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1.
Article in English | WPRIM | ID: wpr-927642

ABSTRACT

OBJECTIVE@#Traditional epidemiological studies have shown that C-reactive protein (CRP) is associated with the risk of cardiovascular diseases (CVDs). However, whether this association is causal remains unclear. Therefore, Mendelian randomization (MR) was used to explore the causal relationship of CRP with cardiovascular outcomes including ischemic stroke, atrial fibrillation, arrhythmia and congestive heart failure.@*METHODS@#We performed two-sample MR by using summary-level data obtained from Japanese Encyclopedia of Genetic association by Riken (JENGER), and we selected four single-nucleotide polymorphisms associated with CRP level as instrumental variables. MR estimates were calculated with the inverse-variance weighted (IVW), penalized weighted median and weighted median. MR-Egger regression was used to explore pleiotropy.@*RESULTS@#No significant causal association of genetically determined CRP level with ischemic stroke, atrial fibrillation or arrhythmia was found with all four MR methods (all Ps > 0.05). The IVW method indicated suggestive evidence of a causal association between CRP and congestive heart failure ( OR: 1.337, 95% CI: 1.005-1.780, P = 0.046), whereas the other three methods did not. No clear pleiotropy or heterogeneity were observed.@*CONCLUSIONS@#Suggestive evidence was found only in analysis of congestive heart failure; therefore, further studies are necessary. Furthermore, no causal association was found between CRP and the other three cardiovascular outcomes.


Subject(s)
C-Reactive Protein/metabolism , Cardiovascular Diseases/metabolism , Genetic Predisposition to Disease , Genotype , Humans , Japan , Mendelian Randomization Analysis , Polymorphism, Single Nucleotide , Risk Factors
2.
Gac. méd. Méx ; 156(6): 563-568, nov.-dic. 2020. tab
Article in Spanish | LILACS | ID: biblio-1249968

ABSTRACT

Resumen Introducción: Los índices neutrófilo/linfocito (INL) y linfocito/proteína C reactiva (ILR) se usan para predecir severidad y mortalidad en diversas infecciones. Objetivo: Establecer en México el mejor punto de corte de INL e ILR para predecir la mortalidad en pacientes hospitalizados por COVID-19. Método: Estudio transversal analítico de pacientes hospitalizados por COVID-19 grave en un hospital de especialidades. Resultados: Falleció 34 % de 242 pacientes analizados. Los sujetos fallecidos tenían mayor edad (62 versus 51 años, p < 0.001), mayor prevalencia de hipertensión arterial sistémica > 10 años (59.4 versus 45.1 %, p = 0.022), así como INL más alto (17.66 versus 8.31, p < 0.001) e ILR más bajo (0.03 versus 0.06, p < 0.002) respecto a quienes sobrevivieron. Los puntos de corte para predecir mortalidad fueron INL > 12 e ILR < 0.03. La combinación de INL e ILR tuvo sensibilidad de 80 %, especificidad de 74 %, valor predictivo positivo de 46.15 %, valor predictivo negativo de 93.02 % y razón de momios de 11.429 para predecir la mortalidad. Conclusión: INL > 12 e ILR < 0.03 son biomarcadores útiles para evaluar el riesgo de mortalidad en pacientes mexicanos con COVID-19 grave.


Abstract Introduction: Neutrophil-to-lymphocyte (NLR) and lymphocyte-to-C-reactive protein (LCR) ratios are used to predict severity and mortality in various infections. Objective: To establish the best NLR and LCR cutoff point to predict mortality in patients hospitalized for COVID-19 in Mexico. Method: Analytical cross-sectional study of patients hospitalized for severe COVID-19 in a specialty hospital. Results: Out of 242 analyzed patients, 34 % died. The deceased subjects were older (62 vs. 51 years; p < 0.001), had a higher prevalence of > 10 years with systemic arterial hypertension (59.4 vs. 45.1 %, p = 0.022), as well as a higher NLR (17.66 vs. 8.31, p < 0.001) and lower LCR (0.03 vs. 0.06, p < 0.002] with regard to those who survived. The cutoff points to predict mortality were NLR > 12 and LCR < 0.03. The combination of NLR/LCR had a sensitivity of 80 %, specificity of 74 %, positive predictive value of 46.15 %, negative predictive value of 93.02 % and an odds ratio of 11.429 to predict mortality. Conclusion: NLR > 12 and LCR < 0.03 are useful biomarkers to evaluate the risk of mortality in Mexican patients with severe COVID- 19.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , C-Reactive Protein/metabolism , Lymphocytes/metabolism , COVID-19/physiopathology , Neutrophils/metabolism , Severity of Illness Index , Cross-Sectional Studies , Predictive Value of Tests , Sensitivity and Specificity , COVID-19/mortality , Mexico/epidemiology
3.
Rev. Assoc. Med. Bras. (1992) ; 66(6): 762-770, June 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1136297

ABSTRACT

SUMMARY Comparison of radiological scoring systems, clinical scores, neutrophil-lymphocyte ratio and serum C-reactive protein level for severity and mortality in acute pancreatitis BACKGROUND/AIMS To compare radiological scoring systems, clinical scores, serum C-reactive protein (CRP) levels and the neutrophil-lymphocyte ratio (NLR) for predicting the severity and mortality of acute pancreatitis (AP). MATERIALS AND METHODS Demographic, clinical, and radiographic data from 80 patients with AP were retrospectively evaluated. The harmless acute pancreatitis score (HAPS), systemic inflammatory response syndrome (SIRS), bedside index for severity in acute pancreatitis (BISAP), Ranson score, Balthazar score, modified computed tomography severity index (CTSI), extrapancreatic inflammation on computed tomography (EPIC) score and renal rim grade were recorded. The prognostic performance of radiological and clinical scoring systems, NLR at admission, and serum CRP levels at 48 hours were compared for severity and mortality according to the revised Atlanta Criteria. The data were evaluated by calculating the receiver operator characteristic (ROC) curves and area under the ROC (AUROC). RESULTS Out of 80 patients, 19 (23.8%) had severe AP, and 9 (11.3%) died. The AUROC for the BISAP score was 0.836 (95%CI: 0.735-0.937), with the highest value for severity. With a cut-off of BISAP ≥2, sensitivity and specificity were 68.4% and 78.7%, respectively. The AUROC for NLR was 0.915 (95%CI: 0.790-1), with the highest value for mortality. With a cut-off of NLR >11.91, sensitivity and specificity were 76.5% and 94.1%, respectively. Of all the radiological scoring systems, the EPIC score had the highest AUROC, i.e., 0.773 (95%CI: 0.645-0.900) for severity and 0.851 (95%CI: 0.718-0.983) for mortality, with a cut-off value ≥6. CONCLUSION The BISAP score and NLR might be preferred as early determinants of severity and mortality in AP. The EPIC score might be suggested from the current radiological scoring systems.


RESUMO Comparação dos sistemas de escores radiológicos, escores clínicos razão neutrófilo/linfócito e níveis séricos de proteína C-reativa para determinação da gravidade e mortalidade em casos de pancreatite aguda OBJETIVO Comparar sistemas de escores radiológicos, escores clínicos, os níveis séricos de proteína C-reativa (PCR) e a razão neutrófilo/linfócitos (RNL) como métodos de previsão de gravidade e mortalidade em casos de pancreatite aguda (PA). MATERIAIS E MÉTODOS Dados demográficos, clínicos e radiográficos de 80 pacientes com PA foram avaliados retrospectivamente. Os valores de Harmless Acute Pancreatitis Score (HAPS), Síndrome da Resposta Inflamatória Sistêmica (SIRS), Índice de Gravidade na Pancreatite Aguda à Beira do Leito (BISAP), escore de Ranson, escore de Balthazar, Índice Modificado de Gravidade por Tomografia Computadorizada (CTSI), escore de Inflamação Extrapancreática em Tomografia Computadorizada (EPIC) e grau renal foram registrados. O desempenho prognóstico dos sistemas de escores clínicos e radiológicos e RNL no momento da internação e os níveis séricos de PCR após 48 horas foram comparados quanto à gravidade, de acordo com os critérios de Atlanta revisados e mortalidade. Os dados foram avaliados pelo cálculo das curvas ROC e da área sob a curva ROC (AUROC). RESULTADOS De 80 pacientes, 19 (23,8%) tinham PA grave e 9 (11,3%) morreram. A AUROC para o escore BISAP foi de 0,836 (95%CI: 0.735-0.937), com o valor mais alto de gravidade. Com um valor de corte de BISAP ≥ 2 , a sensibilidade e a especificidade foram de 68,4% e 78,7%, respectivamente. A AUROC para o a RNL foi de 0,915 (95%CI: 0.790-1), com o valor mais alto de mortalidade. Com um valor de corte de RNL > 11,91, a sensibilidade e a especificidade foram de 76,5% e 94,1%, respectivamente. Entre os sistemas de escore radiológico, o EPIC apresentou o maior valor de AUROC, 0,773 (95%CI: 0.645-0.900) para gravidade e 0,851 (95%CI: 0.718-0.983) para mortalidade com um valor de corte ≥6. CONCLUSÃO O escore BISAP e a RNL podem ser preferíveis como determinantes precoces de gravidade e mortalidade na PA. O escore EPIC pode ser sugerido entre os atuais sistemas de escores radiológicos.


Subject(s)
Humans , Pancreatitis , C-Reactive Protein/metabolism , Prognosis , Severity of Illness Index , Lymphocytes , Acute Disease , Predictive Value of Tests , Retrospective Studies , ROC Curve , Neutrophils
4.
Evid. actual. práct. ambul ; 23(2): e002042, 2020. tab
Article in Spanish | LILACS | ID: biblio-1103530

ABSTRACT

Este artículo resume las diferentes formas de presentación clínica de la enfermedad COVID-19 causada por el virus SARS-Co-2 documentadas fundamentalmente en las tres principales revisiones sistemáticas disponibles. Entre las manifestaciones clínicas de frecuente aparición se destacan la fiebre (83 %), la tos (60 %) y la fatiga (38 %), seguidas por las mialgias (29 %), el aumento de la producción del esputo (27 %) y la disnea (25 %). Entre los hallazgos de laboratorio,predominan el aumento de los valores de proteína C reactiva (69 %), la linfopenia (57 %) y el aumento de los niveles de lactato-deshidrogenasa (52 %). Respecto de las manifestaciones radiológicas, tienen especial importancia las opacificaciones en vidrio esmerilado (80 %), la neumonía bilateral (73 %) y la afectación de tres lóbulos pulmonares o más (57 %).Si bien la evidencia sintetizada tiene limitaciones, permite una aproximación actualizada a los conocimientos disponibles sobre la clínica de esta nueva enfermedad en la población adulta. (AU)


This article summarizes the different forms of clinical presentation of COVID-19, caused by the SARS-Co-2 virus, synthesizing the information collected mainly by three published systematic reviews. Frequent clinical manifestations include fever(83 %), cough (60 %), and fatigue (38 %), followed by myalgia (29 %), increased sputum production (27 %) and dyspnea(25 %). Among the laboratory findings, the most common are the increase in C-reactive protein values (69 %), lymphopenia (57 %) and the increase in lactate dehydrogenase levels (52 %).. Most remarkable radiological features include ground glass opacifications (80 %), bilateral pneumonia (73 %) and the involvement of three or more lung lobes (57 %). Although the synthesized evidence has limitations, it allows an updated approach to the available knowledge about the clinical symptoms of this new disease in the adult population. (AU)


Subject(s)
Humans , Adult , Young Adult , Pneumonia, Viral/physiopathology , Coronavirus Infections/physiopathology , Betacoronavirus/pathogenicity , Pneumonia, Viral/complications , Pneumonia, Viral/etiology , Pneumonia, Viral/diagnostic imaging , Sputum , C-Reactive Protein/metabolism , China , Coronavirus Infections/complications , Coronavirus Infections/etiology , Coronavirus Infections/diagnostic imaging , Cough/diagnosis , Cough/physiopathology , Cough/blood , Dyspnea/diagnosis , Dyspnea/physiopathology , Dyspnea/blood , Fatigue/diagnosis , Fatigue/physiopathology , Fatigue/blood , Pandemics , Fever/diagnosis , Fever/physiopathology , Fever/blood , Myalgia/diagnosis , Myalgia/physiopathology , Myalgia/blood , L-Lactate Dehydrogenase/blood , Lymphopenia/blood
5.
Article in Chinese | WPRIM | ID: wpr-879925

ABSTRACT

Polycystic ovary syndrome (PCOS) is a common endocrine disease of child-bearing period women and one of the main causes of infertility in women. Pentraxin 3 (PTX3) is a multifunctional protein with a series of biological activities. PTX3 participates in the regulation of insulin secretion and glucose metabolism, ovarian cumulus cell function, inflammatory factor activity, androgen metabolism, lipid absorption and transport, and endothelial cell function, thereby improving insulin resistance, promoting follicular development and ovulation, reducing chronic inflammation, inhibiting androgen levels, improving lipid metabolism abnormalities and preventing atherosclerosis and cardiovascular diseases, thus participating in the occurrence of PCOS and its complications. This article reviews the mechanism of PTX3 in PCOS and its complications, trying to provide new ideas and directions for the study of PCOS pathogenesis and its clinical diagnosis and treatment.


Subject(s)
C-Reactive Protein/metabolism , Child , Female , Humans , Insulin Resistance , Polycystic Ovary Syndrome/physiopathology , Serum Amyloid P-Component/metabolism
6.
Arch. endocrinol. metab. (Online) ; 63(2): 121-127, Mar.-Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1001217

ABSTRACT

ABSTRACT Objective We investigated the utility of maternal fetuin-A, N-terminal proatrial natriuretic peptide (pro-ANP), high-sensitivity C-reactive protein (hs-CRP), and fasting glucose levels at 11-14 gestation weeks for predicting pregnancies complicated by gestational diabetes mellitus (GDM). Subjects and methods This prospective cohort study included 327 low-risk pregnant women who completed antenatal follow-up at a tertiary research hospital between January and April 2014. Maternal blood samples were collected between 11-14 gestational weeks in the first trimester of pregnancy and then stored at -80 °C until further analyses. During follow-up, 29 (8.8%) women developed GDM. The study population was compared 1:2 with age- and body mass index-matched pregnant women who did not develop GDM (n = 59). Fasting plasma glucose (FPG) levels and serum fetuin-A, pro-ANP, and hs-CRP levels were measured using automated immunoassay systems. Results There was a significant negative correlation between fetuin-A and hs-CRP (CC = -0.21, p = 0.047) and a positive correlation between FPG and hs-CRP (CC = 0.251, p = 0.018). The areas under the receiver operating characteristic curve for diagnosing GDM were 0.337 (p = 0.013), 0.702 (p = 0.002), and 0.738 (p < 0.001) for fetuin-A, hs-CRP, and FPG, respectively. The optimal cut-off values were > 4.65, < 166, and > 88.5 mg/dL for maternal hs-CRP, fetuin-A, and FPG, respectively. Conclusion Reduced fetuin-A, elevated hs-CRP, and FPG levels in women in the first trimester can be used for the early detection of GDM. Further research is needed before accepting these biomarkers as valid screening tests for GDM.


Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Young Adult , Pregnancy Trimester, First/blood , Blood Glucose/metabolism , C-Reactive Protein/metabolism , Insulin Resistance , Decision Support Techniques , Diabetes, Gestational/diagnosis , Insulin/blood , Biomarkers/blood , Logistic Models , Odds Ratio , Predictive Value of Tests , Retrospective Studies , Follow-Up Studies , Sensitivity and Specificity , Diabetes, Gestational/blood
7.
Clinics ; 74: e608, 2019. tab, graf
Article in English | LILACS | ID: biblio-1011906

ABSTRACT

OBJECTIVE: The present study aimed to investigate the relationship between obesity and mortality in patients with community-acquired pneumonia (CAP) in China. METHODS: In total, 909 patients with CAP were recruited for this study from January 2010 to June 2015. All patients were selected and divided into 4 groups according to their body mass index (BMI) values. All patients' clinical information was recorded. The associations among mortality; BMI; the 30-day, 6-month and 1-year survival rates for different BMI classes; the etiology of pneumonia in each BMI group; and the risk factors for 1-year mortality in CAP patients were analyzed. RESULT: With the exception of the level of C-reactive protein (CRP), no other clinical indexes showed significant differences among the different BMI groups. No significant differences were observed among all groups in terms of the 30-d and 6-month mortality rates (p>0.05). There was a significantly lower risk of 1-year mortality in the obese group than in the nonobese group, (p<0.05). Logistic regression analysis showed that there were seven independent risk factors for 1-year mortality in CAP patients, namely, age, cardiovascular disease, cerebrovascular disease, obesity, APACHE II score, level of CRP and CAP severity. CONCLUSION: Compared with nonobese patients with CAP, obese CAP patients may have a lower mortality rate, especially with regard to 1-year mortality, and CRP may be associated with the lower mortality rate in obese individuals than in nonobese individuals.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Pneumonia/mortality , C-Reactive Protein/metabolism , Obesity/mortality , Severity of Illness Index , Body Mass Index , China/epidemiology , Retrospective Studies , Risk Factors , Community-Acquired Infections/mortality
8.
Zagazig univ. med. j ; 25(3): 317-325, 2019. tab
Article in English | AIM | ID: biblio-1273853

ABSTRACT

Background: Spontaneous Bacterial Peritonitis (SBP) is the most frequent bacterial infection in cirrhotic patients with ascites. The mortality rate in those patients ranges from 40-70%.Aim: to assess level of serum and ascetic fluid polymorph nuclear leucocytes (PMN), high sensitive C reactive protein (hs-CRP) in patients with SBP before and after treatment. Methods: A cohort study was done on 114 patients SBP admitted in the Internal Medicine, Faculty of Medicine, Zagazig University during the period from December 2017 to September 2018. All patients were subjected to full history taking, thorough clinical examination, routine laboratory investigation, ultrasonography and ascitic fluid sampling. They was followed up for 5 days from starting treatment by parenteral third generation cephalosporin and peripheral blood (PMN), serum (hs-CRP), ascitic fluid PMN and hs-CRP were measured again.Results: the largest percentage of the patients were male, had posthepatitic C cirrhosis and child C score. There was statistically non-significant difference between antibiotic responders and non-responders regarding peripheral blood PMN before or five days after antibiotic use. There was statistically non-significant difference in ascitic fluid PMN, serum and ascitic fluid hs-CRP before treatment while the difference is significant between both groups regarding them five days after treatment. Percent change in serum hs-CRP was equal to that of ascitic fluid PMN. Percent change in ascitic fluid hs-CRP was comparable to that of ascitic fluid PMN. Conclusion: Serum and ascitic fluid hs-CRP level can be considered as alternative prognostic markers in cirrhotic patients with SBP


Subject(s)
Ascitic Fluid , C-Reactive Protein/metabolism , Egypt , Peritonitis , Peritonitis/diagnosis , Prognosis
9.
Rev. bras. cir. cardiovasc ; 33(6): 535-541, Nov.-Dec. 2018. tab, graf
Article in English | LILACS | ID: biblio-977478

ABSTRACT

Abstract Objective: To analyze the inflammation resulting from myocardial revascularization techniques with and without cardiopulmonary bypass, based on ultrasensitive C-reactive protein (US-CRP) behavior. Methods: A prospective non-randomized clinical study with 136 patients was performed. Sixty-nine patients were enrolled for Group 1 (on-pump coronary artery bypass - ONCAB) and 67 patients were assigned to Group 2 (off-pump coronary artery bypass - OPCAB). All study participants had blood samples collected for analysis of glucose, triglycerides, creatinine, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL) and creatinephosphokinase (CPK) in the preoperative period. The samples of creatinephosphokinase MB (CKMB), troponin I (TnI) and US-CRP were collected in the preoperative period and at 6, 12, 24, 36, 48 and 72 hours after surgery. We also analyzed the preoperative biological variables of each patient (age, smoking, diabetes mellitus, left coronary trunk lesion, body mass index, previous myocardial infarction, myocardial fibrosis). All angiographically documented patients with >70% proximal multiarterial stenosis and ischemia, documented by stress test or classification of stable angina (class II or III), according to the Canadian Cardiovascular Society, were included. Reoperations, combined surgeries, recent acute myocardial infarction, recent inflammatory disease, deep venous thrombosis or recent pulmonary thromboembolism, acute kidney injury or chronic kidney injury were not included. Results: Correlation values between the US-CRP curve and the ONCAB group, the treatment effect and the analyzed biological variables did not present expressive results. Laboratory variables were evaluated and did not correlate with the applied treatment (P>0.05). Conclusion: The changes in the US-CRP at each moment evaluated from the postoperative period did not show any significance in relation to the surgical technique applied.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Coronary Artery Disease/surgery , Coronary Artery Disease/blood , C-Reactive Protein/metabolism , Cardiopulmonary Bypass/methods , Coronary Artery Bypass, Off-Pump/methods , Postoperative Period , C-Reactive Protein/analysis , Biomarkers/blood , Body Mass Index , Prospective Studies , Preoperative Period , Myocardial Infarction/surgery , Myocardial Infarction/blood
11.
Pesqui. vet. bras ; 38(11): 2124-2128, Nov. 2018. tab
Article in English | LILACS, VETINDEX | ID: biblio-976403

ABSTRACT

The aim of this study was to evaluate and to compare the possible inflammatory changes by screening acute phase proteins concentrations in healthy bitches subjected to ovariohysterectomy. Minimally invasive and conventional (laparotomy) ovariohysterectomies were performed in 17 client-owned adult female mixed breed dogs. Nine animals were subjected to minimally invasive and eight animals to conventional ovariohysterectomy. Blood samples were taken before surgery, 24, 48 hours, and seven days postoperatively. Serum C-reactive concentration was determined by a commercial ELISA kit and serum haptoglobin concentration was measured via hemoglobin binding assay, both previously validated for use in dogs. As the data did not meet the normal distribution criteria, the nonparametric Kruskall-Wallis was performed to compare quantitative variables between groups. One-way ANOVA and the Friedman test were used for multiple comparisons between time points, with a P<0.05 considered significant. C-reactive protein concentration was significantly different (P<0.0001) at 24 hours postoperatively between groups. There was no significant difference in haptoglobin concentration between groups. C-reactive protein and haptoglobin concentrations were significantly different at 24 and 48 hours postoperatively for minimally invasive and conventional ovariohisterectomies. These findings provided an overview of the short-term inflammatory effects produced by minimally invasive and conventional ovariohysterectomies.(AU)


O objetivo deste trabalho foi avaliar e comparar o efeito inflamatório, por meio da determinação de proteínas de fase aguda, produzido por dois protocolos cirúrgicos distintos de ovariohisterectomia em cadelas. Para tanto, foram determinadas as concentrações de proteína C reativa (CRP) e haptoglobina (Hp) de 17 cadelas, sem raça definida, adultas, sendo nove animais submetidos à ovariohisterectomia pela técnica convencional por laparotomia e oito a ovariohisterectomia pela técnica minimamente invasiva. Para avaliar a resposta de fase aguda causada pelo trauma cirúrgico, amostras de sangue foram obtidas antes dos procedimentos cirúrgicos e em quatro momentos distintos após as cirurgias (24, 48 horas e sete dias) para as dosagens de CRP e Hp, com kit comercial ELISA e via ensaio de ligação com a hemoglobina, respectivamente, validados para o uso em cães. Como não houve distribuição normal dos dados, utilizou-se o teste de Kruskall-Wallis para comparação das variáveis quantitativas entre os dois grupos. Os testes de Friedman e One-way ANOVA foram usados para comparações múltiplas entre os momentos avaliados, sendo considerado P<0,05 como significante. Houve diferença significativa (P<0,0001) para as concentrações de CRP 24 horas após o procedimento cirúrgico entre os dois protocolos utilizados. Não houve diferença significativa para as concentrações de Hp entre os dois protocolos cirúrgicos. Foram evidenciadas alterações significativas para as concentrações de CRP e Hp 24 e 48 horas após as ovariohisterectomias, independentemente da técnica cirúrgica utilizada. As concentrações de CRP e Hp demonstraram o efeito inflamatório imediato induzido pela ovariohisterectomia convencional e minimamente invasiva.(AU)


Subject(s)
Animals , Female , Dogs , C-Reactive Protein/metabolism , Haptoglobins/metabolism , Ovariectomy/veterinary , Dogs/surgery , Hysterectomy/veterinary , C-Reactive Protein/analysis , Haptoglobins/analysis , Inflammation/metabolism , Inflammation/blood
12.
Arch. argent. pediatr ; 116(4): 522-528, ago. 2018. graf, tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-950045

ABSTRACT

Introducción. La albúmina modificada por la isquemia puede aumentar en el asma (IMA), estrés oxidativo y la inflamación. El objetivo fue evaluar las concentraciones de IMA en niños asmáticos durante períodos asintomáticos y de exacerbación. Población y métodos. Niños asmáticos y sanos en seguimiento (grupo de referencia). La gravedad de la exacerbación se evaluó mediante la Iniciativa global para el asma (GINA) y la puntuación del índice pulmonar modificado (MPIS). Se usaron pruebas intraepidérmicas y de proteína C reactiva para medir las concentraciones séricas de IMA durante la exacerbación y 4 semanas después del tratamiento. Resultados. Participaron 26 pacientes y 26 controles. Las concentraciones medias de IMA durante la exacerbación (0,45 ± 0,12 ABSU) y durante el período de estabilidad (0,41 ± 0,14 ABSU) fueron mayores que en los niños sanos (0,32 ± 0,08 ABSU): p= 0,001 y p= 0,005, respectivamente. No hubo diferencias en IMA al agrupar a los pacientes por tratamiento antiinflamatorio, infección de las vías respiratorias altas previa a la exacerbación, concentraciones de PCR o sensibilidad a las pruebas intraepidérmicas. Las concentraciones fueron más elevadas en los pacientes con exacerbación grave que leve/moderada (p= 0,009). La correlación entre IMA y la gravedad de la exacerbación (r: 0,498; p= 0,010) fue positiva. Conclusiones. Los niños asmáticos presentaron concentraciones de IMA más elevadas que el grupo de referencia, tanto en el período de estabilidad como durante la exacerbación. Hubo una relación positiva entre las concentraciones de IMA y la gravedad de la exacerbación.


Introduction: Hypoxia may occur in the severe exacerbations of asthma. Ischemia-modified albumin (IMA) may increase in ischemia, in addition to oxidative stress and inflammation. The aim was to evaluate IMA levels in children during the asthma exacerbation and the asymptomatic period. Populations and methods: Children with asthma who were followed up in our clinic were included and healthy children were selected as the control group. The severity of exacerbation was evaluated with Global Initiative for Asthma and Modified Pulmonary Index Score. Serum IMA levels were measured at the time of exacerbation and 4 weeks after treatment during asymptomatic period. Skin prick test and C reactive protein (CRP) levels were measured. Results: A total of 26 patients and 26 controls were included. Mean IMA level was 0.45+0.12 absorbance units -ABSU- during asthma exacerbation and 0.32+0.08 ABSU in the control group (p=0.001). Mean IMA levels (0.41+0.14 ABSU) during the stable period were higher than the control group (p=0.005). There was no difference in terms of IMA levels when patients were grouped according to anti-inflammatory treatment, upper respiratory tract infection before exacerbation, CRP levels or sensitivity of skin prick tests. However, IMA levels were higher in patients with severe asthma exacerbation (p=0.009) in comparison with mild/moderate exacerbation. Positive correlation was observed between IMA levels and severity of exacerbation (r: 0.498, p=0.010). Conclusions: Asthmatic children had higher IMA levels than the control group, both in stable and exacerbated asthma. There was a positive relationship between IMA levels and severity of asthma exacerbation.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Asthma/physiopathology , Anti-Inflammatory Agents/administration & dosage , Asthma/drug therapy , Time Factors , Severity of Illness Index , C-Reactive Protein/metabolism , Skin Tests/methods , Biomarkers/metabolism , Case-Control Studies , Pilot Projects , Cross-Sectional Studies , Prospective Studies , Serum Albumin, Human/metabolism
13.
Arch. argent. pediatr ; 116(4): 542-547, ago. 2018. ilus, tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-950047

ABSTRACT

Introducción. El objetivo del estudio fue investigar la relación entre reflujo vesicoureteral (RVU) y daño renal en pacientes con infección urinaria (IU) sin fiebre, primera IU febril e IU recurrente. El objetivo secundario, determinar si la proteína C-reactiva (PCR) actuaría como predictor de nefroesclerosis en las IU febriles. Población y métodos. Estudio prospectivo; pacientes pediátricos con IU sin fiebre, primera IU febril e IU recurrente. Los análisis de laboratorio de rutina incluyeron hemograma completo, urea, creatinina, análisis de orina completamente automatizado, urocultivo y PCR. Se realizó ecografía urológica luego del diagnóstico de IU, cistouretrografía miccional tras seis semanas y gammagrafía renal estática con ácido dimercaptosuccínico marcado con 99mTc tras seis meses a todos los participantes. Resultados. Participaron 47 niños con IU sin fiebre, 48 con primera IU febril y 61 con IU recurrente. Hubo una diferencia estadísticamente significativa entre los grupos respecto de RVU y nefroesclerosis (p= 0,001 y p= 0,011, respectivamente). También hubo una diferencia estadísticamente significativa respecto de nefroesclerosis entre los pacientes con y sin RVU (p= 0,001). Además, se estableció una diferencia estadísticamente significativa respecto de nefroesclerosis (p < 0,05) en los pacientes con PCR cinco veces mayor o menor que el valor de corte aceptado (5 mg/dl). Conclusión. La proporción de nefroesclerosis fue paralela a la frecuencia de RVU. Cuanto mayor era el grado de RVU, mayor era el daño renal. Se determinó una correlación positiva entre PCR elevada y nefroesclerosis, lo que señala esclerosis durante el diagnóstico de pielonefritis.


Introduction. The aim was to investigate the relationship between vesicoureteral reflux (VUR) and renal damage in non-febrile, febrile for the first time and recurrent urinary tract infection (UTI) patients. The secondary aim was to determine whether C-reactive protein (CRP) in febrile UTIs could be a predictor of renal scarring. Population and methods. This prospective study included non-febrile, febrile for the first time and recurrent pediatric UTI cases. The routine lab analyses comprised a complete blood count, urea, creatinine, fully automated urinalysis, urine culture and CRP analyses. All the participants were examined using urine ultrasonography subsequent to their UTI diagnosis, voiding cystourethrography (VCUG) after six weeks and Tc-99m dimercaptosuccinic acid (DMSA) static renal scintigraphy after six months. Results. There were included 47 children with non-febrile UTIs, 48 with first febrile UTIs and 61 with recurrent UTIs. A statistically significant difference was found among the groups in terms of VUR and renal scarring (p= 0.001 and p= 0.011, respectively). A statistically significant difference was also found in terms of renal scarring between patients with and without VUR (p= 0.001). Moreover, a statistically significant difference was also present in relation to renal scarring (p <0.05) in patients with five-fold lower or higher CRP values than the accepted cut-off value (5mg/dl). Conclusion. The ratio of renal scars detected was found to be parallel to the VUR frequency. The higher the VUR grade, the more renal damage was found. A positive correlation between elevated CRP and renal scarring was determined, indicating the presence of scarring during the diagnosis of pyelonephritis.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Urinary Tract Infections/complications , Vesico-Ureteral Reflux/epidemiology , Cicatrix/epidemiology , Kidney/pathology , Pyelonephritis/complications , Pyelonephritis/diagnosis , Recurrence , Urinary Tract Infections/epidemiology , Vesico-Ureteral Reflux/etiology , C-Reactive Protein/metabolism , Prospective Studies , Ultrasonography/methods , Cicatrix/etiology , Technetium Tc 99m Dimercaptosuccinic Acid/administration & dosage , Fever/etiology , Fever/epidemiology , Kidney/diagnostic imaging
14.
Rev. bras. ter. intensiva ; 30(2): 135-143, abr.-jun. 2018. tab, graf
Article in Portuguese | LILACS | ID: biblio-959315

ABSTRACT

RESUMO Objetivo: Os distúrbios microcirculatórios estão implicados no prognóstico do choque séptico. A hiporresponsividade microvascular pode ser avaliada por meio do índice de perfusão, derivado da oximetria de pulso e hiperemia reativa. Com utilização do índice de perfusão, investigamos a hiperemia reativa e sua relação com a perfusão periférica e os parâmetros clínico-hemodinâmicos no choque séptico. Métodos: Avaliaram-se 82 pacientes, 47 deles com choque séptico e 35 controles. Os exames foram realizados dentro de 24 horas após a admissão. O índice de perfusão foi avaliado antes e após uma oclusão do fluxo sanguíneo durante 3 minutos, utilizando-se análise de resposta temporal por 5 minutos. O índice de perfusão foi também avaliado nas fases hiperêmicas, principalmente com derivação de mecanismos mecanossensitivos (ΔIP0-60) e metabólicos (ΔIP60-120). Realizaram-se testes de correlação entre a hiperemia reativa e dados clínicos hemodinâmicos. Resultados: A hiperemia reativa, medida pelo índice de perfusão, foi significantemente mais baixa no choque séptico apenas até 45 segundos após a desinflação do manguito. No período restante, não houve diferenças estatisticamente significantes entre os grupos. Os picos de índice de perfusão foram similares entre os grupos, embora o pico tenha sido atingido de forma mais lenta no grupo séptico. Os valores de ΔIP0-60 foram mais baixos no choque [1% (-19% - -40%) versus 39% (6% - 75%); p = 0,001]. No entanto, o ΔIP60-120 foi similar entre os grupos [43% (18% - 93%) versus 48% (18% - 98%); p = 0,58]. O tempo até o pico do índice de perfusão se correlacionou de forma positiva com o SOFA e negativamente com os níveis de proteína C-reativa. O pico de índice de perfusão se correlacionou de forma positiva com as doses de vasopressores; os valores de ΔIP60-120 tiveram correlação positiva com o nível de proteína C-reativa e as doses de vasopressores. Não ocorreram outras correlações significantes. Conclusões: Este estudo com base no índice de perfusão sugere que o choque séptico promove hiporresponsividade vascular periférica, enquanto a reatividade vascular posterior é consideravelmente preservada. Estes resultados demonstram resposta hiperêmica periférica dependente do tempo e significante reserva isquêmica no choque séptico.


ABSTRACT Objective: Microcirculation disturbances are implicated in the prognosis of septic shock. Microvascular hyporesponsiveness can be assessed by an oximetry-derived perfusion index and reactive hyperemia. Using this perfusion index, we investigated reactive hyperemia and its relationship with peripheral perfusion and clinical-hemodynamic parameters in septic shock. Methods: Eighty-two patients were evaluated: 47 with septic shock and 35 controls. Tests were performed within 24 hours after admission. The perfusion index was evaluated before and after a 3-min blood flow occlusion using a time-response analysis for 5 min. The perfusion index was also evaluated in the hyperemic phases and was mainly derived by mechanosensitive (ΔPI0-60) and metabolic mechanisms (ΔPI60-120). Correlation tests were performed between reactive hyperemia and clinical-hemodynamic data. Results: Reactive hyperemia measured by the perfusion index was significantly lower in patients with septic shock, but this was only observed for the first 45 seconds after cuff-deflation. In the remaining period, there were no statistical differences between the groups. The peaks in the perfusion index were similar between groups, although the peak was reached more slowly in the septic group. Values of ΔPI0-60 were lower in shock [01% (-19% - -40%) versus 39% (6% - 75%); p = 0.001]. However, ΔPI60-120 was similar between the groups [43% (18% - 93%) versus 48% (18% - 98%); p = 0.58]. The time-to-peak of the perfusion index was correlated positively with the SOFA scores and negatively with C-reactive protein; the peak of the perfusion index was positively correlated with vasopressor doses; and the ΔPI60-120 values were positively correlated with C-reactive protein and vasopressor doses. No other significant correlations occurred. Conclusions: This perfusion index-based study suggests that septic shock promotes initial peripheral vascular hyporesponsiveness and preserves posterior vascular reactivity to a considerable degree. These results demonstrate a time-dependent peripheral hyperemic response and a significant ischemic reserve in septic shock.


Subject(s)
Humans , Male , Female , Aged , Shock, Septic/therapy , Fluid Therapy/methods , Hyperemia/metabolism , Shock, Septic/physiopathology , Time Factors , Vasoconstrictor Agents/administration & dosage , C-Reactive Protein/metabolism , Oximetry/methods , Case-Control Studies , Organ Dysfunction Scores , Hemodynamics , Microcirculation , Middle Aged
15.
Yonsei Medical Journal ; : 154-157, 2018.
Article in English | WPRIM | ID: wpr-742490

ABSTRACT

Chronic urticaria may often be associated with interleukin (IL)-1-mediated autoinflammatory disease, which should be suspected if systemic inflammation signs are present. Here, we report a case of Schnitzler's syndrome without monoclonal gammopathy treated successfully with the IL-1 receptor antagonist anakinra. A 69-year-old man suffered from a pruritic urticarial rash for 12 years. It became aggravated episodically and was accompanied by high fever, arthralgia, leukocytosis, and an elevated C-reactive protein and erythrocyte sedimentation rate. The episodes each lasted for over one week. Neutrophilic and eosinophilic inflammation was found on skin biopsy. However, serum and urine electrophoresis showed no evidence of monoclonal gammopathy. The cutaneous lesions were unresponsive to various kinds of anti-histamines, systemic glucocorticoids, colchicine, cyclosporine, dapsone, and methotrexate, which were administered over a span of 3 years immediately preceding successful treatment. A dramatic response, however, was observed after a daily administration of anakinra. This observation suggests that the correct diagnosis of this case is Schnitzler's syndrome without monoclonal gammopathy. For an adult patient with refractory chronic urticaria and systemic inflammation, Schnitzler's syndrome could be considered as a possible differential diagnosis. Although the typical form of Schnitzler's syndrome exhibits the presence of monoclonal gammopathy as a diagnostic criterion, monoclonal gammopathy may be absent in an atypical form. In such a situation, an IL-1 antagonist should be effective for the management of chronic urticaria.


Subject(s)
Aged , Blood Sedimentation , C-Reactive Protein/metabolism , Chronic Disease , Humans , Interleukin 1 Receptor Antagonist Protein/therapeutic use , Leukocytes/metabolism , Male , Paraproteinemias/complications , Schnitzler Syndrome/blood , Schnitzler Syndrome/drug therapy , Urticaria/complications
16.
Rev. chil. cir ; 69(4): 302-309, ago. 2017. tab, graf
Article in Spanish | LILACS | ID: biblio-899606

ABSTRACT

Introducción: La apendicitis aguda como causa de obstrucción intestinal es una situación clínica infrecuente. Los objetivos de este estudio son los de definir la incidencia de obstrucción intestinal de acuerdo con la clasificación de obstrucción intestinal en apendicitis y la caracterización de su severidad. Métodos: Se diseñó un estudio de cohorte retrospectiva analizando todos los pacientes operados por obstrucción intestinal secundaria a apendicitis durante un periodo de 15 años. Se incluyeron variables continuas y categóricas tales como edad, sexo, periodo de tiempo entre el inicio de los síntomas y el diagnóstico, valores de proteína C reactiva, recuento de leucocitos, tipo de obstrucción intestinal y la puntuación del WSES Sepsis Severity Score. Resultados: Durante el periodo de estudio, un total de 3.626 pacientes fueron operados por apendicitis; en 44 casos se encontró una obstrucción intestinal asociada (1,2%). De acuerdo con la clasificación de obstrucción intestinal en apendicitis, la mayoría de estos pacientes presentaron un íleo mecánico con estrangulación del intestino (48%). La mayor parte de los pacientes (77%) presentaron una puntuación de 3 puntos o menos en el WSES Sepsis Severity Score. Conclusiones: La incidencia de obstrucción intestinal en apendicitis fue mayor de lo esperado. Estos pacientes presentaron una respuesta inflamatoria severa, con una puntuación en el WSES Sepsis Severity Score de 3 puntos. De acuerdo con la clasificación de obstrucción intestinal, la mayoría de los casos presentaron obstrucción mecánica con estrangulación.


Introduction: Appendicitis as a cause of intestinal obstruction is an infrequent condition. The purpose of this study was to define the incidence of intestinal obstruction according to the classification of intestinal obstruction secondary to appendicitis, and to characterize their severity. Methods: A retrospective cohort study analyzing all patients operated on for intestinal obstruction secondary to appendicitis within a 15 year period was designed. Continuous and categorical variables including: age, gender, time interval between onset of symptoms and diagnosis, C-reactive protein and white blood cells values, type of intestinal obstruction and WSES Sepsis Severity Score, were included. Results: During the period of study, 3,626 patients were operated on for appendicitis and 44 cases had associated intestinal obstruction (1.2%). According to the classification of intestinal obstruction in appendicitis, most patients had a mechanical ileus with strangulation (48%). Most patients had a WSES Sepsis Severity Score of 3 or less points (77%). Conclusions: The incidence of intestinal obstruction in appendicitis was higher than expected. These patients had a severe inflammatory response with a WSES Sepsis Severity Score of 3 points. According to the classification of intestinal obstruction in appendicitis, most patients had a mechanical obstruction with strangulation.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Appendicitis/surgery , Appendicitis/complications , Intestinal Obstruction/etiology , Appendicitis/blood , Postoperative Complications/epidemiology , Severity of Illness Index , C-Reactive Protein/metabolism , Acute Disease , Retrospective Studies , Abdomen, Acute/etiology , Intestinal Obstruction/surgery , Intestinal Obstruction/blood
17.
Rev. Salusvita (Online) ; 35(2): 243-257, 2016. ilus
Article in Portuguese | LILACS | ID: biblio-827304

ABSTRACT

Introdução: cervicalgia é a segunda queixa principal mais prevalente relatada pelos pacientes que procuram tratamento quiroprático, e acomete 55% da população (KNOPLICH, 2003; LEAVER et al., 2007). A manipulação vertebral altera a entrada dos sinais sensórios dos tecidos paraespinhais de maneira a melhorar a função fisiológica 3. A função da proteína C-reativa (PCR) in vivo não está bem definida e os resultados de estudos com animais experimentais têm produzido resultados contraditórios. Métodos: em um estudo quase experimental, a concentração sérica de proteína C-reativa após tratamento quiroprático foi determinada em 12 pacientes, sendo seis sintomáticos à cervicalgia e seis assintomáticos. Foram realizadas coletas sanguíneas. A partir das amostras foi dosada a concentração plasmática de proteína C-reativa. Resultados: os resultados sugerem que a manipulação quiroprática estimula a produção de interleucinas que, por sua vez, aumenta a produção da PCR para combater a inflamação. Dessa forma, a melhora do processo inflamatório provocada pelo procedimento quiroprático pode reduzir a descarga dos aferentes nociceptivos e, desta forma, reduzir a sensação de dor. Conclusão: existe uma tendência ao aumento da concentração da PCR, e a diminuição da dor, o que sugere efeitos benéficos da manipulação articular vertebral sobre eventos inflamatórios e nociceptivos. (AU)


Introduction: Neck pain is the second most prevalent chief complaint reported by patients who seek chiropractic care, and affects 55% of the population (KNOPLICH, 2003; LEAVER et al., 2007). The spinal manipulation, in theory, change the entry of sensory signals from paraspinal tissues in order to improve the function physiological 3. The role of C-reactive protein (CRP) in vivo is not well defined and the results of experimental animal studies have produced contradictory results. Methods: A quasiexperimental study, the serum C-reactive protein after chiropractic treatment was determined in 12 patients, 6 with symptomatic and 6 asymptomatic neck. Blood were collected. From the samples was measured plasma concentration of C-reactive protein. Results: The results suggest that chiropractic manipulation stimulates the production of interleukins that in turn, increases the production of CRP to fight inflammation. Thus, the improvement of the inflammatory process caused by the chiropractic procedure can reduce the discharge of nociceptive afferents and thereby reduce the sensation of pain. Conclusion: There is a tendency to increased concentration of CRP and reduction of pain, suggesting beneficial effects of joint manipulation on spinal nociceptive and inflammatory events. (AU)


Subject(s)
Humans , Male , Adult , Middle Aged , C-Reactive Protein/metabolism , Low Back Pain/therapy , Neck Pain/therapy , Manipulation, Chiropractic/methods , Pain Measurement , Evaluation Studies as Topic , Musculoskeletal Manipulations/adverse effects
18.
Braz. j. med. biol. res ; 49(4): e5062, 2016. tab, graf
Article in English | LILACS | ID: biblio-951667

ABSTRACT

Type 2 diabetes mellitus (T2D) is a metabolic disease with inflammation as an important pathogenic background. However, the pattern of immune cell subsets and the cytokine profile associated with development of T2D are unclear. The objective of this study was to evaluate different components of the immune system in T2D patients' peripheral blood by quantifying the frequency of lymphocyte subsets and intracellular pro- and anti-inflammatory cytokine production by T cells. Clinical data and blood samples were collected from 22 men (51.6±6.3 years old) with T2D and 20 nonsmoking men (49.4±7.6 years old) who were matched for age and sex as control subjects. Glycated hemoglobin, high-sensitivity C-reactive protein concentrations, and the lipid profile were measured by a commercially available automated system. Frequencies of lymphocyte subsets in peripheral blood and intracellular production of interleukin (IL)-4, IL-10, IL-17, tumor necrosis factor-α, and interferon-γ cytokines by CD3+ T cells were assessed by flow cytometry. No differences were observed in the frequency of CD19+ B cells, CD3+CD8+ and CD3+CD4+ T cells, CD16+56+ NK cells, and CD4+CD25+Foxp3+ T regulatory cells in patients with T2D compared with controls. The numbers of IL-10- and IL-17-producing CD3+ T cells were significantly higher in patients with T2D than in controls (P<0.05). The frequency of interferon-γ-producing CD3+ T cells was positively correlated with body mass index (r=0.59; P=0.01). In conclusion, this study shows increased numbers of circulating IL-10- and IL-17-producing CD3+ T cells in patients with T2D, suggesting that these cytokines are involved in the immune pathology of this disease.


Subject(s)
Humans , Male , Adult , Middle Aged , Cytokines/blood , T-Lymphocyte Subsets/metabolism , Diabetes Mellitus, Type 2/blood , Reference Values , C-Reactive Protein/metabolism , T-Lymphocytes/cytology , T-Lymphocytes/immunology , T-Lymphocytes/metabolism , Case-Control Studies , T-Lymphocyte Subsets/cytology , T-Lymphocyte Subsets/immunology , Statistics, Nonparametric , Lymphocyte Count , Diabetes Mellitus, Type 2/immunology , Flow Cytometry , Immunity, Cellular
19.
Yonsei Medical Journal ; : 321-327, 2016.
Article in English | WPRIM | ID: wpr-147359

ABSTRACT

PURPOSE: Increased lipoprotein-associated phospholipase A2 (Lp-PLA2) activity and Rho kinase activity may be associated with atherosclerosis. The principal aim of this study was to examine whether darapladib (a selective Lp-PLA2 inhibitor) could reduce the elevated Lp-PLA2 and Rho kinase activity in atherosclerosis. MATERIALS AND METHODS: Studies were performed in male Sprague-Dawley rats. The atherosclerosis rats were prepared by feeding them with a high-cholesterol diet for 10 weeks. Low-dose darapladib (25 mg.kg-1.d-1) and high-dose darapladib (50 mg.kg-1.d-1) interventions were then administered over the course of 2 weeks. RESULTS: The serum levels of triglycerides, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), high-sensitivity C-reactive protein (hs-CRP), and Lp-PLA2, significantly increased in atherosclerosis model groups, as did Rho kinase activity and cardiomyocyte apoptosis (p0.05). CONCLUSION: Darapladib, a Lp-PLA2 inhibitor, leads to cardiovascular protection that might be mediated by its inhibition of both Rho kinase and Lp-PLA2 in atherosclerosis.


Subject(s)
1-Alkyl-2-acetylglycerophosphocholine Esterase/antagonists & inhibitors , Animals , Atherosclerosis/blood , Benzaldehydes , C-Reactive Protein/metabolism , Cholesterol/blood , Cholesterol, HDL/blood , Cholesterol, LDL/blood , Dose-Response Relationship, Drug , Male , Oximes , Phospholipase A2 Inhibitors/administration & dosage , Rats , Rats, Sprague-Dawley , Triglycerides/blood , rho-Associated Kinases/metabolism
20.
Yonsei Medical Journal ; : 1139-1144, 2016.
Article in English | WPRIM | ID: wpr-34051

ABSTRACT

PURPOSE: Patients with gout are similar to those with bacterial infection in terms of the nature of inflammation. Herein we compared the differences in procalcitonin (PCT) levels between these two inflammatory conditions and evaluated the ability of serum PCT to function as a clinical marker for differential diagnosis between acute gouty attack and bacterial infection. MATERIALS AND METHODS: Serum samples were obtained from 67 patients with acute gouty arthritis and 90 age-matched patients with bacterial infection. Serum PCT levels were measured with an enzyme-linked fluorescent assay. RESULTS: Serum PCT levels in patients with acute gouty arthritis were significantly lower than those in patients with bacterial infection (0.096±0.105 ng/mL vs. 4.94±13.763 ng/mL, p=0.001). However, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels showed no significant differences between the two groups. To assess the ability of PCT to discriminate between acute gouty arthritis and bacterial infection, the areas under the curves (AUCs) of serum PCT, uric acid, and CRP were 0.857 [95% confidence interval (CI), 0.798-0.917, p<0.001], 0.808 (95% CI, 0.738-0.878, p<0.001), and 0.638 (95% CI, 0.544-0.731, p=0.005), respectively. There were no significant differences in ESR and white blood cell counts between these two conditions. With a cut-off value of 0.095 ng/mL, the sums of sensitivity and specificity of PCT were the highest (81.0% and 80.6%, respectively). CONCLUSION: Serum PCT levels were significantly lower in patients with acute gouty attack than in patients with bacterial infection. Thus, serum PCT can be used as a useful serologic marker to differentiate between acute gouty arthritis and bacterial infections.


Subject(s)
Area Under Curve , Arthritis, Gouty/diagnosis , Bacterial Infections/diagnosis , Biomarkers/blood , Blood Sedimentation , C-Reactive Protein/metabolism , Calcitonin/blood , Case-Control Studies , Cross-Sectional Studies , Diagnosis, Differential , Female , Humans , Inflammation , Leukocyte Count , Male , Middle Aged , Protein Precursors/blood , Sensitivity and Specificity , Uric Acid/blood
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