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Pre-operative neutrophil–lymphocyte ratio predicts low cardiac output in children after cardiac surgery
- Ilias Iliopoulos, Matthew N. Alder, David S. Cooper, Enrique G. Villarreal, Rohit Loomba, Rashmi D. Sahay, Lin Fei, Paul E. Steele, Saul Flores
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- Journal:
- Cardiology in the Young / Volume 30 / Issue 4 / April 2020
- Published online by Cambridge University Press:
- 05 March 2020, pp. 521-525
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Neutrophil–lymphocyte ratio has been associated with clinical outcomes in several groups of cardiac patients, including patients with coronary artery disease, cardiac failure, and cardiac transplant recipients. We hypothesised that pre- and/or post-operative haematological cell counts are associated with clinical outcomes in children undergoing cardiac surgery for CHD. We performed a post hoc analysis of data collected as part of a prospective observational cohort study (n = 83, data available n = 47) of children evaluated for glucocorticoid receptor levels after cardiac surgery (July 2015–January 2016). The association of neutrophil–lymphocyte ratio with low cardiac output syndrome, time to inotrope free, and vasoactive-inotropic score was examined using proportional odds analysis, cox regression, and linear regression models, respectively. A majority (80%) of patients were infants (median/interquartile range 4.1/0.2–7.6 months) with conotruncal (36%) and left-sided obstructed lesions (28%). Two patients required mechanical circulatory support and three died. Higher pre-operative neutrophil–lymphocyte ratio was associated with higher cumulative odds of severe/moderate versus mild low cardiac output on post-operative day 1 (odds ratio 2.86; 95% confidence interval 1.18–6.93; p = 0.02). Pre-operative neutrophil–lymphocyte ratio was not significantly associated with time to inotrope free or vasoactive-inotrope score. Post-operative neutrophil–lymphocyte ratio was also not associated with outcomes. In children after congenital heart surgery, higher pre-operative neutrophil–lymphocyte ratio was associated with a higher chance of low cardiac output in the early post-operative period. Pre-operative neutrophil–lymphocyte ratio maybe a useful prognostic marker in children undergoing congenital heart surgery.
Contributors
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- By Lenard A. Adler, Pinky Agarwal, Rehan Ahmed, Jagga Rao Alluri, Fawaz Al-Mufti, Samuel Alperin, Michael Amoashiy, Michael Andary, David J. Anschel, Padmaja Aradhya, Vandana Aspen, Esther Baldinger, Jee Bang, George D. Baquis, John J. Barry, Jason J. S. Barton, Julius Bazan, Amanda R. Bedford, Marlene Behrmann, Lourdes Bello-Espinosa, Ajay Berdia, Alan R. Berger, Mark Beyer, Don C. Bienfang, Kevin M. Biglan, Thomas M. Boes, Paul W. Brazis, Jonathan L. Brisman, Jeffrey A. Brown, Scott E. Brown, Ryan R. Byrne, Rina Caprarella, Casey A. Chamberlain, Wan-Tsu W. Chang, Grace M. Charles, Jasvinder Chawla, David Clark, Todd J. Cohen, Joe Colombo, Howard Crystal, Vladimir Dadashev, Sarita B. Dave, Jean Robert Desrouleaux, Richard L. Doty, Robert Duarte, Jeffrey S. Durmer, Christyn M. Edmundson, Eric R. Eggenberger, Steven Ender, Noam Epstein, Alberto J. Espay, Alan B. Ettinger, Niloofar (Nelly) Faghani, Amtul Farheen, Edward Firouztale, Rod Foroozan, Anne L. Foundas, David Elliot Friedman, Deborah I. Friedman, Steven J. Frucht, Oded Gerber, Tal Gilboa, Martin Gizzi, Teneille G. Gofton, Louis J. Goodrich, Malcolm H. Gottesman, Varda Gross-Tsur, Deepak Grover, David A. Gudis, John J. Halperin, Maxim D. Hammer, Andrew R. Harrison, L. Anne Hayman, Galen V. Henderson, Steven Herskovitz, Caitlin Hoffman, Laryssa A. Huryn, Andres M. Kanner, Gary P. Kaplan, Bashar Katirji, Kenneth R. Kaufman, Annie Killoran, Nina Kirz, Gad E. Klein, Danielle G. Koby, Christopher P. Kogut, W. Curt LaFrance, Patrick J.M. Lavin, Susan W. Law, James L. Levenson, Richard B. Lipton, Glenn Lopate, Daniel J. Luciano, Reema Maindiratta, Robert M. Mallery, Georgios Manousakis, Alan Mazurek, Luis J. Mejico, Dragana Micic, Ali Mokhtarzadeh, Walter J. Molofsky, Heather E. Moss, Mark L. Moster, Manpreet Multani, Siddhartha Nadkarni, George C. Newman, Rolla Nuoman, Paul A. Nyquist, Gaia Donata Oggioni, Odi Oguh, Denis Ostrovskiy, Kristina Y. Pao, Juwen Park, Anastas F. Pass, Victoria S. Pelak, Jeffrey Peterson, John Pile-Spellman, Misha L. Pless, Gregory M. Pontone, Aparna M. Prabhu, Michael T. Pulley, Philip Ragone, Prajwal Rajappa, Venkat Ramani, Sindhu Ramchandren, Ritesh A. Ramdhani, Ramses Ribot, Heidi D. Riney, Diana Rojas-Soto, Michael Ronthal, Daniel M. Rosenbaum, David B. Rosenfield, Durga Roy, Michael J. Ruckenstein, Max C. Rudansky, Eva Sahay, Friedhelm Sandbrink, Jade S. Schiffman, Angela Scicutella, Maroun T. Semaan, Robert C. Sergott, Aashit K. Shah, David M. Shaw, Amit M. Shelat, Claire A. Sheldon, Anant M. Shenoy, Yelizaveta Sher, Jessica A. Shields, Tanya Simuni, Rajpaul Singh, Eric E. Smouha, David Solomon, Mehri Songhorian, Steven A. Sparr, Egilius L. H. Spierings, Eve G. Spratt, Beth Stein, S.H. Subramony, Rosa Ana Tang, Cara Tannenbaum, Hakan Tekeli, Amanda J. Thompson, Michael J. Thorpy, Matthew J. Thurtell, Pedro J. Torrico, Ira M. Turner, Scott Uretsky, Ruth H. Walker, Deborah M. Weisbrot, Michael A. Williams, Jacques Winter, Randall J. Wright, Jay Elliot Yasen, Shicong Ye, G. Bryan Young, Huiying Yu, Ryan J. Zehnder
- Edited by Alan B. Ettinger, Albert Einstein College of Medicine, New York, Deborah M. Weisbrot, State University of New York, Stony Brook
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- Book:
- Neurologic Differential Diagnosis
- Published online:
- 05 June 2014
- Print publication:
- 17 April 2014, pp xi-xx
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Genetic parameters of selection and stability and identification of divergent parents for hybridization in rice bean (Vigna umbellata Thunb. (Ohwi and Ohashi)) in India
- S. GUPTA, M. KOZAK, G. SAHAY, A. A. DURRAI, J. MITRA, M. R. VERMA, A. PATTANAYAK, P. D. THONGBAM, A. DAS
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- Journal:
- The Journal of Agricultural Science / Volume 147 / Issue 5 / October 2009
- Published online by Cambridge University Press:
- 22 April 2009, pp. 581-588
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Fifty-two genotypes of rice bean (Vigna umbellata Thunb. (Ohwi and Ohashi)), an under-cultivated crop, were evaluated in the rainy (kharif) seasons of 2001, 2002 and 2003 in the North Eastern Hill Region, India to select suitable genotypes for cultivation in the North Eastern Hill region and to identify promising parents for hybridization programmes. The germplasm studied comprised 44 Indian and eight foreign genotypes. A wide range of variability was observed for eight characters studied (plant height, number of branches/plant, stem thickness, pod length, number of seeds/pod, 100-seed weight, pod weight/plant and seed yield/plant). Number of days to mid-flowering and number of days to maturity showed little variation. High heritability (0·58) and high genetic advance (0·53) were observed for 100-seed weight, high heritability (0·93) and moderate genetic advance (0·37) for seed yield/plant, and high heritability (0·60) and low genetic advance (0·13) for number of days to mid-flowering. Since the main aim in rice bean breeding is to develop high yielding, early maturing genotypes with low plants, selection was based mainly on the mean performance of these three traits over the 3 years, as well as their stability. One of the genotypes, RBL 1, was very high yielding, although the yield was not stable across years. Another genotype, RBS 24, was very early maturing and had very short plants compared with the other genotypes studied. These two, along with several other genotypes selected, may be promising for a hybridization programme aiming to develop dwarf, early maturing genotypes with high yield. The best yielding genotypes, namely RBL 1, RCRB1-3 and IC 187911, may be recommended for cultivation in the shifting cultivation areas (Jhum) regions of North Eastern India.
Mass-Loss from Late-Type Stars: New Observational Evidence
- P. G. Wannier, R. Sahai
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- Journal:
- Symposium - International Astronomical Union / Volume 103 / 1983
- Published online by Cambridge University Press:
- 18 September 2017, p. 292
- Print publication:
- 1983
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Rapid mass-loss is observed in many late-type stars, yet the mass-loss mechanisms operating are not well understood. A survey of molecular emission from circumstellar shells has been carried out using millimeterwave molecular lines and suggests that radiation pressure alone may be inadequate to explain the observed mass-loss, especially in the case of carbon-rich objects which may display rates in excess of 10−5 M⊙/yr. Recent near-IR molecular line observations provide evidence for ejected material at several different velocities along the line-of-sight and may indicate the additional mass-loss mechanism at work. Resonantly scattered IR radiation spatially displaced from the central IR continuum source has now been observed for the first time and sheds new light on the IR absorption-line results, providing information about material within 1016 cm of the central star. These results are discussed along with recent high-resolution millimeterwave observations.
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