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1.
Emerg Microbes Infect ; 9(1): 940-948, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32357808

RESUMEN

The emerging COVID-19 caused by SARS-CoV-2 infection poses severe challenges to global public health. Serum antibody testing is becoming one of the critical methods for the diagnosis of COVID-19 patients. We investigated IgM and IgG responses against SARS-CoV-2 nucleocapsid (N) and spike (S) protein after symptom onset in the intensive care unit (ICU) and non-ICU patients. 130 blood samples from 38 COVID-19 patients were collected. The levels of IgM and IgG specific to N and S protein were detected by ELISA. A series of blood samples were collected along the disease course from the same patient, including 11 ICU patients and 27 non-ICU patients for longitudinal analysis. N and S specific IgM and IgG (N-IgM, N-IgG, S-IgM, S-IgG) in non-ICU patients increased after symptom onset. N-IgM and S-IgM in some non-ICU patients reached a peak in the second week, while N-IgG and S-IgG continued to increase in the third week. The combined detection of N and S specific IgM and IgG could identify up to 75% of SARS-CoV-2 infected patients in the first week. S-IgG was significantly higher in non-ICU patients than in ICU patients in the third week. In contrast, N-IgG was significantly higher in ICU patients than in non-ICU patients. The increase of S-IgG positively correlated with the decrease of C-reactive protein (CRP) in non-ICU patients. N and S specific IgM and IgG increased gradually after symptom onset and can be used for detection of SARS-CoV-2 infection. Analysis of the dynamics of S-IgG may help to predict prognosis.


Asunto(s)
Anticuerpos Antivirales/inmunología , Betacoronavirus/inmunología , Infecciones por Coronavirus/inmunología , Inmunoglobulina G/inmunología , Inmunoglobulina M/inmunología , Proteínas de la Nucleocápside/inmunología , Neumonía Viral/inmunología , Glicoproteína de la Espiga del Coronavirus/inmunología , Anciano , Anticuerpos Antivirales/sangre , Proteína C-Reactiva/análisis , Proteína C-Reactiva/inmunología , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/diagnóstico , Cuidados Críticos/estadística & datos numéricos , Femenino , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Cinética , Masculino , Persona de Mediana Edad , Proteínas de la Nucleocápside/sangre , Pandemias , Neumonía Viral/sangre , Neumonía Viral/diagnóstico , Glicoproteína de la Espiga del Coronavirus/sangre
2.
Ann Clin Microbiol Antimicrob ; 19(1): 18, 2020 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-32414383

RESUMEN

AIMS: The coronavirus disease 2019 (COVID-19) is characterized as highly contagious and deadly; however there is no credible and convenient biomarker to predict the severity of the disease. The aim of the present study was to estimate whether the CRP level is able to act as a marker in indicating the severity of COVID-19. METHODS: Patients who complained cough or chest pain with or without fever were enrolled after laboratory confirmed of SARS-CoV-2 viral nucleic acid via qRT-PCR. Chest computed tomography (CT) was then performed to classify the patients into mild, moderate and severe pneumonia groups according to the interim management guideline. Then linear regression models were applied to analyze the association between c-reactive protein (CRP) levels and severity of COVID-19 pneumonia. RESULTS: When compared to mild pneumonia, the adjusted-Odds Ratio were 11.46, p = 0.029 and 23.40, p = 0.025 in moderate and severe pneumonia, respectively. The area under receiver operation curve was 0.898 (95% CI 0.835, 0.962, p < 0.001). Higher plasma CRP level indicated severe COVID-19 pneumonia and longer inpatients duration. CONCLUSIONS: The level of plasma CRP was positively correlated to the severity of COVID-19 pneumonia. Our findings could assist to discern patients of moderate to severe COVID-19 pneumonia from the mild ones. Our findings may be useful as an earlier indicator for severe illness and help physicians to stratify patients for intense care unit transfer.


Asunto(s)
Proteína C-Reactiva/análisis , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/fisiopatología , Neumonía Viral/sangre , Neumonía Viral/fisiopatología , Adulto , China , Infecciones por Coronavirus/diagnóstico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/diagnóstico , Pronóstico , Tomografía Computarizada por Rayos X
4.
Anticancer Res ; 40(4): 2365-2371, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32234939

RESUMEN

BACKGROUND: Several immune-inflammatory markers are associated with cancer progression. The purpose of the present study was to clarify the influence of the preoperative C-reactive protein-to-albumin ratio (CRP/ALB ratio) on survival of patients with esophageal cancer and recurrence after curative resection. PATIENTS AND METHODS: The preoperative CRP/ALB ratio was evaluated in 122 patients who underwent radical resection for esophageal cancer from 2005 to 2018. The correlations between the CRP/ALB ratio and cancer-specific overall (OS), recurrence-free (RFS) survival and the clinicopathological status were analyzed. RESULTS: The optimal cut-off value of the CRP/ALB ratio determined using receiver operating characteristic curve analysis was 0.04. Patients were divided into two groups based on this cut-off value: the low CRP/ALB group (n=59) and the high CRP/ALB group (n=50). The OS rate at 5 years after surgery was significantly lower in the group with high CRP/ALB at 40.5% whilst it was 63.5% in the low CRP/ALB group (p=0.005). The corresponding RFS rates at 5 years after surgery were 32.5% and 48.3%, respectively, which was a statistically significant difference (p=0.007). A multivariate analysis showed that a high CRP/ALB ratio was a significant independent risk factor for poorer cancer-specific OS and RFS. CONCLUSION: The preoperative CRP/ALB ratio was a strong prognostic marker for patients with esophageal cancer. The surgical strategy, including procedure and perioperative care should be carefully planned for patients with a high CRP/ALB ratio.


Asunto(s)
Proteína C-Reactiva/análisis , Carcinoma de Células Escamosas/cirugía , Neoplasias Esofágicas/cirugía , Albúmina Sérica/análisis , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor/sangre , Carcinoma de Células Escamosas/sangre , Carcinoma de Células Escamosas/patología , Neoplasias Esofágicas/sangre , Neoplasias Esofágicas/patología , Femenino , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Periodo Preoperatorio , Pronóstico , Estudios Retrospectivos
5.
Medicine (Baltimore) ; 99(14): e19165, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32243358

RESUMEN

BACKGROUND: Previous studies have demonstrated that the C-reactive protein to albumin ratio (CAR) is correlated with the clinical outcomes of solid tumors. However, the available data have not been systematically evaluated. The objective of the present meta-analysis was to explore the prognostic value of the CAR in solid tumors. METHODS: Eligible studies were identified from the PubMed, EMBASE and Web of Science electronic databases. The clinical characteristics, disease -free survival (DFS) /progression-free survival (PFS) and overall survival (OS) were extracted from the eligible studies. The pooled hazard ratios (HRs) and 95% confidence intervals were calculated with STATA 12.0 software. We also performed subgroup, meta-regression and sensitivity analyses. RESULTS: In total, twenty-seven eligible studies including 10556 patients were enrolled in the present meta-analysis. The pooled HRs with 95% confidence intervals showed that the CAR was significantly associated with poor OS (HR = 1.95, 95% CI: 1.71-2.22) and DFS/PFS (HR = 1.82, 95% CI: 1.61-2.07) in patients with solid tumors. Although publication bias was found in the studies with regard to OS, a further trim and fill analysis revealed that the adjusted HR was 1.82 (95% CI: 1.69-1.96), which was close to the original HR. Subgroup analysis confirmed the CAR as a strong prognostic marker in patients with solid tumors, regardless of the tumor type, detection time, cut-off value, sample size and area. CONCLUSION: Our meta-analysis indicated that a high CAR might be an unfavorable prognostic marker for OS and DFS/PFS in patients with solid tumors.


Asunto(s)
Proteína C-Reactiva/análisis , Neoplasias/sangre , Neoplasias/mortalidad , Albúmina Sérica/análisis , Biomarcadores de Tumor , Supervivencia sin Enfermedad , Humanos , Pronóstico , Modelos de Riesgos Proporcionales
6.
Medicine (Baltimore) ; 99(14): e19532, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32243370

RESUMEN

BACKGROUND: Pentraxin 3 is an acute inflammatory protein of the long pentraxin subfamily. A meta-analysis was performed to assess diagnostic accuracy of pentraxin 3 for respiratory tract infections. METHODS: We identify studies examining diagnostic value of pentraxin 3 for respiratory tract infections by searching Pubmed, Web of Knowledge, and Cochrane Library. The sensitivity, specificity, negative likelihood ratio (LR), positive LR, and diagnostic odds ratio were pooled. The area under the summary receiver operator characteristic (SROC) curve and Q point value (Q*) were calculated. RESULTS: A total of 8 studies with 961 individuals were eligible for this meta-analysis. The pooled sensitivity of pentraxin 3 in diagnosis of respiratory tract infections was 0.78, the pooled specificity was 0.73, the area under the SROC curve was 0.84, and the Q* was 0.77. The area under the SROC curve of serum and bronchoalveolar lavage fluid (BALF) pentraxin 3 was 0.85 and 0.89, respectively. Meta-regression analysis revealed that cutoff value was the source of heterogeneity among the included studies. The Deek funnel plot test suggested no evidence of publication bias. Subgroup analyses showed that the area under the SROC curve of pentraxin 3 in diagnosis of ventilator-associated pneumonia (VAP) was 0.89. CONCLUSION: Pentraxin 3 has a moderate accuracy for diagnosing respiratory tract infections and VAP. The overall diagnostic value of BALF level of pentraxin 3 is superior to its serum concentration.


Asunto(s)
Proteína C-Reactiva/análisis , Infecciones del Sistema Respiratorio/sangre , Infecciones del Sistema Respiratorio/diagnóstico , Componente Amiloide P Sérico/análisis , Biomarcadores , Líquido del Lavado Bronquioalveolar/química , Humanos , Oportunidad Relativa , Neumonía Asociada al Ventilador/sangre , Neumonía Asociada al Ventilador/diagnóstico , Valor Predictivo de las Pruebas , Curva ROC
7.
Medicine (Baltimore) ; 99(15): e19648, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32282713

RESUMEN

BACKGROUND: Xingnaojing injection (XNJi) is widely used for acute cerebral hemorrhage. However, the efficacy of XNJi for acute cerebral hemorrhage has not been comprehensively proved by systematic analysis yet. Therefore, it is essential to evaluate the efficacy and safety of XNJi in an evidence-based method. METHODS: Six databases were searched with XNJi used for acute cerebral hemorrhage in randomized controlled trials (RCTs). Meta-analysis was performed by Review Manager 5.3. The efficacy rate, brain edema, cerebral hematoma, neurological deficit score, hs-crp, Glasgow Coma Scale (GCS), and activities of daily living (ADL) were systematically evaluated. The Cochrane risk of bias was used to evaluate the methodological quality of eligible studies. RESULTS: This study is registered with PROSPERO (CRD42018098737). Twenty-nine studies with a total of 2638 patients were included in this meta-analysis. Compared with conventional treatment, XNJi got higher efficacy rate (OR = 3.37, 95% CI [2.65, 4.28], P < .00001). Moreover, XNJi showed significant enhancement of efficacy rate via subgroup analysis in course and dosage. In addition, XNJi demonstrated significant improvement in Chinese stroke scale (CSS) and National Institutes of Health Stroke Scale (NHISS) (mean difference [MD] = -4.74, 95% CI [-5.89, -3.60], P < .00001; MD = -4.45, 95% CI [-5.49, -3.41], P < .00001), GCS (MD = 2.72, 95% CI [2.09, 3.35], P < .00001). It also remarkably decreased the level of hs-crp (MD = -6.50, 95% CI [-7.79, -5.21], P < .00001), enhanced ADL (MD = 20.38, 95% CI [17.98, 22.79], P < .00001), and alleviated hematoma and edema (MD = -2.53, 95% CI [-4.75, -0.31] P < .05; MD = -1.74 95% CI [-2.42, -1.07] P < .00001) compared with conventional treatment. CONCLUSION: XNJi is effective in treating acute cerebral hemorrhage with significant improvement of CSS, NHISS and impairment of hs-crp, hematoma, and edema compared with conventional treatment. Moreover, XNJi got remarkable efficacy at the dose of 20, 30, 60 mL and from 7 to 28 days. No serious adverse reactions occurred. These results were mainly based on small-sample and low-quality studies. Therefore, more rigorous, large-scale RCTs were further needed to confirm its efficacy, safety, and detailed characteristic of application.


Asunto(s)
Hemorragia Cerebral/tratamiento farmacológico , Medicamentos Herbarios Chinos/administración & dosificación , Actividades Cotidianas , Enfermedad Aguda , Adulto , Anciano , Anciano de 80 o más Años , Edema Encefálico/epidemiología , Proteína C-Reactiva/análisis , Proteína C-Reactiva/efectos de los fármacos , Hemorragia Cerebral/epidemiología , Medicamentos Herbarios Chinos/efectos adversos , Medicamentos Herbarios Chinos/uso terapéutico , Femenino , Escala de Coma de Glasgow/estadística & datos numéricos , Hematoma , Humanos , Inyecciones , Masculino , Persona de Mediana Edad , Enfermedades del Sistema Nervioso/epidemiología , Enfermedades del Sistema Nervioso/fisiopatología , Ensayos Clínicos Controlados Aleatorios como Asunto
8.
Emerg Microbes Infect ; 9(1): 757-760, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32228222

RESUMEN

The dysfunction of the renin-angiotensin system (RAS) has been observed in coronavirus infection disease (COVID-19) patients, but whether RAS inhibitors, such as angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II type 1 receptor blockers (ARBs), are associated with clinical outcomes remains unknown. COVID-19 patients with hypertension were enrolled to evaluate the effect of RAS inhibitors. We observed that patients receiving ACEI or ARB therapy had a lower rate of severe diseases and a trend toward a lower level of IL-6 in peripheral blood. In addition, ACEI or ARB therapy increased CD3 and CD8 T cell counts in peripheral blood and decreased the peak viral load compared to other antihypertensive drugs. This evidence supports the benefit of using ACEIs or ARBs to potentially contribute to the improvement of clinical outcomes of COVID-19 patients with hypertension.


Asunto(s)
Bloqueadores del Receptor Tipo 1 de Angiotensina II/uso terapéutico , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Antihipertensivos/uso terapéutico , Infecciones por Coronavirus/complicaciones , Hipertensión/tratamiento farmacológico , Neumonía Viral/complicaciones , Sistema Renina-Angiotensina , Anciano , Betacoronavirus , Proteína C-Reactiva/análisis , Complejo CD3 , Linfocitos T CD8-positivos/citología , China , Infecciones por Coronavirus/tratamiento farmacológico , Femenino , Humanos , Hipertensión/complicaciones , Hipertensión/virología , Interleucina-6/sangre , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/tratamiento farmacológico , Estudios Retrospectivos , Resultado del Tratamiento , Carga Viral
10.
Bone Joint J ; 102-B(4): 463-469, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32228083

RESUMEN

AIMS: Prosthetic joint infection (PJI) remains a major clinical challenge. Neutrophil CD64 index, Fc-gamma receptor 1 (FcγR1), plays an important role in mediating inflammation of bacterial infections and therefore could be a valuable biomarker for PJI. The aim of this study is to compare the neutrophil CD64 index in synovial and blood diagnostic ability with the standard clinical tests for discrimination PJI and aseptic implant failure. METHODS: A total of 50 patients undergoing revision hip and knee arthroplasty were enrolled into a prospective study. According to Musculoskeletal Infection Society (MSIS) criteria, 25 patients were classified as infected and 25 as not infected. In all patients, neutrophil CD64 index and percentage of polymorphonuclear neutrophils (PMN%) in synovial fluid, serum CRP, ESR, and serum CD64 index levels were measured preoperatively. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) were analyzed for each biomarker. RESULTS: Serum CD64 index showed no significant difference between the two groups (p = 0.091). Synovial fluid CD64 index and PMN% discriminated good differentiation between groups of PJI and aseptic failure with AUC of 0.946 (95% confidence interval (CI) 0.842 to 0.990) and 0.938 (95% CI 0.832 to 0.987) separately. The optimal threshold value of synovial CD64 index for the diagnosis of PJI was 0.85, with a sensitivity of 92.00%, a specificity of 96.00%, and diagnostic odds ratio (DOR) of 227.11. CONCLUSION: The present study demonstrates that CD64 index in synovial fluid could be a promising laboratory marker for screening PJI. The cut-off values of 0.85 for synovial CD64 index has the potential to distinguish aseptic failure from PJI. Cite this article: Bone Joint J 2020;102-B(4):463-469.


Asunto(s)
Prótesis de Cadera/efectos adversos , Prótesis de la Rodilla/efectos adversos , Neutrófilos/inmunología , Infecciones Relacionadas con Prótesis/diagnóstico , Receptores de IgG/análisis , Líquido Sinovial/inmunología , Artroplastia de Reemplazo de Cadera , Artroplastia de Reemplazo de Rodilla , Biomarcadores/análisis , Sedimentación Sanguínea , Proteína C-Reactiva/análisis , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Osteoartritis de la Cadera/cirugía , Osteoartritis de la Rodilla/cirugía , Estudios Prospectivos , Falla de Prótesis/etiología , Infecciones Relacionadas con Prótesis/etiología , Curva ROC , Reoperación , Sensibilidad y Especificidad
11.
J Korean Med Sci ; 35(13): e142, 2020 Apr 06.
Artículo en Inglés | MEDLINE | ID: mdl-32242348

RESUMEN

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected pneumonia emerged in Wuhan, China in December 2019. In this retrospective multicenter study, we investigated the clinical course and outcomes of novel coronavirus disease 2019 (COVID-19) from early cases in Republic of Korea. METHODS: All of the cases confirmed by real time polymerase chain reaction were enrolled from the 1st to the 28th patient nationwide. Clinical data were collected and analyzed for changes in clinical severity including laboratory, radiological, and virologic dynamics during the progression of illness. RESULTS: The median age was 40 years (range, 20-73 years) and 15 (53.6%) patients were male. The most common symptoms were cough (28.6%) and sore throat (28.6%), followed by fever (25.0%). Diarrhea was not common (10.7%). Two patients had no symptoms. Initial chest X-ray (CXR) showed infiltration in 46.4% of the patients, but computed tomography scan confirmed pneumonia in 88.9% (16/18) of the patients. Six patients (21.4%) required supplemental oxygen therapy, but no one needed mechanical ventilation. Lymphopenia was more common in severe cases. Higher level of C-reactive protein and worsening of chest radiographic score was observed during the 5-7 day period after symptom onset. Viral shedding was high from day 1 of illness, especially from the upper respiratory tract (URT). CONCLUSION: The prodromal symptoms of COVID-19 were mild and most patients did not have limitations of daily activity. Viral shedding from URT was high from the prodromal phase. Radiological pneumonia was common from the early days of illness, but it was frequently not evident in simple CXR. These findings could be plausible explanations for the easy and rapid spread of SARS-CoV-2 in the community.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus , Pandemias , Neumonía Viral , Adulto , Anciano , Enfermedades Asintomáticas , Proteína C-Reactiva/análisis , Estudios de Cohortes , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico por imagen , Tos/etiología , Diarrea/etiología , Fiebre/etiología , Humanos , Linfopenia/etiología , Masculino , Persona de Mediana Edad , Terapia por Inhalación de Oxígeno , Faringitis/etiología , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico por imagen , Síntomas Prodrómicos , Radiografía Torácica , Reacción en Cadena en Tiempo Real de la Polimerasa , República de Corea , Estudios Retrospectivos , Factores de Tiempo , Tomografía Computarizada por Rayos X , Adulto Joven
12.
Medicine (Baltimore) ; 99(14): e19625, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32243388

RESUMEN

Patients with both serous effusion and eosinophilia are rarely reported and geographically distributed; their early diagnosis is difficult.According to the ultimate diagnosis, patients (≤14 years) in West China Second hospital with serous effusion and eosinophilia were divided into two groups including a parasitic group and a non-parasitic group. Clinical data were collected and analyzed between the two groups. Subsequently, significant measurement indicators were evaluated by receiver operating characteristic (ROC) curve to explore the optimal cut-off points for the most appropriate sensitivity and specificity.A total of 884 patients were diagnosed with serous effusion and 61 of them displayed co-morbidity with eosinophilia during enrolled time. Among 61 patients, 34 patients had parasitic infection and 27 had non-parasitic diseases. There were statistical difference in effusion position, the levels of white blood cell count (WBC), eosinophil (EOS), EOS%, C-reactive protein (CRP) between parasitic group and non-parasitic group. ROC curve demonstrated that the areas under the curve of EOS count and EOS% were >80%, and the corresponding optimal cut-off values were 1.71 × 10/L and 25.6% for distinguishing between parasitic and non-parasitic infections in our patients.This study provided a quantified index for potentially quick and convenient indicators of pediatric patients presenting with both eosinophilia and effusion. Eosinophils were helpful to improve the initial diagnosis with awareness of parasitic diseases. For the cases with EOS > 1.71 × 10/L or EOS% > 25.6%, parasitic infection should be considered and serological tests are recommended in our region.


Asunto(s)
Enfermedades Parasitarias/diagnóstico , Derrame Pleural/diagnóstico , Eosinofilia Pulmonar/diagnóstico , Proteína C-Reactiva/análisis , Niño , Preescolar , China , Diagnóstico Diferencial , Diagnóstico Precoz , Eosinófilos/metabolismo , Femenino , Humanos , Pacientes Internos , Recuento de Leucocitos , Masculino , Enfermedades Parasitarias/sangre , Enfermedades Parasitarias/complicaciones , Derrame Pleural/sangre , Derrame Pleural/parasitología , Eosinofilia Pulmonar/sangre , Eosinofilia Pulmonar/parasitología , Curva ROC , Estudios Retrospectivos , Sensibilidad y Especificidad
13.
BMC Res Notes ; 13(1): 194, 2020 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-32238170

RESUMEN

OBJECTIVE: The early diagnosis of neonatal sepsis remains a challenge for physicians. The initiation or/and discontinuation of the empirical antibiotic therapy at neonates with sepsis is a dilemma due to the lack of definitive diagnosis and the fear of misdiagnosing a case with its serious outcomes, which can follow up. Therefore, this study aimed to assess the usefulness of C-reactive protein (CRP) as an inflammatory biomarker in the prediction of the neonatal sepsis diagnosis in Butembo, the Democratic Republic of the Congo, in sub-Saharan Africa. Blood culture and quantitative CRP measurements were performed for each neonate. Receiver operating characteristics (ROC) analyses were done in the assessment of CRP accuracy in diagnosing neonatal sepsis. RESULTS: Of the 228 neonates screened for sepsis, 69 (30.3%) had a positive blood culture. Of the 228 neonates with suspected sepsis, 94 (41.2%) had a positive CRP. Among the 69 cases with positive blood culture, CRP identified 66 cases. The sensitivity, specificity, positive and negative predictive values of CRP were 95.7%, 82.4%, 70.2%, and 97.8%, respectively. The area under the curve (AUC) for the CRP ROC analysis was 0.948. CRP showed its usefulness in the diagnosis of neonatal sepsis.


Asunto(s)
Proteína C-Reactiva/análisis , Sepsis Neonatal/diagnóstico , Área Bajo la Curva , Biomarcadores/sangre , Estudios Transversales , República Democrática del Congo , Humanos , Recién Nacido , Valor Predictivo de las Pruebas , Curva ROC , Sensibilidad y Especificidad
14.
Med Sci Monit ; 26: e920684, 2020 Apr 13.
Artículo en Inglés | MEDLINE | ID: mdl-32283546

RESUMEN

BACKGROUND Acute pancreatitis (AP) is a symptom of sudden pancreas inflammation, which causes patients severe suffering. In general, fibroblast growth factor (FGF) levels are increased and amylase and lipase activities are elevated during AP pathogenesis, but protein concentration are low. However, the mechanism through which FGF signaling regulates AP pathogenesis remains elusive. MATERIAL AND METHODS The concentrations of PGE2, TNF-alpha, sCRP, FGF1, and FGF2 in the serum samples of the AP group and healthy control group were detected by enzyme-linked immunosorbent assay. In addition, IkappaBalpha and p-IkappaBalpha levels were analyzed in the serum samples. Subsequently, the AP rat model was established, and FGF1, FGF2, anti-FGF1, and anti-FGF2 antibodies and Bay11-7082 were injected into AP rats. TNF-alpha, PAI-1 JNK, p-JNK, IkappaBalpha, and p-IkappaBalpha levels were also examined. RESULTS Results showed that levels of PGE2, TNF-alpha, sCRP, p-IkappaBalpha, FGF1, and FGF2, as well as amylase and lipase activity were increased in patients with AP compared with those in healthy people. In addition, protein concentrations were lower in patients with AP than in the healthy group. Activation of FGF signaling by injecting FGF1 or FGF2 also inhibited AP-induced inflammation response in the pancreas and increased amylase and lipase activities, as well as protein concentration. However, the injection of FGF1 and FGF2 antibodies accelerated AP-mediated inflammation responses in the serum. In addition, Bay11-7082 injection inhibited AP activation of inflammation response and amylase and lipase activities. Protein concentration were also increased in AP rats. CONCLUSIONS FGF signaling protects against AP-mediated damage by inhibition of AP-activating inflammatory responses.


Asunto(s)
Factor 1 de Crecimiento de Fibroblastos/metabolismo , Factor 2 de Crecimiento de Fibroblastos/metabolismo , Inflamación/metabolismo , Pancreatitis/patología , Transducción de Señal , Enfermedad Aguda , Adulto , Amilasas/metabolismo , Animales , Proteína C-Reactiva/análisis , Estudios de Casos y Controles , Dinoprostona/sangre , Femenino , Factor 1 de Crecimiento de Fibroblastos/sangre , Factor 2 de Crecimiento de Fibroblastos/sangre , Humanos , Inflamación/patología , Lipasa/metabolismo , Masculino , Persona de Mediana Edad , Inhibidor NF-kappaB alfa/sangre , Nitrilos/farmacología , Ratas , Ratas Sprague-Dawley , Sulfonas/farmacología , Factor de Necrosis Tumoral alfa/sangre
15.
Med Mal Infect ; 50(4): 332-334, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32243911

RESUMEN

BACKGROUND: COVID-19 is a new infectious disease, for which there is currently no treatment. It is therefore necessary to explore biomarkers to determine the extent of lung lesions and disease severity. OBJECTIVE: We aimed to assess the usefulness of CRP levels in the early stage of COVID-19 and to correlate them with lung lesions and severe presentation. METHODS: Confirmed cases of COVID-19 were selected at the Fever Unit in two regions of Guizhou, China. On admission CRP levels were collected, and the diameter of the largest lung lesion was measured in the most severe lung lesion by lung CT scan. Differences in the diameter and CRP levels were compared in the following groups of patients: mild group, moderate group, severe group, and critical group. RESULT: CRP levels and the diameter of the largest lung lesion in the moderate group were higher than those in the mild group (Mann-Whitney test=-2.647, -2.171, P˂0.05), those in the severe group were higher than those in the moderate group (Mann-Whitney test=0.693, -2.177, P˂0.05), and those in the critical group were higher than those in the severe group (Mann-Whitney test=-0.068, -1.549, P˂0.05). The difference was statistically significant. CRP levels were positively correlated with the diameter of lung lesion and severe presentation (correlation coefficient=0.873, 0.734, P˂0.001). CONCLUSION: In the early stage of COVID-19 CRP levels were positively correlated with lung lesions and could reflect disease severity.


Asunto(s)
Proteína C-Reactiva/análisis , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/diagnóstico , Progresión de la Enfermedad , Enfermedades Pulmonares/sangre , Enfermedades Pulmonares/patología , Pulmón/patología , Neumonía Viral/sangre , Neumonía Viral/diagnóstico , Adolescente , Adulto , Biomarcadores/sangre , Niño , Preescolar , China/epidemiología , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/patología , Enfermedad Crítica , Femenino , Humanos , Lactante , Enfermedades Pulmonares/diagnóstico , Enfermedades Pulmonares/epidemiología , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/patología , Factores de Tiempo , Tomografía Computarizada por Rayos X , Adulto Joven
16.
BMC Infect Dis ; 20(1): 205, 2020 Mar 06.
Artículo en Inglés | MEDLINE | ID: mdl-32143599

RESUMEN

BACKGROUND: The occurrence of segmental/lobar pattern pneumonia (S/L-PP) in children has recently increased. The pathogens of the disease may change for the misuse of antibiotics and the application of vaccines. Therefore, pathogens positive in hospitalized children with S/L-PP and their association with clinical characteristics may have changed. The aim of this study was to analyze the pathogens positive in hospitalized children with S/L-PP and their association with clinical characteristics. METHOD: The current study analyzed the epidemiological and clinical characteristics of pathogens positive in children with S/L-PP under 14 years old at a single hospital between 1st Jan 2014 and 31st Dec 2018 retrospectively. The pathogens were detected by microbial cultivation, indirect immunofluorescence of the kit (PNEUMOSLIDE IgM), Elisa, and/or real-time PCR in the samples of the patients. RESULTS: A total of 593 children with S/L-PP received treatment at a single hospital during the study period by inclusion criteria. Four hundred fifty-one patients were single positive for one pathogen and 83 patients were positive for at least 2 pathogens. Mycoplasma pneumoniae (M.pneumoniae) (72.34%) was the most commonly detected pathogen, followed by Streptococcus pneumoniae (S.pneumoniae) (8.77%). The prevalence of M.pneumoniae in children with S/L-PP increased with time (p < 0.05). The positive rate of M.pneumoniae increased with ages of patients (p < 0.05). M.pneumoniae was statistically associated with the extrapulmonary manifestations while S.pneumoniae was statistically associated with abnormal white blood cells (WBCs) and C reactive proteins (CRPs) (p < 0.05). CONCLUSION: M.pneumoniae was the most positive pathogen in children with S/L-PP. The positive rate of M.pneumoniae in children with S/L-PP increased with time and the ages of children. M.pneumoniae was associated with extrapulmonary manifestations while S.pneumoniae was associated with abnormal WBCs and CRPs.


Asunto(s)
Mycoplasma pneumoniae/aislamiento & purificación , Neumonía por Mycoplasma/diagnóstico , Neumonía Neumocócica/diagnóstico , Streptococcus pneumoniae/aislamiento & purificación , Adolescente , Proteína C-Reactiva/análisis , Niño , Niño Hospitalizado , Preescolar , Femenino , Humanos , Lactante , Leucocitos/citología , Masculino , Neumonía por Mycoplasma/epidemiología , Neumonía Neumocócica/epidemiología , Prevalencia , Estudios Retrospectivos , Estaciones del Año
17.
BMC Infect Dis ; 20(1): 199, 2020 Mar 06.
Artículo en Inglés | MEDLINE | ID: mdl-32143636

RESUMEN

BACKGROUND: Campylobacter jejuni is a motile, gram-negative rod known for causing self-limiting enterocolitis while rarely causing extraintestinal infections. We report the first case of a patient with Campylobacter jejuni osteomyelitis in both femora. CASE PRESENTATION: A 54-year-old female presented with progressive pain in both upper extremities. Her past medical history mentioned a lymphoplasmacytic lymphoma (LPL) for which she had received dexamethasone, cyclophosphamide and fludarabine and was still receiving maintenance therapy with intravenous rituximab. Two months prior to presentation, she received oral fluoroquinolone for a recurrent enterocolitis with stool cultures positive for Campylobacter jejuni. Palpation of the left quadriceps femoris muscle was remarkably painful during physical examination. Laboratory testing showed elevated C-reactive protein and recent low gamma globulin levels. The presumptive diagnosis at this point was a transformation of LPL to a large B cell lymphoma. In order to determine the preferred site for biopsy, a fluorine-18 fluoro-2-deoxy-D-glucose positron emission tomography combined with computed tomography was done. However, blood cultures taken on admission showed growth of Campylobacter jejuni in both aerobic bottles, with a strain resistant to fluoroquinolones. Diagnosis of Campylobacter jejuni osteomyelitis was confirmed with 16S ribosomal RNA gene polymerase chain reaction performed on femoral bone obtained through biopsy. Treatment with intravenous imipenem/cilastatin followed by intravenous and oral doxycycline proved insufficient. Subsequently, the patient was treated successfully with intravenous meropenem for six weeks and concurrent intravenous immunoglobulin. CONCLUSION: We report the first case of Campylobacter jejuni osteomyelitis in both femora in a patient with acquired hypogammaglobulinemia. Diagnosis was confirmed by blood cultures and positive 16S ribosomal RNA gene polymerase chain reaction for Campylobacter spp. on bone biopsy. Treatment was successful with intravenous meropenem and immunoglobulin. Our report showcases an unusual manifestation in a patient with immunodeficiency and discusses failure of initial antibiotic therapy.


Asunto(s)
Infecciones por Campylobacter/diagnóstico , Inmunodeficiencia Variable Común/diagnóstico , Osteomielitis/diagnóstico , Antibacterianos/uso terapéutico , Proteína C-Reactiva/análisis , Infecciones por Campylobacter/complicaciones , Infecciones por Campylobacter/tratamiento farmacológico , Infecciones por Campylobacter/microbiología , Campylobacter jejuni/genética , Campylobacter jejuni/aislamiento & purificación , Inmunodeficiencia Variable Común/complicaciones , Doxiciclina/uso terapéutico , Femenino , Fémur/efectos de los fármacos , Humanos , Persona de Mediana Edad , Osteomielitis/complicaciones , Osteomielitis/tratamiento farmacológico , Osteomielitis/microbiología , Tomografía Computarizada por Tomografía de Emisión de Positrones , ARN Ribosómico 16S/genética , ARN Ribosómico 16S/metabolismo
18.
Medicine (Baltimore) ; 99(9): e19350, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32118773

RESUMEN

Survival estimates are very important to patients with terminal cancer. The C-reactive protein (CRP)/albumin ratio is associated with cancer outcomes. However, few studies have investigated the dose-response association in terminal cancer patients. Therefore, we aimed to evaluate the association between the CRP/albumin ratio and mortality in terminal cancer patients using a longitudinal analysis. We retrospectively investigated the electronic medical records of 435 inpatients with terminal cancer admitted to the palliative care unit of Yeouido St. Mary's Hospital between October 8, 2015, and January 17, 2018. In total, 382 patients with terminal cancer were enrolled in the study. The serum CRP/albumin ratio measured at admission had a linear dose-response relationship with the risk of death among the terminal cancer patients (P for linearity = .011). The multivariate analyses showed that the CRP/albumin ratio was an independent prognostic factor (Model 1, CRP/albumin ratio >48.53 × 10: HR = 2.68, 95% CI = 1.82-3.93; Model 2, tertile 2: HR = 1.91, 95% CI = 1.31-2.82 and tertile 3: HR = 3.66, 95% CI = 2.24-5.97). The relationship between a high CRP/albumin ratio and poor survival was a flat L-shape for survival time with an inflection point at approximately 15 days, while the relationship was not significant in terminal cancer patients who survived beyond 30 days. This study demonstrated that high CRP/albumin ratios are significantly and independently associated with the short-term survival prognosis of terminal cancer patients within 30 days.


Asunto(s)
Proteína C-Reactiva/clasificación , Neoplasias/complicaciones , Pronóstico , Albúmina Sérica Humana/clasificación , Adulto , Anciano , Proteína C-Reactiva/análisis , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/sangre , Cuidados Paliativos/métodos , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Albúmina Sérica Humana/análisis
19.
Medicine (Baltimore) ; 99(10): e19359, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32150077

RESUMEN

Monitoring anti-TNF agents in inflammatory bowel disease (IBD) patients may be helpful in optimizing outcomes. We aimed to evaluate potential correlations among demographic, clinical, laboratory, or imaging parameters, as well as serum levels of infliximab (IFX) and adalimumab (ADA) and their respective antibodies, in the clinical management of IBD patients.A cross-sectional study of 95 patients with Crohn's disease (CD) or ulcerative colitis (UC) in maintenance therapy with infliximab or adalimumab was performed. Drug trough levels and anti-drug levels were determined using ELISA-based assays.Regarding the serum IFX dosage, patients with higher relative C-reactive protein (CRP) levels had significantly lower relative serum IFX levels (<3 µg/mL) (P = .028). In contrast, higher concentrations of anti-IFX antibodies were found in patients who were not on concomitant immunomodulators (P = .022) and who had more biological-related adverse events (P = .001) and higher levels of CRP (P = .042). Serum CRP levels were also negatively correlated with IFX (CC = -0.315; P = .033) but positively correlated with the presence of IFX antibodies (CC = 0.327; P = .027). Serum albumin dosage showed a positive correlation with levels of both IFX (CC = 0.379; P = .004) and ADA (CC = 0.699; P = .003).Although anti-TNF-α trough levels and immunogenicity do not show a significant correlation with disease outcome, our results reinforce the use of combination therapy for patients treated with infliximab. Moreover, we confirmed the presence of significant associations between anti-TNF-α trough levels and immunogenicity with body mass index (BMI), the concomitant use of immunomodulators, the rates of side effects, and laboratory markers, including serum albumin and CRP.


Asunto(s)
Enfermedades Inflamatorias del Intestino/sangre , Factor de Necrosis Tumoral alfa/análisis , Adalimumab/análisis , Adalimumab/sangre , Adalimumab/uso terapéutico , Adulto , Biomarcadores/análisis , Biomarcadores/sangre , Índice de Masa Corporal , Proteína C-Reactiva/análisis , Estudios Transversales , Femenino , Humanos , Infliximab/análisis , Infliximab/sangre , Infliximab/uso terapéutico , Masculino , Persona de Mediana Edad , Factor de Necrosis Tumoral alfa/sangre
20.
Medicine (Baltimore) ; 99(10): e19362, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32150079

RESUMEN

BACKGROUND: In recent years, several studies have investigated the prognostic role of the pretreatment C-reactive protein/albumin ratio (CAR) in gastric cancer and yielded conflicting results. Therefore, we performed a meta-analysis to assess the prognostic role of the pretreatment CAR in gastric cancer. METHODS: Studies assessing the prognostic role of the pretreatment CAR in patients with gastric cancer were searched from PubMed, Embase, and Cochrane Library up to June 6, 2019. Pooled hazard ratios (HRs) for overall survival (OS), recurrence-free survival (RFS), and cancer-specific survival (CSS) were estimated using a fixed-effects model. RESULTS: Eight observational studies including 3102 patients were enrolled in this meta-analysis. The pooled result showed that patients with a high CAR had worse OS (pooled HR = 1.87; 95% confidence interval (CI) = 1.55-2.26; P < .001). Results from subgroup analyses indicated that patient country, adjuvant chemotherapy rate, and CAR cut-off value could not affected the property of the correlation (P < .001). However, the intensity of the correlation was affected by these factors. In addition, patients with a high CAR had significantly worse RFS (pooled HR = 2.11; 95% CI = 1.41-3.15; P < .001) and CSS (HR = 1.59; 95% CI = 1.08-2.35; P = .019). CONCLUSION: A high pretreatment CAR was significantly associated with poor survival for patients with gastric cancer. The prognostic significance of the pretreatment CAR in gastric cancer is need to be confirmed by clinical trials of large sample size.


Asunto(s)
Proteína C-Reactiva/análisis , Pronóstico , Albúmina Sérica/análisis , Neoplasias Gástricas/sangre , Humanos , Modelos de Riesgos Proporcionales , Curva ROC
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