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Totan M, Matacuta-Bogdan IO, Hasegan A, Maniu I. Vitamin D Levels in COVID-19 and NonCOVID-19 Pediatric Patients and Its Relationship with Clinical and Laboratory Characteristics. Biomedicines 2024; 12:905. [PMID: 38672258 PMCID: PMC11048677 DOI: 10.3390/biomedicines12040905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/14/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
25-hydroxyvitamin D [25(OH)D] is a marker with an important role in regulating the inflammatory response. Low concentrations of this vitamin are often found among the population, correlated with increased risk of respiratory tract infections. The aim of the study is to evaluate the relationship between vitamin D levels and clinical and laboratory markers in children and adolescents hospitalized with and without COVID-19. A retrospective study, including all patients tested for SARS-CoV-2 and having vitamin D measured, was performed. All included hospitalized cases, 78 COVID-19 patients and 162 NonCOVID-19 patients, were divided into subgroups according to their 25(OH)D serum levels (<20 ng/mL-deficiency, 20-30 ng/mL-insufficiency, ≥30 ng/mL-normal or <30 ng/mL, ≥30 ng/mL) and age (≤2 years, >2 years). Vitamin D deficiency and insufficiency increased with age, in both COVID-19 and NonCOVID-19 groups. All symptoms were encountered more frequently in cases of pediatric patients with COVID-19 in comparison with NonCOVID-19 cases. The most frequently encountered symptoms in the COVID-19 group were fever, loss of appetite, and nasal congestion. In the NonCOVID-19 group, serum 25(OH)D concentrations were positively correlated with leukocytes, lymphocytes, and LMR and negatively correlated with neutrophils, NLR, and PLR while no significant correlation was observed in the case of COVID-19 group. Differences between vitamin D status and clinical and laboratory parameters were observed, but their clinical significance should be interpreted with caution. The results of this study may offer further support for future studies exploring the mechanisms of the relationship between vitamin D and clinical and laboratory markers as well as for studies investigating the implications of vitamin D deficiency/supplementation on overall health/clinical outcomes of patients with/without COVID-19.
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Affiliation(s)
- Maria Totan
- Faculty of Medicine, Lucian Blaga University of Sibiu, 2A Lucian Blaga Str., 550169 Sibiu, Romania; (M.T.); (A.H.)
- Clinical Laboratory, Pediatric Clinical Hospital Sibiu, 2-4 Pompeiu Onofreiu Str., 550166 Sibiu, Romania
| | | | - Adrian Hasegan
- Faculty of Medicine, Lucian Blaga University of Sibiu, 2A Lucian Blaga Str., 550169 Sibiu, Romania; (M.T.); (A.H.)
| | - Ionela Maniu
- Research Team, Pediatric Clinical Hospital Sibiu, 550166 Sibiu, Romania
- Research Center in Informatics and Information Technology, Mathematics and Informatics Department, Faculty of Sciences, Lucian Blaga University of Sibiu, 550025 Sibiu, Romania
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Baran B, Yetkin NA, Tutar N, Türe Z, Oymak FS, Gülmez İ. The Role of Sequentially Monitored Laboratory Values and Inflammatory Biomarkers in Assessing the Severity of COVID-19. Cureus 2024; 16:e51458. [PMID: 38298278 PMCID: PMC10829529 DOI: 10.7759/cureus.51458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2023] [Indexed: 02/02/2024] Open
Abstract
With the onset of the pandemic in 2020, COVID-19 pneumonia has become a common cause for hospitalization and is associated with high mortality rates. Inflammatory biomarkers play a crucial role in understanding and monitoring the progression of various diseases, including COVID-19. The objective of this study was to assess the significance of sequentially monitored standard laboratory tests, including complete blood cell count, D-dimer, fibrinogen, ferritin, albumin, C-reactive protein (CRP), as well as newly calculated inflammatory biomarkers in predicting the severity and prognosis of COVID-19 pneumonia. This single-center retrospective study included 194 patients hospitalized due to COVID-19 pneumonia. Patients were grouped based on the severity of their clinical symptoms, with 134 categorized as severe disease and 60 as mild-moderate disease. The patients' demographic data and laboratory values at hospital admission and on the third day of hospitalization were comparatively evaluated. In the severe illness group, there were more complaints about shortness of breath and a significant drop in the SPO2 value was observed at the time of application (p =0.005 and p<0.001, respectively). The overall mortality rate in all patients was 9% (18/194), and all deaths occurred within the severe disease group. All laboratory parameters, with the exception of platelet count and ferritin levels, were significantly associated and correlated with the severity of the disease during the hospitalization period. Among the biomarkers, there was no significant difference in neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) on the first day, a significant increase was observed on the third day of hospitalization in the severe disease group (p=0.050 vs. 0.003 and p=0.073 vs. 0.020, respectively). No significant difference was observed only in the PNR (platelet/neutrophil ratio) value among the inflammatory biomarkers (p=0.090 vs. p=0.354). In conclusion, the SPO2 level of COVID-19 patients at admission and the subsequent laboratory parameters examined show a significant relationship with the severity of the disease. In addition, simple inflammation biomarkers derived from laboratory values have shown a very significant relationship and correlation in the diagnosis and follow-up of the disease. In both admission and follow-up evaluation, a more significant association was observed with CRP-related biomarkers such as CRP/albumin ratio and CRP/lymphocyte ratio rather than NLR and PLR, which are widely used in the literature, in showing the severity of COVID-19. In patients with pneumonia, the laboratory assessment made on the third day of hospitalization reflects the severity of the disease more clearly than on the first day.
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Affiliation(s)
- Burcu Baran
- Respiratory Medicine, Erciyes University, Kayseri, TUR
| | - Nur A Yetkin
- Respiratory Medicine, Erciyes University, Kayseri, TUR
| | - Nuri Tutar
- Respiratory Medicine, Erciyes University, Kayseri, TUR
| | - Zeynep Türe
- Infectious Diseases, Erciyes University, Kayseri, TUR
| | - Fatma S Oymak
- Respiratory Medicine, Erciyes University, Kayseri, TUR
| | - İnci Gülmez
- Respiratory Medicine, Erciyes University, Kayseri, TUR
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Dantas GHM, de Alkmim Moreira Nunes R, Casimiro-Lopes G, Neves EB, de Castro JBP, de Souza Vale RG. Analysis of physiological markers and risk factors for the development of rhabdomyolysis in military personnel: a systematic review. Rev Environ Health 2023; 38:613-620. [PMID: 35852130 DOI: 10.1515/reveh-2022-0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/18/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To analyze case reports with individual patient data belonging to the Armed Forces submitted to specific physical or military combat training that was affected by rhabdomyolysis and identify factors that influenced the diagnosis and clinical evolution of the syndrome. CONTENT We conducted a systematic review following the PRISMA guidelines and registered on PROSPERO (CRD42021242465). We searched MedLine (via PubMed), Scopus, Cochrane, Lilacs, SciELO, CINAHL, Web of Science, SPORTDiscus, ScienceDirect, and PEDro databases for studies that reported cases of military personnel affected by rhabdomyolysis. SUMMARY AND OUTLOOK Thirteen studies met the inclusion criteria. Forty-nine individual cases of rhabdomyolysis were analyzed. From them, it was possible to identify several associated factors, which were responsible for developing rhabdomyolysis in military personnel. Thirty military personnel (60%) practiced physical training and 20 (40%) practiced specific military combat training. The creatine kinase (CK) peak ranged from 1,040 to 410,755 U/L, with an average of 44.991 U/L, and 14 (28%) of the cases reported alteration of renal function and four militaries (8%) evolved to death condition. Physical activities performed strenuously and without proper planning conditions such as room temperature, the period without adequate water intake, the amount of equipment used during the activity contributed to the development of rhabdomyolysis in the cases of military personnel analyzed in the present study. Therefore, it is recommended that future studies investigate the relationship between the prevalence of rhabdomyolysis cases and the severity of its consequence when associated with progressive methods of training, hydration control, acclimatization to austere environments, monitoring for the existence of hereditary diseases, and control of the use of supplementary nutritional substances.
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Affiliation(s)
- Guilherme Henrique Mattos Dantas
- Laboratory of Exercise and Sport (LABEES), Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro, Brazil
- Postgraduate Program in Exercise and Sport Sciences (PPGCEE), Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
| | - Rodolfo de Alkmim Moreira Nunes
- Laboratory of Exercise and Sport (LABEES), Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro, Brazil
- Postgraduate Program in Exercise and Sport Sciences (PPGCEE), Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
| | - Gustavo Casimiro-Lopes
- Postgraduate Program in Exercise and Sport Sciences (PPGCEE), Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
- Laboratory of Exercise Pathophysiology (LAFE), Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Eduardo Borba Neves
- Postgraduate Program on Biomedical Engineering (PPGEB), Federal Technological University of Paraná (UTFPR), Curitiba, PR, Brazil
| | - Juliana Brandão Pinto de Castro
- Laboratory of Exercise and Sport (LABEES), Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro, Brazil
- Postgraduate Program in Exercise and Sport Sciences (PPGCEE), Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
| | - Rodrigo Gomes de Souza Vale
- Laboratory of Exercise and Sport (LABEES), Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro, Brazil
- Postgraduate Program in Exercise and Sport Sciences (PPGCEE), Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
- Laboratory of Exercise Physiology, Estácio de Sá University, Cabo Frio, RJ, Brazil
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Hou H, Zou S, Wei W, Wang T, Wang Y, Wu S, Wang F, Liu W, Huang M, Peng J. Kinetics and prognostic significance of laboratory markers in patients with severe fever with thrombocytopenia syndrome: insight from a comprehensive analysis. J Infect Dis 2023:jiad426. [PMID: 37804100 DOI: 10.1093/infdis/jiad426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/19/2023] [Accepted: 09/26/2023] [Indexed: 10/08/2023] Open
Abstract
Severe Fever with Thrombocytopenia Syndrome (SFTS) is an emerging infectious disease with significant mortality. Identifying prognostic factors that influence patient outcomes is crucial for effective clinical management. In this study, we assessed the dynamic changes of laboratory markers and their association with outcomes in 93 SFTS patients. We found that age and hypertension were significantly associated with poor outcomes in SFTS patients. The deceased group exhibited lower platelet counts, elevated liver and kidney function markers, coagulation profiles, inflammatory markers, and cytokines compared to the survival group. Kinetic analysis showed that these markers gradually normalized in the survival group, while they remained persistently abnormal in the deceased group. Furthermore, hypertension, elevated AST, PCT, and IL-10 were identified as independent risk factors for predicting poor prognosis of SFTS patients. These findings provide valuable insights into the prognostic significance of laboratory markers and highlight the importance of early identification of high-risk SFTS patients.
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Affiliation(s)
- Hongyan Hou
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Siyu Zou
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Wei
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ting Wang
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yun Wang
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shiji Wu
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Feng Wang
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weiyong Liu
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ming Huang
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Peng
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Liu Y, Cheng L, Zhao M, Zhan H, Li X, Huang Y, Li H, Hou Y, Li Y. Development and validation of diagnostic and activity-assessing models for relapsing polychondritis based on laboratory parameters. Front Immunol 2023; 14:1274677. [PMID: 37854592 PMCID: PMC10579920 DOI: 10.3389/fimmu.2023.1274677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 09/15/2023] [Indexed: 10/20/2023] Open
Abstract
Background Relapsing polychondritis (RP) as a rare autoimmune disease is characterized by recurrent inflammation of the organs containing cartilage. Currently, no biomarkers have been integrated into clinical practice. This study aimed to construct and evaluate models based on laboratory parameters to aid in RP diagnosis, assess activity assessment, and explore associations with the pathological process. Methods RP patients and healthy controls (HCs) were recruited at the Peking Union Medical College Hospital from July 2017 to July 2023. Clinical data including Relapsing Polychondritis Disease Activity Index (RPDAI) score and laboratory tests were collected. Differences in laboratory data between RP patients and HCs and active and inactive patients were analyzed. Results The discovery cohort (cohort 1) consisted of 78 RP patients and 94 HCs. A model based on monocyte counts and neutrophil to lymphocyte ratio (NLR) could effectively distinguish RP patients from HCs with an AUC of 0.845. Active RP patients exhibited increased erythrocyte sedimentation rate, complement 3, platelet to lymphocyte ratio (PLR), NLR, and C-reactive protein to albumin ratio (CAR) compared with stable patients, which were also positively correlated with RPDAI. Notably, CAR emerged as an independent risk factor of disease activity (OR = 4.422) and could identify active patients with an AUC of 0.758. To confirm the reliability and stability of the aforementioned models, a replication cohort (cohort 2) was enrolled, including 79 RP patients and 94 HCs. The monocyte-combined NLR and CAR showed a sensitivity of 0.886 and 0.577 and a specificity of 0.830 and 0.833 in RP diagnosis and activity prediction, respectively. Furthermore, lower natural killer cell levels in RP patients and higher B-cell levels in active patients may contribute to elucidating the pathological mechanisms of disease occurrence and exacerbation. Conclusions The utilization of laboratory parameters provides cost-effective and valuable markers that can assist in RP diagnosis, identify disease activity, and elucidate pathogenic mechanisms.
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Affiliation(s)
- Yongmei Liu
- Department of Clinical Laboratory, State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Linlin Cheng
- Department of Clinical Laboratory, State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Mengzhu Zhao
- Department of Rheumatology and Clinical Immunology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology. Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
- Department of Rheumatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Haoting Zhan
- Department of Clinical Laboratory, State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaomeng Li
- Department of Clinical Laboratory, State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
- Department of Clinical Laboratory, Peking University People’s Hospital, Beijing, China
| | - Yuan Huang
- Department of Clinical Laboratory, State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Haolong Li
- Department of Clinical Laboratory, State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Yong Hou
- Department of Rheumatology and Clinical Immunology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology. Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Yongzhe Li
- Department of Clinical Laboratory, State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
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Shahul Hameed MR, Shahul Hameed S, Rafi Ahamed R, Thomas FA, George B. WBC Count vs. CRP Level in Laboratory Markers and USG vs. CT Abdomen in Imaging Modalities: A Retrospective Study in the United Arab Emirates to Determine Which Are the Better Diagnostic Tools for Acute Appendicitis. Cureus 2023; 15:e47454. [PMID: 37873039 PMCID: PMC10590494 DOI: 10.7759/cureus.47454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2023] [Indexed: 10/25/2023] Open
Abstract
Introduction Acute Appendicitis (AA) is the most common surgical emergency. Despite the use of various diagnostic parameters, the rate of negative appendectomy remains high (30%). Thus, through our retrospective study, we aim to analyse whether white blood cell (WBC) count or C-reactive protein (CRP) level is more indicative in the confirmation of AA. We also analysed imaging modalities ultrasonography (USG) and computed tomography (CT) of the abdomen to find out which is better for diagnosing AA. Methods Patients with suspected AA admitted for laparoscopic appendectomy in Saqr Hospital, Ras Al Khaimah, United Arab Emirates, during 2019-2020 were included in the study. Patients who had either or both WBC and CRP values were included in the study and their diagnosis was confirmed based on histological appendectomy findings. Data analysis was done using IBM SPSS Statistics for Windows, Version 23.0 (Released 2015; IBM Corp., Armonk, New York, United States), receiver operating characteristic (ROC) curve, and chi-square test as required. p-value of <0.05 was considered statistically significant. Results Out of the 320 patients with suspected AA, WBC had a p-value of 0.8 (insignificant). A total of 228 patients who had elevated WBC had confirmed histological diagnosis of AA, and 152 patients who were tested for CRP and had elevated levels had confirmed histological diagnosis of AA. CRP had a p-value of 0.04 (significant). However, when the ROC curve was used as evidence to see which was a better test, WBC and CRP both had a low area under the curve (AUC), which proved that they were not the most accurate diagnostic marker in diagnosing AA. However, CRP was slightly better than WBC. A total of 266 patients underwent USG abdomen and it had a p-value of 0.4 (insignificant), while 118 patients underwent CT scan, which had a p-value of 0.01 (significant). CT abdomen was statistically proven as a better radiological investigation. Also, when the ROC curve was used to compare USG and CT abdomen, CT again proved to be a better radio diagnostic method for AA. Conclusions From our study, it can be concluded that CRP is better than WBC in ruling in appendicitis and CT abdomen is better than USG in diagnosing appendicitis, but CT abdomen is only next to histological diagnosis in confirming AA. Hence, we recommend doing CRP as the primary laboratory marker for suspected cases of AA. CT abdomen is the ideal imaging modality in cases of suspected AA where clinical examination, laboratory values, and ultrasound examination are inconclusive.
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Affiliation(s)
| | | | | | - Faiba A Thomas
- Psychiatry, RAK (Ras Al Khaimah) College of Medicine, Ras Al Khaimah, ARE
| | - Biji George
- Surgery, RAK (Ras Al Khaimah) College of Medicine, Ras Al Khaimah, ARE
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Musat O, Sorop VB, Sorop MI, Lazar V, Marti DT, Susan M, Avram CR, Oprisoni A, Vulcanescu DD, Horhat FG, Bagiu IC, Horhat DI, Diaconu MM. COVID-19 and Laboratory Markers from Romanian Patients-A Narrative Review. Life (Basel) 2023; 13:1837. [PMID: 37763241 PMCID: PMC10532991 DOI: 10.3390/life13091837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/09/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
COVID-19 has significantly impacted the whole world, and Romania was no exception. Biomarkers play a crucial role in understanding and managing the disease. However, research regarding laboratory analyses for patients with COVID-19 is fairly limited. For detection, PCR testing is still considered the golden standard, while antibodies are still useful for monitoring both patients and their vaccination status. In our country, biomarkers such as CRP, LDH, transaminases, cardiac, and iron markers have been used to assess the status of patients and even predict illness outcome. CRP, IL-6, LDH, FER, fibrinogen, creatinine, and vitamin D levels have been associated with increased severity, risk of ICU admission, and death. Cardiac markers and D-dimers are also good predictors, but their role seems more important in patients with complications. HDL cholesterol and BUN levels were also suggested as potential biomarkers. Hematological issues in SARS-CoV-2 infections include neutrophilia, lymphopenia and their ratio, while PCT, which is a marker of bacterial infections, is better to be used in patients with co- or supra-infections. The current research is a narrative review that focuses on the laboratory results of Romanian COVID-19 patients. The goal of this article is to provide an update on the research on biomarkers and other laboratory tests conducted inside the borders of Romania and identify gaps in this regard. Secondly, options for further research are discussed and encouraged.
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Affiliation(s)
- Ovidiu Musat
- Department of Ophthalmology, “Carol Davila” University of Medicine and Pharmacy, Dionisie Lupu Street, No. 37, Sector 2, 020021 Bucharest, Romania;
- Department of Ophthalmology, “Dr Carol Davila” Central Military Emergency University Hospital, Mircea Vulcanescu Street, No. 88, 010825 Bucharest, Romania
| | - Virgiliu Bogdan Sorop
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania; (V.B.S.); (M.M.D.)
| | - Madalina Ioana Sorop
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (M.I.S.); (D.D.V.)
| | - Viorica Lazar
- Department of General Medicine, “Vasile Goldis” University of Medicine, Liviu Rebreanu Street, No. 86, 310048 Arad, Romania;
- Pediatric Clinic II, Clinical Hospital Emergency of Arad County, Andrényi Károly Street, No. 2-4, 310037 Arad, Romania
| | - Daniela Teodora Marti
- Department of Biology and Life Sciences, “Vasile Goldis” University of Medicine, Liviu Rebreanu Street, No. 86, 310048 Arad, Romania;
- Clinical Analysis Laboratory Clinical Hospital Emergency of Arad County, Andrényi Károly Street, No. 2-4, 310037 Arad, Romania
| | - Monica Susan
- Department of Internal Medicine, Centre for Preventive Medicine, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania;
| | - Cecilia Roberta Avram
- Department of Residential Training and Post-University Courses, “Vasile Goldis” Western University, Liviu Rebreanu Street 86, 310414 Arad, Romania;
| | - Andrada Oprisoni
- Department of Pediatrics, Discipline of Pediatric Oncology and Hematology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania;
| | - Dan Dumitru Vulcanescu
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (M.I.S.); (D.D.V.)
- Department of Microbiology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania;
- Multidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Clinical Analysis Laboratory, “Louis Turcanu” Emergency Clinical Hospital for Children, Iosif Nemoianu Street 2, 300011 Timisoara, Romania
| | - Florin George Horhat
- Department of Microbiology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania;
- Multidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Clinical Analysis Laboratory, “Louis Turcanu” Emergency Clinical Hospital for Children, Iosif Nemoianu Street 2, 300011 Timisoara, Romania
| | - Iulia Cristina Bagiu
- Department of Microbiology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania;
- Multidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Clinical Analysis Laboratory, “Louis Turcanu” Emergency Clinical Hospital for Children, Iosif Nemoianu Street 2, 300011 Timisoara, Romania
| | - Delia Ioana Horhat
- Department of ENT, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania;
| | - Mircea Mihai Diaconu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania; (V.B.S.); (M.M.D.)
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Viscardi S, Marileo L, Delgado H, San Martín A, Hernández L, Garcés P, Guzmán-Oyarzo D, Boguen R, Medina G, Letelier P, Villano I, Guzmán N. Obesity Is Associated with Changes in Laboratory Biomarkers in Chilean Patients Hospitalized with COVID-19. J Clin Med 2023; 12:jcm12103392. [PMID: 37240496 DOI: 10.3390/jcm12103392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/02/2023] [Accepted: 03/07/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND AND AIMS It is reported that patients with obesity are more frequently hospitalized for COVID-19, and evidence exists that obesity is a risk factor, regardless of other comorbidities. The objective of this study was to evaluate the association of obesity with changes in laboratory biomarkers in hospitalized Chilean patients. MATERIALS AND METHODS A total of 202 hospitalized patients (71 with obesity and 131 without obesity) with a diagnosis of COVID-19 were included in the study. Demographic, clinical, and laboratory (days 1, 3, 7, 15) data were obtained. We performed a statistical analysis, assuming significance with a value of p < 0.05. RESULTS Significant differences in chronic respiratory pathology are observed between patients with and without obesity. The inflammatory markers CPR, ferritin, NLR, and PLR are elevated during the evaluated period, while changes in leukocyte populations are present on day 1 (eosinophils) and day 3 (lymphocytes). Finally, a persistent elevation of D-dimer level is observed, presenting significant differences on day 7 between patients with and without obesity. Obesity had a positive correlation with admission to the critical patient unit, invasive mechanical ventilation, and length of hospital stay. CONCLUSION Patients with obesity hospitalized for COVID-19 present marked elevations of inflammatory and hemostasis parameters, with a correlation between obesity, changes in laboratory biomarkers, and the risk of adverse clinical outcomes also observed.
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Affiliation(s)
- Sharon Viscardi
- Laboratorio de Investigación en Salud de Precisión, Departamento de Procesos Diagnósticos y Evaluación, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Manuel Montt 56, Campus San Francisco, Temuco 4813302, Chile
- Núcleo de Investigación en Producción Alimentaria, Universidad Católica de Temuco, Rudecindo Ortega 02950, Temuco 4813302, Chile
- Biotechnology of Functional Foods Laboratory, Camino Sanquilco, Parcela 18, La Araucanía, Padre Las Casas 4850827, Chile
| | - Luis Marileo
- Biotechnology of Functional Foods Laboratory, Camino Sanquilco, Parcela 18, La Araucanía, Padre Las Casas 4850827, Chile
- Programa de Doctorado en Ciencias Agropecuarias, Facultad de Recursos Naturales, Universidad Católica de Temuco, Rudecindo Ortega 02950, La Araucanía, Temuco 4813302, Chile
| | - Hugo Delgado
- Clinical Laboratory, Hospital Dr. Hernán Henríquez Aravena, Temuco 4813302, Chile
| | - Andrés San Martín
- Clinical Laboratory, Hospital Dr. Hernán Henríquez Aravena, Temuco 4813302, Chile
| | - Loreto Hernández
- Complejo Asistencial Padre Las Casas, Padre Las Casas 4850827, Chile
| | | | - Dina Guzmán-Oyarzo
- Escuela de Tecnología Médica, Facultad de Medicina y Ciencias, Universidad San Sebastián Sede Concepción, Concepción 4080871, Chile
| | - Rodrigo Boguen
- Laboratorio de Investigación en Salud de Precisión, Departamento de Procesos Diagnósticos y Evaluación, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Manuel Montt 56, Campus San Francisco, Temuco 4813302, Chile
| | - Gustavo Medina
- Laboratorio de Investigación en Salud de Precisión, Departamento de Procesos Diagnósticos y Evaluación, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Manuel Montt 56, Campus San Francisco, Temuco 4813302, Chile
| | - Pablo Letelier
- Laboratorio de Investigación en Salud de Precisión, Departamento de Procesos Diagnósticos y Evaluación, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Manuel Montt 56, Campus San Francisco, Temuco 4813302, Chile
| | - Ines Villano
- Department of Experimental Medicine, Section of Human Physiology and Unit of Dietetics and Sports Medicine, Università degli Studi della Campania "Luigi Vanvitelli", 80100 Naples, Italy
| | - Neftalí Guzmán
- Laboratorio de Investigación en Salud de Precisión, Departamento de Procesos Diagnósticos y Evaluación, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Manuel Montt 56, Campus San Francisco, Temuco 4813302, Chile
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9
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de Menezes DC, de Lima PDL, de Lima IC, Uesugi JHE, Vasconcelos PFDC, Quaresma JAS, Falcão LFM. Metabolic Profile of Patients with Long COVID: A Cross-Sectional Study. Nutrients 2023; 15:nu15051197. [PMID: 36904195 PMCID: PMC10005061 DOI: 10.3390/nu15051197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/08/2023] Open
Abstract
A significant proportion of patients experience a wide range of symptoms following acute coronavirus disease 2019 (COVID-19). Laboratory analyses of long COVID have demonstrated imbalances in metabolic parameters, suggesting that it is one of the many outcomes induced by long COVID. Therefore, this study aimed to illustrate the clinical and laboratory markers related to the course of the disease in patients with long COVID. Participants were selected using a clinical care programme for long COVID in the Amazon region. Clinical and sociodemographic data and glycaemic, lipid, and inflammatory screening markers were collected, and cross-sectionally analysed between the long COVID-19 outcome groups. Of the 215 participants, most were female and not elderly, and 78 were hospitalised during the acute COVID-19 phase. The main long COVID symptoms reported were fatigue, dyspnoea, and muscle weakness. Our main findings show that abnormal metabolic profiles (such as high body mass index measurement and high triglyceride, glycated haemoglobin A1c, and ferritin levels) are more prevalent in worse long COVID presentations (such as previous hospitalisation and more long-term symptoms). This prevalence may suggest a propensity for patients with long COVID to present abnormalities in the markers involved in cardiometabolic health.
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Affiliation(s)
| | | | - Igor Costa de Lima
- Center for Biological Health Sciences, State University of Pará (UEPA), Belém 66087-670, Brazil
| | | | | | - Juarez Antônio Simões Quaresma
- Center for Biological Health Sciences, State University of Pará (UEPA), Belém 66087-670, Brazil
- School of Medicine, São Paulo University (USP), São Paulo 01246903, Brazil
- Tropical Medicine Center, Federal University of Pará (UFPA), Belém 66055-240, Brazil
| | - Luiz Fábio Magno Falcão
- Center for Biological Health Sciences, State University of Pará (UEPA), Belém 66087-670, Brazil
- School of Medicine, São Paulo University (USP), São Paulo 01246903, Brazil
- Correspondence:
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Pavlyshyn H, Sarapuk I. Skin-to-skin contact-An effective intervention on pain and stress reduction in preterm infants. Front Pediatr 2023; 11:1148946. [PMID: 37033163 PMCID: PMC10073438 DOI: 10.3389/fped.2023.1148946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/07/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction The outcomes of pain and stress in preterm infants in the neonatal intensive care units (NICUs) compel the continued search for pain- and stress-reducing interventions. The objective of the study To investigate how skin-to-skin contact (SSC) influences chronic pain and stress in preterm infants in the NICU. Materials and methods The study included 140 preterm infants in the NICU with gestational age less than 34 weeks. The overall design was a baseline-response design. Urine and saliva were collected before (baseline) and after SSC to measure pain and stress markers by enzyme immunoassay method. The behavioral indicators of chronic pain were assessed using the EDIN (Échelle Douleur Inconfort Nouveau-Né-neonatal pain and discomfort). Results There was a significant decrease in the dopamine level in preterm infants after SSC in comparison with baseline values (85.99 [69.35; 112.20] pg/ml vs. 132.20 [104.80; 183.70] pg/ml), p < 0.001. The β-endorphin and serotonin levels increased after SSC (40.09 [26.81; 70.63] pg/ml vs. 29.87 [20.61; 46.94] pg/ml, p = 0.009 and 25.49 [20.45; 40.08] ng/ml vs. 22.30 [15.13; 31.65] ng/ml, p = 0.011, respectively). A significant decrease in cortisol levels in saliva and urine after SSC in comparison with baseline values (0.125 [0.079; 0.225] μg/dl vs. 0.371 [0.188; 1.002] μg/dl, p = 0.000 and 27.06 [14.59; 35.35] ng/ml vs. 35.25 [19.78; 61.94] ng/ml, p = 0.001, with a simultaneous increase of oxytocin level (57.00 [36.55; 88.49] pg/ml vs. 38.20 [28.78; 56.04] pg/ml, p = 0.009 were revealed. The total pain EDIN score in infants after SSC was below 6 points, significantly decreasing compared to the baseline (p < 0.05). Conclusion Preterm infants in the NICU experience stress and pain, which were confirmed by the EDIN pain scale and laboratory markers. The level of dopamine and cortisol as pain and stress hormones were reliably high, and normalized after regular SSC. Simultaneously, pain-relieving and anti-stress markers of oxytocin, β-endorphin and serotonin reliably increased in preterm infants in response to the SSC.
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Safonova YA, Klitsenko OA. [A new screening method for the diagnosis of sarcopenia in people 65 years and older.]. Adv Gerontol 2023; 36:647-653. [PMID: 38180363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
Diagnosis of sarcopenia is difficult due to the limitations of measuring muscle mass, which requires specialized equipment. Simple screening tools can be useful in general practice. The aim of the study was to develop a new screening method for diagnosing sarcopenia based on risk factors and biomarkers of the disease. The study included 230 people over 65 years and older (70 men and 160 women, median age 75 [68; 79] years) examined in a medical institution in St. Petersburg. Sarcopenia was diagnosed according to the updated consensus of the European Working Group on Sarcopenia 2 (EWGSOP2, 2018). When constructing a mathematical model, such indicators as the number of falls, BMI, fatigue, and the level of C-reactive protein in the blood serum had the greatest diagnostic significance of sarcopenia. The calculations showed high sensitivity - 91,4%, specificity - 88,7% and accuracy - 89,9% of the screening method for diagnosing sarcopenia in people 65 years and older.
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Affiliation(s)
- Y A Safonova
- I.I.Mechnikov North-West State Medical University, 41 Kirochnaya str., St.-Petersburg 191015, Russian Federation,-mail:
- Rheumatic Clinical Hospital № 25, 30 Bolshaya Podiacheskaya str., St. Petersburg 190068, Russian Federation
| | - O A Klitsenko
- I.I.Mechnikov North-West State Medical University, 41 Kirochnaya str., St.-Petersburg 191015, Russian Federatione,-mail:
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12
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Li Z, Huang L, Guo B, Zhang P, Wang J, Wang X, Yao W. The predictive ability of routinely collected laboratory markers for surgically treated spinal metastases: a retrospective single institution study. BMC Cancer 2022; 22:1231. [PMID: 36447178 PMCID: PMC9706860 DOI: 10.1186/s12885-022-10334-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/18/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE We aimed to identify effective routinely collected laboratory biomarkers for predicting postoperative outcomes in surgically treated spinal metastases and attempted to establish an effective prediction model. METHODS This study included 268 patients with spinal metastases surgically treated at a single institution. We evaluated patient laboratory biomarkers to determine trends to predict survival. The markers included white blood cell (WBC) count, platelet count, neutrophil count, lymphocyte count, hemoglobin, albumin, alkaline phosphatase, creatinine, total bilirubin, calcium, international normalized ratio (INR), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR). A nomogram based on laboratory markers was established to predict postoperative 90-day and 1-year survival. The discrimination and calibration were validated using concordance index (C-index), area under curves (AUC) from receiver operating characteristic curves, and calibration curves. Another 47 patients were used as a validation group to test the accuracy of the nomogram. The prediction accuracy of the nomogram was compared to Tomita, revised Tokuhashi, modified Bauer, and Skeletal Oncology Research Group machine-learning (SORG ML). RESULTS WBC, lymphocyte count, albumin, and creatinine were shown to be the independent prognostic factors. The four predictive laboratory markers and primary tumor, were incorporated into the nomogram to predict the 90-day and 1-year survival probability. The nomogram performed good with a C-index of 0.706 (0.702-0.710). For predicting 90-day survival, the AUC in the training group and the validation group was 0.740 (0.660-0.819) and 0.795 (0.568-1.000), respectively. For predicting 1-year survival, the AUC in the training group and the validation group was 0.765 (0.709-0.822) and 0.712 (0.547-0.877), respectively. Our nomogram seems to have better predictive accuracy than Tomita, revised Tokuhashi, and modified Bauer, alongside comparable prediction ability to SORG ML. CONCLUSIONS Our study confirmed that routinely collected laboratory markers are closely associated with the prognosis of spinal metastases. A nomogram based on primary tumor, WBC, lymphocyte count, albumin, and creatinine, could accurately predict postoperative survival for patients with spinal metastases.
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Affiliation(s)
- Zhehuang Li
- grid.414008.90000 0004 1799 4638Department of Musculoskeletal Oncology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 45000 Henan China
| | - Lingling Huang
- grid.414008.90000 0004 1799 4638Department of Musculoskeletal Oncology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 45000 Henan China
| | - Bairu Guo
- grid.414008.90000 0004 1799 4638Department of Musculoskeletal Oncology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 45000 Henan China
| | - Peng Zhang
- grid.414008.90000 0004 1799 4638Department of Musculoskeletal Oncology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 45000 Henan China
| | - Jiaqiang Wang
- grid.414008.90000 0004 1799 4638Department of Musculoskeletal Oncology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 45000 Henan China
| | - Xin Wang
- grid.414008.90000 0004 1799 4638Department of Musculoskeletal Oncology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 45000 Henan China
| | - Weitao Yao
- grid.414008.90000 0004 1799 4638Department of Musculoskeletal Oncology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 45000 Henan China
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Jain PN, Acosta S, Annapragada A, Checchia PA, Moreira A, Muscal E, Sartain SE, Tejtel SKS, Vogel TP, Shekerdemian L, Rusin CG. Comparison of Laboratory and Hemodynamic Time Series Data Across Original, Alpha, and Delta Variants in Patients With Multisystem Inflammatory Syndrome in Children. Pediatr Crit Care Med 2022; 23:e372-e381. [PMID: 35507775 PMCID: PMC9345524 DOI: 10.1097/pcc.0000000000002976] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To compare the clinical, laboratory, and hemodynamic parameters during hospitalization for patients with multisystem inflammatory syndrome in children (MIS-C), across the Original/Alpha and the Delta variants of severe acute respiratory syndrome coronavirus 2 infection. DESIGN Retrospective cohort study. SETTING Single-center quaternary children's hospital. PATIENTS Children with MIS-C admitted from May 2020 to February 2021(Original and Alpha variant cohort) and August 2021 to November 2021 (Delta variant cohort). MEASUREMENTS AND MAIN RESULTS Continuous vital sign measurements, laboratory results, medications data, and hospital outcomes from all subjects were evaluated. Of the 134 patients (102 with Original/Alpha and 32 with Delta), median age was 9 years, 75 (56%) were male, and 61 (46%) were Hispanics. The cohort with Original/Alpha variant had more males (61% vs 41%; p = 0.036) and more respiratory/musculoskeletal symptoms on presentation compared with the Delta variant ( p < 0.05). More patients in the Original/Alpha variant cohort received mechanical ventilation (16 vs 0; p = 0.009). Median hospital length of stay (LOS) was 7 days, and ICU LOS was 3 days for the entire cohort. ICU LOS was shorter in cohort with the Delta variant compared with the Original/Alpha variant (4 vs 2 d; p = 0.001). Only one patient had cardiac arrest, two needed extracorporeal membrane oxygenation, and two needed left ventricular assist device (Impella, Danvers, MA), all in the Original/Alpha variant cohort; no mortality occurred in the entire cohort. MIS-C cohort associated with the Delta variant had lower INR, prothrombin time, WBCs, sodium, phosphorus, and potassium median values ( p < 0.05) during hospitalization compared with the Original/Alpha variants. Hemodynamic assessment showed significant tachycardia in the Original/Alpha variants cohort compared with the Delta variant cohort ( p < 0.05). INTERVENTIONS None. CONCLUSIONS Patients with MIS-C associated with the Delta variants had lower severity during hospitalization compared with the Original/Alpha variant. Analysis of distinct trends in clinical and laboratory parameters with future variants of concerns will allow for potential modification of treatment protocol.
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Affiliation(s)
- Parag N Jain
- Division of Critical Care Medicine, Texas Children's Hospital, Houston, TX
| | | | - Ananth Annapragada
- E. B. Singleton Department of Radiology, Texas Children's Hospital, Houston, TX
| | - Paul A Checchia
- Division of Critical Care Medicine, Texas Children's Hospital, Houston, TX
| | - Axel Moreira
- Division of Critical Care Medicine, Texas Children's Hospital, Houston, TX
| | - Eyal Muscal
- Division of Rheumatology, Texas Children's Hospital, Houston, TX
| | - Sarah E Sartain
- Division of Hematology and Oncology, Texas Children's Hospital, Houston, TX
| | | | - Tiphanie P Vogel
- Division of Rheumatology, Texas Children's Hospital, Houston, TX
| | - Lara Shekerdemian
- Division of Critical Care Medicine, Texas Children's Hospital, Houston, TX
| | - Craig G Rusin
- Division of Cardiology, Texas Children's Hospital, Houston, TX
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Li J, Zhao X, Su W, Shen R, Xiao Y, Wang X, Xu X, Xu C, Li N, Yu Y. Magnetically Guided Capsule Endoscopy and Magnetic Resonance Enterography in Children With Crohn's Disease: Manifestations and the Value of Assessing Disease Activity. Front Pharmacol 2022; 13:894808. [PMID: 35571113 PMCID: PMC9091172 DOI: 10.3389/fphar.2022.894808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 04/08/2022] [Indexed: 11/13/2022] Open
Abstract
Objective: To investigate the value of magnetically guided capsule endoscopy (MGCE) and magnetic resonance enterography (MRE) in assessing the activity of pediatric Crohn's disease. Methods: Clinical data from 82 subjects with pediatric Crohn's disease, who underwent MGCE and MRE from October 2018 to March 2021 were analyzed retrospectively. Pairwise comparisons of several indexes, including MaRIA, CECDAI, PCDAI, and SES-CD, were performed by Spearman's rank correlation test and kappa consistency analysis. CECDAI and MaRIA values predicted whether patients were moderately or severely active (PCDAI ≥30) clinically by logistic regression analysis. The area under the receiver operating characteristic curve (AUC) quantified the evaluation value of moderate to severe activity of pediatric CD. Results: In judging the severity of CD in the small intestine, the correlation coefficient between CECDAI and MaRIA was 0.406 (p < 0.05), and the kappa value of the consistency analysis was 0.299 (p < 0.05). MaRIA was weakly correlated with PCDAI (r = 0.254, p < 0.05), and they were weakly consistent in assessing the activity of Crohn's disease (kappa = 0.135, p < 0.05). For predicting clinically moderate to severe activity, the fitted AUC based on CECDAI and MarRIA was 0.917, which was higher than applying a single parameter (CECDAI = 0.725, MarRIA = 0.899, respectively). MaRIA and serum albumin were significantly and negatively correlated (r = -1.064, p < 0.05). The consistency of the detection rate of gastric ulcers by MGCE and gastroscopy was moderate (kappa = 0.586, p < 0.05), and the detection rate of ulcers in the terminal ileum between MGCE and colonoscopy showed high consistency (kappa = 0.609, p < 0.05). Conclusions: MGCE and MRE are valuable, non-invasive methods for evaluating small bowel lesions in children with CD. The combined application of MGCE and MRE can better characterize the disease activity.
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Affiliation(s)
- Jia Li
- Department of Pediatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xuesong Zhao
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wen Su
- Department of Pediatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruizhe Shen
- Digestive Endoscopy Center, Department of Gastroenterology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuan Xiao
- Department of Pediatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinqiong Wang
- Department of Pediatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xu Xu
- Department of Pediatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chundi Xu
- Department of Pediatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Na Li
- Department of Pediatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,School of Tropical Medicine and The Second Affiliated Hospital, Hainan Medical University, Haikou, China
| | - Yi Yu
- Department of Pediatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Bögli SY, Wang SS, Pietrzko E, Müller A, Eisele A, Keller E, Brandi G. Plasma Inflammatory Markers and Ventriculostomy-Related Infection in Patients With Hemorrhagic Stroke: A Retrospective and Descriptive Study. Front Neurol 2022; 13:861435. [PMID: 35547383 PMCID: PMC9081843 DOI: 10.3389/fneur.2022.861435] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/15/2022] [Indexed: 11/17/2022] Open
Abstract
Background Diagnosis of ventriculostomy-related infection (VRI) remains difficult due to the various existing definitions. In patients with hemorrhagic stroke, its diagnosis might be further complicated by the presence of intraventricular blood. Furthermore, hemorrhagic stroke per se may cause symptoms compatible with VRI. This study aimed to evaluate the benefit of plasma inflammatory markers for the diagnosis of VRI and its differentiation from patients with non-cerebral infection and patients without infection in a cohort of patients with hemorrhagic stroke. Methods A total of 329 patients with hemorrhagic stroke and an external ventricular drain (EVD) in situ were admitted to the Neurocritical Care Unit, University Hospital Zurich over a period of 6 years. Of those patients, 187 with subarachnoid hemorrhage and 76 with spontaneous intracerebral hemorrhage were included. Patients with VRI were compared to patients without any infection and to patients with non-cerebral infection, with regards to their clinical characteristics, as well as their inflammatory plasma and cerebrospinal fluid (CSF) markers. For the analysis, peak values were considered. Results The VRI was diagnosed in 36% of patients with subarachnoid and in 17% of patients with intracerebral hemorrhage. The VRI was diagnosed on an average day 9±6.2 after EVD insertion, one day after the white blood cell count (WBC) peaked in CSF (8 ± 6.3). Plasma inflammatory markers (WBC, C-reactive protein “CRP” and procalcitonin “PCT”) did not differ among patients with VRI compared to patients without infection. The CRP and PCT, however, were higher in patients with non-cerebral infection than in patients with VRI. The WBC in CSF was generally higher in patients with VRI compared to both patients without any infection and patients with non-cerebral infection. Conclusions No differences in plasma inflammatory markers could be found between patients with VRI and patients without any infection. Conversely, CRP/PCT were higher in patients with non-cerebral infection than in patients with VRI. Altogether, CRP, PCT, and WBC are not suitable parameters for VRI diagnosis in neurocritical care unit patients.
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Affiliation(s)
- Stefan Yu Bögli
- Neurocritical Care Unit, Department of Neurosurgery and Institute for Intensive Care Medicine, University Hospital Zürich, Zürich, Switzerland.,Department of Neurology, University Hospital Zürich, Zürich, Switzerland.,Clinical Neuroscience Center, University Hospital and University of Zürich, Zürich, Switzerland
| | - Sophie S Wang
- Neurocritical Care Unit, Department of Neurosurgery and Institute for Intensive Care Medicine, University Hospital Zürich, Zürich, Switzerland.,Department of Neurosurgery and Neurotechnology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Elisabeth Pietrzko
- Neurocritical Care Unit, Department of Neurosurgery and Institute for Intensive Care Medicine, University Hospital Zürich, Zürich, Switzerland
| | - Achim Müller
- Neurocritical Care Unit, Department of Neurosurgery and Institute for Intensive Care Medicine, University Hospital Zürich, Zürich, Switzerland.,Department of Neurology, University Hospital Zürich, Zürich, Switzerland
| | - Amanda Eisele
- Neurocritical Care Unit, Department of Neurosurgery and Institute for Intensive Care Medicine, University Hospital Zürich, Zürich, Switzerland.,Department of Neurology, University Hospital Zürich, Zürich, Switzerland
| | - Emanuela Keller
- Neurocritical Care Unit, Department of Neurosurgery and Institute for Intensive Care Medicine, University Hospital Zürich, Zürich, Switzerland.,Clinical Neuroscience Center, University Hospital and University of Zürich, Zürich, Switzerland
| | - Giovanna Brandi
- Neurocritical Care Unit, Department of Neurosurgery and Institute for Intensive Care Medicine, University Hospital Zürich, Zürich, Switzerland.,Clinical Neuroscience Center, University Hospital and University of Zürich, Zürich, Switzerland
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Shafie M, Homayouni Rad A, Mirghafourvand M. Effects of prebiotic-rich yogurt on menopausal symptoms and metabolic indices in menopausal women: a triple-blind randomised controlled trial. Int J Food Sci Nutr 2022; 73:693-704. [PMID: 35264075 DOI: 10.1080/09637486.2022.2048360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study aimed to investigate the effects of prebiotics on metabolic indices and menopausal symptoms. This triple-blind randomised controlled trial was conducted on 60 menopausal women. The participants were assigned to two groups based on block randomisation. Over 6 weeks, the experimental group received 100 g of prebiotic-rich yogurt daily after lunch and the control group received regular yogurt. Menopausal symptoms and metabolic indices were assessed before and after the treatment. The mean total score of menopausal symptoms (p < 0.001), anxiety (p < 0.001), depression (p = 0.003), vasomotor (p < 0.001), and low-density lipoprotein (p = 0.028) was statistically lower in the experimental group than the control group. Moreover, the serum insulin level was statistically higher among those in the experimental group (p = 0.011). The study results demonstrated the positive effects of prebiotic-rich yogurt on menopausal symptoms and some metabolic indices. Trial registration: Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N52; Date of registration: 12/4/2019. URL: https://en.irct.ir/user/trial/41105/view; Date of first registration: 12/5/2019.
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Affiliation(s)
- Mehrnaz Shafie
- Students' Research Committee, Tabriz University of Medical sciences, Tabriz, Iran
| | - Aziz Homayouni Rad
- Department of Food Science and Technology, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical sciences, Tabriz, Iran
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Simsek Yurt N, Ocak M, Yurt YC. Epidemiological and clinical characteristics of 3334 cases with prediagnosis coronavirus disease - 2019 (COVID-19) in Turkey. Int J Clin Pract 2021; 75:e14496. [PMID: 34173700 PMCID: PMC8420156 DOI: 10.1111/ijcp.14496] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/13/2021] [Accepted: 06/10/2021] [Indexed: 12/17/2022] Open
Abstract
AIM This study aims to analyse the epidemiological and clinical features of the patients admitted to the hospital with the prediagnosis of coronavirus disease 19 (COVID-19) in Turkey. MATERIALS AND METHODS In this retrospective study, epidemiological and clinical features, laboratory markers, radiological features, therapeutic approaches, and survival conditions of the patients with the prediagnosis of COVID-19 from March 11th to June 30th, 2020 have been analysed and reported. The data of the cases were divided into four groups and then compared with each other: first group includes confirmed cases with positive reverse transcriptase polymerase chain reaction (RT-PCR) and chest computed tomography (CT) imaging results considered as COVID-19 lung involvement, second group includes the clinically diagnosed cases with negative RT-PCR and positive CT imaging abnormalities, third group includes mild and asymptomatic cases with positive RT-PCR and negative CT findings, fourth group includes suspected cases with negative RT-PCR and negative CT findings. Post-hoc analysis was performed to evaluate the differences among the groups. RESULTS In total, 3334 patients with the prediagnosis of COVID-19 admitted to the emergency department. Based on the post hoc analyses, significant differences were found among the four groups in terms of their test results of leukocytes, haemoglobin, platelet, neutrophils, urea and C-reactive protein (CRP) (P < .001). Furthermore, the factors of age groups, hospitalisation, intensive care unit follow-up and mortality rate of the four groups showed a significant difference among the groups (P = .001). CONCLUSION The mean leukocytes, neutrophils and platelet counts of patients with positive RT-PCR were found to be lower than the ones with negative RT-PCR. The mean serum levels of CRP were found to be higher in patients with lung involvement compared with other patient groups.
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Affiliation(s)
- Nur Simsek Yurt
- Clinic of Family MedicineHealth Sciences University Samsun Training and Research HospitalSamsunTurkey
| | - Metin Ocak
- Clinic of EmergencySamsun Gazi State HospitalSamsunTurkey
| | - Yusuf Can Yurt
- Clinic of EmergencySamsun Gazi State HospitalSamsunTurkey
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18
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Yildiz H, Castanares-Zapatero D, Pierman G, Pothen L, De Greef J, Aboubakar Nana F, Rodriguez-Villalobos H, Belkhir L, Yombi JC. Validation of Neutrophil-to-Lymphocyte Ratio Cut-off Value Associated with High In-Hospital Mortality in COVID-19 Patients. Int J Gen Med 2021; 14:5111-5117. [PMID: 34511993 PMCID: PMC8420786 DOI: 10.2147/ijgm.s326666] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 08/20/2021] [Indexed: 12/18/2022] Open
Abstract
Introduction The neutrophil-to-lymphocyte ratio (NLR) could be a predictive factor of severe COVID-19. However, most relevant studies are retrospective, and the optimal NLR cut-off point has not been determined. The objective of our research was identification and validation of the best NLR cut-off value on admission that could predict high in-hospital mortality in COVID-19 patients. Methods Medical files of all patients admitted for COVID-19 pneumonia in our dedicated COVID-units between March and April 2020 (derivation cohort) and between October and December 2020 (validation cohort) were reviewed. Results Two hundred ninety-nine patients were included in the study (198 in the derivation and 101 in the validation cohort, respectively). Youden’s J statistic in the derivation cohort determined the optimal cut-off value for the performance of NLR at admission to predict mortality in hospitalized patients with COVID-19. The NLR cut-off value of 5.94 had a sensitivity of 62% and specificity of 64%. In ROC curve analysis, the AUC was 0.665 [95% CI 0.530–0.801, p= 0.025]. In the validation cohort, the best predictive cut-off value of NLR was 6.4, which corresponded to a sensitivity of 63% and a specificity of 64% with AUC 0.766 [95% CI 0.651–0.881, p <0.001]. When the NLR cut-off value of 5.94 was applied in the validation cohort, there was no significant difference in death and survival in comparison with the derivation NLR cut-off. Net reclassification improvement (NRI) analysis showed no significant classification change in outcome between both NLR cut-off values (NRI:0.012, p=0.31). Conclusion In prospective analysis, an NLR value of 5.94 predicted high in-hospital mortality upon admission in patients hospitalized for COVID-19 pneumonia.
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Affiliation(s)
- Halil Yildiz
- Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | | | - Guillaume Pierman
- Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Lucie Pothen
- Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Julien De Greef
- Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Frank Aboubakar Nana
- Department of Pneumology, Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | | | - Leila Belkhir
- Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Jean Cyr Yombi
- Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
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19
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Szewczyk AK, Jamroz-Wiśniewska A, Rejdak K. A Retrospective Analysis of Pain Etiology in Middle-Aged Patients with Peripheral Neuropathy. ACTA ACUST UNITED AC 2021; 57:787. [PMID: 34440993 DOI: 10.3390/medicina57080787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/15/2021] [Accepted: 07/29/2021] [Indexed: 11/26/2022]
Abstract
Background and Objectives: Correct assessment and a multidisciplinary approach appear to be extremely important in preventing peripheral neuropathy and its complications. The purpose of this study was to find the correlations and dissimilarities between different types of peripheral neuropathy, the occurrence of pain, and laboratory results. Materials and Methods: This retrospective study assessed 124 patients who were hospitalized in our neurology department due to various types of sensory or motor disturbances. The patients were eventually diagnosed with peripheral neuropathy, based on the electrophysiological study, anamnesis, physical examination, and laboratory results. The whole group was subjected to statistical analysis. Results: The mean age of patients was over 56 years, with a slight woman predominance. A statistically significant (p < 0.05) relationship between the place of residence and gender was seen, where more men than women live in the rural area, while more women than men live in the urban area. Most often we observed symmetric, sensorimotor, demyelinating, inflammatory, and chronic neuropathy. More than 40% of patients reported pain. A statistically significant correlation between the evolution/severity and the occurrence of pain was seen in subacute type (p < 0.05) and small fibre neuropathy (p < 0.01). Conclusions: A higher incidence of peripheral neuropathy in middle-aged people will become essential in the aging society with lifestyle and chronic disorders. Peripheral neuropathy is slightly more common in women than men and its occurrence may be influenced by work performed or internal and external factors. In the study group, more than 40% of patients reported pain, therefore the pain measurement for each patient should be implemented and repeated at every visit. An assessment of sodium level and, in women, markers of neuroinflammation level in the various types of peripheral neuropathy may be an interesting direction for the future.
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20
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Al Hindi S, Khalaf Z, Nazzal K, Nazzal O, Ahmed A, Alshaibani L. Acute Pancreatitis in Children: The Clinical Profile at a Tertiary Hospital. Cureus 2021; 13:e14871. [PMID: 33968545 PMCID: PMC8103661 DOI: 10.7759/cureus.14871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2021] [Indexed: 11/05/2022] Open
Abstract
Objectives The clinical course and progression of acute pancreatitis are poorly understood to date, necessitating more studies of clinical profiles during the disease. Moreover, understanding the etiologies and clinical presentations of acute pancreatitis (AP) in children can contribute to early diagnosis and, hence, earlier interventions. Therefore, this article aims to study the clinical profiles of children with acute pancreatitis (AP) in relation to complications and other variables. Study design We retrospectively studied 56 patients who presented with AP to the pediatric department in Salmaniya Medical Complex between January 2006 and December 2017. Cases of chronic pancreatitis and ages above 12 years were excluded. The data concerned demographics, etiology, clinical data, hospital course, and outcomes. Results The study included 56 patients aged a mean of 8.46 years (male:female - 33:23). The average hospital stay was 7.68 days. Patients received parenteral feeds a mean of 2.77 days. All patients had an ultrasound, nine required CT scans (16.1%), and five MRIs (8.9%). There were 18 local complications (32.1%): pseudocysts (n=3, 5.36%), cholangitis (n=2, 3.6%), and edema (n=13, 23.2%). There were 23 intensive care unit (ICU) admissions (41.1%). No mortalities occurred but there were six recurrences (10.7%). Symptoms of abdominal pain, vomiting, fever, and nausea occurred in 100%, 57.1%, 35.7%, and 23.2% of patients, respectively. Etiologies were 41.1% biliary, 23.2% idiopathic, 19.6% traumatic, and 8.93% drug-induced. Leukocytes were elevated in 20 patients (35.7%), c-reactive protein (CRP) in five (8.93%), serum amylase in 45 (80.4%), and urinary amylase in all 56 patients (100%). Conclusion Most pediatric AP cases were attributed to biliary causes followed by trauma. Age was significantly correlated with complication rates (P=0.013). Abdominal pain was a more common symptom than vomiting. Leukocytosis was associated with ICU admissions. There was no significant relation between c-reactive protein, serum amylase, or urinary amylase, and complications or ICU admissions. Pediatric AP was self-limiting and there were no fatalities.
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Affiliation(s)
- Saeed Al Hindi
- Department of Pediatric Surgery, Salmaniya Medical Complex, Manama, BHR
| | - Zahra Khalaf
- Department of Pediatric Surgery, Salmaniya Medical Complex, Manama, BHR
| | - Khaled Nazzal
- Department of Surgery, Ibn Al-Nafees Hospital, Manama, BHR
| | - Osama Nazzal
- Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, BHR
| | - Alya Ahmed
- Department of Internal Medicine, King Hamad University Hospital, Manama, BHR
| | - Lama Alshaibani
- Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, BHR
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21
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Kanik A, Eliacik K, Kanik ET, Tekindal MA. Clinical Usefulness of Acute-Phase Markers in Distinguishing between PFAPA and Other Exudative Tonsillitis Causes: A Methodological Study. J Trop Pediatr 2021; 67:6067639. [PMID: 33411886 DOI: 10.1093/tropej/fmaa124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND We investigated the practical use of procalcitonin (PCT), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and complete blood count (CBC) parameters in distinguishing periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis syndrome (PFAPA) attacks from exudative tonsillitis associated with group A streptococcus (GAS) and Epstein-Barre virus (EBV). METHODS The study population consisted of cases with exudative tonsillitis who had been subsequently diagnosed as PFAPA, EBV, and GAS tonsillitis through a period of 6 years. We retrieved the CBC, ESR, CRP and PCT data from patients' medical records. RESULTS Of the patients, 47 (35.6%) had PFAPA, 36 (27.3%) had GAS and 49 (37.1%) had EBV tonsillitis. Median CRP, ESR and PCT values of patients with PFAPA were 78 (17-92) mg/dl, 44 (11-83) mm/h, 0.16 (0.01-1.45) ng/ml, respectively. The CRP and ESR levels were significantly higher in PFAPA and GAS groups compared with the EBV group (p = 0.001). There was no significant difference between the groups regarding the PCT levels. CONCLUSION The study indicated no benefit of PCT in distinguishing PFAPA from the others. However, we found that CRP, ESR, and CBC parameters could be useful in identifying PFAPA and GAS than EBV tonsillitis.
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Affiliation(s)
- Ali Kanik
- Department of Pediatrics, İzmir Katip Çelebi University, Faculty of Medicine, İzmir, Turkey
| | - Kayı Eliacik
- Department of Pediatrics, Tepecik Teaching and Research Hospital, İzmir, Turkey
| | - Esra Toprak Kanik
- Department of Pediatric Allergy and Immunology, Dr. Behcet Uz Childrens Hospital, İzmir, Turkey
| | - Mustafa Agah Tekindal
- Faculty of Veterinary Medicine, Department of Biostatistics, Selcuk University, Konya, Turkey
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22
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Sohlberg EM, Thomas IC, Yang J, Kapphahn K, Velaer KN, Goldstein MK, Wagner TH, Chertow GM, Brooks JD, Patel CJ, Desai M, Leppert JT. Laboratory-wide association study of survival with prostate cancer. Cancer 2020; 127:1102-1113. [PMID: 33237577 DOI: 10.1002/cncr.33341] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 08/27/2020] [Accepted: 10/13/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Estimates of overall patient health are essential to inform treatment decisions for patients diagnosed with cancer. The authors applied XWAS methods, herein referred to as "laboratory-wide association study (LWAS)", to evaluate associations between routinely collected laboratory tests and survival in veterans with prostate cancer. METHODS The authors identified 133,878 patients who were diagnosed with prostate cancer between 2000 and 2013 in the Veterans Health Administration using any laboratory tests collected within 6 months of diagnosis (3,345,083 results). Using the LWAS framework, the false-discovery rate was used to test the association between multiple laboratory tests and survival, and these results were validated using training, testing, and validation cohorts. RESULTS A total of 31 laboratory tests associated with survival met stringent LWAS criteria. LWAS confirmed markers of prostate cancer biology (prostate-specific antigen: hazard ratio [HR], 1.07 [95% confidence interval (95% CI), 1.06-1.08]; and alkaline phosphatase: HR, 1.22 [95% CI, 1.20-1.24]) as well laboratory tests of general health (eg, serum albumin: HR, 0.78 [95% CI, 0.76-0.80]; and creatinine: HR, 1.05 [95% CI, 1.03-1.07]) and inflammation (leukocyte count: HR, 1.23 [95% CI, 1.98-1.26]; and erythrocyte sedimentation rate: HR, 1.33 [95% CI, 1.09-1.61]). In addition, the authors derived and validated separate models for patients with localized and advanced disease, identifying 28 laboratory markers and 15 laboratory markers, respectively, in each cohort. CONCLUSIONS The authors identified routinely collected laboratory data associated with survival for patients with prostate cancer using LWAS methodologies, including markers of prostate cancer biology, overall health, and inflammation. Broadening consideration of determinants of survival beyond those related to cancer itself could help to inform the design of clinical trials and aid in shared decision making. LAY SUMMARY This article examined routine laboratory tests associated with survival among veterans with prostate cancer. Using laboratory-wide association studies, the authors identified 31 laboratory tests associated with survival that can be used to inform the design of clinical trials and aid patients in shared decision making.
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Affiliation(s)
- Ericka M Sohlberg
- Department of Urology, Stanford University School of Medicine, Stanford, California
| | - I-Chun Thomas
- Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Jaden Yang
- Quantitative Sciences Unit, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Kristopher Kapphahn
- Quantitative Sciences Unit, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Kyla N Velaer
- Department of Urology, Stanford University School of Medicine, Stanford, California
| | - Mary K Goldstein
- Veterans Affairs Palo Alto Health Care System, Palo Alto, California.,Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Todd H Wagner
- Veterans Affairs Palo Alto Health Care System, Palo Alto, California.,Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Glenn M Chertow
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - James D Brooks
- Department of Urology, Stanford University School of Medicine, Stanford, California
| | - Chirag J Patel
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts
| | - Manisha Desai
- Quantitative Sciences Unit, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - John T Leppert
- Department of Urology, Stanford University School of Medicine, Stanford, California.,Veterans Affairs Palo Alto Health Care System, Palo Alto, California.,Department of Medicine, Stanford University School of Medicine, Stanford, California
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23
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Assandri R, Canetta C, Viganò G, Buscarini E, Scartabellati A, Montanelli A. Laboratory markers included in the Corona Score can identify false negative results on COVID-19 RT-PCR in the emergency room. Biochem Med (Zagreb) 2020; 30:030402. [PMID: 32774118 PMCID: PMC7394256 DOI: 10.11613/bm.2020.030402] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 06/25/2020] [Indexed: 12/20/2022] Open
Abstract
After December 2019 outbreak in China, the novel Coronavirus infection (COVID-19) has very quickly overflowed worldwide. Infection causes a clinical syndrome encompassing a wide range of clinical features, from asymptomatic or oligosymptomatic course to acute respiratory distress and death. In a very recent work we preliminarily observed that several laboratory tests have been shown as characteristically altered in COVID-19. We aimed to use the Corona score, a validated point-based algorithm to predict the likelihood of COVID-19 infection in patients presenting at the Emergency rooms. This approach combines chest images-relative score and several laboratory parameters to classify emergency room patients. Corona score accuracy was satisfactory, increasing the detection of positive patients' rate.
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Affiliation(s)
- Roberto Assandri
- Clinical Investigation Laboratory, ASST-Crema, Maggiore Hospital, Crema, Italy
| | - Ciro Canetta
- Internal Medicine Unit, ASST-Crema, Maggiore Hospital, Crema, Italy
| | - Giovanni Viganò
- Emergency Medicine Unit,ASST-Crema, Maggiore Hospital, Crema, Italy
| | | | | | - Alessandro Montanelli
- Clinical Investigation Laboratory, ASST-Bergamo Est, Bolognini Hospital Seriate, Bergamo, Italy
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24
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Borovac JA, Glavas D, Susilovic Grabovac Z, Supe Domic D, Stanisic L, D’Amario D, Duplancic D, Bozic J. Right Ventricular Free Wall Strain and Congestive Hepatopathy in Patients with Acute Worsening of Chronic Heart Failure: A CATSTAT-HF Echo Substudy. J Clin Med 2020; 9:jcm9051317. [PMID: 32370248 PMCID: PMC7290588 DOI: 10.3390/jcm9051317] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 04/25/2020] [Accepted: 04/27/2020] [Indexed: 12/20/2022] Open
Abstract
Right ventricular (RV) function is an important predictor of prognosis in patients with heart failure. However, the relationship of the RV free wall longitudinal strain (RV FWS) and the degree of hepatic dysfunction during the acute worsening of heart failure (AWHF) is unknown. We sought to determine associations of RV FWS with laboratory liver function tests and parameters of RV function including tricuspid annular plane systolic excursion (TAPSE), RV fractional area change (RV FAC), maximal tricuspid jet velocity (TR Vmax), RV S′ velocity, and estimated RV systolic pressure (RVSP). A total of 42 AWHF patients from the CATSTAT-HF study were stratified in two groups by the RV FWS median (−16.5%). Patients < RV FWS median had significantly prolonged international normalized ratio (INR; p = 0.002), increased total bilirubin (p < 0.001) and alkaline phosphatase (ALP; p = 0.020), and decreased albumin (p = 0.005) and thrombocytes (p = 0.017) compared to patients > RV FWS median. RV FWS independently correlated to total bilirubin (β = 0.457, p = 0.004), ALP (β = 0.556, p = 0.002), INR (β = 0.392, p = 0.022), albumin (β = −0.437, p = 0.013), and thrombocytes (β = −404, p = 0.038). Similarly, TAPSE, RV FAC, and RV S′ significantly correlated with RV FWS. In conclusion, RV impairment, reflected in reduced RV FWS, is independently associated with a higher degree of hepatic dysfunction among patients with AWHF (CATSTAT-HF ClinicalTrials gov number, NCT03389386).
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Affiliation(s)
- Josip A. Borovac
- Department of Pathophysiology, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia;
- Institute of Emergency Medicine of Split-Dalmatia County, Spinciceva 1, 21000 Split, Croatia
- Clinic for Cardiovascular Diseases, University Hospital of Split, Spinciceva 1, 21000 Split, Croatia; (D.G.); (Z.S.G.); (D.D.)
| | - Duska Glavas
- Clinic for Cardiovascular Diseases, University Hospital of Split, Spinciceva 1, 21000 Split, Croatia; (D.G.); (Z.S.G.); (D.D.)
- Department of Internal Medicine, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia
| | - Zora Susilovic Grabovac
- Clinic for Cardiovascular Diseases, University Hospital of Split, Spinciceva 1, 21000 Split, Croatia; (D.G.); (Z.S.G.); (D.D.)
| | - Daniela Supe Domic
- Department of Medical Laboratory Diagnostics, University Hospital of Split, Spinciceva 1, 21000 Split, Croatia; (D.S.D.); (L.S.)
- Department of Health Studies, University of Split, Rudjera Boskovica 35 P.P. 464, 21000 Split, Croatia
| | - Lada Stanisic
- Department of Medical Laboratory Diagnostics, University Hospital of Split, Spinciceva 1, 21000 Split, Croatia; (D.S.D.); (L.S.)
- Department of Health Studies, University of Split, Rudjera Boskovica 35 P.P. 464, 21000 Split, Croatia
| | - Domenico D’Amario
- Department of Cardiovascular and Thoracic Sciences, IRCCS Fondazione Policlinico A. Gemelli, Università Cattolica Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy;
| | - Darko Duplancic
- Clinic for Cardiovascular Diseases, University Hospital of Split, Spinciceva 1, 21000 Split, Croatia; (D.G.); (Z.S.G.); (D.D.)
- Department of Internal Medicine, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia
| | - Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia;
- Correspondence: ; Tel.: +385-21-557-871
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25
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Neuman MG, Seitz HK, French SW, Malnick S, Tsukamoto H, Cohen LB, Hoffman P, Tabakoff B, Fasullo M, Nagy LE, Tuma PL, Schnabl B, Mueller S, Groebner JL, Barbara FA, Yue J, Nikko A, Alejandro M, Brittany T, Edward V, Harrall K, Saba L, Mihai O. Alcoholic-Hepatitis, Links to Brain and Microbiome: Mechanisms, Clinical and Experimental Research. Biomedicines 2020; 8:E63. [PMID: 32197424 PMCID: PMC7148515 DOI: 10.3390/biomedicines8030063] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/02/2020] [Accepted: 03/09/2020] [Indexed: 02/07/2023] Open
Abstract
The following review article presents clinical and experimental features of alcohol-induced liver disease (ALD). Basic aspects of alcohol metabolism leading to the development of liver hepatotoxicity are discussed. ALD includes fatty liver, acute alcoholic hepatitis with or without liver failure, alcoholic steatohepatitis (ASH) leading to fibrosis and cirrhosis, and hepatocellular cancer (HCC). ALD is fully attributable to alcohol consumption. However, only 10-20% of heavy drinkers (persons consuming more than 40 g of ethanol/day) develop clinical ALD. Moreover, there is a link between behaviour and environmental factors that determine the amount of alcohol misuse and their liver disease. The range of clinical presentation varies from reversible alcoholic hepatic steatosis to cirrhosis, hepatic failure, and hepatocellular carcinoma. We aimed to (1) describe the clinico-pathology of ALD, (2) examine the role of immune responses in the development of alcoholic hepatitis (ASH), (3) propose diagnostic markers of ASH, (4) analyze the experimental models of ALD, (5) study the role of alcohol in changing the microbiota, and (6) articulate how findings in the liver and/or intestine influence the brain (and/or vice versa) on ASH; (7) identify pathways in alcohol-induced organ damage and (8) to target new innovative experimental concepts modeling the experimental approaches. The present review includes evidence recognizing the key toxic role of alcohol in ALD severity. Cytochrome p450 CYP2E1 activation may change the severity of ASH. The microbiota is a key element in immune responses, being an inducer of proinflammatory T helper 17 cells and regulatory T cells in the intestine. Alcohol consumption changes the intestinal microbiota and influences liver steatosis and liver inflammation. Knowing how to exploit the microbiome to modulate the immune system might lead to a new form of personalized medicine in ALF and ASH.
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Affiliation(s)
- Manuela G. Neuman
- In Vitro Drug Safety and Biotechnology, Toronto, ON M5G 1L5, Canada;
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, Toronto, ON M5G 1L5, Canada
| | - Helmut Karl Seitz
- Department of Medicine, Centre of Alcohol Research, University of Heidelberg, Salem Medical Centre, 337374 Heidelberg, Germany; (H.K.S.); (S.M.)
| | - Samuel W. French
- Department of Pathology, Harbor-UCLA Medical Center and Los Angeles BioMedical Institute, Torrance, CA Harbor-UCLA Medical Center, Torrance, CA 90509, USA; (S.W.F.); (F.A.B.); (J.Y.); (A.N.); (M.A.); (T.B.); (V.E.)
| | - Stephen Malnick
- Department Internal Medicine C, Kaplan Medical Centre and Hebrew University of Jerusalem, Rehovot 76100, Israel;
| | - Heidekazu Tsukamoto
- Southern California Research Center for ALPD and Cirrhosis, Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90089-5311, USA;
- Department of Veterans; Affairs Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA
| | - Lawrence B. Cohen
- Division of Gastroenterology, Sunnybrook Health Sciences Centre, Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON M4N 3M5, Canada;
| | - Paula Hoffman
- Department of Pharmacology, University of Colorado School of Medicine, Aurora, CO 80045-0511, USA; (P.H.); (B.T.); (K.H.); (L.S.)
| | - Boris Tabakoff
- Department of Pharmacology, University of Colorado School of Medicine, Aurora, CO 80045-0511, USA; (P.H.); (B.T.); (K.H.); (L.S.)
| | - Michael Fasullo
- College of Nanoscale Science and Engineering, SUNY Polytechnic Institute, Albany, NY 12205, USA;
| | - Laura E. Nagy
- Departments of Pathobiology and Gastroenterology, Center for Liver Disease Research, Cleveland Clinic Foundation, Cleveland, OH 44195, USA;
| | - Pamela L. Tuma
- Department of Biology, The Catholic University of America, Washington, DC 20064, USA; (P.L.T.); (J.L.G.)
| | - Bernd Schnabl
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA;
| | - Sebastian Mueller
- Department of Medicine, Centre of Alcohol Research, University of Heidelberg, Salem Medical Centre, 337374 Heidelberg, Germany; (H.K.S.); (S.M.)
| | - Jennifer L. Groebner
- Department of Biology, The Catholic University of America, Washington, DC 20064, USA; (P.L.T.); (J.L.G.)
| | - French A. Barbara
- Department of Pathology, Harbor-UCLA Medical Center and Los Angeles BioMedical Institute, Torrance, CA Harbor-UCLA Medical Center, Torrance, CA 90509, USA; (S.W.F.); (F.A.B.); (J.Y.); (A.N.); (M.A.); (T.B.); (V.E.)
| | - Jia Yue
- Department of Pathology, Harbor-UCLA Medical Center and Los Angeles BioMedical Institute, Torrance, CA Harbor-UCLA Medical Center, Torrance, CA 90509, USA; (S.W.F.); (F.A.B.); (J.Y.); (A.N.); (M.A.); (T.B.); (V.E.)
| | - Afifiyan Nikko
- Department of Pathology, Harbor-UCLA Medical Center and Los Angeles BioMedical Institute, Torrance, CA Harbor-UCLA Medical Center, Torrance, CA 90509, USA; (S.W.F.); (F.A.B.); (J.Y.); (A.N.); (M.A.); (T.B.); (V.E.)
| | - Mendoza Alejandro
- Department of Pathology, Harbor-UCLA Medical Center and Los Angeles BioMedical Institute, Torrance, CA Harbor-UCLA Medical Center, Torrance, CA 90509, USA; (S.W.F.); (F.A.B.); (J.Y.); (A.N.); (M.A.); (T.B.); (V.E.)
| | - Tillman Brittany
- Department of Pathology, Harbor-UCLA Medical Center and Los Angeles BioMedical Institute, Torrance, CA Harbor-UCLA Medical Center, Torrance, CA 90509, USA; (S.W.F.); (F.A.B.); (J.Y.); (A.N.); (M.A.); (T.B.); (V.E.)
| | - Vitocruz Edward
- Department of Pathology, Harbor-UCLA Medical Center and Los Angeles BioMedical Institute, Torrance, CA Harbor-UCLA Medical Center, Torrance, CA 90509, USA; (S.W.F.); (F.A.B.); (J.Y.); (A.N.); (M.A.); (T.B.); (V.E.)
| | - Kylie Harrall
- Department of Pharmacology, University of Colorado School of Medicine, Aurora, CO 80045-0511, USA; (P.H.); (B.T.); (K.H.); (L.S.)
| | - Laura Saba
- Department of Pharmacology, University of Colorado School of Medicine, Aurora, CO 80045-0511, USA; (P.H.); (B.T.); (K.H.); (L.S.)
| | - Opris Mihai
- In Vitro Drug Safety and Biotechnology, Toronto, ON M5G 1L5, Canada;
- Department Family Medicine Clinic CAR, 010164 Bucharest, Romania
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Shohat N, Goswami K, Fillingham Y, Tan TL, Calkins T, Della Valle CJ, George J, Higuera C, Parvizi J. Diagnosing Periprosthetic Joint Infection in Inflammatory Arthritis: Assumption Is the Enemy of True Understanding. J Arthroplasty 2018; 33:3561-3566. [PMID: 30100134 DOI: 10.1016/j.arth.2018.07.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 06/30/2018] [Accepted: 07/16/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Despite concern over the interpretation of serum and synovial fluid tests to screen and diagnose periprosthetic joint infection (PJI) in patients with inflammatory arthritis, only a single study has investigated this area. We aimed to assess accuracy of clinical and laboratory markers for PJI diagnosis in the context of underlying inflammatory arthritis. METHODS This multicenter study was conducted on total joint arthroplasty patients at 3 different centers between 2001 and 2016. PJI was defined based on Musculoskeletal Infection Society criteria. Acute PJI cases were excluded. Patients operated for a diagnosis other than infection, who did not subsequently fail at 1-year follow-up, were considered aseptic revisions. Serum C-reactive protein and erythrocyte sedimentation rate, synovial white blood cell and differential, as well as alpha-defensin and results of frozen section were documented. RESULTS In total, 1220 patients undergoing revision total joint arthroplasty (567 PJI, 653 aseptic) were included. Fifty-five septic patients and 61 in the aseptic group had inflammatory arthritis. Although mean levels of serum C-reactive protein and synovial white blood cell in inflammatory arthritis patients were significantly higher compared to patients without inflammatory arthritis, there were no significant differences in PJI patients. The thresholds associated with increased risk for PJI in patients with and without inflammatory arthritis were similar and closely resembled traditional cut-points. CONCLUSION We demonstrate higher baseline immune upregulation in aseptic revision cases with inflammatory arthritis, but no significant differences are seen for PJI. Conventional PJI thresholds for serum and synovial diagnostic markers should be adhered to. Assumptions about inflammatory arthritis patients needing differential diagnostic protocols should be avoided.
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Affiliation(s)
- Noam Shohat
- The Rothman Institute at Thomas Jefferson University, Philadelphia, PA; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Karan Goswami
- The Rothman Institute at Thomas Jefferson University, Philadelphia, PA
| | - Yale Fillingham
- The Rothman Institute at Thomas Jefferson University, Philadelphia, PA
| | - Timothy L Tan
- The Rothman Institute at Thomas Jefferson University, Philadelphia, PA
| | | | | | | | | | - Javad Parvizi
- The Rothman Institute at Thomas Jefferson University, Philadelphia, PA
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Abstract
Background and aim The non-alcoholic fatty liver disease (NAFLD) and its sub-entity, the non-alcoholic steatohepatitis (NASH) represent a field of a tremendous progress in recent years. Clinicians need to remain updated with new data on pathogenesis and therapy. The present mini review aims to present some new scientific reports on the diagnosis of NAFLD and NASH for clinical practitioners. Methods A systematic literature search of the main international databases was performed. We looked for seminal and innovative papers published in main international languages. A narrative review of the topic was consequently written. Results This review describes new data on the diagnosis of NAFLD including NASH. Liver punction biopsy remains the gold standard. However many patients and clinicians prefer to use noninvasive methods. We present the serological tests and the imaging methods used to diagnose inflammation and fibrosis occurring in NAFLD and NASH. Conclusions NAFLD-NASH are multifaceted entities that have to be diagnosed and treated by skilled and informed practitioners.
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Affiliation(s)
- Dan L Dumitrascu
- Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Manuela G Neuman
- In Vitro Drug Safety and Biotechnology; Toronto, Ontario, Canada.,Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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28
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Dumnicka P, Maduzia D, Ceranowicz P, Olszanecki R, Drożdż R, Kuśnierz-Cabala B. The Interplay between Inflammation, Coagulation and Endothelial Injury in the Early Phase of Acute Pancreatitis: Clinical Implications. Int J Mol Sci 2017; 18:E354. [PMID: 28208708 PMCID: PMC5343889 DOI: 10.3390/ijms18020354] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 01/17/2017] [Accepted: 01/31/2017] [Indexed: 02/07/2023] Open
Abstract
Acute pancreatitis (AP) is an inflammatory disease with varied severity, ranging from mild local inflammation to severe systemic involvement resulting in substantial mortality. Early pathologic events in AP, both local and systemic, are associated with vascular derangements, including endothelial activation and injury, dysregulation of vasomotor tone, increased vascular permeability, increased leukocyte migration to tissues, and activation of coagulation. The purpose of the review was to summarize current evidence regarding the interplay between inflammation, coagulation and endothelial dysfunction in the early phase of AP. Practical aspects were emphasized: (1) we summarized available data on diagnostic usefulness of the markers of endothelial dysfunction and activated coagulation in early prediction of severe AP; (2) we reviewed in detail the results of experimental studies and clinical trials targeting coagulation-inflammation interactions in severe AP. Among laboratory tests, d-dimer and angiopoietin-2 measurements seem the most useful in early prediction of severe AP. Although most clinical trials evaluating anticoagulants in treatment of severe AP did not show benefits, they also did not show significantly increased bleeding risk. Promising results of human trials were published for low molecular weight heparin treatment. Several anticoagulants that proved beneficial in animal experiments are thus worth testing in patients.
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Affiliation(s)
- Paulina Dumnicka
- Department of Medical Diagnostics, Jagiellonian University Medical College, Medyczna 9, 30-688 Kraków, Poland.
| | - Dawid Maduzia
- Department of Anatomy, Jagiellonian University Medical College, Kopernika 12, 31-034 Kraków, Poland.
| | - Piotr Ceranowicz
- Department of Physiology, Jagiellonian University Medical College, Grzegórzecka 16, 31-531 Kraków, Poland.
| | - Rafał Olszanecki
- Department of Pharmacology, Jagiellonian University Medical College, Grzegórzecka 16, 31-531 Kraków, Poland.
| | - Ryszard Drożdż
- Department of Medical Diagnostics, Jagiellonian University Medical College, Medyczna 9, 30-688 Kraków, Poland.
| | - Beata Kuśnierz-Cabala
- Department of Diagnostics, Chair of Clinical Biochemistry, Jagiellonian University Medical College, Kopernika 15A, 31-501 Kraków, Poland.
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Parcina M, Brune M, Kaese V, Zorn M, Spiegel R, Vojvoda V, Fleming T, Rudofsky G, Paul Nawroth P. No short-term effects of calorie-controlled Mediterranean or fast food dietary interventions on established biomarkers of vascular or metabolic risk in healthy individuals. Nutr Res Pract 2014; 9:165-73. [PMID: 25861423 PMCID: PMC4388948 DOI: 10.4162/nrp.2015.9.2.165] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 09/15/2014] [Accepted: 09/15/2014] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND/OBJECTIVES This study addressed the question whether the composition of supposedly 'healthy' or 'unhealthy' dietary regimes has a calorie-independent short-term effect on biomarkers of metabolic stress and vascular risk in healthy individuals. SUBJECTS/METHODS Healthy male volunteers (age 29.5 ± 5.9 years, n = 39) were given a standardized baseline diet for two weeks before randomization into three groups of different dietary regimes: fast food, Mediterranean and German cooking style. Importantly, the amount of calories consumed per day was identical in all three groups. Blood samples were analyzed for biomarkers of cardiovascular risk and metabolic stress after two weeks of the baseline diet and after two weeks of the assigned dietary regime. RESULTS No dietary intervention affected the metabolic or cardiovascular risk profile when compared in-between groups or compared to baseline. Subjects applied to the Mediterranean diet showed a statistically significant increase of uric acid compared to baseline and compared to the German diet group. Plasma concentrations of urea were significantly higher in both the fast food group and the Mediterranean group, when compared to baseline and compared to the German diet group. No significant differences were detected for the levels of vitamins, trace elements or metabolic stress markers (8-hydroxy-2-deoxyguanosine, malondialdehyde and methylglyoxal, a potent glycating agent). Established parameters of vascular risk (e.g. LDL-cholesterol, lipoprotein(a), homocysteine) were not significantly changed in-between groups or compared to baseline during the intervention period. CONCLUSIONS The calorie-controlled dietary intervention caused neither protective nor harmful short-term effects regarding established biomarkers of vascular or metabolic risk. When avoiding the noxious effects of overfeeding, healthy individuals can possess the metabolic capacity to compensate for a potentially disadvantageous composition of a certain diet.
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Affiliation(s)
- Marijo Parcina
- Department of Internal Medicine I and Clinical Chemistry, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Maik Brune
- Department of Internal Medicine I and Clinical Chemistry, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany. ; Division of Molecular Metabolic Control, German Cancer Research Center (DKFZ) Heidelberg, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Vareska Kaese
- Department of Internal Medicine I and Clinical Chemistry, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Markus Zorn
- Department of Internal Medicine I and Clinical Chemistry, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Rainer Spiegel
- Department of Internal Medicine I and Clinical Chemistry, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Valerija Vojvoda
- Department of Cellular Immunology, Institute of Immunology, Rockefellerova 2, 10000 Zagreb, Croatia
| | - Thomas Fleming
- Department of Internal Medicine I and Clinical Chemistry, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Gottfried Rudofsky
- Department of Internal Medicine I and Clinical Chemistry, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Peter Paul Nawroth
- Department of Internal Medicine I and Clinical Chemistry, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
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Abstract
Laboratory markers have been investigated in inflammatory bowel disease (IBD) for diagnostic and differential diagnostic purposes, for assessment of disease activity and risk of complications, for prediction of relapse, and for monitoring the effect of therapy. The introduction of biological therapies in IBD has renewed interest in inflammatory markers (especially C reactive protein (CRP)), given their potential to select responders to these treatments. Of all the laboratory markers, CRP is the most studied and has been shown to have the best overall performance. CRP is an objective marker of inflammation and correlates well with disease activity in Crohn's disease (CD). Increased CRP levels are associated with better response rates and normal CRP levels predict high placebo response rates in clinical trials with biologicals. However, despite the advantages of CRP over other markers, it is still far from ideal. Furthermore, CRP correlates less well with disease activity in patients with ulcerative colitis (UC) as compared with CD. Other laboratory markers, including erythrocyte sedimentation rate (ESR), leucocyte and platelet count, albumin, and 1 acid glycoprotein (orosomucoid), have been studied either less extensively in IBD or have proven to be less useful than CRP. Faecal markers seem promising and may be more specific in detecting gut inflammation in patients with established IBD. Promising results have been reported with the use of faecal calprotectin in CD as well as in UC. Recent data however suggest that the performance of the faecal calprotectin test is superior for UC than for CD. Taken together, laboratory markers are useful and should be part of the global management of our IBD patients. They are however not magic and until more data become available, the use of CRP and other laboratory markers should be seen as an additive tool to clinical observation and physical examination rather than a replacement.
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Affiliation(s)
- S Vermeire
- Department of Internal Medicine, Division of Gastroenterology, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium.
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