Search Results (421)

Background and Objectives: Hematological parameters are increasingly being investigated as readily accessible biomarkers for the diagnosis of obstructive sleep apnea syndrome (OSAS). In our study, we aimed to investigate the relationship between OSAS and albumin indices and the uric acid-to-HDL ratio (UHR). Methods: The demographic and laboratory data and AHI (apnea–hypopnea index) values of 613 patients who underwent polysomnography were obtained retrospectively from their files. Blood parameters such as white blood cells (WBCs), red blood cell distribution width (RDW), red blood cells (RBCs), hemoglobin (Hb), hematocrit (Hct), platelets (PLTs), C-reactive protein (CRP), albumin, blood urea nitrogen (BUN), and high-density lipoproteins (HDLs) were obtained from the files. Laboratory indices such as the BUN-to-albumin ratio (BAR), neutrophil-to-albumin ratio (NAR), RDW-to-albumin ratio (RAR), CRP-to-albumin ratio (CAR), and UHR were calculated. OSAS was categorized as simple snoring (SS) (control) (AHI < 5), mild (5 ≤ AHI < 15), moderate (15 ≤ AHI < 30), and severe (AHI ≥ 30). The patients were also grouped as severe (AHI ≥ 30) and non-severe (5 > AHI < 30) OSAS and compared in terms of laboratory parameters and indices. Results: Of the 613 participants, 366 (59.7%) were men, and the average age of participants was 55.22 ± 11.13 years. The biomarkers such as RBCs, Hb, Htc, CRP, BUN, creatinine, uric acid, HDLs, CAR, RAR, BAR, and UHR showed significant differences between OSAS patients and controls. WBCs, basophils, RBCs, RDW, Htc, PLTs, HDLs, uric acid, RAR, NAR, and UHR indices were significantly different between the severe OSAS and non-severe OSAS groups (p < 0.05). BAR (OR = 1.151; CI = 1.056 − 1.256; p = 0.001) and UHR (OR = 2.257; 95% CI = 1.507 − 3.382; p < 0.001) were the most important indices predicting OSAS, while RAR (OR = 1.844; CI = 1.224 − 2.778; p = 0.003) and UHR (OR = 2.203; 95% CI = 1.496 − 3.243; p < 0.001) were the strongest indices associated with severe OSAS. Conclusion: In our study, RAR, BAR, and UHR indices were closely associated with the presence and severity of OSAS. These indices can be considered low-cost, readily available methods for predicting OSAS patients. Full article

Background/Objectives: This study was designed to investigate the potential clinical, biochemical, haematological, and pathological associations of carpal tunnel syndrome through a multidisciplinary approach encompassing the fields of internal medicine, gastroenterology, and neurology. Methods: The study group (CTS-positive) comprised 265 patients who presented with dyspeptic complaints and underwent upper gastrointestinal endoscopy, gastric antrum biopsy, electromyography, and comprehensive biochemical and haematological analyses. A control group of 265 patients with similar symptoms but without CTS was selected for comparison. A comparative analysis was conducted on clinical findings, gastric biopsy results, and biochemical and haematological parameters. Results: There were no significant differences in age, gender distribution, or gastric biopsy findings (Helicobacter pylori, intestinal metaplasia, atrophy, and dysplasia) between the CTS-positive and CTS-negative groups. However, significant biochemical differences were identified, including elevated calcium and reduced magnesium levels in CTS-positive patients. Haematological evaluations revealed higher lymphocyte, eosinophil, basophil, erythrocyte, haemoglobin, and haematocrit levels, along with reduced neutrophil-to-lymphocyte ratios and red blood cell distribution widths in the CTS-positive group. Further analysis in the form of correlation and logistic regression analyses provided further confirmation of the association of elevated calcium, haemoglobin, and lymphocyte levels with increased risk of CTS. Conclusions: This multidisciplinary study identifies significant associations between CTS and specific biochemical and haematological parameters, notably calcium-magnesium imbalance and erythrocyte indices. These findings suggest underlying biological interactions that may guide future diagnostic and therapeutic strategies for patients with carpal tunnel syndrome. Full article

Background: Elevated serum IgE has been reported in severe COVID-19, suggesting that mast cell activation, allergic-like responses, and possible viral immune evasion occur. Objective: This study aimed to assess serum IgE, IgG, eosinophils, basophils, IL-10, and IL-33 in COVID-19 patients, and evaluate the infiltration of mast cells, basophils, and plasma cells in fatal cases. Methods: This retrospective study included 21 patients with severe COVID-19 or related respiratory conditions hospitalized in Plovdiv, Bulgaria (February 2020–May 2022). Serum immunoglobulins were quantified via immunoassays; IL-10 and IL-33 were also measured. Lung tissues from 30 autopsies were examined histologically and immunohistochemically using CD117 (mast cells) and CD138 (plasma cells). Results: Elevated IgE (>100 IU/mL) occurred in 10/21 patients, with two patients exhibiting levels exceeding 1000 IU/mL. High IgE correlated with reduced eosinophils and basophils, except in post-COVID lobar pneumonia. IL-10 was significantly increased, while IL-33 was reduced in acute and long COVID. Lung histology showed the accumulation of mast cells and plasma cells (5–20/field) during the diffuse alveolar damage and acute respiratory distress syndrome (ARDS) phases, but not in later fibrotic stages. Basophils are located near capillary basement membranes and the endothelium. Conclusions: SARS-CoV-2 may induce IgE-driven allergic-like mechanisms that contribute to severity. Monitoring IgE and mast cell activity may provide prognostic and therapeutic value, while elevated IgG4 could mitigate the effects of IgE. Full article

Aflatoxin contamination of animal feeds may impact broiler chicken health and production. The adverse impact of aflatoxin can be ameliorated and detoxified by adding capable binding agents, such as Saccharomyces cerevisiae. A total of 648 mixed gender 1-day-old Ross-308 were assigned to a 3 × 2 factorial experiment to investigate the effect of aflatoxin B1 (AF) and Saccharomyces cerevisiae (SAC) on growth performance, blood parameters and carcass characteristics. Chickens were randomly allocated to dietary treatments consisting of three levels of AF at 0, 20 and 60 µg/kg, and with or without SAC (10¹⁰ cells/kg) supplementation of 1 g/kg of dried yeast. Results showed that both AF and SAC increased average daily feed intake (both, p < 0.001) and reduced feed efficiency (p < 0.001 and p = 0.035, respectively), while only AF reduced average daily gain (p = 0.009). Supplementation with SAC improved the average daily feed intake in chickens subjected to AF60 (interaction, p < 0.001), suggesting that SAC could improve the appetite of broilers. Chickens fed AF had a lower carcass weight (p = 0.028) and heart weight (p = 0.031), but higher carcass-normalized weight of gizzard (p = 0.038) and liver (p = 0.010). Aflatoxin administration reduced white blood cells (p = 0.030), lymphocytes (p = 0.029) and basophils (p < 0.001), while increasing neutrophils (p = 0.009). SAC reduced neutrophils (p = 0.004) and mean corpuscular haemoglobin (p < 0.001) while increasing lymphocytes (p = 0.003) and basophils (p = 0.015). The haematological results suggest that AF caused a disturbance in the immune system, compromising the health of the chicken, whereas SAC potentially mitigates these alterations. Dietary AF increased the activity of glutamate oxaloacetate transaminase (p = 0.009). These findings suggest a potential use of Saccharomyces cerevisiae as a natural binder to reduce aflatoxicosis in poultry production systems. Full article

The purpose of this study was to evaluate normal values of healthy human bone marrow (n = 56) and identify gender- and age-related variations using cell lineage markers and maturational curves. Using 10-color quantitative flow cytometry, various cell types were identified, including B cells, T cells, NK cells, granulocytes, monocytes, erythroblasts, plasma cells, basophils, mast cells, and dendritic cells. Results revealed significant age-related declines in the absolute counts of nucleated cells (p = 0.001), including CD34+ immature B cells (p = 0.006) and CD34- immature B cells (p = 0.004). Declines were also observed for T cells (p = 0.002), cytotoxic T cells (p < 0.001), double-negative T cells (p = 0.0001), NK cells (p = 0.007), CD16- NK cells (p < 0.001), metamyelocytes (p = 0.002), neutrophils (p = 0.001), basophils (p = 0.009), promonocytes (p = 0.001), mature monocytes (p = 0.007), and plasmacytoid dendritic cells (p = 0.001). Gender differences showed males had more intermediate monocytes (p = 0.009) compared to females. In summary, this study provides normal values for hematopoietic cells, highlighting age- and gender-related disparities critical for understanding hematopoietic dynamics. Full article

Background and Objectives: This study aims to evaluate the diagnostic potential of routinely available hematological parameters for acute myocardial infarction (AMI) by employing an Explainable Neural Network (ENN) model that combines high predictive accuracy with interpretability. Materials and Methods: A publicly available dataset comprising 981 individuals (477 AMI patients and 504 controls) was analyzed. A broad set of hematological features—including white blood cell subtypes, red cell indices, and platelet-based markers—was used to train an ENN model. Bootstrap resampling was applied to enhance model generalizability. The model’s performance was assessed using standard classification metrics such as accuracy, sensitivity, specificity, F1-score, and Matthews Correlation Coefficient (MCC). SHapley Additive exPlanations (SHAP) were employed to provide both global and individualized insights into feature contributions. Results: The study analyzed hematological and biochemical parameters of 981 individuals. The explainable neural network (ENN) model demonstrated excellent diagnostic performance, achieving an accuracy of 94.1%, balanced accuracy of 94.2%, F1-score of 93.9%, and MCC of 0.883. The AUC was 0.96, confirming strong discriminative ability. SHAP-based explainability analyses highlighted neutrophils (NEU), white blood cells (WBC), RDW-CV, basophils (BA), and lymphocytes (LY) as the most influential predictors. Individual- and class-level SHAP evaluations revealed that inflammatory and erythrocyte-related parameters played decisive roles in AMI classification, while distributional analyses showed narrower parameter ranges in healthy individuals and greater heterogeneity among patients. Conclusions: The findings suggest that cost-effective, non-invasive blood parameters can be effectively utilized within interpretable AI frameworks to enhance AMI diagnosis. The integration of ENN with SHAP provides a dual benefit of diagnostic power and transparent rationale, facilitating clinician trust and real-world applicability. This scalable, explainable model offers a clinically viable decision-support tool aligned with the principles of precision medicine and ethical AI. Full article

Background and Objectives: Otitis media with effusion (OME), frequently associated with obstructive adenoid hypertrophy (OAH), is a leading cause of paediatric hearing loss. Clinically distinguishing effusion types (serous vs. mucoid) and predicting postoperative hearing recovery are unresolved challenges. This study evaluated the utility of preoperative blood inflammatory markers in predicting effusion characteristics and short-term hearing outcomes following adenoidectomy with tympanostomy tube (TT) insertion. Materials and Methods: In this retrospective cohort study, 232 children under 12 years old in 2024 and undergoing adenoidectomy (with or without TT insertion) were categorised into serous OME (n = 42), mucoid OME (n = 78), and non-effusion (n = 112) groups. Preoperative blood sample analyses assessed neutrophil, lymphocyte, eosinophil, basophil, and platelet counts, along with derived indices, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), eosinophil-to-basophil ratio (EBR), mean platelet volume (MPV), and systemic immune–inflammation index (SII). Hearing was evaluated at 2 weeks and 1 month postoperatively. Statistical analyses used SPSS v.28, with significance set at p < 0.05. Result: Mucoid OME patients exhibited significantly elevated neutrophil counts, platelet counts, eosinophils, NLR, and SII compared to those in serous OME and non-effusion groups (p < 0.05). All serous OME children achieved normal hearing by the first follow-up, whereas 15.4% of mucoid OME cases had transient mild hearing loss persisting after 2 weeks (p = 0.008; OR=15.97) but resolving by 1 month. Preoperative neutrophil count independently predicted delayed hearing recovery (p = 0.021). Conclusions: Systemic inflammatory markers, particularly neutrophil count, NLR, and SII, effectively differentiate mucoid OME from other effusion types and correlate with short-term hearing recovery. Neutrophil count may serve as a prognostic tool for surgical planning and patient counselling. Prospective studies are warranted to validate these findings in broader paediatric populations. Full article

Indigenous chickens are raised in various rural areas in large quantities throughout Sudan. They must be transported over various distances to centralized slaughterhouses or for other purposes. In this study, we examined indigenous chicken farmers’ perceptions of chicken welfare during transportation. A total of 160 indigenous chickens (80 control + 80 transported with their owners) participated in this study. Our findings revealed that 69% and 88% of the farmers indicated that they were not knowledgeable about animal rights and animal welfare, respectively. The majority of the farmers (86%) reported that they were unaware of animal protection laws. Furthermore, the transported chickens showed a significantly long tonic immobility duration (p < 0.05) compared to the control chickens. Moreover, low pecking behavior was significant (p < 0.05) in transported chickens compared to control, particularly on day one of the experiment. In addition, the mean values of glucose, TWBCs, monocytes, basophils, eosinophils, H/L ratio, Hb, MCHC, and PLT were significantly higher (p < 0.05) in transported chickens compared to the controls. In addition, TNF-a, IL-1β, IL-2, IL-4, IFN-γ, IL-17, as well as ROS, MDA, cortisol, glucose, and total cholesterol were significantly higher (p < 0.05) in transportation chickens compared to control, while CAT, GSH, ATP, and SOD were significantly lower (p < 0.05) in transportation chickens compared to control. We conclude that the traditional transportation of indigenous Sudanese chickens affected their welfare, and this was associated with farmers’ low perceptions of chicken welfare, and stress-induced blood profile changes. Full article

Folic acid and its derivatives (e.g., folinic acid) are a group of water-soluble compounds collectively known as vitamin B9. Synthetic folic acid is a component of dietary supplements, medications and other pharmaceuticals and fortified foods. Folinic acid (5-formyltetrahydrofolic acid) is the active metabolite of folic acid. It is used to treat vitamin B9 deficiency and as an adjunct to various combination therapies. Hypersensitivity reactions to folic acid or folinic acid are rare and occur following exposure to synthetic folic acid or its derivatives but not on natural folates. In people allergic to folates, cross-reactions are possible following exposure to folic acid analogues (including antifolates, e.g., methotrexate). The mechanism of hypersensitivity to folic acid and/or folinic acid has not been clearly established. Both IgE-dependent and non-IgE-dependent hypersensitivity reactions are likely. It is possible that folic or folinic acid is either an immunogen or a hapten. Diagnosing hypersensitivity to folic/folinic acid is difficult. There are no validated in vitro or in vivo diagnostic tests. The basophil activation test (BAT) appears to be a promising tool for diagnosing folate allergy. The aims of the manuscript were to review published clinical cases of hypersensitivity reactions to folic or folinic acid, potential mechanisms of these reactions and possible cross-allergies, and current diagnostic possibilities of folate hypersensitivity. Full article

Specific venom immunotherapy (VIT) in patients with hymenoptera venom allergy (HVA) represents a well-studied approach to reduce the severity of a possible anaphylactic reaction. Currently, data on mechanisms of tolerance induction at the cellular level within the first hours of therapy are lacking. To address this, total and unoccupied high-affinity IgE receptor (FcεRI) numbers per basophil, soluble FcεRI (sFcεRI) and serum tryptase levels were measured before and after the first day of VIT induction in HVA patients. Additionally, basophil activation tests (BATs) were performed at those time points. In the early phase of VIT induction, no significant change in total FcεRI receptor density on basophils was observed, but a significant increase in unoccupied FcεRI was noticeable, predominantly in patients with high total IgE and low baseline unoccupied FcεRI density. No meaningful difference in serum tryptase levels or sFcεRI levels was observed after VIT induction. BATs showed heterogeneous results, often unchanged before and after VIT (in 47% of the cases), sometimes increased (in 40%) and only rarely decreased EC₅₀ sensitivity (in 13%). Changes in the BAT EC₅₀ correlated with FcεRI receptor density changes in basophils. In summary, VIT induction led to an increased ratio of unoccupied-to-total FcεRI without notable tryptase or sFcεRI serum elevation, pointing towards subthreshold cell activation with receptor internalization and recycling. However, the mostly unchanged or even increased basophil sensitivity in EC₅₀ calls for further research to clarify the clinical relevance of these rapid receptor modulations. Full article

Background: Cow’s milk allergy (CMA) is the most common food allergy in children, typically resolving by adolescence. In contrast, the clinical spectrum of allergies to non-cow mammalian milk and their patterns of IgE cross-reactivity are less well documented. Nutritional differences between various mammalian milks may also impact dietary management in milk-allergic patients. Objectives: To characterize clinical features, onset age, and IgE cross-reactivity patterns of non-cow mammalian milk allergies in adult patients seen at a tertiary allergy center, and to compare these findings with published cases. Methods: A retrospective analysis of patients included in the “Extended Laboratory Investigation for Rare Causes of Anaphylaxis study” with mammalian milk allergy was performed using clinical history, skin testing, and serum-specific IgE measurements. Cross-reactivity patterns were assessed in selected cases using immunoblotting, specific IgE inhibition, and basophil activation testing, and compared with published reports of non-cow mammalian milk allergy. Results: In our case series of 22 patients with mammalian milk allergy and 10 healthy control subjects, 3 patients were identified with isolated adult-onset non-cow mammalian milk allergy (n = 1 buffalo milk; n = 2 mare milk), confirmed via immunoblotting and basophil activation testing. Streptavidin-based specific IgE measurement for buffalo cheese was positive in the buffalo milk allergic patient. The literature review identified 82 cases of non-cow mammalian milk allergy. These cases typically showed late onset (mean age 8.6 years; range 1–70 years), severe reactions (CoFAR (Consortium for Food Allergy Research) grade 3 or 4 in 66%, and one fatality), and selective sensitization (affecting sheep and/or goat, camel, mare, buffalo, donkey, or combinations thereof in 56, 10, 5, 5, 4, and 2 cases, respectively). Conclusions: Non-cow mammalian milk allergies are rare but generally present later in life with selective IgE cross-reactivity, differing from the broader cross-reactivity observed in CMA. This selectivity may allow for safe dietary alternatives. These findings underscore the need for improved diagnostics and personalized dietary management in this patient population. Full article

Background: The spleen is the primary reservoir of immune cells in mammals. Diverse stimuli can disrupt spleen homeostasis, resulting in spleen injury and immune dysfunction. This study employed a porcine model to assess the therapeutic potential of salvianolic acid B (SAB) against lipopolysaccharide (LPS)-induced splenic injury. Methods: Seventy-two male weanling piglets were randomly assigned to one of four groups: CON-SS, SAB-SS, CON-LPS, and SAB-LPS. The CON-SS and CON-LPS groups received a basal diet, while SAB-SS and SAB-LPS groups received a SAB-supplemented diet. After 14 d, the CON-SS and SAB-SS groups received an intraperitoneal injection of sterile saline, whereas the CON-LPS and SAB-LPS groups were injected with LPS. Blood and spleen tissues were harvested 6 h post-injection for biochemical analysis. Results: LPS induced systemic immune disorders in piglets, as evidenced by increased immune organ indices and decreased white blood cell, lymphocyte, and basophil counts in blood (p < 0.05). LPS also caused histoarchitectural disruption, cell apoptosis, oxidative stress, and inflammation in the spleen (p < 0.05). Conversely, SAB improved splenic histopathology and reduced splenic apoptosis and pro-inflammatory mediators in piglets (p < 0.05). SAB significantly mitigated peroxidation accumulation by facilitating the nuclear translocation of nuclear factor erythroid 2-related factor 2 and strengthening the antioxidant system, and inhibited nucleotide-binding oligomerization domain, leucine-rich repeat and pyrin domain-containing 3 (NLRP3) inflammasome activation (p < 0.05). Mechanistically, SAB attenuated LPS-induced splenic oxidative stress and NLRP3 inflammasome activation by restoring mitochondrial structure and function (p < 0.05). Conclusions: This research unveils that SAB alleviates LPS-induced spleen disorder by reinforcing antioxidant system and suppressing NLRP3 inflammasome, highlighting SAB’s potential as a prospective therapeutic agent for spleen disorders. Full article

The white snook (Centropomus viridis) is an emerging aquaculture species with high market acceptance, exhibiting catadromous and protandric hermaphroditic characteristics in adulthood. This study aimed to preliminarily characterize certain hematological and biochemical parameters, as well as blood cell morphology, for identifying possible variations between sexes maintained under aquaculture recirculating system (RAS) conditions. The white snook broodstock was anesthetized with clove oil, and biometric values, as well as sex classification, were measured. Then, blood samples were collected from 14 females (7132 ± 1610 g) and 20 males (2200 ± 0.963 g) via caudal vessel puncture to analyze selected hematological parameters, blood biochemistry, and cellular morphology. Fulton’s condition factor (K) showed no differences between sexes, indicating a healthy fish status. Females showed significantly higher serum cholesterol, glucose, and triglyceride levels than males. Also, hematocrit (HCT) and mean corpuscular volume (MCV) were elevated in females. No sex-related differences were observed in red or white cell counts or in blood cell dimensions. Morphological characterization identified erythrocytes, thrombocytes, and three types of leukocytes: lymphocytes (small and large lymphocytes), neutrophils, and monocytes, with no eosinophils or basophils detected in either sex. These findings provide fundamental reference values for the hematological and biochemical profiles of C. viridis broodstock in captivity and highlight sex-specific differences relevant for reproductive and health monitoring. However, it should be considered that the sample size used to establish reference ranges for the species is small, so it is recommended to implement a monitoring plan for this and other broodstocks of this emerging species. Full article

Objectives: The present study aimed to determine the reference intervals for complete blood count and total protein parameters in Greek indigenous Capra prisca goats and to evaluate their associations with parasitic burden, age and reproductive stage. Methods: Two-hundred clinically health goats were grouped by parasite status (gastrointestinal nematodes, Eimeria spp., and lungworm infection), age (3–6-month-old growing kids; lactating non-pregnant goats ≤ 3 or >3 years old) and reproductive stage (non-lactating pregnant goats; lactating non-pregnant goats). Blood samples were analyzed for erythrogram, leukogram and megakaryocytic parameters using an automated analyzer and manual blood smears. Total plasma proteins were measured using refractometry. Results: Gastrointestinal nematode-infected animals (>300 eggs per gram of feces) were associated with a significant reduction in red blood cell counts and hematocrit estimation, and an increase in mean corpuscular hemoglobin and mean corpuscular hemoglobin concentrations, while lungworm-infected animals were associated with decreased red blood cells, red cell distribution width and neutrophils, and increased lymphocytes compared to non-infected animals. Eimeria spp. affected only basophils in growing kids. Age influenced all erythrocytic and leukocytic parameters (apart from neutrophils and monocytes), as well as all megakaryocytic parameters and total proteins, with younger animals showing higher red and white blood cell counts and platelets compared to adults. Pregnant does had elevated hemoglobin, hematocrit, neutrophils and monocytes compared with lactating non-pregnant does. Conclusions: The calculated 95% reference intervals for our demographic groups of animals provide a useful diagnostic framework for assessing Capra prisca health in Greek goat farming. Full article

Background and Objectives: Acute lymphoblastic leukemia (ALL) is a hematologic malignancy characterized by the aberrant proliferation of immature lymphoid cells. Lymphoblasts derived from the B-cell lymphoid lineage are identified as B-ALL. A20, CYLD and Cezanne are deubiquitinase genes that inhibit inflammatory response and tumor progression. Age-related increases in tumor necrosis factor (TNF)-α are associated with poor outcomes in ALL. Little is known about the associations of A20, CYLD and Cezanne with leukocyte accumulation in B-ALL. Materials and Methods: Blood samples of 147 patients with B-ALL and 144 healthy subjects were examined. Gene expression profiles were determined by quantitative PCR, gene polymorphisms by direct DNA sequencing, immunophenotype by flow cytometry and secretion of inflammatory cytokines by an ELISA. Results: Genetic analysis of the A20 gene identified six nucleotide changes in exon 7. Sequencing of the Cezanne gene identified three variants in intron 10. The results indicated that B-ALL patients carrying the A20 p.P348L and Cezanne rs1230581026 variants had higher variant frequencies and lower expression levels than healthy controls. Importantly, carriers of the A20 p.P348L variant had a higher numbers of CD20⁺ and HLA DR⁺ cells than those with a normal genotype, and carriers of the Cezanne rs1230581026 variant had increases in neutrophil, basophil, monocyte, lymphocyte, and CD38⁺ cell counts as well as age-related increases in the levels of TNF-α. Conclusions: The results indicate that the A20 p.P348L and Cezanne rs1230581026 variants are associated with low expression levels of A20/Cezanne, leukocyte expansion and poor outcomes in B-ALL patients. Full article