The value of hematological inflammatory parameters in the differential diagnosis of testicular torsion and epididymo-orchitis in children

Aim: To investigate the value of neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) in differentiating acute scrotal conditions. Methods: A total of 60 patients, including 30 epididymo-orchitis and 30 testicular torsions, diagnosed and treated in our clinic between January 1, 2010 and December 2022, were included in the study. The patients were divided into two groups; group 1 (testicular torsion = TT) and Group 2 (epididymo-orchitis = EO). The age, diagnosis, and hemogram parameters of the patients were evaluated. Results: Both Group 1 and Group 2 consisted of 30 patients each. The mean ages of group 1 and 2 were 13.7, and 11.2 years, respectively (p>0.05). When compared to the group 2, NLR was higher in the group 2 (p<0.05). There was no statistically significant difference between the groups in terms of PLR value (p >0.05). ROC analysis was performed for NLR. According to the ROC analysis; at a cut-off value of 2.92, the sensitivity was 51% and the specificity was 87%, AUC (0.79; CI: 0.694 - 0.896). Conclusion: TT and EO can be diagnosed using inflammatory markers such as NLR. However, additional prospective studies are neede

Absolute White Blood Cell Count and Neutrophil-Lymphocyte Ratio May Predict the Need for Double- J Stent Insertion in Ureteral Stones in Children: A Comparative Study

Objective: Our goal was to determine whether or not a double-J (DJ) stent insertion is required in cases of ureteral stones based on the absolute white blood cell (WBC) counts, neutrophillymphocyte ratio (NLR), absolute monocyte counts, and other laboratory markers. Materials and Methods: The patients were divided into two groups as those who did (Group 1), and did not (Group 2) need DJ stent insertion. The age, symptoms, diagnosis, hemogram parameters, and treatment results of the patients were evaluated. Results: Forty-nine percent (n=44) of the patients were female and 51% (n=46) were male. The groups did not differ in terms of age and gender (p>0.05). A higher incidence of hematuria was observed in Group 1 (p<0.05). WBC (p<0.05), NLR (p<0.05), and monocyte counts (p<0.05) were found to be higher in Group 1. In the ROC analysis; WBC and NLR were found to be two predictive markers for the need for DJ stent insertion. At a cut-off value of 12.6 x 109/L, WBC had 37% sensitivity, and 81% specificity (AUC: 0.67; 95% CI: 0.54-0.80), and at a cut-off value of 3.8, NLR had 65% sensitivity, and 76% specificity (AUC: 0.70; 95%CI: 0.57-0.82) in predicting the need for a DJ stent insertion. Reoperation was not required in any case. Conclusion: In cases of ureteral stones, the absolute WBC count and NLR may help determine the requirement (if any) for a double-J stent insertion

Fingolimod Alters Tissue Distribution and Cytokine Production of Human and Murine Innate Lymphoid Cells

Sphingosine-1 phosphate receptor 1 (S1PR1) is expressed by lymphocytes and regulates their egress from secondary lymphoid organs. Innate lymphoid cell (ILC) family has been expanded with the discovery of group 1, 2 and 3 ILCs, namely ILC1, ILC2 and ILC3. ILC3 and ILC1 have remarkable similarity to CD4+ helper T cell lineage members Th17 and Th1, respectively, which are important in the pathology of multiple sclerosis (MS). Whether human ILC subsets express S1PR1 or respond to its ligands have not been studied. In this study, we used peripheral blood/cord blood and tonsil lymphocytes as a source of human ILCs. We show that human ILCs express S1PR1 mRNA and protein and migrate toward S1P receptor ligands. Comparison of peripheral blood ILC numbers between fingolimod-receiving and treatment-free MS patients revealed that, in vivo, ILCs respond to fingolimod, an S1PR1 agonist, resulting in ILC-penia in circulation. Similarly, murine ILCs responded to fingolimod by exiting blood and accumulating in the secondary lymph nodes. Importantly, ex vivo exposure of ILC3 and ILC1 to fingolimod or SEW2871, another S1PR1 antagonist, reduced production of ILC3- and ILC1- associated cytokines GM-CSF, IL-22, IL-17, and IFN-γ, respectively. Surprisingly, despite reduced number of lamina propria-resident ILC3s in the long-term fingolimod-treated mice, ILC3-associated IL-22, IL-17A, GM-CSF and antimicrobial peptides were high in the gut compared to controls, suggesting that its long term use may not compromise mucosal barrier function. To our knowledge, this is the first study to investigate the impact of fingolimod on human ILC subsets in vivo and ex vivo, and provides insight into the impact of long term fingolimod use on ILC populations

Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study

BACKGROUND: Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12 g dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (≥week 3) onwards. OBJECTIVE: To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN: A multicentre observational study. SETTING: The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS: The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES: The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS: Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g dl-1 in week 2 and 8.0 [7.3 to 9.0] g dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS: Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02350348

AHC interview with Eric Thuna

April 12, 2010Digital imageEric (Erich) Thuna was born on Nov. 1, 1924 in Vienna, Austria, where he lived in the 4th District (Schoenburgerstrasse 25). Mr. Thuna attended elementary school in Waltergasse from 1932 to 1938. After ‘Anschluss’ Eric Thuna fled to Luxemburg where he stayed until October 1940. He went to Marseille, France, where he was interned (Bayonne, Kay Mousserole), then to Spain and Portugal, before he finally arrived in the United States in June of 1941. He was a car mechanic and then a plant manager until his retirement to Coconut Creek, Florida in 1989

AHC interview with Eric Lamet

April 8, 2010Digital imageEric Lamet was born on May 27, 1930 as Erich Lifschuetz in Vienna, Austria, where he spent his early childhood. In 1938 he left with his mother for Italy. After a brief attempt to go on to France, they moved to Southern Italy, where they were interned at a small camp town from 1941 to 1943. After the war, he continued to live in Naples with his mother and his stepfather. In 1950 they immigrated to the United States. His parents moved on to Mexico, but he remained in the US

AHC interview with Leo Haas

April 8, 2010Digital imageLeo Haas was born in November 1926 in Vienna, Austria, where he joined the Zionist youth organization Betar. In late 1938 he left Austria and emigrated to Belgium, where he survived the war as a laborer on a farm. In 1947 he immigrated to the United States, where he met his wife. He worked as an auctioneer and an appraiser, before retiring to Florida

AHC interview with Rose Norwat

May 3, 2010Digital imageRose Norwat, née Rosa Baron was born in December 1921 in Vienna, Austria, where she went to school until 1939. In February 1939 she immigrated via Paris to the United States, where she found employment in a factory producing Christmas decorations

AHC interview with Antonie Blum

April 14, 2010Digital imageAntonie Blum, née Hant, was born 1927 into a family of Eastern European ancestry. Leaving Vienna in 1939, she and her family fled to her relatives in Poland and subsequently to the Ukraine. Upon her father's refusal to obtain Russian citizenship, which would have cancelled his application for a US immigration affidavit, the family was expelled to Siberia. Her father died in Siberia due to the difficult environment and poor health conditions

AHC interview with Lawrence Bauer.

March 2, 2010Lawrence Bauer was born in Vienna, Austria in 1922 as Ludwig Bauer. He grew up in a politically conscious social democratic environment and was a member of ‘Blau Weiss’. When he had to leave Handelsschule in 1938, he emigrated to Bratislava, Slovakia where he was interned in a camp by local security forces. With the support of the local Jewish community, he managed to survive and find his way to Palestine illegally. Upon his arrival, Mr. Bauer was interned by the British and finally released after 9 months. He worked as a private and military bus driver for several years. Few years after the War of Independence, Mr. Bauer immigrated to the United States, where he worked as a waiter in eastern and southeastern states.Austrian Heritage Collectio