Search Results (564)

Air pollution contributes significantly to morbidity and mortality globally. The Niger Delta Region of Nigeria flares the second largest amount of natural gas in the world, with residents of oil-producing communities bearing the burden of outdoor pollution that may have adverse effects on their health and well-being. Our study aimed to investigate the haematological indices of residents of a selected gas-flaring site. We conducted a cross-sectional study, wherein a total of eighty adults aged 24 to 73 years were recruited from communities located within a radius of approximately 5 to 10 km from the gas-flaring facility. Blood specimens were collected from consenting participants and analysed for various haematological parameters, including Red Blood Cell (RBC) count, Packed Cell Volume (PCV), Haemoglobin (HB), Mean Cell Haemoglobin (MCH), platelet count (PLT), White Blood Cell (WBC) count, neutrophil (NEU), lymphocytes (LYMs), and Monocyte + Basophil + Eosinophil (MXD). The analysis was performed using an automated Sysmex KX21N haematological analyser. Overall, there was a significant decrease in RBC counts (p < 0.001) and a significant elevation in WBCs (p < 0.001) among people residing within a 5 km radius compared to those residing within a 10 km radius. About 42.5% of males residing within a 5 Km radius exhibited low RBC counts in contrast to only 15% of males residing within a 10 km radius. The WBC levels were found to be significantly higher (p < 0.001) than the reference range among both males and females residing within a 5 km radius compared to those residing at a distance of 10 km. In the female population, 15% of individuals residing within a 5 km and 10 Km radius exhibited RBC levels below the reference category, while 7.5% showed RBC levels above the reference range. Exposure to gas flaring may alter haematological indices. It is, therefore, recommended that a comprehensive longitudinal study be conducted among residents of oil-producing communities and workers at gas-flaring facilities in the Niger Delta region of Nigeria to assess the potential environmental and health implications of their exposure to chemical pollutants. Full article

Background and Objectives: Direct oral anticoagulants (DOACs) have become the cornerstone of stroke prevention in the management of atrial fibrillation (AF). While their efficacy in preventing catastrophic outcomes is well documented, the exploration of their effects on haematological parameters, particularly in clinically stable AF patients, remains markedly underrepresented in existing research. The aim of our investigation was to delineate the variations in key haematological parameters, with a special focus on haemoglobin (Hb), in a cohort of clinically stable patients afflicted with AF and receiving diverse oral anticoagulant treatments. Materials and Methods: In this retrospective study, 742 patients with AF were evaluated. Following exclusion criteria, 530 patients were included and categorised based on the change in their Hb levels (ΔHb < 2 [n = 473] vs. ΔHb ≥ 2 [n = 57]) after one year of initial prescription of DOACs. Results: Patients in the ΔHb ≥ 2 g/dL group demonstrated significantly higher baseline haemoglobin levels during the pre-DOAC period (13.5 [12.3–14.6] vs. 14.6 [13.1–15.7]; p = 0.002). Baseline haemoglobin was identified as a predictive factor for a decrease in Hb ≥ 2 g/dL, with higher initial values being associated with more pronounced reductions (OR, 95% CI: 1.424 [1.178–1.723]; p < 0.005). This pattern was observed consistently across various types and dosages of DOACs. Conclusions: This study underscores the importance of vigilant clinical monitoring for anaemia in patients undergoing DOAC therapy, even when their clinical course appears to be stable. Full article

The aim of the present study was the evaluation of the bioaccumulation of cadmium (Cd), Zinc (Zn), Chrome (Cr), Lead (Pb), Iron (Fe) and Copper (Cu), in the blood, serum, tail and mane of horses from the industrialized area of Milazzo (Messina, Sicily), to understand the relationships between haematological parameters: Red Blood Cells (RBCs), White Blood Cells (WBCs), Haemoglobin (Hb), Haematocrit (Hct), Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin (MCH), Mean Corpuscular Haemoglobin Concentration (MCHC), Platelets (PLTs) and the concentrations of trace elements. Blood and hair samples from 20 healthy Italian Saddle horses and water, hay and concentrates samples were obtained to determine the haemogram and mineral concentration using a Thermo Scientific iCAP-Q ICP-MS spectrometer. Descriptive analysis showed a higher concentration of Zn, Cr, Pb, Fe, and Cu in the blood and a higher concentration of Cd in the tail than other substrates. A positive correlation was found for Cr (p < 0.0001) and Zn (p < 0.01) between blood and serum substrates, for Zn (p < 0.001) between mane and tail and for Pb (p < 0.01) between blood and mane, while a negative correlation was observed for Cr (p < 0.01) between blood and tail. Results showed a close relationship between the bioaccumulation of certain trace elements in biological substrates and haematological parameters, which represent useful biomarkers suggesting further studies, given the role of haematological parameters in athletic horses. Full article

Background and Objective: The aim of this study was to evaluate cardiorespiratory fitness (CRF) measures, maximal oxygen consumption (VO₂ max), and minute ventilation/carbon dioxide production (V_E/VCO₂ slope and others) among the T2DM population based on glycated haemoglobin (HBA1c). Material and Methods: The present study comprised a cross-sectional design, with two groups, based on HbA1c values (≤7 and ≥7.1). Laboratory samples were taken to evaluate glycated haemoglobin and fasting blood glucose (FBS). Cardiopulmonary exercise testing was performed to calculate various fitness-related parameters. Data analysis: An independent t-test was used to analyse the outcomes in the two groups. p < 0.05 was considered significant. Linear regression was used to examine the influence of predictor variables on dependent variables. Results: A total of 70 patients agreed to participate in the study, with 19 females and 51 males. The mean (standard deviation) BMI (body mass index) of all participants was 29.7(5.2), the mean (SD) weight was 84.4 (18.9) kg, and the mean height was 167.4 (23) cm. The average age of the individuals was 52 ± 8 years. The independent t-test revealed a significant difference between the two groups in terms of CRF measures. Conclusions: The current research identified the presence of poor glycaemic control and cardiorespiratory fitness measures among the Brazilian population with T2DM. HBA1c, duration of diabetes, age, and BMI can be employed to predict the ventilatory threshold (VT) and VO₂ max. Full article

Previous research has shown that higher glycosylated haemoglobin (HbA1c) levels are related to poorer quality of life. The objective was to analyse the moderating role of emotional intelligence (EI) in the relationship between HbA1c levels and quality of life through both positive (PA) and negative affect (NA) in individuals with Type 1 diabetes (T1D). A total of 72 participants with T1D (mean age = 41.10, SD = 10.73) were assessed on HbA1c. Psychological constructs were measured through the following questionnaires: MSCEIT (EI), PANAS (affect), and EsDQOL (quality of life). Higher levels of HbA1c and NA were related to a worse quality of life. In contrast, higher PA was related to a better quality of life. In addition, higher EI was associated with lower NA and worries about diabetes. In individuals with low EI scores, EI had a positive moderating effect on the relationship between HbA1c and NA. The moderated mediation analysis revealed a significant positive indirect effect of HbA1c on quality of life through NA moderated by EI for these individuals with low EI scores. This study shows how higher HbA1c levels have a negative impact on the quality of life of individuals with T1D and low EI levels by increasing their NA. Full article

Background and Aims: Lynch syndrome (LS) carries a substantial lifetime risk of colorectal cancer which is currently mitigated by biennial colonoscopy surveillance. Paramount to the surveillance programme is the removal of adenomas before malignant transformation but there is an associated service burden and morbidity of repeated endoscopy. We investigated if faecal immunochemical testing (FIT) for faecal haemoglobin has the diagnostic performance to replace colonoscopy. Methods: In this retrospective cohort study, patients due to undergo planned surveillance for LS between November 2020 and April 2022 were sent two FIT kits prior to colonoscopy. Test diagnostic performance of colorectal cancer (CRC), advanced and non-advanced adenoma detection was calculated for single and double FIT strategies. A faecal-Hb of 10 µg Hb/g was considered positive. Results: In total, 78 patients, with 45 (57.7%) female, median age 52 years (IQR 41–63), completed at least one FIT and colonoscopy. The median time from FIT to colonoscopy was 47 days. A single FIT was positive in 7/30 cases of adenoma (2/3 advanced, 5/27 non-advanced). A total of 64 (82.1% of FIT1T returners) completed a second FIT. Using the greatest of the two FITs (FIT2TMAX) 8/26 (2/3 advanced, 4/23 non-advanced), patients with adenomas were identified. There were no cases of CRC. The sensitivity for adenoma detection was 23.3% and 23.1%, respectively. Conclusions: In patients with LS awaiting colonoscopy, FIT has a low sensitivity for detecting adenomas and advanced adenomas. This is not improved by the addition of a second FIT test. Full article

Background/Objectives: Recent studies show conflicting results regarding sex-related differences in outcomes following aortic surgery. This study primarily evaluated 20-year mortality rates, along with 30-day and one- and five-year rates, and postoperative complications in female and male patients who underwent elective and acute ascending aortic surgery at a tertiary care centre. Methods: This retrospective observational study analysed data from 676 adult patients who underwent ascending aortic surgery in Amsterdam UMC, between January 2001 and December 2020. Descriptive statistics, Fisher’s Exact test, Kaplan–Meier survival analysis, and logistic regression were used to assess differences in mortality rates. Results: Patient characteristics for elective and acute procedures were different. Females were generally older (elective: 69 vs. 62 years, p < 0.001, acute: 70 vs. 62 years, p = 0.002), with smaller body surface area (elective/acute: 1.8 vs. 2.1 m², p < 0.001), lower preoperative haemoglobin (elective: 8.3 vs. 8.9 mmol/L, p < 0.001, acute: 7.8 vs. 8.4 mmol/L, p < 0.001) and estimated glomerular filtration rate (elective: 64 vs. 91 mL/min, p < 0.001; acute: 67 vs. 83 mL/min, p = 0.004). Females undergoing elective procedures had a lower body mass index (25.0 vs. 26.6 kg/m², p = 0.006), better left ventricle function (p = 0.048) and higher incidence of chronic obstructive pulmonary disease (15 vs. 8%, p = 0.032). In elective procedures, the 20-year mortality rate (49% vs. 30%, p < 0.001) was significantly higher in females, especially those under 60 years (OR of 3.158 [1.2–8.6], p = 0.024). Mortality rates up to one year were comparable. Five-year mortality rate (26% vs. 16%, p = 0.027) was higher. Females had longer ventilation times (32% vs. 15%, p < 0.001) and intensive care unit stays (2 vs. 1 days, p = 0.005). For acute procedures, morbidity and mortality rates were comparable between sexes. Conclusions: Females under 60, undergoing elective ascending aortic surgery showed higher long-term all-cause mortality rates. Implementing sex-specific management strategies and extended follow-up could be essential for improving outcomes in this group. Full article

Background and Objectives: Diabetic foot sepsis (DFS) accounts for approximately 60% of hospital admissions in patients with diabetes mellitus (DM). Individuals with DM are at risk of severe COVID-19. This study investigated factors associated with major amputation and mortality in patients admitted with DFS during the COVID-19 pandemic. Materials and Methods: Demographic information, COVID-19 and HIV status, clinical findings, laboratory results, treatment and outcome from records of patients with diabetic foot sepsis, were collected and analysed. Supervised machine learning algorithms were used to compare their ability to predict mortality due to diabetic foot sepsis. Results: Overall, 114 records were found and 57.9% (66/114) were of male patients. The mean age of the patients was 55.7 (14) years and 47.4% (54/114) and 36% (41/114) tested positive for COVID-19 and HIV, respectively. The median c-reactive protein was 168 mg/dl, urea 7.8 mmol/L and creatinine 92 µmol/L. The mean potassium level was 4.8 ± 0.9 mmol, and glycosylated haemoglobin 11.2 ± 3%. The main outcomes included major amputation in 69.3% (79/114) and mortality of 37.7% (43/114) died. AI. The levels of potassium, urea, creatinine and HbA1c were significantly higher in the deceased. Conclusions: The COVID-19 pandemic led to an increase in the rate of major amputation and mortality in patients with DFS. The in-hospital mortality was higher in patients above 60 years of age who tested positive for COVID-19. The Random Forest algorithm of ML can be highly effective in predicting major amputation and death in patients with DFS. Full article

Background: Lung cancer carries a high burden of systemic symptoms, including in survivors, leading to a reduced quality of life (QoL). We assessed whether a 12-week multicomponent supervised exercise programme, including muscular strength and aerobic training, was beneficial in patients who had undergone surgery for early non-small cell lung cancer (NSCLC) in terms of physical performance, QoL, and metabolic and nutritional analytical parameters. Methods: Physical performance was measured by gait speed, handgrip strength, 30 s sit-to-stand (30s-STS) test repetitions, distance covered in the 6 min walk test (6MWT), and the Short Physical Performance Battery (SPPB) score. QoL was assessed with the EORTC-QLQ-C30 questionnaire. Blood glucose, cholesterol, triglycerides, total proteins, albumin, pre-albumin, creatinine, c-reactive protein, insulin-growth factor 1 (IGF-1), and the haemoglobin and hematocrit percentages were measured before and after the intervention in order to observe any beneficial effects related to metabolic markers. Results: After the intervention, the mean scores for the 6MWT (p < 0.001), STS (p < 0.001), 6MWT (p < 0.01), and SPPB (p < 0.01) had significantly improved. However, handgrip strength and nutritional analytical were unchanged. The EORTC-QLQ-C30 functions and symptoms significantly improved after the intervention (p < 0.05 and p < 0.01, respectively). A significant decrease in cholesterol, triglycerides, and IGF-1 and a significant increase in pre-albumin in blood was also observed post-intervention (p < 0.05). Conclusions: This supervised, community-based 12-week multicomponent was feasible (adherence rate 70.35%) and provided benefits not only to physical performance but also to the quality of life of patients with NSCLC. Full article

Anaemia in pregnancy is a global problem of significance in all settings. The most common cause is iron deficiency. Large numbers of women are affected, ranging up to 25–30% antenatally and 20–40% postnatally. It is associated with serious adverse outcomes for both the mother and her baby. The risk of low birth weight, preterm birth, postpartum haemorrhage, stillbirth, and neonatal death are all increased in the presence of anaemia. For the infants of affected pregnancies, complications may include neurocognitive impairment. Making an accurate diagnosis during pregnancy has its challenges, which include the choice of thresholds of haemoglobin below which a diagnosis of anaemia in each trimester of pregnancy can be made and, aligned with this question, which are the most appropriate biomarkers to use to define iron deficiency. Treatment with oral iron supplements increases the haemoglobin concentration and corrects iron deficiency. But high numbers of women fail to respond, probably due to poor adherence to medication, resulting from side effects. This has resulted in an increased use of more expensive intravenous iron. Doubts remain about the optimal regimen to of oral iron for use (daily, alternate days, or some other frequency) and the cost-effectiveness of intravenous iron. There is interest in strategies for prevention but these have yet to be proven clinically safe and effective. Full article

Background/Objectives: Lipid metabolism and adiponectin modulate erythropoiesis in vitro and in general population studies and may also affect responsiveness to erythropoietin in patients undergoing haemodialysis (HD). However, little is known about the impact of lipid-associated biomarkers on reticulocyte production and erythropoietin resistance index (ERI) in patients undergoing HD. Therefore, we aimed to investigate their impacts in 167 stable patients undergoing HD. Methods: Pre-dialysis blood samples were collected and analysed for reticulocyte counts and serum lipid profiles by routine analyses and serum carnitine profiles (C0–C18) by LC-MS/MS. ERI was calculated as erythropoietin dose/kg/week normalized for haemoglobin levels. Results: The independent positive determinants of reticulocyte count were log [Triglyceride (TG)] and logC18:1. A large proportion of longer-chain acylcarnitines was positively correlated with reticulocyte counts, possibly resulting from the accumulation of acylcarnitines in mitochondria undergoing fateful exocytosis from reticulocytes. These results indicate a possible association between reticulocyte formation and reduced β-oxidation, which occurs during the peripheral phase of erythroblast enucleation. Total cholesterol (TC) and log [C2/(C16 + C18:1)] as a putative marker of β-oxidation efficiency were negative independent determinants of ERI. Moreover, acyl chain length had a significantly positive impact on the correlation coefficients of individual acylcarnitines with ERI, suggesting that enhanced β-oxidation may be associated with reduced ERI. Finally, adiponectin had no independent association with reticulocyte counts or ERI despite its negative association with HDL-C levels. Conclusions: Enhanced fatty acid β-oxidation and higher TC levels may be associated with lower ERI, whereas higher TG levels and longer acylcarnitines may be related to the latest production of reticulocytes in stable patients undergoing HD. Full article

Objectives: Ankylosing spondylitis (AS) is an autoinflammatory, chronic disease. Patients with AS are at increased risk of cardiovascular disease (CVD). The link between AS and subclinical atherosclerosis is multifactorial and still not completely understood. The aim of this study was to examine the potential associations between carotid intima–media thickness (cIMT) and different cardiometabolic biomarkers in individuals with AS. Methods: A total of 96 patients with AS were prospectively included. cIMT was measured via ultrasonography. Multiple linear regression analysis was used to find the best predictors of cIMT values. Principal component analysis (PCA) was implemented to extract factors that were further tested via binary logistic regression analysis in relation to cIMT. Results: Waist circumference (WC), low-density lipoprotein cholesterol (LDL-c), and the BASDAI score were independently correlated with cIMT in AS patients (p = 0.037, p = 0.060, and p = 0.048, respectively; adjusted R² = 0.113). PCA extracted four panels of biomarkers, i.e., “haematology–lipid-related factor” (i.e., ferritin, haemoglobin, HDL-c, and triglycerides), “proinflammatory–prothrombotic-related factor” (i.e., platelets, neutrophils, and C-reactive protein), “LDL-c–vitamin-related factor” (i.e., vitamins D and B12, and LDL-c), and “age–glucometabolic-related factor” (i.e., age and HbA1c), in relation to higher cIMT in patients with AS. Among these four clusters, “age–glucometabolic-related factor” was an independent predictor of increased cIMT (p < 0.001). Conclusions: In addition to traditional cardiometabolic risk factors, WC and LDL-c, the disease activity score (BASDAI) is independently related to subclinical atherosclerosis in AS patients. The joint involvement of heterogeneous cardiometabolic risk factors may reflect different pathophysiological processes of subclinical atherosclerosis in patients with AS. Full article

Background: Surgery often leads to bleeding associated with hypofibrinogenemia. Supplementation with fibrinogen concentrate appears to be effective and safe, although findings from studies are inconsistent. The primary aim of this study was to assess the safety of fibrinogen concentrate during the perioperative period. Methods: This single-centre, prospective, observational study included adult patients undergoing scheduled or emergency surgery related to bleeding coagulopathy and the administration of fibrinogen concentrate. Patients were followed until their discharge from the institution. Comprehensive data were collected, including age, sex, type of surgery, associated comorbidities, anticoagulant and/or anti-aggregating therapy, and the number of blood transfusions. Laboratory data on plasma fibrinogen concentration, haemoglobin, and platelet count before and after surgery were also collected. The primary outcomes were the mortality rate at discharge and any reported thrombotic or thromboembolic events, including deep vein thrombosis, pulmonary embolism, and myocardial infarction. Results: The study included 91 adult patients who had undergone surgery, with 29 surgeries (32%) conducted in an emergency setting. The mean age was 59.2 years, and 53.8% were male. Major bleeding occurred in 29 cases, mainly in older males and those on anticoagulant therapy. The pre-operative fibrinogen level averaged 161 mg/dL, and the average dosage of fibrinogen concentrate administered was 2.7 g. Eight patients died (8.8%), mostly due to septic or cardiogenic shock, with deaths being more frequent in emergency settings. Thromboembolic events occurred in eight patients, none of whom died. No additional adverse events directly related to the administration of fibrinogen concentrate were reported. Conclusions: Our findings suggest a favourable safety profile for fibrinogen concentrate in surgical patients, as evidenced by a low incidence of deaths and thromboembolic events, which were primarily attributed to other factors. Future research should strive to increase statistical robustness to further illuminate clinically significant patient safety measures. Full article

Background: Despite the implementation of various preventive measures, India continues to experience an alarmingly high under-five mortality rate (U5MR). The most recent nationwide data on U5MRs has provided an opportunity to re-examine the associated factors of U5MRs using advanced techniques. This study attempted to identify the associated determinants of U5MRs via the generalised additive Cox proportional hazards method. Methods: This study analysed the fifth round of unit-level data for 213,612 children from the National Family Health Survey (NFHS-5) to identify the risk factors associated with U5MRs, employing a generalised additive Cox proportional hazards regression analysis. Results: The children who had a length of pregnancy of less than 9 months had a 2.621 (95% CI: 2.494, 2.755) times greater hazard of U5MRs than the children who had a gestational period of 9 months or more. The non-linear association with U5MRs was highest in the mother’s age, followed by the mother’s haemoglobin, the mother’s education, and household wealth score. The relationships between the mother’s age and the mother’s haemoglobin level with the U5MR were found to be U-shaped. Conclusions: This study highlights the importance of addressing maternal and socioeconomic factors while improving access to healthcare services in order to reduce U5MRs in India. Furthermore, the findings underscore the necessity for more sophisticated approaches to healthcare delivery that consider the non-linear relationships between predictor variables and U5MRs. Full article

The nutritional utility of leguminous products such as corticated marama bean (Tylosema esculentum) meal (CMBM) in quail diets is limited by high fibre levels. This study evaluated the impact of dietary CMBM pre-treated with fibrolytic multi-enzyme (FMENZ) on growth performance, and physiological and meat quality responses in Jumbo Coturnix quail. Two hundred and forty 7-day-old Jumbo quail (29.4 ± 2.72 g initial live weight) were randomly distributed to five experimental diets, with six replicate cages each (eight birds/cage). The diets were a grower diet without CMBM, and the same grower diet plus 100 g/kg CMBM pre-treated with 0, 1, 1.5, and 2% (v/w) FMENZ. Positive quadratic responses (p < 0.05) were recorded for overall feed intake and body weight gain in weeks 2 and 3. The control diet promoted the highest (p < 0.05) gain-to-feed ratio in weeks 2 and 3, and the best weight gains and glucose levels, but reduced lipase levels. Final body weights declined linearly [p = 0.037] with FMENZ levels. Breast pH increased linearly, while haemoglobin and 1 h post-mortem chroma showed positive quadratic effects (p < 0.05) with FMENZ levels. The use of the enzymes did not improve the feed value of CMBM in Jumbo quail diets. Full article