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1.
Medicine (Baltimore) ; 99(9): e19239, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32118728

RESUMO

Despite the availability of a series of tests, detection of chronic traumatic osteomyelitis is still exhausting in clinical practice. We hypothesized that machine learning based on computed-tomography (CT) images would provide better diagnostic performance for extremity traumatic chronic osteomyelitis than the serological biomarker alone. A retrospective study was carried out to collect medical data from patients with extremity traumatic osteomyelitis according to the criteria of musculoskeletal infection society. In each patient, serum levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and D-dimer were measured and CT scan of the extremity was conducted 7 days after admission preoperatively. A deep residual network (ResNet) machine learning model was established for recognition of bone lesion on the CT image. A total of 28,718 CT images from 163 adult patients were included. Then, we randomly extracted 80% of all CT images from each patient for training, 10% for validation, and 10% for testing. Our results showed that machine learning (83.4%) outperformed CRP (53.2%), ESR (68.8%), and D-dimer (68.1%) separately in accuracy. Meanwhile, machine learning (88.0%) demonstrated highest sensitivity when compared with CRP (50.6%), ESR (73.0%), and D-dimer (51.7%). Considering the specificity, machine learning (77.0%) is better than CRP (59.4%) and ESR (62.2%), but not D-dimer (83.8%). Our findings indicated that machine learning based on CT images is an effective and promising avenue for detection of chronic traumatic osteomyelitis in the extremity.


Assuntos
Extremidades/lesões , Osteomielite/diagnóstico por imagem , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , China , Doença Crônica , Bases de Dados Factuais , Feminino , Produtos de Degradação da Fibrina e do Fibrinogênio , Humanos , Escala de Gravidade do Ferimento , Aprendizado de Máquina , Masculino , Pessoa de Meia-Idade , Osteomielite/sangue , Osteomielite/diagnóstico , Estudos Retrospectivos , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X
2.
J Korean Med Sci ; 35(10): e65, 2020 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-32174064

RESUMO

BACKGROUND: Neutrophil gelatinase-associated lipocalin (NGAL), a bacteriostatic agent, is known to inhibit erythropoiesis leading to anemia. We aimed to investigate the associations of NGAL, anemia, and renal scarring in children with febrile urinary tract infections (UTIs). METHODS: We retrospectively reviewed the medical records of 261 children with febrile UTIs. The relationship between the presence of anemia and plasma NGAL levels was investigated. NGAL performance in comparison with serum C-reactive protein (CRP) at admission and after 72 hours of treatment was also evaluated for the prediction of renal scarring as well as acute pyelonephritis (APN) and vesicoureteral reflux (VUR). RESULTS: Plasma NGAL levels were elevated in patients with anemia compared with those without anemia. Multiple linear regression analysis showed an inverse relationship between NGAL levels and erythrocyte counts (standard ß = -0.397, P < 0.001). Increased NGAL, but not CRP, was independently associated with the presence of anemia (odds ratio [OR], 2.37; 95% confidence interval [CI], 1.07-5.27; P < 0.05). Receiver operating curve analyses showed good diagnostic profiles of pre- and post-treatment NGAL for identifying APN, VUR, and renal scarring (all P < 0.05). For detecting renal scars, the area under the curve of post-treatment NGAL (0.730; 95% CI, 0.591-0.843) was higher than that of post-treatment CRP (0.520; 95% CI, 0.395-0.643; P < 0.05). The presence of anemia and elevated NGAL at admission (> 150 ng/mL) were independent risk factors for renal scarring in children with febrile UTIs. With anemia, NGAL levels increased consecutively in children with febrile UTI without renal involvement, with APN without scar, and with APN with renal scarring. CONCLUSION: Increased plasma NGAL levels may be associated with the presence of anemia and renal scarring in children with febrile UTIs.


Assuntos
Anemia/complicações , Lipocalina-2/sangue , Infecções Urinárias/complicações , Biomarcadores/sangue , Proteína C-Reativa/análise , Estudos de Casos e Controles , Criança , Feminino , Febre , Humanos , Rim/patologia , Masculino , Razão de Chances , Pielonefrite/complicações , Refluxo Vesicoureteral/complicações
3.
Medicine (Baltimore) ; 99(11): e19071, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32176032

RESUMO

BACKGROUND: It is important to manage inflammation after craniotomy. It may be prudent to reduce the excessive usage of antibiotics and to add supplementary treatments like acupuncture, which would be effective and safe. However, there are only a few studies available to date on the effects of acupuncture on anti-inflammatory response after craniotomy. The aim of this study was to explore the anti-inflammatory effects of acupuncture in patients after a craniotomy. METHODS: This study was a single-center, prospective, open-label, controlled trial. Forty-four subjects who underwent craniotomy for an unruptured aneurysm, facial spasm, or brain tumor were allocated to either an acupuncture group or a control group. Both groups received postoperative routine care in the Department of Neurosurgery. The subjects in the acupuncture group also received a total of 6 acupuncture treatments sessions within 8 days after craniotomy. Acupuncture treatments included acupuncture, electroacupuncture, and intradermal acupuncture. The serum interleukin (IL)-1ß and IL-6, tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and erythrocyte sedimentation rate levels were assessed four times within 7 days after surgery. The presence of fever, use of additional antibiotics, presence of infection including pneumonia or urinary tract infection, and safety were also reviewed. RESULTS: The IL-1ß levels of subjects who underwent aneurysmal clipping were significantly lower in the acupuncture group (P = .02). TNF-α levels of subjects who underwent aneurysmal clipping at the seventh postoperative day were also significantly lower in the acupuncture group (P = .03). Six cases of fever of unknown origin were observed in the control group, while none were seen in the acupuncture group, revealing that the incidence of fever was significantly lower in the acupuncture group (P = .02). No adverse events occurred during the trial. CONCLUSION: Acupuncture showed a possibility of alleviating inflammation by attenuating the levels of proinflammatory cytokines and significantly reduced the incidence of fever of unknown origin in patients after craniotomy. Acupuncture would be suitable as an adjunctive therapy to alleviate inflammation after craniotomy.


Assuntos
Terapia por Acupuntura/métodos , Craniotomia/efeitos adversos , Inflamação/terapia , Complicações Pós-Operatórias/terapia , Proteína C-Reativa/análise , Feminino , Humanos , Inflamação/sangue , Inflamação/etiologia , Interleucina-1beta/sangue , Interleucina-6/sangue , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fator de Necrose Tumoral alfa/sangue
4.
J Korean Med Sci ; 35(11): e77, 2020 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-32193903

RESUMO

BACKGROUND: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease with high mortality in East Asia. This study aimed to develop, for primary care providers, a prediction score using initial symptoms and basic laboratory blood tests to differentiate between SFTS and other endemic zoonoses in Korea. METHODS: Patients aged ≥ 18 years diagnosed with endemic zoonoses during a 3-year period (between January 2015 and December 2017) were retrospectively enrolled from 4 tertiary university hospitals. A prediction score was built based on multivariate logistic regression analyses. RESULTS: Of 84 patients, 35 with SFTS and 49 with other endemic zoonoses were enrolled. In multivariate logistic regression analysis, independent predictors of SFTS included neurologic symptoms (odds ratio [OR], 12.915; 95% confidence interval [CI], 2.173-76.747), diarrhea (OR, 10.306; 95% CI, 1.588-66.895), leukopenia (< 4,000/mm³) (OR, 19.400; 95% CI, 3.290-114.408), and normal C-reactive protein (< 0.5 mg/dL) (OR, 24.739; 95% CI, 1.812-337.742). We set up a prediction score by assigning one point to each of these four predictors. A score of ≥ 2 had 82.9% sensitivity (95% CI, 71.7%-87.5%) and 95.9% specificity (95% CI, 88.0%-99.2%). The area under the curve of the clinical prediction score was 0.950 (95% CI, 0.903-0.997). CONCLUSION: This study finding suggests a simple and useful scoring system to predict SFTS in patients with endemic zoonoses. We expect this strategic approach to facilitate early differentiation of SFTS from other endemic zoonoses, especially by primary care providers, and to improve the clinical outcomes.


Assuntos
Febre Hemorrágica com Síndrome Renal/diagnóstico , Febre por Flebótomos/diagnóstico , Tifo por Ácaros/diagnóstico , Adulto , Idoso , Animais , Proteína C-Reativa/análise , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Phlebovirus , República da Coreia , Estudos Retrospectivos , Zoonoses/diagnóstico
5.
Medicine (Baltimore) ; 99(9): e19350, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32118773

RESUMO

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


Assuntos
Proteína C-Reativa/classificação , Neoplasias/complicações , Prognóstico , Albumina Sérica Humana/classificação , Adulto , Idoso , Proteína C-Reativa/análise , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/sangue , Cuidados Paliativos/métodos , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Albumina Sérica Humana/análise
6.
Medicine (Baltimore) ; 99(10): e19359, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32150077

RESUMO

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


Assuntos
Doenças Inflamatórias Intestinais/sangue , Fator de Necrose Tumoral alfa/análise , Adalimumab/análise , Adalimumab/sangue , Adalimumab/uso terapêutico , Adulto , Biomarcadores/análise , Biomarcadores/sangue , Índice de Massa Corporal , Proteína C-Reativa/análise , Estudos Transversais , Feminino , Humanos , Infliximab/análise , Infliximab/sangue , Infliximab/uso terapêutico , Masculino , Pessoa de Meia-Idade , Fator de Necrose Tumoral alfa/sangue
7.
Medicine (Baltimore) ; 99(10): e19362, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32150079

RESUMO

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


Assuntos
Proteína C-Reativa/análise , Prognóstico , Albumina Sérica/análise , Neoplasias Gástricas/sangue , Humanos , Modelos de Riscos Proporcionais , Curva ROC
8.
Medicine (Baltimore) ; 99(11): e19477, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32176079

RESUMO

We assessed the predictive value of serum ammonia level on admission for the 28-day mortality of patients with sepsis.We retrospectively included septic patients admitted to the emergency department of West China Hospital, Sichuan University and The Fourth People's Hospital of Zigong city from June 2017 to May 2018. Patients were divided into 2 groups according to 28-day survival. Comparisons of serum ammonia level and sequential organ failure assessment (SOFA) score were made between 2 groups. Multivariate logistic regression models were employed to determine independent risk factors affecting 28-day mortality rate, and receiver operating characteristic (ROC) curve was also used to evaluate the efficacy of risk factors.Total of 316 patients were included into the study, 221 survived to 28 days and 95 were died before 28 days. The 28-day mortality rate was 30.06%. Multivariate logistic regression analyses revealed that the ammonia level, C reactive protein, SOFA score, and the leukocyte were independent risk factors for the 28-day mortality rate. In predicting the 28-day mortality rate, the SOFA score presented an area under the ROC curve (AUC) of 0.815, and the ammonia levels presented the AUC of 0.813.The ammonia level, C reactive protein, SOFA score, and the leukocyte are independent risk factors for 28-day mortality rate in septic patients. Moreover, the serum ammonia and SOFA score have similar predictive values. The serum ammonia level is also a suitable early indicator for prognostic evaluation of patients with sepsis as well.


Assuntos
Amônia/sangue , Serviço Hospitalar de Emergência , Sepse/sangue , Sepse/mortalidade , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escores de Disfunção Orgânica , Valor Preditivo dos Testes , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida
9.
Angiology ; 71(4): 366-371, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32000500

RESUMO

Contrast-induced nephropathy (CIN) accounts for about 10% of all hospital-acquired acute kidney injury. We aimed to assess the role of the combination of 2 inflammatory biomarkers, the C-reactive protein (CRP)/albumin ratio (CAR), in the development of CIN after percutaneous coronary intervention (PCI) in patients with non-ST-elevation myocardial infarction (NSTEMI). Patients with NSTEMI (n = 205) treated by PCI were classified according to the development of CIN. Both groups were compared according to clinical, laboratory, and demographic characteristics, including inflammatory biomarkers and specifically, CAR. Contrast-induced nephropathy was observed in 10.2% of patients. More advanced age, the presence of diabetes and dyslipidemia, left ventricular ejection fraction, and CAR correlated with the development of CIN. Analysis also showed a significant association between CAR and the development of CIN (CAR in CIN (+): 8.54 ± 8.48, range: 0.7-32, median: 7.13 vs CAR in CIN (-): 2.36 ± 3.01, range: 0.1-24, median: 1.33, P < .001). Multivariate logistic regression analysis showed the impact of CAR on the development of CIN (odds ratio: 1.244, 95% confidence interval: 1.102; 1.392, P < .01). We conclude that CAR, as a combination of 2 inflammatory biomarkers, is a more accurate predictor of CIN development compared with the single-marker assessment of albumin and CRP in the context of NSTEMI.


Assuntos
Lesão Renal Aguda/induzido quimicamente , Albuminas/metabolismo , Proteína C-Reativa/metabolismo , Meios de Contraste/efeitos adversos , Infarto do Miocárdio sem Supradesnível do Segmento ST/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/metabolismo , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio sem Supradesnível do Segmento ST/cirurgia , Intervenção Coronária Percutânea , Valor Preditivo dos Testes , Estudos Prospectivos
10.
Angiology ; 71(4): 349-359, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32013536

RESUMO

C-reactive protein (CRP) and high-sensitivity CRP (hsCRP), along with a series of hematological indices, platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), mean platelet volume (MPV), platelet distribution width (PDW), and red blood cell distribution width (RDW), are regarded to be related to the incidence of no-reflow or slow flow. Clinical studies were retrieved from the electronic databases of PubMed, EMBASE, Google Scholar, Clinical Trials, and science direct from their inception to August 24, 2019. A total of 21 studies involving 7403 patients were included in the meta-analysis. Pooled analysis results revealed patients with higher hsCRP (odds ratio [OR] = 1.03, 95% confidence interval [CI], 1.01-1.05, P = .006), hsCRP (OR = 1.04, 95% CI: 1.0-1.08, P = .012), NLR (OR = 1.23, 95% CI: 1.11-1.37, P < .0001), PLR (OR = 1.13, 95% CI: 1.07-1.20, P < .0001), and MPV (OR = 2.13, 95% CI: 1.57-2.90, P < .0001) all exhibited significantly higher no-reflow incidence, but there was no significant association between no-reflow risk and RDW or PDW. Patients with higher CRP/hsCRP also performed higher rate of slow flow (OR = 1.06, 95% CI: 1.01-1.11, P = .018). Preangiographic CRP/hsCRP could independently predict no-reflow and slow flow. Moreover, some hematological indices are associated with no-flow.


Assuntos
Testes Hematológicos , Infarto do Miocárdio/sangue , Infarto do Miocárdio/cirurgia , Fenômeno de não Refluxo/sangue , Intervenção Coronária Percutânea , Índice de Gravidade de Doença , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , Angiografia Coronária , Circulação Coronária , Humanos , Valor Preditivo dos Testes
11.
Acta Cir Bras ; 34(12): e201901204, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32074166

RESUMO

PURPOSE: To examine the therapeutic effect of external adenosine on an acetic acid-induced acute ulcerative colitis model in rats. METHODS: Thirty male mature rats were divided into three groups as control, acute colitis (AC) and AC+adenosine group (AC+AD). AC was induced by rectal administration of 4% acetic acid (AA). 5mg/kg/day adenosine was performed i.p for 4 weeks to AC+AD group. Rectum and colon were excised for microscopic and histopathological histopathologic evaluations, and immunohistochemical analysis of nuclear factor kappa B (NF-kB). Blood samples were collected for biochemical detection of TNF-α, Pentraxin-3 and malondialdehyde (MDA) levels. RESULTS: AC group had generalized hyperemia and hemorrhage with increased macroscopic and histopathological scores compared with control (P <0.0001) while adenosine treatment decreased these scores significantly (P <0.001), with reduced distribution of disrupted epithelium, leukocyte infiltrates, and focal hemorrhage. AC group showed significantly increased immunoexpression of NF-kB in rectum, plasma and tissue levels of TNF-α, plasma Pentraxin-3 and MDA levels (P <0.0001) while adenosine reduced these levels (P < 0.05). CONCLUSION: Adenosine appears to promote healing of colon and rectum exposed to AA-induced AC, suggesting a boosting effect of adenosine on the intestinal immune system to cure ulcerative colitis.


Assuntos
Adenosina/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Colite Ulcerativa/tratamento farmacológico , Ácido Acético , Doença Aguda , Animais , Proteína C-Reativa/análise , Colite Ulcerativa/induzido quimicamente , Colite Ulcerativa/patologia , Colo/patologia , Ensaio de Imunoadsorção Enzimática , Imuno-Histoquímica , Masculino , Malondialdeído/sangue , NF-kappa B/análise , Ratos Sprague-Dawley , Reto/patologia , Valores de Referência , Reprodutibilidade dos Testes , Componente Amiloide P Sérico/análise , Substâncias Reativas com Ácido Tiobarbitúrico , Fatores de Tempo , Resultado do Tratamento , Fator de Necrose Tumoral alfa/análise
12.
Artigo em Chinês | MEDLINE | ID: mdl-32074756

RESUMO

Objective: To observe the efficacy of continuous positive airway pressure (CPAP) in the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS) and its affection on patients' blood gas analysis, C reactive protein(CRP) levels. Methods: This prospective study was performed from October 2016 to July 2017. Fifty hospitalized adult patients with medium or severe OSAHS, who were diagnosed by polysomnography (PSG) in Department of Otorhinolaryngology, Affiliated Hospital of Inner Mongolia Medical University, were collected as a case group. Those patients met the standards of medium or severe OSAHS, among whom 40 were male, 10 were female, the age was between 30 and 65, with a mean age of (47.24±10.28) years, and BMI was (27.94±3.43) kg/m(2). Meanwhile, 50 healthy individuals were chose in the same term as a control group, among whom 37 were male, 13 were female, the age was between 29 and 69, with a mean age of (51.28±10.58) years, body mass index(BMI) was (26.98±2.70) kg/m(2), and apnea-hypopnea index (AHI) was<5/h. The differences of blood gas analysis pH, arterial oxygen saturation (SaO(2)), arterial partial pressure of carbon dioxide (PaCO(2)), arterial partial pressure of oxygen (PaO(2)), CRP before and after the treatment of CPAP in case group and in the control group were compared. The choosing data were disposed and analyzed with statistics software of SPSS 20.0. Among which t test was adopted for measurement data, χ(2) test was adopted for enumeration data, and nonparametric rank sum test was adopted for other measurement data. Results: Before the CPAP treatment, pH, PaO(2) and SaO(2) levels in case group were lower than that in control group, respectively [7.34±0.03 vs. 7.37±0.04, (75.93±9.08) mmHg vs. (80.07±10.94) mmHg (1 mmHg=0.133 kPa), (89.71±6.09) mmHg vs.(93.29±5.36) mmHg, all P<0.05]. Both PaCO(2) level and CRP were higher than that in control group [(43.02±8.43) mmHg vs.(39.26±8.20) mmHg, 1.28[0.27,5.83] mg/L(Median[P(25),P(75)]) vs. 0.51[0.21,2.13] mg/L, both P<0.05]. After the CPAP treatment, pH(7.36±0.04), PaO(2) [(80.28±9.96) mmHg] and SaO(2) [(92.94±4.01) mmHg] level in case group were increased than pretreatment, respectively. Moreover, PaCO(2) level [(39.46±8.36) mmHg] and CRP(0.44[0.21,3.40] mg/L) are decreased than pretreatment (P<0.05), respectively. Conclusion: The CRP and blood gas analyses are significant index to evaluate the state of an illness and to estimate the prognosis of disease of OSAHS, which is deserved to generalize.


Assuntos
Dióxido de Carbono/sangue , Pressão Positiva Contínua nas Vias Aéreas , Oxigênio/sangue , Apneia Obstrutiva do Sono/sangue , Apneia Obstrutiva do Sono/terapia , Adulto , Idoso , Pressão Arterial , Proteína C-Reativa/análise , Estudos de Casos e Controles , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pressão Parcial , Estudos Prospectivos
13.
Anticancer Res ; 40(2): 1161-1166, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32014969

RESUMO

BACKGROUND: Glioblastoma (GBM) is the most common malignant brain tumor in adults and still carries a dismal prognosis. As several studies detected a connection between inflammation and GBM prognosis, we sought to explore possible associations between routinely investigated inflammatory parameters and GBM outcome. PATIENTS AND METHODS: Patients treated for GBM at our Institution between 2004 and 2014 were included. White blood cell count (WBC), C-reactive protein (CRP) and the ratio of platelets and WBC (Plt/WBC) were evaluated preoperatively. Medical records were reviewed for clinical parameters (age, sex, preoperative clinical condition, genetic alterations). Study endpoints were overall (OS) and 1- and 2-year survival. RESULTS: In the final cohort consisting of 565 individuals with GBM, univariate analysis showed significant associations for WBC, CRP and Plt/WBC ratio with OS. Kaplan-Meier survival plot confirmed significantly poorer OS in patients with WBC>12/nl and with CRP≥2.9 mg/dl. In multivariate analysis, a WBC of >12/nl was an independent prognostic factor for all three outcome parameters and CRP≥2.9 mg/dl for OS and 1-year survival. CONCLUSION: Preoperative WBC and CRP values were confirmed as independent predictors of GBM outcome. This emphasizes the need for further evaluation of the role of inflammation in the prognosis of GBM.


Assuntos
Biomarcadores , Neoplasias Encefálicas/metabolismo , Neoplasias Encefálicas/mortalidade , Glioblastoma/metabolismo , Glioblastoma/mortalidade , Adulto , Idoso , Neoplasias Encefálicas/etiologia , Neoplasias Encefálicas/cirurgia , Proteína C-Reativa , Feminino , Glioblastoma/etiologia , Glioblastoma/cirurgia , Humanos , Mediadores da Inflamação , Estimativa de Kaplan-Meier , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Período Pré-Operatório , Prognóstico , Estudos Retrospectivos
14.
Nihon Shokakibyo Gakkai Zasshi ; 117(2): 150-156, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32037360

RESUMO

New chemotherapeutic regimens such as S-1 plus docetaxel, S-1 plus oxaliplatin and capecitabine plus oxaliplatin are reported to be effective and safe as postoperative adjuvant chemotherapy (PAC) for advanced gastric cancer (GC) patients. Although the use of these PACs is increasing, it is still unclear how to choose the best regimen for advanced GC patients. Therefore, we aimed to investigate which clinical characteristics are associated with recurrence after curative surgery in patients receiving S-1 as PAC. Thirty-nine patients who received a PAC regimen with S-1 for more than 1 year after curative surgery for advanced GC were enrolled. Univariate and multivariate analyses using the Cox proportional hazard model were performed to detect clinical characteristics that correlated with recurrence. Patients were divided into two groups, recurrence, and non-recurrence, and receiver operating characteristic (ROC) curve analysis was used to identify the cut-off values. Kaplan-Meier analysis and the log-rank test were used for comparison of relapse-free survival (RFS). Fifteen patients had a recurrence after surgery (38.5%, 15/39). Multivariate analysis using clinical characteristics revealed that preoperative C-reactive protein (CRP) (>0.3/≤0.3, mg/dL) (HR 10.73;95% C.I., 1.824-63.14;P=0.009) was significantly associated with recurrence. Kaplan-Meier analysis and the log-rank test demonstrated that preoperative CRP (>0.3/≤0.3, mg/dL) was also significantly associated with RFS (P<0.001). Therefore, preoperative CRP is significantly associated with recurrence and RFS after curative surgery in advanced GC patients receiving S-1 as PAC.


Assuntos
Proteína C-Reativa/metabolismo , Quimioterapia Adjuvante/métodos , Ácido Oxônico/uso terapêutico , Neoplasias Gástricas/cirurgia , Tegafur/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica , Combinação de Medicamentos , Humanos , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos
15.
Zhongguo Dang Dai Er Ke Za Zhi ; 22(2): 112-117, 2020 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-32051076

RESUMO

OBJECTIVE: To study the value of lactate dehydrogenase (LDH) in predicting refractory Mycoplasma pneumoniae pneumonia (RMPP) in children. METHODS: Propensity score matching was used to select 73 children with RMPP (refractory group) and 146 children with non-refractory Mycoplasma pneumoniae pneumonia (common group). The logistic regression analysis, restricted cubic spline model, and decision curve analysis were used to analyze the clinical value of LDH in predicting RMPP. RESULTS: There were significant differences in the incidence of high fever, white blood cell count, platelet count, percentage of neutrophils, and serum levels of C-reactive protein, procalcitonin, hemoglobin, albumin, glutamic-pyruvic transaminase, aspartate aminotransferase and LDH (P<0.05). There were also significant differences between the two groups in the Mycoplasma pneumoniae-DNA load in nasopharyngeal aspirates and the incidences of pleural effusion, pulmonary consolidation, atelectasis, shortness of breath and skin lesions (P<0.05). The multivariate logistic regression analysis showed that high fever, hemoglobin level, LDH level, and pulmonary consolidation were independent predictive factors for RMPP (OR=10.097, 0.956, 1.006, and 3.756; P<0.05). The results of the restricted cubic spline analysis showed a non-linear dose-response relationship between the continuous changes of LDH and the development of RMPP (P<0.01). The decision curve analysis showed that LDH had an important clinical value in predicting RMPP. CONCLUSIONS: LDH is an independent predictive factor for the development of RMPP and its intensity of association with the development of RMPP exhibits a non-linear dose-response relationship.


Assuntos
Mycoplasma pneumoniae , Pneumonia por Mycoplasma , Proteína C-Reativa , Criança , Humanos , L-Lactato Desidrogenase , Estudos Retrospectivos
16.
Medicine (Baltimore) ; 99(5): e18821, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32000385

RESUMO

BACKGROUND: Though studies have shown association between C-reactive protein (CRP) level and the risk of ovarian cancer (OC), there have been some inconsistencies. The current metaanalysis was conducted to study the relationship between CRP and OC. PATIENTS AND METHODS: Three electronic databases of PubMed, Embase, and Cochrane Library were searched for prospective studies of OC from inception till May 2018. Relative risk (RR) was summarized using random-effects model, and the results of sensitivity, subgroup analyses, and publication biases were also calculated. RESULTS: A total of 13 cohorts involving 1,852 OC patients were included for the final meta-analysis. The summary RRs indicated that high CRP was associated with an increased risk of all invasive OC (RR:1.36; 95% confidence interval [CI]:1.03-1.80; P = .032), while moderate CRP showed no significant impact on the risk of all invasive OC compared with low CRP (RR:1.17; 95% CI:0.97-1.41; P = .107). High (RR: 1.42; 95% CI: 0.85-2.37; P = .183) or moderate (RR: 1.29; 95% CI: 0.94-1.77; P = .119) CRP levels showed little or no effect on serous OC. Similarly, no significant differences for the comparisons of high versus low (RR: 1.82; 95% CI: 0.27-12.42; P = .540) or moderate versus low (RR: 0.72; 95% CI: 0.31-1.69; P = .455) CRP levels for the risk of mucinous OC were observed. Moreover, high (RR: 0.58; 95% CI: 0.13-2.54; P = .471) or moderate (RR: 0.81; 95% CI: 0.44-1.47; P = .484) CRP levels were not associated with the risk of endometrioid OC compared with low CRP levels. CONCLUSION: High CRP levels were associated with increased risk of invasive OC. The risk of other OC types with CRP levels showed no association.


Assuntos
Proteína C-Reativa/metabolismo , Neoplasias Ovarianas/sangue , Estudos de Coortes , Feminino , Humanos , Medição de Risco
17.
Medicine (Baltimore) ; 99(3): e18740, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32011454

RESUMO

To investigate the interaction between the single nucleotide polymorphism of the 3' untranslated region (3'UTR) of the pentraxin 3 (PTX3) gene, as well as environmental factors and the preeclampsia risk in a Chinese Han population.Sanger sequencing was used to analyze rs5853783 and rs73158510 loci of the PTX3 gene 3'UTR from 235 patients with preeclampsia and 235 control subjects. The plasma PTX3 protein level was measured by enzyme-linked immunosorbent assay (ELISA).The risk of preeclampsia in the PTX3 gene rs5853783 locus D allele carriers was 0.72 times higher than that of the I allele carriers (95% CI: 0.60-0.84, P < .001). The risk of preeclampsia in the PTX3 gene rs73158510 locus A allele carriers was 1.36 times higher than in the G allele carriers (95% CI: 1.16-1.55, P < .001). The area under the ROC curve (AUC) for the diagnosis of preeclampsia by plasma PTX3 protein levels was 0.906 (P < .001). The PTX3 gene rs5853783 and rs73158510 single nucleotide polymorphisms (SNPs) were associated with plasma PTX3 protein levels. The AUC of plasma PTX3 protein level diagnosis of preeclampsia in PTX3 gene rs5853783 locus II genotype subjects was up to 0.9371, followed by the ID genotype (AUC = 0.8586); the DD genotype was the lowest (AUC = 0.8154). The AUC of plasma PTX3 protein level diagnosis of preeclampsia in rs73158510 locus GG genotype subjects was 0.9102, GA genotype was 0.8766, and AA genotype was 0.8750.The rs5853783 and rs73158510 SNPs in the 3'UTR region of the PTX3 gene are associated with the risk of preeclampsia in a Chinese Han population.


Assuntos
Regiões 3' não Traduzidas/genética , Proteína C-Reativa/genética , Polimorfismo de Nucleotídeo Único , Pré-Eclâmpsia/genética , Componente Amiloide P Sérico/genética , Adolescente , Adulto , Alelos , Grupo com Ancestrais do Continente Asiático , China/etnologia , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Pré-Eclâmpsia/etnologia , Gravidez , Fatores de Risco
18.
Medicine (Baltimore) ; 99(7): e18882, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32049787

RESUMO

RATIONALE: Procalcitonin (PCT) is used as a biomarker for identifying the occurrence of sepsis. Previous studies have reported high levels of PCT with acetaminophen intoxication without evidence of infection. Here, we report two patients with acetaminophen intoxication with high levels of PCT without showing any symptoms of bacterial infection. PATIENT CONCERNS: This case study examined two unrelated patients with acetaminophen intoxication admitted to emergency at different times. The first patient was admitted to the emergency department after ingesting approximately 8000 mg (153.8 mg/kg) of acetaminophen. On admission, C-reactive protein (CRP), glutamic oxaloacetic transaminase (GOT), and glutamic pyruvic transaminase (GPT) were normal. PCT and acetaminophen levels were 31.89 ng/mL and below 0.5 µg/mL, respectively. The second patient was admitted to the emergency department 8 h after ingesting ∼23,600 mg (280.6 mg/kg) of acetaminophen. By the second day of admission, GOT and GPT increased to 2508 and 1473 IU/L, respectively. PCT was 45.66 ng/mL with acetaminophen level at 116.9 µg/mL. Both patients were clear of symptoms associated with bacterial infection. DIAGNOSIS: Acetaminophen intoxication. INTERVENTIONS: N-acetylcysteine was given intravenously to both patients for 20 h per protocol. OUTCOMES: Both patients were discharged without complications. LESSONS: Observations suggests that elevated levels of PCT in patients intoxicated with acetaminophen may be associated with involvement of other organs impacted by cytokine stimuli from sterile inflammation resulting from hepatic damage rather than PCT secretion directly caused by hepatic cell damage.


Assuntos
Acetaminofen/toxicidade , Acetilcisteína/administração & dosagem , Overdose de Drogas/tratamento farmacológico , Pró-Calcitonina/metabolismo , Acetilcisteína/uso terapêutico , Alanina Transaminase/análise , Aspartato Aminotransferases/análise , Proteína C-Reativa/análise , Overdose de Drogas/diagnóstico , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
19.
Medicine (Baltimore) ; 99(8): e18912, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32080074

RESUMO

BACKGROUND: Knee osteoarthritis (KOA) is the most common form of degenerative arthritis. We used Phellinus linteus (PL), which has been well-known anti-inflammatory function. In this study, we will evaluate if PL extract improves symptoms with KOA. METHODS: This study will be an 8-week single-center randomized controlled double-blind clinical trial. Total of 24 subjects with KOA will be enrolled and they will be divided into 3 groups, PL 1,000 mg, PL 1,500 mg and placebo. Subjects will be followed up every 4 weeks with efficacy and safety at the 2nd and 3rd visits. All subjects should maintain a dosage schedule for this protocol. The primary outcome will be assessed with the Korean version of the Western Ontario and McMasters Universities. And the secondary outcomes will be measured using the visual analog scale, quality of life scale (EQ-5D-3L), ESR, C-reactive protein, and C-telopeptide of type-II collagen. Statistical analysis will be performed on the principle of full analysis set. DISCUSSION: This study has inclusion and exclusion criteria and a well-controlled intervention. This clinical trial is the first step to assess the efficacy and safety of PL in patients with KOA. This study will make an important contribution to the literature and aid follow-up research into the use of PL in KOA.


Assuntos
Cartilagem Articular/efeitos dos fármacos , Articulação do Joelho/efeitos dos fármacos , Osteoartrite do Joelho/tratamento farmacológico , Extratos Vegetais/administração & dosagem , Administração Oral , Adulto , Idoso , Sedimentação Sanguínea/efeitos dos fármacos , Proteína C-Reativa/efeitos dos fármacos , Colágeno Tipo I/efeitos dos fármacos , Humanos , Pessoa de Meia-Idade , Osteoartrite do Joelho/sangue , Osteoartrite do Joelho/patologia , Peptídeos/efeitos dos fármacos , Placebos/administração & dosagem , Extratos Vegetais/uso terapêutico , Estudos Prospectivos , Qualidade de Vida , República da Coreia/epidemiologia , Resultado do Tratamento
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