Search Results (1,587)

Background: Dengue fever is one of the most common mosquito-borne viral infections, with severe cases characterized by plasma leakage, hemorrhage, and multi-organ involvement. Identification of dengue serotypes and reliable biomarkers is essential for predicting disease progression and guiding timely interventions. Methods: This prospective cohort study was conducted at a super-speciality tertiary care hospital in southern India from July 2024 to July 2025. A total of 69 patients presenting with dengue warning signs were included in the study. Patients were categorized into the severe dengue group (n = 25) and non severe dengue group (n = 44). Clinical data, laboratory findings, dengue serotype, and serial serum samples collected on Days 1, 4, and 8 were analyzed to evaluate the predictive and monitoring efficacy of Interleukin-6 (IL-6) and Interleukin-8 (IL-8), and followed up till discharge. Results: Out of 69 dengue patients with warning signs, 32 dengue-positive patients were serotyped, which included DEN V-1 (31.3%), DEN V-2 (31.3%), DEN V-3 (15.6%), DEN V-4 (18.8%), and mixed DEN V-(2 + 3) (3.1%). Severe dengue patients exhibited a higher frequency of secondary dengue infection (IgG) than primary dengue infection (88% vs. 12%), with statistically significantly higher packed cell volume, hemoglobin levels, high AST levels, and prolonged activated partial thromboplastin time, as well as lower platelet counts and albumin levels. Platelet transfusion was given to 35 dengue patients, which had also resulted in significant length of stay in hospital in comparison to non-transfused patients. IL-6 and IL-8 levels were significantly elevated in severe dengue patients when compared to non-severe dengue patients on Day 1 and Day 4, followed by a decline on Day 8, corresponding with clinical recovery. However, the elevated IL-8 levels were observed to be significantly associated with longer hospital stays, indicating its potential role as an early predictor of disease progression. Conclusions: The observed co-circulation of multiple serotypes reflects the hyper-endemic pattern reported across India. Early measurement of these cytokines IL-6 and IL-8 helps distinguish severe from non-severe dengue among patients presenting with warning signs. IL-6 and IL-8 may have potential as biomarkers for disease severity. However their role in guiding platelet transfusion requires further investigation in non-severe cases and prioritizing timely management for those at higher risk of severe disease. Full article

Objectives: To evaluate the association between fecal calprotectin (FC) levels and routinely available blood-based inflammatory indices measured during the same clinical episode in pediatric patients, as well as to assess the diagnostic performance of a novel composite parameter, the Gastrointestinal Inflammation Index (GII). Methods: This retrospective cross-sectional study included pediatric patients who underwent simultaneous testing for FC, complete blood count, C-reactive protein, and albumin between 2022 and 2025. Hematological inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), red cell distribution width (RDW), platelet mass index (PMI), systemic immune-inflammation index (SII), and the newly developed GII, were calculated. Correlations between FC and inflammatory indices were analyzed. Receiver operating characteristic (ROC) curve analysis was performed to evaluate diagnostic performance, and multivariate logistic regression was used to identify independent predictors of FC positivity. Results: Elevated FC levels were significantly associated with higher C-reactive protein levels, lower albumin concentrations, and increased values of RDW, PMI, SII, and GII (all p < 0.001). GII scores increased progressively across FC categories. In ROC analysis, GII demonstrated the highest discriminatory ability for predicting FC positivity (AUC = 0.660), followed by SII and PMI. In multivariate logistic regression analysis, only NLR remained an independent predictor of FC positivity (OR = 0.65, 95% CI: 0.44–0.97; p = 0.033). Conclusions: Blood-based inflammatory indices show significant associations with fecal calprotectin levels in pediatric inflammatory bowel disease. The novel GII may reflect the integrated systemic inflammatory burden related to intestinal involvement, while NLR appears to be a robust and practical independent marker. These indices may serve as adjunctive, rapid, and cost-effective supportive tools in clinical decision-making, although their moderate diagnostic performance limits their use as standalone screening markers. Full article

Background and Objectives: Thrombocytopenia complicates 6.6–11.6% of pregnancies. While gestational thrombocytopenia (GT) is usually benign, etiologies such as immune thrombocytopenia (ITP), preeclampsia, and HELLP syndrome require individualized management. This study aimed to characterize the etiological spectrum, maternal peripartum hematologic outcomes, blood product utilization, and mode of delivery in a tertiary-center cohort of thrombocytopenic pregnancies and to assess whether platelet count should influence delivery mode decisions. Materials and Methods: This retrospective cohort study included 137 thrombocytopenic pregnant women at a tertiary center (2010–2019), categorized by etiology and severity. Peripartum hemoglobin, hematocrit, and platelet counts were compared between delivery groups. Blood product utilization was recorded and analyzed using t-test, ANOVA, chi-square, Fisher’s exact, and Fisher–Freeman–Halton tests; binary logistic regression was used for multivariable analysis. Results: GT (43.1%) and ITP (32.1%) were the most prevalent diagnoses; cesarean delivery rate was 52.6%. Postpartum Hb was higher in the vaginal delivery group (10.24 ± 1.28 vs. 9.80 ± 1.26 g/dL; p = 0.003), while platelet counts were paradoxically lower (p = 0.039). Platelet transfusion rates did not differ significantly between delivery modes (23.1% vs. 27.8%; p = 0.621). Severe thrombocytopenia required platelet transfusion in 92.6% of cases versus 11.6% (moderate) and 0% (mild) (p < 0.001). RBC transfusion was highest in gestational hypertensive disease (41.2%) versus GT (5.1%) and ITP (2.3%) (p < 0.001). General anesthesia was used in 75% of cesarean cases. Conclusions: Delivery mode in thrombocytopenic pregnancies should be guided by obstetric indications, not platelet count alone. Although postpartum platelet counts declined more steeply after vaginal delivery, this did not increase transfusion requirements. Gestational hypertensive disorders carried the greatest hemorrhagic burden, highlighting the need for etiology-specific multidisciplinary planning. The high general anesthesia rate warrants prospective institutional audit of anesthetic decision-making protocols to determine adherence to current neuraxial anesthesia thresholds. This study is limited to maternal peripartum hematologic outcomes; neonatal outcomes were not captured and should be addressed in future prospective research. Full article

The adoption of cost-effective feeding regimes is essential to maintain the growth and physiological status of lambs after weaning. The economic benefits of an alternative concentrate diet for Omani lambs were also assessed. Twenty male Omani lambs (12.31 ± 3.22 kg; 5 months old) were allocated to a commercial concentrate (control) or formulated concentrate group (n = 10/treatment) for 63 days. The formulated concentrate consisted of date palm fronds (29%), barley (20%), fish meal (12%), date syrup (10%), Moringa oleifera (28%), and salt (1%), with all ingredient proportions expressed on a dry matter (DM) basis. Growth performance, feed efficiency, hematological indices, serum biochemical parameters, and cost analyses were evaluated using individual lambs as the experimental unit. Growth performance, feed efficiency, hematological and serum biochemical parameters, and cost analyses were performed. Final body weight (BW), total weight gain (TWG), average daily gain (ADG), and feed conversion ratio (FCR) were similar between the groups (p > 0.05). The average daily feed intake was similar between groups (p = 0.321). However, the feed cost per kg of gain and feeding cost were lower (p < 0.001) by 63 and 58%, respectively, for the formulated concentrate group. Time × group interactions were observed for red blood cell parameters, with higher platelet counts (p < 0.001) and reticulocyte hemoglobin content (p = 0.018) in the formulated concentrate group. The serum biochemical parameters changed over time, with similar responses between the groups. Appropriate substitution of ingredients in lamb concentrate diets with agricultural by-products positively influenced economic efficiency. Full article

Microplastics are emerging environmental contaminants capable of crossing epithelial barriers and circulating systemically, potentially affecting organisms, including humans. This study investigated the hematological and biochemical effects of sub-chronic oral exposure to polystyrene microplastics (PS-MPs) in male Swiss albino mice. Animals received 1 μm PS-MPs in drinking water at 0.01 mg/day for four weeks, followed by a two-week recovery period. Blood samples were collected weekly for hematological and biochemical analysis. PS-MP exposure resulted in an increased number of certain immunocytes after the first week of treatment. The highest values compared with the control group were observed in Week 2, reaching 18.5 ± 4.61 vs. 7.2 ± 1.14; 10.9 ± 2.58 vs. 5.1 ± 1.20; and 5.8 ± 2.35 vs. 2.2 ± 0.69 × 10⁹ cells/L for white blood cells, lymphocytes, and granulocytes, respectively (p < 0.001). A significant increase in platelet count was also observed, becoming evident by Week 6 (725.8 ± 307.96 vs. 470.1 ± 121.87 × 10⁹ cells/L, p < 0.05). The elevated alanine aminotransferase and aspartate aminotransferase activities observed after PS-MP exposure were potentially associated with hepatic pathology, erythrocyte damage, and inflammatory responses. No significant recovery was observed during the period after exposure. These findings demonstrate that sub-chronic oral PS-MP exposure induces inflammatory responses and may disrupt organ function. Full article

Platelet-rich plasma (PRP) therapies are increasingly used in musculoskeletal and regenerative medicine; however, substantial variability in reported outcomes persists even when similar preparation protocols are employed. In quantitative terms, PRP preparation can be interpreted as a stochastic process in which uncertainty propagates through multiple biological and technical inputs. Herein we propose a probabilistic framework to quantify variability in the platelet dose delivered (PDD) using Monte Carlo simulations. The platelet dose was formulated as a random variable defined by a multiplicative model involving the platelet count (modeled as a normal distribution), concentration factor (log-normal), injected volume (uniform), and processing efficiency (beta). Input parameters were represented by probability distributions derived from ranges reported in the literature, and uncertainty propagation was explored through 100,000 Monte Carlo iterations. The resulting simulations revealed a wide dispersion in PDD, characterized by a right-skewed distribution with a median of 3.1 × 10⁹ platelets and an interquartile range of 1.9 × 10⁹ platelets, yielding a coefficient of variation exceeding 50%. Sensitivity analysis based on variance-based global sensitivity measures (Sobol indices) identified the injected volume and concentration factor as the dominant contributors to output variability, with substantial interaction effects between these parameters accounting for a considerable portion of total variance. The baseline platelet count and processing efficiency had comparatively smaller effects. These results demonstrate how probabilistic modeling can clarify the sources of variability in PRP preparation and provide a generalizable framework for uncertainty quantification in multiplicative biomedical systems. Full article

Background/Objectives: This study aimed to compare hematological and inflammatory markers among patients with dry and wet age-related macular degeneration (AMD) and healthy controls, and to evaluate the influence of geographic atrophy (GA) in dry AMD and treatment response (TR) in wet AMD on these markers. Methods: The study included patients with dry AMD (n = 54), wet AMD (n = 53), and age- and sex-matched controls (n = 55). Hematological parameters, serum albumin, and systemic inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune–inflammation index (SII), systemic inflammation response index (SIRI), pan-immune–inflammation value (PIV), and hemoglobin, albumin, lymphocyte, and platelet index (HALP), were compared among the groups. Results: Age and sex distributions did not differ significantly between groups. Compared to controls, the wet AMD group had significantly higher neutrophil counts (p = 0.013), red cell distribution width (RDW) (p = 0.033), and inflammatory indices, including NLR, PLR, SII, SIRI, and PIV (all p < 0.01). HALP levels were significantly lower in wet AMD (p < 0.001). Dry AMD patients also had higher PLR (p = 0.045) and RDW (p = 0.005) than controls. When comparing wet and dry AMD groups directly, SIRI (p = 0.041) and PIV (p = 0.029) were significantly elevated in wet AMD, indicating stronger systemic inflammatory burden. In the dry AMD subgroup, patients with GA had significantly lower hemoglobin (p = 0.002) and erythrocyte counts (p = 0.039) than those without GA. No significant differences were observed between TR-positive and TR-negative wet AMD patients. Conclusions: Patients with wet AMD exhibit a more pronounced systemic inflammatory profile than both dry AMD patients and healthy controls. These findings support the hypothesis that systemic inflammation may contribute to AMD pathogenesis. Geographic atrophy in dry AMD may also be associated with additional hematologic alterations, whereas treatment response in wet AMD is not reflected in systemic markers. Full article

Cold exposure is an unavoidable stressor in cold regions, leading to growth retardation, oxidative damage, and endocrine disruption. This study investigated changes in blood parameters and antioxidant function in the brown adipose tissue (BAT) of mice exposed to cold. Sixteen naturally mated female mice (aged 70 days) were selected and divided into a control group (CON, n = 8, 25 ± 1 °C) and a cold exposure group (CE, n = 8, 4 ± 1 °C). Each pregnant female gave birth to approximately 12 pups, and the litter (dams and pups co-housed) served as the independent experimental unit, with both euthanized for sampling when the pups reached 20 days of age. Results showed that cold exposure increased ADFI and ADG but decreased the feed conversion rate (FCR) in lactating mice. It also decreased platelet count (PLT) and mean corpuscular hemoglobin concentration (MCHC), elevated lactate dehydrogenase (LDH) activity, and decreased TG and non-esterified fatty acid (NEFA) levels. Hormonal changes included increased adrenocorticotropic hormone (ACTH), apelin 12 (AP12), INS, NE, decreased cortisol (COR), LEP, and thyroid-stimulating hormone (TSH). In pups, cold exposure inhibited growth, reduced PLT, plateletcrit (PCT), red blood cells (RBC), and hemoglobin (HGB), altered lipid profiles, and induced hormonal shifts. Notably, cold exposure enhanced the BAT antioxidant capacity in pups, increasing the total antioxidant capacity (T-AOC) and antioxidant enzyme activities, as supported by gene expression. These findings suggest that, despite growth suppression, mice maintain homeostasis by modulating blood parameters and enhancing BAT antioxidant function to mitigate cold-induced damage. Full article

Background: The endothelial activation and stress index (EASIX), derived from the serum lactate dehydrogenase, creatinine, and platelet counts, is a composite biomarker for endothelial dysfunction and systemic stress. It has been developed to predict clinical outcomes in hematologic malignancies. This study aimed to investigate the EASIX’s predictive role in contrast-induced nephropathy (CIN) and in-hospital mortality in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods: A total of 1552 patients with STEMI who underwent primary PCI were retrospectively included. The patients were divided into two groups: CIN (+) and CIN (−). Baseline demographic, laboratory, clinic, and procedural variables were compared between the two groups. Logistic regression analysis was performed to identify independent predictors of CIN and in-hospital mortality, while receiver operating characteristic (ROC) curves were used to determine the optimal EASIX cut-off values. Results: CIN developed in 7.6% (n = 118) of the study population, and these patients had significantly increased EASIX scores. Those with CIN were older and exhibited higher rates of diabetes mellitus, chronic kidney disease (CKD), and decreased left ventricular ejection fraction (LVEF) (all p < 0.001). In multivariable analysis, age (OR 1.053), CKD (OR 1.338), reduced LVEF (OR 0.965), and EASIX (OR 2.467) independently predicted CIN. EASIX > 0.93 demonstrated strong discriminatory ability (AUC 0.785; sensitivity 72% and specificity 72%). EASIX also independently predicted in-hospital mortality (OR 3.592), with an optimal cut-off > 0.88 (AUC 0.774). Conclusions: By integrating markers of renal function, endothelial activation, and systemic stress, EASIX may serve as a useful and reliable indicator for predicting CIN development and in-hospital mortality in STEMI patients undergoing primary PCI. Full article

Background/Objective: Coagulopathy is a hallmark of sepsis, associated with poor outcomes. Although platelet count has commonly been used for risk stratification, its prognostic value has remained limited. This study compared the ability of the International Normalized Ratio (INR) and platelet count to predict in-hospital mortality in septic patients; Methods: A retrospective study was conducted including adult patients diagnosed with sepsis and admitted to Hospital Universitario Son Llàtzer (Spain) between 2006 and 2022. The INR and platelet count at diagnosis were categorized using clinical thresholds. The primary outcome was in-hospital mortality. Results: Among 6433 patients (60.6% females), mortality was 8.8%. Mortality increased from 6.3% (INR ≤ 1.2) to 20.2% (INR 2.0–3.0), slightly decreasing at INR > 3.0 (10.8%). The platelet count showed a weaker association, with the highest mortality observed at <50 × 10⁹/L (24.6%). The combined markers identified a high-risk subgroup with 50% mortality (INR > 3.0 and platelet count < 50 × 10⁹/L). In the full cohort, multivariable analysis confirmed the INR as an independent predictor of mortality (OR 2.183, p = 0.0002), whereas the platelet count was not significant. The model including the INR achieved an AUC 0.746, while adding the platelet count did not improve performance. Conclusions: the INR at diagnosis was a strong and independent predictor of in-hospital mortality, outperforming the platelet count. These findings could support the consideration of the INR in early risk stratification frameworks and highlight the need for prospective validation before integration into sepsis guidelines. Full article

Background/Objectives: Platelet-rich plasma (PRP)–based regimens are widely used in non-scarring alopecia, yet objective response is variable and clinic-ready predictors are lacking. We evaluated short-term trichoscopic outcomes in routine practice and tested whether baseline complete blood count–derived inflammatory status, quantified by the neutrophil-to-lymphocyte ratio (NLR), can stratify response under PRP-based therapy. Methods: We performed an ambispective observational cohort study (October 2024–October 2025) in an outpatient dermatology practice. The final analytic cohort included 129 patients allocated to four treatment groups: PRP alone (n = 54), PRP combined with microneedling-assisted Purasomes Hair & Scalp Complex (HCS50+, Dermoaroma; exosome-containing) (n = 33), PRP combined with microneedling-assisted Mesoaroma Hair Cocktail (scalp formulation; nutrient complex) (n = 24), and a nutrient complex alone (n = 18). Trichoscopy (FotoFinder ATBM; FotoFinder Systems GmbH, Bad Birnbach, Germany) was obtained at baseline (T1) and first follow-up (T2). Density response was defined as a ≥10% increase in total hair density and hair-cycle response as an anagen fraction increase ≥5 percentage points. Predictive analyses were prespecified and restricted to PRP-containing regimens, using logistic regression and a multilayer perceptron with repeated cross-validation for internal validation. Results: Across the full cohort (n = 129), total hair density and hair-cycle parameters improved from T1 to T2. In the PRP-containing subgroup (n = 111), baseline NLR strongly discriminated density responders (AUC 0.85, bootstrap 95% CI 0.77–0.91). In multivariable models, NLR remained independently associated with density response (OR 0.31 per 1-unit increase, 95% CI 0.20–0.48). Conclusions: In this cohort, baseline NLR was associated with discrimination of early trichoscopic response in PRP-based treatment of non-scarring alopecia. Using the Youden-derived cut-off (NLR = 2.202), patients with NLR > 2.202 had a higher risk of density non-response (72.1% vs. 4.7%), corresponding to a 15.49-fold increased failure risk in this cohort. These findings are exploratory and hypothesis-generating, and external validation and calibration are required before any routine clinical or decision-support use. Full article

Background: Transcatheter tricuspid edge-to-edge repair (T-TEER) is the most widely used treatment option for patients with tricuspid regurgitation (TR). In real-world practice, a substantial proportion of referred patients are not eligible for T-TEER or do not achieve an adequate early TR reduction and may therefore require alternative transcatheter tricuspid valve interventions (TTVI)—orthotopic or heterotopic tricuspid valve implantation. The aim of the study was to characterize patients with severe TR referred for transcatheter treatment, and identify patients in whom alternative TTVI strategies may be required. Methods: The CAPTURE Study (NCT 06838611) enrolls consecutive patients referred for TR treatment. All patients undergo clinical and echocardiographic assessment to determine eligibility for T-TEER. Candidates for alternative TTVI strategies were defined as patients disqualified from T-TEER due to anatomical ineligibility or those with unsuccessful T-TEER, defined as next-day TTE showing TR more than moderate. This pilot analysis includes patients enrolled from November 2023 to December 2024. Results: 147 patients were enrolled, 77 (52.4%) patients were qualified for T-TEER and the procedure was performed in 71 (48.3%) patients, with successful TR reduction in 55 cases (77.5% of treated patients); a subset of 34 patients (23.1%) was identified as potential candidates for alternative TTVI strategies. These patients exhibited more advanced TR (torrential TR 76.5% vs. 18.2%; p < 0.001) and right heart failure symptoms (ascites 44.1% vs. 12.7%; p < 0.001). Additionally, they had significantly higher bilirubin concentration (1.09 [1.20] mg/dL vs. 0.61 [0.42] mg/dL; p = 0.003), lower hemoglobin level (11.8 [1.7] g/dL vs. 12.3 [1.7] g/dL; p = 0.017) and platelet count (161.0 [51.0] × 109/L vs. 183.0 [79.0] × 109/L; p = 0.015), suggesting an increased bleeding risk. Conclusions: In this preliminary single-center real-world cohort, approximately half of the patients with severe TR were eligible for T-TEER, whereas more than 20% emerged as potential candidates for alternative TTVI strategies. This subgroup was characterized by more advanced right-sided remodeling and laboratory features suggestive of hepatic dysfunction and increased bleeding risk, which may have important implications for Heart Team decision-making and procedural planning. Full article

Background/Objectives: High-grade serous ovarian cancer (HGSOC) represents the most aggressive subtype of epithelial ovarian cancer and is frequently diagnosed at advanced stages. Increasing evidence suggests that systemic inflammation plays an important role in tumor progression and clinical outcomes. This study aimed to evaluate the association between preoperative systemic inflammatory indices and tumor burden, perioperative outcomes, and recurrence risk in patients with HGSOC undergoing primary debulking surgery. Methods: We conducted a retrospective study including 125 patients with histopathologically confirmed HGSOC who underwent primary debulking surgery between January 2020 and December 2025. Preoperative hematological parameters obtained within 24 h before surgery were used to calculate inflammatory indices including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI). Associations between inflammatory markers, clinicopathological characteristics, perioperative outcomes, and recurrence were analyzed using non-parametric tests and logistic regression models. Results: The mean patient age was 53.66 ± 9.14 years, and most patients presented with advanced disease (FIGO III–IV: 70.4%). Patients with T3 tumors showed significantly higher monocyte (0.66 vs. 0.50 × 10⁹/L, p = 0.003), neutrophil (5.43 vs. 4.99 × 10⁹/L, p = 0.042), and platelet counts (325 vs. 280 × 10⁹/L, p = 0.006) and lower lymphocyte counts (1.79 vs. 1.96 × 10⁹/L, p = 0.009). Composite inflammatory indices were also increased in advanced disease, including PLR (177 vs. 153, p = 0.009), AISI (492 vs. 341, p = 0.002), and SIRI (1.65 vs. 1.18, p = 0.018). Patients requiring postoperative blood transfusion had higher neutrophil counts (7.65 vs. 4.97 × 10⁹/L, p < 0.001) and elevated SIRI (2.56 vs. 1.55, p < 0.001). Patients with recurrence had significantly higher platelet counts (339 vs. 293 × 10⁹/L, p = 0.001) and SII values (2849 vs. 2586, p = 0.012). In multivariate analysis, SII remained independently associated with recurrence (OR 1.022 per 100-unit increase; 95% CI 1.002–1.043; p = 0.033) together with advanced FIGO stages (OR 2.863; 95% CI 1.011–8.104; p = 0.048). Conclusions: Preoperative systemic inflammatory markers are significantly associated with tumor burden, surgical outcomes, and recurrence risk in HGSOC. An elevated SII appears to be an independent predictor of recurrence and may represent a practical biomarker for improving preoperative risk stratification and postoperative surveillance. Full article

Background: Hypertension (HT) and atrial fibrillation (AF) are frequently coexisting conditions, with inflammation being a crucial pathophysiological mechanism shared by both. The systemic immune-inflammation index (SII), a newly introduced combined inflammatory marker, includes the parameters of platelets, neutrophils, and lymphocytes. Current literature lacks studies investigating the relationship between SII and newly developed AF in patients with controlled HT. Therefore, this study aimed to explore the association of SII with AF in hypertensive patients on anti-hypertensive therapy. Methods: This retrospective case–control study included 68 hypertensive patients with controlled blood pressure who underwent 24 h Holter monitoring. Patients were divided into two groups based on the presence of atrial fibrillation (AF-positive, n = 32; AF-negative, n = 36). SII values were calculated from complete blood counts. Demographic, clinical, and laboratory characteristics were compared between groups. Correlation analysis was performed to assess associations of SII with clinical parameters. Multivariable logistic regression identified independent predictors of AF. Optimal cut-off values for systemic immune-inflammation index and age were determined through receiver operating characteristic analysis. Results: Patients with AF were significantly older than those without AF (p < 0.01). The systemic immune-inflammation index was significantly higher in patients with atrial fibrillation (p = 0.02). Patients with AF also had higher heart rates (p = 0.04) and creatinine levels (p < 0.01). SII showed a moderate positive correlation with C-reactive protein (CRP) (r = 0.393, p < 0.01) and a weak correlation with heart rate (r = 0.251, p = 0.039). In multivariable analysis, SII (OR: 1.024, p = 0.04) and age (OR: 1.130, p < 0.01) was independently associated with AF. Receiver operating characteristic analysis determined an SII cut-off of 483.0 with a sensitivity of 53.1% and specificity of 52.8%. The age cut-off was found to be 63 years with sensitivity and specificity being 62.5% and 66.7%, respectively. Conclusions: The systemic immune-inflammation index was significantly elevated in newly diagnosed AF patients with well-controlled hypertension and was an independent predictor of AF. It is a simple, readily available biomarker that may assist in identifying hypertensive patients at high risk for the development of AF. These results should be validated in future studies, and the role of inflammation in the pathogenesis of atrial fibrillation should be further explored. Full article

Background: An increasing number of reports showed patients with bulky tumors after lattice radiation therapy (LRT) treatment achieved good local control. However, in these reports, LRT was previously used primarily for palliation. We reported a case that LRT plays a synergistic role in the radical treatment of locally advanced bulky cervical cancer (LABCC) combined with INTERLACE study protocol. Methods: The patient was a 54-year-old female with LABCC and treated with LRT combined with the INTERLACE study protocol. She received three fractions of 3 Gy each to the gross tumor volume (GTV) and three fractions of 9 Gy each to the lattice therapy volume (LTV), on an emergent basis, using volumetric modulated arc therapy (VMAT). Subsequently, according to the INTERLACE study protocol, chemotherapy and radiotherapy were carried out and the standard follow-up examinations were conducted. Adverse events (AEs) were assessed according to the Common Terminology Criteria for AEs (CTCAE) version 5.0. Results: The patient initially received LRT, which reduced the tumor burden and controlled bleeding. After this was combined with the INTERLACE study protocol, the complete clinical response (cCR) was achieved and they maintained this status for 13 months after the completion of concurrent chemoradiotherapy (CCRT), with only manageable grade IV hematological toxicity observed after the completion of CCRT. During this period, only manageable grade IV hematological toxicity (platelet count 16 × 10⁹/L, white blood cell count 0.33 × 10⁹/L) was observed. Conclusions: In this case, LRT combined with INTERLACE study protocol appears to be a safe and effective for the treatment of LABCC which improved the patient’s quality of life without uncontrolled treatment-related toxicity. Full article