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1.
Article in Chinese | WPRIM | ID: wpr-888346

ABSTRACT

OBJECTIVE@#To observe the changes of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and nerve function in patients with spinal tuberculosis before and after surgery, explore the timing of surgical intervention, and evaluate its influence on surgical safety.@*METHODS@#A retrospective analysis was conducted on 387 patients with spinal tuberculosis who received surgical treatment from March 2012 to March 2017, including 278 males and 109 females, aged 12 to 86 years old with an average of (49.9±19.1) years. There were 64 cases of cervical tuberculosis, 86 cases of thoracic tuberculosis, 76 cases of thoracolumbar tuberculosis and 161 cases of lumbar tuberculosis. There were 297 patients with single segmental involvementand 90 patients with multiple segmental involvement. Among them, 62 cases presented neurological damage, and preoperative spinal cord neurological function depended on ASIA grade, 5 cases of grade A, 8 cases of grade B, 39 cases of grade C, and 10 cases of grade D. According to the duration of preoperative antituberculosis treatment, the patients were divided into group A (256 cases, receiving conventional quadruple antituberculosis treatment for 2-4 weeks before surgery) and group B (131 cases, receiving conventional quadruple antituberculosis treatment for more than 4 weeks before surgery). The two groups were compared in terms of gender, age, preoperative complicated pulmonary tuberculosis, lesion site, lesion scope, surgical approach, drug resistance and other general clinical characteristics. ESR, CRP, visual analogue scale(VAS), Oswestry Disability Index (ODI), Frankel grade and postoperative complications were observed.@*RESULTS@#All 387 patients were followed up for 12 to 36 (18.3±4.5) months. There were no significant differences in gender, age, preoperative pulmonary tuberculosis, lesion site, lesion range, surgical approach, preoperative drug resistance and other characteristics between two groups. A total of 32 patients in two groups did not heal after surgery, with an incidence rate of 8.27%. The VAS and spinal cord dysfunction index of the two groups were significantly improved after surgery (@*CONCLUSION@#After 2-4 weeks of anti tuberculosis treatment before operation, patients with spinal tuberculosis could be operated upon with ESR and CRP in a descending or stable period. In principle, patients with spinal tuberculosis and paraplegia should be treated as soon as possible after active preoperative management of the complication without emergency surgery.


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Blood Sedimentation , Child , Female , Humans , Male , Middle Aged , Retrospective Studies , Spinal Fusion , Thoracic Vertebrae , Tuberculosis, Spinal/surgery , Young Adult
2.
Actual. osteol ; 17(1): 8-17, 2021. graf, tab
Article in English | LILACS, BINACIS, UNISALUD | ID: biblio-1291888

ABSTRACT

Objective: The main purpose of this study was to evaluate serum 25-hydroxyvitamin D (25OHD) levels and its association with in"ammatory markers in patients with rheumatologic diseases (RD). Methods: A cross-sectional study in 154 women with RD (rheumatoid arthritis, spondyloarthritis and other connective tissue diseases) and 112 healthy individuals as a control group (CG) was carried out. Results: No differences in serum and urine calcium, serum phosphate, and urinary deoxypyridinoline were found. RD group had lower 25OHD and higher PTH compared to CG. RD group had higher C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) compared to CG. The overall mean level of 25OHD (ng/ml) was 26.3±12.0 in the CG and 19.4±6.8 in the RD group (p<0.0001). Moreover, CG had lower percentage of individuals with 25OHD de!ciency compared to RD (29.9% vs 53.2%). The femoral neck BMD was signi!cantly lower in postmenopausal RD women compared to CG. 25OHD levels signi!cantly correlated with ESR and CRP as in"ammatory markers. Age, BMI, presence of RD, and CRP were signi!cantly and negatively associated with 25OHD levels through linear regression analysis. According to univariate logistic regression analysis for 25OHD deficiency (<20 ng/ml), a significant and negative association with BMI, presence of RD, ESR and CRP were found. Conclusion: Patients with RD had lower 25OHD levels than controls and the presence of a RD increases by 2.66 the risk of vitamin D de!ciency. In addition, 25OHD has a negative correlation with ESR and CRP as in"ammatory markers. (AU)


Objetivo El objetivo principal de este estudio fue evaluar los niveles séricos de 25-hidroxivitamina D (25OHD) y su asociación con marcadores inflamatorios en enfermedades reumatológicas. Materiales y métodos: Se realizó un estudio transversal en 154 mujeres con enfermedades reumatológicas (artritis reumatoide, espondiloartritis y otras enfermedades del tejido conectivo) y 112 individuos sanos como grupo control (GC). Resultados: No se encontraron diferencias en el calcio sérico y urinario, el fosfato sérico y la desoxipiridinolina urinaria entre el GC y los sujetos con enfermedades reumatológicas. El grupo de pacientes con enfermedades reumatológicas tenía 25OHD más bajo y PTH más alto en comparación con el GC. Asimismo, el grupo de individuos con enfermedades reumatológicas tenía proteína C reactiva (PCR) y velocidad de eritrosedimentación (VES) más altas en comparación con el GC. El nivel de 25OHD (ng/ml) fue 26,3±12,0 en el GC y 19,4±6,8 en el grupo con enfermedades reumatológicas (p<0,0001). Además, el GC presentó un porcentaje menor de deficiencia de 25OHD en comparación con el grupo con enfermedades reumatológicas (29,9% vs 53,2%). La DMO del cuello femoral fue significativamente menor en las mujeres posmenopáusicas con enfermedades reumatológicas en comparación con el GC. La 25OHD correlacionó significativamente con la VES y la PCR como marcadores inflamatorios. El análisis de regresión lineal mostró que la edad, el IMC, la presencia de una enfermedad reumatológica y la PCR se asociaron significativa y negativamente con los niveles de 25OHD. Mientras que el análisis de regresión logística univariada mostró que la deficiencia de 25OHD (<20 ng/ml), se asoció significativa y negativamente con el IMC, la presencia de una enfermedad reumatológica, la VES y los niveles de PCR. Conclusiones: Los pacientes con enfermedades reumatológicas tenían niveles de 25OHD más bajos que los controles y la presencia de una enfermedad reumatológica aumenta en 2.66 el riesgo de deficiencia de vitamina D. Además, la 25OHD mostró correlación negativa con la VES y la PCR como marcadores inflamatorios. (AU)


Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Vitamin D/analogs & derivatives , Vitamin D/blood , Vitamin D Deficiency/etiology , Biomarkers , Rheumatic Diseases/complications , Inflammation/blood , Phosphates/blood , Blood Sedimentation , C-Reactive Protein , Body Mass Index , Bone Density , Logistic Models , Calcium/urine , Calcium/blood , Rheumatic Diseases/blood , Risk , Cross-Sectional Studies , Postmenopause , Amino Acids/urine
3.
Article in English | LILACS-Express | LILACS, BBO | ID: biblio-1155000

ABSTRACT

ABSTRACT Objective: To evaluate the level of inflammatory factors of erythrocyte sedimentation rate and reactive protein C in benign and malignant thyroid nodules. Material and Methods: In this case-control study, patients who were referred because of an enlarged thyroid gland were selected, patients who had undergone surgery for the thyroid nodule were included in the study. Erythrocyte sedimentation rate and reactive protein C were measured before surgery in patients who were candidates for thyroid surgery. The histopathological records of patients were retrospectively reviewed. Relevant cases had a cytological evaluation of thyroid nodules by fine-needle aspiration cytology (FNAC). The mean of ESR / CRP in both groups was compared using an independent t-test (p>0.05). Results: In malignant tumor type, in all patients, with Pill (PTC), analyzes in the malignant group showed a significant difference between the mean ESR / CRP in both groups with and without thyroid history. Sub-analyzes in the malignant group were significantly different between the mean ESR / CRP in both groups with and without thyroid histories (p=0.009) (40.16 ± 28.81). The association between ESR and CRP, ESR / CRP and tumor size, ESR / CRP and age in each group as well as in the whole patients were evaluated using Pearson correlation test, which showed a positive association between ESR age and ESR (p=0.024, r=0.375). In the malignant group, a negative correlation was found between the age and the CRP rate (p=0.027, r=-0.441), and in the total patients between the age and the rate (ES=0.043, r=-0.256). Conclusion: Factors such as ESR and CRP, which are considered acute phase reactors and their levels increase in acute inflammatory conditions, may not have a significant increase in chronic inflammatory conditions and malignancies.


Subject(s)
Blood Sedimentation/drug effects , Protein C , Thyroid Neoplasms/diagnostic imaging , Case-Control Studies , Cross-Sectional Studies/methods , Data Interpretation, Statistical , Iran/epidemiology
4.
Rev. méd. Chile ; 148(3): 362-370, mar. 2020. graf
Article in Spanish | LILACS | ID: biblio-1115800

ABSTRACT

Biomarkers in inflammatory bowel disease are an essential tool in clinical practice. They allow a non-invasive evaluation of patients and thus guide decision-making at different stages of the disease, including diagnostic suspicion, severity assessment, relapse prediction, and treatment response. Although biomarkers in blood such as erythrocyte sedimentation rate and C-reactive protein, are the most commonly used biomarkers, because their low cost and accessibility, they lack specificity. Currently, fecal biomarkers offer greater reliability, applicability, and specificity. Fecal calprotectin is the most commonly used marker. This review discusses the advantages and disadvantages of biomarkers in inflammatory bowel disease, as well as their clinical applications and new biomarkers currently under research.


Subject(s)
Humans , Inflammatory Bowel Diseases , Blood Sedimentation , Biomarkers , Reproducibility of Results , Leukocyte L1 Antigen Complex , Feces
5.
Article in English | WPRIM | ID: wpr-811273

ABSTRACT

OBJECTIVES: Pentoxifylline (PTX) is a methylxanthine derivative that has been implicated in the pathogenesis of peripheral vessel disease and intermittent lameness. The purpose of this study was to investigate the effect of PTX and tocopherol in patients diagnosed with osteoradionecrosis (ORN), bisphosphonate-related osteonecrosis of the jaw (BRONJ), and chronic osteomyelitis using digital panoramic radiographs.MATERIALS AND METHODS: This study was performed in 25 patients who were prescribed PTX and tocopherol for treatment of ORN, BRONJ, and chronic osteomyelitis between January 2014 and May 2018 in Seoul National University Dental Hospital. Radiographic densities of the dental panorama were compared prior to starting PTX and tocopherol, at 3 months, and at 6 months after prescription. Radiographic densities were measured using Adobe Photoshop CS6 (Adobe System Inc., USA). Blood sample tests showing the degree of inflammation at the initial visit were considered the baseline and compared with results after 3 to 6 months. Statistical analysis was performed using the Mann–Whitney test and repeated measurement ANOVA using IBM SPSS 23.0 (IBM Corp., USA).RESULTS: Eight patients were diagnosed with ORN, nine patients with BRONJ, and the other 8 patients with chronic osteomyelitis. Ten of the 25 patients were men, average age was 66.32±14.39 years, and average duration of medication was 151.8±80.65 days (range, 56–315 days). Statistically significant increases were observed in the changes between 3 and 6 months after prescription (P<0.05). There was no significant difference between ORN, BRONJ, and chronic osteomyelitis. Only erythrocyte sedimentation rate (ESR) was statistically significantly lower than before treatment (P<0.05) among the white blood cell (WBC), ESR, and absolute neutrophil count (ANC).CONCLUSION: Long-term use of PTX and tocopherol can be an auxiliary method in the treatment of ORN, BRONJ, or chronic osteomyelitis in jaw.


Subject(s)
Bisphosphonate-Associated Osteonecrosis of the Jaw , Blood Sedimentation , Humans , Inflammation , Jaw , Leukocytes , Male , Methods , Neutrophils , Osteomyelitis , Osteoradionecrosis , Pentoxifylline , Prescriptions , Radiography, Panoramic , Seoul , Tocopherols
7.
Rev. argent. cir ; 112(2): 171-177, 2020. ilus, tab
Article in English, Spanish | LILACS | ID: biblio-1125798

ABSTRACT

Antecedentes: la colecistectomía laparoscópica es uno de los procedimientos quirúrgicos más frecuentemente realizados. Las diferencias en la anatomía y en el grado de inflamación vesicular suelen causar dificultades técnicas intraoperatorias. Objetivo: determinar el valor de la proteína C reactiva (PCR) y la velocidad de sedimentación globular (VSG) como predictores de colecistectomía dificultosa y evaluar su aplicación en la planificación prequirúrgica de un programa de residencia universitario. Material y métodos: se confeccionó un estudio retrospectivo, analítico, en un hospital universitario de tercer nivel. Se incluyeron 104 pacientes adultos operados de colecistectomía laparoscópica por litiasis vesicular sintomática entre enero y julio de 2019. Se categorizó a los pacientes en un grupo de colecistectomías dificultosas y otro de colecistectomías no dificultosas. Resultados: se obtuvieron diferencias estadísticamente significativas al comparar los valores de VSG y PCR de ambos grupos (p < 0,001). La sensibilidad de la VSG fue del 100%, la especificidad del 45%, el VPP del 40% y el VPN de 100%. La sensibilidad de la PCR fue del 87,5%, la especificidad del 86,3%, el VPP del 70% y el VPN de 95%. Ambos parámetros se vieron elevados en 14 de 16 colecistectomías dificultosas y en 2 de 44 colecistectomías no dificultosas. La sensibilidad para ambos parámetros elevados fue del 87,5%, la especificidad del 95%, el VPP del 87,5% y el VPN de 95%. Conclusión: la VSG y la PCR han demostrado ser un método fiable en la predicción de colecistectomías dificultosas por litiasis vesicular sintomática. Esto podría ser aplicado en la programación de cirugías dentro de un programa de residencia universitario.


Background: laparoscopic cholecystectomy is one of the most common procedures performed in general surgery. The anatomical differences of the gallbladder and the presence of factors related to inflammation can cause technical issues during surgery. Objective: the aim of the present study was to determine the value of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) as predictors of difficult cholecystectomy and to evaluate their application during presurgical planning within a university residency program. Material and methods: we conducted a retrospective and analytical study in a tertiary university hospital. A total of 104 adult patients undergoing laparoscopic cholecystectomy due to symptomatic cholelithiasis between January and July 2019 were included. The patients were categorized into two groups: difficult cholecystectomy and non-difficult cholecystectomy. Results: there were statistically significant differences in ESR and CRP values between both groups (p < 0.001). Sensitivity of ESR was 100%, specificity was 45%, with a PPV of 40% and NPV of 100%. Sensitivity of CRP was 87.5%, specificity was 86.3%, with a PPV of 70% and NPV of 95%. Both parameters were elevated in 14 of 16 difficult cholecystectomies and in 2 of 44 non-difficult cholecystectomies. Sensitivity of CRP was 87.5%, specificity was 86.3%, with a PPV of 70% and NPV of 95%. Conclusion: measuring ESR and CRP has proved to be a reliable method to predict difficult cholecystectomies due to symptomatic cholelithiasis. This could be applied for surgical planning within a university residency program.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Young Adult , C-Reactive Protein/analysis , Cholecystectomy, Laparoscopic/methods , General Surgery/methods , Blood Sedimentation , Body Mass Index , Retrospective Studies , Hospitals, University , Inflammation/diagnosis , Internship and Residency
8.
Säo Paulo med. j ; 137(6): 517-522, Nov.-Dec. 2019. tab
Article in English | LILACS | ID: biblio-1094529

ABSTRACT

ABSTRACT BACKGROUND: Juvenile idiopathic arthritis (JIA) is the commonest chronic rheumatic disease among children. When not treated effectively, JIA can lead to functional disability, due to joint damage, along with long-term morbidities. OBJECTIVES: To describe the use of tocilizumab therapy for 11 patients with polyarticular JIA (pJIA) and systemic JIA (sJIA) who presented inadequate response or were refractory to disease-modifying anti-rheumatic drugs (DMARDs) and/or other biological therapies; and to evaluate its benefits, safety and tolerability. DESIGN AND SETTING: Observational retrospective case series at a tertiary-level training and research hospital. METHODS: We reviewed the medical records of 11 consecutive patients with JIA who received tocilizumab (anti-IL-6) therapy in our pediatric nephrology and rheumatology outpatient clinic. We analyzed their demographic data, clinical and laboratory findings, treatment response and adverse reactions. We determined the efficacy of tocilizumab treatment using the American College of Rheumatology (ACR) pediatric (Pedi) response criteria, including ACR Pedi 30, 50, 70 and 90 scores. We used the Wilcoxon test to compare measurements before and after treatment. RESULTS: Tocilizumab was given to seven patients with sJIA and four with pJIA (one of the pJIA patients was rheumatoid factor-positive). In most patients, we observed improvement of symptoms, absence of articular and extra-articular inflammation and continued inactive disease. ACR Pedi 30, 50 and 70 scores were achieved by 90.9% of the patients. Five patients showed minor side effects, possibly due to use of tocilizumab. CONCLUSIONS: Tocilizumab therapy should be considered for treating patients with diagnoses of pJIA or sJIA who are resistant to non-biological DMARDs and/or other biological therapies.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Arthritis, Juvenile/drug therapy , Antirheumatic Agents/therapeutic use , Antibodies, Monoclonal, Humanized/therapeutic use , Platelet Count , Arthritis, Juvenile/blood , Blood Sedimentation , C-Reactive Protein/analysis , Drug Resistance , Hemoglobins/analysis , Retrospective Studies , Treatment Outcome , Antirheumatic Agents/administration & dosage , Antibodies, Monoclonal, Humanized/administration & dosage , Leukocytes
9.
Rev. chil. infectol ; 36(5): 636-641, oct. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1058090

ABSTRACT

Resumen Introducción: La enfermedad de Kawasaki (EK) es una vasculitis sistémica aguda con riesgo de desarrollar aneurismas coronarios. Objetivos: Describir características clínico-epidemiológicas en niños con diagnóstico de EK en Argentina. Analizar factores de riesgo para el desarrollo de complicaciones coronarias (CC). Población y Métodos: Estudio multicéntrico, retrospectivo, transversal, observacional y analítico. Incluyó pacientes bajo 18 años de edad, con diagnóstico de EK en hospitales de Argentina, entre el 1 de enero de 2010 y el 31 de diciembre de 2013. Resultados: N = 193 sujetos. Edad: mediana: 29 meses. Tasa promedio total país 5 casos/10.000 egresos hospitalarios. Presentaron CC 15,5%. Mayor riesgo de CC: Mayor cantidad de días de fiebre al momento de colocación del tratamiento (p = 0,0033); Aumento de: frecuencia cardíaca (p = 0,0021), eritrosedimentación (VSG) (p = 0,005), proteína C reactiva (PCR) (p < 0,0001), leucocitosis (p = 0,0006), neutrofilia (p = 0,0021); Disminución de hematocrito (p = 0,0007) y hemoglobina (p < 0,0001). Asociación con CC: alteraciones cardiológicas no coronarias (ORv10.818); PCR mayor de 68 mg/L (OR = 11.596); leucocitos mayores a 20.000/mm3 (OR= 4.316); y VSG mayor de 64 mm/1° hora (OR = 4.267). Conclusión: La forma de presentación más frecuente fue EK completa, el riesgo de CC fue mayor en varones, menores de 5 años de edad, los factores de riesgo (clínicos y de laboratorio) fueron semejantes a los descritos en la bibliografía.


Background: Kawasaki disease (EK) is an acute systemic vasculitis with a risk of developing coronary aneurysms. Aim: To describe the clinical and epidemiological characteristics of children with EK in Argentina and to analyse the risk factors for the development of coronary's complications (CC). Methods: Multicenter, retrospective, cross-sectional, observational and analytical study. It included patients younger than 18 years of age diagnosed with EK in hospitals in Argentina, between January the 1st, 2010 and December the 31th, 2013. Results: N = 193 subjects. Age: medium: 29 months. Total incidence 5 cases / 10,000 hospital discharges. CC was observed in 15.5% of patients. Increased risk factors for CC: Elevated number of days with fever at the time of treatment placement (p = 0.0033); Increased of: heart frequency (p = 0.0021), erythrosedimentation (ESR) (p = 0.005), C-reactive protein (CRP) (p < 0.0001), leukocytes (p = 0.0006), neutrophils (p = 0.0021); Decreased of hematocrit (p = 0.0007) and hemoglobin (p < 0.0001).Association with CC: non-coronary cardiological alterations (OR = 10,818); PCR greater than 68 mg /L (OR = 11,596); leukocytes greater than 20,000 / mm3 (OR = 4.316); and ESR greater than 64 mm / 1 hour (OR = 4.267). Conclusion: The most frequent form of presentation was complete EK, the risk of CC was higher in males, younger than 5 years old, the risk factors (clinical and laboratory) were similar to those described in the literature.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Coronary Disease/etiology , Coronary Disease/epidemiology , Mucocutaneous Lymph Node Syndrome/complications , Mucocutaneous Lymph Node Syndrome/epidemiology , Argentina/epidemiology , Seasons , Blood Sedimentation , C-Reactive Protein/analysis , Incidence , Cross-Sectional Studies , Retrospective Studies , Risk Factors , Immunoglobulins, Intravenous/therapeutic use , Statistics, Nonparametric , Risk Assessment , Mucocutaneous Lymph Node Syndrome/therapy
10.
Arq. bras. oftalmol ; 82(4): 263-269, July-Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1019422

ABSTRACT

ABSTRACT Purpose: To compare retinal and choroidal thickness in patients with Behçet's disease with and without ocular involvement as well as to evaluate the correlation between erythrocyte sedimentation rate and choroidal thickness among patients with Behçet's disease. Methods: This was a prospective interventional study investigating erythrocyte sedimentation as well as choroidal and retinal thickness among patients with Behçet's disease. Patients who were diagnosed based on The International Criteria for Behçet's Disease with (Group A) or without (Group B) ocular involvement and a matched control group (Group C) participated in the study. Optical coherence tomography measurements and blood tests were performed on the same day. Retinal and choroidal thickness were measured using spectral-domain optical coherence tomography (Spectralis, Heidelberg Engineering, Heidelberg, Germany), and central macular thickness, central subfoveal choroidal thickness, and retinal nerve fiber layer thickness were measured using optical coherence tomography. Results: Average erythrocyte sedimenta­tion values were 9.89 mm/h in Group A, 16.21 mm/h in Group B, and 3.89 mm/h in Group C; average central subfoveal choroidal thickness values were 350.66, 331.74, and 325.95 mm, respectively. Average central macular thickness and retinal nerve fiber layer thickness values of patients in Groups A, B and C were 226.39 and 225.97mm; 234.11 and 92.00 mm; and 97.58 and 99.84 mm, respectively. No significant difference was seen between Group A and B patients in central subfoveal choroidal thickness, central macular thickness, or retinal nerve fiber layer thickness values. Central macular thickness was statistically significantly thinner in Groups A and B than in Group C (p=0.016). Group A had thinning in the nasal quadrant of the retinal and general retinal nerve fiber layers when compared with those in Group C (p=0.010 and 0.041, respectively). A connection could not be established between the erythrocyte sedimentation, central subfoveal cho­roidal thickness, central macular thickness, and retinal nerve fiber layer thickness in the patients with Behçet's disease. Conclusion: The erythrocyte sedimentation rate is typically used to test for activation of Behçet's disease and assess treatment response. In our study, we could not establish a connection between the erythrocyte sedimentation rate and central subfoveal choroidal thickness, central macular thickness, and retinal nerve fiber layer thickness in patients with systematically active Behçet's disease without ocular involvement.


RESUMO Objetivos: Comparar a espessura da retina e da coroide em pacientes com doença de Behçet, com e sem acometimento ocular e avaliar a correlação entre a taxa de sedimentação de eritrócitos e a espessura da coroide em pacientes com doença de Behçet. Métodos: Estudo prospectivo intervencional que investigou a sedimentação de eritrócitos, espessura de coroide e da retina em pacientes com doença de Behçet. Os pacientes que foram diagnosticados com base nos Critérios Internacionais para a Doença de Behçet com (Grupo A) ou sem (Grupo B) envolvimento ocular e um grupo controle correspondente (Grupo C) participaram do estudo. Medidas de tomografia de coerência óptica e exames de sangue foram realizados no mesmo dia. As espessuras da retina e da coroide foram medidas utilizando tomografia de coerência óptica de domínio espectral (Spectralis, Heidelberg Engineering, Hidelberg, Germany) e a espessura macular central, a espessura coroidal subfoveal central e a espessura da camada de fibra nervosa da retina foram medidas usando tomografia de coerência óptica. Resultados: Os valores médios de sedimentação de eritrócitos foram de 9,89 mm/h no Grupo A, 16,21 mm/h no Grupo B e 3,89 mm/h no Grupo C; os valores médios da espessura da coroide subfoveal central foram 350,66, 331,74 e 325,95 mm respectivamente. Os valores médios da espessura macular central e da espessura da camada de fibra nervosa da retina dos pacientes nos grupos A, B e C foram de 226,39, 225,97, 234,11 mm e 92,00, 97,58, 99,84 mm respectivamente. Não houve diferença significativa entre pacientes do Grupo A e B na espessura da coroide subfoveal central, espessura macular central ou valores da espessura da camada de fibra nervosa da retina. A espessura macular central foi estatisticamente significativamente mais fina nos Grupos A e B do que no Grupo C (p=0,016). O Grupo A apresentou afinamento na porção nasal das camadas retiniana e geral da fibra nervosa da retina quando comparado com o Grupo C (p=0,010, p=0,041, respectivamente). Não foi possível estabelecer uma conexão entre a sedimentação dos eritrócitos, a espessura subfoveal central da coroide, a espessura macular central e espessura da camada de fibras nervosas da retina nos pacientes com doença de Behçet. Conclusão: A taxa de sedimentação de eritrócitos é comumente utilizada para testar a ativação da doença de Behçet e avaliar a resposta ao tratamento. Em nosso estudo, não foi possível estabelecer uma conexão entre a taxa de sedimentação de eritrócitos e a espessura da coroide subfoveal central, espessura macular central e espessura da camada de fibras nervosas da retina em pacientes com doença de Behçet sistematicamente ativa sem envolvimento ocular.


Subject(s)
Humans , Male , Female , Adult , Retina/pathology , Blood Sedimentation , Behcet Syndrome/pathology , Behcet Syndrome/blood , Choroid/pathology , Reference Values , Retina/diagnostic imaging , Uveitis/etiology , Uveitis/pathology , Case-Control Studies , Behcet Syndrome/complications , Prospective Studies , Choroid/diagnostic imaging , Statistics, Nonparametric , Tomography, Optical Coherence/methods , Intraocular Pressure , Nerve Fibers/pathology
11.
Rev. colomb. reumatol ; 26(1): 24-30, Jan.-Mar. 2019. tab
Article in English | LILACS | ID: biblio-1098962

ABSTRACT

ABSTRACT Objective: To determine whether seropositivity in rheumatoid arthritis patients treated with adalimumab (ADL) is associated with the presence of anti-adalimumab (anti-ADL) antibodies. Materials and methods: A descriptive observational study that included patients diagnosed with rheumatoid arthritis according to ACR 1987 criteria, and who were on treatment with ADL as the first biological, for at least six months. All patients were evaluated for rheumatoid factor, anti-citrulline antibodies, erythrocyte sedimentation rate, C-reactive protein, clinimetric indices, and level of anti-ADL antibodies. Results: A total of 80 patients with a mean age of 56 years were evaluated, of whom 86% were women. The mean duration of the disease was 15 years, and the ADL exposure time was 52 months (median value). The seropositivity for rheumatoid factor tended to be higher in patients who developed anti-ADL antibodies compared to those who did not (90.5% vs. 66.1%). The magnitude of the association between rheumatoid factor and the presence of anti-ADL antibodies was shown to be strong and statistically significant (OR = 4.87, 95% CI; 1.03-23.03). Adjusted multivariate regression analyses showed a strong association (OR = 9.77, 95% CI; 1.74-54.79) between seropositivity and the presence of anti-ADL antibodies, which, given the low number of patients, lacks precision (95% CI very wide). Conclusions: Seropositive patients tend to have more anti-ADL antibodies. However, a larger sample size is required to obtain the necessary precision and greater certainty in these findings.


RESUMEN Objetivo: Determinar si la seropositividad en pacientes con artritis reumatoide tratados con adalimumab (ADL), se asocia a la presencia de anticuerpos anti-adalimumab (anti-ADL). Materiales y métodos: Es un estudio observacional descriptivo que incluyó pacientes con diagnóstico de artritis reumatoide según criterios ACR1987, que estaban en tratamiento con ADL como primer biológico, por al menos 6 meses. Todos los pacientes se evaluaron para factor reumatoide, anticuerpos anticitrulina, velocidad de sedimentación globular, proteína C reactiva, índices clinimétricos y nivel de anticuerpos anti-ADL. Resultados: Se evaluaron 80 pacientes con edad promedio de 56 arios, el 86% fueron mujeres, la duración promedio de la enfermedad fue de 15 años y el tiempo de exposición a ADL de 52 meses (valor mediano). La seropositividad para factor reumatoide tendió a ser mayor en los pacientes que desarrollaron anticuerpos anti-ADL en comparación con los que no (90,5% vs. 66,1%). La magnitud de la asociación entre factor reumatoide y la presencia de anticuerpos anti-ADL tendió a ser fuerte y estadísticamente significativa (OR = 4,87; IC 95%: 1,03-23,03). Los análisis ajustados de regresión multivariable mostraron una asociación fuerte (OR = 9,77; IC 95%: 1,74-54,79) entre la seropositividad y la presencia de anticuerpos anti-ADL, que dado el bajo número de pacientes carece de precisión (IC 95% muy amplios). Conclusiones: Los pacientes seropositivos tienden a presentar más anticuerpos anti-ADL; sin embargo, se requiere tener un mayor tamaño muestral para obtener la precisión necesaria y tener mayor certeza en estos hallazgos.


Subject(s)
Humans , Adult , Middle Aged , Aged , Aged, 80 and over , Arthritis, Rheumatoid , Biological Therapy , Adalimumab , Therapeutics , Blood Sedimentation , C-Reactive Protein
12.
Med. infant ; 26(1): 19-26, Marzo 2019. tab, ilus
Article in Spanish | LILACS | ID: biblio-994720

ABSTRACT

Introducción: Para predecir una infección en estadios tempranos en niños con cáncer se han evaluado marcadores como ESD, PCR y PCT. Objetivo: evaluar la precisión diagnóstica para bacteriemia de estos marcadores al ingreso en niños con fiebre y leucemia aguda (LA) o linfoma (L) internados entre 2013-2016. Métodos: estudio analítico retrospectivo. Revisión de historias clínicas. Se calcularon sensibilidad, especificidad, valor predictivo positivo, valor predictivo negativo y área bajo la curva ROC para cada marcador en MedCalc® V16.8.4. Se obtuvo autorización del Comité de Ética. Resultados:en total se internaron 31 niños con diagnóstico de LA y L, 19 presentaron fiebre y 12 no. Hubo 40 episodios de fiebre clasificados en 4 grupos: bacteriemia 14 (35%), infección documentada microbiológicamente 5 (12.5%), infección documentada clínicamente 2 (5%) y fiebre de origen desconocido 19 (47.5%). Los niveles de PCT fueron mayores en el grupo de bacteriemia registrando un valor promedio de 1,17ng/ mL (p: 0.045). El área bajo la curva ROC entre el grupo con y sin bacteriemia fue de 0.50 para ESD, 0.65 para PCR y 0.83 para PCT con S de 77.78%, E de 66.67%, VPP de 50% y VPN de 92.86%. Discusión: la PCT mostró ser el más eficaz que ESD y PCR para predecir bacteriemia. se deben realizar investigaciones con biomarcadores con el objeto de disminuir el uso inadecuado de antibióticos en pacientes con fiebre secundaria a enfermedad y acortar los tiempos de tratamiento en pacientes con infecciones adecuadamente resueltas mejorando ampliamente la calidad de vida en niños con cáncer (AU)


Introduction: To predict infection in early stages in children with cancer, markers such as ESR, CRP, and PCT have been evaluated. Objective: To evaluate the diagnostic precision for bacteremia of these markers on admission of children with fever and acute leukemia (AL) or lymphoma (L) admitted between 2013- 2016. Methods: A retrospective analytical study. Review of the clinical records. Sensitivity, specificity, positive predictive value, negative predictive value, and area under the ROC curve were calculated for each marker in MedCalc® V16.8.4. The study was approved by the Ethics Committee. Results: Overall, 31 children with AL and L were admitted, 19 of whom presented with fever and 12 did not. There were 40 episodes of fever classified into 4 groups: bacteremia 14 (35%), microbiologically documented infection 5 (12.5%), clinically documented infection 2 (5%), and fever of unknown etiology 19 (47.5%). PCT levels were higher in the group with bacteremia with a mean value of 1.17ng/mL (p:0.045). The area under the ROC curve between the groups with and without bacteremia was 0.50 for ESR, 0.65 for CRP, and 0.83 for PCT with a sensitivity of 77.78%, specificity of 66.67%, PPV of 50%, and NPV of 92.86%. Discussion: PCT showed a greater efficacy than ESD and CRP to predict bacteremia. Research on biomarkers should be conducted to reduce the inadequate use of antibiotics in patients with fever secondary to disease and to shorten treatment times in patients with adequately resolved infections, thereby improving quality of life in children with cancer (AU)


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Blood Sedimentation , Leukemia/complications , Polymerase Chain Reaction/methods , Bacteremia/diagnosis , Fever/complications , Lymphoma/complications , Acute Disease , Retrospective Studies , Risk Factors , Bacteremia/microbiology
13.
Arq. neuropsiquiatr ; 77(2): 101-105, Feb. 2019. tab
Article in English | LILACS | ID: biblio-983887

ABSTRACT

ABSTRACT Cerebral vein thrombosis (CVT) is a rare but serious cause of acute stroke. Inflammation is a hypothetical etiological factor in CVT. Objective: The aim of this study was to evaluate inflammatory marker levels in CVT patients and compare these with healthy individuals. Methods: This prospective case-control study was conducted with 36 newly-diagnosed CVT patients age- and sex-matched with 40 healthy individuals. The laboratory investigations included a serum hemogram, full biochemistry profiles, high sensitivity C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-HDL cholesterol ratio (MHR) values were calculated and compared between the patients and healthy participants. Results: The mean age was 41.4 ± 11.8 years for patients, and 39.3 ± 12.5 for controls. Lymphocyte, total bilirubin, indirect bilirubin, and HDL levels were significantly lower in CVT patients (p < 0.05), while CRP, and ESR values were significantly higher. In the CVT patients the mean NLR and PLR values were significantly higher than in the control individuals. Smoking rates, alcohol consumption, white blood cell, neutrophil, platelet, and MHR values were similar in both groups (p > 0.05). Conclusions: We suggest that NLR, PLR, CRP, ESR, and bilirubin can be used in clinical practice for prediction of CVT in suspected patients as they are inexpensive parameters and widely available. However, further large-scale studies are required to confirm this relationship.


RESUMEN la trombosis de la vena cerebral (CVT) es una causa rara pero grave de accidente cerebrovascular agudo. La inflamación es un factor etiológico hipotético en CVT. Objetivo: El objetivo de este estudio fue evaluar los niveles de marcadores inflamatorios en pacientes con CVT y compararlos con los sujetos sanos. Métodos: Este estudio prospectivo de casos y controles se realizó con 36 pacientes con TVC recién diagnosticados y 40 sujetos sanos con edad y sexo similares. Las investigaciones de laboratorio incluyeron hemograma sérico, perfiles bioquímicos completos, proteína C-reactiva (CRP) de alta sensibilidad y velocidad de sedimentación eritrocitaria (ESR). Se calculó la relación de neutrófilos a linfocitos (NLR), relación de plaquetas a linfocitos (PLR) y monocitos a HDL-colesterol (MHR) y se compararon entre pacientes y sujetos sanos. Resultados: La edad media fue de 41,4 ± 11,8 años para los pacientes y de 39,3 ± 12,5 para los controles. Los niveles de linfocitos, bilirrubina total, bilirrubina indirecta y HDL fueron significativamente más bajos en pacientes con CVT (p ≤ 0.05), mientras que los valores de CRP y ESR fueron significativamente más altos. En los pacientes con CVT, los valores medios de NLR y PLR fueron significativamente más altos que en los sujetos control. Las tasas de tabaquismo, consumo de alcohol, glóbulos blancos, neutrófilos, plaquetas y MHR fueron similares en ambos grupos (p > 0.05). Conclusiones: Sugerimos que la NLR, la PLR, la CRP, la ESR y la bilirrubina se pueden usar en la práctica clínica para la predicción de la CVT en pacientes sospechosos, ya que son parámetros económicos y están ampliamente disponibles. Sin embargo, se requieren más estudios a gran escala para confirmar esta relación.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Cerebral Veins , Venous Thrombosis/blood , Inflammation/blood , Platelet Count , Reference Values , Bilirubin/blood , Blood Sedimentation , C-Reactive Protein/analysis , Biomarkers/blood , Case-Control Studies , Logistic Models , Prospective Studies , Statistics, Nonparametric , Lymphocyte Count , Mean Platelet Volume , Cholesterol, HDL/blood , Neutrophils
14.
Säo Paulo med. j ; 137(1): 39-44, Jan.-Feb. 2019. tab
Article in English | LILACS | ID: biblio-1004743

ABSTRACT

ABSTRACT BACKGROUND: Up to 5% of familial Mediterranean fever (FMF) cases are unresponsive to colchicine, through resistance, side effects and toxicity. Anakinra is an alternative treatment for FMF patients whose disease remains uncontrolled with colchicine. We aimed to evaluate anti-interleukin-1 treatment regarding clinical findings, laboratory parameters and quality of life (QoL) among FMF patients presenting resistance and toxicity towards colchicine. DESIGN AND SETTING: Descriptive observational study at the rheumatology clinic, Adnan Menderes University Medical School, Aydın, Turkey. METHODS: Among the patients included, age, sex, MEFV genotypes, acute-phase reactants, hepatic/renal function tests, average colchicine dose, disease duration, attack frequency, attack duration, disease severity, proteinuria, amyloidosis and QoL were evaluated. Colchicine resistance was defined as > 6 typical episodes/year or > 3 per 4-6 months. Kolmogorov-Smirnov, Friedman and two-way analysis of variance tests were used for statistical analyses. RESULTS: Between 2015 and 2017, 14 FMF patients receiving anakinra were enrolled. The mean colchicine dose was 1.7 ± 0.3 mg/day before use of anakinra. Ten patients were attack-free after treatment, while three showed reductions of at least 50% in attack frequency, attack duration and disease severity. Proteinuria levels in all patients with renal amyloidosis decreased after treatment. QoL among patients with renal amyloidosis differed significantly from QoL among non-amyloidosis patients. Mean visual analogue scale scores significantly improved in both groups after use of anakinra. CONCLUSIONS: Use of anakinra reduced attack frequency and proteinuria and acute-phase reactant levels, and improved QoL, with only a few uncomplicated side effects among colchicine-resistant or intolerant FMF patients. Injection-site reactions of severity insufficient to require discontinuation of treatment were seen.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Familial Mediterranean Fever/drug therapy , Quality of Life , Drug Resistance/drug effects , Colchicine/therapeutic use , Interleukin-1/antagonists & inhibitors , Antirheumatic Agents/therapeutic use , Interleukin 1 Receptor Antagonist Protein/therapeutic use , Familial Mediterranean Fever/physiopathology , Proteinuria/urine , Reference Values , Time Factors , Turkey , Severity of Illness Index , Blood Sedimentation , Reproducibility of Results , Retrospective Studies , Analysis of Variance , Treatment Outcome , Statistics, Nonparametric , Visual Analog Scale , Amyloidosis/physiopathology , Amyloidosis/drug therapy , Kidney Diseases/physiopathology , Kidney Diseases/drug therapy
15.
Article in English | WPRIM | ID: wpr-763361

ABSTRACT

OBJECTIVE: To investigate serum 25-hydroxyl vitamin D (25(OH)D) and vitamin D-binding protein (VDBP) concentrations in women with endometriosis according to the severity of disease. METHODS: Women with mild endometriosis (n = 9) and advanced endometriosis (n = 7), as well as healthy controls (n = 16), were enrolled in this observational study. Serum total 25(OH)D concentrations were analyzed using the Elecsys vitamin D total kit with the Cobas e602 module. Concentrations of bioavailable and free 25(OH)D were calculated. Concentrations of VDBP were measured using the Human Vitamin D BP Quantikine ELISA kit. Variables were tested for normality and homoscedasticity using the Shapiro-Wilk test and Leven F test, respectively. Correlation analysis was used to identify the variables related to total 25(OH)D and VDBP levels. To assess the effects of total 25(OH)D and VDBP levels in the three groups, multivariate generalized additive modeling (GAM) was performed. RESULTS: Gravidity and parity were significantly different across the three groups. Erythrocyte sedimentation rate (ESR) and CA-125 levels increased as a function of endometriosis severity, respectively (p= 0.051, p= 0.004). The correlation analysis showed that total 25(OH)D levels were positively correlated with gravidity (r = 0.59, p< 0.001) and parity (r = 0.51, p< 0.003). Multivariate GAM showed no significant relationship of total 25(OH)D levels with EMT severity after adjusting for gravidity and ESR. However, the coefficient of total 25(OH)D levels with gravidity was significant (1.87; 95% confidence interval, 0.12–3.63; p= 0.040). CONCLUSION: These results indicate that vitamin D and VDBP levels were not associated with the severity of endometriosis.


Subject(s)
Blood Sedimentation , Endometriosis , Enzyme-Linked Immunosorbent Assay , Female , Gravidity , Humans , Observational Study , Parity , Vitamin D , Vitamin D-Binding Protein , Vitamins
16.
Article in English | WPRIM | ID: wpr-763360

ABSTRACT

OBJECTIVE: Vitamin D-binding protein (VDBP) mediates various biological processes in humans. The goal of this study was to investigate whether VDBP gene polymorphisms could predispose Korean women to endometriosis. METHODS: We prospectively enrolled women with endometriosis (n = 16) and healthy controls (n = 16). Total serum 25-hydroxyl vitamin D (25(OH)D) concentrations were measured using an Elecsys vitamin D total kit. Levels of bioavailable and free 25(OH)D were calculated. Concentrations of VDBP were measured using a vitamin D BP Quantikine ELISA kit. DNA was extracted using a DNeasy blood & tissue kit. Two single-nucleotide polymorphisms (SNPs; rs4588 and rs7041) in GC, the gene that codes for VDBP, were analyzed using a TaqMan SNP genotyping assay kit. The functional variant of VDBP was determined based on the results of the two SNPs. RESULTS: Gravidity and parity were significantly lower in the endometriosis patients than in the control group, but serum CA-125 levels and the erythrocyte sedimentation rate were significantly higher. Total serum 25(OH)D levels in the endometriosis patients were significantly lower than in the control group. However, serum bioavailable 25(OH)D, free 25(OH)D, and VDBP levels did not differ significantly between the endometriosis and control groups. The genotypes and allele frequencies of GC were similar in both groups. CONCLUSION: Korean women with endometriosis had lower total serum 25(OH)D concentrations than controls. Neither serum VDBP concentrations nor polymorphisms in the gene coding for VDBP were associated with endometriosis. Further studies are needed to investigate the pathophysiology and clinical implications of 25(OH)D and VDBP in endometriosis.


Subject(s)
Biological Phenomena , Blood Sedimentation , Clinical Coding , DNA , Endometriosis , Enzyme-Linked Immunosorbent Assay , Female , Gene Frequency , Genotype , Gravidity , Humans , Parity , Polymorphism, Genetic , Polymorphism, Single Nucleotide , Prospective Studies , Vitamin D , Vitamin D-Binding Protein , Vitamins
17.
Article in Korean | WPRIM | ID: wpr-770030

ABSTRACT

PURPOSE: Fungal periprosthetic joint infection (PJI) is a rare but devastating complication following total knee arthroplasty (TKA). On the other hand, a standardized procedure regarding an accurate treatment of this serious complication of knee arthroplasty is lacking. The clinical progress of staged reimplantation in patients who had fungus-related PJI after TKA was reviewed retrospectively. MATERIALS AND METHODS: Ten patients who had a fungal related PJI after TKA between 2006 and 2017 using staged reimplantation surgery were reviewed. These patients were compared with 119 patients who had a PJI in the same period. The failure rate of infection control, intravenous antimicrobial using the period, and the clinical results were evaluated by comparing the range of motion and Korean knee score (KKS) between pre-staged reimplantation and the last follow-up. RESULTS: In the fungal infection group, 7 out of 10 cases (70.0%) had failed in infection control using staged reimplantation and in the non-fungal group, 7 out of 119 cases (5.9%) had failed (p=0.04). In the non-fungal group, the mean duration of antibiotics was 6.2 weeks. In the fungus group, the mean duration of antibiotics was 15.3 weeks, which was 9.1 weeks longer (p < 0.001). The range of motion of the knee was increased in the two groups (p=0.265). At the last follow-up, the KKS was 71.01 points in the non-fungal group and 61.3 points in the fungal group (p=0.012). Erythrocyte sedimentation rate and C-reactive protein (CRP) decreased in the two groups, but the CRP was significantly different in the two groups (p=0.007). CONCLUSION: The treatment of fungus-related PJIs using staged reimplantation showed uneven clinical progress and unsatisfactory clinical improvements compared to non-fungal PJI. Therefore, it is necessary to consider the use of an antifungal mixed cement spacer at resection arthroplasty and oral antifungal agent after reimplantation.


Subject(s)
Anti-Bacterial Agents , Arthroplasty , Arthroplasty, Replacement, Knee , Blood Sedimentation , C-Reactive Protein , Follow-Up Studies , Fungi , Hand , Humans , Infection Control , Joints , Knee , Range of Motion, Articular , Replantation , Retrospective Studies
18.
Korean Circulation Journal ; : 755-765, 2019.
Article in English | WPRIM | ID: wpr-759456

ABSTRACT

BACKGROUND AND OBJECTIVES: Immunological variability in Kawasaki disease (KD) shows age-specific differences; however, specific differences in laboratory values have not been compared between infants and non-infants with KD. We compared age-adjusted Z-values (Z) of white and red blood cells in infants with KD with those in non-infants with KD. METHODS: This study retrospectively investigated 192 infants and 667 non-infants recruited between 2003 and 2015 at the Korea University Hospital. Laboratory values for infants with KD and non-infants with KD were analyzed and age-unadjusted raw values (R) and age-adjusted Z for blood cells counts were determined. RESULTS: Z in infants with KD during pre-intravenous immunoglobulin (IVIG), post-IVIG, and chronic phases showed increased lymphopenia and eosinophilia, low neutrophil:lymphocyte and neutrophil:eosinophil ratios, worse anemia, increased thrombocytosis, and reduced erythrocyte sedimentation rates compared with those in non-infants with KD. The optimal cut-off value for pre-IVIG Z-hemoglobin for prediction of KD in all patients was 40 mg/L (AUC, 0.811; sensitivity/specificity, 0.712/0.700; p=0.04). CONCLUSIONS: Laboratory characteristics enable differentiation between infants and non-infants with KD and contribute to a better understanding of changes in blood cell counts. Infants with incomplete KD can be more easily differentiated from infants with simple febrile illness using pre-IVIG Z-hemoglobin and pre-IVIG CRP values.


Subject(s)
Anemia , Blood Cell Count , Blood Cells , Blood Sedimentation , C-Reactive Protein , Eosinophilia , Erythrocytes , Humans , Immunoglobulins , Infant , Korea , Leukocyte Count , Lymphopenia , Mucocutaneous Lymph Node Syndrome , Retrospective Studies , Thrombocytosis
19.
Article in Korean | WPRIM | ID: wpr-786529

ABSTRACT

PURPOSE: Periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome is a leading cause of periodic fever in children. This study describes the clinical characteristics of PFAPA syndrome in patients from a single center.METHODS: Thirteen children diagnosed with PFAPA syndrome at Seoul National University Children's Hospital were included in this study. Retrospective medical chart reviews were performed.RESULTS: Among the 13 patients, 8 (61.5%) were male. The median follow-up duration was 3.3 years (range, 10 months–8.3 years). The median age of periodic fever onset was 3 years (range, 1–6 years). All patients had at least 5 episodes of periodic fever and pharyngitis, managed with oral antibiotics, before diagnosis. The median occurrence of fever was every 3.9 weeks and lasted for 4.2 days. All patients had pharyngitis and 12 (92.3%) had cervical lymphadenitis. Blood tests were performed for 12 patients, and no patients had neutropenia. Both the C-reactive protein and erythrocyte sedimentation rate were elevated at medians of 4.5 mg/dL (range, 0.4–13.2 mg/dL) and 29 mm/hr (range, 16–49 mm/hr), respectively. Throat swab cultures and rapid streptococcal antigen tests were negative. Nine (69.2%) patients received oral prednisolone at a median dose of 0.8 mg/kg, and in 6 (66.7%) patients, fever resolved within a few hours. Three (23.1%) patients received tonsillectomy and adenoidectomy.CONCLUSIONS: PFAPA syndrome should be considered when a child presents with periodic fever along with aphthous stomatitis, pharyngitis, or cervical lymphadenitis. Glucocorticoid administration is effective for fever resolution and can reduce unnecessary use of antibiotics.


Subject(s)
Adenoidectomy , Anti-Bacterial Agents , Blood Sedimentation , C-Reactive Protein , Child , Diagnosis , Fever , Follow-Up Studies , Hematologic Tests , Humans , Lymphadenitis , Male , Neutropenia , Pharyngitis , Pharynx , Prednisolone , Retrospective Studies , Seoul , Stomatitis, Aphthous , Tonsillectomy , Yemen
20.
Braz. j. med. biol. res ; 52(8): e8309, 2019. tab, graf
Article in English | LILACS | ID: biblio-1011605

ABSTRACT

This study aimed to detect the expression of the long non-coding RNA (lncRNA) antisense non-coding RNA in the INK4 locus (ANRIL) and evaluate its correlation with disease risk, stenosis degree, inflammation, as well as overall survival (OS) in coronary artery disease (CAD) patients. A total of 230 patients who underwent diagnostic coronary angiography were consecutively recruited and assigned to CAD group (n=125) or control group (n=105) according to presence or absence of CAD. Gensini score was calculated to assess the severity of coronary artery damage. Plasma samples were collected and the expression ANRIL was detected in all participants. High-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), and cytokines including tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6, IL-8, IL-10, and IL-17 in CAD patients were measured and OS was calculated. The relative expression of ANRIL was higher in CAD patients compared to controls (P<0.001). Receiver operating characteristic disclosed that ANRIL could distinguish CAD patients from controls with an area under the curve of 0.789 (95%CI: 0.731-0.847). Spearman's rank correlation test revealed that expression of ANRIL was positively correlated with Gensini score (P=0.001), levels of hs-CRP (P=0.001), ESR (P=0.038), TNF-α (P=0.004), and IL-6 (P<0.001), while negatively correlated with IL-10 level (P=0.008) in CAD patients. Kaplan-Meier curve revealed that high expression of ANRIL was associated with shorter OS (P=0.013). In conclusion, circulating ANRIL presented a good diagnostic value for CAD, and its high expression was associated with increased stenosis degree, raised inflammation, and poor OS in CAD patients.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Coronary Artery Disease/diagnosis , RNA, Long Noncoding/genetics , Prognosis , Blood Sedimentation , Coronary Artery Disease/complications , Coronary Artery Disease/genetics , Coronary Artery Disease/blood , C-Reactive Protein/analysis , Survival Analysis , Cytokines/blood , Risk Assessment , Coronary Stenosis/complications , Inflammation/diagnosis
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