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1.
Clinics ; 76: e2690, 2021. tab, graf
Article in English | LILACS | ID: biblio-1278911

ABSTRACT

This study aimed to explore the relationship between plasma interleukin 6 (IL-6) levels, adverse cardiovascular events, and the severity of acute coronary syndrome (ACS). A literature review was performed of studies regarding IL-6 and ACS extracted from databases including EMBASE, Cqvip, MEDLINE, Web of Knowledge, PubMed, Cochrane Library, China National Knowledge Infrastructure, and Wanfang data. The Newcastle-Ottawa scale (NOS) was used to evaluate the quality of the literature. The literature was screened, its quality was evaluated, and relevant data were extracted for performing meta-analysis using RevMan software (version 5.3). A total of 524 studies were included in the initial survey. After several rounds of screening and analysis, six studies met the inclusion criteria and underwent meta-analysis using a fixed-effect model. Patients were divided into non-severe and severe groups based on the concentration of high-sensitivity C-reactive protein. Meta-analysis of the relationship between IL-6 and the severity of ACS showed that the plasma IL-6 level of patients in the severe group was significantly higher than that of patients in the non-severe group (p<0.00001). Additionally, patients with experience of major adverse cardiovascular events had significantly higher plasma IL-6 levels than did patients without experience of such events (p<0.00001). In summary, patients with ACS and high IL-6 levels tended to be in a critical condition, with a higher risk of adverse cardiovascular events and worse prognosis. Thus, IL-6 levels could indicate whether patients with ACS may have adverse cardiovascular events and determine the severity of ACS.


Subject(s)
Humans , Interleukin-6 , Acute Coronary Syndrome , Prognosis , C-Reactive Protein , China
2.
Actual. osteol ; 17(1): 8-17, 2021. graf, tab
Article in English | LILACS, BINACIS, UNISALUD | ID: biblio-1291888

ABSTRACT

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


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


Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Vitamin D/analogs & derivatives , Vitamin D/blood , Vitamin D Deficiency/etiology , Biomarkers , Rheumatic Diseases/complications , Inflammation/blood , Phosphates/blood , Blood Sedimentation , C-Reactive Protein , Body Mass Index , Bone Density , Logistic Models , Calcium/urine , Calcium/blood , Rheumatic Diseases/blood , Risk , Cross-Sectional Studies , Postmenopause , Amino Acids/urine
3.
Rev. chil. endocrinol. diabetes ; 14(2): 59-64, 2021. tab, ilus
Article in Spanish | LILACS | ID: biblio-1283550

ABSTRACT

INTRODUCCIÓN: El hipotiroidismo subclínico (HSC) se define bioquímicamente por una elevación en la concentración sérica de la hormona estimulante de la tiroides (TSH), con niveles normales de tiroxina libre (T4L). La asociación entre el HSC y el daño cardiovascular ha sido un tema controversial. OBJETIVO: determinar la asociación entre el HSC y el desarrollo de la enfermedad cardiovascular mediante la cuantificación de la proteína C reactiva ultrasensible PCR-us y la determinación de lípidos circulantes asociados a la enfermedad cardiovascular y la ateroesclerosis. MÉTODOS: Estudio descriptivo, correlacional de corte transversal realizado en el Hospital IESS de Riobamba, Ecuador en el periodo comprendido desde enero a diciembre de 2019. Se estudiaron 70 individuos (40 pacientes con HSC y 30 controles) con edades entre 18 y 75 años. Se realizaron las historias clínicas y el examen físico a cada paciente y la toma de las muestras sanguíneas para determinar la concentración sérica de los siguientes parámetros bioquímicos y hormonales: colesterol total, triglicéridos, HDL colesterol y LDL colesterol, TSH, T4L y PCR-us. RESULTADOS: Se encontró un incremento significativo en la concentración de colesterol total (p<0.0001), LDL colesterol (p<0.01) y PCR-us (p<0.0001) en los pacientes con HSC vs los controles. Se observó una correlación positiva (p<0.0001; r=0.9148) entre la TSH y la PCR-us en los pacientes con HSC. CONCLUSIÓN: los pacientes con HSC experimentan una elevación en los niveles séricos de PCR-us la cual está correlacionada con un incremento en la concentración sérica de TSH. Estos parámetros asociados a un aumento del colesterol total y de la LDL colesterol sugieren un estado inflamatorio de bajo grado que podría estar asociado con el desarrollo de aterosclerosis y daño cardiovascular.


INTRODUCTION: Subclinical hypothyroidism (SH) is defined biochemically by an elevation in serum thyroid stimulating hormone (TSH) concentration, with normal levels of free thyroxine (T4L). The association between SH and cardiovascular damage has been a controversial issue. OBJECTIVE: to determine the association between SH and the development of cardiovascular disease through the quantification of the high sensitivity C-reactive protein (hs-PCR) and the determination of circulating lipids associated to cardiovascular disease and atherosclerosis. METHODS: Observational, correlational cross-sectional study with patients captured in the internal medicine office as well as those attending screening activities at the IESS Hospital in Riobamba- Ecuador, in the period from January to December 2019. Seventy individuals (40 patients with SH and 30 controls) between the ages of 18 and 75 years were studied. Each patient's medical history and physical examination were performed, and blood samples were taken to determine the serum concentration of the following biochemical and hormonal parameters: total cholesterol, triglycerides, HDL cholesterol and LDL cholesterol, TSH, T4L and hs-PCR. RESULTS: A significant increase in the concentration of total cholesterol (p<0.0001), LDL cholesterol (p<0.01) and hs-PCR (p<0.0001) was found in patients with SH vs. controls. A positive correlation (p<0.0001; r=0.9148) was observed between TSH and hs-PCR in patients with SH. CONCLUSION: patients with SH experience an elevation in serum hs-PCR levels which is correlated with an increase in serum TSH concentration. These parameters associated with an increase in total cholesterol and LDL cholesterol suggest a low-grade inflammatory state that may be associated with the development of atherosclerosis and cardiovascular damage.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , C-Reactive Protein/analysis , Cardiovascular Diseases/etiology , Hypothyroidism/blood , Thyrotropin/blood , Body Mass Index , Cross-Sectional Studies , Ecuador , Atherosclerosis , Hypothyroidism/complications , Cholesterol, HDL/blood , Cholesterol, LDL/blood
4.
Braz. j. med. biol. res ; 54(11): e11295, 2021. tab, graf
Article in English | LILACS | ID: biblio-1339451

ABSTRACT

This study aimed to investigate the diagnostic value of heparin-binding protein (HBP) in the cerebrospinal fluid of children with purulent meningitis (PM). This study included 118 children with PM diagnosed at our hospital from January 2018 to January 2020, 110 children with viral meningitis (VM) and 80 children with suspected meningitis who were ruled out by cerebrospinal fluid (CSF) analysis during the same period. HBP and white blood cell (WBC) count in the CSF, and inflammatory factors, including C-reactive protein (CRP), tumor necrosis factor (TNF)-α, and procalcitonin (PCT), were measured. Receiver-operator characteristic curves were used to analyze the predictive value of HBP, CRP, PCT, and TNF-α levels in the diagnosis of PM by CSF analysis. HBP levels in the CSF of children with PM were higher, while the CRP and serum PCT and TNF-α levels were elevated in all groups (P<0.05). In addition, HBP levels in the CSF were more accurate for the diagnosis of PM than traditional diagnostic indexes. HBP levels in the CSF can be used as an important reference for early diagnosis of PM.


Subject(s)
Humans , Child , Meningitis, Bacterial/diagnosis , Meningitis, Viral , C-Reactive Protein , Blood Proteins , Antimicrobial Cationic Peptides , Procalcitonin
5.
Article in Chinese | WPRIM | ID: wpr-880067

ABSTRACT

OBJECTIVE@#To investigate the clinical value of expression level of interleukin-2 receptor (IL-2R) and interleukin-8 (IL-8) in the fever patients with hematological malignancies.@*METHODS@#A total of 121 inpatients in the First Affiliated Hospital of Anhui Medical University from April 2018 to October 2019 were enrolled in this study. The patients were separated into infection group (61 cases) and non-infection group (60 cases). In the meantime, 40 healthy people without fever or infection in the hospital for physical examination were set as matched group. C-reactive protein (CRP), procalcitonin (PCT), and cytokines were detected in all the patients with fever after admission and infection control. While, blood samples were taken from healthy people during physical examination.@*RESULTS@#The expression levels of IL-2R in infection group were higher than those in the control group (P<0.001), and the level of serum IL-2R in infection group was also higher than that in the non-infection group (P<0.05). Based on Spearman analysis, in patients with malignant hematologic disease, serum IL-2R level was positively correlated with CRP (r=0.557, P<0.001) and IL-8 (r=0.479, P<0.001), and IL-8 level was positively correlated with CRP (r=0.318, P<0.001). Compared with the non-infection group, the area under the curve (AUC) for the level of CRP, PCT, and IL-2R of the infection group was 0.714 (95%CI: 0.623-0.806), 0.765 (95%CI: 0.680-0.851), and 0.761 (95%CI: 0.686-0.836), the sensitivity was 0.705, 0.852, and 0.705, and the specificity was 0.717, 0.70, and 0.60, respectively. While, AUC of CRP+PCT, CRP+IL-2R, PCT+IL-2R, and CRP+PCT+IL-2R was 0.789 (95%CI: 0.712-0.866), 0.702 (95%CI: 0.623-0.782), 0.757 (95%CI: 0.677-0.838), and 0.789 (95%CI: 0.712-0.866), the sensitivity was 0.738, 0.934, 0.705, and 0.738, and the specificity was 0.840, 0.470, 0.810, and 0.840, respectively.@*CONCLUSION@#CRP, PCT, IL-2R, and IL-8 are useful parameters for diagnosis of the infectious fever in patients with hematological malignancies, which provides the basis of initial diagnosis and rational use of antibioties for clinician.


Subject(s)
Biomarkers , C-Reactive Protein , Calcitonin , Calcitonin Gene-Related Peptide , Hematologic Neoplasms , Humans , Interleukin-8 , Protein Precursors , Receptors, Interleukin-2 , Sepsis
6.
Rev. colomb. cardiol ; 27(6): 630-636, nov.-dic. 2020. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1289283

ABSTRACT

Resumen Objetivo: Encontrar una relación entre los niveles de proteína C reactiva (PCR) y fibrinógeno, y la extensión de la aterosclerosis en el síndrome coronario agudo. Métodos: Estudio observacional prospectivo, en el que se incluyeron 873 pacientes con síndrome coronario atendidos en un hospital entre 2016 y 2018. Se analizaron niveles de PCR y fibrinógeno, marcadores metabólicos y extensión de la aterosclerosis coronaria. Resultados: No se halló correlación positiva entre los niveles de PCR y fibrinógeno y los marcadores metabólicos, así como tampoco con enfermedad de uno, dos y tres vasos (p 0,829; p 0,810). Conclusiones: Los niveles sanguíneos de PCR y fibrinógeno se relacionan con la tasa de eventos cardiovasculares, pero no se ha podido demostrar que exista relación entre estos y la severidad de la aterosclerosis coronaria.


Abstract Objective: To determine whether there is a relationship between C - reactive protein and fibrinogen levels and the extent of atherosclerosis in acute coronary syndrome. Methods: A prospective observational study was conducted that include 873 patients with coronary syndrome treated in a hospital between the years 2016 and 2018. An analysis was made that included C - reactive protein and fibrinogen levels, metabolic markers, extent of coronary atherosclerosis. Results: No positive correlation was found between the C - reactive protein and fibrinogen levels and the metabolic markers, nor with one, two, or three vessel disease (P=.829; P=.810). Conclusions: Although blood C-Reactive Protein and fibrinogen levels are associated with the rate of cardiovascular events, this study was unable to demonstrate whether there is a relationship between these and the severity of the coronary atherosclerosis.


Subject(s)
Humans , Male , Female , Middle Aged , C-Reactive Protein , Fibrinogen , Coronary Vessels , Atherosclerosis
7.
Int. j. odontostomatol. (Print) ; 14(4): 685-693, dic. 2020. tab, graf
Article in English | LILACS | ID: biblio-1134558

ABSTRACT

ABSTRACT: The purpose of this study was to evaluate the changes in vital signs and laboratory tests of patients with odontogenic infections who required hospitalization as well as checking their effectiveness in determining the severity of the case and possible correlations with the length of stay. Patients with odontogenic infections who required hospitalization were assessed prospectively between October 2016 and April 2018. The patients were divided into two groups considered as simple (Group 1) or complex (Group 2) cases according to the length of stay. The personal data, comorbidities, signs and symptoms, vital signs and laboratory tests were analyzed. In this study, 84 cases of maxillofacial infections were detected and 50 cases of odontogenic infections were included. There were significant increases in heart rate (p = 0.012), leukocytosis (p = 0.037), neutrophilia (p = 0.021), neutrophil/lymphocyte (N/L) ratio (p = 0.044) and C-reactive protein (CRP) levels (p = 0.004) in Group 2. Additionally, there were positive correlations between the length of stay and the following variables: heart rate (p = 0.028), leukocytosis (p = 0.045), neutrophilia (p = 0.033), N/L ratio (p = 0.041) and CRP level (p = 0.003). The N/L ratio was found to have a greater value in regression analysis. It was concluded that there were significant increases in heart rate, leukocytosis, neutrophilia, N/L ratio and CRP levels for the complex cases. There were also positive correlations between the length of stay and the following variables: heart rate, leukocytosis, neutrophilia, N/L ratio and CRP level.


RESUMEN: El propósito de este estudio fue evaluar los cambios en los signos vitales y las pruebas de laboratorio de pacientes con infecciones odontogénicas que requirieron hospitalización, así como verificar su efectividad para determinar la gravedad del caso y las posibles correlaciones con la duración de la internación. Pacientes con infecciones odontogénicas que requirieron hospitalización fueron evaluados prospectivamente entre octubre de 2016 y abril de 2018. Los pacientes se dividieron en dos grupos considerados como casos simples (Grupo 1) o complejos (Grupo 2) según la duración de la internación. Se analizaron los datos personales, comorbilidades, signos y síntomas, signos vitales y pruebas de laboratorio. En este estudio, se detectaron 84 casos de infecciones maxilofaciales y se incluyeron 50 casos de infecciones odontogénicas. Hubo aumentos significativos en la frecuencia cardíaca (p = 0,012), leucocitosis (p = 0,037), neutrofilia (p = 0,021), relación neutrófilos / linfocitos (N/L) (p = 0,044) y niveles de proteína C reactiva (PCR) (p = 0,004) en el Grupo 2. Además, hubo correlaciones positivas entre la duración de la internación y las siguientes variables: frecuencia cardíaca (p = 0,028), leucocitosis (p = 0,045), neutrofilia (p = 0,033), relación N/L (p = 0,041) y nivel de PCR (p = 0,003). Se encontró que la relación N/L tenía un mayor valor en el análisis de regresión. En conclusión, hubo aumentos significativos en la frecuencia cardíaca, leucocitosis, neutrofilia, relación N/L y niveles de PCR para los casos complejos. También hubo correlaciones positivas entre la duración de la internación y las siguientes variables: frecuencia cardíaca, leucocitosis, neutrofilia, relación N/L y nivel de PCR.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Vital Signs , Focal Infection, Dental/therapy , Severity of Illness Index , C-Reactive Protein , Drainage , Prospective Studies , Risk Factors , Statistics, Nonparametric , Age and Sex Distribution , Hospitalization , Length of Stay
8.
Rev. cuba. cir ; 59(3): e893, jul.-set. 2020. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1144430

ABSTRACT

RESUMEN Introducción: La apendicitis aguda es la urgencia quirúrgica más frecuente en cualquier hospital del mundo. Aunque la mayoría de las veces se trata de un proceso intrabdominal banal, en ocasiones presenta una no desdeñable morbilidad y todavía en la época actual. Esta morbimortalidad se asocia, en la mayoría de los casos, a estados avanzados de afección apendicular. Objetivo: Predecir, con la cifra de bilirrubina, la proteína C reactiva y el recuento leucocitario, el estado del proceso apendicular agudo que presentaban los pacientes. Métodos: Se realizó un estudio observacional descriptivo en el que se han incluido aquellos pacientes intervenidos por sospecha de apendicitis aguda durante un periodo de 3 años (2017-2019) que cumplían los criterios de inclusión. Se analizó, como datos de laboratorio, la cifra de leucocitos, proteína C reactiva y bilirrubina. Resultados: Se observó un aumento de las cifras de proteína C reactiva y bilirrubina en los casos apendiculares avanzados, al igual que otros autores han evidenciado en la literatura. Así mismo, estos dos valores han resultado ser un factor de riesgo para presentar formas graves. El nivel de leucocitos sin embargo no ha demostrado relacionarse con la gravedad del proceso. Conclusiones: Vemos relevante el uso de los biomarcadores estudiados para predecir la gravedad apendicular con el objetivo de mejorar la asistencia en estos enfermos y disminuir las complicaciones derivadas del retraso terapéutico(AU)


ABSTRACT Introduction: Acute appendicitis is the most frequent surgical emergency in any hospital worldwide. Although most of the time it is a trivial intraabdominal process, sometimes it presents an unneglectable morbidity. This morbidity and the subsequent mortality are associated, in most cases, with advanced stages of an appendicular disease. Objective: To predict, using the value corresponding to bilirubin, C-reactive protein and leukocyte count, the state of acute appendicular process presented by patients. Methods: A descriptive observational study was carried out, including patients operated on for suspected acute appendicitis during a period of three years (2017-2019) and who met the inclusion criteria. The values for leukocyte count, C-reactive protein, and bilirubin were analyzed as laboratory data. Results: An increase in the values of C-reactive protein and bilirubin levels was observed in advanced appendicular cases, as other authors have shown in the medical literature. Likewise, these two values ​​have turned out to be a risk factor for presenting severe forms. However, the level of leukocytes has not been shown to be related to the severity of the process. Conclusions: We consider the use of the biomarkers studied as relevant to predict appendicular severity in view of improving care of these patients and reducing complications derived from therapeutic delay(AU)


Subject(s)
Humans , Appendicitis/surgery , Bilirubin/adverse effects , C-Reactive Protein/adverse effects , Risk Factors , Leukocyte Count/methods , Epidemiology, Descriptive , Observational Studies as Topic
9.
Int. j. morphol ; 38(4): 1155-1159, Aug. 2020. tab
Article in Spanish | LILACS | ID: biblio-1124909

ABSTRACT

La colecistitis aguda (CA) es la principal complicación de la litiasis vesicular. Existe evidencia que respalda el hecho que la proteína C reactiva (PCR) se elevaría en distintos niveles según gravedad de la CA. El objetivo de este estudio fue determinar asociación entre valores de PCR y estadios clínicos de gravedad de CA. Serie de casos consecutivos de adultos con CA diagnosticada por clínica, ultrasonografía y criterios de Tokio; tratados en un centro de salud terciario de La Paz, Bolivia (diciembre 2019 y enero 2020). La variable resultado fue niveles de PCR. Otras de interés fueron variables biodemográficas. Se aplicó estadística descriptiva (cálculo de porcentajes, de medidas de tendencia central y de dispersión); y posteriormente, se aplicaron estadísticas analíticas para estudiar asociación entre variables (test exacto de Fisher para variables categóricas y t de student para variables continuas). Se estudiaron 44 pacientes (33 con CA leve y 10 con CA moderada), con edad promedio de 51,7±15,3 años; 59,1 % de sexo femenino. El peso, estatura e IMC promedio fueron 69,6±10,3 kg; 1,6±0,1 m; y 27,0±3,1 kg/m2 respectivamente. Las cifras promedio de PCR fueron 9,0±11,6 y 29,5±20,2 en los subgrupos CA leve y moderada respectivamente (p=0,001). Los valores de PCR se asociaron a dos estadios de gravedad clínica de CA.


Serum levels of C-reactive protein as a marker of gravity of acute cholecystitis. Prospective series of cases. Acute cholecystitis (AC) is the main complication of cholelithiasis. There is evidence supporting the fact that C-reactive protein (CRP) would rise at different levels depending on severity of AC. The objective of this study was to determine the association between CRP values and clinical stages of CA severity. Series of consecutive cases of adults with AC diagnosed by clinical, ultrasound and Tokyo criteria; treated at a tertiary health center in La Paz, Bolivia between December 2019 and January 2020. The result variable was CRP determination. Others of interest were biodemographic variables. Descriptive statistics (calculation of percentages, measures of central tendency and dispersion) were applied; later, analytical statistics were applied to study the association between variables (Fisher's exact test for categorical variables and Student's t test for continuous variables). Also, 44 patients were treated (33 with mild AC and 10 with moderate AC), with an average age of 51.7±15.3 years; 59.1 % female. Average weight, height and BMI were 69.6±10.3 kg; 1.59±0.1 m; and 27±3.1 kg/m2 respectively. The mean CRP values were 9.0±11.6 and 29.5±20.2 in the mild and moderate AC subgroups respectively (p=0.001). CRP values were associated with two stages of clinical severity of Acute Cholecystitis.


Subject(s)
Humans , Male , Female , Middle Aged , C-Reactive Protein/analysis , Cholecystitis, Acute/diagnosis , Prognosis , Severity of Illness Index , Biomarkers/blood , Prospective Studies , Cholecystitis, Acute/blood
10.
Rev. Assoc. Med. Bras. (1992) ; 66(8): 1070-1076, Aug. 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1136347

ABSTRACT

SUMMARY OBJECTIVE This study aimed to investigate the predictive value of the newly defined C-Reactive Protein (CRP)/Albumin Ratio (CAR) in determining the development of atrial fibrillation (AF) in comparison with other inflammatory markers, such as Neutrophil/Lymphocyte (N/L) Ratio and Platelet/Lymphocyte (P/L) Ratio, in patients undergoing Coronary Artery Bypass Grafting (CABG) surgery. METHODS The population of this observational study consisted of 415 patients undergoing CABG. The study cohort was subdivided into two groups based on the development of AF. Complete blood counts, serum CRP, and serum albumin levels were evaluated before the CABG. The CAR, N/L, and P/L ratios of all the patients were calculated. Predictors of postoperative AF were determined by multiple logistic regression analysis (MLRA). RESULTS During follow-up, 136 patients (32.8%) developed postoperative AF. With MLRA, independent risk factors for postoperative AF were determined as follows: fasting glucose level (OR: 1.01; 95 % CI: 1.00-1.01, P <0.001), age (OR: 1.12; 95 % CI: 1.07-1.17, P <0.001), left ventricle ejection fraction (OR: 0.90; 95 % CI: 0.87-0.94, P <0.001), male gender (OR: 3.32; 95 % CI: 1.39-7.90, P = 0.007), 24-hour drainage amount (OR: 1.004; 95 % CI: 1.002-1.005, P <0.001), and CAR (OR: 1.82; 95 % CI: 1.53-2.16, P <0.001). Receiver Operating Characteristic curve analysis showed that CAR (C-statistic: 0.75; 95% CI: 0.71-0.79, p< 0.001) was a significant predictor of AF. CONCLUSION Novel inflammatory marker CAR can be used as a reliable marker to predict the development of AF following CABG.


RESUMO OBJETIVO Este estudo teve como objetivo investigar o valor preditivo da recém-definida relação entre Proteína C-Reativa (PCR) e Albumina (CAR) na determinação do desenvolvimento de Fibrilação Atrial (FA) em comparação com outros marcadores inflamatórios, como proporção de Neutrófilos para Linfócitos (N/L) e relação Plaquetas/Linfócitos (P/L) em pacientes submetidos à Cirurgia de Revascularização do Miocárdio (CRM). MÉTODOS A população deste estudo observacional foi composta por 415 pacientes submetidos à cirurgia de revascularização do miocárdio. A coorte do estudo foi subdividida em dois grupos de acordo com o desenvolvimento da FA. Contagens sanguíneas completas, PCR sérica e albumina sérica foram obtidas antes da CRM. Os valores de CAR, relação N/L e relação P/L foram calculados. Os preditores de FA pós-operatória foram determinados por análise de regressão logística múltipla. RESULTADOS Durante o acompanhamento, 136 pacientes (32,8%) desenvolveram FA pós-operatória. Com análise de regressão logística múltipla, foram determinados os fatores de risco para FA pós-operatória: glicemia de jejum (OR: 1,01; IC 95%: 1,00-1,01, p<0,001), idade (OR: 1,12; IC 95%: 1,07-1,17, p<0,001), fração de ejeção do ventrículo esquerdo (OR: 0,90; IC 95%: 0,87-0,94, p<0,001), sexo masculino (OR: 3,32; IC 95%: 1,39-7,90, p=0,007), quantidade de drenagem de 24 horas (OR: 1,004; IC 95%: 1,002-1,005, p<0,001), CAR (OR: 1,82; IC 95%: 1,53-2,16, p<0,001). A análise da curva de características operacionais do receptor mostrou que o CAR (estatística C: 0,75; IC 95%: 0,71-0,79, p<0,001) foi um preditor significativo de FA. CONCLUSÃO O novo marcador inflamatório CAR é confiável para prever o desenvolvimento de FA após a operação de revascularização miocárdica.


Subject(s)
Humans , Male , Atrial Fibrillation , Postoperative Complications , C-Reactive Protein , Coronary Artery Bypass , Risk Factors , ROC Curve
11.
Rev. Assoc. Med. Bras. (1992) ; 66(8): 1043-1048, Aug. 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1136336

ABSTRACT

SUMMARY OBJECTIVE Monocyte count to HDL-C Ratio (MHR) and Fibrinogen to Albumin Ratio (FAR) have recently emerged as markers of inflammation in atherosclerotic diseases. Our goal was to investigate the relationships of MHR and FAR with the severity of carotid artery stenosis (CAS) in patients with asymptomatic carotid artery disease. METHODS This retrospective study consisted of 300 patients with asymptomatic CAS. Pre-angiographic MHR, FAR, and high-sensitive C-reactive protein (hsCRP) were measured. Carotid angiography was performed in patients with ≥50% stenosis on carotid ultrasonography. Patients were first split into 2 groups based on the degree of CAS and then tertiles (T) of MHR. RESULTS 96 patients had clinically insignificant CAS (<50%) (Group-1), and 204 patients had clinically significant CAS (≥50%) (Group-2). Group-2 had higher MHR, FAR, and hsCRP than group-1. Patients in T3 had higher MHR, FAR, and hsCRP than in T1 and T2. MHR, FAR, and hsCRP were correlated with each other (p<0.001, for all). MHR, FAR, and hsCRP were independent predictors of significant CAS. MHR better predicted a significant CAS than FAR and hsCRP (p<0.05). CONCLUSION Pre-angiographic MHR may be a better predictor than FAR and hsCRP in identifying a clinically significant carotid stenosis in patients with asymptomatic CAS. Patients with asymptomatic CAS and a high level of MHR should be followed-up closely to supervise risk-factor control and intensify treatment.


RESUMO OBJETIVO Recentemente, a contagem de monócitos para a proporção HDL-C (MHR) e a relação fibrinogênio para albumina (FAR) emergiram como marcadores de inflamação em doenças ateroscleróticas. Nosso objetivo é investigar a relação da MHR e FAR com a gravidade da estenose da artéria carótida (CAS) em pacientes com doença assintomática da artéria carótida. MÉTODOS Este estudo retrospectivo incluiu 300 pacientes com CAS assintomática. MHR pré-angiográfica, FAR e proteína C reativa de alta sensibilidade (hsCRP) foram medidas. A angiografia carotídea foi realizada em pacientes com estenose ≥50% na ultrassonografia carotídea. Os pacientes foram primeiramente divididos em dois grupos com base no grau de CAS e depois nos tercis (T) da MHR. RESULTADOS Noventa e seis pacientes apresentaram um CAS clinicamente insignificante (<50%) (grupo 1) e 204 pacientes apresentaram CAS clinicamente significativo (≥50%) (grupo 2). O grupo 2 apresentou MHR, FAR e hsCRP superior ao grupo 1. Pacientes em T3 apresentaram maior MHR, FAR e hsCRP do que em T1 e T2. MHR, FAR e hsCRP foram correlacionados entre si (p<0,001, para todos). MHR, FAR e hsCRP foram preditores independentes de CAS significativa. MHR predisse melhor uma CAS significativa que FAR e hsCRP (p<0,05). CONCLUSÕES A MHR pré-angiográfica pode ser um melhor preditor que a FAR e a hsCRP na identificação de estenose carotídea clinicamente significativa em pacientes com CAS assintomática. Pacientes com CAS assintomática e alto nível de MHR devem ser acompanhados de perto para supervisionar o controle dos fatores de risco e intensificar o tratamento.


Subject(s)
Humans , Carotid Artery Diseases , C-Reactive Protein , Monocytes , Retrospective Studies
12.
Rev. Assoc. Med. Bras. (1992) ; 66(8): 1049-1056, Aug. 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1136335

ABSTRACT

SUMMARY OBJECTIVE This study aimed to investigate the predictive value of the newly defined C-Reactive Protein (CRP)/Albumin Ratio (CAR) in determining the development of atrial fibrillation (AF) in comparison with other inflammatory markers, such as Neutrophil/Lymphocyte (N/L) Ratio and Platelet/Lymphocyte (P/L) Ratio, in patients undergoing Coronary Artery Bypass Grafting (CABG) surgery. METHODS The population of this observational study consisted of 415 patients undergoing CABG. The study cohort was subdivided into two groups based on the development of AF. Complete blood counts, serum CRP, and serum albumin levels were evaluated before the CABG. The CAR, N/L, and P/L ratios of all the patients were calculated. Predictors of postoperative AF were determined by multiple logistic regression analysis (MLRA). RESULTS During follow-up, 136 patients (32.8%) developed postoperative AF. With MLRA, independent risk factors for postoperative AF were determined as follows: fasting glucose level (OR: 1.01; 95 % CI: 1.00-1.01, P <0.001), age (OR: 1.12; 95 % CI: 1.07-1.17, P <0.001), left ventricle ejection fraction (OR: 0.90; 95 % CI: 0.87-0.94, P <0.001), male gender (OR: 3.32; 95 % CI: 1.39-7.90, P = 0.007), 24-hour drainage amount (OR: 1.004; 95 % CI: 1.002-1.005, P <0.001), and CAR (OR: 1.82; 95 % CI: 1.53-2.16, P <0.001). Receiver Operating Characteristic curve analysis showed that CAR (C-statistic: 0.75; 95% CI: 0.71-0.79, p< 0.001) was a significant predictor of AF. CONCLUSION Novel inflammatory marker CAR can be used as a reliable marker to predict the development of AF following CABG.


RESUMO OBJETIVO Este estudo teve como objetivo investigar o valor preditivo da recém-definida relação entre Proteína C-Reativa (PCR) e Albumina (CAR) na determinação do desenvolvimento de Fibrilação Atrial (FA) em comparação com outros marcadores inflamatórios, como proporção de Neutrófilos para Linfócitos (N/L) e relação Plaquetas/Linfócitos (P/L) em pacientes submetidos à Cirurgia de Revascularização do Miocárdio (CRM). MÉTODOS A população deste estudo observacional foi composta por 415 pacientes submetidos à cirurgia de revascularização do miocárdio. A coorte do estudo foi subdividida em dois grupos de acordo com o desenvolvimento da FA. Contagens sanguíneas completas, PCR sérica e albumina sérica foram obtidas antes da CRM. Os valores de CAR, relação N/L e relação P/L foram calculados. Os preditores de FA pós-operatória foram determinados por análise de regressão logística múltipla. RESULTADOS Durante o acompanhamento, 136 pacientes (32,8%) desenvolveram FA pós-operatória. Com análise de regressão logística múltipla, foram determinados os fatores de risco para FA pós-operatória: glicemia de jejum (OR: 1,01; IC 95%: 1,00-1,01, p<0,001), idade (OR: 1,12; IC 95%: 1,07-1,17, p<0,001), fração de ejeção do ventrículo esquerdo (OR: 0,90; IC 95%: 0,87-0,94, p<0,001), sexo masculino (OR: 3,32; IC 95%: 1,39-7,90, p=0,007), quantidade de drenagem de 24 horas (OR: 1,004; IC 95%: 1,002-1,005, p<0,001), CAR (OR: 1,82; IC 95%: 1,53-2,16, p<0,001). A análise da curva de características operacionais do receptor mostrou que o CAR (estatística C: 0,75; IC 95%: 0,71-0,79, p<0,001) foi um preditor significativo de FA. CONCLUSÃO O novo marcador inflamatório CAR é confiável para prever o desenvolvimento de FA após a operação de revascularização miocárdica.


Subject(s)
Humans , Male , Atrial Fibrillation , Postoperative Complications , C-Reactive Protein , Coronary Artery Bypass , Risk Factors , ROC Curve
13.
Int. j. morphol ; 38(3): 558-564, June 2020. tab, graf
Article in English | LILACS | ID: biblio-1098287

ABSTRACT

Chronic hepatotoxicity is a debilitating and frequently life-threatening disease resulting in progressive liver failure. The toxic chemical, thioacetamide (TAA) is used to evaluate hepatoprotective agents, and the polyphenolic compound, resveratrol was proposed as a novel treatment for diseases with hyperactivation of the mammalian target of rapamycin (mTOR) cell signaling pathway. This analysis sought to investigate the potential protective effect of resveratrol against liver injury induced by TAA via the inhibition of hepatic mTOR. Model group rats received several injections of TAA (200 mg/kg; twice a week for 8 weeks) before being sacrificed at week 10 and the protective group was pretreated with resveratrol (20 mg/kg) daily for two weeks prior to TAA injections and continued receiving both agents until the end of the experiment. Harvested liver tissues were examined using light microscopy and liver homogenates were assayed for biomarkers of inflammation and assessed the levels of mTOR protein in all animal groups. In addition, blood samples were assayed for biomarkers of liver injury enzyme. TAA substantially damaged the hepatic tissue of the model group such as infiltration of inflammatory cells, vacuolated cytoplasm, dark pyknotic nuclei, and dilated congested blood vessel that were effectively protected by resveratrol. Resveratrol also significantly (p<0.05) inhibited TAA-induced mTOR, high sensitivity c-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in harvested liver homogenates and blood samples. Thus, we conclude that resveratrol effectively protects against TAA-induced hepatotoxicity in rats, possibly due to the inhibition of mTOR and inflammation.


La hepatotoxicidad crónica es una enfermedad debilitante y potencialmente mortal que produce insuficiencia hepática progresiva. La toxicidad del químico de la tioacetamida (TAA) se utiliza para evaluar los agentes hepatoprotectores y el compuesto polifenólico, resveratrol, se propuso como un nuevo tratamiento para enfermedades con hiperactivación de la vía de señalización celular mTOR (mammalian Target of Rapamycin). Aquí buscamos investigar el posible efecto protector del resveratrol contra la lesión hepática inducida por TAA a través de la inhibición de la vía de señalización mTOR en hepatocitos. Las ratas del grupo modelo recibieron varias inyecciones de TAA (200 mg / kg; dos veces por semana durante 8 semanas) antes de ser sacrificadas en la semana 10 y el grupo protector se trató previamente con resveratrol (20 mg / kg) diariamente durante dos semanas antes de las inyecciones de TAA y continuó recibiendo ambos agentes hasta el final del experimento. Se examinaron los tejidos hepáticos recolectados usando microscopía óptica y se analizaron los homogeneizados hepáticos para detectar biomarcadores de inflamación y se evaluaron los niveles de proteína mTOR en todos los grupos de animales. Además, se analizaron muestras de sangre para detectar biomarcadores de la enzima de lesión hepática. TAA dañó sustancialmente el tejido hepático del grupo modelo, con infiltración de células inflamatorias, citoplasma vacuolado, núcleos picnóticos oscuros y vasos sanguíneos congestionados dilatados que estaban efectivamente protegidos por el resveratrol. El resveratrol también inhibió significativamente (p <0.05) mTOR, proteína C-reactiva (hs-CRP), factor de necrosis tumoral alfa (TNF-α), interleucina-6 (IL-6), alanina aminotransferasa (ALT ) y aspartato aminotransferasa (AST) en las muestras de sangre y de hígados recolectados. En conclusión, el resveratrol protege eficazmente contra la hepatotoxicidad inducida por TAA en ratas, posiblemente debido a la inhibición de mTOR y de la inflamación.


Subject(s)
Animals , Male , Mice , Thioacetamide/toxicity , Chemical and Drug Induced Liver Injury/drug therapy , TOR Serine-Threonine Kinases/antagonists & inhibitors , Resveratrol/administration & dosage , Aspartate Aminotransferases/analysis , C-Reactive Protein/analysis , Tumor Necrosis Factor-alpha/analysis , Alanine Transaminase/analysis , Disease Models, Animal
14.
Rev. Assoc. Med. Bras. (1992) ; 66(6): 762-770, June 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1136297

ABSTRACT

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


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


Subject(s)
Humans , Pancreatitis , C-Reactive Protein/metabolism , Prognosis , Severity of Illness Index , Lymphocytes , Acute Disease , Predictive Value of Tests , Retrospective Studies , ROC Curve , Neutrophils
15.
Rev. bras. cir. cardiovasc ; 35(3): 299-306, May-June 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1137279

ABSTRACT

Abstract Objective: To evaluate the prognostic value of C-reactive protein to albumin ratio (CAR) in patients with severe aortic valve stenosis undergoing surgical aortic valve replacement (AVR). Methods: Four hundred seventy-six patients with severe degenerative aortic stenosis who underwent successful isolated surgical AVR were enrolled. Hospitalization due to heart failure, surgical aortic reoperation, paravalvular leakage rates, and long-term mortality were evaluated in the whole study group. The participants were divided into two groups, as 443 patients without mortality (group 1) and 33 patients with mortality (group 2) during the follow-up time. Results: CAR was lower in patients without mortality than in those with mortality during the follow-up time (0.84 [0.03-23.43] vs. 2.50 [0.22-26.55], respectively, P<0.001). Age (odds ratio [OR]: 1.062, confidence interval [CI]: 1.012-1.114, P=0.014), CAR (OR: 1.221, CI: 1.125-1.325, P<0.001), ejection fraction (OR: 0.956, CI: 0.916-0.998, P=0.042), and valve type (OR: 2.634, CI: 1.045-6.638, P=0.040) were also found to be independent predictors of long-term mortality. Additionally, rehospitalization (0.86 [0.03-26.55] vs. 1.6 [0.17-24.05], P=0.006), aortic reoperation (0.87 [0.03-26.55] vs. 1.6 [0.20-23.43], P=0.016), and moderate to severe aortic paravalvular leakage (0.86 [0.03-26.55] vs. 1.86 [0.21-19.50], P=0.023) ratios were associated with higher CAR. Conclusion: It was firstly described that CAR was strongly related with increased mortality rates in patients with isolated severe aortic stenosis after surgical AVR. Additionally, rehospitalization, risk of paravalvular leakage, and aortic reoperation rates were higher in patients with increased CAR than in those without it.


Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Aortic Valve Stenosis/surgery , Heart Valve Prosthesis , Heart Valve Prosthesis Implantation , Aortic Valve/surgery , Prognosis , C-Reactive Protein , Angiotensin-Converting Enzyme Inhibitors , Risk Factors , Treatment Outcome , Angiotensin Receptor Antagonists
16.
Rev. Col. méd. cir ; 159(1): 26-30, abr 2020. tab
Article in Spanish | LILACS, LIGCSA | ID: biblio-1247559

ABSTRACT

Objetivo: describir el riesgo cardiovascular de pacientes con diabetes mellitus tipo 2 (DM2), según los valores de proteína C reactiva ultrasensible (PCR-us). Material y métodos: estudio descriptivo transversal, realizado en el Patronato del Diabético de zona 1, Ciudad de Guatemala, en el cual participaron 196 pacientes mayores de 50 años de edad, obteniéndose características sociodemográficas, medidas antropométricas. Además, se tomaron muestras de sangre que fueron procesadas en iCroma ll para determinar los valores de Proteína C reactiva ultrasensible (PCR-us). Resultados: los pacientes que aceptaron formar parte del estudio, tuvieron una media de edad de 62±8.62 DE; 74.4% (146) fueron del sexo femenino; 54% (106) eran católicos y el 82.1% (161), residían en la Ciudad de Guatemala. El estado nutricional fue normal en el 26% (50), el 11% (21) tenía sobrepeso y 63% (125), obesidad. Para índice cintura cadera (ICC) con respecto al sexo femenino, se obtuvo una media de 0.89±0.05 DE y una media 0.97±0.05 DE del sexo masculino. Respecto al riesgo cardiovascular, se obtuvo una media en valores de PCR-us de 2.9±2.8 DE, con 76% (148) de los pacientes en riesgo cardiovascular moderado/alto. Conclusiones: los valores de PCR-us tuvieron una media de 2.9±2.8 DE y 8 de cada 10 pacientes están en riesgo moderado/alto. De los pacientes estudiados, 7 de cada 10 fueron mujeres, con una media para a edad de 62 años. Se encontraron 7 de cada 10 con sobrepeso u obesidad, con una media para índice cintura cadera con respecto al sexo elevado.


Objective: to describe the cardiovascular risk of patients with type 2 diabetes mellitus, according to the values of ultrasensitive C-reactive protein (PCR-us). Material and methods: descriptive cross-sectional study, carried out on 196 patients over 50 years of age, from the Diabetic Board of Trustees in Zone 1, Guatemala. Data on sociodemographic characteristics, anthropometric measurements and blood were obtained. The blood samples were processed in iCroma ll to determine the values of ultrasensitive reactive Protein C (PCR-us). Results: the patients who accepted to be part of the study had a mean age of 62 ± 8.62 SD years; 74.4% (146) were female; 54% (106) were catholic, and 82.1% (161) resided in Guatemala City. Nutritional status was normal in 50 patients (26%), 21, overweight (11%) and 125, obese (63%). For the waisthip index, with respect to the female, an average of 0.89 ± 0.05 SD and for males, an average 0.97 ± 0.05 SD were obtained. Regarding cardiovascular risk, an average in PCR-us values of 2.9 ± 2.8 SD was obtained; 76% (148) of patient were at moderate / high cardiovascular risk.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , C-Reactive Protein/analysis , Cardiovascular Diseases/etiology , Cardiovascular Diseases/prevention & control , Diabetes Mellitus, Type 2/complications , Cross-Sectional Studies , Risk Factors , Overweight , Diet, Healthy , Obesity/complications
17.
Braz. j. otorhinolaryngol. (Impr.) ; 86(2): 180-184, March-Apr. 2020. tab
Article in English | LILACS | ID: biblio-1132566

ABSTRACT

Abstract Introduction: Sudden hearing loss is a significant otologic emergency. Previous studies have revealed a coexistence of sudden hearing loss with chronic inflammation. The predictive importance of C-reactive protein/albumin values as a prognostic factor has been shown in various inflammatory and tumoral conditions. Objectives: The aim of this study was to determine whether the C-reactive protein/albumin ratio in sudden hearing loss can be used for prognostic purposes and whether there is a relationship between the neutrophil/lymphocyte ratio and the C-reactive protein/albumin ratio. Methods: A retrospective examination was made of 40 patients diagnosed with idiopathic sudden hearing loss and a control group of 45 healthy subjects. The pure tone averages of all the patients were determined on first presentation and repeated at 3 months after the treatment. The patients were separated into 2 groups according to the response to treatment. The neutrophil/lynphocyte ratio and the C-reactive protein/albumin ratios were calculated from the laboratory tests. Results: The patients included 16 females and 24 males with a mean age of 44.1 ± 14.2 years and the control group was composed of 23 females and 22 males with a mean age of 42.2 ± 13.8 years. The mean C-reactive protein/albumin ratio was 0.95 ± 0.47 in the patient group and 0.74 ± 0.13 in the control group. The difference was statistically significant (p = 0.009). The mean C-reactive protein/albumin ratio was 0.79 ± 0.12 in the response to treatment group and 1.27 ± 0.72 in the non-response group, with no significant difference determined between the groups (p = 0.418). The mean neutrophil/lymphocyte ratio was 3.52 ± 3.00 in the response to treatment group and 4.90 ± 4.60 in the non-response group, with no statistically significant difference determined between the groups (p = 0.261). Conclusion: C-reactive/albumin ratio was significantly higher in patients with sudden hearing loss than in the control group. Although C-reactive protein/albumin ratio was found to be lower in sudden hearing loss patients who responded to treatment compared to those who did not, the difference between two groups was not statistically significant.


Resumo Introdução: A perda auditiva neurossensorial súbita ou surdez súbita é uma emergência otológica significativa. Estudos anteriores revelaram uma coexistência dessa condição com inflamação crônica. A importância preditiva dos valores da relação proteína C-reativa/albumina como fator prognóstico tem sido demonstrada em várias condições inflamatórias e tumorais. Objetivos: O objetivo deste estudo foi determinar se a relação proteína C-reativa/albumina na perda auditiva neurossensorial súbita pode ser usada para fins prognósticos e se existe uma associação entre as relações neutrófilo/linfócito e proteína C-reativa/albumina. Método: Foram avaliados retrospectivamente 40 pacientes com diagnóstico de perda auditiva neurossensorial súbita idiopática e um grupo controle de 45 indivíduos saudáveis. As médias de tons puros de todos os pacientes foram determinadas na primeira consulta e repetidas 3 meses após o tratamento. Os pacientes foram separados em 2 grupos de acordo com a resposta ao tratamento. As relações neutrófilo/linfócito e proteína C-reativa/albumina foram calculadas a partir de testes laboratoriais. Resultados: Os pacientes incluíam 16 mulheres e 24 homens, com média de 44,1 ± 14,2 anos, e o grupo controle por 23 mulheres e 22 homens, com média de 42,2 ± 13,8 anos. A média da relação proteína C-reativa/albumina foi de 0,95 ± 0,47 no grupo de pacientes e de 0,74 ± 0,13 no grupo controle e a diferença foi estatisticamente significante (p = 0,009). A média da relação proteína C-reativa/albumina foi de 0,79 ± 0,12 do grupo com resposta ao tratamento e de 1,27 ± 0,72 no grupo sem resposta, sem diferença significante entre os grupos (p = 0,418). A média da relação neutrófilo/linfócito foi de 3,52 ± 3,00 no grupo com resposta ao tratamento e de 4,90 ± 4,60 no grupo sem resposta, sem diferença estatisticamente significativa entre os grupos (p = 0,261). Conclusão: A relação proteína C-reativa/albumina foi significantemente maior nos pacientes com perda auditiva neurossensorial súbita do que no grupo controle. No entanto, embora a relação proteína C-reativa/albumina tenha sido menor nos pacientes com perda auditiva neurossensorial súbita que responderam ao tratamento em comparação a aqueles que não apresentaram resposta, a diferença entre os dois grupos não foi estatisticamente significante.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , C-Reactive Protein/analysis , Methylprednisolone/therapeutic use , Hearing Loss, Sudden/drug therapy , Hearing Loss, Sudden/blood , Hearing Loss, Sensorineural/drug therapy , Hearing Loss, Sensorineural/blood , Prognosis , Serum Albumin/analysis , Biomarkers/blood , Case-Control Studies , Predictive Value of Tests , Retrospective Studies , Treatment Outcome , Lymphocyte Count , Neutrophils
18.
Pesqui. vet. bras ; 40(3): 202-209, Mar. 2020. tab, graf, ilus
Article in English | ID: biblio-1135603

ABSTRACT

The objective of this research was to creates a reference interval for C-reactive protein (CRP)/albumin ratio (CAR) in the canine species and to analyze the potential of CRP, albumin and the relationship between both, to serve as indicators of disease severity, length of hospital stay (LoS) and mortality in this species. For this, an outcome study was conducted in a Veterinary Teaching Hospital in southern Brazil. One hundred ninety dogs were included randomly, without distinction of gender, age, or breed, from June 2013 to November 2016. Plasma was collected from them and analyzed for assessment of CRP and albumin. The reference range stipulated for CAR in dogs was 0.36-0.60, as determined by the confidence interval of mean resamplings (in percentiles). The frequencies mean, and standard deviations of the variables, correlation analysis, and comparative analysis (Kruskal-Wallis in α = 5%) were calculated. Elevation (above reference) of CAR was determined to be proportional to the severity of the underlying disease, and CRP means were reasonable. Besides, hypoalbuminemia was indicative of systemic disease, but not of severity. Thus, CAR was a better marker of disease severity than were CRP and albumin, analyzed separately. Concerning LoS, there was a positive correlation with CAR (p<0.01) in patients, and the same was not observed with CRP and albumin. Concerning mortality, hypoalbuminemia was the only marker valid in animals with a critical illness (p=0.04). In conclusion, CAR is a better marker of disease severity and LoS in dogs than are CRP and albumin analyzed separately.(AU)


O objetivo desta pesquisa foi determinar um intervalo de referência para a relação proteína C reativa (PCR)/albumina (R:PCR/ALB) na espécie canina e analisar o potencial de PCR, albumina e a relação entre ambas como indicadores de gravidade de doença, tempo de internação (TI) e mortalidade nesta espécie. Para isso, um estudo foi realizado em um Hospital Veterinário Escola no sul do Brasil. Cento e noventa cães foram incluídos aleatoriamente, sem distinção de sexo, idade ou raça, de junho de 2013 a novembro de 2016. O plasma foi coletado e analisado para avaliação da PCR e albumina. O intervalo de referência estipulado para o R:PCR/ALB em cães foi de 0,36-0,60, conforme determinado pelo intervalo de confiança da média das reamostragens (em percentis). Foram calculadas as frequências, médias e desvios-padrões das variáveis, análises de correlação e análises comparativas (Kruskal-Wallis em α = 5%). Notou-se elevação (acima da referência) da R:PCR/ALB proporcional à gravidade da doença de base, sendo normais as médias da PCR. Adicionalmente, a hipoalbuminemia foi indicadora de doença sistêmica, mas, não de gravidade. Dessa forma, a R:PCR/ALB foi melhor indicadora de gravidade de doença do que a PCR e albumina, analisadas separadamente. Em relação ao TI, houve correlação positiva com a R:PCR/ALB (p<0,01) em doentes, não sendo observado o mesmo com a PCR e albumina. Em relação à mortalidade, a hipoalbuminemia foi a única marcadora válida em animais com doenças críticas (p=0,04). Conclui-se, portanto, que a R:PCR/ALB é melhor marcadora de gravidade de doença e TI em cães do que a PCR e albumina analisadas separadamente.(AU)


Subject(s)
Animals , Dogs , Prognosis , Severity of Illness Index , C-Reactive Protein , Serum Albumin , Outcome Assessment, Health Care , Dog Diseases/diagnosis , Hospitalization
19.
Säo Paulo med. j ; 138(1): 19-26, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1099388

ABSTRACT

ABSTRACT BACKGROUND: Studies have shown that physical activity levels can be inversely associated with high-sensitivity C-reactive protein (hs-CRP) levels. However, the amount of physical activity required to maintain normal hs-CRP levels is still a matter for speculation. OBJECTIVE: To identify the amount of physical activity necessary to discriminate the hs-CRP levels in adults. DESIGN AND SETTING: Cross-sectional study at six teaching and research institutions. METHODS: The study sample comprised 10,231 adults aged 35 to 74 years who were participants in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Receiver operating characteristic (ROC) curves were constructed to compare the amount of physical activity in two domains (leisure time and commuting) with hs-CRP levels. The sensitivity and specificity were calculated to identify the best cutoff for physical activity level that would be needed to maintain normal levels of hs-CRP (< 3 mg/l). RESULTS: The area under the ROC curve was only statistically significant for discriminating normal levels of hs-CRP according to the amount of physical activity when the two study domains were added together. The accumulated physical activity level of 200 minutes/week was the best cutoff for discriminating normal levels of hs-CRP in adults of both sex. CONCLUSIONS: Physical activity in the leisure-time and commuting domains together, of duration 200 minutes/week, was associated with normal hs-CRP values.


Subject(s)
Humans , Adult , Middle Aged , Aged , C-Reactive Protein , Exercise , Brazil , Biomarkers , Cross-Sectional Studies , Longitudinal Studies
20.
Arq. bras. cardiol ; 114(2): 268-272, Feb. 2020. tab
Article in English | LILACS | ID: biblio-1088864

ABSTRACT

Abstract Background: Periodontitis and coronary artery disease (CAD) share an inflammatory etiology; there is a recent concern regarding the investigation of an association between these two conditions. Current theories indicate that cytokines and proteins have an important role in this process. C-reactive protein and interleukin-6 are inflammatory derivatives produced in the presence of periodontitis and in the pathophysiology of coronary disease. The polymorphisms of CRP + 1444 C > T and IL6-174 G > C are recognized in the literature as being related to CAD. Objective: This study investigates the association between periodontitis and coronary artery disease, through the presence of PCR and IL-6 polymorphisms. Methods: We selected 80 patients who underwent diagnostic catheterization in the HU of UFSM. The presence of periodontitis was determined by the Community Periodontal Index, whereas the CAD was established by the medical report. DNA was collected from a saliva sample and the presence of polymorphism was determined by PCR and restriction enzymes. A significance level of 5% was adopted. Results: The mean age of all participants (p = 0.035, OR 2.65; 95%CI: (1.02-6.87) male gender (p = 0.012, OR 3.37; 95% CI: (1.28- (p = 0.013, OR 3.66; 95% CI: (1.27-10.5)), PCR polymorphism + 1444C > T (p = 0.001, OR 6.37; 95% CI:, (2.25-17.9)) and IL6 -174 G > C polymorphism (p = 0.025, OR 2.87, 95% CI: (1.09-7.55)) were statistically associated with the presence of CAD. Age > 60 years and presence of the PCR +1444 C > T polymorphism remained independently associated with CAD after adjustment by logistic regression. Conclusions: The presence of the PCR + 1444 C > T polymorphism in this study was independently associated with the presence of coronary artery disease.


Resumo Fundamento: A periodontite e a doença arterial coronariana (DAC) compartilham uma etiologia inflamatória. Existe preocupação na investigação de associação entre essas duas condições. Há citocinas e proteínas com papel importante neste processo, como a proteína C-reativa (PCR) e a interleucina 6 (IL-6), que são derivados inflamatórios produzidos na presença da periodontite e na fisiopatologia da DAC. Os polimorfismos da PCR+1444 C > T e da IL-6 -174 G > C são reconhecidos na literatura como relacionados à DAC. Objetivo: Este estudo objetiva comprovar a associação entre periodontite e DAC, através da presença dos polimorfismos da PCR e da IL-6. Métodos: Foram selecionados 80 pacientes que se submeteram ao cateterismo diagnóstico no Hospital Universitário da Universidade Federal de Santa Maria (UFSM). A periodontite foi determinada pelo índice periodontal comunitário; a DAC, pelo laudo médico. Foi coletado o ácido desoxirribonucleico (DNA) pela saliva e estabelecido o polimorfismo pela avaliação da PCR/RFLP. Foi adotado um nível de significância estatística de 5%. Resultados: A idade mediana de todos os participantes (p = 0,035; OR 2,65; IC 95% [1,02-6,87]), gênero masculino (p = 0,012; OR 3,37; IC 95% [1,28-8,9]), periodontite (p = 0,013; OR 3,66; IC 95% [1,27-10,5]), polimorfismo da PCR +1444 C > T (p = 0,001; OR 6,37; IC 95% [2,25-17,9]) e polimorfismo da IL-6 -174G > C (p = 0,025; OR 2,87; IC 95% [1,09-7,55]) foram estatisticamente relacionados à DAC. Após ajuste com a regressão logística, mantiveram-se independentemente associadas à DAC a idade maior que 60 anos e o polimorfismo da PCR +1444 C > T. Conclusões: O polimorfismo da PCR +1444 C > T, neste estudo, esteve independentemente relacionado à DAC.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Periodontitis/complications , Periodontitis/genetics , Coronary Artery Disease/complications , Coronary Artery Disease/genetics , C-Reactive Protein/genetics , Interleukin-6/genetics , Polymorphism, Single Nucleotide , Brazil , C-Reactive Protein/analysis , Logistic Models , Sex Factors , Polymerase Chain Reaction , Risk Factors , Age Factors , Interleukin-6/analysis , Alleles
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