Serum amylase and lipase levels for prediction of postendoscopic retrograde cholangiopancreatography pancreatitis.

BACKGROUND: The aim of the present study was to assess 2- and 4-h postendoscopic retrograde cholangiopancreatography (ERCP) serum amylase and lipase levels for prediction of post-ERCP, pancreatitis (PEP), and their predictive cutoff values. MATERIALS AND METHODS: In this cross-sectional study, we evaluated serum amylase and lipase levels before the procedure, 2 h and 4 h after the procedure, and in patients with persisting abdominal pain, 24 h afterward. A total of 300 adult patients who underwent ERCP procedures from March 2014 to June 2015 in referral hospital in Isfahan were studied. The receiver operating characteristic analysis was applied to determine the predictive score of amylase and lipase levels for PEP 2 and 4 h after ERCP. RESULTS: The 2-h serum amylase cutoff values of 241 IU/L (normal range: 28-100 IU/L) had a very high negative predictive value (NPV) (98.7%) but a poor positive predictive value (49.2%) for prediction of PEP (area under curve [AUC]: 0.947; 95% confidence interval [CI]: 0.914-0.979). Based on our results, the patients might be considered for supportive therapy of PEP with the 4-h serum amylase above the cut point of 839.5 IU/L with a specificity of 95.1% (AUC: 0.978; 95% CI: 0.964-0.992). In addition, the 2- and 4-h serum lipase levels at cut points of 216 IU/L (AUC: 0.954; 95% CI: 0.931-0.977) and 656.5 IU/L (AUC: 0.966; 95% CI: 0.945-0.986) (normal value <60 IU/L), respectively, had the best sensitivity (97.1%) and high NPVs (99.6%) for exclusion of PEP. CONCLUSION: Measurements of serum amylase and lipase 2- and 4-h post-ERCP might be useful in prediction of PEP.

Correlation of N-terminal pro-B-type natriuretic peptide levels and cardiac magnetic resonance imaging T2* in patients with ß-thalassaemia major.

BACKGROUND: Cardiac death secondary to myocardial iron toxicity occurs in 50% of patients with transfusion-dependent ß-thalassaemia major. N-terminal pro-B-type natriuretic peptide (NT-proBNP) seems to be a useful tool for early detection of cardiac haemosiderosis. We designed this study to determine whether plasma NT-proBNP levels are predictive of cardiac iron concentration, based on heart T2* assessment by magnetic resonance imaging (MRI). MATERIALS AND METHODS: We evaluated plasma NT-proBNP levels in 50 patients with ß-thalassaemia major, aged 18 to 46 years, with preserved left ventricular systolic function, all of whom had undergone cardiac MRI within 3 months before the study. Next, three groups were defined based on heart T2* value as: group A, patients without evidence of cardiac iron overload (T2*>20 ms); group B, patients with mild to moderate cardiac iron overload (10 ms