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1.
Dis Markers ; 2022: 7979500, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35928925

RESUMO

Objective: This study was designed to analyze the expression of miR-155 in serum exosomes in children with epilepsy and to explore its diagnostic value. Methods: From March 2020 to March 2021, 43 hospitalized children with epilepsy admitted to the Department of Neurology of the hospital were included, and another 43 gender- and age-matched healthy children were randomly selected as the healthy control group during the same period. Then fasting serum samples of the two groups were collected to extract the exosomes. The morphology of the exosomes was evaluated under a transmission electron microscope, and the expression of specific protein markers on the surface was detected by Western Blot. In addition, the relative expression of miR-155 in serum exosomes in children with epilepsy with different courses of the disease and different degrees of abnormal electroencephalography (EEG) was compared, and the area under the receiver operating characteristic (ROC) curve (ROC-AUC) was used to evaluate the diagnostic value of miR-155. Results: A higher relative expression level of miR-155 in serum exosomes was obtained in the epilepsy group, as compared to the healthy control group (P<0.05), and the relative expression of miR-155 in serum exosomes in children with epilepsy was correlated with the course of the disease and the degree of abnormal EEG (both P<0.05). In addition, the expression of miR-155 in serum exosomes showed high diagnostic efficiency for epilepsy (AUC = 0.813, P<0.05). Conclusion: The expression of miR-155 in serum exosomes in children with epilepsy is up-regulated, and its level is related to the course of the disease and the degree of abnormal EEG, so miR-155 in serum exosomes may be used as a biomarker for the diagnosis and assessment of the severity of epilepsy.


Assuntos
Epilepsia , Exossomos , MicroRNAs , Biomarcadores/sangue , Criança , Epilepsia/diagnóstico , Epilepsia/genética , Exossomos/genética , Humanos , MicroRNAs/sangue , Curva ROC
2.
Contrast Media Mol Imaging ; 2022: 8199917, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35909581

RESUMO

To investigate the prognostic potential of serum aldehyde dehydrogenase isoform 1 (ALDH1) level in acute cerebral infarction, and the molecular mechanism in mediating neurological deficits, a total of 120 acute cerebral infarction cases within 72 h of onset were retrospectively analyzed. Serum ALDH1 level in them was detected by qRT-PCR. Receiver operating characteristic (ROC) and Kaplan-Meier curves were depicted for assessing the diagnostic and prognostic potentials of ALDH1 in acute cerebral infarction, respectively. An in vivo acute cerebral infarction model in rats was established by performing MCAO, followed by evaluation of neurological deficits using mNSS and detection of relative levels of ALDH1, Smad2, Smad4, and p21 in rat brain tissues. Pearson's correlation test was carried out to verify the correlation between ALDH1 and mNSS and relative levels of Smad2, Smad4, and p21. Serum ALDH1 level increased in acute cerebral infarction patients. A high level of ALDH1 predicted a poor prognosis of acute cerebral infarction patients. In addition, ALDH1 was sensitive and specific in distinguishing acute cerebral infarction cases, presenting a certain diagnostic potential. mNSS was remarkably higher in acute cerebral infarction rats than that of controls. Compared with sham operation group, relative levels of ALDH1, Smad2, and Smad4 were higher in brain tissues of modeling rats, whilst p21 level was lower. ALDH1 level in brain tissues of modeling rats was positively correlated to mNSS, and mRNA levels of Smad2 and Smad4, but negatively correlated to p21 level. Serum ALDH1 level is a promising prognostic and diagnostic factor of acute cerebral infarction, which is correlated to 90-day mortality. Increased level of ALDH1 in the brain of cerebral infarction rats is closely linked to neurological function, which is associated with the small mothers against decapentaplegic (Smad) signaling and p21.


Assuntos
Família Aldeído Desidrogenase 1 , Infarto Cerebral , Retinal Desidrogenase , Família Aldeído Desidrogenase 1/sangue , Família Aldeído Desidrogenase 1/metabolismo , Animais , Biomarcadores/sangue , Isquemia Encefálica/sangue , Isquemia Encefálica/metabolismo , Infarto Cerebral/sangue , Infarto Cerebral/metabolismo , Humanos , Prognóstico , Isoformas de Proteínas/sangue , Isoformas de Proteínas/metabolismo , Ratos , Retinal Desidrogenase/análise , Retinal Desidrogenase/sangue , Retinal Desidrogenase/metabolismo , Estudos Retrospectivos , Acidente Vascular Cerebral/sangue , Acidente Vascular Cerebral/metabolismo
3.
Pol Merkur Lekarski ; 50(297): 177-182, 2022 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-35801600

RESUMO

Ischemic stroke is the main cause of permanent disability in adult patients. No commonly accepted method were discovered to predict stroke before the first symptoms. Activation of matrix metalloproteinases (MMPs), tissue inhibitor of metalloproteinases (TIMP) and S100B protein may be observe in patients with symptomatic carotid artery stenosis. Hemorrhagic transformation of ischemic stroke may be associated with changes in MMP, TIMP and S100B. AIM: The aim of this study was to determine if MMP-9, TIMP-1 and S-100B protein may markers of forthcoming ischemic stroke in patients undergoing carotid endarterectomy. MATERIALS AND METHODS: Blood samples were taken and an analysis of circulating proteins (MMP-9, TIMP-1, S100B) 73 subsequent patients with carotid artery stenosis ≥70% (33 asymptomatic and 40 symptomatic), who were referred for potential revascularization. RESULTS: A statistically significant difference was found between MMP- 9 levels in patients with ischemic stroke compared to patients with asymptomatic carotid stenosis after endarterectomy. Also, average TIMP-1 levels in patients with ischemic stroke and stenosis ≥70% were statistically significantly higher than the average levels in patients after endarterectomy. In terms of S-100B, a higher mean value was observed in patients with stroke than in endarterectomy group. No statistical differences were found in the levels of that proteins in the hemorrhagic transformation of ischemic stroke. CONCLUSIONS: Increased levels of MMP-9, TIMP-1 and S-100B in patients with ischemic stroke compared to patients with asymptomatic carotid stenosis after endarterectomy showed that abovementioned proteins may be a good predictive factor of ischemic stroke in patients undergoing carotid endarterectomy.


Assuntos
Estenose das Carótidas , Endarterectomia das Carótidas , AVC Isquêmico , Adulto , Biomarcadores/sangue , Artérias Carótidas , Estenose das Carótidas/complicações , Estenose das Carótidas/cirurgia , Endarterectomia das Carótidas/efeitos adversos , Humanos , AVC Isquêmico/diagnóstico , AVC Isquêmico/etiologia , Metaloproteinase 9 da Matriz/sangue , Subunidade beta da Proteína Ligante de Cálcio S100/sangue , Inibidor Tecidual de Metaloproteinase-1/sangue
4.
J Assoc Physicians India ; 70(7): 11-12, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35833396

RESUMO

BACKGROUND: The diagnosis of heart failure (HF) remains essentially clinical-Based. However, the history, physical examination, and chest radiograph findings are often inadequate in the diagnosis because multiple other conditions that affect the cardiopulmonary system mimic the symptoms of HF. N-terminal pro-BNP (NT-proBNP) has long been used for diagnosing HF. N-terminal pro-BNP values vary with different patient parameters. There is a scarcity of Indian studies on this topic. Especially with the use of newer drugs like angiotensin receptor neprilysin inhibitor (ARNI), it is important to have data from our own population on the same. AIMS AND OBJECTIVES: (i) To assess the role of NT-proBNP in the diagnosis of HF. (ii) Achieve diagnostic clarity in cases having cardiorespiratory symptoms and signs like acute onset dyspnea, pedal edema, and basal crepitations. (iii) To study the effect of various factors like age, body mass index (BMI), and creatinine on NT-proBNP. (iv) Establish a relation between NT-proBNP levels and left ventricular ejection fraction (LVEF), disease severity, and etiology of HF. MATERIALS AND METHODS: An observational prospective study of 50 patients presenting with acute onset breathlessness was carried out, fulfilling inclusion and exclusion criteria over a period of 10 months. Detailed history and examination of the patients were obtained. Venous sample for the measurement of NT-proBNP was collected within 24 hours of onset of symptoms. Other relevant blood and radiographic investigations were obtained. The NT-proBNP "cut-offs" set forth by the American Heart Association (AHA)/American College of Cardiology (ACC) were used to "rule in" or "rule out" HF. Two-dimensional echocardiography (2D Echo) was used to confirm the diagnosis. The correlation between NT-proBNP and various parameters like age, BMI, creatinine, and LVEF was obtained. Sensitivity and specificity tests were applied as well. RESULTS: Out of the 50 patients presenting with acute onset dyspnea, the most common cause was ischemic heart disease (IHD) (44%) followed by dilated cardiomyopathy (DCM) (32%), chronic obstructive pulmonary disease (COPD) (10%), anemia (4%), followed by other causes. The median NT-proBNP value was the highest for IHD patients (9485 pg/mL), followed by DCM (8969 pg/mL), followed by COPD (2846 pg/mL), and followed by anemia (850 pg/mL). There is a significant positive correlation between NT-proBNP and age (coefficient of correlation r = 0.4007, significance level p = 0.0389, and class interval = 0.137-0.61). There is a significant negative correlation between creatinine clearance and NT-proBNP (coefficient of correlation r = -0.372, significance level p = 0.007, and class interval = -0.58 to -0.105). There was significant negative correlation between LVEF and NT-proBNP (coefficient of correlation r = -0.36, significance level p = 0.009, and class interval = -0.58 to -0.09). Higher LVEF is associated with lower NT-proBNP values. There is marked heterogeneity in the values though. CONCLUSION: It is seen that the values of NT-proBNP vary with factors like age, BMI, and creatinine clearance in addition to LVEF. This may lead to falsely positive or falsely negative diagnosis of HF. With the above observations in mind, it can be concluded that NT-proBNP can help diagnose HF but only in addition to clinical findings.


Assuntos
Insuficiência Cardíaca , Peptídeo Natriurético Encefálico , Doença Pulmonar Obstrutiva Crônica , Biomarcadores/sangue , Creatinina/sangue , Dispneia/sangue , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/diagnóstico , Humanos , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Estudos Prospectivos , Doença Pulmonar Obstrutiva Crônica/sangue , Volume Sistólico , Função Ventricular Esquerda
5.
Chron Respir Dis ; 19: 14799731221108516, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35830291

RESUMO

OBJECTIVE: To explore the optimal cut-off value of serum procalcitonin (PCT) level in predicting bacterial infection in hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: 204 hospitalized patients with AECOPD were enrolled in this study. Their diagnoses and treatments followed routine protocols in Fu-Xing Hospital affiliated to Capital Medical University, Beijing, China. Extra blood samples were taken for serum PCT level testing and the results were blinded to the treating physicians. On discharge, clinical data were collected and the treating physicians made comprehensive analyses to determine whether the AECOPD were triggered by respiratory tract bacterial infection or non-bacterial causes according to the "new diagnostic criteria" defined in this study. In the AECOPD patients with bacterial infection, treating physicians decided whether they had bacterial pneumonia based on imaging studies. Receiver operating characteristic curve (ROC) was used to analyze the accuracy of serum PCT level in predicting bacterial infection. RESULTS: In the 173 AECOPD patients who did not have pneumonia, 115 had evidences of bacterial infection while 58 did not. The median PCT levels were 0.1(0.08, 0.18) ng/ml and 0.07 (0.05, 0.08) ng/ml for each group, which were statistically different. The proposed optimal cut-off value of serum PCT level in predicting bacterial infection was 0.08 ng/mL according to this study, with a sensitivity of 81%, specificity of 67% and area under the ROC curve (AUC) of 0.794. There were 31 AECOPD patients diagnosed with pneumonia, their median PCT level was 0.23 ng/mL. CONCLUSIONS: The serum PCT levels slightly increased in the majority of hospitalized patients with AECOPD compared with reference range. When PCT level was ≥0.08 ng/mL, AECOPD was more likely to be caused by bacterial infection. A significantly elevated PCT levels may indicate combination of AECOPD and bacterial pneumonia.


Assuntos
Pneumonia Bacteriana , Pró-Calcitonina , Doença Pulmonar Obstrutiva Crônica , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , Humanos , Pneumonia Bacteriana/sangue , Pneumonia Bacteriana/diagnóstico , Pró-Calcitonina/sangue , Doença Pulmonar Obstrutiva Crônica/sangue , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Curva ROC
6.
Ann Med ; 54(1): 1732-1737, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35775463

RESUMO

OBJECTIVE: To explore the diagnostic value of combined detection of serum amyloid A (SAA), C-reactive protein (CRP) and procalcitonin (PCT) in children with bacteria or non-bacterial respiratory tract infection. METHODS: 200 children with respiratory tract infections diagnosed in our hospital were included in the study. According to the results of the aetiological examination, they were divided into bacterial infection group and non-bacterial infection group. At the same time, 100 healthy children admitted to the hospital for physical examination during the same period were selected as the healthy subjects control group. Changes in serum SAA, PCT and CRP in three groups were compared. Comparison of a positive rate of the single index and combined detection were performed. Children with bacterial infections were treated with conventional antibiotics. The changes in serum SAA, PCT and CRP in the infection group before and after treatment were compared. The efficacy of SAA, PCT and CRP alone and in combination was compared. RESULTS: The serum SAA, PCT and CRP levels in the bacterial infection group were higher than those in the non-bacterial infection group and healthy children, and the differences were statistically significant. The positive detection rates and combined detection rates of serum SAA, PCT and CRP in the bacterial infection group were higher than those in the non-bacterial infection group and the healthy subject's control group. After conventional antibiotic treatment, serum SAA, PCT and CR levels in children with bacterial infection were significantly decreased. CONCLUSION: The combined detection based on SAA, CRP and PCT can effectively identify and diagnose respiratory tract infection in children, providing a certain reference for the promotion of the diagnostic scheme. Key messagesSerum SAA, PCT and CRP were highly expressed in children with respiratory tract infection, and the expression level was the highest in children with bacterial pneumonia.The combined detection of serum SAA, CRP and PCT indicators have higher diagnostic efficiency and can effectively make a differential diagnosis of respiratory tract infection in children.


Assuntos
Infecções Bacterianas , Proteína C-Reativa , Pró-Calcitonina , Infecções Respiratórias , Proteína Amiloide A Sérica , Infecções Bacterianas/sangue , Infecções Bacterianas/diagnóstico , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , Calcitonina/sangue , Criança , Diagnóstico Diferencial , Humanos , Pró-Calcitonina/sangue , Infecções Respiratórias/sangue , Infecções Respiratórias/diagnóstico , Proteína Amiloide A Sérica/metabolismo
7.
Artigo em Inglês | MEDLINE | ID: mdl-35805808

RESUMO

Multiple sclerosis (MS) is one of the most prevalent causes of nontraumatic neurological impairment in young adults. This review aims to determine the impact of exercise on cytokine and adipokine profile levels as inflammatory markers in MS patients across various exercise paradigms. We used specific keywords in PubMed, Web of Science, The Cochrane Library, and Scopus to find randomized clinical trials addressing the effects of physical activity and exercise training on inflammatory markers levels in MS patients. The majority of the research showed no considerable changes in IL-6 levels, while three studies reported declining levels after the intervention. Approximately half of the trials observed a change in TNF-α and IL-10 levels after exercise interventions, while the other half showed no meaningful changes. Other markers such as IL-17, IL-4, IL-12, adipokines, and BDNF showed fluctuations in levels. We found no universal agreement on the effects of different exercise training protocols on the serum level of inflammatory markers in patients with MS. More research is needed to fully identify the effects of exercise on cytokines in MS patients.


Assuntos
Adipocinas , Citocinas , Exercício Físico , Esclerose Múltipla , Adipocinas/sangue , Biomarcadores/sangue , Citocinas/sangue , Humanos , Esclerose Múltipla/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Adulto Jovem
8.
Artigo em Inglês | MEDLINE | ID: mdl-35897470

RESUMO

Athletes incorporate altitude training programs into their conventional training to improve their performance. The purpose of this study was to determine the effects of an 8-week altitude training program that was supplemented with intermittent hypoxic training (IHE) on the blood biomarkers, sports performance, and safety profiles of elite athletes. In a single-blind randomized clinical trial that followed the CONSORT recommendations, 24 male athletes were randomized to an IHE group (HA, n = 12) or an intermittent normoxia group (NA, n = 12). The IHE consisted of 5-min cycles of hypoxia-normoxia with an FIO2 of between 10-13% for 90 min every day for 8 weeks. Hematological (red blood cells, hemoglobin, hematocrit, hematocrit, reticulated hemoglobin, reticulocytes, and erythropoietin), immunological (leukocytes, monocytes, and lymphocytes), and renal (urea, creatinine, glomerular filtrate, and total protein) biomarkers were assessed at the baseline (T1), day 28 (T2), and day 56 (T3). Sports performance was evaluated at T1 and T3 by measuring quadriceps strength and using three-time trials over the distances of 60, 400, and 1000 m on an athletics track. Statistically significant increases (p < 0.05) in erythropoietin, reticulocytes, hemoglobin, and reticulocyte hemoglobin were observed in the HA group at T3 with respect to T1 and the NA group. In addition, statistically significant improvements (p < 0.05) were achieved in all performance tests. No variations were observed in the immunological or renal biomarkers. The athletes who were living and training at 1065 m and were supplemented with IHE produced significant improvements in their hematological behavior and sports performance with optimal safety profiles.


Assuntos
Desempenho Atlético , Eritropoetina , Exercício Físico , Altitude , Atletas , Biomarcadores/sangue , Exercício Físico/fisiologia , Hemoglobinas/metabolismo , Humanos , Hipóxia , Masculino , Consumo de Oxigênio , Aptidão Física , Método Simples-Cego
9.
Mymensingh Med J ; 31(3): 600-605, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35780339

RESUMO

The serum Alanine Transaminase (ALT) activity has been regarded as a reliable and sensitive marker of liver disease. In the context of obesity ALT may also be a good indicator of overall health. Obesity has been reported as a risk factor associated with elevation of ALT, which is a surrogate marker of Non-alcoholic fatty liver disease (NAFLD). Elevated ALT may correlate with the severity of NAFLD in obese female. This study was done to evaluate the changes of serum ALT in obese female age ranged 30-60 years in comparison to normal healthy female of same age. At the same time we can know the relationship between body mass index and serum ALT concentration in obese female. This analytical cross-sectional study was carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from January 2020 to December 2020. A total number of 100 female subjects were included in this study. Among them fifty (50) normal healthy female were taken as control group (Group I) and fifty (50) obese female were taken as study group (Group II). The level of serum ALT was determined by Ultra violet (UV) method. Data were expressed as mean±SD and statistical significance of difference among the group was calculated by unpaired Student's 't' test. Pearson's correlation coefficient test was done to find the correlation of serum ALT with BMI by using SPSS (version 21.0). During interpretation of results, p values of <0.001 were considered as statistically highly significant. In this study, serum level of ALT was significantly higher (p<0.001) in obese female compared to those of healthy control female. In addition, there is a positive correlation of serum ALT with BMI. From the results of the present study, it can be concluded that, elevated ALT was significantly associated with high BMI as well as with other feature of NAFLD.


Assuntos
Alanina Transaminase , Índice de Massa Corporal , Hepatopatia Gordurosa não Alcoólica , Obesidade , Adulto , Alanina Transaminase/sangue , Biomarcadores/sangue , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/complicações , Obesidade/complicações
10.
Cardiovasc Diabetol ; 21(1): 127, 2022 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-35787704

RESUMO

BACKGROUND: Raised liver function tests (LFTs) have been correlated with multiple metabolic abnormalities and variably associated with cardiorenal outcomes. We sought to systematically test the relationship between LFT levels within the accepted range and major cardiorenal outcomes in a large clinical trial in type 2 diabetes, and the possible impact of placebo-controlled canagliflozin treatment. METHODS: We measured serum alanine aminotransferase (ALT), aspartic aminotransferase (AST), gamma-glutamyl transferase (γGT), alkaline phosphatase (ALP), and bilirubin concentrations in 10,142 patients, at baseline and repeatedly over follow-up. The relation of LFTs to first hospitalized heart failure (HHF), cardiovascular (CV) and all-cause mortality, and progression of renal impairment was investigated using multivariate proportional-hazards models. RESULTS: In univariate association, ALT was reciprocally predictive, and ALP was positively predictive, of all adjudicated outcomes; γGT also was directly associated with CV-but not renal-outcomes. In multivariate models including all 5 LFTs and 19 potential clinical confounders, ALT was independently associated with lower, and γGT with higher, CV outcomes risk. Canagliflozin treatment significantly reduced ALT, AST, and γGT over time. In a fully adjusted model including updated LFT levels and treatment, γGT was independently associated with CV and all-cause mortality, ALP with renal dysfunction progression, and canagliflozin treatment with significant reduction in HHF and renal risk. CONCLUSIONS: Higher γGT levels are top LFT markers of risk of HHF and death in patients with diabetes and high CV risk, while ALT are protective. Canagliflozin lowers the risk of HHF and renal damage independently of LFTs and potential confounders.


Assuntos
Canagliflozina , Diabetes Mellitus Tipo 2 , Insuficiência Cardíaca , Testes de Função Hepática , Inibidores do Transportador 2 de Sódio-Glicose , Fosfatase Alcalina/sangue , Biomarcadores/sangue , Canagliflozina/uso terapêutico , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/tratamento farmacológico , Insuficiência Cardíaca/sangue , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/prevenção & controle , Humanos , Fígado , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêutico
11.
BMC Cardiovasc Disord ; 22(1): 306, 2022 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-35794529

RESUMO

BACKGROUND: Postoperative pneumonia (PP) is one of the most common complications after cardiac surgery. This study was designed to access the diagnostic value of interleukin-6 (IL-6) for pneumonia within the first 5 days after cardiac surgery in adults. METHOD: This prospective observational study enrolled 694 patients who admitted to our center from 10 October 2020 to 30 June 2021. Blood samples were collected after admission and on five consecutive days after surgery to measure IL-6, procalcitonin (PCT), C-reactive protein (CRP) and white blood cells (WBC) respectively. Combined with clinical data, we assessed the diagnostic performance of different biomarkers using univariate and multifactorial analyses as well as receiver operating characteristic curves (ROC) and the area under the curve (AUC). RESULT: Finally, 68 patients were diagnosed with PP (PP Group). In addition, 626 cases were assigned to the control group (Non-PP Group). From postoperative day 1 (POD1) to day 5, IL-6 and PCT levels showed higher diagnostic value (P < 0.001, P < 0.05, respectively); meanwhile, there was no difference in white blood cell counts between the two groups; CRP showed some value from POD2 onwards (P < 0.001). Among these biomarkers, IL-6 on POD1 [AUC: 0.78, 95% confidence interval (CI): 0.71-0.83], IL-6 on POD2 (AUC: 0.77, 95% CI: 0.71-0.82) and CRP levels on POD3 (AUC: 0.77, 95% CI: 0.70-0.84) had the highest diagnostic value. Multivariate analysis found that smoking status [odds ratio(OR): 7.79, 95% CI: 3.05, 19.88, p < 0.001], drinking status (OR: 22.68, 95% CI: 9.29, 55.37, p < 0.001) and hypertension (OR: 2.85, 95% CI: 1.28, 6.35, p = 0.011), IL-6 on POD2 (OR: 1.01, 95% CI: 1.00, 1.01, p = 0.018), mechanical ventilation time (OR: 1.03, 95% CI: 1.00, 1.05, p = 0.040) and intensive care unit stay time (OR: 1.01, 95% CI: 1.00, 1.02, p < 0.001) were independent risk factors for postoperative pneumonia. CONCLUSION: Smoking, drinking, hypertension, prolonged duration of mechanical ventilation and intensive care unit stay, and IL-6 on POD2 were independent risk factors for pneumonia after cardiovascular surgery. IL-6 level on POD2 may serve as a promising indicator, better than WBC, PCT and CRP.


Assuntos
Hipertensão , Interleucina-6 , Pneumonia , Adulto , Biomarcadores/sangue , Proteína C-Reativa/análise , Calcitonina/análise , Progressão da Doença , Humanos , Hipertensão/sangue , Interleucina-6/sangue , Pneumonia/sangue , Pneumonia/diagnóstico , Complicações Pós-Operatórias/sangue , Pró-Calcitonina/sangue , Estudos Prospectivos , Precursores de Proteínas/sangue
12.
Med Sci Monit ; 28: e936534, 2022 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-35821629

RESUMO

BACKGROUND Calprotectin (S100A8/A9 or myeloid-related protein 8/14) is a heterodimeric S100 complex expressed in leukocytes. Calprotectin participates in development of the inflammatory response by binding to receptors for advanced glycation end-products (RAGE) and Toll-like receptors (TLR). The clinical activity of systemic lupus erythematosus (SLE) is evaluated using the Systemic Lupus International Collaborating Clinics (SLICC) criteria and the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). This Polish single-center case-control study aimed to evaluate serum levels of calprotectin as a rapid diagnostic biomarker of SLE (59 patients with SLE were compared with 52 healthy controls). MATERIAL AND METHODS Calprotectin concentration was measured with the use of enzyme-linked immunosorbent assay (ELISA). The SLE activity of the patients was assessed by the SLEDAI scale. Statistical analysis of the results was carried out using MedCalc 15.8 software. P<0.05 was considered statistically significant. RESULTS A significantly higher concentration of calprotectin was found in the study group compared to the control group (medians: 3.11 vs 2.45 ng/ml; P=0.0013). We found that calprotectin has high sensitivity (89.83%) and specificity (53.85%) in differentiating between SLE patients and healthy volunteers. We found that calprotectin has very high sensitivity (100%) and specificity (82.46%) in detection of patients with moderate and severe SLE assessed using SLEDAI. CONCLUSIONS Consistent with previous studies, serum calprotectin level was revealed to have potential as a rapid diagnostic biomarker of disease activity in patients with SLE.


Assuntos
Complexo Antígeno L1 Leucocitário , Lúpus Eritematoso Sistêmico , Biomarcadores/sangue , Calgranulina A , Estudos de Casos e Controles , Humanos , Complexo Antígeno L1 Leucocitário/sangue , Lúpus Eritematoso Sistêmico/sangue , Lúpus Eritematoso Sistêmico/diagnóstico , Polônia , Índice de Gravidade de Doença
13.
Can J Gastroenterol Hepatol ; 2022: 1048104, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35855954

RESUMO

Objectives: We assessed the potential of glial cell line-derived neurotrophic factor (GDNF) as a useful biomarker to predict cirrhosis in chronic hepatitis B (CHB) patients. Methods: A total of 735 patients from two medical centers (385 CHB patients and 350 healthy controls) were included to determine the association of serum and tissue GDNF levels with biopsy-proven cirrhosis. The diagnostic accuracy of serum GDNF (sGDNF) was estimated and compared with other indices of cirrhosis. Results: We showed significantly higher levels of sGDNF in CHB patients with fibrosis (28.4 pg/ml vs. 11.6 pg/ml in patients without) and patients with cirrhosis (33.8 pg/ml vs. 23.5 pg/ml in patients without). The areas under receiver operating curve (AUROCs) of sGDNF were 0.83 (95% confidence interval (CI): 0.80-0.87) for predicting liver fibrosis and 0.84 (95% CI: 0.79-0.89) for cirrhosis. Findings from the serum protein level and hepatic mRNA expression were consistent. Using the best cutoff to predict cirrhosis, we categorized the patients into sGDNF-high and sGDNF-low groups. The sGDNF-high group had significantly larger Masson's trichrome and reticulin staining-positive area, higher Scheuer score, and METAVIR fibrosis stage (all p < 0.001) but not steatosis. On multivariable regression, sGDNF was independently associated with cirrhosis with an odds ratio of 6.98 (95% CI: 1.10-17.94). Finally, we demonstrated that sGDNF outperformed AST to platelet ratio index, FIB-4, fibroscore, forn index, and fibrometer in differentiating F4 vs. F3. Conclusion: Using serum, tissue mRNA, and biopsy data, our study revealed a significant potential of sGDNF as a novel noninvasive biomarker for cirrhosis in CHB patients.


Assuntos
Fator Neurotrófico Derivado de Linhagem de Célula Glial , Hepatite B Crônica , Cirrose Hepática , Aspartato Aminotransferases , Biomarcadores/sangue , Biópsia , Fator Neurotrófico Derivado de Linhagem de Célula Glial/sangue , Hepatite B Crônica/sangue , Humanos , Cirrose Hepática/sangue , Cirrose Hepática/virologia , Contagem de Plaquetas , RNA Mensageiro , Curva ROC , Estudos Retrospectivos
14.
Zhonghua Xin Xue Guan Bing Za Zhi ; 50(7): 684-689, 2022 Jul 24.
Artigo em Chinês | MEDLINE | ID: mdl-35856225

RESUMO

Objective: To explore the value of the assessment of plasma trimethylamine N-oxide (TMAO) combined with N-terminal pro-B-type natriuretic peptide (NT-proBNP) on predicting the all-cause mortality, length of hospitalization, and hospital cost in ischemic heart failure (IHF) patients. Methods: This prospective cohort study included 189 patients (157 males, mean age (64.0±10.5) years) with a left ventricular ejection fraction<45% caused by coronary artery disease, who hospitalized in our department from March 2016 to December 2020. Baseline data, including demographics, comorbid conditions and laboratory examination, were analyzed. The cumulative rate of all-cause mortality was evaluated using the Kaplan-Meier method and compared between the groups according to the log-rank test. Relative risks were reported as hazard ratios (HR) and 95% confidence interval (95%CI) calculated using the Cox proportional-hazards analysis, with stepwise adjustment for covariables. Spearman correlation analysis was then performed to determine the relationship between TMAO combined with NT-proBNP and length of hospitalization and hospital cost. Results: There were 50 patients in the low TMAO+low NT-proBNP group, 89 patients in high TMAO or high NT-proBNP group, 50 patients in high TMAO+high NT-proBNP group. The mean follow-up period was 3.0 years. Death occurred in 70 patients (37.0%), 27 patients (54.0%) in high TMAO+high NT-proBNP group, 29 patients (32.6%) in high TMAO or high NT-proBNP group and 14 patients (28.0%) in low TMAO+low NT-proBNP group. TMAO, in combination with NT-proBNP, improved all-cause mortality prediction in IHF patients when stratified as none, one or both biomarker(s) elevation, with the highest risk of all-cause mortality in high TMAO+high NT-proBNP group (HR=3.62, 95%CI 1.89-6.96, P<0.001). ROC curve analysis further confirmed that TMAO combined with NT-proBNP strengthened the prediction performance on the risk of all-cause death (AUC=0.727(95%CI 0.640-0.813), sensitivity 55.0%, characteristic 83.1%). Spearman correlation analysis showed that IHF patients with high TMAO and high NT-proBNP were positively associated with longer duration of hospitalization (r=0.191,P=0.009), but not associated with higher hospital cost (r=0.030, P=0.686). Conclusions: TMAO combined with NT-proBNP are valuable prediction tool on risk stratification of patients with IHF, and those with two biomarkers elevation face the highest risk of mortality during follow-up period, and are associated with the longer hospital stay.


Assuntos
Insuficiência Cardíaca , Metilaminas , Peptídeo Natriurético Encefálico , Idoso , Biomarcadores/sangue , Feminino , Insuficiência Cardíaca/sangue , Insuficiência Cardíaca/diagnóstico , Hospitalização , Humanos , Masculino , Metilaminas/sangue , Pessoa de Meia-Idade , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos , Prognóstico , Estudos Prospectivos
15.
J Prev Alzheimers Dis ; 9(3): 469-479, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35841248

RESUMO

BACKGROUND: Ongoing research seeks to identify blood-based biomarkers able to predict onset and progression of Alzheimer's disease (AD). OBJECTIVE: The unfolded conformational variant of p53 (U-p53AZ), previously observed in AD individuals, was evaluated in plasma samples from individuals participating in the Australian Imaging, Biomarkers and Lifestyle (AIBL) cohort for diagnostic and prognostic assessment, validated on a neuropsychological-based diagnosis, over the course of six years. DESIGN: Retrospective Longitudinal Prognostic biomarker study. SETTING: Single-center study based on the AIBL cohort. PARTICIPANTS: 482 participants of the AIBL cohort, aged 60-85 years, without uncontrolled diabetes, vascular disease, severe depression or psychiatric illnesses. MEASUREMENTS: The AlzoSure® Predict test, consisting of immunoprecipitation (IP) followed by liquid chromatography (LC) tandem mass spectrometry (MS/MS), was performed to quantify the AZ 284® peptide as readout of U-p53AZ and compared with an independent neuropsychological diagnosis. The amyloid load via amyloid ß-positron emission tomography (Aß-PET) and supporting clinical information were included where possible. RESULTS: U-p53AZ diagnostic and prognostic performance was assessed in both time-independent and time-dependent (36, 72 and 90 months following initial sampling) analyses. Prognostic performance of Aß-PET and survival analyses with different risk factors (gender, Aß-PET and APOE ε4 allele status) were also performed. U-p53AZ differentiated neuropsychologically graded AD from non-AD samples, and its detection at intermediate/high levels precisely identified present and future symptomatic AD. In both time-independent and time-dependent prognostic analyses U-p53AZ achieved area under the curve (AUC) >98%, significantly higher than Aß-PET AUCs (between 84% and 93%, P respectively <0.0001 and <0.001). As single factor, U-p53AZ could clearly determine the risk of AD neuropsychological diagnosis over time (low versus intermediate/high U-p53AZ hazard ratio=2.99). Proportional hazards regression analysis identified U-p53AZ levels as a major independent predictor of AD onset. CONCLUSIONS: These findings support use of U-p53AZ as blood-based biomarker predicting whether individuals would reach neuropsychologically-defined AD within six years prior to AD diagnosis. Integration of U-p53AZ in screening processes could support refined participant stratification for interventional studies.


Assuntos
Doença de Alzheimer , Proteína Supressora de Tumor p53 , Doença de Alzheimer/sangue , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/genética , Peptídeos beta-Amiloides/metabolismo , Biomarcadores/sangue , Humanos , Fragmentos de Peptídeos/sangue , Fragmentos de Peptídeos/química , Estudos Retrospectivos , Espectrometria de Massas em Tandem , Proteína Supressora de Tumor p53/sangue , Proteína Supressora de Tumor p53/química , Proteína Supressora de Tumor p53/genética
16.
J Clin Neurosci ; 102: 87-94, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35753156

RESUMO

INTRODUCTION: Recent studies indicate that Alzheimer's disease- (AD) related biomarkers, including amyloid ß (Aß40 and Aß42) and tau proteins (P-tau and T-tau), in blood and cerebrospinal fluid (CSF) are associated with obstructive sleep apnea (OSA). However, the results have been inconsistent. Therefore, the primary purpose of this meta-analysis was to determine the relationship between blood and CSF AD-related biomarkers and OSA. METHODS: We searched the Embase, PubMed, Scopus, and Cochrane Library databases for relevant articles till February 2022. RESULTS: Eight articles were finally included after the literature screening, including 446 patients with OSA and 286 controls. Pooled analysis showed that CSF Aß42 (SMD = -0.220, P = 0.136), T-tau (SMD = 0.012, P = 0.89), and P-tau (SMD = 0.099, P = 0.274) levels were not different between patients with OSA and controls. In patients with moderate to severe OSA, CSF Aß42 (SMD = -0.482, P = 0.031) were significantly lower than in controls. Blood T-tau (SMD = 0.560, P = 0.026), P-tau (SMD = 0.621, P < 0.001), and Aß40 (SMD = 0.656, P < 0.001) levels were significantly higher in patients with OSA than in controls. Blood Aß42 (SMD = 0.241, P = 0.232) were not different between patients with OSA and controls. CONCLUSION: OSA is associated with changes in AD-related markers. Higher OSA severity may be associated with the development of AD. AD-related biomarkers, especially in the blood, are clinically efficient, less invasively assessed and monitored, and may be useful for detecting OSA and related cognitive impairments. Further studies are needed to confirm these results.


Assuntos
Doença de Alzheimer , Apneia Obstrutiva do Sono , Doença de Alzheimer/sangue , Doença de Alzheimer/líquido cefalorraquidiano , Doença de Alzheimer/diagnóstico , Peptídeos beta-Amiloides/sangue , Peptídeos beta-Amiloides/líquido cefalorraquidiano , Biomarcadores/sangue , Biomarcadores/líquido cefalorraquidiano , Humanos , Fragmentos de Peptídeos/sangue , Fragmentos de Peptídeos/líquido cefalorraquidiano , Apneia Obstrutiva do Sono/sangue , Apneia Obstrutiva do Sono/líquido cefalorraquidiano , Apneia Obstrutiva do Sono/complicações , Proteínas tau/sangue , Proteínas tau/líquido cefalorraquidiano
17.
Neurology ; 99(4): e347-e354, 2022 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-35654597

RESUMO

BACKGROUND AND OBJECTIVES: To examine whether the brain biomarkers total-tau (T-tau), glial fibrillary acidic protein (GFAP), and ß-amyloid (Aß) isomers 40 and 42 in plasma relate to the corresponding concentrations in CSF, blood-brain barrier integrity, and duration of postconcussion syndrome (PCS) due to repetitive head impacts (RHIs) in professional athletes. METHOD: In this cross-sectional study, professional athletes with persistent PCS due to RHI (median of 1.5 years after recent concussion) and uninjured controls were assessed with blood and CSF sampling. The diagnosis of PCS was based on the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition). The athletes were enrolled through information flyers about the study sent to the Swedish Hockey League (SHL) and the SHL Medicine Committee. The controls were enrolled through flyers at University of Gothenburg and Sahlgrenska University Hospital, Sweden. The participants underwent lumbar puncture and blood assessment at Sahlgrenska University Hospital. The main outcome measures were history of RHI and PCS severity (PCS >1 year vs PCS <1 year) in relation to plasma and CSF concentrations of T-tau, GFAP, Aß40, and Aß42. Plasma T-tau, GFAP, Aß40, and Aß42 were quantified using an ultrasensitive assay technology. RESULTS: A total of 47 participants (28 athletes [median age 28 years, range 18-52] with persistent PCS due to RHI and 19 controls [median age, 25 years, range 21-35]) underwent paired blood and CSF sampling. T-tau, Aß40, and Aß42 concentrations measured in plasma did not correlate with the corresponding CSF concentrations, while there was a correlation between plasma and CSF levels of GFAP (r = 0.45, p = 0.020). There were no significant relationships between plasma T-tau, GFAP, and blood-brain barrier integrity as measured by the CSF:serum albumin ratio. T-tau, GFAP, Aß40, and Aß42 measured in plasma did not relate to PCS severity. None of the markers measured in plasma correlated with number of concussions, except decreased Aß42 in those with higher number of concussions (r = -0.40, p = 0.04). DISCUSSION: T-tau, GFAP, Aß40, and Aß42 measured in plasma do not correspond to CSF measures and may have limited utility for the evaluation of the late effects of RHI, compared with when measured in CSF. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that in professional athletes with postconcussion symptoms, plasma concentrations of T-tau, GFAP, Aß40, and Aß42 are not informative in the diagnosis of late effects of repetitive head injuries.


Assuntos
Biomarcadores , Concussão Encefálica , Síndrome Pós-Concussão , Adolescente , Adulto , Peptídeos beta-Amiloides , Atletas , Biomarcadores/sangue , Biomarcadores/líquido cefalorraquidiano , Concussão Encefálica/diagnóstico , Estudos Transversais , Humanos , Pessoa de Meia-Idade , Fragmentos de Peptídeos , Síndrome Pós-Concussão/diagnóstico , Adulto Jovem , Proteínas tau
18.
APMIS ; 130(9): 590-596, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35751642

RESUMO

Ferritin, the central iron storage protein, has attracted attention as a biomarker of severe COVID-19. Few studies have investigated regulators of iron metabolism in the context of COVID-19. The aim was to evaluate biomarkers for iron metabolism in the acute phase response to community-acquired pneumonia (CAP) caused by SARS-CoV-2 compared with CAP caused by bacteria or influenza virus in hospitalized patients. A cross-sectional study of 164 patients from the Surviving Pneumonia Cohort recruited between January 8, 2019 and May 26, 2020. Blood samples were collected at admission and analyzed for levels of C-reactive protein (CRP), ferritin, soluble transferrin receptor, erythroferrone, and hepcidin. Median (IQR) hepcidin was higher in SARS-CoV-2 with 143.8 (100.7-180.7) ng/mL compared with bacterial and influenza infection with 78.8 (40.1-125.4) and 53.5 (25.2-125.8) ng/mL, respectively. The median ferritin level was more than 2-fold higher in patients with SARS-CoV-2 compared with the other etiologies (p < 0.001). Patients with SARS-CoV-2 had lower levels of erythroferrone and CRP compared with those infected with bacteria. Higher levels of hepcidin and lower levels of erythroferrone despite lower CRP levels among patients with SARS-CoV-2 compared with those infected with bacteria indicate alterations in iron metabolism in patients with SARS-CoV-2 infection.


Assuntos
COVID-19 , Infecções Comunitárias Adquiridas , Influenza Humana , Pneumonia Bacteriana , Pneumonia Viral , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , COVID-19/complicações , Infecções Comunitárias Adquiridas/sangue , Infecções Comunitárias Adquiridas/diagnóstico , Estudos Transversais , Ferritinas , Hepcidinas/metabolismo , Humanos , Influenza Humana/complicações , Ferro/metabolismo , Pneumonia Bacteriana/sangue , Pneumonia Bacteriana/diagnóstico , Pneumonia Viral/sangue , Pneumonia Viral/diagnóstico , SARS-CoV-2
19.
Clin Chem ; 68(8): 1084-1093, 2022 07 27.
Artigo em Inglês | MEDLINE | ID: mdl-35762561

RESUMO

BACKGROUND: Growth differentiation factor 15 (GDF-15) is a stress-responsive biomarker associated with several types of cardiovascular diseases. However, conflicting results have been reported regarding its association with incident atrial fibrillation (AF) in the general population. METHODS: In 10 234 White and Black Atherosclerosis Risk in Communities (ARIC) Study participants (mean age 60 years, 20.5% Blacks) free of AF at baseline (1993 to 1995), we quantified the association of GDF-15 with incident AF using Cox regression models. GDF-15 concentration was measured by an aptamer-based proteomic method. AF was defined as AF diagnosis by electrocardiogram at subsequent ARIC visits or AF diagnosis in hospitalization records or death certificates. Harrell's c-statistic and categorical net reclassification improvement were computed for risk discrimination and reclassification. RESULTS: There were 2217 cases of incident AF over a median follow-up of 20.6 years (incidence rate 12.3 cases/1000 person-years). After adjusting for potential confounders, GDF-15 was independently associated with incident AF, with a hazard ratio (HR) of 1.42 (95% CI, 1.24-1.62) for the top vs bottom quartile. The result remained consistent (HR 1.23 [95% CI, 1.07-1.41]) even after further adjusting for 2 cardiac biomarkers, cardiac troponin T and natriuretic peptide. The results were largely consistent across demographic subgroups. The addition of GDF-15 modestly improved the c-statistic by 0.003 (95% CI, 0.001-0.006) beyond known risk factors of AF. CONCLUSIONS: In this community-based biracial cohort, higher concentrations of GDF-15 were independently associated with incident AF, supporting its potential value as a clinical marker of AF risk.


Assuntos
Aterosclerose , Fibrilação Atrial , Fator 15 de Diferenciação de Crescimento , Aterosclerose/complicações , Aterosclerose/epidemiologia , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/epidemiologia , Biomarcadores/sangue , Fator 15 de Diferenciação de Crescimento/sangue , Humanos , Incidência , Pessoa de Meia-Idade , Proteômica , Medição de Risco , Fatores de Risco
20.
Rev Assoc Med Bras (1992) ; 68(6): 860-865, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35766702

RESUMO

OBJECTIVE: The objective of this study was to evaluate whether a single measurement of vascular endothelial growth factor could distinguish between intrauterine pregnancy and ectopic pregnancy and to correlate the levels of vascular endothelial growth factor with serum levels of progesterone andß-human chorionic gonadotropin in each subgroup. METHODS: Ninety patients with a positive human chorionic gonadotropin test and either abdominal pain or vaginal bleeding were selected; pregnancies were singletons, spontaneously conceived, 42-56 days of gestational age. All patients had a transvaginal ultrasound examination and were divided into three subgroups: abnormal intrauterine pregnancy, tubal pregnancy, and normal intrauterine pregnancy. Tubal pregnancies were surgically treated and histologically confirmed. Blood samples were collected for the determination of ß-human chorionic gonadotropin, progesterone, and vascular endothelial growth factor and their concentrations were compared in each subgroup. Receiver operating characteristic curve was calculated by comparing the subgroup of tubal pregnancy to the other groups. A Fisher discriminant function analysis was performed. The level of significance was 5%. RESULTS: One-way analysis of variance revealed a significant correlation between the different subgroups and ß-human chorionic gonadotropin, progesterone, and vascular endothelial growth factor serum levels (p<0.001). Vascular endothelial growth factor concentration was significantly higher for patients with tubal pregnancy than for other subgroups (p<0.05). ß-Human chorionic gonadotropin and progesterone levels were higher in the subgroup with normal intrauterine pregnancies compared with the subgroups with tubal and abnormal intrauterine pregnancies (p<0.05). Serum vascular endothelial growth factor level >188.7 ng/mL predicted tubal pregnancy with 96.7% sensitivity, 95.0% specificity, 90.6% positive predictive value, and 98.3% negative predictive value. CONCLUSIONS: Serum vascular endothelial growth factor could be a marker in discriminating intrauterine pregnancy from tubal pregnancy; its levels are increased in women with ectopic pregnancy compared with women with normal and abnormal intrauterine pregnancies.


Assuntos
Gravidez Tubária , Gravidez , Fator A de Crescimento do Endotélio Vascular , Biomarcadores/sangue , Gonadotropina Coriônica/sangue , Feminino , Humanos , Gravidez/sangue , Gravidez Tubária/sangue , Gravidez Tubária/diagnóstico por imagem , Progesterona/sangue , Fator A de Crescimento do Endotélio Vascular/sangue
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