Nucleated red blood cells (NRBCs) are premature erythrocyte precursors that reside in the bone marrow of humans of all ages as an element of erythropoiesis. They rarely present in healthy adults’ circulatory systems but can be found circulating in fetuses and neonates. An NRBC count is a cost-effective laboratory test that is currently rarely used in everyday clinical practice; it is mostly used in the diagnosis of hematological diseases/disorders relating to erythropoiesis, anemia, or hemolysis. However, according to several studies, it may be used as a biomarker in the diagnosis and clinical outcome prognosis of preterm infants or severely ill adult patients. This would allow for a quick diagnosis of life-threatening conditions and the prediction of a possible change in a patient’s condition, especially in relation to patients in the intensive care unit. In this review, we sought to summarize the possible use of NRBCs as a prognostic marker in various disease entities. Research into the evaluation of the NRBCs in the pediatric population most often concerns neonatal hypoxia, the occurrence and consequences of asphyxia, and overall neonatal mortality. Among adults, NRBCs can be used to predict changes in clinical condition and mortality in critically ill patients, including those with sepsis, trauma, ARDS, acute pancreatitis, or severe cardiovascular disease.

Background: Acinetobacter, specifically A. baumannii, are becoming a great threat to hospitalized patients due to increasing antibiotic resistance. The aim of this study was to describe the epidemiology, clinical characteristics, antimicrobial susceptibility pattern and outcome of Acinetobacter infections in pediatric cancer patients and hematopoietic stem cell transplant (HSCT) recipients in Poland. Methods: A total of 125 episodes of Acinetobacter species infections were reported in patients <18 years treated in Polish pediatric hematology and oncology centers over a period from 2012 to 2023. Infections were subdivided into oncohematological disease (OHD) group (n = 106; 84.8%) and HSCT group (n = 19; 15.2%). Each episode represented a separate infection event; therefore, a patient who was infected more than once during the course of treatment was counted for each infection episode. Results: A. baumannii is the most common Acinetobacter species in all groups. The most common diagnoses in OHD group were acute lymphoblastic leukemia (ALL) (n = 32; 30.2%) and acute myeloid leukemia (AML) (n = 13; 12.3%). The most common underlying diseases that were indication for HSCT were hemophagocytic lymphohistiocytosis (n = 3; 15.8%) and neuroblastoma (n = 3; 15.8%). Mortality was significantly higher in the HSCT group compared to the OHD group. In the OHD group, deaths did not correlate with the type of antibiotic, with an exception for gentamicin, which correlated with higher mortality. In the HSCT group, deaths did not correlate with the type of antibiotic, except for levofloxacin that was correlated with a higher mortality rate. Conclusions: Acinetobacter infections are a great danger to immunocompromised patients. More research is needed in order to prevent and treat antibiotic-resistant bacteria.

Background: Acinetobacter, significantly A.baumannii, are becoming a great threat to hospitalized patients due to increasing antibiotic resistance. The aim of this study was to describe the epidemiology, clinical characteristic, antimicrobial susceptibility pattern and outcome of Acinetobacter infections in pediatric cancer patients and HSCT recipients in Poland. Methods: a total of 125 episodes of Acinetobacter species infections were reported in pa-tients < 18 years treated in Polish pediatric hematology and oncology centers over a pe-riod from 2012 to 2023. Infections were subdivided into oncohematological diseases (OHD) group (n=106; 84,8%) and hematopoietic stem cell transplant (HSCT) group (n=19; 15,2%). Results: A.baumannii is the most common Acinetobacter species in all groups. The most common diagnoses of infected patients in OHD group were: ALL (n=32; 30.2%) and AML (n=13; 12.3%). The most common underlying disease that was indication for HSCT among infected patients were hemophagocytic lymphohistiocytosis (n=3; 15.8%) and neuroblastoma (n=3; 15.8%). In OHD group, deaths did not correlate with the type of antibiotic, with an exception for gentamicin, which correlates with higher mortality. In HSCT group, deaths did not correlate with the type of antibiotic, except for levofloxa-cin that was correlated with higher mortality rate. Mortality was significantly higher in the HSCT group compared to the OHD group. Conclusions: Acinetobacter infections are a great danger to immunocompromised pa-tients. More research is needed in order to prevent and treat antibiotic resistant bacteria.

Flammer syndrome, which has been described in literature only recently, combines two basic components: primary vascular dysregulation and symptoms not directly related to vascular function (prolonged sleep onset time, low pain threshold or specific personality traits). Some health-protective effects, such as a reduced risk atherosclerosis and metabolic syndrome, have also been noted. Flammer syndrome most often coexists with ocular diseases, normal tension glaucoma in particular, as well as with neurological disorders, such as multiple sclerosis. Diagnosis is based on a detailed physical examination; however, standardised diagnostic methods are missing. A three-component therapeutic strategy, including appropriate lifestyle, proper nutrition and pharmacotherapy in the form of magnesium preparations or low-dose calcium channel blockers, is used for Flammer syndrome. Clinical studies in 2016 and 2019 showed that multiple sclerosis patients are significantly more likely to develop typical symptoms of Flammer syndrome compared to controls. These included dizziness, low body weight, non-migraine headaches, reduced feeling of thirst, prolonged sleep onset time, and a tendency towards perfectionism. Although the aetiology of Flammer syndrome and multiple sclerosis or the causes underlying the clinical correlations between them have not been clarified so far, expanded research may contribute to better care for those at increased risk of developing multiple sclerosis, as well as improved therapy and support for patients, with consideration given to challenges that may arise from the coexistence of both diseases.