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1.
Medicine (Baltimore) ; 99(9): e19350, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32118773

RESUMO

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.


Assuntos
Proteína C-Reativa/classificação , Neoplasias/complicações , Prognóstico , Albumina Sérica Humana/classificação , Adulto , Idoso , Proteína C-Reativa/análise , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/sangue , Cuidados Paliativos/métodos , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Albumina Sérica Humana/análise
2.
Zhonghua Fu Chan Ke Za Zhi ; 55(1): 29-35, 2020 Jan 25.
Artigo em Chinês | MEDLINE | ID: mdl-32074770

RESUMO

Objective: To observe the dynamic changes of human serum albumin (HSA) level during pregnancy and study the early warning significance of HSA level on the onset of preeclampsia (PE) . Methods: Totally 369 PE pregnant women (PE group) and 309 normal pregnant women (control group) without PE who admitted in Haidian Maternal and Child Health Hospital from January 2013 to December 2017 were selected. HSA levels were tested before meeting the criterion of PE in the first trimester, the early-third trimester and the late-third trimester, the difference between the two groups were compared. The relationship between the HSA level and the incidence of complications in PE patients was analyzed. Results: (1)The mean values of HSA level in PE group and control group were (41.9±3.1) versus (40.0±2.2) g/L, (34.2±2.7) versus (35.4±2.7) g/L and (33.7±2.9) versus (36.7±3.3) g/L in the first trimester,the early-third trimester and the late-third trimester respectively,the difference in the first trimester was no significance (P>0.05), while the differences in the early-third trimester and the late-third trimester were both significant (all P<0.05). (2) The HSA level during pregnancy of PE group showed a continuous downward trend, while the control group was V-shaped trend. The receiver operating characteristic (ROC) curve analysis showed that PE could be early warned by the decrease of HSA level in PE group [area under curve (AUC)=0.742, cut-off value=5.97 g/L, sensitivity 70.8%, specificity 62.8%], the same result was in severe PE (AUC=0.756, cut-off value=6.85 g/L, sensitivity 70.8%, specificity 72.0%). The level of HSA was negatively correlated with the incidence of complications (r=-0.19, P<0.01). Conclusions: Excessive decrease of HSA level is an early warning factor for PE onset. The higher the baseline of HSA level and the greater the extent of pregnancy decline, the risk of PE in pregnant women is higher. The lower of HSA level in PE, the incidence of complications is higher. The excessive decrease of HSA level may be the first clinical manifestation before the onset of clinical symptoms of PE, so it may be the warning factor and one of the laboratory indicators in the PE sub-clinical stage.


Assuntos
Pré-Eclâmpsia/diagnóstico , Albumina Sérica Humana/análise , Biomarcadores/sangue , Estudos de Casos e Controles , Feminino , Humanos , Pré-Eclâmpsia/sangue , Gravidez , Primeiro Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Curva ROC
3.
J Surg Res ; 246: 292-299, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31630013

RESUMO

BACKGROUND: Laparoscopic proximal gastrectomy (LPG) with double-tract reconstruction (DTR) is performed as a function-preserving surgery for patients with adenocarcinoma of esophagogastric junction. However, whether LPG with DTR has postoperative advantages over laparoscopic total gastrectomy (LTG) is debatable. To evaluate benefits of LPG with DTR, we compared short-term surgical outcomes between LPG with DTR and LTG for adenocarcinoma of esophagogastric junction (AEG). METHODS: Twelve patients who underwent LPG with DTR for AEG between February 2016 and August 2017 were included. Twenty-four patients who underwent LTG in the same period were matched to LPG with DTR cases for demographics, comorbidities, tumor characteristics, and tumor node metastasis stage. Short-term surgical outcomes were compared between the two groups. RESULTS: Demographics of the LPG with DTR group and LTG group were comparable. The number of harvested lymph nodes in the LPG with DTR group was less than that in the LTG group, and the amount of estimated blood loss, the operative time, the days of gas-passing, start of diet, postoperative hospital stay were not significantly different between the groups. Furthermore, the postoperative reflux symptom in the LPG with DTR group was not significantly different with that in the LTG group. However, the increasing percentages of the serum albumin, total protein, and hemoglobin levels in the LPG with DTR group were significantly higher than those in the LTG group. CONCLUSIONS: This study reveals that LPG with DTR may be a valuable procedure for the treatment of AEG because it has the advantages over LTG in terms of postoperative serum albumin, total protein, and hemoglobin.


Assuntos
Adenocarcinoma/cirurgia , Gastrectomia/efeitos adversos , Laparoscopia/efeitos adversos , Complicações Pós-Operatórias/sangue , Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos , Neoplasias Gástricas/cirurgia , Adenocarcinoma/patologia , Junção Esofagogástrica/patologia , Junção Esofagogástrica/cirurgia , Feminino , Gastrectomia/métodos , Hemoglobinas/análise , Humanos , Laparoscopia/métodos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Estudos Retrospectivos , Albumina Sérica Humana/análise , Neoplasias Gástricas/patologia , Fatores de Tempo , Resultado do Tratamento
5.
Dis Colon Rectum ; 62(12): 1485-1493, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31567920

RESUMO

BACKGROUND: Systemic inflammation may influence the response to systemic chemotherapy or the prognosis in patients with various cancers. The Naples prognostic score, based on inflammatory and nutritional statuses, is a useful prognostic marker in patients undergoing surgery for colorectal cancer; however, its significance in patients with metastatic colorectal cancer remains unclear. OBJECTIVE: We aimed to evaluate the prognostic significance of the Naples prognostic factor in patients with metastatic colorectal cancer receiving first-line chemotherapy and to compare its prognostic accuracy with the neutrophil:lymphocyte ratio, platelet:lymphocyte ratio, and the systemic immune-inflammatory index. DESIGN: This was a retrospective study of prospectively collected data. SETTINGS: This study was conducted at a university hospital. PATIENTS: A total of 259 patients received first-line systemic chemotherapy for metastatic colorectal cancer. MAIN OUTCOME MEASURES: The Naples prognostic score was calculated by a composite score of albumin and cholesterol concentrations, lymphocyte:monocyte ratio, and neutrophil:lymphocyte ratio. The patients were divided into 3 groups based on increasing Naples scores (groups 0-2), and the associations of the Naples prognostic score with clinicopathologic features and overall survival were evaluated. RESULTS: Higher Naples prognostic score was positively associated with right-sided primary tumors and synchronous metastases and negatively with primary tumor resection. Patients in group 2 (high Naples prognostic score) had significantly shorter overall survival than those in groups 0 and 1 (p = 0.012 and 0.022). Multivariate Cox regression analysis identified the Naples prognostic score as an independent prognostic factor for overall survival (HR = 1.574; p = 0.004). Time-dependent receiver operating characteristic curve analysis showed that Naples prognostic score was more sensitive than other prognostic factors for predicting overall survival. LIMITATIONS: The main limitations are the sample size, single institutional feature, and treatment heterogeneity. CONCLUSIONS: The Naples prognostic score may be a useful prognostic marker in patients with metastatic colorectal cancer receiving systemic chemotherapy. See Video Abstract at http://links.lww.com/DCR/B72. LA PUNTUACIÓN PRONÓSTICA DE NÁPOLES ES UN MARCADOR PRONÓSTICO ÚTIL EN PACIENTES CON CÁNCER COLORRECTAL METASTÁSICO: La inflamación sistémica puede influir en la respuesta a la quimioterapia sistémica o el pronóstico en pacientes con varios tipos de cáncer. La puntuación pronóstica de Nápoles, basada en estados inflamatorios y nutricionales, es un marcador pronóstico útil en pacientes sometidos a cirugía por cáncer colorrectal; sin embargo, su importancia en pacientes con cáncer colorrectal metastásico sigue siendo incierta.El objetivo fue evaluar la importancia pronóstica del factor pronóstico de Nápoles en pacientes con cáncer colorrectal metastásico que reciben quimioterapia de primera línea y comparar su precisión pronóstica con la relación neutrófilos: linfocitos, plaquetas: linfocitos y el índice sistémico inmune-inflamatorio.Este estudio se realizó en un hospital universitario.Este fue un estudio retrospectivo de datos recolectados prospectivamente.Un total de 259 pacientes recibieron quimioterapia sistémica de primera línea para el cáncer colorrectal metastásico.La puntuación pronóstica de Nápoles se calculó mediante una puntuación compuesta de concentraciones de albúmina y colesterol, proporción de linfocitos: monocitos y proporción de neutrófilos: linfocitos. Los pacientes se dividieron en tres grupos basados en el aumento de las puntuaciones de Nápoles (grupos 0-2, respectivamente) y se evaluaron las asociaciones de la puntuación pronóstica de Nápoles con las características clínico-patológicas y la supervivencia general.La puntuación pronóstica de Nápoles es más alta se asoció positivamente con los tumores primarios del lado derecho y metástasis sincrónicas, y negativamente con la resección del tumor primario. Los pacientes del grupo 2 (alto puntaje pronóstico de Nápoles) tuvieron una supervivencia general significativamente menor que los de los grupos 0 y 1 (p = 0.012 y 0.022, respectivamente). El análisis de regresión de Cox multivariado identificó la puntuación pronóstica de Nápoles como un factor pronóstico independiente para la supervivencia global (índice de riesgo = 1.574; p = 0.004). El análisis de la curva característica de funcionamiento del receptor dependiente del tiempo mostró que la puntuación pronóstica de Nápoles era más sensible que otros factores pronósticos para predecir la supervivencia global.Las principales limitaciones son el tamaño de la muestra, la característica institucional única y la heterogeneidad del tratamiento.La puntuación pronóstica de Nápoles puede ser un marcador pronóstico útil en pacientes con cáncer colorrectal metastásico que reciben quimioterapia sistémica. Vea el Abstract del video en http://links.lww.com/DCR/B72.


Assuntos
Biomarcadores Tumorais/imunologia , Neoplasias Colorretais/tratamento farmacológico , Estado Nutricional , Adulto , Idoso , Idoso de 80 Anos ou mais , Colesterol/sangue , Neoplasias Colorretais/sangue , Tratamento Farmacológico , Feminino , Humanos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Contagem de Plaquetas , Prognóstico , Curva ROC , Estudos Retrospectivos , Tamanho da Amostra , Albumina Sérica Humana/análise , Resultado do Tratamento
6.
BMC Cancer ; 19(1): 931, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533682

RESUMO

BACKGROUND: A high prevalence of postoperative complications is closely associated with a worse short- and long-term outcome. This current study aimed to investigate potential risk factors including albumin-to-fibrinogen ratio (AFR) for severe postoperative complications (SPCs) in surgical gastric cancer (GC) patients. METHODS: Elderly patients (≥65 years) with primary GC who underwent elective radical laparoscopic gastrectomy under general anesthesia were included. According to the Clavien-Dindo classification system, the severity of complications was assessed from Grade I to V and SPCs were defined as C-D Grade ≥ IIIa. The clinicopathological features, operative-associated characteristics, postoperative recovery and laboratory tests were compared between patients with or without SPCs. Receiver operating characteristic (ROC) curve analysis using Youden's Index was established for determining the predictive value and cut-off threshold of AFR for SPCs. Binary univariate and multivariate logistic regression models were used to assess factors influencing SPCs. RESULTS: A total of 365 elderly GC patients were finally included in the analysis, of which 52 (52/365, 14.2%) patients had developed SPCs within postoperative 30 days. Preoperative AFR level predicted SPCs in surgical GC patients with an AUC of 0.841, a sensitivity of 76.36% and a specificity of 80.77%, respectively (P < 0.001). The multivariate analysis revealed that a lower AFR level (OR: 1.94, 95% CI: 1.09-3.36, P = 0.017) and an older age (OR: 1.81, 95% CI: 1.06-3.04, P = 0.023) were two independent predictive factors for SPCs in surgical GC patients. CONCLUSIONS: Preoperative AFR level is a useful predictor for SPCs in elderly GC subjects after radical laparoscopic gastrectomy.


Assuntos
Fibrinogênio/análise , Gastrectomia , Complicações Pós-Operatórias , Albumina Sérica Humana/análise , Neoplasias Gástricas/cirurgia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Laparoscopia , Masculino , Estudos Retrospectivos , Neoplasias Gástricas/complicações , Neoplasias Gástricas/metabolismo , Neoplasias Gástricas/patologia
7.
Sensors (Basel) ; 19(18)2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31527396

RESUMO

The presence of small amounts of human serum albumin (HSA) in urine or microalbuminuria (30-300 µg/mL) is a valuable clinical biomarker for the early detection of chronic kidney disease (CKD). Herein, we report on the development of an inexpensive and disposable immunosensor for the sensitive, specific, and label-free detection of HSA using electrochemical impedance spectroscopy (EIS). We have utilized a simple one-step screen-printing protocol to fabricate the carbon-based three-electrode system on flexible plastic substrates. To enable efficient antibody immobilization and improved sensitivity, the carbon working electrode was sequentially modified with electropolymerized polyaniline (PANI) and electrodeposited gold nanocrystals (AuNCs). The PANI matrix serves as an interconnected nanostructured scaffold for homogeneous distribution of AuNCs and the resulting PANI/AuNCs nanocomposite synergically improved the immunosensor response. The PANI/AuNCs-modified working electrode surface was characterized using scanning electron microscopy (SEM) and the electrochemical response at each step was analyzed using EIS in a ferri/ferrocyanide redox probe solution. The normalized impedance variation during immunosensing increased linearly with HSA concentration in the range of 3-300 µg/mL and a highly repeatable response was observed for each concentration. Furthermore, the immunosensor displayed high specificity when tested using spiked sample solutions containing different concentrations of actin protein and J82 cell lysate (a complex fluid containing a multitude of interfering proteins). Consequently, these experimental results confirm the feasibility of the proposed immunosensor for early diagnosis and prognosis of CKD at the point of care.


Assuntos
Compostos de Anilina/química , Técnicas Biossensoriais/métodos , Ouro/química , Nanocompostos/química , Insuficiência Renal Crônica/diagnóstico , Carbono/química , Linhagem Celular Tumoral , Espectroscopia Dielétrica , Eletrodos , Humanos , Nanopartículas Metálicas/química , Albumina Sérica Humana/análise , Propriedades de Superfície
8.
Acta Diabetol ; 56(12): 1323-1331, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31494747

RESUMO

AIMS: Nephropathic patients show higher levels of advanced glycation end products (AGEs) and oxidized human serum albumin (HSAox) compared to healthy subjects. These two classes of compounds are formed as the result of oxidative insults; for this reason, they can be useful oxidative stress biomarkers. The present study examines the variation of AGEs and HSAox in hemodialysis (HD) patients before and after dialysis session, evaluating the impact of different dialytic techniques and filters on their removal. METHODS: A total of 50 healthy subjects (control group) and 130 HD patients were enrolled in the study. Hemodialysis patients were subdivided based on dialytic techniques: 109 in diffusive technique and 22 in convective technique. We monitored HSAox, AGEs and other laboratory parameters at early morning in healthy subjects and in HD patients before and after the dialysis procedures. RESULTS: The level of HSAox decreases after a single dialytic session (from 58.5 ± 8.8% to 41.5 ± 11.1%), but the concentration of total AGEs increases regardless of adopted dialytic techniques (from 6.8 ± 5.2 µg/ml to 9.2 ± 4.4 µg/ml). In our study, levels of HSAox and total AGEs are similar in diabetic and non-diabetic HD patients. The increase in total AGEs after dialysis was only observed using polysulfone filters but was absent with polymethacrylate filters. CONCLUSIONS: HSAox is a simple and immediate method to verify the beneficial effect of a single dialysis session on the redox imbalance, always present in HD patients. Total AGEs assayed by ELISA procedure seem to be a less reliable biomarker in this population.


Assuntos
Biomarcadores , Produtos Finais de Glicação Avançada/sangue , Diálise Renal , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/terapia , Albumina Sérica Humana/metabolismo , Biomarcadores/análise , Biomarcadores/sangue , Estudos de Casos e Controles , Nefropatias Diabéticas/sangue , Nefropatias Diabéticas/diagnóstico , Nefropatias Diabéticas/epidemiologia , Nefropatias Diabéticas/terapia , Feminino , Produtos Finais de Glicação Avançada/análise , Humanos , Masculino , Pessoa de Meia-Idade , Oxirredução , Estresse Oxidativo/fisiologia , Polímeros/química , Ácidos Polimetacrílicos/química , Prognóstico , Diálise Renal/métodos , Diálise Renal/estatística & dados numéricos , Insuficiência Renal Crônica/sangue , Insuficiência Renal Crônica/epidemiologia , Albumina Sérica Humana/análise , Sulfonas/química , Resultado do Tratamento
9.
Zhonghua Zhong Liu Za Zhi ; 41(8): 599-603, 2019 Aug 23.
Artigo em Chinês | MEDLINE | ID: mdl-31434451

RESUMO

Objective: To investigate the relationship between systemic inflammatory markers such as neutrophil/lymphocyte ratio (NLR) and C-reactive protein/albumin ratio (CAR), and lymph node metastasis in patients with cN0 gastric cancer. To establish a nomogram model to predict the risk of lymph node metastasis in patients with cN0 gastric cancer. Methods: The preoperative systemic inflammatory markers and clinical data of 134 patients with cN0 gastric cancer were retrospectively analyzed, and these markers of patients with negative (pN0) or positive (pN+ ) lymph node metastasis in postoperative pathological diagnosis were compared. The receiver operating characteristic (ROC) curve was used to evaluate the predictive effect of preoperative systemic inflammatory markers on lymph node metastasis. The influencing factors for lymph node metastasis were assessed by univariate analysis and multivariate logistic regression analysis. A nomogram subsequently established by R software was validated by Bootstrap resampling as internal validation. Results: Compared with pN0 group, NE (P=0.022), CRP (P<0.001), NLR (P<0.001), PLR (P=0.003) and CAR (P<0.001) were higher, LY (P=0.003) and Alb (P=0.042) were lower in pN+ group. ROC curve analysis showed that the area under the curve (AUC) of postoperative pathological lymph node metastasis in patients with cN0 gastric cancer diagnosed by NLR, PLR and CAR were 0.687, 0.651 and 0.694, respectively, and the best cutoff values were 2.12, 113.59 and 0.02, respectively. The corresponding sensitivity and specificity were 62.9% and 72.2%, 77.4% and 48.6%, 74.2% and 58.3%, respectively. Univariate analysis showed that tumor size, depth of invasion, NLR, PLR and CAR were associated with lymph node metastasis in cN0 gastric cancer patients (all P<0.05). Multivariate analysis showed that depth of invasion, NLR and CAR were independent influencing factors of lymph node metastasis in patients with cN0 gastric cancer. OR were 8.084, 3.540 and 3.092, respectively (all P<0.05). The C-index of the nomogram model was 0.847 (95% CI: 0.782-0.915). The predicting calibration curve was properly fit with the ideal curve in calibration chart. Conclusion: Combination of NLR and CAR to establish a nomogram model has a good consistency and can accurately predict the risk of lymph node metastasis in patients with cN0 gastric cancer.


Assuntos
Metástase Linfática , Nomogramas , Neoplasias Gástricas/patologia , Proteína C-Reativa/análise , Humanos , Valor Preditivo dos Testes , Período Pré-Operatório , Estudos Retrospectivos , Albumina Sérica Humana/análise
10.
Int J Biol Macromol ; 138: 602-617, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31319084

RESUMO

Albumin is a globular protein which plays a pivotal role in maintaining plasma pressure and the nutritional balance. Different compounds are transported by binding to albumin in the blood. Also, human health is closely related to the serum albumin concentration in blood plasma or other biological fluids. Due to the high structural similarity with human serum albumin (HSA), bovine serum albumin (BSA) has been widely investigated as a model protein in different fields. Importantly, albumin detection has recently gained huge interest, as this protein serves as an important indicator of cow health, and its milk and meat quality. Also, it is also known as an allergenic and a carrier protein. As a result, it is highly essential to determine bovine albumin in various industries, such as medicine, pharmaceutical, clinical and food. Therefore, the development of new, efficient, fast and straightforward methods for selective detection of BSA is critical. This review seeks to highlight different characteristics of BSA and its importance. Then, by focusing on recent developments made in the last two decades in BSA biosensing and determination methods, the use of different biomaterials/nanomaterials is discussed.


Assuntos
Técnicas Biossensoriais , Soroalbumina Bovina/análise , Animais , Bovinos , Transferência Ressonante de Energia de Fluorescência , Corantes Fluorescentes/química , Humanos , Nanopartículas Metálicas/química , Modelos Moleculares , Estrutura Molecular , Nanotecnologia , Conformação Proteica , Soroalbumina Bovina/química , Albumina Sérica Humana/análise , Albumina Sérica Humana/química , Espectrometria de Fluorescência
11.
Arerugi ; 68(6): 691-695, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31308335

RESUMO

BACKGROUND: Paradoxical response (PR) is defined as a clinical or radiological worsening in patients receiving adequate anti-tuberculosis treatment, with the exclusion of documented relapse or of other disease presentations. Although most patients with PR show spontaneous improvement, some cases presenting with diffuse alveolar damage have also been reported. METHODS: Retrospective clinical and laboratory data were collected on 89 patients of pulmonary tuberculosis who were treated at our hospital between April 2013 and January 2019. RESULTS: PR occurred in 21 patients (24%), and the median onset time after anti-tuberculosis treatment was 22 days. The time to onset of PR was shorter in diffuse pulmonary infiltrates group than in local pulmonary infiltrates group or in pleural effusion group. Low serum albumin, elevated lactate dehydrogenase (LDH), high Creactive protein (CRP) and chest radiographic appearance exceeding one-lung area were associated with PR incidence. There was no difference in sputum smear grading and pulmonary cavitation. Six out of the ten patients died, developing PR with diffuse pulmonary infiltrates. CONCLUSION: Low albumin and chest radiographic appearance exceeding one-lung area were risk factors for developing PR. Diffuse pulmonary infiltrates in early phase of anti-tuberculosis treatment was related with Inhospital mortality.


Assuntos
Tuberculose Pulmonar/diagnóstico por imagem , Tuberculose Pulmonar/tratamento farmacológico , Proteína C-Reativa/análise , Mortalidade Hospitalar , Humanos , Incidência , L-Lactato Desidrogenase/sangue , Radiografia , Radiografia Torácica , Estudos Retrospectivos , Fatores de Risco , Albumina Sérica Humana/análise , Escarro , Resultado do Tratamento
12.
J Stroke Cerebrovasc Dis ; 28(9): 2442-2447, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31303439

RESUMO

BACKGROUND AND PURPOSE: In-stent restenosis (ISR) is unfavorable to the long-term efficacy of carotid angioplasty and stenting (CAS). Inflammation plays a critical role in the development of ISR. The aim of the study was to investigate whether neutrophil to albumin ratio (NAR) is a predictor of ISR in patients undergoing CAS. METHODS: We retrospectively recruited patients who underwent CAS. These patients were divided into restenosis group and nonrestenosis group. NAR was examined prior to the CAS procedure. Clinical and radiographic assessments were performed at 6 months and annually after the procedure. ISR was defined as greater than or equal to 50% stenosis in the treated lesion. Cox regression was used to identify predictors of ISR following CAS. RESULTS: During a mean follow-up period of 14.6 months, a total of 459 treated arteries (in 427 participants) were enrolled, among which 72 (15.7%) developed ISR. On multivariate analysis, baseline NAR greater than or equal to13.4, residual stenosis, lesion length, and baseline glucose level were associated with ISR (hazard ratio 1.94[95% confidence interval (CI), 1.08-3.49], 1.09[95% CI, 1.07-1.12], 1.04[95% CI, 1.01-1.06], and 1.01[95% CI, 1.00-1.02], respectively). CONCLUSION: Elevated preprocedural NAR may be a predictor of ISR in patients undergoing CAS.


Assuntos
Angioplastia/efeitos adversos , Angioplastia/instrumentação , Estenose das Carótidas/terapia , Neutrófilos , Albumina Sérica Humana/análise , Stents , Idoso , Biomarcadores/sangue , Estenose das Carótidas/sangue , Estenose das Carótidas/diagnóstico por imagem , Feminino , Humanos , Leucócitos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Recidiva , Sistema de Registros , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
13.
Med Sci Monit ; 25: 4342-4352, 2019 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-31182704

RESUMO

BACKGROUND A retrospective study aimed to investigate the association between the CRP to albumin ratio and prognosis in patients with resectable non-metastatic breast cancer in terms of disease-free survival (DFS) and overall survival (OS) using propensity score matching. MATERIAL AND METHODS Patients with newly diagnosed resectable non-metastatic breast cancer (n=200) who underwent modified radical mastectomy between January 2008 to June 2013 included a group with an increased CRP to albumin ratio ≥0.029 (n=80) and a group with reduced CRP to albumin ratio <0.029 (n=120). Propensity score matching was used to estimate the prognostic role of the CRP to albumin ratio, and a 1: 1 matching using four covariates was performed to overcome selection bias. The prognostic significance of the CRP to albumin ratio was analyzed using receiver operating characteristic (ROC) curves. Kaplan-Meier survival analysis and a Cox proportional hazards model were conducted to identify the impact on DFS and OS. RESULTS An increased CRP to albumin ratio was associated with increased age, post-menopausal status, and a high risk of recurrence or death in patients with breast cancer. An increased preoperative CRP to albumin ratio was significantly associated with reduced disease-free survival (DFS) and overall survival (OS) (all P<0.05). Multivariate analysis showed that an increased CRP to albumin ratio was an independent risk factor for long-term outcome and predicted reduced DFS (HR, 2.225; P=0.024) and OS (HR, 9.189; P=0.003). CONCLUSIONS Preoperative evaluation of the CRP to albumin ratio was an independent prognostic indicator in patients with resectable breast cancer.


Assuntos
Neoplasias da Mama/metabolismo , Neoplasias da Mama/mortalidade , Adulto , Idoso , Biomarcadores Tumorais/metabolismo , Proteína C-Reativa/análise , Proteína C-Reativa/metabolismo , China , Intervalo Livre de Doença , Feminino , Humanos , Estimativa de Kaplan-Meier , Pessoa de Meia-Idade , Prognóstico , Pontuação de Propensão , Modelos de Riscos Proporcionais , Curva ROC , Estudos Retrospectivos , Albumina Sérica/metabolismo , Albumina Sérica Humana/análise , Albumina Sérica Humana/metabolismo
14.
Clin Exp Nephrol ; 23(9): 1141-1146, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31183589

RESUMO

BACKGROUND: Transcatheter arterial chemoembolization (TACE) is widely used for unresectable hepatocellular carcinoma (HCC). The purpose of this study was to investigate incidence and risk factors of contrast-induced nephropathy (CIN) after TACE in patients with HCC. METHODS: In this single-center retrospective study, we examined 461 consecutive TACE sessions in 260 patients between January 2003 and October 2015. CIN was defined as an increase in serum creatinine levels by ≥ 0.5 mg/dl or ≥ 25% from baseline within 72 h after TACE. We calculated incidence rate of CIN and tried to identify its risk factors by logistic regression analysis. RESULTS: Twenty-one cases of CIN (5%) were observed in 461 TACE sessions. One patient required subsequent hemodialysis transiently. In univariate analysis, tumor size > 5 cm [odds ratio (OR) 5.76, 95% confidence interval (CI) 2.34-14.14, p < 0.001], chronic kidney disease (OR 2.54, 95% CI 1.05-6.14, p = 0.04), serum hemoglobin level [OR 0.79 (per 1 g/dl increase), 95% CI 0.64-0.98, p = 0.03] and serum albumin level [OR 0.44 (per 1 g/dl increase), 95% CI 0.19-1.02, p = 0.05] were associated with the development of CIN. Stepwise logistic regression methods showed that tumor size > 5 cm (OR 7.81, 95% CI 2.99-20.46, p < 0.001) and serum albumin [OR 0.29 (per 1 g/dl increase), 95% CI 0.11-0.75, p = 0.01] were risk factors of CIN. CONCLUSIONS: In this study, HCC tumor size and lower serum albumin level were independent predictors of CIN after TACE.


Assuntos
Carcinoma Hepatocelular/terapia , Quimioembolização Terapêutica/efeitos adversos , Meios de Contraste/efeitos adversos , Nefropatias/induzido quimicamente , Neoplasias Hepáticas/terapia , Idoso , Idoso de 80 Anos ou mais , Carcinoma Hepatocelular/sangue , Carcinoma Hepatocelular/diagnóstico por imagem , Meios de Contraste/administração & dosagem , Feminino , Humanos , Incidência , Nefropatias/diagnóstico , Nefropatias/epidemiologia , Neoplasias Hepáticas/sangue , Neoplasias Hepáticas/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Albumina Sérica Humana/análise , Fatores de Tempo , Tóquio/epidemiologia , Resultado do Tratamento , Carga Tumoral
15.
Nutrients ; 11(7)2019 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-31252552

RESUMO

Systemic lupus erythematosus (SLE) is characterized with aberrant responses in the immune systems and lupus nephritis (LN) is one of the most serious complications of SLE. This study evaluated the clinical significance of different nutritional indices in 207 renal biopsy-proven LN patients. The clinical and laboratory data were reviewed, and five different nutritional indices were calculated: (i) Controlling nutritional status (CONUT) score; (ii) prognostic nutritional index (PNI); (iii) nutritional risk index; (iv) neutrophil-to-lymphocyte ratio; and (v) body mass index. The factors associated with end-stage renal failure (ESRF) were assessed using a Cox-proportional hazard analysis. The patients with ESRF had significantly lower median PNI (31.1 vs. 34.7, p = 0.012) than those without ESRF at baseline. The CONUT score and PNI had the highest correlation between the SLE disease activity index-2000 (r = 0.467 and p = -0.356, all p < 0.001) and was significantly associated with SLE activity-related measures. In the Cox-proportional hazard analysis, PNI (odds ratio 0.925, 95% confidence interval 0.865-0.989, p = 0.022) was independently associated with ESRF along with creatinine and chronicity index, and the renal survival rate was significantly lower in patients with PNI ≤35.41 than in those with PNI >35.41 (p = 0.003). Among nutritional indices, the CONUT score and PNI better correlated with disease activity and PNI was associated with ESRF.


Assuntos
Lúpus Eritematoso Sistêmico/complicações , Nefrite Lúpica/fisiopatologia , Avaliação Nutricional , Estado Nutricional , Adulto , Biomarcadores/sangue , Índice de Massa Corporal , Colesterol/sangue , Feminino , Humanos , Falência Renal Crônica/etiologia , Falência Renal Crônica/fisiopatologia , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/fisiopatologia , Nefrite Lúpica/sangue , Nefrite Lúpica/diagnóstico , Nefrite Lúpica/etiologia , Contagem de Linfócitos , Linfócitos , Masculino , Pessoa de Meia-Idade , Neutrófilos , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Albumina Sérica Humana/análise
16.
Biosens Bioelectron ; 141: 111399, 2019 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-31195199

RESUMO

Abnormal protein concentration levels in human body fluids, such as urine, serum etc., are considered to associate with disease states, providing essential information for the pre-clinical diagnosis. This paper presents a wireless immunoglobulin-coated magnetoelastic (ME) biosensor for fast, cost-effective detections of human serum albumin (HSA) with small sample volumes at a microliter scale. This is the first portable resonant sensor based on magnetostrictive effect that can monitor different molecular states of HSA. Anti-HSA Immunoglobulin G (IgG) was immobilized on the surface of the ME sensor to selectively capture HSA. The rapid conjugation between the antibody and antigen changed the sensor surface states and thus induced resonance frequency shifts (RFS), which were monitored in real time for the qualitative and quantitative analysis of HSA. This paper brings forward a System on Chip (SoC)-based system architecture to realize the function of RFS sampling. The performance of the portable device was validated to be comparable to that of the Vector Network Analyzer (VNA) AV3620 using different concentrations of HSA solution. The RFS were linearly proportional to the HSA concentrations in the range from 0.1 to 100 µg/mL with a linearity up to 0.998, a sensitivity of 8.70 Hz/µg.mL-1 and a detection limit of 0.039 µg/mL, indicating good feasibility of this method. Meanwhile, the response of this portable ME biosensor was quick and specific to HSA targets. This ME biosensor shows high potential to be used in diagnosing abnormal HSA.


Assuntos
Técnicas Biossensoriais/instrumentação , Albumina Sérica Humana/análise , Anticorpos Imobilizados/química , Desenho de Equipamento , Humanos , Imunoglobulina G/química , Limite de Detecção , Magnetismo/instrumentação
17.
BMC Cancer ; 19(1): 538, 2019 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-31164099

RESUMO

BACKGROUND: Despite recent advances in the treatments of hepatocellular carcinoma (HCC), the prognosis of HCC patients remains controversial. The purpose of this study was to investigate the prognostic performance of pretreatment albumin to C-reactive protein ratio (ACR) in patients with HCC. METHODS: This study included 409 initially diagnosed HCC patients retrospectively. The optimal cut-off points for distinguishing high and low ACR value was determined by the X-tile software. The chi-squared test was used for comparing the baseline clinicopathologic parameters in different groups and subgroups. The Cox regression with log-rank tests was used to analyze OS and DFS, and Kaplan-Meier curves was used to estimate the prognosis of HCC patients. RESULTS: Patients with lower ACR were significantly correlated with advanced clinical parameters, using a cut-off points of 5.4 (high ACR, n = 236 vs. low ACR, n = 173). Multivariate analysis demonstrated that ACR was associated with OS (HR = 0.544, 95% CI: 0.385-0.769, p = 0.001), with DFS (HR = 0.550, 95% CI: 0.392-0.772, p = 0.001). Treatment exposure (HR = 2.191; 95% CI: 1.533-3.132; p <  0.001), tumor size (HR = 1.973; 95% CI: 1.230-3.164; p = 0.005), serum AFP level (HR = 1.752; 95% CI: 1.277-2.403; p = 0.001), and TNM stage (HR = 0.470; 95% CI: 0.319-2.504; p <  0.001), were independent factors for OS in HCC patients. Treatment exposure (HR = 2.244; 95% CI: 1.590-3.166; p <  0.001), TNM stage (HR = 2.075; 95% CI: 1.436-3.000; p <  0.001), serum AFP level (HR = 1.819; 95% CI: 1.340-2.469; p = 0.001), tumor size (HR = 1.730; 95% CI: 1.113-2.689; p = 0.015), and ACR (HR = 0.550; 95% CI: 0.392-0.772; p = 0.001) were independent factors for DFS in HCC patients. CONCLUSIONS: Pretreatment ACR is a convenient and useful parameter for HCC patients predicting OS and DFS. Lower ACR was associated with advanced TNM stage, larger tumor size, and a high concentration of AFP. These results may help to design strategies to personalize management approaches among HCC patients.


Assuntos
Proteína C-Reativa/análise , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/mortalidade , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/mortalidade , Albumina Sérica Humana/análise , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/análise , Distribuição de Qui-Quadrado , Intervalo Livre de Doença , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Carga Tumoral , Adulto Jovem , alfa-Fetoproteínas/análise
18.
Opt Express ; 27(12): 17080-17090, 2019 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-31252925

RESUMO

In past studies, liquid crystal (LC)-based immunoassays were accomplished by fabricating an LC cell with two pieces of glass slides after immunobinding, which makes the determination of the immunoassay not in real-time and requires trained personnel. Herein, we developed the LC-based immunoassay by using rectangular capillaries as the substrate for immunobinding. The inner surface of rectangular capillaries was decorated with a long alkyl saline, dimethyloctadecyl[3-(trimethoxysilyl)propyl]ammonium chloride (DMOAP), followed by immobilization of human serum albumin (HSA) as the probe. In this situation, the orientation of LC was homeotropic and dark LC image was observed under polarized light. When the solution containing anti-human serum albumin (anti-HSA) were dispensed into the capillary through capillary action, the specific immunobinding between HSA and anti-HSA formed an immunocomplex on the inner surface of capillary, which disrupted the original orientation of LC and led to a dark-to-bright transition of the LC images. The quantification of anti-HSA can be achieved by measuring the length of the bright LC image in the rectangular capillary. By using this immunoassay, the limit of detection (LOD) for anti-HSA is 1 µg/mL, and it did not respond to HSA and anti-human immunoglobulin G (anti-h-IgG). On the other hand, the diversity of the LC-based immunoassay can be extended for HSA detection when we immobilized anti-HSA in the capillary. Because the post-fabrication of LC cell was waived by using rectangular capillaries to develop the LC-based immunoassay, it is more convenient for users to handle and collect more reliable data. Moreover, the results of the immunoassay were visualized through naked-eye and could be recorded by a smartphone; it is more suitable for portable and point-of-care applications.


Assuntos
Técnicas Biossensoriais/métodos , Imunoensaio/métodos , Cristais Líquidos/química , Humanos , Imagem Tridimensional , Albumina Sérica Humana/análise , Processamento de Sinais Assistido por Computador , Smartphone
19.
Anal Chim Acta ; 1070: 104-111, 2019 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-31103163

RESUMO

Herein, we introduce a nanopaper-based analytical device (NAD) or "lab-on-nanopaper" device for visual sensing of human serum albumin (HSA) in human blood serums, which relies on embedding of curcumin within transparent bacterial cellulose (BC) nanopaper. BC nanopaper is an appropriate candidate to be an excellent platform for the development of optical (bio)sensors due to having exceptional properties such as optical transparency, high flexibility, porosity, biodegradability, and printability. The hydrophilic test zones were created on the fabricated bioplatform through creating the hydrophobic walls via laser printing technology. The color changes of curcumin embedded in BC nanopaper (CEBC) due to the inhibitory effect of HSA on the curcumin degradation in alkaline solutions, which can be monitored visually (naked eye/Smartphone camera) or spectroscopically using a spectrophotometer, were linearly proportional to the HSA concentration in the range of 10-300 µM and 25-400 µM, respectively. The developed NAD/CEBC as a novel albumin assay kit was successfully utilized to the determination of HSA in human blood serum samples with satisfactory results. Building upon the fascinating features of BC nanopaper as a very promising bioplatform in optical (bio)sensing applications we are confident "lab-on-nanopaper" devices/NADs, which take the advantages of the nanopaper and also meet the ASSURED criteria, could be considered as a new generation of optical (bio)sensing platforms that are currently based on paper, glass or plastic substrates.


Assuntos
Bactérias/química , Celulose/química , Curcumina/química , Nanoestruturas/química , Papel , Albumina Sérica Humana/análise , Humanos
20.
PLoS One ; 14(5): e0216173, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31048923

RESUMO

BACKGROUND: We evaluated the ability of various grading scales including platelet-albumin-bilirubin (PALBI) and albumin-bilirubin (ALBI) grades to predict overall survival (OS) according to treatment modality in patients with hepatocellular carcinoma (HCC). METHODS: The cohort of 6,669 patients with HCC was selected randomly from the 2008-2012 national cohort of the Korean Central Cancer Registry. The OS of 6,507 of these patients was evaluated using the Child-Turcotte-Pugh (CTP) class, Model for End-stage Liver Disease (MELD) score, and ALBI and PALBI grades. RESULTS: The patient's mean age was 59.7 years. The most patients were hepatitis B virus (63.4%) and CTP class A (71.8%). The median OS durations of PALBI grade1 (38.4%), grade2 (33.2%), and grade3 (28.4%) patients were 81, 30, and 5 months, respectively (P<0.001). The PALBI grade had a larger area under the receiver operator characteristic curve (AUC) than did the CTP class, MELD score, and ALBI grade (overall AUC: 0.675 vs. 0.633, 0.645, and 0.642, respectively; P < 0.001). Moreover, the PALBI and ALBI grades enabled sub-classification of CTP A patients (P < 0.001). In a multivariate analysis, the PALBI and ALBI grades were significant risk factors for OS (P < 0.05). According to treatment modality, the PALBI grade was predictive of OS in patients receiving transarterial chemoembolization or supportive care. The ALBI grade was predictive of OS in patients undergoing surgical resection or radiofrequency ablation. CONCLUSION: The PALBI and ALBI grades are more reliable for accessing liver function and predicting OS in patients with HCC. Moreover, according to treatment modality, appropriate use of the ALBI and PALBI grades will enable accurate determination of the prognosis of patients with HCC.


Assuntos
Carcinoma Hepatocelular/mortalidade , Carcinoma Hepatocelular/patologia , Idoso , Bilirrubina/análise , Biomarcadores Tumorais , Plaquetas/patologia , Estudos de Coortes , Feminino , Humanos , Estimativa de Kaplan-Meier , Fígado/patologia , Testes de Função Hepática , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Curva ROC , República da Coreia/epidemiologia , Estudos Retrospectivos , Albumina Sérica Humana/análise , Análise de Sobrevida
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