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1.
Am J Dent ; 34(2): 97-100, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33940667

RESUMEN

PURPOSE: This pilot study assessed the periodontal status and biomarkers of systemic inflammation in acute coronary syndrome (ACS) patients. METHODS: 15 ACS patients on statin (anti-cholesterol) therapy, were recruited into the study an average of 9 months after discharge from university hospital. Blood and mouthrinse samples were collected for analysis of inflammatory biomarkers including high sensitivity C-reactive protein (hsCRP), IL-6, IL-1ß, TNF-α, and MMP-9. Full-mouth periodontal examination, including pocket depth (PD), clinical attachment levels (CAL), bleeding on probing (BOP), and tooth mobility, was performed. RESULTS: When their periodontal status was assessed by CAL, 100% of these statin-treated ACS patients exhibited moderate (66.7%) to severe (33.3%) periodontal disease, which appears to be higher than the rate described for the general adult population (i.e., 47% for periodontitis). In addition, (1) their blood hsCRP levels ranged from 0.94 to 12.6 mg/L with a mean of 3.41 mg/L, which is considered high risk for cardiovascular disease (CVD) in spite of their statin therapy, and (2) the data demonstrated a positive correlation between severe periodontitis and elevated blood hsCRP levels (P< 0.05), consistent with systemic inflammation. CLINICAL SIGNIFICANCE: This pilot study provides preliminary data for future large-scale studies to define the relationship between ACS and chronic periodontitis, the underlying mechanisms, and the potential therapeutic efficacy of appropriate periodontal management to reduce the risk for cardiovascular disease.


Asunto(s)
Síndrome Coronario Agudo , Periodontitis Crónica , Síndrome Coronario Agudo/tratamiento farmacológico , Adulto , Proteína C-Reactiva/análisis , Humanos , Índice Periodontal , Proyectos Piloto
2.
Medicine (Baltimore) ; 100(14): e25141, 2021 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-33832077

RESUMEN

ABSTRACT: The aim of this research is to observe the effect of insulin pump combined with Ulinastatin on the levels of procalcitonin (PCT), triglycerides (TG), pentraxin-3(PTX-3), and C-X3-C motif chemokine ligand 1 (CX3CL1) in patients with diabetic ketoacidosis and pancreatitis.A total of 72 patients with diabetic ketoacidosis and pancreatitis who were admitted to our hospital from February 2016 to February 2020 were selected as the research subjects. They were divided into study groups (36 cases, given insulin pump combined Ulinastatin treatment) and control group (36 cases, given insulin pump treatment). Statistics of changes in blood amylase (AMS), blood glucose, blood ketones, glycosylated hemoglobin (HbA1c), PCT, TG, PTX-3, and chemokine CX3CL in pancreatic tissue before and after treatment.After treatment, the clinical efficacy of the study group was significantly higher than that of the control group (94.44% vs 75.00%), the difference was significant (P < .05). After treatment, the clinical symptoms (abdominal distension, abdominal pain, body temperature, blood sugar, HbA1c and blood amylase) in the study group were significantly less time-to-normal than in the control group, and the difference was significant (P < .05). After treatment, the AMS, blood sugar, HbA1c, and blood ketones of the 2 groups were all lower than before treatment, and the study group's AMS, blood sugar, HbA1c, and blood ketones were all lower In the control group, the difference was significant (P < .05). After treatment, the 2 groups of PCT, TG, PTX-3, and CX3CL were all lower than before treatment, among which the study group PCT, TG, PTX-3, and CX3CL1 were lower than the control group, the difference was significant (P < .05). After treatment, the total adverse reaction rate of the 2 groups was not significantly different (P > .05), but the total adverse reaction rate of the study group was lower than that of the control group.The combination of insulin pump and ulinastatin in the treatment of patients with diabetic ketoacidosis complicated with acute pancreatitis has a effect, which can shorten the recovery time of clinical symptoms, reduce the levels of PCT, TG, PTX-3, and CX3CL1, and has fewer adverse reactions. It is worthy of clinical application.


Asunto(s)
Cetoacidosis Diabética/tratamiento farmacológico , Glicoproteínas/administración & dosificación , Insulinas/administración & dosificación , Pancreatitis/tratamiento farmacológico , Inhibidores de Tripsina/administración & dosificación , Adulto , Anciano , Proteína C-Reactiva/análisis , Proteína C-Reactiva/efectos de los fármacos , Estudios de Casos y Controles , Quimiocina CX3CL1/sangre , Quimiocina CX3CL1/efectos de los fármacos , Cetoacidosis Diabética/complicaciones , Quimioterapia Combinada , Femenino , Humanos , Sistemas de Infusión de Insulina , Masculino , Persona de Mediana Edad , Pancreatitis/complicaciones , Polipéptido alfa Relacionado con Calcitonina/sangre , Polipéptido alfa Relacionado con Calcitonina/efectos de los fármacos , Componente Amiloide P Sérico/análisis , Componente Amiloide P Sérico/efectos de los fármacos , Triglicéridos/sangre
3.
Medicine (Baltimore) ; 100(14): e25200, 2021 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-33832080

RESUMEN

ABSTRACT: Persistent disease activity is associated with a poor prognosis in patients with inflammatory bowel disease (IBD). This study aims to explore the accuracy of the highly sensitive C-reactive protein/albumin ratio (CAR) in determining IBD activity.The clinical data of 231 IBD patients treated at Peking Union Medical College Hospital from 2012 to 2018 were analyzed retrospectively. The patients were classified as having active disease or remission according to the Crohn disease activity index scores for patients with Crohn disease (CD) and partial Mayo scores for patients with ulcerative colitis (UC).This study included 231 IBD patients (137 CD and 94 UC). From these groups, 182 patients had active disease, while 49 patients were in remission. The platelet counts, erythrocyte sedimentation rates, high-sensitivity C-reactive protein levels, and CAR scores were significantly higher, while hemoglobin levels, ALB, and body mass indexes were significantly lower in patients with active disease (P < 0.01). The hsCRP, CAR, and ALB significantly correlated with disease activity for both CD and UC (P < 0.001). The area under the curve (AUC) of CAR was highest among the laboratory indexes at 0.829, and the AUC of CAR in the UC patients was larger than that of the CD patients. Also, CAR with cutoff value of 0.06 displayed the highest sensitivity among the indexes for IBD activity at 83.05%.CAR is a useful biomarker for identifying disease activity in patients with CD and UC. Higher CAR levels are indicative of increased IBD activity. CAR may be more valuable in UC than that in CD for assessing the degree of IBD activity.


Asunto(s)
Proteína C-Reactiva/análisis , Colitis Ulcerosa/sangre , Enfermedad de Crohn/sangre , Albúmina Sérica/análisis , Adulto , Biomarcadores/sangre , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Índice de Severidad de la Enfermedad
4.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(4): 492-498, 2021 Apr 06.
Artículo en Chino | MEDLINE | ID: mdl-33858061

RESUMEN

Objective: To explore the correlation of damage-associated molecular pattern molecules(DAMPs) serum S100, C-reactive protein (CRP), serum amyloid A (SAA) and uric acid (UA) with age and body mass index (BMI) to provide direction for further study of metabolic inflammation and inflammaging. Methods: The observational study method was used,and three hundred and sixty-six healthy people (131 males and 235 females) were selected from the physical examination center of the Second People's Hospital of Hunan Province from May to October 2020. They were divided into three age groups according to the age interval of 20 years, including 156 (53 males and 103 females) aged 20-40 years, 110 (36 males and 74 females) aged 41-60 years, and 100 (42 males and 58 females) aged 61-80 years. Kruskal Wallis H test was used to compare the differences of serum S100, CRP, SAA and UA levels among different age groups. According to the Health Industry Standards of the People's Republic of China-Weight Determination for Adults, the boundary is BMI =24 kg/m2. The healthy people were divided into non overweight (BMI<24 kg/m2) and overweight (BMI ≥ 24 kg/m2) two groups. The 1∶1 propensity score was used to match the age and gender. There were 96 non overweight subjects [43 males, 53 females, age 52 (35, 66) years], 96 overweight subjects [44 males, 52 females, age 52 (36, 64) years]. The serum levels of S100, CRP, SAA and UA in different BMI groups were compared by Mann-Whitney U test. Results: The median serum UA concentrations in males and females were 356 and 277 µmol/L, and the levels of serum UA of male was significantly higher than that of female (Z=-10.428, P<0.001); the median serum SAA concentrations in males and females were 3.1 mg/L and 4.4 mg/L, while the serum SAA level of female was significantly higher than that of male (Z=3.652, P<0.001); for 20-40, 41-60, and 61-80 years old group, the median concentration of serum S100 was 0.058, 0.057, 0.070 µg/L, and the median concentration of serum CRP was 0.32, 0.58, 0.93 mg/L; the median serum SAA concentrations were 3.2, 4.0, 5.2 mg/L; serum uric acid concentrations were (301.8±61.5), (298.6±69.8), (329.0±77.8) µmol/L. The levels of serum S100, CRP, SAA, UA in 61-80 years group were significantly higher than those of 20-40 years group (H=-2.749, H=-6.731, H=-5.033, H=-2.521, P=0.018, P<0.001, P<0.001, P=0.035) and 41-60 years old group (H=-2.719, H=-2.539, H=-2.540, H=-2.486, P=0.020, P=0.033, P=0.033, P=0.039).The levels of serum CRP of 41-60 years group was significantly higher than that of 20-40 years group (H=-4.108,P<0.001). There was no significant difference in levels of serum S100, SAA and UA between 20-40 years group and 41-60 years group (H=0.189, H=-2.360, H=-0.165, P=1.000, P=0.055, P=1.000); the levels of serum CRP and SAA were positively correlated with age (rs =0.342, rs =0.301, P<0.001, P<0.001); for overweight, non-overweight group, the median concentrations of serum S100 were 0.065 µg/L, 0.059 µg/L, the median concentrations of serum CRP were 0.92 mg/L, 0.47 mg/L, the median concentrations of serum SAA were 5.0 mg/L, 4.1 mg/L, the median concentrations of serum UA were 339.5 µmol/L, 301.5 µmol/L, the levels of CRP, SAA and UA in the overweight group were higher than those in the non-overweight group (Z=4.278, Z=2.025, Z=3.787, P<0.001, P=0.043, P<0.001); the levels of S100 in the overweight group was higher than those in the non-overweight group, but there was no significant difference in S100 between the two groups (Z=0.862, P=0.388); the levels of Serum CRP and UA were positively correlated with BMI (rs =0.348, rs =0.264, P<0.001, P=0.009). Conclusions: With the increase of age, the serum S100, CRP, SAA and UA levels of healthy people may be on the rise, especially the serum CRP and SAA levels are positively correlated with age; the serum S100, CRP, SAA and UA levels of overweight people may be higher than those of non-overweight people, especially the serum CRP, UA levels are positively correlated with BMI.


Asunto(s)
Alarminas , Ácido Úrico , Adulto , Anciano , Anciano de 80 o más Años , Índice de Masa Corporal , Proteína C-Reactiva/análisis , China , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
5.
Artículo en Inglés | MEDLINE | ID: mdl-33799436

RESUMEN

BACKGROUND: The aim of this study was to determine whether a causative relationship exists between the development of liver damage and increased high-sensitivity C-reactive protein (HsCRP) levels by long-term follow-up in Japanese workers. METHODS: The target participants comprised 7830 male workers in a Japanese steel company. The prospective cohort study was performed over a 6-year period, and annual health screening information was analyzed by pooled logistic regression. The endpoint, regarded as the development of liver damage, was defined as aspartate aminotransferase (AST) ≥ 40 IU/L. RESULTS: A significant relationship between the development of liver damage and increased HsCRP levels was observed after adjusting for confounding factors such as various physiological and blood chemistry parameters and lifestyle factors. The odds ratio of a 1.5-fold increase in HsCRP was 1.07 (95% confidence interval: 1.03-1.10, p < 0.001). CONCLUSIONS: The results suggested that an increase of HsCRP is associated with the development of liver damage.


Asunto(s)
Proteína C-Reactiva , Hígado , Proteína C-Reactiva/análisis , Humanos , Japón/epidemiología , Hígado/química , Masculino , Estudios Prospectivos , Factores de Riesgo
6.
Nan Fang Yi Ke Da Xue Xue Bao ; 41(3): 453-458, 2021 Mar 25.
Artículo en Chino | MEDLINE | ID: mdl-33849839

RESUMEN

OBJECTIVE: To assess the value of serum amyloid A (SAA), procalcitonin (PCT) and high-sensitivity C-reactive protein (hs-CRP) in the diagnosis of pulmonary tuberculosis (PTB) complicated by pneumonia. OBJECTIVE: We collected serum samples from patients with pneumonia, patients with PTB, patients with PTB complicated by pneumonia and patients with PTB complicated by sepsis hospitalized in our hospital between April, 2019 and April, 2020. Serum levels of SAA, PCT and hs-CRP were tested, and receiver- operating characteristic (ROC) curves were used to evaluate their efficacy for predicting PTB with concurrent pneumonia and the possibility of differentiating PTB cases with pneumonia from those with sepsis using these 3 parameters. We also tested serum levels of SAA, PCT and hs-CRP in patients with PTB and those with PTB complicated by pneumonia admitted from May to July in 2020 to verify the accuracy of these 3 parameters combined for predicting the complication of PTB by pneumonia. OBJECTIVE: Compared with the patients with PTB, the patients with pneumonia had significantly higher SAA and hs-CRP levels; serum SAA, PCT and hs-CRP levels were all significantly elevated in patients with PTB complicated by pneumonia (all P < 0.05). The levels of hs-CRP, white blood cell, D-dimer, FIB, APTT and neutrophil ratio were positively correlated with serum SAA level (all P < 0.05). The areas under the ROC curve (AUC) for serum SAA, PCT, and hs-CRP were 0.762, 0.781, and 0.800, respectively, and their combined AUC was 0.849 (all P < 0.001). For predicting PTB complicated by pneumonia, SAA combined with PCT had the same sensitivity (53.85%) and specificity (90.48%) as SAA, PCT and hs-CRP all combined. Serum SAA and PCT levels were similar between PTB patients with pneumonia and those with sepsis. OBJECTIVE: Combined detection of serum SAA and PCT levels can be helpful in the diagnosis of PTB complicated by pneumonia, but neither of them is capable of differentiating the complication of pneumonia from sepsis possibly due to influence by abnormal blood coagulation.


Asunto(s)
Neumonía , Sepsis , Tuberculosis Pulmonar , Biomarcadores , Proteína C-Reactiva/análisis , Humanos , Neumonía/complicaciones , Neumonía/diagnóstico , Polipéptido alfa Relacionado con Calcitonina , Curva ROC , Sepsis/complicaciones , Sepsis/diagnóstico , Proteína Amiloide A Sérica/análisis , Tuberculosis Pulmonar/complicaciones , Tuberculosis Pulmonar/diagnóstico
7.
Sci Rep ; 11(1): 8192, 2021 04 14.
Artículo en Inglés | MEDLINE | ID: mdl-33854118

RESUMEN

The study aimed to explore the influencing factors on critical coronavirus disease 2019 (COVID-19) patients' prognosis and to construct a nomogram model to predict the mortality risk. We retrospectively analyzed the demographic data and corresponding laboratory biomarkers of 102 critical COVID-19 patients with a residence time ≥ 24 h and divided patients into survival and death groups according to their prognosis. Multiple logistic regression analysis was performed to assess risk factors for critical COVID-19 patients and a nomogram was constructed based on the screened risk factors. Logistic regression analysis showed that advanced age, high peripheral white blood cell count (WBC), low lymphocyte count (L), low platelet count (PLT), and high-sensitivity C-reactive protein (hs-CRP) were associated with critical COVID-19 patients mortality risk (p < 0.05) and these were integrated into the nomogram model. Nomogram analysis showed that the total factor score ranged from 179 to 270 while the corresponding mortality risk ranged from 0.05 to 0.95. Findings from this study suggest advanced age, high WBC, high hs-CRP, low L, and low PLT are risk factors for death in critical COVID-19 patients. The Nomogram model is helpful for timely intervention to reduce mortality in critical COVID-19 patients.


Asunto(s)
/mortalidad , Factores de Edad , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Proteína C-Reactiva/análisis , /diagnóstico , Comorbilidad , Enfermedad Crítica/mortalidad , Femenino , Humanos , Modelos Logísticos , Recuento de Linfocitos , Masculino , Persona de Mediana Edad , Modelos Teóricos , Nomogramas , Recuento de Plaquetas , Estudios Retrospectivos , Factores de Riesgo
8.
BMC Infect Dis ; 21(1): 368, 2021 Apr 19.
Artículo en Inglés | MEDLINE | ID: mdl-33874899

RESUMEN

BACKGROUND: Kawasaki disease (KD) as an acute, systemic vasculitis is the leading cause of acquired heart disease in children under the age of 5 years. METHODS: A 10-year cross-sectional retrospective study was designed to assess 190 Iranian children with KD during 2008-2018. Demographic data, clinical and laboratory manifestations from the onset of symptoms to diagnosis, clinical signs and symptoms, and subsequent treatments were evaluated to predict hospitalization stay, complications, and response to treatment. RESULTS: Children with KD had a male-to-female ratio of 1.18:1 and an average age of 36 months. There was an insignificantly more incidence of KD in cold seasons. The most frequent symptoms were fever (92.6%), oral mucus membrane changes (75.8%), bilateral bulbar conjunctival injection (73.7%), polymorphous skin rash (73.2%), peripheral extremity changes (63.7%), and cervical lymphadenopathy (60.0%). The rate of gastrointestinal, cardiac, joint, and hepatic complications was determined to be 38.4, 27.9, 6.8, and 4.2%, respectively. 89.5% of patients received intravenous immunoglobulin (IVIG) plus aspirin as the first line of treatment, while, 16.3% of them needed an extra second line of treatment. Significantly low serum sodium levels and high platelet counts were detected in KD patients with cardiac complications. Cardiac complications often were more encountered in patients who did not respond to the first line of treatment. Higher platelet count, lower serum sodium amount, and C-reactive protein (CRP) level were significantly associated with a need for an additive second line of treatment. A significant relationship between hospitalization stay and hemoglobin level was found. CONCLUSION: As most of the clinical manifestations and complications were following other reports released over the past few years, such data can be confidently used to diagnose KD in Iran. Seasonal incidence and a positive history of recent infection in a notable number of patients may provide clues to understand possible etiologies of KD. Laboratory markers can successfully contribute to health practitioners with the clinical judgment of the need for additional treatments, possible complications, and hospitalization duration.


Asunto(s)
Enfermedades Gastrointestinales/complicaciones , Inmunoglobulinas Intravenosas/uso terapéutico , Síndrome Mucocutáneo Linfonodular/diagnóstico , Proteína C-Reactiva/análisis , Niño , Preescolar , Aneurisma Coronario/etiología , Estudios Transversales , Exantema/etiología , Femenino , Fiebre/etiología , Cardiopatías/complicaciones , Humanos , Incidencia , Lactante , Irán/epidemiología , Masculino , Síndrome Mucocutáneo Linfonodular/complicaciones , Síndrome Mucocutáneo Linfonodular/tratamiento farmacológico , Síndrome Mucocutáneo Linfonodular/epidemiología , Recuento de Plaquetas , Estudios Retrospectivos
9.
Lancet Haematol ; 8(5): e365-e375, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33894171

RESUMEN

This Review outlines a practical approach to assessing and managing polyclonal hypergammaglobulinaemia in adults. Polyclonal hypergammaglobulinaemia is most commonly caused by liver disease, immune dysregulation, or inflammation, but can also provide an important diagnostic clue of rare diseases such as histiocyte disorders, autoimmune lymphoproliferative syndrome, Castleman disease, and IgG4-related disease. Causes of polyclonal hypergammaglobulinaemia can be divided into eight categories: liver disease, autoimmune disease and vasculitis, infection and inflammation, non-haematological malignancy, haematological disorders, IgG4-related disease, immunodeficiency syndromes, and iatrogenic (from immunoglobulin therapy). Measuring serum concentrations of C-reactive protein and IgG subclasses are helpful in diagnosis. IL-6-mediated inflammation, associated with persistently elevated C-reactive protein concentrations (≥30 mg/L), is an important driver of polyclonal hypergammaglobulinaemia in some cases. Although the presence of markedly elevated serum IgG4 concentrations (>5 g/L) is around 90% specific for diagnosing IgG4-related disease, mildly elevated serum IgG4 concentrations are seen in many conditions. In most cases, managing polyclonal hypergammaglobulinaemia simply involves treating the underlying condition. Rarely, however, polyclonal hypergammaglobulinaemia can lead to hyperviscosity, requiring plasmapheresis.


Asunto(s)
Hipergammaglobulinemia/diagnóstico , Corticoesteroides/uso terapéutico , Proteínas Sanguíneas/análisis , Proteína C-Reactiva/análisis , Citocinas/metabolismo , Enfermedades Hematológicas/complicaciones , Enfermedades Hematológicas/patología , Humanos , Hipergammaglobulinemia/tratamiento farmacológico , Hipergammaglobulinemia/etiología , Inmunoglobulina G/sangre , Hepatopatías/complicaciones , Hepatopatías/patología
10.
Medicine (Baltimore) ; 100(14): e25287, 2021 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-33832097

RESUMEN

ABSTRACT: It is important for patients to maintain a good nutritional status as a health promotion strategy to improve the immune function and thus the prognosis of coronavirus disease 2019 (COVID-19).The objective of this retrospective study is to analyze the relationships of nutritional status with inflammation levels, protein reserves, baseline immune status, severity, length of hospital stay, and prognosis of COVID-19 patients.A total of 63 COVID-19 patients hospitalized in the People's Hospital and the Traditional Chinese Medicine Hospital of the Xinzhou District, Wuhan, China, from January 29, 2020 to March 17, 2020. Sixty-three patients were divided into 3 groups according to the guidelines, moderate (n = 22), severe (n = 14), and critical (n = 25), respectively. The differences in the total nutrition risk screening (NRS) score, inflammation level, protein reserve, baseline immune status, length of hospital stay, and prognosis were compared among patients with moderate, severe, and critical COVID-19.Patients with higher NRS scores tend to have more severe COVID-19, higher C-reactive protein and serum procalcitonin levels, higher white blood cell counts, lower lymphocyte counts, and higher mortality rates (P < .05).Nutritional status may be an indirect factor of the severity and prognosis of COVID-19.


Asunto(s)
/fisiopatología , Estado Nutricional/fisiología , Adulto , Anciano , Proteínas Sanguíneas , Sedimentación Sanguínea , Proteína C-Reactiva/análisis , Femenino , Globulinas/análisis , Humanos , Tiempo de Internación/estadística & datos numéricos , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Polipéptido alfa Relacionado con Calcitonina/sangre , Pronóstico , Proteínas , Estudios Retrospectivos , Albúmina Sérica/análisis , Índice de Severidad de la Enfermedad
11.
Sci Rep ; 11(1): 8080, 2021 04 13.
Artículo en Inglés | MEDLINE | ID: mdl-33850271

RESUMEN

The objective of the study was to identify distinct patterns in inflammatory immune responses of COVID-19 patients and to investigate their association with clinical course and outcome. Data from hospitalized COVID-19 patients were retrieved from electronic medical record. Supervised k-means clustering of serial C-reactive protein levels (CRP), absolute neutrophil counts (ANC), and absolute lymphocyte counts (ALC) was used to assign immune responses to one of three groups. Then, relationships between patterns of inflammatory responses and clinical course and outcome of COVID-19 were assessed in a discovery and validation cohort. Unbiased clustering analysis grouped 105 patients of a discovery cohort into three distinct clusters. Cluster 1 (hyper-inflammatory immune response) was characterized by high CRP levels, high ANC, and low ALC, whereas Cluster 3 (hypo-inflammatory immune response) was associated with low CRP levels and normal ANC and ALC. Cluster 2 showed an intermediate pattern. All patients in Cluster 1 required oxygen support whilst 61% patients in Cluster 2 and no patient in Cluster 3 required supplementary oxygen. Two (13.3%) patients in Cluster 1 died, whereas no patient in Clusters 2 and 3 died. The results were confirmed in an independent validation cohort of 116 patients. We identified three different patterns of inflammatory immune response to COVID-19. Hyper-inflammatory immune responses with elevated CRP, neutrophilia, and lymphopenia are associated with a severe disease and a worse outcome. Therefore, targeting the hyper-inflammatory response might improve the clinical outcome of COVID-19.


Asunto(s)
/patología , Inmunidad , Adulto , Anciano , Proteína C-Reactiva/análisis , /virología , Análisis por Conglomerados , Femenino , Humanos , Linfocitos/citología , Masculino , Persona de Mediana Edad , Neutrófilos/citología , Factores de Riesgo , /aislamiento & purificación
12.
Analyst ; 146(7): 2131-2137, 2021 Apr 07.
Artículo en Inglés | MEDLINE | ID: mdl-33861260

RESUMEN

As inflammation plays a role in the pathogenesis of acute coronary syndromes, C-reactive protein (CRP) can be used as a biomarker. To detect CRP precisely, the authors prepared a CRP electrochemical biosensor consisting of an eight Ag ion-intercalated multifunctional DNA four-way junction (MF-DNA-4WJ) and a porous rhodium nanoparticle (pRhNP) heterolayer on a micro-gap electrode. To increase conductivity, we used eight Ag+ ion-inserted DNA four-way junctions through a C-C mismatch. Each DNA 4WJ was designed to have the CRP aptamer sequence, an anchoring region (thiol group), and two of four C-C mismatch regions at the end of the fragments. After an annealing step, the MF-DNA-4WJ assembly configuration and selective binding of CRP were confirmed through native TBM-PAGE (Tris-borate-magnesium chloride-polyacrylamide gel electrophoresis). The Au micro-gap electrode was fabricated to load 5 µl of the sample, and this was performed during eight experiments on one chip to establish the accuracy of the data. Then, pRhNPs were immobilized on a Au micro-gap electrode using cysteamine. To confirm the electrochemical properties, cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS) were conducted. The durability of pRhNPs was confirmed through CV. To test the sensing performance of the prepared CRP biosensor, the limit of detection (LOD) and selectivity tests were conducted using EIS. The results indicated that charge transfer resistance (Rct) can be used efficiently to probe these interactions within the variable CRP concentration range, from 1 pM to 100 nM (0.23 ng L-1-23 µg L-1). The LOD of this sensor was 0.349 pM (0.08 ng L-1) (at S/N = 3). As a result of diluting the CRP to the same concentration range in a 20% human serum sample, the LOD was 3.55 fM (0.814 pg L-1) (at S/N = 3).


Asunto(s)
Técnicas Biosensibles/métodos , Proteína C-Reactiva/análisis , ADN/química , Oro/química , Rodio/química , Plata/química , ADN/genética , Técnicas Electroquímicas , Electrodos , Humanos , Nanopartículas del Metal , Sensibilidad y Especificidad
13.
BMC Infect Dis ; 21(1): 356, 2021 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-33863287

RESUMEN

BACKGROUND: COVID-19 pandemic has forced physicians to quickly determine the patient's condition and choose treatment strategies. This study aimed to build and validate a simple tool that can quickly predict the deterioration and survival of COVID-19 patients. METHODS: A total of 351 COVID-19 patients admitted to the Third People's Hospital of Yichang between 9 January to 25 March 2020 were retrospectively analyzed. Patients were randomly grouped into training (n = 246) or a validation (n = 105) dataset. Risk factors associated with deterioration were identified using univariate logistic regression and least absolute shrinkage and selection operator (LASSO) regression. The factors were then incorporated into the nomogram. Kaplan-Meier analysis was used to compare the survival of patients between the low- and high-risk groups divided by the cut-off point. RESULTS: The least absolute shrinkage and selection operator (LASSO) regression was used to construct the nomogram via four parameters (white blood cells, C-reactive protein, lymphocyte≥0.8 × 109/L, and lactate dehydrogenase ≥400 U/L). The nomogram showed good discriminative performance with the area under the receiver operating characteristic (AUROC) of 0.945 (95% confidence interval: 0.91-0.98), and good calibration (P = 0.539). Besides, the nomogram showed good discrimination performance and good calibration in the validation and total cohorts (AUROC = 0.979 and AUROC = 0.954, respectively). Decision curve analysis demonstrated that the model had clinical application value. Kaplan-Meier analysis illustrated that low-risk patients had a significantly higher 8-week survival rate than those in the high-risk group (100% vs 71.41% and P < 0.0001). CONCLUSION: A simple-to-use nomogram with excellent performance in predicting deterioration risk and survival of COVID-19 patients was developed and validated. However, it is necessary to verify this nomogram using a large-scale multicenter study.


Asunto(s)
/diagnóstico , Nomogramas , Adulto , Anciano , Proteína C-Reactiva/análisis , China , Femenino , Hospitalización , Humanos , L-Lactato Deshidrogenasa/sangre , Recuento de Leucocitos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Pandemias , Curva ROC , Estudios Retrospectivos , Factores de Riesgo , Tasa de Supervivencia
14.
Medicine (Baltimore) ; 100(16): e25542, 2021 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-33879701

RESUMEN

ABSTRACT: The disease progression of gouty arthritis (GA) is relatively clear, with the 4 stages of hyperuricemia (HUA), acute gouty arthritis (AGA), gouty arthritis during the intermittent period (GIP), and chronic gouty arthritis (CGA). This paper attempts to construct a clinical diagnostic model based on blood routine test data, in order to avoid the need for bursa fluid examination and other tedious steps, and at the same time to predict the development direction of GA.Serum samples from 579 subjects were collected within 3 years in this study and were divided into a training set (n = 379) and validation set (n = 200). After a series of multivariate statistical analyses, the serum biochemical profile was obtained, which could effectively distinguish different stages of GA. A clinical diagnosis model based on the biochemical index of the training set was established to maximize the probability of the stage as a diagnosis, and the serum biochemical data from 200 patients were used for validation.The total area under the curve (AUC) of the clinical diagnostic model was 0.9534, and the AUCs of the 5 models were 0.9814 (Control), 0.9288 (HUA), 0.9752 (AGA), 0.9056 (GIP), and 0.9759 (CGA). The kappa coefficient of the clinical diagnostic model was 0.80.This clinical diagnostic model could be applied clinically and in research to improve the accuracy of the identification of the different stages of GA. Meanwhile, the serum biochemical profile revealed by this study could be used to assist the clinical diagnosis and prediction of GA.


Asunto(s)
Artritis Gotosa/diagnóstico , Reglas de Decisión Clínica , Pruebas Hematológicas/estadística & datos numéricos , Adulto , Área Bajo la Curva , Artritis Gotosa/etiología , Biomarcadores/sangre , Sedimentación Sanguínea , Nitrógeno de la Urea Sanguínea , Proteína C-Reactiva/análisis , Estudios de Casos y Controles , Progresión de la Enfermedad , Femenino , Humanos , Hiperuricemia/sangre , Hiperuricemia/complicaciones , Análisis de los Mínimos Cuadrados , Recuento de Leucocitos , Lipoproteínas HDL/sangre , Masculino , Persona de Mediana Edad , Análisis Multivariante , Oportunidad Relativa , Valor Predictivo de las Pruebas , Análisis de Componente Principal , Pronóstico , Análisis de Regresión , Reproducibilidad de los Resultados , Ácido Úrico/sangre
15.
Medicine (Baltimore) ; 100(16): e25547, 2021 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-33879703

RESUMEN

ABSTRACT: This study aimed to estimate the value of serum procalcitonin (PCT) for non-invasive positive pressure ventilation (NIPPV) prediction in the patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).A total of 220 AECOPD patients were divided into NIPPV group (n = 121) and control group (routine treatment, n = 99) based on the routine standards and physicians' experience. Logistic regression analysis was performed to identify the independent factors for NIPPV treatment. Additionally, the predictive values of the factors were measured through receiver operation characteristic (ROC) curve.NIPPV group and control group showed significant differences in respiratory rate (RR), PaO2, PaCO2, pH, oxygenation index, erythrocyte sedimentation rate (ESR), neutrophil, CRP (C-reaction protein), and PCT (P < .05 for all). PCT, CRP, PaCO2, RR, and neutrophil were independently correlated with NIPPV treatment in AECOPD. ROC curve showed that PCT had superior predictive value, with AUC of 0.899, the sensitivity of 86%, and the specificity of 91.9%. The cut-off value of serum PCT for NIPPV prediction was 88.50 ng/l.AECOPD patients who require NIPPV treatment frequently have high levels of PCT, CRP, PaCO2, RR and neutrophil. Serum PCT may be employed as an indicator for NIPPV treatment in AECOPD patients.


Asunto(s)
Reglas de Decisión Clínica , Ventilación no Invasiva/estadística & datos numéricos , Respiración con Presión Positiva/estadística & datos numéricos , Polipéptido alfa Relacionado con Calcitonina/sangre , Enfermedad Pulmonar Obstructiva Crónica/sangre , Enfermedad Aguda , Anciano , Análisis de los Gases de la Sangre , Sedimentación Sanguínea , Proteína C-Reactiva/análisis , Femenino , Humanos , Recuento de Leucocitos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Neutrófilos/metabolismo , Valor Predictivo de las Pruebas , Enfermedad Pulmonar Obstructiva Crónica/terapia , Curva ROC , Valores de Referencia , Frecuencia Respiratoria , Brote de los Síntomas
16.
BMC Infect Dis ; 21(1): 312, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33794783

RESUMEN

BACKGROUND: Staphylococcus aureus (S. aureus) bacteraemia is increasingly acquired from community settings and is associated with a mortality rate of up to 40% following complications. Identifying risk factors for complicated S. aureus bacteraemia would aid clinicians in targeting patients that benefit from expedited investigations and escalated care. METHODS: In this prospective observational cohort study, we aimed to identify risk factors associated with a complicated infection in community-onset S. aureus bacteraemia. Potential risk factors were collected from electronic medical records and included: - patient demographics, symptomology, portal of entry, and laboratory results. RESULTS: We identified several potential risk factors using univariate analysis. In a multiple logistic regression model, age, haemodialysis, and entry point from a diabetic foot ulcer were all significantly protective against complications. Conversely, an unknown entry point of infection, an entry point from an indwelling medical device, and a C-reactive protein concentration of over 161 mg/L on the day of admission were all significantly associated with complications. CONCLUSIONS: We conclude that several factors are associated with complications including already conducted laboratory investigations and portal of entry of infection. These factors could aid the triage of at-risk patients for complications of S. aureus bacteraemia.


Asunto(s)
Bacteriemia/diagnóstico , Proteína C-Reactiva/análisis , Staphylococcus aureus/aislamiento & purificación , Adulto , Anciano , Bacteriemia/complicaciones , Bacteriemia/microbiología , Estudios de Cohortes , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Neumonía/complicaciones , Neumonía/diagnóstico , Estudios Prospectivos , Factores de Riesgo , Enfermedades de la Piel/complicaciones , Enfermedades de la Piel/diagnóstico
17.
Reumatismo ; 73(1): 59-63, 2021 Apr 19.
Artículo en Inglés | MEDLINE | ID: mdl-33874649

RESUMEN

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can show musculoskeletal symptoms such as peripheral arthritis. In rare cases, peripheral arthritis can develop after the resolution of SARS-CoV-2. We present two cases of spondyloarthritis induced by SARS-CoV-2; one case with axial and peripheral spondyloarthritis and the other with peripheral spondyloarthritis. Both cases refer to Lebanese patients who were HLA-B27 positive. These two cases highlight the possible predisposition of HLA-B27 positive patients to the development of spondyloarthritis symptoms triggered by SARS-CoV-2.


Asunto(s)
Artritis/diagnóstico , Espondiloartritis/etiología , Articulación de la Muñeca , Adulto , Artritis/diagnóstico por imagen , Artritis/etiología , Proteína C-Reactiva/análisis , /diagnóstico , Predisposición Genética a la Enfermedad , Antígeno HLA-B27/sangre , Humanos , Masculino , Persona de Mediana Edad , Articulación Sacroiliaca/diagnóstico por imagen , Articulación Sacroiliaca/patología , Espondiloartritis/sangre
18.
Recenti Prog Med ; 112(3): 216-218, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33687360

RESUMEN

We analysed RRI and other hemodynamic, re-spiratory and inflammation parameters in critically ill pa-tients affected by severe covid-19 with acute distress respi-ratory syndrome (ARDS) aiming at verifying their modifica-tions during supine and prone positioning and any mutual correlation or interplay with RRI.


Asunto(s)
Velocidad del Flujo Sanguíneo , Inflamación/fisiopatología , Riñón/fisiopatología , Pulmón/fisiopatología , Arteria Renal/fisiopatología , Circulación Renal , /fisiopatología , Biomarcadores , Proteína C-Reactiva/análisis , /complicaciones , Creatinina/sangre , Diástole , Diagnóstico Precoz , Femenino , Humanos , Inflamación/sangre , Inflamación/diagnóstico , Pruebas de Función Renal , Masculino , Persona de Mediana Edad , Oxígeno/sangre , Posición Prona , /etiología , Posición Supina , Sístole
19.
Ann Clin Microbiol Antimicrob ; 20(1): 17, 2021 Mar 16.
Artículo en Inglés | MEDLINE | ID: mdl-33726761

RESUMEN

BACKGROUND: Abnormal laboratory findings are common in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The aim of this systematic review was to investigate the effect of the level of some laboratory factors (C-reactive protein (CRP), creatinine, leukocyte count, hemoglobin, and platelet count) on the severity and outcome of coronavirus disease 2019 (COVID-19). METHODS: We searched PubMed, Web of Science, Scopus, and Google Scholar. We collected the articles published before May 26, 2020. We gathered the laboratory factors in groups of patients with COVID-19, and studied the relation between level of these factors with severity and outcome of the disease. RESULTS: Mean CRP level, creatinine, hemoglobin, and the leukocytes count in the critically ill patients were significantly higher than those of the other groups (non-critical patients); mean CRP = 54.81 mg/l, mean creatinine = 86.82 µmol/l, mean hemoglobin = 144.05 g/l, and mean leukocyte count = 7.41 × 109. The lymphocyte count was higher in patients with mild/moderate disease (mean: 1.32 × 109) and in the invasive ventilation group (mean value of 0.72 × 109), but it was considerably lower than those of the other two groups. The results showed that the platelet count was higher in critically ill patients (mean value of 205.96 × 109). However, the amount was lower in the invasive ventilation group compared with the other groups (mean level = 185.67 × 109). CONCLUSION: With increasing disease severity, the leukocyte count and the level of CRP increase significantly and the lymphocyte count decreases. There seems to be a significant relation between platelet level, hemoglobin, and creatinine level with severity of the disease. However, more studies are required to confirm this.


Asunto(s)
/sangre , Índice de Severidad de la Enfermedad , Proteína C-Reactiva/análisis , Creatinina/sangre , Hemoglobinas/análisis , Humanos , Laboratorios , Recuento de Leucocitos , Recuento de Plaquetas
20.
Sci Rep ; 11(1): 5975, 2021 03 16.
Artículo en Inglés | MEDLINE | ID: mdl-33727641

RESUMEN

Since the emergence of SARS-CoV-2, numerous studies have been attempting to determine biomarkers, which could rapidly and efficiently predict COVID-19 severity, however there is lack of consensus on a specific one. This retrospective cohort study is a comprehensive analysis of the initial symptoms, comorbidities and laboratory evaluation of patients, diagnosed with COVID-19 in Huoshenshan Hospital, Wuhan, from 4th February to 12th March, 2020. Based on the data collected from 63 severely ill patients from the onset of symptoms till the full recovery or demise, we found not only age (average 70) but also blood indicators as significant risk factors associated with multiple organ failure. The blood indices of all patients showed hepatic, renal, cardiac and hematopoietic dysfunction with imbalanced coagulatory biomarkers. We noticed that the levels of LDH (85%, P < .001), HBDH (76%, P < .001) and CRP (65%, P < .001) were significantly elevated in deceased patients, indicating hepatic impairment. Similarly, increased CK (15%, P = .002), Cre (37%, P = 0.102) and CysC (74%, P = 0.384) indicated renal damage. Cardiac injury was obvious from the significantly elevated level of Myoglobin (52%, P < .01), Troponin-I (65%, P = 0.273) and BNP (50%, P = .787). SARS-CoV-2 disturbs the hemolymphatic system as WBC# (73%, P = .002) and NEUT# (78%, P < .001) were significantly elevated in deceased patients. Likewise, the level of D-dimer (80%, P < .171), PT (87%, P = .031) and TT (57%, P = .053) was elevated, indicating coagulatory imbalances. We identified myoglobin and CRP as specific risk factors related to mortality and highly correlated to organ failure in COVID-19 disease.


Asunto(s)
Proteína C-Reactiva/análisis , Mioglobina/análisis , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , /mortalidad , Comorbilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Insuficiencia Multiorgánica/etiología , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Análisis de Supervivencia , Tórax/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Troponina I/sangre
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