Clinical laboratory最新文献

Background: Inflammation and autoimmunity are pivotal contributors to myocardial infarction (MI) risk, with emerging evidence linking autoimmune disorders to MI pathogenesis. To further elucidate this relationship, we conducted a prospective cohort study investigating the prognostic impact of antiphospholipid antibodies (aPLs), antinuclear antibodies (ANA), and anti-extractable nuclear antigen antibodies (anti-ENA) on recurrent MI.

Methods: In this single-center study, 458 patients with acute MI (AMI) were enrolled and prospectively followed for 3 years. Autoantibody profiles, including aPLs (anti-cardiolipin antibodies [ACA], anti-β2-glycoprotein I [anti-β2GPI], lupus anticoagulant [LA]), ANA, and anti-ENA, were assessed and compared between recurrent AMI and non-recurrent AMI groups. The primary endpoints were all-cause mortality and recurrent AMI at 3-, 12-, and 36-months post-enrollment.

Results: Compared to non-recurrent AMI patients, those with recurrent AMI exhibited significantly higher positivity rates for ACA IgG (p = 0.034), ACA IgM (p = 0.039), anti-β2GPI IgG (p = 0.025), anti-β2GPI IgM (p = 0.035), and PLs + ANA/anti-ENA (p = 0.001). Multivariate analysis identified aPLs + ANA/anti-ENA (HR: 2.84, 95% CI: 1.45 - 6.12, p = 0.033), hypertension (HR: 2.83, 95% CI: 1.23 - 5.65, p = 0.027), and hyperlipidemia (HR: 2.67, 95% CI: 1.34 - 5.37, p = 0.039) as independent risk factors of AMI recurrence. The cumulative recurrence rates at 3, 12, and 36 months were 0.7%, 2.6%, and 6.8%, respectively, while the cumulative mortality rates were 6.5%, 12.0%, and 15.9%.

Conclusions: Concurrent positivity for aPLs and ANA/anti-ENA serves as an independent risk factor for recurrent AMI and is associated with increased mortality in AMI patients. These findings underscore the prognostic significance of autoimmune dysregulation in AMI outcomes.

Background: Blood transfusion is effective in treating and managing numerous medical conditions. However, repeated transfusions increase the risk of alloimmunization. This study aimed to determine the prevalence and risk factors associated with alloimmunization in transfusion-dependent patients in the Aseer province.

Methods: This study included 149 patients. Data were obtained retrospectively from medical records and include age, gender, diagnosis, blood group, Rh phenotype, presence of alloantibodies, and transfusion history.

Results: Out of the 149 patients, 78 (52.3%) were male and 71 (48.6%) were female, with a mean age of 24.58 ± 23.21 years (range 1 - 88 years). Alloimmunization was detected in 15 (10.2%) patients, predominantly in those with blood group O (8, 53%) and Rh-D positive status (12, 80%). A significant proportion (12, 80%) had received > 15 transfusion units per year. The most frequently identified alloantibodies were anti-E (4, 26%) and anti K (4, 26%). Alloimmunization was significantly associated with age, Rh-D blood group, and the number of transfusion units received (p ≤ 0.05).

Conclusions: Transfusion-dependent patients are at increased risk of alloimmunization, particularly those with Rh-D positivity, older age, and a high transfusion burden. The risk of alloimmunization could be mitigated by implementing extended red cell phenotyping and matched transfusion strategies. These findings underscore the need for optimized transfusion policies to minimize alloimmunization-related complications in this vulnerable patient population.

Background: We aimed to investigate the correlation of plasma neuropeptide Y (NPY) with specific cognitive domains in patients with Parkinson's disease (PD) cognitive impairment (CI).

Methods: The study included thirty-six PD patients with normal cognitive function (PD-NC), 57 PD patients with mild cognitive impairment (PD-MCI), 30 PD patients with dementia (PDD), and 46 healthy individuals. Every patient underwent thorough clinical evaluations and neuropsychological examinations. Plasma NPY expression was assessed using ELISA. The effects of plasma NYP levels on PD-CI events or PDD were analyzed using univariate and multivariate logistic models. Multiple linear regression analyses were constructed to assess the independent associations of plasma NYP levels with z scores in 5 cognitive domains.

Results: Plasma NYP levels were reduced in patients with PD compared with healthy controls (p < 0.001). Plasma NYP levels were the highest in PD-NC patients and decreased with increasing CI, with the PDD group having the lowest plasma NYP levels. Multivariate logistic regression adjusted for years of education and UPDRS-III subscores showed a significant correlation between NYP and CI (p = 0.005). Plasma NYP was significantly correlated with a linear model between each of the 5 cognitive domains, including attention, executive function, language, memory, and visuospatial function.

Conclusions: Reduced plasma NPY levels are associated with CI in PD patients and are strongly correlated with 5 cognitive domains.

Background: Tropheryma whipplei is a rare pathogenic bacterium, a Gram-positive actinomycete widely distributed in the natural environment. It mainly infects individuals with immunodeficiency, but is rarely observed in individuals with normal immune function. Most patients present with non-specific symptoms, and since it is not feasible to culture the bacteria using conventional methods, diagnosing this infection is very difficult. In this case, next-generation sequencing (NGS) detection via bronchoscopy confirmed the final diagnosis of Tropheryma whipplei infection.

Methods: Bronchoscopy and next-generation sequencing were used.

Results: Through bronchoscopy, NGS of bronchoalveolar lavage fluid indicated the presence of Tropheryma whipplei. Therefore, anti-infective treatment was administered.

Conclusions: For cases of long-standing chest pain of unknown origin with abnormal findings on chest imaging, it is crucial to stabilize the patient's condition while identifying the underlying cause. Prompt implementation of relevant diagnostic procedures, such as bronchoscopy, is essential for establishing a diagnosis.

Background: Idiopathic pulmonary hemosiderosis (IPH) is a rare condition characterized by recurrent alveolar bleeding, hemosiderin deposition, and pulmonary fibrosis, predominantly affecting children. Its diagnosis and management are complex.

Methods: A case involving a 3-year-old female patient with iron deficiency anemia and recurrent pneumonia was analyzed supported by laboratory and imaging investigations. Clinical symptoms included nausea, fever, and pallor.

Results: Initial evaluations indicated moderate anemia (HGB 73 g/L) and signs of infection, with imaging revealing diffuse ground-glass opacities. Following the exclusion of other conditions, a diagnosis of IPH was established, and comprehensive treatment resulted in notable clinical improvement.

Conclusions: This case underscores the importance of multidisciplinary collaboration in diagnosing and managing IPH, particularly in pediatric patients, to enhance outcomes and quality of life.

Background: Titin is a large sarcomeric protein (~ 3,800 kDa) essential for muscle function. The urinary N-terminal fragment of titin (N-titin) has emerged as a noninvasive biomarker for muscle injury in adults, but its clinical significance in neonates remains unclear.

Methods: A retrospective cohort study involving 523 neonates admitted to the NICU/GCU at Nihon University Itabashi Hospital between October 2021 and December 2023 was conducted. Urinary N-titin, collected within 24 hours of birth, was measured using enzyme-linked immunosorbent assay (ELISA) and normalized to creatinine (N-titin/Cr). Associations among neonatal, maternal, and delivery factors were analyzed. A subgroup analysis was performed in neonates with asphyxia. Reference percentiles of N-titin/Cr were separately established for neonates with and without asphyxia. Clinical courses were reviewed for neonates whose N-titin/Cr ratio exceeded the 95th percentile as well as for those with neuromuscular diseases or chromosomal abnormalities.

Results: Urinary N-titin levels negatively correlated with gestational age (p = 0.0035) and Apgar score (p < 0.0001). Positive correlations were found among AST, ALT, LDH, creatine kinase (CK), and lactate levels (all p < 0.0001). Stronger correlations with muscle-derived enzymes were observed in neonates with asphyxia. Higher N-titin levels were associated with non-reassuring fetal status, placental abruption, and emergency cesarean delivery. Six neonates with asphyxia exceeded the 95th percentile; three died and two had mild developmental delays. No neuro-muscular disease was identified. Seven patients with Down syndrome were identified in this study.

Conclusions: Urinary N-titin levels reflect acute perinatal stress, particularly neonatal asphyxia. The establishment of reference values may support its use as an early biomarker in neonates.

Background: Primary mucosal melanoma is a rare tumor that is usually diagnosed at advanced stages. It is of unknown etiopathogenesis with poor prognosis due to unfavorable response to treatments.

Methods: The aim of this study was to analyze the clinical and laboratory characteristics of 28 cases of primary mucosal melanoma in Southwest China.

Results: The mean age of the patients was 57 years, and 12 patients (43%) were men. Gene mutations were detected in 25% of the study population, and patients with gene mutations had a lower risk of relapse compared to patients without mutation (HR 0.258, p = 0.048). The study population had mucosal melanoma originating from head/neck (46%), anorectum (43%), and genital tract (11%). Patients with mucosal melanoma originating from genital tract had a higher peripheral blood lymphocyte-to-monocyte ratio (6.7) and a larger number of eosinophil (0.34 x 109/L) when compared to patients with mucosal melanoma originating from head/neck (3.1; 0.16 x 109/L) or patients with mucosal melanoma originating from anorectum (4.3; 0.14 x 109/L). At diagnosis, 3 patients (11%) developed organ metastasis. Patients with organ metastasis had a higher level of S100 protein (0.706 ng/mL) when compared to patients without metastasis (0.095 ng/mL) or patients with lymph node metastasis (0.067 ng/mL). S100 protein could be used to predict organ metastasis (cutoff value, 0.0935 ng/mL; AUC, 0.924; sensitivity, 0.89; specificity, 0.90).

Conclusions: Among primary mucosal melanoma patients, gene mutations are associated with longer disease-control survival. S100 protein could help to improve the stratification process with a high risk of tumor progression.

Artificial intelligence (AI), including machine learning (ML) and deep learning (DL), has become a crucial element in medical virology, transforming the research and treatment of viral illnesses. AI is transforming viral research and clinical practice by improving genomic analysis, diagnostic accuracy, treatment innovation, and epidemiological modeling. AI's contributions are significant and extensive, encompassing the analysis of intricate viral genomes, the expedited development of antiviral treatments, and the forecasting of disease evolution. Notwithstanding obstacles like data privacy, algorithmic bias, and ethical dilemmas, the amalgamation of AI with advanced technologies, including quantum computing and protein language models, is poised to herald a new epoch of virological advancement. This letter emphasizes the necessity for interdisciplinary collaboration to use AI's transformational capabilities while maintaining stringent ethical monitoring in combating viral infections.

Background: This study aimed to evaluate the correlation between preoperative CA19-9, CEA, CA125, and AFP levels of and prognosis for patients diagnosed with colorectal carcinoma.

Methods: This was a retrospective study, which involved 400 CRC patients treated with radical resection between January 2022 and December 2024 and categorized into two groups: development (n = 280) and validation (n = 120). Clinicopathological data, including age, gender, operative method, tumor size, tumor location, TNM stage, CA19-9, CEA, CA125, and AFP, was assessed. The patients got checked up every three months for the first year, and then every six months afterwards.

Results: Univariate and multivariate analyses revealed that age (> 70 years), tumor staging, N-stage, preoperative CA125, and CA19-9 were associated with the prognosis of CRC patients. Univariate analysis revealed that tumor size (p = 0.026, HR = 1.64, 95% CI = 0.81 - 3.35) and CEA (p = 0.029, HR = 2.73, 95% CI = 0.24 - 4.42) were associated with the prognosis of CRC patients.

Conclusions: This study revealed the prognostic impact of the tumor markers CA125, CA19-9, and CEA in patients with nonmetastatic CRC.

Background: Insufficient blood supply negatively affects transfusion-dependent patients. Sustaining adequate blood units relies on community education. As future healthcare professionals, medical science students may assist in increasing the number of blood donations. This study assessed blood donation knowledge among medical science students at Umm Al-Qura University in Makkah City, Saudi Arabia.

Methods: Twenty-three questions were administered in an online survey to assess knowledge, attitudes, and practices (KAP) of medical science students regarding blood donation. A chi-squared test was used to examine associations with the status of the blood donation.

Results: A total of 286 students from four departments responded to the questionnaire. Remarkably, higher contributions regarding knowledge and attitude questions were observed in female participants, compared to male participants. Furthermore, students that donated blood demonstrated greater awareness of their blood group (p < 0.05), minimum weight legibility, and knowledge regarding the duration of the blood donation procedure (p < 0.01).

Conclusions: This study assessed the KAP regarding blood donation among medical science students at Umm Al-Qura University, Saudi Arabia. Furthermore, the most commonly reported barrier was the belief that the individual was not sufficiently fit or healthy to donate. Consequently, targeted education is crucial to emphasize the importance of blood donation and mitigate hospital blood shortages, especially for patients who require blood transfusion units regularly.