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1.
Medicine (Baltimore) ; 100(9): e24724, 2021 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-33655937

RESUMO

ABSTRACT: Brain metastasis is a common site of distant metastasis of non-small-cell lung cancer (NSCLC) that greatly reduces the prognosis of patients. In this study, we explored the correlation between different clinical factors and secondary brain metastases in NSCLC in an attempt to identify NSCLC patient populations at high risk of metastasis to the central nervous system.We collected data for 350 NSCLC patients from the medical record system of the First Affiliated Hospital of Nanchang University from June 2015 to June 2019, and these patients had pathologically verified diagnoses. The correlations between age at the time of diagnosis, sex, histological type, calcium concentration, hemoglobin (HB), fibrinogen (Fbg), activated partial thromboplastin time (APTT), alkaline phosphatase (ALP), carcinoembryonic antigen (CEA), CA125, and CA199 levels and brain metastasis were analyzed. Multivariate logistic regression analysis was used to identify risk factors for NSCLC brain metastasis. A receiver operating characteristic (ROC) curve was used to calculate the cutoff, sensitivity, and specificity of the independent related factors.Of the 350 patients, 57 were diagnosed with brain metastases. Univariate and multivariate logistic regression analysis indicated that lesion diameter, calcium concentration, and CEA level were independent risk factors correlated with brain metastasis (P < .05). There were no significant differences in age, sex, type of histopathology, presence or absence of mediastinal lymph node metastasis, HB, Fbg, APTT, ALP, cancer antigen 125 (CA-125), or cancer antigen 199 (CA-199) levels between patients with brain metastases and patients without brain metastases (P > .05, respectively). ROC curves demonstrated that these factors had comparable accuracy in predicting brain metastasis (area under the curve [AUCs] were 0.620, 0.661, and 0.729, respectively). The cutoff values for lesion diameter, calcium, and CEA were 5.050 cm, 2.295 mmol/L, and 11.160 ng/mL, respectively. The sensitivities for prediction brain metastasis were 59.6%, 64.9%, and 73.3%, with specificities of 63.1%, 59.2%, and 70.3%, respectively.According to our study, lesion diameter, calcium concentration, and CEA level are independent risk factors for brain metastases in NSCLC patients. Thus, we can strengthen the regular follow-up of NSCLC patients with tumor diameter > 5.050 cm, calcium > 2.295 mmol/L, CEA > 11.160 ng/mL, and use these factors as a reference for preventive treatments.


Assuntos
Neoplasias Encefálicas/secundário , Carcinoma Pulmonar de Células não Pequenas/secundário , Neoplasias Pulmonares/patologia , Idoso , Fosfatase Alcalina/sangue , Antígenos Glicosídicos Associados a Tumores/sangue , Antígeno Ca-125/sangue , Cálcio/sangue , Antígeno Carcinoembrionário/sangue , Feminino , Fibrinogênio/análise , Hemoglobinas/análise , Humanos , Modelos Logísticos , Pulmão/patologia , Neoplasias Pulmonares/sangue , Masculino , Proteínas de Membrana/sangue , Pessoa de Meia-Idade , Tempo de Tromboplastina Parcial , Valor Preditivo dos Testes , Curva ROC , Valores de Referência , Estudos Retrospectivos , Fatores de Risco , Sensibilidade e Especificidade , Carga Tumoral
2.
J Pediatr Endocrinol Metab ; 34(3): 385-387, 2021 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-33577728

RESUMO

OBJECTIVES: Coronavirus disease (COVID-19) rapidly spread worldwide in a few months and was declared as a worldwide pandemic by WHO in March 2020. Transient benign hyperphosphatasemia (THI) is a benign condition associated with marked elevation of alkaline phosphatase (ALP) without any other kidney, bone, and liver pathologies. CASE PRESENTATION: Herein, we report a previously healthy 16-month-old female patient who developed a secondary transient benign hyperphosphatasemia associated with SARS-CoV-2. Patient whole family's SARS-CoV-2 real-time reverse transcription-polymerase chain reaction (RT-PCR) results were positive. Since THI is a diagnosis of exclusion, other reasons that may cause ALP elevation should be ruled out. ALP activity decreased and turned to normal ranges within the following month. THI has been reported to be in association with various conditions. Its relationship with many viruses has been reported previously. CONCLUSIONS: If ALP elevation is detected in patients with COVID 19 due to the increasing number of infections, THI should be considered if there is no other accompanying pathology.


Assuntos
Fosfatase Alcalina/sangue , Distúrbios do Metabolismo do Fósforo/complicações , Distúrbios do Metabolismo do Fósforo/diagnóstico , /sangue , Feminino , Humanos , Lactente , Distúrbios do Metabolismo do Fósforo/sangue , Índice de Gravidade de Doença , Fatores de Tempo
3.
BMC Surg ; 21(1): 72, 2021 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-33536005

RESUMO

BACKGROUND: Most hepatocellular carcinoma (HCC) patients' liver function indexes are abnormal. We aimed to investigate the relationship between (alkaline phosphatase + gamma-glutamyl transpeptidase)/lymphocyte ratio (AGLR) and the progression as well as the prognosis of HCC. METHODS: A total of 495 HCC patients undergoing radical hepatectomy were retrospectively analyzed. We randomly divided these patients into the training cohort (n = 248) and the validation cohort (n = 247). In the training cohort, receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value of AGLR for predicting postoperative survival of HCC patients, and the predictive value of AGLR was evaluated by concordance index (C-index). Further analysis of clinical and biochemical data of patients and the correlation analysis between AGLR and other clinicopathological factors were finished. Univariate and multivariate analyses were performed to identify prognostic factors for HCC patients. Survival curves were analyzed using the Kaplan-Meier method. RESULTS: According to the ROC curve analysis, the optimal predictive cut-off value of AGLR was 90. The C-index of AGLR was 0.637 in the training cohort and 0.654 in the validation cohort, respectively. Based on this value, the HCC patients were divided into the low-AGLR group (AGLR ≤ 90) and the high-AGLR group (AGLR > 90). Preoperative AGLR level was positively correlated with alpha-fetoprotein (AFP), tumor size, tumor-node-metastasis (TNM) stage, and microvascular invasion (MVI) (all p < 0.05). In the training and validation cohorts, patients with AGLR > 90 had significantly shorter OS than patients with AGLR ≤ 90 (p < 0.001). Univariate and multivariate analyses of the training cohort (HR, 1.79; 95% CI 1.21-2.69; p < 0.001) and validation cohort (HR, 1.82; 95% CI 1.35-2.57; p < 0.001) had identified AGLR as an independent prognostic factor. A new prognostic scoring model was established based on the independent predictors determined in multivariate analysis. CONCLUSIONS: The elevated preoperative AGLR level indicated poor prognosis for patients with HCC; the novel prognostic scoring model had favorable predictive capability for postoperative prognosis of HCC patients, which may bring convenience for clinical management.


Assuntos
Alanina Transaminase/sangue , Biomarcadores/sangue , Carcinoma Hepatocelular/sangue , Carcinoma Hepatocelular/cirurgia , Hepatectomia , Neoplasias Hepáticas/sangue , Neoplasias Hepáticas/cirurgia , Linfócitos/patologia , Adulto , Idoso , Fosfatase Alcalina/sangue , Carcinoma Hepatocelular/diagnóstico , Feminino , Humanos , Neoplasias Hepáticas/diagnóstico , Linfócitos/metabolismo , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Curva ROC , Estudos Retrospectivos , Fatores de Risco , gama-Glutamiltransferase/sangue
4.
Nat Commun ; 12(1): 816, 2021 02 05.
Artigo em Inglês | MEDLINE | ID: mdl-33547301

RESUMO

Serum liver enzyme concentrations are the most frequently-used laboratory markers of liver disease, a major cause of mortality. We conduct a meta-analysis of genome-wide association studies of liver enzymes from UK BioBank and BioBank Japan. We identified 160 previously-unreported independent alanine aminotransferase, 190 aspartate aminotransferase, and 199 alkaline phosphatase genome-wide significant associations, with some affecting multiple different enzymes. Associated variants implicate genes that demonstrate diverse liver cell type expression and promote a range of metabolic and liver diseases. These findings provide insight into the pathophysiology of liver and other metabolic diseases that are associated with serum liver enzyme concentrations.


Assuntos
Alanina Transaminase/genética , Fosfatase Alcalina/genética , Aspartato Aminotransferases/genética , Genoma Humano , Hepatopatias/genética , Fígado/enzimologia , Alanina Transaminase/sangue , Fosfatase Alcalina/sangue , Aspartato Aminotransferases/sangue , Bancos de Espécimes Biológicos , Células Endoteliais/enzimologia , Células Endoteliais/patologia , Regulação da Expressão Gênica , Estudo de Associação Genômica Ampla , Hepatócitos/enzimologia , Hepatócitos/patologia , Humanos , Japão , Células Matadoras Naturais/enzimologia , Células Matadoras Naturais/patologia , Macrófagos do Fígado/enzimologia , Macrófagos do Fígado/patologia , Fígado/patologia , Hepatopatias/sangue , Hepatopatias/classificação , Hepatopatias/patologia , Locos de Características Quantitativas , Característica Quantitativa Herdável , Análise de Célula Única , Reino Unido
5.
Clin Lab ; 67(2)2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33616334

RESUMO

BACKGROUND: COVID-19 has recently been declared an epidemic by the WHO, and there is an urgent need for affected countries and laboratories to assess and treat people at risk of COVID-19. A heat procedure has been suggested for specimen inactivation. This study was designed to evaluate the effect of serum heating on biochemical indexes, and providing a basis for accurate detection results of the COVID-19 patients. METHODS: We collected 29 normal cases of two tubes of 5 mL whole blood. One tube was analyzed directly, and the other was analyzed after heating at 56°C 30 minutes. RESULTS: A total of 34 serum biochemical index quantitative results were obtained, 28/34 indexes were not significantly affected by the heat inactivation and remained clinically interpretable. As the thermal inactivation for these indexes showed good correlation, ALB (p = 0.04, Pearson R = 0.91, 2.6% mean increase), CysC (p = 0.03, Pearson R = 0.98, 9.9% mean increase), CO2CP (p < 0.001, Pearson R = 0.96, 13% mean decrease), they were still inter-pretable. Four biochemical indexes ALP, CK, CK-MB, and insulin were inactivated and showed significant statistical differences (p < 0.001). CONCLUSIONS: Our study showed CK, CK-MB, ALP, and insulin were sensitive to heat and will be inhibited or degrade after heating, indicating that the rapid decrease of this indexes in the COVID-19 patients may be caused by sample heat inactivation. For safety and diagnostic accuracy, we recommend the use of a point-of-care device for blood gases, electrolytes, troponin, and liver and renal function tests within a ISL 2 or above biosafety cabinet with level 3 or above biosafety laboratory practice.


Assuntos
Análise Química do Sangue , Erros de Diagnóstico/prevenção & controle , Temperatura Alta/efeitos adversos , Inativação de Vírus , Fosfatase Alcalina/sangue , Análise Química do Sangue/métodos , Análise Química do Sangue/normas , /diagnóstico , Creatina Quinase/sangue , Feminino , Humanos , Insulina/sangue , Masculino , Pessoa de Meia-Idade , Sistemas Automatizados de Assistência Junto ao Leito , /fisiologia , Sensibilidade e Especificidade
6.
BMJ Case Rep ; 14(1)2021 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-33431459

RESUMO

Primary Sjögren's syndrome (pSS) is a chronic slowly progressive autoimmune disease characterised by lymphocytic infiltration of salivary and lacrimal glands with varying degree of systemic involvement. Renal involvement, a recognised extraglandular manifestation of pSS, is commonly related to tubular dysfunction and generally manifests as distal renal tubular acidosis (RTA), proximal RTA, tubular proteinuria and nephrogenic diabetes insipidus. Untreated long-standing RTA is known to cause metabolic bone disease. Here, we present the report of a patient with sclerotic metabolic bone disease related to pSS with combined distal and proximal RTA and negative workup for other causes of sclerotic bone disease. A significant clinical and biochemical improvement, including recovery of proximal tubular dysfunction, was noted with alkali therapy. This case suggests the need to consider pSS in the diagnostic algorithm of a patient presenting with sclerotic bone disease.


Assuntos
Acidose Tubular Renal/diagnóstico , Dor nas Costas/imunologia , Doenças Ósseas Metabólicas/diagnóstico , Síndrome de Sjogren/diagnóstico , Absorciometria de Fóton , Acidose Tubular Renal/sangue , Acidose Tubular Renal/tratamento farmacológico , Acidose Tubular Renal/imunologia , Adulto , Fosfatase Alcalina/sangue , Dor nas Costas/sangue , Densidade Óssea/imunologia , Doenças Ósseas Metabólicas/sangue , Doenças Ósseas Metabólicas/tratamento farmacológico , Doenças Ósseas Metabólicas/imunologia , Feminino , Humanos , Citrato de Potássio/uso terapêutico , Cintilografia , Síndrome de Sjogren/sangue , Síndrome de Sjogren/complicações , Síndrome de Sjogren/imunologia , Esqueleto/diagnóstico por imagem , Bicarbonato de Sódio/uso terapêutico
7.
Lancet Haematol ; 8(3): e194-e204, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33508247

RESUMO

BACKGROUND: Several risk stratification models have been proposed in recent years for systemic mastocytosis but have not been directly compared. Here we designed and validated a risk stratification model for progression-free survival (PFS) and overall survival (OS) in systemic mastocytosis on the basis of all currently available prognostic factors, and compared its predictive capacity for patient outcome with that of other risk scores. METHODS: We did a retrospective prognostic modelling study based on patients diagnosed with systemic mastocytosis between March 1, 1983, and Oct 11, 2019. In a discovery cohort of 422 patients from centres of the Spanish Network on Mastocytosis (REMA), we evaluated previously identified, independent prognostic features for prognostic effect on PFS and OS by multivariable analysis, and designed a global prognostic score for mastocytosis (GPSM) aimed at predicting PFS (GPSM-PFS) and OS (GPSM-OS) by including only those variables that showed independent prognostic value (p<0·05). The GPSM scores were validated in an independent cohort of 853 patients from centres in Europe and the USA, and compared with pre-existing risk models in the total patient series (n=1275), with use of Harrells' concordance index (C-index) as a readout of the ability of each model to risk-stratify patients according to survival outcomes. FINDINGS: Our GPSM-PFS and GPSM-OS models were based on unique combinations of independent prognostic factors for PFS (platelet count ≤100 × 109 cells per L, serum ß2-microglobulin ≥2·5 µg/mL, and serum baseline tryptase ≥125 µg/L) and OS (haemoglobin ≤110 g/L, serum alkaline phosphatase ≥140 IU/L, and at least one mutation in SRSF2, ASXL1, RUNX1, or DNMT3A). The models showed clear discrimination between low-risk and high-risk patients in terms of worse PFS and OS prognoses in the discovery and validation cohorts, and further discrimination of intermediate-risk patients. The GPSM-PFS score was an accurate predictor of PFS in systemic mastocytosis (C-index 0·90 [95% CI 0·87-0·93], vs values ranging from 0·85 to 0·88 for pre-existing models), particularly in non-advanced systemic mastocytosis (C-index 0·85 [0·76-0·92], within the range for pre-existing models of 0·80 to 0·93). Additionally, the GPSM-OS score was able to accurately predict OS in the entire cohort (C-index 0·92 [0·89-0·94], vs 0·67 to 0·90 for pre-existing models), and showed some capacity to predict OS in advanced systemic mastocytosis (C-index 0·72 [0·66-0·78], vs 0·64 to 0·73 for pre-existing models). INTERPRETATION: All evaluated risk classifications predicted survival outcomes in systemic mastocytosis. The REMA-PFS and GPSM-PFS models for PFS, and the International Prognostic Scoring System for advanced systemic mastocytosis and GPSM-OS model for OS emerged as the most accurate models, indicating that robust prognostication might be prospectively achieved on the basis of biomarkers that are accessible in diagnostic laboratories worldwide. FUNDING: Carlos III Health Institute, European Regional Development Fund, Spanish Association of Mastocytosis and Related Diseases, Rare Diseases Strategy of the Spanish National Health System, Junta of Castile and León, Charles and Ann Johnson Foundation, Stanford Cancer Institute Innovation Fund, Austrian Science Fund.


Assuntos
Mastocitose Sistêmica/diagnóstico , Adulto , Idoso , Fosfatase Alcalina/sangue , Subunidade alfa 2 de Fator de Ligação ao Core/genética , Feminino , Hemoglobinas/análise , Humanos , Estimativa de Kaplan-Meier , Masculino , Mastocitose Sistêmica/mortalidade , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Prognóstico , Intervalo Livre de Progressão , Proteínas Repressoras/genética , Estudos Retrospectivos , Fatores de Risco , Fatores de Processamento de Serina-Arginina/genética
8.
Environ Toxicol Pharmacol ; 83: 103597, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33493675

RESUMO

The purpose of this study was to confirm the limit of salinity tolerance in juvenile olive flounders (Paralichthys olivaceus) by changes in blood parameters, AChE, antioxidant and stress responses. The P. olivaceus (mean weight 38.8 ± 4.2 g and mean length 16.4 ± 1.2 cm) were exposed to different concentrations of salinity (seawater, 16, 8, 4, 2, and 0 psu) for 2 weeks. Plasma osmotic pressure was significantly decreased in the P. olivaceus at 0 psu. Hematological parameters such as hematocrit and hemoglobin were significantly decreased in the P. olivaceus at low salinity. Plasma components also changed significantly in the low salinity environment. As a stress indicator, cortisol was significantly increased at low salinity. SOD and GST antioxidant responses, were significantly increased. GSH level in the liver was significantly increased, whereas a significant decrease was observed in the gill GSH level. AChE was significantly increased in P. olivaceus at low salinity. The results of this study indicate that exposure to salinities lower than 8 psu leads to changes in hematological parameters, neurotransmitter, antioxidant and stress responses of P. olivaceus.


Assuntos
Linguado/metabolismo , Estresse Oxidativo , Salinidade , Acetilcolinesterase/metabolismo , Alanina Transaminase/sangue , Fosfatase Alcalina/sangue , Animais , Aspartato Aminotransferases/sangue , Proteínas de Peixes/metabolismo , Linguado/sangue , Brânquias/efeitos dos fármacos , Brânquias/metabolismo , Glutationa/metabolismo , Glutationa Transferase/metabolismo , Hidrocortisona/sangue , Fígado/efeitos dos fármacos , Fígado/metabolismo , Superóxido Dismutase/metabolismo
9.
J Med Virol ; 93(4): 2365-2373, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33314141

RESUMO

Coronavirus disease 2019 (COVID-19) is a newly emerging infectious disease. Our understanding of the clinical characteristics of liver damage and the relationship with disease severity in COVID-19 is still limited. To investigate the serum hepatic enzyme activities in different phenotypes of COVID-19 patients, evaluate their relationship with the illness severity and analyze the correlation of glycyrrhizin treatment and abnormal liver enzyme activities, one hundred and forty-seven patients with COVID-19 were enrolled in a retrospective study that investigated hepatic dysfunction. Liver alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactic dehydrogenase (LDH), Y-glutamyl transferase (GGT), superoxide dismutase (SOD), and alkaline phosphatase (ALP) were analyzed in these patients. Patients with diammonium glycyrrhizinate (DG) treatment were further investigated. Of the 147 patients, 56 (38.1%) had abnormal ALT activity and 80 (54.4%) had abnormal AST activity. The peak of abnormal hepatic enzyme activities occurred at 3 to 6 days after on admission. Serum AST and LDH levels were elevated, while the SOD level was decreased in severe and critical patients, compared with mild cases. DG treatment may alleviate the abnormal liver enzyme activities in non-critical COVID-19 patients. Abnormal liver functions may be observed in patients with COVID-19, and were associated with SARS-CoV-2-induced acute liver damage. Glycyrrhizin treatment may be an effective therapeutic approach for the outcome of abnormal hepatic enzyme activities in severe COVID-19 cases. Serum hepatic enzyme tests may reflect the illness severity and should be monitored.


Assuntos
/enzimologia , Fígado/enzimologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Alanina Transaminase/sangue , Fosfatase Alcalina/sangue , Aspartato Aminotransferases/sangue , /metabolismo , Feminino , Humanos , Fígado/metabolismo , Testes de Função Hepática , Masculino , Pessoa de Meia-Idade , Fenótipo , Estudos Retrospectivos , Índice de Gravidade de Doença , Superóxido Dismutase/sangue , Adulto Jovem
10.
Actas urol. esp ; 44(10): 692-700, dic. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-198946

RESUMO

INTRODUCCIÓN: Los marcadores inflamatorios tienen valor pronóstico en diferentes tumores por la intervención de los fenómenos inflamatorios de las diferentes etapas del desarrollo tumoral. El objetivo de este estudio es demostrar el valor pronóstico de estos marcadores, así como de otras variables clínicas y analíticas en pacientes con cáncer de próstata metastásico resistente a la castración (CPRCm). MATERIAL Y MÉTODOS: Estudio de cohortes prospectivo realizado en 80 pacientes diagnosticados de CPRCm. Se recogieron datos clínicos y analíticos, estimándose los siguientes marcadores inflamatorios: recuento total de neutrófilos (RTN), ratio neutrófilo/linfocito (RN/L), recuento total de plaquetas (RTP), ratio plaquetas/linfocito (RP/L), ratio linfocito/monocito (RL/M) e índice sistémico de inflamación (ISI). igualmente se determinaron los valores de albúmina, hemoglobina (Hb), fosfatasa alcalina (FA) y lactato deshidrogenasa (LDH). RESULTADOS: Los pacientes con RTN > 7500, RN/L > 3, RP/L > 150, RL/M > 3 y/o ISI > 535.000, presentaron una mediana de supervivencia significativamente menores que el resto de pacientes, siendo el RTP el único marcador que no mostró asociación significativa. Además, la RN/L, RP/L y el ISI se correlacionaron inversamente con el tiempo de supervivencia. Los pacientes con hipoalbuminemia, anemia y valores elevados de LDH presentaron medianas de supervivencia significativamente menores. La albumina y la hemoglobina presentaron a su vez una correlación directa con el tiempo total de supervivencia. La necesidad de analgesia también se asoció con una menor supervivencia. CONCLUSIÓN: Los valores de determinados marcadores inflamatorios se asocian con menor supervivencia en pacientes con CPRCm, pudiendo considerarse su uso en la práctica clínica para evaluar el pronóstico y estimar la supervivencia


INTRODUCTION: Inflammatory markers have prognostic value in various tumors due to the role of inflammatory phenomena at different stages of tumor development. The aim of this study is to demonstrate the prognostic value of these markers, as well as other clinical and analytical variables in patients with metastatic castration-resistant prostate cancer (mCRPC). MATERIAL AND METHODS: Prospective cohort study carried out on 80 patients diagnosed with mCRPC. Clinical and analytical data were collected, and the following inflammatory markers were estimated: Absolute Neutrophil Count (ANC), Neutrophil-Lymphocyte Ratio (NLR), Total Platelet Count (TPC), Platelet-Lymphocyte Ratio (PLR), Lymphocyte-Monocyte Ratio (LMR) and Systemic Inflammation Index (SII). The values of albumin, hemoglobin (Hb), alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) were also determined. RESULTS: Patients with ANC> 7500, NLR>3, PLR>150, LMR>3 and/or SII>535,000, presented significantly lower median survival time than the remaining patients, and TPC was the only marker which did not show a significant association. Moreover, NLR, PLR and SII were inversely correlated with survival time. Patients with hypoalbuminemia, anemia, and elevated LDH values had significantly lower median survival time. Albumin and hemoglobin were directly correlated to overall survival time. The need for analgesia was also associated with shorter survival. CONCLUSION: The values of certain inflammatory markers are associated with shorter survival time in patients with mCRPC, and their use in clinical practice can be considered to evaluate the prognosis and estimate survival


Assuntos
Humanos , Masculino , Idoso , Idoso de 80 Anos ou mais , Neoplasias de Próstata Resistentes à Castração/sangue , Neoplasias de Próstata Resistentes à Castração/secundário , Biomarcadores Tumorais/sangue , Estudos Prospectivos , Neoplasias de Próstata Resistentes à Castração/patologia , Contagem de Plaquetas , Contagem de Linfócitos , Neutrófilos , Valores de Referência , Albumina Sérica/análise , Hemoglobinas/análise , Fosfatase Alcalina/sangue , L-Lactato Desidrogenase/sangue , Prognóstico , Estimativa de Kaplan-Meier , Modelos de Riscos Proporcionais
11.
Eur Rev Med Pharmacol Sci ; 24(24): 13072-13088, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33378061

RESUMO

OBJECTIVE: Liver involvement of SARS-CoV-2 infection has been reported in several papers, but without homogeneous findings. We aimed to systematically review the prevalence of liver involvement in patients with SARS-CoV-2 infection at their hospital admission, and its correlation with disease severity and clinical outcomes in patients with or without pre-existing chronic liver disease. MATERIALS AND METHODS: We systematically searched PubMed, Embase, Web of Science, Medline, PMC, clinical trial registries, and other Coronavirus family publications for studies reporting data on SARS-CoV-2 infection or COVID-19 and liver function tests (LFTs) alterations, as well as clinical course of patients with chronic liver disease or cirrhosis. Case reports, preprints, editorials, reviews were excluded. We also revised literature to describe the background of liver involvement during SARS-CoV-2 infection. RESULTS: 36 studies, including 20724 patients with SARS-CoV-2 infection, were included. The pooled prevalence of LFTs abnormalities at admission was 46.9% (AST 26.5%, ALT 22.8%, GGT 22.5%, ALP 5.7%, tBIL 8.0%). ALT, AST, tBIL were independent predictors of disease severity (ALT OR 1.54, 95% CI 1.17-2.03; AST OR 3.17, 95% CI 2.10-4.77; tBIL OR 2.32, 95% CI 1.18-4.58) and in-hospital mortality (ALT OR 1.48, 95% CI 1.12-1.96; AST OR 4.39, 95% CI 2.68-7.18; tBIL OR 7.75, 95% CI 2.28-26.40). Heterogeneity among studies was high. The few available data also reported that COVID-19 was associated with increased risk of liver decompensation and mortality in patients with liver cirrhosis. CONCLUSIONS: LFTs alterations were reported in up to 47% of unselected patients with COVID-19 and were associated with severe disease or in-hospital mortality. In cirrhotic patients, COVID-19 was associated with high risk of liver decompensation or mortality.


Assuntos
/epidemiologia , Hepatopatias/epidemiologia , Alanina Transaminase/sangue , Fosfatase Alcalina/sangue , Aspartato Aminotransferases/sangue , Bilirrubina/sangue , /mortalidade , Mortalidade Hospitalar , Humanos , Hepatopatias/sangue , Testes de Função Hepática , Razão de Chances , Prevalência , Prognóstico , Índice de Gravidade de Doença , gama-Glutamiltransferase/sangue
12.
Medicine (Baltimore) ; 99(40): e22572, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019469

RESUMO

RATIONALE: Atorvastatin is the most common drug used in therapy for cardiovascular diseases. The most common adverse side effects associated with statins are myopathy and hypertransaminasemia. Here, we report a rare case of gamma glutamyl transpeptidase (GGT) elevation induced by atorvastatin. PATIENT CONCERNS: A 47-year-old male was admitted to our hospital with dyslipidemia, he had been taking pitavastatin 2 mg/day for 2 months. The levels of total cholesterol (265.28 mg/dL) and low-density lipoprotein-cholesterol (LDL) (179.15 mg/dL) were also high. DIAGNOSIS: Blood lipid test showed mixed dyslipidemia. INTERVENTION: Atorvastatin 10 mg/day was given to the patient. OUTCOMES: The patient came back to our hospital for blood tests after 4 weeks. Although no symptoms were detectable, the patient's GGT level was markedly elevated (up to 6-fold over normal level) with less marked increases in alkaline phosphatase (ALP) and alanine aminotransferase (ALT). The serum GGT level returned to normal within 6 weeks of cessation of atorvastatin. LESSONS: This is a case of GGT elevation without hyperbilirubinemia, hypertransaminasemiam, or serum creatine phosphokinase (CPK) abnormalities despite an atorvastatin regimen. This case highlights GGT elevation caused by atorvastatin, a rare but serious condition. Clinicians should be aware of these possible adverse effects and monitor liver function tests in patients on statin therapy.


Assuntos
Atorvastatina/efeitos adversos , Dislipidemias/tratamento farmacológico , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Quinolinas/efeitos adversos , gama-Glutamiltransferase/efeitos dos fármacos , Alanina Transaminase/sangue , Fosfatase Alcalina/sangue , Atorvastatina/administração & dosagem , Atorvastatina/uso terapêutico , Doenças Cardiovasculares/tratamento farmacológico , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Dislipidemias/diagnóstico , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Quinolinas/administração & dosagem , Quinolinas/uso terapêutico , Suspensão de Tratamento , gama-Glutamiltransferase/sangue
13.
PLoS One ; 15(9): e0239060, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32941511

RESUMO

Quokkas (Setonix brachyurus) are small macropodid marsupials from Western Australia, which are identified as of conservation concern. Studies on their blood analytes exist but involve small sample sizes and are associated with very little information concerning the health of the animals. Blood was collected from free-ranging quokkas from Rottnest Island (n = 113) and mainland (n = 37) Western Australia, between September 2010 and December 2011, to establish haematology and blood chemistry reference intervals. Differences in haematology and blood chemistry between sites (Rottnest Island v mainland) were significant for haematology (HMT, p = 0.003), blood chemistry (BLC, p = 0.001) and peripheral blood cell morphology (PBCM, p = 0.001). Except for alkaline phosphatase, all blood chemistry analytes were higher in mainland animals. There were also differences with time of year in HMT (p = 0.001), BLC (p = 0.001) and PBCM (p = 0.001) for Rottnest Island quokkas. A small sample of captive animals (n = 8) were opportunistically sampled for plasma concentrations of vitamin E and were found to be deficient compared with wild-caught animals. Fifty-eight of the 150 quokkas were also tested for the presence of Salmonella, microfilariae, Macropodid herpesvirus-6, Theileria spp., Babesia spp., trypanosomes, Cryptococcus spp. and other saprophytic fungi. All eight infectious agents were detected in this study. Infectious agents were detected in 24 of these 58 quokkas (41%), with more than one infectious agent detected for all 24 individuals. Salmonella were detected concurrently with microfilariae in 8 of these 24 quokkas, and this mixed infection was associated with lower values across all haematological analytes, with Salmonella having the greater involvement in the decreased haematological values (p < 0.05). There was no evidence for an effect of sex on HMT, BLC and PBCM. Our data provide important haematological and blood chemistry reference intervals for free-ranging quokkas. We applied novel methods of analyses to HMT and BLC that can be used more broadly, aiding identification of potential disease in wildlife.


Assuntos
Macropodidae/sangue , Fosfatase Alcalina/sangue , Animais , Animais Selvagens/sangue , Animais Selvagens/microbiologia , Animais Selvagens/virologia , Análise Química do Sangue , Doenças Transmissíveis/sangue , Doenças Transmissíveis/microbiologia , Doenças Transmissíveis/veterinária , Doenças Transmissíveis/virologia , Feminino , Testes Hematológicos , Macropodidae/microbiologia , Macropodidae/virologia , Masculino , Estações do Ano , Vitamina E/sangue , Austrália Ocidental
14.
J Cancer Res Ther ; 16(4): 839-842, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32930127

RESUMO

Background: Lung cancer is considered as the most commonly diagnosed cancer. It is the leading cause of cancer-related mortality. Smoking and environmental pollutants act as important risk factors in majority of lung cancer cases (80%-90%). Material and Methods: This is a hospital-based study carried on in lung cancer patients of North India. Demographic profile of lung cancer patients was recorded. Hematological and biochemical profiles of lung cancer patients and healthy controls were compared. Results: Highest proportion of lung cancer was found in the age group of 46-60 years. Lung cancer was seen in highest number in male gender (76.63%) and also in those patients belonging to the rural category (84.58%). In this study, only 3.98% lung cancer patients having the past history of cancer and 5.47% showing the family history of cancer. Significant differences were found in weight and body mass index (BMI) of lung cancer patients when compared to healthy control (P < 0.0001). Hemoglobin (Hb) was found lower in lung cancer patients as compared with healthy controls. Significant difference was also observed in Hb levels of these two groups (P < 0.000). The serum protein level was lower in lung cancer patients than healthy controls. A significant difference was also observed in the protein levels of these two groups (P < 0.0001). Serum alkaline phosphatase (ALP) levels were higher in lung cancer patients in comparison to healthy controls. A significant difference was also observed in serum ALP levels in lung cancer patients as compared with healthy controls (P < 0.0001). Conclusions: Significant difference between BMI, Hb, serum albumin, and total protein was found in this study. These biomarkers may be helpful in the diagnosis of lung cancer at early stage and also in the follow-up assessment of the effects of treatment.


Assuntos
Neoplasias Pulmonares/sangue , Neoplasias Pulmonares/epidemiologia , Adulto , Idoso , Fosfatase Alcalina/sangue , Biomarcadores/sangue , Índice de Massa Corporal , Feminino , Testes Hematológicos , Hemoglobinas/metabolismo , Hospitais/estatística & dados numéricos , Humanos , Índia/epidemiologia , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Fatores de Risco , Fumar/sangue , Fumar/epidemiologia , Fatores Socioeconômicos
15.
J Cancer Res Ther ; 16(4): 874-877, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32930133

RESUMO

Aim of Study: The present study was planned to analyze serum heme oxygenase-1 levels in osteosarcoma patients. Materials and Methods: Twenty five histopathologically confirmed cases of osteosarcoma localized without metastasis of all the ages attending the Orthopedic Clinics were included in the study group and twenty five patients having musculoskeletal pain (age and sex matched) served as control. Five ml of venous blood was collected aseptically from antecubital vein and serum was be separated by centrifugation and analyzed the same day. Routine biochemistry investigations were performed as per standard enzymatic methods by autoanalyzer. Serum Heme oxygenase-1 was analyzed by enzyme-linked immunosorbent assay. Results: In osteosarcoma patients, serum HO-1 levels were increased as compared to patients having musculoskeletal pain (P < 0.05). Workers have found that HO-1 induction in prostate cancer cell lines (PC3) cells restored the proliferation of osteoblasts, which was inhibited during co-culture with parental prostate cancer cell line PC3 cells. However, no concrete data are available on blood levels of HO in osteosarcoma. Major role of HO-1 is the protection against oxidative injury, additionally, it regulates cell proliferation, modulates inflammatory response and facilitates angiogenesis. Conclusion: Findings of the present study suggests that pharmacological agents that regulate HO activity or HO-1 gene silencing may become powerful tools for preventing the onset or progression of various cancers and sensitize them to anticancer therapies.


Assuntos
Neoplasias Ósseas/enzimologia , Heme Oxigenase-1/sangue , Osteossarcoma/enzimologia , Adolescente , Adulto , Fosfatase Alcalina/sangue , Antioxidantes/metabolismo , Biomarcadores Tumorais/sangue , Neoplasias Ósseas/sangue , Neoplasias Ósseas/patologia , Estudos de Casos e Controles , Criança , Feminino , Humanos , Masculino , Osteossarcoma/sangue , Osteossarcoma/patologia , Prognóstico , Adulto Jovem
16.
Blood Coagul Fibrinolysis ; 31(8): 575-577, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32897891

RESUMO

: It is now known that SARS-CoV-2 infection because of coronavirus is highly contagious and caused varying degrees of illness throughout the world. Hepatic dysfunction and the slight elevation of liver enzymes have been reported in cases of COVID-19 infection. Transient hyperphosphatasemia is a benign condition characterized by the elevation of serum alkaline phosphatase and the return to normal levels within weeks or months of first observation. We reported the first infant case of severe hyperphosphatasemia because of SARS-CoV-2 infection, in a 9-month-old child admitted to the Pediatric Covid-19 Unit of Amiens University Hospital. Given the hepatic tropism and COVID-19-related hyperinflammatory reactions, our case suggests that, an isolated severe hyperphosphatasemia in children with SARS-CoV-2 infection should increase the possibility of transient hyperphosphatasemia, even if is also demonstrated a classic natural history of the transient hyperphosphatasemia during viral infection, especially in SARS-CoV-2 infection.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Hiperfosfatemia/virologia , Pneumonia Viral/complicações , Fosfatase Alcalina/sangue , Betacoronavirus/genética , Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , França , Humanos , Lactente , Masculino , Pandemias , Pneumonia Viral/diagnóstico , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Carga Viral
17.
PLoS One ; 15(8): e0237793, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32822383

RESUMO

PURPOSE: It has been demonstrated that, for various types of cancer, the pretreatment albumin/alkaline phosphatase ratio (AAPR) was a prognostic factor. Therefore, in order to determine AAPR's prognostic effect on cancer, the meta-analysis was hereby performed. PATIENTS AND METHODS: The relevant studies conducted before November 10, 2019, were comprehensively searched in Web of Science, PubMed, and Embase. HRs(hazard ratios) with related 95%CIs(confidence intervals) were adopted to estimate AAPR's prognostic impact on overall survival (OS) & disease-free survival (DFS). RESULTS: Our meta-analysis involved thirteen cohort studies, which included 5,204 cases of 8 types. The results of this meta-analysis indicated that higher AAPR was corrected with better OS (pooled HR = 0.52; 95%CI = 0.47-0.58; P<0.001) and DFS (pooled HR = 0.55; 95%CI = 0.47-0.66; P<0.001). Subgroup analysis on OS was based on the cancer system, treatment methods, and cutoff value. Moreover, higher AAPR was statistically in associated with lighter infiltration (pooled OR = 0.79; 95%CI = 0.73-0.85; P<0.001), no lymph nodes metastasis (pooled OR = 0.89; 95%CI = 0.83-0.95; P = 0.001), and no distant metastasis (pooled OR = 0.92; 95%CI = 0.86-0.99; P = 0.028). CONCLUSION: Higher AAPR was related to better prognosis of cancer, and in cancer therapy, AAPR could be taken as a promising marker of prognosis. It might help physicians to select the most appropriate treatments by evaluating the current status of patients with cancer. Future multicenter prospective clinical trials were required to verify its applications.


Assuntos
Fosfatase Alcalina/sangue , Neoplasias/diagnóstico , Albumina Sérica/análise , Biomarcadores Tumorais/sangue , Intervalo Livre de Doença , Humanos , Neoplasias/sangue , Neoplasias/terapia , Prognóstico
18.
Actual. osteol ; 16(2): [104]-[115], mayo.-ago. 2020. graf, tab
Artigo em Espanhol | LILACS | ID: biblio-1129698

RESUMO

La fosfatasa alcalina baja o hipofosfatasemia, ya sea debida a causas genéticas (hipofosfatasia) o secundarias, presenta correlato clínico. Nuestro objetivo es estimar la prevalencia de hipofosfatasemia crónica persistente y describir sus hallazgos osteometabólicos. Se realizó una búsqueda electrónica de afiliados adultos al Hospital Italiano de Buenos Aires, entre 2013 y 2017, con al menos 2 determinaciones de fosfatasa alcalina igual a 30 UI/l o menor y ninguna mayor de 30 UI/l (rango de referencia 30-100 UI/l). Se excluyeron aquellos con causas secundarias diagnosticadas y se analizaron los correlatos clínico y bioquímico. Se detectó hipofosfatasemia crónica persistente en 78 de 105.925, 0,07% (0,06-0,09) de los afiliados. Solo uno fue excluido por tener causa secundaria. Eran 61,1% mujeres de 44 (34-56) años, fosfatasa alcalina 24 (20-27) UI/L, fosfatemia 4,1 (3,8-4,6) mg/dl. Se observaron osteoartritis, calcificaciones vasculares y fracturas, menos frecuentemente litiasis renal, calcificación del ligamento longitudinal común anterior, pérdida dental y convulsiones. El 63,6% tenían al menos una de las características clínico-radiológicas evaluadas, pero en solo 5,2% fue mencionado el diagnóstico de hipofosfatasemia en la historia clínica. La densitometría evidenció algún grado de afección (osteopenia u osteoporosis) en 76,2%. Se constataron 19 fracturas, con predominio en radio. La prevalencia de hipofosfatasemia fue similar a lo previamente reportado. El reconocimiento fue bajo; sin embargo, se observaron variadas manifestaciones músculo-esqueléticas, similares a las descriptas en la hipofosfatasia del adulto, por lo cual ­ante una hipofosfatasemia sin causa secundaria­ se sugiere considerar este diagnóstico. (AU)


Low alkaline phosphatase (ALP) or hypophosphatasemia either due to genetic (hypophosphatasia) or secondary causes, presents a clinical correlate. Our objectives are to estimate the prevalence of persistent hypophosphatasemia and to describe the clinical findings. We performed a search using the electronic medical records of the members of the Hospital Italiano de Buenos Aires health care system, between 2013 and 2017. Adult members with ≥ 2 ALP ≤ 30 IU/l, no ALP >30 IU/l (normal range 30-100 UI/l) and without diagnosed secondary causes were analyzed. Persistent hypophosphatasemia was detected in 78 of 105.925, 0.07% (0.06-0.09) of members. Only one was excluded due to a secondary cause, 61.1% were women, 44 (34-56) year-old, ALP 24 (20-27) IU/l and phosphatemia 4.1 (3.8-4.6) mg/dl. Osteoarthritis, vascular calcifications and fractures were detected, and nephrolithiasis, DISH (Diffuse idiopathic skeletal hyperostosis), tooth loss, and seizures were less frequently observed. At least one of the mentioned characteristics were present in 63.6 %, but only 5.2% had hypophosphatasemia registered in their clinical record. Densitometry showed osteopenia or osteoporosis in 76.2%. There were 19 fractures, most of them in radius. The prevalence of hypophosphatasemia was similar to what has been previously reported. Hypophosphatasemia finding in medical records was low, but far from being asymptomatic, clinical manifestations were observed. In the presence of hypophosphatasemia without a secondary cause, adult hypophosphatasia should be uspected. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Músculo Esquelético/patologia , Hipofosfatasia/etiologia , Osteoporose/etiologia , Doenças Ósseas Metabólicas/etiologia , Densidade Óssea , Prevalência , Estudos Transversais , Hipofosfatemia/diagnóstico , Hipofosfatemia/etiologia , Difosfonatos/uso terapêutico , Fosfatase Alcalina/deficiência , Fosfatase Alcalina/fisiologia , Fosfatase Alcalina/sangue , Fraturas por Osteoporose/etiologia , Hipofosfatasia/diagnóstico , Hipofosfatasia/genética
19.
BMJ Open ; 10(7): e040517, 2020 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-32641369

RESUMO

INTRODUCTION: COVID-19 has spread rapidly in China and around the world. Published studies have revealed that some patients with COVID-19 had abnormal liver function in laboratory tests. However, the results were inconsistent and the analysis of epidemiological data stratified by the severity of COVID-19 was not available in previous meta-analyses. Furthermore, these meta-analyses were suspected of overestimating the incidence of liver injury in patients with COVID-19 because some studies considered transaminase elevation as liver injury, which might partially result from cardiac and muscle injury. This systematic review aims to enrol published literatures related to COVID-19 without language restriction, analyse the data based on the severity of the COVID-19 and explore the impact of varied definitions of liver injury on the incidence of liver injury. METHODS AND ANALYSIS: We have conducted a preliminary search on PubMed and Excerpta Medica Database on 13 April 2020, for the studies published after December 2019 on the prevalence of acute liver injury and hypertransaminemia in patients with COVID-19. Two reviewers will independently screen studies, extract data and assess the risk of bias. We will estimate the pooled incidence of hypertransaminemia and acute liver injury in patients with COVID-19 by using the random-effects model. The I² test will be used to identify the extent of heterogeneity. Publication bias will be assessed by funnel plot and performing the Begg's and Egger's test if adequate studies are available. We will perform a risk of bias assessment using the Joanna Briggs Institute's critical appraisal checklist. ETHICS AND DISSEMINATION: Since this study will be based on the published data, it does not require ethical approval. The final results of this study will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42020179462.


Assuntos
Infecções por Coronavirus/epidemiologia , Hepatopatias/epidemiologia , Pneumonia Viral/epidemiologia , Doença Aguda , Alanina Transaminase/sangue , Fosfatase Alcalina/sangue , Aspartato Aminotransferases/sangue , Betacoronavirus , Bilirrubina/sangue , Humanos , Incidência , Hepatopatias/sangue , Pandemias , Prevalência
20.
Am J Gastroenterol ; 115(7): 1066-1074, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32618657

RESUMO

INTRODUCTION: In primary biliary cholangitis (PBC), bilirubin and alkaline phosphatase (ALP) are widely established as independent predictors of prognosis. Current treatment goals do not aim for normalization of surrogate markers because their association with survival has not been defined. METHODS: The patient cohort from the GLOBAL PBC Study Group was used, comprising of long-term follow-up data from European and North American centers. Ursodeoxycholic acid-treated and untreated patients with bilirubin levels ≤1 × upper limit of normal (ULN) at baseline or 1 year were included. The association of normal ALP with transplant-free survival was assessed in a subgroup with ALP ≤1.67 × ULN at 1 year. Optimal thresholds of bilirubin and ALP to predict liver transplantation (LT) or death were evaluated. RESULTS: There were 2,281 patients included in the time zero cohort and 2,555 patients in the 1-year cohort. The bilirubin threshold with the highest ability to predict LT or death at 1 year was 0.6 × ULN (hazard ratio 2.12, 95% CI 1.69-2.66, P < 0.001). The 10-year survival rates of patients with bilirubin ≤0.6 × ULN and >0.6 × ULN were 91.3% and 79.2%, respectively (P < 0.001). The risk for LT or death was stable below the bilirubin levels of 0.6 × ULN, yet increased beyond this threshold. Ursodeoxycholic acid-induced reduction in bilirubin below this threshold was associated with an 11% improvement in 10-year survival. Furthermore, ALP normalization was optimal, with 10-year survival rates of 93.2% in patients with ALP ≤ 1 × ULN and 86.1% in those with ALP 1.0-1.67 × ULN. DISCUSSION: Attaining bilirubin levels ≤0.6 × ULN or normal ALP are associated with the lowest risk for LT or death in patients with PBC. This has important implications for treatment targets.


Assuntos
Fosfatase Alcalina/sangue , Bilirrubina/sangue , Colagogos e Coleréticos/uso terapêutico , Colangite/tratamento farmacológico , Ácido Ursodesoxicólico/uso terapêutico , Biomarcadores/sangue , Colangite/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Valores de Referência , Taxa de Sobrevida
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