Search Results (544)

Objective: This study aimed to develop a nomogram prediction model for predicting 14-day in-hospital mortality in patients with acute myocardial infarction (AMI) and ventricular septal rupture (VSR). Methods: Clinical data of 86 hospitalized patients (44 survivors and 42 non-survivors within 14 days) were retrospectively collected in Nanjing First Hospital from 1 March 2015 to 7 August 2025. Lasso regression and multivariable logistic regression were used to identify predictors, which were subsequently incorporated into the nomogram development. The model performance was assessed using area under the receiver operating characteristic curve (AUC), calibration plots, decision curve analysis (DCA), and clinical impact curves, with internal validation via 1000 bootstrap resamples. Results: Analysis of lasso regression and multivariable logistic regression analysis identified WBC count (OR = 1.31, 95% CI: 1.01–1.28, p = 0.040), D-dimer level (OR = 1.18, 95% CI: 1.01–1.38, p = 0.043), early revascularization (OR = 0.22, 95% CI: 0.06–0.88, p = 0.032), ventilatory support (OR = 3.48, 95% CI: 1.07–11.29, p = 0.038), and infection (OR = 3.97, 95% CI: 1.02–15.42, p = 0.047) as independent predictors of 14-day mortality for patients. Based on the results, a prediction nomogram model was constructed. The model achieved an area under the receiver operating characteristic curve (AUC) of 0.866 (95% CI: 0.785–0.946), with sensitivity of 0.857 (95% CI: 0.751–0.963) and specificity of 0.818 (95% CI: 0.704–0.932). Calibration plots demonstrated acceptable agreement between predicted and observed probabilities; decision curve analysis (DCA) and clinical impact curve further confirmed its net benefit and clinical utility. By 1000 bootstrap resampling iterations, the model demonstrated an apparent AUC of 0.864, 95% CI: 0.776–0.938, confirming reasonable discriminative performance. Conclusions: In summary, this study developed a clinical interpretable nomogram to estimate short-term (14-day) in-hospital mortality risk in patients with AMI-VSR; it provides a robust and interpretable tool for predicting short-term in-hospital mortality. Full article

Objective: The purpose of this study was to determine the biological association between host-derived HSP47 and fungal-derived HSP90 in the context of vulvovaginal candidiasis (VVC) and to examine their relationships with clinical, inflammatory, and metabolic phenotypes in infected and healthy women. Methods: This study followed a six-month case–control design (February–July 2025) and was conducted at the University of Tabuk Hospital in Tabuk, Saudi Arabia. A total of 84 women aged 18–45 years were recruited, of which 42 were VVC-infected, and 42 were healthy controls. ELISA kits were used to test vaginal swabs for HSP47 and HSP90. Clinical, hematological, cytokine, and metabolic markers were also evaluated. Mann–Whitney U, Spearman correlation, and multiple linear regression tests were performed to analyze the data. Results: The levels of HSP47 and HSP90 were significantly higher among infected patients (2.29 ng/mL and 3341 ng/mL, respectively) when compared with controls (0.58 ng/mL and 1025.7 ng/mL; p < 0.001). Women who were infected were older (p = 0.02), but there were no significant differences in terms of BMI (p = 0.29). The levels of vitamin D and adiponectin were significantly decreased (p < 0.001), while pro-inflammatory cytokines (IL-6, TNF-α, IFN-γ, TGF-β, and IL-8) and WBC counts were higher compared to the control group. The hematology results were characterized by inflammation-related anemia and disturbed protein metabolism. The ROC analysis demonstrated good diagnostic performance, with an AUC of 1.0 in the case of HSP47 and 0.905 in the case of HSP90. In the case of the infected patients, the regression models were found to be weak (HSP90 R² = 0.154; HSP47 R² = 0.273), although HSP47 retained significant connections with IL-8 (p = 0.005) and IFN-γ (p = 0.028). Conclusions: High levels of HSP47 and HSP90 are observed in VVC, reflecting an epithelial stress response and fungal persistence. These HSPs have high diagnostic accuracy, which justifies their potential as biomarkers for the timely detection of VVC; they also have further implications as early biomarkers for prognostic and treatment monitoring support, despite the poor predictive models. This study has some limitations that must be addressed; in particular, the regression analyses failed to provide statistically significant predictive models, likely due to the limited sample size. In addition, the specificity of HSP90 and HSP47 for VVC in comparison with other vaginal infections was not evaluated. Full article

Circulating tumor cells (CTCs) are valuable liquid-biopsy biomarkers, yet their extreme rarity makes high-purity, high-throughput enrichment challenging. In spiral inertial microfluidics, high cell loading induces long-range hydrodynamic interactions that broaden the focused blood-cell stream; consequently, a subpopulation completes the ~0.5 and ~1.0 Dean-cycle migrations with a phase delay, compressing the CTC–blood cell gap and degrading purity. Here we propose a Dean-cycle phase-regulated double-spiral design informed by this phenomenon. This design aims to mitigate the stream-broadening effect by boosting the Dean number during the first half-cycle to promote synchronized blood-cell migration and shifting the CTC equilibrium position near one full cycle to further widen the CTC–blood cell separation. We implement this strategy in a second-generation double-spiral microfluidic chip (SDMC) and scale it to a four-channel parallel array (ASDMC). Under optimized conditions, ASDMC processes diluted whole blood (hematocrit = 4%) without the need for red blood cell (RBC) lysis or antibody labeling, achieving a sample throughput of 1200 μL·min⁻¹. Specifically, it exhibits a mean recovery rate of 98.8% across three spiked tumor cell lines (MCF-7, PC-9, and Mahlavu) and a mean white blood cell (WBC) depletion efficiency of 93.3%. In a pilot clinical testing of 20 patients (NSCLC and HCC), enriched fractions enabled immunofluorescence identification of CK⁺CD45⁻DAPI⁺ CTCs, with an exploratory trend of increasing CTC counts with advanced disease stage (4–34 cells·mL⁻¹). These results describe a scalable, label-free platform, and the observed purification performance aligns with our proposed mechanism: Dean-cycle phase regulation to mitigate blood-cell migration lag. Our findings support further technical validation and clinical assessment in larger cohorts. Full article

Objective: The aim of this case series was to investigate the safety and efficacy of vancomycin–gentamicin embedded PMMA beads (VGPB) in the setting of acute pyogenic soft tissue infections (STIs) of the extremities. Materials and Methods: A retrospective study of 19 cases diagnosed with pyogenic STIs of the lower or upper extremity in two academic institutions was conducted between January 2017 and December 2023. All patients underwent surgical debridement, systemic antibiotics and intrawound deposition of vancomycin and gentamicin embedded cement beads (2 g of vancomycin plus 1 g of gentamicin diluted in 40 g of PMMA). Upon second look (4th–7th day post-index surgery) the cement beads were removed, serum samples from the surgical site of infection and from peripheral blood were obtained and the concentration of eluted vancomycin and gentamicin was measured. Furthermore, the white blood cell count (WBC), C reactive protein serum levels (CRP) and erythrocyte sedimentation rate (ESR) were measured before the surgical debridement and after the end of the bead therapy. All patients were reevaluated after discharge with a mean follow-up of 4.4 years (range, 1 to 7.6). Results: Wound vancomycin and gentamicin levels were significantly higher than those measured in the serum (34.01 ± 4.47 μg/mL versus 11.96 ± 2.79 μg/mL, p < 0.001 and 5.75 ± 1.22 μg/mL versus 0.51 ± 0.14 μg/mL, p < 0.001 respectively). Serum vancomycin and gentamicin concentrations were below the level of toxicity and no adverse events related to antibiotic-embedded bead treatment were documented. Serum WBC, ESR and CRP levels before debridement (13,446 ± 935.7 c/μL, 42.3 ± 18.7 mm/h and 113.9 ± 20.26 mg/L respectively) were significantly higher than those after the end of treatment (7889 ± 1203.6 c/μL, p < 0.001; 30.3 ± 9.14 mm/h, p = 0.017; and 22.7 ± 6.68 mg/L, p < 0.001 respectively). Two cases (10.5%) had a local recurrence of their STIs. Both of them relapsed within 4 months after their treatment and both had Gram-negative pathogens. Conclusions: Vancomycin–gentamicin PMMA bead pouch therapy appears to be a safe and effective adjuvant treatment for pyogenic soft tissue infections, offering high local antibiotic availability without systemic adverse effects. Full article

Background: An unfavorable course of SARS-CoV-2 infection can lead to significant morbidity and mortality. The study aimed to develop a simple, accessible, and reliable tool to anticipate the poor results among COVID-19 pneumonia patients. Methods: This retrospective cohort study involves 306 individuals with severe COVID-19 pneumonia enrolled between March 2021 and June 2021. Each patient had confirmed SARS-CoV-2 infection and required oxygen therapy. Differential blood count and serum CRP were taken on admission day. Medical data were collected from the hospital’s information system. Results: Of 306 patients (133 females, 173 males, aged 66.3 ± 15.2 years), 105 (34.3%) died. Counts of neutrophils, lymphocytes, and eosinophils differed significantly between survivors and deceased (p < 0.001; p = 0.002; p = 0.009, respectively) and had substantially differentiating properties in ROC analysis. Built with the counts of neutrophils, lymphocytes, and eosinophils, the White Blood Cell Score (WBCS) was developed. WBCS robustly predicted mortality (OR = 2.821; CI: 2.037–3.906; p < 0.001) in the investigated population. Cumulative risk of death according to WBCS (ranging from 0 to 3 points) was as follows: 0 points—10.9%, 1 point—23.5%, 2 points—33.1%, 3 points—34.1%. Conclusions: Based on differential blood count, the proposed WBCS is easy to use and can be helpful in predicting mortality among severe COVID-19 patients. Full article

Background/Objectives: Dietary fiber has been associated with lower levels of inflammatory biomarkers, but nationally representative evidence using recent U.S. data remains limited. We evaluated the association between dietary fiber intake and inflammatory biomarkers in U.S. adults using the National Health and Nutrition Examination Survey (NHANES) 2017–2018, the last fully completed cycle before the COVID-19 pandemic, providing a pre-pandemic benchmark for future comparisons. Methods: We analyzed 3570 adults (≥20 years) from NHANES 2017–2018 with complete dietary and biomarker data. Fiber intake was averaged from two 24 h recalls. Outcomes included serum high-sensitivity C-reactive protein (hs-CRP; primary outcome), white blood cell count (WBC), and neutrophil count. Survey-weighted regression models adjusted for demographic, socioeconomic, lifestyle, clinical, and dietary covariates. Associations were examined continuously (per 5 g/day fiber), by quartiles, and with restricted cubic splines. Sensitivity analyses excluded participants with cardiometabolic conditions or modified covariate sets. Results: Each 5 g/day higher fiber intake was associated with 4–7% lower hs-CRP (p < 0.001). Participants in the highest versus lowest fiber quartile had 20.7% lower hs-CRP (95% CI −27.1, −14.4) and 47% lower odds of elevated hs-CRP (OR 0.53, 95% CI 0.32–0.85). Secondary outcomes showed significant inverse associations: each +5 g/day was associated with −0.98% WBC (95% CI −1.84, −0.13; p = 0.024) and −1.44% neutrophils (95% CI −2.62, −0.26; p = 0.017) in fully adjusted models. Spline analyses showed no nonlinearity for WBC (p = 0.227) but nonlinear inverse associations for neutrophils (p = 0.0017). Sensitivity analyses confirmed robustness to exclusion of individuals with diabetes, hypertension, or hyperlipidemia, and to alternative covariate specifications. Conclusions: Higher dietary fiber intake was independently associated with a more favorable inflammatory biomarker profile (hs-CRP, WBC, and neutrophils) in U.S. adults, providing a pre-pandemic benchmark for future comparisons. Longitudinal and interventional studies are needed to clarify temporality and causality. Full article

Objective: This study aims to investigate the correlation between blood leukocyte, CRP, LDH, and cytokine levels and the severity of illness in children with adenovirus pneumonia. Methods: A total of 100 children with adenovirus pneumonia (55 mild cases and 45 severe cases) who were treated at Guangzhou Women and Children’s Medical Center from January 2022 to January 2024, and 40 healthy children as a control group, were selected. Clinical data, some laboratory test data, and serum cytokine levels detected by flow cytometry were collected, and statistical methods were used to analyze the correlation between relevant indicators and the severity of the illness. Results: The research showed that among general clinical manifestations, the proportions of children with fever, dyspnea, pleural effusion, and moist rales in the severe group were all higher than those in the mild group (p < 0.05). Among the collected laboratory test data, indicators such as WBC, neutrophils, and LDH were significantly higher than in the mild group and the control group (p < 0.05) and were positively correlated with the severity of the disease. Regarding the tested cytokines, most children with adenovirus pneumonia showed elevated levels, and cytokines such as IL-6, IL-2, and IL-8 were significantly positively correlated with the disease. In the ROC curve analysis, NEU 6.03 × 10⁹/L (sensitivity 82.2%, specificity 72.7%, AUC 0.830) and IL-6 41.823 pg/mL (sensitivity 75.6%, specificity 81.8%, AUC 0.833) demonstrated certain value in the early identification of children with severe disease. Conclusion: In this study, laboratory indicators (C-reactive protein, lactate dehydrogenase, neutrophils, etc.) and changes in the levels of specific cytokines (TNF-β, IL-2, IL-6, IL-8, etc.) in children with adenovirus pneumonia were closely related to the severity of the disease. Notably, neutrophil count and interleukin-6 were significantly positively correlated with disease severity and had high AUC values, suggesting they may be important parameters for early prediction of the progression of mild adenovirus infection to severe disease. Full article

Platelet-rich gel (PRG) is a fibrin-based biobased biomaterial generated by activating platelet-rich plasma (PRP), yet its biological characterization has commonly relied on univariate measurements of isolated mediators. This study aimed to define the multivariate biological organization of PRG and related hemocomponents (PRP, chemically induced platelet lysate (CIPL), and plasma) in a canine model under single exposure to non-steroidal anti-inflammatory drugs (NSAIDs). In a randomized crossover design (n = 6 dogs), hemocomponents were produced at baseline (0 h) and 6 h after administration of carprofen or firocoxib. Platelet and white blood cell (WBC) counts, growth factors (platelet-derived growth factor-BB (PDGF-BB) and transforming growth factor beta-1 (TGF-β1)), and cytokines (tumor necrosis factor alpha (TNF-α), interleukin-1 beta, and interleukin-10) were integrated using linear mixed-effects modeling, principal component analysis (PCA), and hierarchical clustering. PRG was derived from a leukocyte-poor PRP precursor with moderate platelet enrichment (~1.6-fold vs. whole blood) and a marked WBC reduction (~8–9-fold). In mixed-effects modeling, hemocomponent type significantly influenced the PDGF-BB:TNF-α log-ratio, with PRG (estimate −1.12; 95% CI −1.34 to −0.90) and plasma (−2.06; 95% CI −2.28 to −1.84) lower than PRP, while CIPL did not differ. Time and NSAID effects were not supported. PCA identified two orthogonal axes explaining 61.3% of total variance (PC1 = 43.7%, PC2 = 18.6%), separating a platelet/trophic dimension (log(PDGF-BB), log(TGF-β1), platelet count, PDGF-BB:TNF-α log-ratio) from an inflammatory dimension (log(TNF-α), log(IL-1β)). Overall, hemocomponent composition emerged as the primary determinant of mediator organization, supporting the interpretation of PRG as a structured, biomaterial defined by coordinated mediator networks. Full article

Background: BH3 mimetics (such as venetoclax and navitoclax) are increasingly investigated in the context of the “one-two punch” anticancer strategy, wherein senescence-inducing therapies are combined with senolytic clearance. However, real-world pharmacovigilance evidence describing hematologic adverse event (AE) patterns and serious outcomes for venetoclax versus navitoclax in such combination settings remains limited. This study aims at providing an expectation based on the current reporting of the safety implications of senolytics combined with senescence-inducing therapy in clinical practice. Methods: We analyzed de-duplicated U.S. FDA Adverse Event Reporting System (FAERS) reports retrieved on 1 August 2025. Venetoclax reports (Q2 2016–Q2 2025) were categorized as monotherapy or combination with senescence-inducing chemotherapy (predefined based on published evidence of therapy-induced senescence [TIS]). Hematologic AEs were grouped into three categories (isolated low WBC, isolated low platelet count, and multi-lineage cytopenia). Disproportionality analyses were conducted using the Reporting Odds Ratio (ROR) and Proportional Reporting Ratio (PRR) with 95% CIs and chi-squared testing. Navitoclax reports were analyzed descriptively due to limited volume. Results: A total of 47,508 venetoclax reports were included (34,485 monotherapy; 13,023 combination). Compared with monotherapy, combination therapy showed disproportionate reporting signals (ROR/PRR; reflecting reporting disproportionality rather than incidence or causal risk) for low WBC (ROR 2.87, PRR 2.59) and multi-lineage cytopenias (ROR 3.54, PRR 2.94), while isolated low platelet count was under-represented (ROR 0.31, PRR 0.32). For outcomes, combination therapy demonstrated higher reporting signals for life-threatening outcomes (ROR 7.06, PRR 6.56), hospitalization (ROR 1.74, PRR 1.39), and other outcomes (ROR 2.36, PRR 1.57), while death (ROR 0.55, PRR 0.65) and non-serious outcomes (ROR 0.26, PRR 0.29) were proportionally less reported (all p < 0.001). Navitoclax had 172 reports; hematologic cytopenias and serious outcomes were frequent, but analyses were descriptive only. Conclusions: In FAERS, venetoclax combined with senescence-inducing chemotherapy shows stronger reporting signals for leukopenia and multi-lineage cytopenias and for several serious outcome categories compared with monotherapy. These reporting patterns highlight the need for further care in terms of clinical implementation of the currently investigated senolytics prior to the consideration of the “one-two punch” strategy. Full article

Volatile organic compounds (VOCs) are ubiquitous environmental pollutants, and mixed VOC exposure has been linked to systemic inflammation. However, evidence remains limited regarding source-oriented VOC exposure patterns and their associations with inflammatory biomarkers in the general population. Using data from 1812 Korean adults participating in the Korea National Health and Nutrition Examination Survey (KNHANES) from July 2020 to August 2021, we identified source-oriented urinary VOC exposure patterns through factor analysis, yielding combustion-dominant and solvent-dominant indices. Environmental relevance was evaluated using an airborne VOC index, and associations with white blood cell (WBC) count were examined using generalized linear models, including interaction analyses by smoking status (defined specifically as conventional cigarette users). Both urinary indices were significantly associated with the airborne VOC index (p < 0.05), supporting their environmental validity. In models without interaction terms, the solvent-dominant index was positively associated with WBC count (β = 0.091, p = 0.030), while the combustion-dominant index did not reach statistical significance (β = 0.107, p = 0.081). However, significant interactions by smoking were observed for both indices (p for interaction < 0.001). Among conventional smokers, higher exposure to both combustion-dominant β = 0.614, p < 0.001) and solvent-dominant β = 0.571, p < 0.001) patterns was significantly associated with increased WBC counts, whereas no such associations were found among non-smokers. These findings indicate that while VOC patterns impact systemic inflammation, the associations are significantly modified by cigarette smoking. Our results underscore the importance of source-oriented approaches and the explicit evaluation of effect modification when assessing the health impacts of mixed VOC exposure. Full article

Central nervous system (CNS) evaluation for leukemic involvement is essential both at initial diagnosis and throughout relapse surveillance in childhood acute lymphoblastic leukemia (ALL). Accurate CNS risk classification is a cornerstone of individualized chemotherapy and has significantly advanced treatment strategies. However, detecting leukemic cells in the cerebrospinal fluid (CSF) is challenging, particularly when only a small number of cells are present. While cytomorphology remains a standard diagnostic method, it is limited by low sensitivity and interobserver variability, especially in low-cellularity or equivocal samples. Flow cytometry offers superior sensitivity and specificity and is increasingly recommended to confirm or clarify ambiguous findings. Current guidelines support the use of both cytomorphologic review and flow cytometry to maximize diagnostic accuracy. Evidence consistently demonstrates that any detectable CSF blasts—even in the setting of low WBC counts—are associated with increased risk of CNS relapse and poorer outcomes, underscoring the importance of risk-adapted CNS-directed therapy. Although the prognostic significance of isolated flow-only positivity remains under study, emerging data suggest that timely therapeutic intensification may mitigate adverse outcomes. Additional modalities, including advanced flow cytometry and molecular assays, may further refine CSF assessment in the future. This review summarizes current diagnostic approaches and highlights the need for standardized protocols for CSF evaluation in pediatric ALL. Full article

Background: The Sysmex XN series (XN-1000 and XN-9100, Sysmex Corporation, Kobe, Japan) represents a latest-generation automated hematology platform integrating fluorescence-based technologies and multi-channel analysis (WDF and WPC) to improve leukocyte characterization. This study aimed to evaluate the performance of the Sysmex XN series in detecting leukocyte abnormalities flagged during routine complete blood count analysis in a large cohort of healthy donors, using morphological assessment and flow cytometry as confirmatory methods. Methods: Approximately 8000 healthy blood donors from the AOU Meyer Transfusion Centre were evaluated between 2021 and 2024. All samples underwent CBC analysis using the XN-1000 and XN-9100 analyzers with the WDF channel. Samples showing WBC-related flags were subjected to reflex testing with the WPC channel, followed by digital blood smear review using the DI-60 system (CellaVision, Lund, Sweden) and flow cytometric immunophenotyping. Results: WDF flags for “blasts/abnormal lymphocytes” were identified in 23 samples. Two samples were negative on WPC analysis as well as on morphological and flow cytometric evaluation. Among the remaining cases, WPC analysis identified flags for abnormal lymphocytes, atypical lymphocytes, or blasts, which were variably associated with reactive changes, transient immune activation, or clonal lymphoproliferative conditions. In one donor, monoclonal B-cell lymphocytosis was diagnosed by flow cytometry. Overall, reactive morphological features confirmed by flow cytometry were observed in approximately 50% of flagged cases. Conclusions: WPC analysis provides relevant additional diagnostic information and demonstrates higher specificity compared with the WDF channel alone; however, it does not fully resolve all instrument-generated flags, confirming the essential role of morphological assessment. Interestingly, the frequent occurrence of inflammatory profiles in recently vaccinated donors suggests that transient immune activation may influence leukocyte flagging. Larger studies are warranted to further investigate this association and to optimize the diagnostic performance of the WPC channel in donor screening. Full article

Background: This study aimed to identify factors influencing non-invasive ventilation (NIV) outcomes in patients with hypercapnic respiratory failure due to various respiratory conditions in a resource-limited intensive care unit (ICU) setting. These predictors can guide us in the prompt decision of ventilation, resulting in better outcomes. Methods: Patients requiring NIV for hypercapnic respiratory failure of any cause were included. Arterial blood gases were measured at 1 and 24 h, and an improvement in pH ≥ 7.35 was taken as a cut-off for early and late physiological responses, respectively. Binary regression analysis was used to identify predictors of physiological response, need for mechanical ventilation, and mortality. Results: Among 226 patients (139 males), the underlying causes were obstructive (71%), restrictive (25%), and infective disorders (4%). Older age, higher one-hour PCO₂, FiO_2, and respiratory rate were associated with increased mortality. Late physiological response correlated with higher IPAP and WBC counts, while higher WBC counts also predicted need for mechanical ventilation on binary logistic regression. Conclusions: Higher one-hour PCO₂, older age, higher FiO₂, respiratory rate, WBC count, and IPAP predicted an unfavorable outcome of NIV in acute hypercapnoic respiratory failure. Locally generated data can support timely escalation to mechanical ventilation and inform patient selection for initial NIV therapy in resource-limited settings. Full article

Accurate preoperative diagnosis of periprosthetic joint infection (PJI) is difficult, complicating distinction between septic and aseptic failures. This study assessed the value of common serum biomarkers and three calculated ratios—albumin–globulin ratio (AGR), C-reactive protein–albumin ratio (CAR), and C-reactive protein–AGR ratio (CAGR)—in diagnosing PJI after primary total hip arthroplasty (THA). We retrospectively reviewed patients undergoing revision THA for PJI or aseptic failure from 2011 to 2021 at a single institution. Inclusion required reported serum white blood cell count (WBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), albumin (Alb), and total protein (TP). Diagnostic performance was evaluated using areas under the curve (AUCs), with higher values indicating better accuracy. Ratios were defined as: AGR = Alb/[TP − Alb], CAR = CRP/Alb, and CAGR = CRP/AGR. Among 128 cases, 67 were PJI and 61 aseptic. AUCs were: WBC (0.53), CRP (0.69), ESR (0.75), Alb (0.69), Glb (0.63), TP (0.53), AGR (0.72), CAR (0.70), and CAGR (0.71). Optimal cutoff, sensitivity, and specificity were: CRP (10.5, 0.76, 0.59), ESR (41.0, 0.70, 0.72), AGR (1.10, 0.64, 0.75), CAR (3.37, 0.73, 0.64), and CAGR (10.9, 0.75, 0.66). ESR, AGR, CAR, and CAGR demonstrated acceptable accuracy. These readily available markers and ratios may aid PJI diagnosis, supporting improved clinical decision-making. Full article

Background and Objectives: This study aimed to explore peripheral blood and OCT risk biomarkers that may modify the anatomical and functional response to intravitreal bevacizumab (IVB) treatment in diabetic macular edema (DME). Materials and Methods: The study included patients with non-proliferative diabetic retinopathy (NDR) who had not previously undergone laser photocoagulation or IVB. Data on demographics, hemogram, and biochemistry within one month before treatment were collected. Best corrected visual acuity (BCVA), intraocular pressure (IOP), and spectral-domain OCT (SD-OCT) measurements were recorded before and after three monthly IVB injections. OCT parameters included central macular thickness (CMT), inner and outer retinal thickness (IRT, ORT), ganglion cell layer thickness (GCT), and central choroidal thickness (CCT). Results: The study analyzed 48 eyes. Significant improvements were seen in BCVA (logMAR 0.44 to 0.18), while IOP increased slightly (15 to 17.5 mmHg). There were notable reductions in CMT, GCT, and IRT. Anatomical success (83.3%) was associated in univariate analysis with greater OCT improvement and higher white blood cell count (WBC) levels (p < 0.05). Central macular thickness decreased by 27% (from 427 to 312 μm), and visual acuity improved from 0.44 to 0.18 logMAR. In logistic regression analysis, factors associated with functional success (75%) included higher blood urea nitrogen (BUN) levels [OR 1.11 (95% CI: 1.03–1.21), p = 0.008], lower low-density lipoprotein (LDL) levels (p = 0.013), and lower baseline intraocular pressure (IOP) (p = 0.013). Conclusions: Intravitreal bevacizumab is effective in early diabetic macular edema. Elevated BUN and lower LDL levels may be associated with a favorable functional response to treatment Full article