Predictive value of hematological and phenotypical parameters on postchemotherapy leukocyte recovery

Background: Grade IV chemotherapy toxicity is defined as absolute neutrophil count <500/μL. The nadir is considered as the lowest neutrophil number following chemotherapy, and generally is not expected before the 7th day from the start of chemotherapy. The usual prophylactic dose of rHu-G-CSF (Filgrastim) is 300 μg/day, starting 24-48 h after chemotherapy until hematological recovery. However, individual patient response is largely variable, so that rHu-G-CSF doses can be different. The aim of this study was to verify if peripheral blood automated flow cytochemistry and flow cytometry analysis may be helpful in predicting the individual response and saving rHu-G-CSF. Methods: During Grade IV neutropenia, blood counts from 30 cancer patients were analyzed daily by ADVIA 120 automated flow cytochemistry analyzer and by Facscalibur flow cytometer till the nadir. "Large unstained cells" (LUCs), myeloperoxidase index (MPXI), blasts, and various cell subpopulations in the peripheral blood were studied. At nadir rHu-G-CSF was started and 81 chemotherapy cycles were analyzed. Cycles were stratified according to their number and to two dose-levels of rHuG-CSF needed to recovery (300-600 vs. 900-1200 μg) and analyzed in relation to mean values of MPXI and mean absolute number of LUCs in the nadir phase. The linear regressions of LUCs % over time in relation to two dose-levels of rHu-G-CSF and uni-multivariate analysis of lymphocyte subpopulations, CD34+ cells, MPXI, and blasts were also performed. Results: In the nadir phase, the increase of MPXI above the upper limit of normality (>10; median 27.7), characterized a slow hematological recovery. MPXI levels were directly related to the cycle number and inversely related to the absolute number of LUCs and CD34 +/CD45+ cells. A faster hematological recovery was associated with a higher LUC increase per day (0.56% vs. 0.25%), higher blast (median 36.7/μL vs. 19.5/μL) and CD34+/CD45+ cell (median 2.2/μL vs. 0.82/μL) counts. Conclusions: Our study showed that some biological indicators such as MPXI, LUCs, blasts, and CD34 +/CD45+ cells may be of clinical relevance in predicting individual hematological response to rHu-G-CSF. Special attention should be paid when nadir MPXI exceeds the upper limit of normality because the hematological recovery may be delayed. © 2009 Clinical Cytometry Society

Predicting heart failure outcome from cardiac and comorbid conditions: The 3C-HF score

Background: Prognostic stratification in heart failure (HF) is crucial to guide clinical management and treatment decision-making. Currently available models to predict HF outcome have multiple limitations. We developed a simple risk stratification model, based on routinely available clinical information including comorbidities, the Cardiac and Comorbid Conditions HF (3C-HF) Score, to predict all-cause 1-year mortality in HF patients. Methods: We recruited in a cohort study 6274 consecutive HF patients at 24 Cardiology and Internal Medicine Units in Europe. 2016 subjects formed the derivation cohort and 4258 the validation cohort.Weentered information on cardiac and comorbid candidate prognostic predictors in amultivariablemodel to predict 1-year outcome

Temporal Registration in In-Utero Volumetric MRI Time Series

We present a robust method to correct for motion and deformations in in-utero volumetric MRI time series. Spatio-temporal analysis of dynamic MRI requires robust alignment across time in the presence of substantial and unpredictable motion. We make a Markov assumption on the nature of deformations to take advantage of the temporal structure in the image data. Forward message passing in the corresponding hidden Markov model (HMM) yields an estimation algorithm that only has to account for relatively small motion between consecutive frames. We demonstrate the utility of the temporal model by showing that its use improves the accuracy of the segmentation propagation through temporal registration. Our results suggest that the proposed model captures accurately the temporal dynamics of deformations in in-utero MRI time series.National Institutes of Health (U.S.) (NIH NIBIB NAC P41EB015902)National Institutes of Health (U.S.) (NIH NICHD U01HD087211)National Institutes of Health (U.S.) (NIH NIBIB R01EB017337)Wistron CorporationMerrill Lynch Wealth Management (Fellowship

Influence of age at weaning and nutritive value of weaning diet on growth performance and caecal traits in rabbits

[EN] To investigate the relationship between dietary nutrient concentration and weaning age on growth performance and caecal characteristics of rabbits, a trial was carried out on 64 litters (eight rabbits/litter) comparing two weaning ages (25 vs. 34 d) and two diets (HC: high concentrated and LC: low concentrated diet) offered to the kits from 18 to 34 d of age. At 34 d of age 54 animals per group were caged individually and all were fed the LC diet until 45 d of age. All animals were then fed a standard fattening diet (37% neutral detergent fiber, 3.4% ether extract and 18.0% crude protein on dry matter basis) until slaughter at 80 d. The digestibility trial was performed from 56 to 60 d of age on another group of 16 rabbits (8 per diet). During the experimental period (18-80 d of age), feed intake and animal weights were recorded. Caecal volatile fatty acids were measured at 45 and 80 d of age, while microbiological analysis was performed at 25 and 34 d on healthy suckling rabbits. Digestibility of dry matter, protein, neutral detergent fiber, fat and energy was higher in rabbits fed the HC diet (by 7.7, 7.4, 13.1, 26.7, 10.6%, respectively; P<0.001) than in those fed the LC diet. Growth rate and feed conversion ratio (FCR) from 18 to 34 d improved by 7.7 and 9.5% in rabbits fed HC in comparison to the LC diet, respectively (P¿0.061). Diet offered around weaning did not influence growth rate or FCR from 34 to 80 d of age. Rabbits weaned earlier increased feed intake (by 67.8%) from 25 to 34 d, but reduced growth rate (by 26.8%) compared to animals weaned at 34 d (P<0.001). Early weaning reduced live weight during the entire fattening period (P¿0.018), as well as the FCR (by 4%; P<0.001). Caecal pH was lower at 45 d of age in rabbits weaned at 25 d than in those weaned at 34 d (5.53 vs. 5.83; P=0.019). Treatments did not affect total caecal VFA concentration, but HC diet decreased caecal acetic concentration and increased butyric acid level compared to the LC diet at 45 d (P¿0.001). HC diet tended to reduce caecal counts of Enterobacteriacae (P=0.093), while it did not affect facultative anaerobic bacteria, E. Coli and Costridium spp. The LC diet increased at 25 d the number of Clostridium perfringens in comparison with the HC group at the same age and in comparison with animals fed both two diets at 34 d (P<0.001). The values of E. Coli and Enterobacteriaceae increased (P¿0.008) from 25 to 34 d of age, whereas that of Clostridium spp. decreased. Weaning at 25 d increased mortality from 18 to 34 d compared with rabbits weaned at 34 d (7.02 vs. 2.46%, P=0.017). However, during the fattening period (34-80 d) rabbits weaned earlier showed lower mortality (7.41 vs. 17.6%; P=0.024).This work has been realized within the CUNISVEZZ research project financed by the Agricultural Department of the Regione Lombardia as part of the 2004 research and development plan, d.g.r. 30/04/2004 n. VII/17326. The authors wish to thank Nicoletta Cesari for her technical assistance.Cesari, V.; Grilli, G.; Ferrazzi, V.; Toschi, I. (2009). Influence of age at weaning and nutritive value of weaning diet on growth performance and caecal traits in rabbits. World Rabbit Science. 17(4):195-205. https://doi.org/10.4995/wrs.2009.64419520517