Search Results (765)

Data of experimental, comparative, and allometric studies was examined in relation to the wider oxygen transport cascade, including branchial ventilation, diffusion across the water–blood barrier, blood oxygen transport, muscle capillarization, and mitochondrial content. Experimental reductions in functional gill area are associated with lower maximal oxygen consumption and reduced critical swimming speed, whereas reversible gill remodelling may increase exposed lamellar surface under hypoxia or increased oxygen demand. Comparative evidence indicates that gill area accounts for a measurable, but incomplete, component of variation in metabolic rate and hypoxia tolerance. A descriptive comparison of ten published paired gill surface area (GSA) and standard metabolic rate (SMR) datasets did not reveal a consistently negative difference between gill surface area and standard metabolic demand across the species and experimental conditions examined. This comparison addresses maintenance metabolism but does not test oxygen-supply constraints during routine or maximal activity. The broader evidence reviewed includes large salmonids with cardiovascular compensation, cyprinids with reversible gill remodelling, haemoglobinless icefishes, and active pelagic taxa with high cardiorespiratory and locomotor investment. Collectively, these examples show that the functional significance of gill area depends on interacting branchial, cardiovascular, haematological, tissue-level, and ecological traits. Full article

Background: Carbapenem-resistant Enterobacterales (CRE) are a major therapeutic challenge, particularly in settings where metallo-β-lactamases are prevalent. Aztreonam–avibactam (AZA) may provide activity against metallo-β-lactamase-producing isolates, whereas ceftazidime–avibactam (CZA) has limited activity against the isolates that harbor these enzymes. This study aimed to evaluate the in vitro activity of aztreonam–avibactam and ceftazidime–avibactam against invasive carbapenem-resistant Enterobacterales isolates and to characterize the distribution of carbapenemase genes in a tertiary-care center in Türkiye. Methods: A total of 100 non-duplicate CRE isolates recovered from blood cultures and sterile body fluids between January 2024 and January 2026 were included. Species identification and routine antimicrobial susceptibility testing were performed using MALDI-TOF MS and an automated system. CZA and AZA MICs were determined by gradient diffusion testing, whereas CZA–aztreonam synergy was assessed separately using a disk/gradient diffusion-based method. Carbapenemase genes were detected by real-time PCR. Whole-genome sequencing was performed for the two AZA-resistant Escherichia coli isolates. Results: The isolate collection was dominated by Klebsiella pneumoniae (87.0%), and most isolates were recovered from blood cultures (80.0%). CZA susceptibility was observed in 31.0% of isolates, with MIC_50/90 values of 256/256 mg/L. In contrast, AZA showed high in vitro activity, with 98.0% of isolates categorized as susceptible and MIC_50/90 values of 0.25/0.50 mg/L. CZA–aztreonam synergy was detected in 98.0% of isolates. Qualitative CZA–aztreonam synergy testing did not fully concord with direct AZA MIC-based susceptibility categorization: one AZA-resistant isolate showed a positive synergy result, whereas one synergy-negative isolate remained AZA-susceptible. Carbapenemase genes were detected in 99.0% of isolates; bla_NDM was the most frequent gene (81.0%), followed by bla_OXA-48 (72.0%), bla_KPC (14.0%), and bla_VIM (4.0%). The most common carbapenemase profile was bla_NDM + bla_OXA-48 (62.0%). bla_NDM carriage was strongly associated with CZA resistance, and CZA MICs were significantly higher among bla_NDM-positive isolates. The two AZA-resistant E. coli isolates belonged to ST500 and ST410, and both carried a YRIK insertion in PBP3; one of them additionally showed ompF disruption associated with a 4 bp insertion. Conclusions: AZA demonstrated potent in vitro activity against invasive CRE isolates in this setting, whereas CZA activity was substantially limited, likely reflecting the high prevalence of bla_NDM and frequent carbapenemase co-carriage. These findings support the potential value of AZA in regions with emerging metallo-β-lactamase predominance and highlight the importance of local molecular surveillance to guide antimicrobial strategies. Full article

The erythrocyte sedimentation rate (ESR) is a routine marker of inflammation in human medicine, and it is influenced by erythrocyte features and the level of some plasma proteins. The Westergren method is the reference technique in humans; however, this manual technique has been scarcely used in animals and has not been validated. An automated veterinary in-clinic device (MINI-PET) is able to measure ESR on EDTA-blood tubes. This study aimed to evaluate the comparability of ESR values measured with two tests in cats and dogs admitted to a veterinary clinic and in anemic individuals. Analytical comparability and decision limits were calculated in both species and clinical groups. Comparisons were also made between the two species. The two ESR methods had different decision limits in the investigated population of dogs and cats, and a method-specific interpretation of their results is suggested. Healthy cats had significantly higher values than healthy dogs using both the Westergren and MINI-PET methods. By both methods, anemic individuals had higher ESR values than the matched subgroups with erythrogram values within the reference range, probably due to concurrent inflammation in most anemic animals studied. In general, ESR measures should be evaluated in conjunction with erythrogram values. Full article

Background: We compared biochemical, micronutrient-related and complete blood count (CBC)-derived inflammatory profiles among children with obesity, undernutrition and normal weight, and explored the discriminatory performance of selected routine laboratory markers for the obesity phenotype. Methods: In this single-centre retrospective comparative study, medical records of children aged 2–17 years evaluated between January 2023 and December 2025 were reviewed. Participants were classified as obese, undernourished or normal weight using World Health Organization (WHO) body mass index-for-age (BMI-for-age) references. Liver enzymes, lipid parameters, iron-related indices, micronutrient levels, zinc, insulin and CBC-derived inflammatory indices were compared across groups using non-parametric omnibus tests. Exploratory receiver operating characteristic (ROC) analyses were performed for selected markers. Results: A total of 690 children were included: 100 with obesity, 90 with undernutrition and 500 with normal weight. The obesity group was significantly older than the normal-weight group (median 11.0 vs. 7.5 years; p < 0.001). Obesity was characterised by higher alanine aminotransferase (ALT), insulin, triglycerides, neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI), together with lower high-density lipoprotein (HDL) cholesterol, 25-hydroxyvitamin D [25(OH)D] and aspartate aminotransferase-to-alanine aminotransferase (AST/ALT) ratio (all p < 0.05). In exploratory, age-unadjusted ROC analyses, the AST/ALT ratio yielded the highest AUC among the evaluated biomarkers (AUC 0.859; 95% CI 0.823–0.895; optimal cut-off ≤ 1.52; sensitivity 77.0%; specificity 77.6%), followed by SIRI (AUC 0.751; 95% CI 0.700–0.802). Conclusions: Pediatric obesity was associated with a distinct liver enzyme-metabolic-inflammatory laboratory profile, whereas undernutrition exhibited a different micronutrient-biochemical pattern. Because the study was retrospective and age-unadjusted, these findings should be interpreted as exploratory and hypothesis-generating. Prospective studies with age-balanced sampling, pubertal staging and liver imaging are required before clinical implementation. Full article

Over the past decade, the incidence of infectious syphilis has been on the rise in the general Chinese population. Consequently, Treponema Pallidum (TP) testing has been proposed as a surrogate marker for sexually transmitted pathogens and for monitoring risky sexual behaviors among blood donors globally. In addition, sexual contact with individuals chronically infected with hepatitis B virus (HBV) is recognized as one of the primary routes of HBV transmission. Blood donors may acquire HBV infection through sexual contact with chronically infected partners, particularly with occult hepatitis B infections (OBIs), which are characterized by intermittent and extremely low viral loads. Therefore, the prevalence of OBIs among syphilis-positive blood donations and the corresponding risks to blood safety require further investigation. This study aimed to investigate the prevalence of OBIs among syphilis-positive blood donors and assess the surrogate value of TP testing for evaluating OBI-related risks to blood supply. After routine screening using serological assays and nucleic acid testing (NAT), blood donation samples with positive anti-TP enzyme-linked immunosorbent assay (ELISA) results were collected and further confirmed by the Treponema Pallidum Particle Agglutination Assay (TPPA). For blood donations confirmed positive for syphilis, further tests were performed to characterize whether the donations had HBV co-infection, including electrochemiluminescence immunoassay (ECLI) for the detection of hepatitis B surface antigen (HBsAg), anti-hepatitis B surface antibody (anti-HBs), hepatitis B e antigen (HBeAg), anti-hepatitis B e antibody (anti-HBe), and anti-hepatitis B core antibody (anti-HBc). Additionally, quantitative real-time polymerase chain reaction (qPCR) was used for HBV DNA quantification, and nested PCRs for the S and basal core promoter/precore (BCP/PC) region were conducted in combination with high-volume nucleic acid extraction. Subsequently, molecular characterization of HBV DNA in these co-infected samples was carried out by DNA sequencing to analyze the viral genetic features. Of 252 anti-TP ELISA+ donations screened from 64,871 blood samples, 138 (138/250, 55.2%) donations were confirmed syphilis-positive but NAT−, among which 78 (78/138, 56.5%) were anti-HBc-positive, and 88 (88/138, 63.7%) had anti-HBs. Notably, seven donations (7/138, 5.1%) were diagnosed as OBI co-infections, and available sequence analysis revealed that three cases were genotype B and one case was genotype C. In addition, several mutations in the S region of the HBV genome were identified, including Q101R, K122R, Q129H, T131N, M133T, G145R, and Y161F mutations. Furthermore, nucleotide mutations such as T1719G, A1752T, G1896A, and A1762T/G1764A in the BCP/PC regions were also detected in these OBI donations. These mutations may contribute to the extremely low HBV viral loads and/or failure in HBsAg detection, collectively leading to OBIs. These data indicate that syphilis screening of blood donors has potential to serve as an additional safeguard measure for excluding donations co-infected with OBIs. The high prevalence of undetected OBIs in syphilis-positive blood donors further supports that syphilis screening has the potential to serve as a surrogate marker for HBV-related risks in the blood supply. Full article

Respiratory medicine is transitioning from symptom-driven, standardized care to a more precise, patient-specific approach guided by molecular profiling. This evolution is being enabled by advances in liquid biopsy, multiomics, and artificial intelligence (AI) analytics. Fractional exhaled nitric oxide (FeNO) and blood eosinophils, the two commonly used markers in asthma, are now being joined by more precise airway markers such as galectin-10, which could aid clinicians in making more informed decisions for biological treatments. In chronic obstructive pulmonary disease (COPD) similar progress is underway, with treatment now emphasizing inflammation endotypes, especially eosinophilic patterns, to direct therapeutic choices. Alongside these developments, routine blood-based ratios (e.g., platelet-to-lymphocyte and neutrophil-to-lymphocyte) are being explored as predictors of exacerbation risk, and forced oscillation testing (FOT) is proving useful for picking up early disease shifts. In more severe conditions, biomarkers are linked to an early and better prognosis, enabling timely intervention. Markers like Matrix metalloproteinase-7 (MMP-7) and CC chemokine ligand 18 (CCL18) have proven to be reliable indicators of mortality and disease progression in idiopathic pulmonary fibrosis. Meanwhile, in lung cancer, liquid biopsies, especially those measuring circulating tumor DNA and micro-RNA (miRNA) panels, are enhancing screening accuracy while helping to cut down on the high false-positive rates seen with low-dose computerised tomography (CT). Other respiratory conditions such as bronchiectasis, pulmonary embolism, pneumonia, and acute respiratory distress syndrome (ARDS) are also benefiting from biomarker advances. At the same time there is a growing push to standardize how these biomarkers are measured. AI-based clinical decision support systems are also playing an increasingly important role in the translation of all these complicated data into actionable clinical insights. Together these developments pave the way for improved respiratory care that is precise and responsive to individual patient needs. Full article

Distinguishing seizures from other causes of transient loss of consciousness in the emergency department (ED) is challenging. This PRISMA-guided systematic review evaluated serum brain injury biomarkers for the acute diagnosis of seizures in adults. We searched PubMed and Web of Science for studies published between 2015 and 2025 and included 14 studies in which blood sampling occurred shortly after the event, reflecting the ED diagnostic window. Given the heterogeneity across studies, the overall certainty of the evidence was low. Neuron-specific enolase (NSE) and ubiquitin carboxyl-terminal hydrolase L1 (UCH-L1) were consistently elevated after epileptic seizures compared to healthy controls. NSE effectively differentiated seizures from syncope, while UCH-L1 and glial fibrillary acidic protein (GFAP) distinguished epileptic from psychogenic non-epileptic seizures (PNESs). Neurofilament light chain (NfL) remained stable after a single seizure but increased markedly in status epilepticus (SE). S100B and BDNF results were inconsistent. Although no single biomarker serves as a standalone test, NSE and UCH-L1 are promising complementary diagnostic tools for identifying epileptic seizures in adults. Furthermore, NfL is a strong candidate marker for SE, reflecting neuroaxonal injury. Larger prospective, standardized studies are needed before routine ED implementation. Full article

Background/Objectives: Metabolic syndrome (MetS) and dry eye disease (DED) share inflammatory mechanisms, yet few studies have examined objective tear function and serum inflammatory markers together in this population. The aim of this study was to compare tear function tests and a panel of systemic inflammatory indices between patients with MetS who did and did not have DED. Methods: This observational comparative study enrolled 104 adults with MetS (52 MetS-DED and 52 MetS-nonDED), with group-level comparability for age and sex. All participants underwent ophthalmologic evaluation, including the Ocular Surface Disease Index (OSDI), the Schirmer I test, and fluorescein tear break-up time (TBUT). DED was defined by a mean Schirmer I value of ≤5 mm/5 min. Routine blood tests were used to derive the neutrophil-, platelet-, monocyte-, and eosinophil-to-lymphocyte ratios (NLR, PLR, MLR, ELR), the neutrophil–lymphocyte–platelet ratio (NLPR), the C-reactive protein (CRP)-to-albumin ratio, and the monocyte-to-high density lipoprotein cholesterol (HDL) ratio. Between-group comparisons, receiver operating characteristic (ROC) analysis with Youden’s index, and age- and sex-adjusted binary logistic regression were performed. Results: TBUT and Schirmer I values were significantly lower in the MetS-DED group, whereas OSDI scores did not differ between the groups. NLR, MLR, NLPR, CRP, and the CRP-to-albumin ratio were significantly higher in MetS-DED patients (all p < 0.05), while classic metabolic parameters were comparable. ROC analysis revealed statistically significant but weak-to-modest discriminatory ability (areas under the curve (AUCs) 0.617–0.652). In age- and sex-adjusted models, MLR (odds ratio (OR) = 1.072 per 0.01 unit, p = 0.046), the CRP-to-albumin ratio (OR = 1.062 per 0.01 unit, p = 0.011), and NLPR (OR = 1.123 per 0.001 unit, p = 0.038) remained significantly associated with MetS-DED. Conclusions: Among individuals with MetS, the presence of DED was accompanied by impaired tear function and a more pronounced systemic inflammatory profile despite similar metabolic parameters. However, the modest discriminatory performance and borderline adjusted associations indicate that these findings should be regarded as preliminary signals rather than evidence supporting the clinical use of these markers for screening or risk identification. Full article

Background: This study aimed to investigate the potential benefits of the Perfusion Index (PI) and Pleth Variability Index (PVI), which indicate tissue microcirculatory perfusion, in the management of fluid therapy in patients with gastrointestinal (GI) bleeding, as well as their relationship with laboratory parameters. Methods: PI, PVI, and oxygen saturation values were measured using a Masimo pulse oximeter, along with routine tests, in patients with overt gastrointestinal bleeding presenting with melena, hematemesis, or hematochezia. These values were reassessed in patients who received treatment and fluid replacement prior to discharge. Baseline and discharge values were compared. The study examined whether there was a significant change in these values following treatment. The relationship between PI and PVI values and demographic findings, oxygen saturation, urea, creatinine, hematocrit, hemoglobin, and white blood cell counts were evaluated. Results: A total of 100 patients were included in the study, 55 (55%) of whom were male and 45 (45%) female, with a mean age of 65.8 ± 8.3 years. Of the patients, 81 had upper GI bleeding, and 19 had lower GI bleeding. Of the upper GI bleeds, 6 were esophageal variceal bleeds, and 75 were due to other causes. Perfusion index (PI) and plethysmographic variability index (PVI) measurements were obtained at initial admission and prior to discharge. The discharge PI value increased significantly compared with the admission PI value, whereas the discharge PVI value decreased significantly compared with the admission PVI value. PVI value. (p < 0.001) The relationship between PI and PVI values and other variables was analyzed using Spearman’s correlation analysis. A significant negative correlation was found between PI-admission and PVI-admission, and between PI-discharge and PVI-discharge. (p < 0.001). Additionally, a significant but mild positive correlation was observed between PVI-out and age, creatinine, and urea. (p < 0.010, p < 0.030) Our results demonstrated a significant difference between PI-in and PI-out values following fluid replacement therapy. PVI-in and PVI-out values also differed significantly. There was a significant negative correlation between PI and PVI values. These findings suggest that the effectiveness of fluid replacement therapy can be monitored using PI and PVI. Conclusions: Monitoring fluid therapy in cases of gastrointestinal bleeding using the Massimo pulse oximeter is a simple, inexpensive, repeatable, noninvasive, feasible and appropriate method. Our study has significantly demonstrated that fluid replacement leads to an increase in PI values and a decrease in PVI values. Full article

Background: Optimising medication for Attention Deficit Hyperactivity Disorder (ADHD) is often hindered by the lack of practical physiological indicators that can inform treatment effects. Electrooculography (EOG) has been suggested as a low-burden marker of neurophysiological processes relevant to ADHD, but its responsiveness to medication within routine clinical settings is not well established. Methods: We analysed anonymised clinical records from adults with ADHD receiving stable, ongoing medication who underwent closed-eye EOG recordings immediately before and after taking their scheduled dose during standard consultations. Recordings were obtained using clinical EEG equipment. Heart rate and blood pressure, measured after each EOG session, were included as contextual indices of physiological state. Pre–post changes were assessed using paired t-tests and binomial tests, with effect sizes and confidence intervals reported for the main pre–post comparisons, with Pearson correlations used to evaluate associations between EOG and cardiovascular measures. Results: Both mean and peak EOG power showed consistent within-session reductions, with the majority of individuals exhibiting a decrease across measures. Cardiovascular parameters showed no systematic pre–post change, and differences in cardiovascular measures did not correlate with changes in EOG activity. Conclusions: Closed-eye EOG showed systematic within-session modulation in adults with ADHD on stable treatment. These preliminary findings suggest that EOG is sensitive to short-latency physiological changes occurring within a clinical timeframe. However, the present design does not establish pharmacological specificity, and further controlled studies are needed to determine whether such changes are specifically medication related and whether they have relevance for treatment monitoring and titration. Full article

Background/Objectives: The anticoagulant used for blood collection is a fundamental but underexplored variable in platelet-rich plasma (PRP) preparation. Ethylenediaminetetraacetic acid (EDTA) and sodium citrate act on platelets through distinct calcium chelation mechanisms with potentially different consequences for PRP quality. Our group has previously demonstrated that biological and demographic variables independently modulate platelet composition in PRP; the present study extends this analysis to the pre-analytical anticoagulant variable. No prospective paired clinical study has systematically compared the effects of EDTA and sodium citrate on platelet morphological parameters in a real clinical setting. This study aimed to characterise these differences and evaluate their implications for orthobiologic therapy. Methods: A prospective within-subject paired-sample study was conducted at Instituto Cugat—Quirónsalud Barcelona (November 2025–April 2026). Twenty-six consecutive adult patients undergoing routine blood extraction prior to orthopaedic procedures had blood drawn simultaneously into K₂-EDTA and sodium citrate (3.2%) tubes. Full haematological analysis was performed on a Sysmex XN automated analyser within 30 min. Primary outcomes were mean platelet volume (MPV), platelet distribution width (PDW), large platelet ratio (P-LCR), large platelet cell count (P-LCC), and plateletcrit (PCT). Statistical comparisons used the paired t-test or Wilcoxon signed-rank test; effect sizes were quantified as Cohen’s d. Results: Seven of eight platelet-related parameters differed significantly between anticoagulants (all p < 0.001). Compared to sodium citrate, EDTA produced systematically higher MPV (+10.1%, d = 2.81), P-LCR (+25.8%, d = 2.41), P-LCC (+24.3%, d = 1.70), PDW (+13.5%, d = 1.33), PCT (+7.3%, d = 0.78), RDW-CV (+2.0%, d = 0.83), and RDW-SD (+2.6%, d = 0.80). MPV was higher with EDTA in all 26/26 paired samples without exception. Total platelet count did not differ significantly (p = 0.135). Effect sizes for all morphological parameters were large (d ≥ 0.78). Conclusions: EDTA is associated with large, reproducible, and universal platelet morphological changes consistent with calcium chelation-induced artefact, not genuine platelet hypertrophy. These artefactual changes systematically overestimate platelet size and large platelet indices by up to 26%, with direct implications for PRP quality assessment in orthobiologic medicine. Sodium citrate should remain the anticoagulant of choice for PRP preparation. Clinicians using EDTA must recognise that morphological parameters do not reflect functional platelet capacity. Full article

Trap–neuter–return (TNR) programs are the leading non-lethal approach to managing free-roaming cat populations. When cats are anesthetized for surgical sterilization, veterinarians have a brief opportunity to obtain blood samples for pre-surgical screening, infectious-disease surveillance, and contribution to population-level reference-interval research. Field conditions, however, make collecting good-quality blood samples difficult: cats are often dehydrated and stressed, the procedure is kept brief, and their medical history is unknown. This narrative review draws on the American Society for Veterinary Clinical Pathology (ASVCP) reference-interval guidelines, feline anesthesia and the blood-collection literature, and operational experience from Portuguese TNR programs to describe seven points in the sampling workflow at which technique most often fails: anesthetic depth verification, controlled aspiration speed, immediate EDTA-tube mixing, post-venipuncture hemostasis, hemolysis recognition, precise FIV/FeLV point-of-care test timing, and adherence to a maximum-attempts limit. Three recurrent failure modes—collapsed veins from excessive aspiration, clotted EDTA samples from inadequate mixing, and hematoma formation from insufficient hemostasis—account for the majority of poor samples observed in routine practice. The framework presented here is intended to support reproducible, welfare-compliant sample collection during TNR operations, giving veterinary teams a single, structured reference that supports both animal welfare and the diagnostic value of the samples they collect. Full article

Background/Objectives: The lymphocyte-to-monocyte ratio (LMR) is an inflammation-based prognostic score (IBPS) that can be easily calculated using routine blood tests. Handgrip strength (HGS), a key diagnostic component of sarcopenia, also predicts survival. Nonetheless, the prognostic role of combined LMR and HGS in patients with pancreatic head cancer undergoing pancreaticoduodenectomy remains unclear. This exploratory study aimed to analyze whether the combination of preoperative LMR and HGS is associated with overall survival. Methods: We retrospectively analyzed 105 patients with pancreatic head cancer who underwent pancreaticoduodenectomy at Chiba University Hospital from January 2016 to December 2020. We examined the prognostic values of IBPSs and HGS and compared combinations of preoperatively measurable factors. Results: Multivariate analysis assessing preoperatively measurable factors demonstrated that low preoperative HGS, low preoperative LMR, and high preoperative carbohydrate antigen 19-9 level were associated with poor overall survival (hazard ratio [HR]: 2.41, 95% confidence interval [CI]: 1.29–4.51, p = 0.006; HR: 2.05, 95% CI: 1.12–3.76, p = 0.020; and HR: 2.68, 95% CI: 1.25–5.76, p = 0.011, respectively). The combination of low HGS and low LMR was associated with poor overall survival, although only 12 patients were included in this subgroup. Multivariate analysis evaluating clinicopathological factors demonstrated that this combination was associated with poor overall survival (HR: 2.85, 95% CI: 1.06–7.69, p = 0.038). Conclusions: In this single-center exploratory study, the combination of preoperative LMR and HGS was associated with poor overall survival in patients with surgically resected pancreatic head cancer. Further prospective multicenter validation is required before this combined marker can be used for clinical decision-making. Full article

Routinely tested biochemical and haematological molecules in the management of diabetes control, including glycated haemoglobin (HbA1c) evaluation, are related to estimated whole blood viscosity (eWBV), which is an indicator of diabetic rheology pathology. Examination of the molecules control could establish their value for clinical laboratory-based cardiovascular risk assessment. The study investigated changes in full blood count (FBC) parameters and lipid profiles with eWBV and HbA1c. The predictiveness of FBC parameters for eWBV and HbA1c is explored. This was a laboratory-based observational study that used mixed-methods analyses. Cross-sectional, longitudinal, descriptive, correlation, and regression approaches were applied to archived clinical pathology data from two health facilities, including a dataset of N = 21,026. Results: Lipid profile molecules significantly change with the level of HbA1c (p < 0.001). The levels of eWBV and its determinant molecules also change with HbA1c, and with seasonal variations (p < 0.001). Considering the predictiveness of FBC parameters for HbA1c and eWBV levels, red blood cells (RBC) and their indices, i.e., haemoglobin molecules, show statistical significance. For instance, RBC most strongly predicted HbA1c (r = 0.30) and was highest for eWBV (r = 0.54), while mean cell volume (MCV) showed strongest inverse correlation with HbA1c (r = −0.47). Conclusion: This study demonstrates that routine FBC parameters, RBC and its indices, offer a practical, low-cost approach to both monitoring and prediction of HbA1c with blood flow issues. This broadens the understanding of blood rheology in diabetes. Future research should move beyond de-identified laboratory datasets and involve patients’ primary data collection to include medication and clinical information that are unavailable in pathology records. Full article

Cardiac tamponade in pregnancy is an exceptional maternal–fetal emergency in which physiological tachycardia, hypervolaemia and dependent oedema mask the classical signs of tamponade. Corynebacterium amycolatum is a non-diphtherial, Gram-positive coryneform commensal of human skin and mucosa that is increasingly recognised as a true invasive pathogen, although pericardial infection has rarely, if ever, been reported. We aimed to describe the diagnostic and decompression strategy in such a case. We report a 29-year-old woman at 30 + 4 weeks of gestation with class III obesity (pre-pregnancy body mass index 36 kg/m²), pregnancy-induced hypertension and diet-controlled type 2 diabetes referred after a routine echocardiogram suggested tamponade despite preserved haemodynamic compensation. Transthoracic echocardiography demonstrated a large circumferential pericardial effusion with diastolic right-atrial and right-ventricular collapse, a plethoric inferior vena cava and respiratory mitral-inflow variation. Severe maternal obesity superimposed on advanced gestation degraded the acoustic windows, elevated the diaphragm, displaced the heart anteriorly and brought the gravid uterus into the subxiphoid corridor, rendering percutaneous pericardiocentesis prohibitively hazardous. After multidisciplinary heart-team review, a left anterior mini-thoracotomy with pleuro-pericardial window evacuated approximately 1000 mL of fluid. Aerobic culture yielded C. amycolatum (MALDI-TOF), with histological pericarditis and a consistent antibiogram; autoimmune, viral and neoplastic causes were excluded, although blood cultures and extended viral testing were not performed. Targeted intravenous cefazolin was given, and the patient delivered a healthy term neonate at 39 weeks, with a normal 7-month echocardiogram. To the best of our knowledge, this is among the first reported cases of C. amycolatum pericardial tamponade in pregnancy. Because blood cultures and molecular confirmation of pericardial involvement were not obtained, a contaminant or incidental role for the organism cannot be entirely excluded, and the causal attribution should be regarded as probable rather than definitive. The case highlights heart-team-based individualised decompression and the cautious microbiological interpretation of organisms traditionally regarded as commensals. Full article