ABSTRACT
PURPOSE: Patients with pneumonia often are unrecognized as also having sepsis. We evaluated protein C, as a potential biomarker, to differentiate between patients with pneumonia and sepsis. MATERIALS AND METHODS: A retrospective chart review was performed for all protein C tests over a 14-month period (January 11, 2007, to March 10, 2008) at an 8-hospital system with 1706 total beds. Charts were screened for the discharge diagnoses of sepsis, severe sepsis, septic shock, bacteremia, and pneumonia. Protein C levels were compared between patients with sepsis and pneumonia, and at time intervals of 0 to 12 hours, 12 to 24 hours, 24 to 48 hours, and more than 48 hours after diagnosis. RESULTS: One thousand forty-seven protein C levels were obtained in 980 patients. Thirty-two protein C levels met the inclusion and exclusion criteria for the sepsis group, and 34 for the pneumonia group. Overall, the mean protein C levels were significantly less in patients with sepsis at 59.2% (95% confidence interval [CI], 49.5%-68.9%) compared with patients with pneumonia at 108.9% (95% CI, 95.6%-122.3%; P < .001). In addition, levels within each of the time intervals were also significantly lower in the sepsis group. CONCLUSIONS: In this study, protein C levels performed well in differentiating between patients with sepsis or pneumonia in the early period after diagnosis.
Subject(s)
Pneumonia/diagnosis , Protein C/analysis , Sepsis/diagnosis , Adolescent , Adult , Aged , Biomarkers/blood , Child , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Pneumonia/blood , Predictive Value of Tests , Retrospective Studies , Sepsis/blood , Time Factors , Young AdultABSTRACT
The present study sought to examine acute effects of alcohol on cognitive processing and performance within the context of two prominent theories of alcohol's effects; namely, that alcohol restricts the focus of attention (e.g. Steele and Josephs, 1990. Journal of Abnormal Psychology, 97, 196-205) and that alcohol impairs response inhibition (e.g. Fillmore and Vogel-Sprott, 1999. Experimental and Clinical Psychopharmacology, 7, 49-55; Fillmore and Vogel-Sprott, 2000. Journal of Studies on Alcohol, 61, 239-246). Forty-five participants were randomly assigned to receive either a placebo level of alcohol (0.04 g/kg), a moderate dose (0.40 g/kg), or a higher dose (0.80 g/kg). Brain electrical activity (ERPs) and behavioral responses (reaction time and accuracy) were measured while participants performed a modified flanker task, in which a target letter was flanked by response-compatible or response-incompatible letters. Analyses of behavioral data showed that alcohol increased response competition in accuracy but not response times, suggesting that alcohol influences response selection more than attentional processes per se. This finding is in-line with predictions derived from the response inhibition model. ERP latency data provided mixed support for both models. ERP amplitude data showed that the high dose of alcohol primarily influenced a mostly frontal negativity in the ERP, present on both correct and incorrect response trials. Differences in self-reported susceptibility to alcohol were most evident in the amplitude of the P3 component. Findings are discussed in terms of the differential effects of acute dose and susceptibility on information processing.
