (12.31 ± 2.80) × 109/L and neutrophil count (9.67 ± 2.90)×109/L than those without HCA (10.35 ± 2.53) × 109/L and 7.82 ± 2.82 × 109/L, respectively) (both p < 0.05). The cut-off value of WBC count at 10.15×109/L was found to be the most effective in identifying HCA, with an Area Under Curve (AUC) of 0.707 (95% CI: 0.56-0.86; p = 0.012), sensitivity of 86.11%, specificity of 57.90%, Positive Predictive Value (PPV) of 79.49%, Negative Predictive Value (NPV) of 68.75%, and Youden index of 0.44. The combination of WBC + neutrophil had a slightly higher (AUC = 0.711, 95% CI: 0.57-0.86; p = 0.011), specificity (68.42%), and PPV (81.25%), but lower sensitivity (72.22%), than the WBC count alone. A cut-off value of neutrophil at 7.46 × 109/L was effective in identifying HCA, with an AUC of 0.689 (95% CI: 0.53-0.84; p = 0.022). Discussion: Combination use of WBC+neutrophil was found to be the most accurate predictor of HCA among women with PPROM after surgery of cervical cerclage.

RESUMO

Few studies have analyzed the indicators of oxidative stress in marine mammals following exposure to lipopolysaccharides (LPS); sex and maturity-related differences have not been explored. The objective of this study was to compare the indicators of oxidative stress following exposure to LPS for 24 and 48 h in isolated Pacific bottlenose dolphin (Tursiops truncatus; N = 12) leukocytes in relation to sex and maturity stage, using spectrophotometry. Following 48 h under experimental conditions (10 µg LPS mL-1), the leukocytes from males (n = 5) produced significantly more superoxide radical (O2•-; F (1, 8) = 13.965, p = 0.006) and displayed significantly greater activities of catalase (CAT; F (1, 8) = 9.465, p = 0.015) and glutathione S-transferase (GST; p = 0.028) compared to the leukocytes from females (n = 7). Following 48 h under experimental conditions, maturity-stage did not significantly influence the indicators of oxidative stress. Mature bottlenose dolphins (n = 7) had a significantly higher average daily dietary intake compared to immature bottlenose dolphins (n = 5; F (1, 10) = 5.825, p = 0.036). These results suggest that sex-related strategies for coping with a proinflammatory challenge may be present within the leukocytes from bottlenose dolphins, while potential maturity stage-related strategies require further investigation.

Assuntos

Golfinho Nariz-de-Garrafa , Animais , Masculino , Feminino , Lipopolissacarídeos , Leucócitos , Estresse Oxidativo

RESUMO

Piscirickettsia salmonis is the etiological agent of Piscirickettsiosis, a severe disease that affects Atlantic salmon (Salmo salar) farmed in Chile and many other areas (Norway, Scotland, Ireland, Canada and the USA). This study investigated the effects of low-dose P. salmonis infection (1 × 102 CFU/ml) on Atlantic salmon. In this study, we challenged fish with an isolated representative of the EM-90 genogroup via intraperitoneal injection for 42 days. Infected fish displayed decreased haematocrit and haemoglobin levels at day 13 post-infection, indicating erythropenia, haemolysis and haemodilution. Conversely, their white blood cell counts increased on days 13 and 21 post-infection. Additionally, their iron levels decreased from day 2 post-infection, indicating iron deficiency and an inability to retrieve stored iron before infection. Their magnesium levels also decreased at day 28 post-infection, possibly due to osmoregulatory problems. Also, we observed an increase in lactate dehydrogenase activity on days 5, 21, and 28 post-infection, suggesting early symptoms of hepatotoxicity. Later analyses determined a decrease in plasma glucose levels from day 2 post-infection. This may be attributed to the hypoxic conditions caused by P. salmonis, leading to an excess utilization of stored carbohydrates. Our results suggest that the blood parameters we studied are useful for monitoring the physiological status of Atlantic salmon infected with P. salmonis.

Assuntos

Doenças dos Peixes , Salmo salar , Animais , Glicemia , Magnésio , Doenças dos Peixes/microbiologia , Ferro , Lactato Desidrogenases , Hemoglobinas

RESUMO

Knowledge about the immune responses against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, particularly regarding the function of eosinophils, has been steadily emerging recently. There exists controversy regarding the implications of eosinophils in the coronavirus disease 2019 (COVID-19)'s pathology. We report a retrospective cohort study including the comparison of leukocyte counts in COVID-19 patients, considering the outcomes of recovery (n = 59) and death (n = 60). Among the different types of leukocytes, the eosinophil counts were those that showed the greatest difference between recovered and deceased patients. Eosinopenia (eosinophil count < 0.01 × 109/L) was more frequently observed in deceased than recovered patients (p = 0.0012). The eosinophil counts more rapidly increased and showed a greater proportion over the course of the disease in the recovered than deceased patients. Furthermore, the estimated survival rate was greater in patients without eosinopenia than in patients with eosinopenia (p = 0.0070) during hospitalization. Importantly, recovered but not deceased patients showed high negative correlations of the eosinophils with the neutrophil-to-lymphocyte ratio (NLR) and neutrophil counts at Day 9 of the onset of clinical symptoms (p ≤ 0.0220). Our analysis suggests that eosinopenia may be associated with unfavorable disease outcomes and that the eosinophils have a beneficial function in COVID-19 patients, probably contributing by controlling the exacerbated inflammation induced by neutrophils.

Assuntos

COVID-19/sangue , COVID-19/virologia , Eosinófilos , Interações Hospedeiro-Patógeno , Contagem de Leucócitos , SARS-CoV-2 , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores , COVID-19/diagnóstico , COVID-19/imunologia , Comorbidade , Progressão da Doença , Eosinófilos/imunologia , Feminino , Interações Hospedeiro-Patógeno/imunologia , Humanos , Estimativa de Kaplan-Meier , Tempo de Internação , Leucócitos , Contagem de Linfócitos , Linfócitos , Masculino , Pessoa de Meia-Idade , Neutrófilos , Prognóstico , Estudos Retrospectivos , SARS-CoV-2/imunologia , Índice de Gravidade de Doença , Adulto Jovem

RESUMO

Background: Bacteremia is a serious condition. We aimed to assess the role of immature neutrophils in peripheral blood smears for prediction of bacteremia in children. Methods: In this cross-sectional study conducted in Salvador, Brazil, blood cultures collected from patients aged ≤18 years were identified. White Blood Cell count (WBC) was performed upon admission. Medical charts were reviewed and cases from the community were included. Results: Out of 833 potentially eligible patients, 263 (31.6%) were excluded. Therefore, the study group comprised 570 patients being blood collected for culture upon admission from all of them and WBC performed upon admission from 566. The median age was 2 years (IQR: 9.4 mo-5 y) and 300 (52.6%) were male. Acute respiratory infection was the most frequent diagnosis (n = 388; 68.1%), being 250 (43.9%) lower (LRTI) and 138 (24.2%) upper respiratory tract infections. Blood culture was positive in 9 (1.6%; 95% CI: 0.8-2.9%) cases, out of which 7 (2.8%) had LRTI. Streptococcus pneumoniae (n = 3), Haemophilus (n = 2), Neisseria meningitidis, viridans streptococci, Streptococcus agalactiae, and Acinetobacter baumanii (n = 1 each) were isolated. The total WBC/mm3 did not differ when children with positive or negative blood culture were compared (12,100 [IQR: 6,950-15,250] vs. 11,000 [IQR: 7,900-14,900]; P = 0.9). However, presence of any immature neutrophil was significantly more frequent among patients with bacteremia in comparison with patients without bacteremia (100% [9/9] vs. 40% [223/557]; P < 0.001). The absolute number of immature neutrophils was significantly lower among children without bacteremia (0 [IQR: 0-259] vs. 325 [IQR: 275-1,106]; P < 0.001). Overall, the area under the ROC curve of the number of immature neutrophils in regard to bacteremia was 0.82 (95% CI: 0.76-0.88; P = 0.001). Among 413 patients with absolute number of immature neutrophils <242/mm3, none had bacteremia; among 153 patients with absolute number of immature neutrophils ≥242/mm3, 9 (5.9%) had bacteremia. Absolute number of immature neutrophils ≥242/mm3 showed: sensitivity 100% (95% CI: 71.7-100%), specificity 74.1% (95% CI: 70.4-77.7%), negative predictive value 100% (95% CI: 99.3-100.0%), and positive predictive value 5.9% (95% CI: 2.9-10.5%). When only children with LRTI were analyzed, the results were similar. Conclusion: The absolute number of immature neutrophils in peripheral blood smear is a potential tool to rule out bacteremia among children with community-acquired infections.

RESUMO

PURPOSE: The aim of this study was to evaluate the clinical, histological, hematological, and oxidative stress effects of cannabidiol (CBD) in mice with induced oral mucositis. METHODS: We used 90 mice of the CF-1 strain in which oral mucositis was induced using a protocol with 5-fluorouracil (5-FU) chemotherapy. The animals were divided randomly into 10 study groups. Three groups were treated with different doses of CBD (3, 10, and 30 mg/kg), while 2 were control groups (positive control: 5-FU + mechanical trauma + placebo; and negative control: mechanical trauma + placebo), and 2 experimental times were studied (4 and 7 days). All treatments were by intraperitoneal administration. RESULTS: In the clinical evaluation, the groups treated with CBD showed less severity of oral lesions compared with the positive control at both experimental times. The intensity of the inflammatory response was also lower in the groups treated with this drug, but there was no statistically significant difference when compared with the positive control. With regard to erythrocyte, leukocyte, and platelet counts and anti-oxidant enzyme activity, the groups treated with CBD showed better results, but only some of these variables showed statistically significant differences. CONCLUSIONS: CBD seems to exert an anti-inflammatory and anti-oxidant activity favoring a faster resolution of oral mucositis in this animal model.

Assuntos

Mucosite , Estomatite , Animais , Canabidiol , Modelos Animais de Doenças , Fluoruracila/efeitos adversos , Mucosa Intestinal , Camundongos , Estomatite/induzido quimicamente , Estomatite/tratamento farmacológico

RESUMO

The aims of this study were to investigate the frequency of HIV-1 RNA level discordance between the cerebrospinal fluid (CSF) and plasma and of CSF viral escape (CVE) in patients with HIV-1 subtype C on antiretroviral therapy, and evaluate the CSF white blood cell (WBC) performance characteristics in predicting CSF discordance in HIV+ group and the frequency of cognitive impairment in individuals with CSF HIV discordance or escape. HIV-1 RNA levels were assessed in plasma and CSF samples from 68 HIV+ participants without opportunistic infection. CSF discordance was found in 7.4% and CVE in 10%, with comparable frequencies between HIV-1B and C. Twenty samples (29%) showed increased CSF WBC counts. This group had higher CSF and plasma HIV-1 RNA levels than the group with normal WBC counts (p < 0.0001 and 0.006, respectively). The odds of CSF discordance were 18 times higher for a person with CSF WBC count of > 5 cells/mm3 than the group with normal CSF WBC count. CSF WBC counts (cut-off of 15 cells/mm3) showed high-performance characteristics as a predictive biomarker of CSF discordance (AUC the ROC curve 0.98). The frequency of cognitive impairment for CSF escape or discordance was 83% and 80%. The odds of cognitive impairment in these groups were 19 and 15 times higher than those for an HIV(-) person. Viral discordance or escape in the CNS occurs at a comparable frequency for HIV-1C and HIV-1B. The CSF WBC count was effective as a predictive biomarker of CSF and plasma discordance.

Assuntos

Infecções por HIV , Leucocitose/líquido cefalorraquidiano , RNA Viral/sangue , RNA Viral/líquido cefalorraquidiano , Adulto , Fármacos Anti-HIV/uso terapêutico , Feminino , Infecções por HIV/tratamento farmacológico , HIV-1 , Humanos , Masculino , Pessoa de Meia-Idade

RESUMO

INTRODUCTION: Generalized secondary peritonitis is one of the most common emergencies encountered in surgical departments with a mortality of up to 20%. While early prognostic assessment of peritonitis is essential for the objective classification of the severity of the disease, the late presentation of the majority of patients to health facilities affects this situation, further complicating effective management and promoting the occurrence of complications. In Haiti, few studies on surgical pathologies are available, and with regard to peritonitis, only two thesis works have been listed on the subject. This study aims to: explore the demographic, clinical and etiological characteristics of peritonitis in the main referral hospital in the metropolitan region of the Haiti, and evaluate the main delays and its relationship with the severity of the disease by measuring the MPI score. METHODOLOGY: It is a correlational descriptive study, retrospectively carried out over a period of 6 years, from January 2013 to December 2018 in the surgical department of the Hospital of the State University of Haiti. The study population is composed of all patients diagnosed, hospitalized and operated on in the peritonitis ward during the study period Pearson's correlation with α < 0.05 was used as the significance threshold and the correlation of complications and duration of management by Spearman's correlation to assess the relationship between sex, age group, complications and length of hospital stay. A multiple linear regression will be done for the most significant correlations. The comparison of the means was made by the Z test, with α < 0.05 as the significance threshold, and the student T test for variables with two modalities such as complication. The ANOVA test was used to cross-reference dependent and independent variables with more than 2 modalities, and the Pearson chi-square test for qualitative variables with etiological and demographic diagnoses.