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Sample records for abnormal procalcitonin levels

  1. Procalcitonin levels in salmonella infection

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    Vikas Mishra

    2015-01-01

    Full Text Available Aim: Procalcitonin (PCT as a diagnostic marker for bacteremia and sepsis has been extensively studied. We aimed to study PCT levels in Salmonella infections whether they would serve as marker for early diagnosis in endemic areas to start empiric treatment while awaiting blood culture report. Materials and Methods: BACTEC blood culture was used to isolate Salmonella in suspected enteric fever patients. Serum PCT levels were estimated before starting treatment. Results: In 60 proven enteric fever patients, median value of serum PCT levels was 0.22 ng/ml, values ranging between 0.05 and 4 ng/ml. 95% of patients had near normal or mild increase (<0.5 ng/ml, only 5% of patients showed elevated levels. Notably, high PCT levels were found only in severe sepsis. Conclusion: PCT levels in Salmonella infections are near normal or minimally increased which differentiates it from other systemic Gram-negative infections. PCT cannot be used as a specific diagnostic marker of typhoid.

  2. Procalcitonin serum levels in tertian malaria

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    Chiwakata Collins B

    2003-10-01

    Full Text Available Abstract Background Procalcitonin (PCT is closely correlated with parasite burden and clinical outcome in falciparum malaria. The role of PCT in tertian malaria has not previously been investigated. Patients and methods PCT serum levels in 37 patients with tertian malaria were analysed. Clinical and laboratory parameters were assessed and statistically correlated both to the initial PCT levels and during the course of the disease. Results PCT levels rose for one day after commencing treatment and declined thereafter. However, there was no significant correlation with parasite burden, clinical parameters, laboratory values, or the presence of semi-immunity. Before treatment, the majority of patients showed normal or slightly elevated PCT levels ( Conclusions There is a fundamental difference in the relationship of PCT with tertian malaria not seen in other infectious diseases in which elevated PCT levels have been observed. This suggests distinct pathophysiological pathways in malaria.

  3. Serum procalcitonin levels in patients with primary pulmonary coccidioidomycosis.

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    Sakata, Kenneth K; Grys, Thomas E; Chang, Yu-Hui H; Vikram, Holenarasipur R; Blair, Janis E

    2014-10-01

    The serum procalcitonin assay has emerged as a promising biomarker to distinguish between bacterial and viral respiratory tract infections but has not been used to differentiate coccidioidomycosis from bacterial infection. A correlation between procalcitonin serum levels and coccidioidomycosis has never been reported. To determine any association between serum procalcitonin levels and primary pulmonary coccidioidomycosis. We identified and enrolled 20 immunocompetent patients with symptomatic primary pulmonary coccidioidomycosis of coccidioidomycosis at a median of 32 days after symptom onset. Larger prospective studies are needed to confirm this finding.

  4. [Increase of serum procalcitonin levels during a neuroleptic malignant syndrome].

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    Cabot, B; Pautas, E; Gatey, M; Perivier, S; Mahieux, F; Pinquier, C; Hausfater, P

    2009-01-01

    When fever occurs in a patient treated with a neuroleptic, the diagnosis of a neuroleptic malignant syndrome is difficult to differentiate to that of an infectious event. Among inflammation biomarkers of inflammation, serum procalcitonin levels increase both quickly and specifically during a bacterial infection. We report the first case of a neuroleptic malignant syndrome associated with a significant increase of serum procalcitonin levels, without concomitant septic syndrome. The neuroleptic malignant syndrome might be a non-infectious clinical situation associated with an increased serum procalcitonin concentration.

  5. Serum Procalcitonin Level Reflects the Severity of Cellulitis

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    Noh, Soo Hyeon; Park, Seok Don

    2016-01-01

    Background Cellulitis is a common bacterial infection of the superficial skin. Procalcitonin is one of the precursor proteins of calcitonin, its levels are elevated in bacterial infection, and it has been established as a diagnostic marker for severe bacterial infections. Objective This study evaluated the clinical usefulness of procalcitonin for predicting disease severity and prognosis of cellulitis. Methods We reviewed the medical records of 160 patients diagnosed with cellulitis in the past 3 years. Body temperature, procalcitonin, white blood cell (WBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels were measured on their first day of admission. The associations of procalcitonin, WBC, ESR, and CRP with the body temperature and the number of hospitalized days were assessed. Results Procalcitonin, WBC, and CRP showed a positive correlation with body temperature. In addition, procalcitonin, WBC, ESR, and CRP showed a positive correlation with number of hospitalized days (p<0.05). Conclusion In patients diagnosed with cellulitis, proclacitonin was a helpful parameter to indicate the severity of disease and also a useful predictor of prognosis. PMID:27904269

  6. The impact of tracheotomy on levels of procalcitonin in patients without sepsis: a prospective study

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    Xingui Dai; Chunlai Fu; Changfa Wang; Yeping Cai; Sheng’an Zhang; Wei Guo; Daibing Kuang

    2015-01-01

    OBJECTIVE: Procalcitonin is a reliable biomarker of infection and sepsis. We aimed to determine whether tracheotomy influences the procalcitonin concentrations in patients without sepsis and assess whether operative duration and procedure affect the peak procalcitonin level. METHODS: A total of 38 non-septic patients who required a tracheotomy underwent either a percutaneous dilatational tracheotomy (n=19) or a surgical tracheotomy (n=19). Procalcitonin levels were measured at the beginning ...

  7. Procalcitonin Levels in Patients with Complete and Incomplete Kawasaki Disease

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    Hwa Jin Cho

    2013-01-01

    Full Text Available Incomplete Kawasaki disease (iKD is considered to be a less complete form of Kawasaki disease (cKD, and several differences in the laboratory presentations of iKD and cKD have been noted. We investigated serum procalcitonin levels in patients with iKD, cKD, and other febrile diseases (a control group. Seventy-seven patients with cKD, 24 with iKD, and 41 controls admitted to our hospital from November 2009 to November 2011 were enrolled in the present study. We obtained four measurements of serum procalcitonin levels and those of other inflammatory markers from each patient. Samples were taken for analysis on the day of diagnosis (thus before treatment commenced; D0 and 2 (D2, 14 (D14, and 56 days (D56 after intravenous immunoglobulin infusion. We obtained control group data at D0. The mean D0 serum procalcitonin levels of cKD patients (0.71±1.36 ng/mL and controls (0.67±1.06 ng/mL were significantly higher than those of iKD patients (0.26±0.26 ng/mL (P=0.014 and P=0.041, resp.. No significant difference in mean procalcitonin level was evident among groups at any subsequent time. In conclusion, the serum procalcitonin level of patients with acute-stage cKD was significantly higher than that of iKD patients.

  8. Serum procalcitonin levels in patients with ankylosing spondylitis.

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    Ozmen, Mustafa; Oktay, Esin; Tarhan, Emine F; Aslan, Ozgur; Oflazoglu, Utku; Koseoglu, Mehmet H

    2016-05-01

    Procalcitonin is a marker of bacterial and fungal infection and sepsis. The present study evaluated the relationship between serum procalcitonin levels and disease activity in patients with ankylosing spondylitis (AS). A total of 61 patients who met the 1984 New York criteria for AS were studied. Twenty-four age- and sex-matched healthy volunteers were recruited to this study as a control group. Disease activity was assessed by the Bath AS Disease Activity Index (BASDAI). The functional status of patients was evaluated by the Bath AS Functional Index (BASFI). Spinal mobility was measured by the Bath AS Metrology Index (BASMI). Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and serum procalcitonin levels were measured. Thirty patients were on anti-tumor necrosis factor-alpha treatment and 31 patients were on conventional treatment. Seventeen (28%) of the AS patients were active (BASDAI > 4) and 44 (72%) of the AS patients were in remission. The median ESR was 14 (34-6) mm/h and 4 (7-2) mm/h (P < 0.001) for the patient and control groups, respectively. The median CRP level was 0.91 (2.72-0.37) mg/dL and 0.15 (0.25-0.07) mg/dL in the patient and control groups, respectively (P < 0.001). Median BASDAI, BASFI and BASMI scores for all AS patients were 3.6 (5.25-2.29), 2.5 (4.22-0.91) and 3 (5-1), respectively. Serum procalcitonin levels were normal (< 0.05 ng/mL) for all patients and controls. Serum procalcitonin levels were not high in AS patients and controls, and the levels were independent of disease activity and medications. If bacterial or fungal infection is suspected in an AS patient, serum procalcitonin level may be useful for diagnosis. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  9. The impact of tracheotomy on levels of procalcitonin in patients without sepsis: a prospective study

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    Xingui Dai

    2015-09-01

    Full Text Available OBJECTIVE: Procalcitonin is a reliable biomarker of infection and sepsis. We aimed to determine whether tracheotomy influences the procalcitonin concentrations in patients without sepsis and assess whether operative duration and procedure affect the peak procalcitonin level. METHODS: A total of 38 non-septic patients who required a tracheotomy underwent either a percutaneous dilatational tracheotomy (n=19 or a surgical tracheotomy (n=19. Procalcitonin levels were measured at the beginning of the tracheotomy and at 2 h, 4 h, 8 h, 24 h, 48 h and 72 h after the procedure. RESULTS: The baseline procalcitonin concentration before the tracheotomy was 0.24±0.13 ng/mL. The postoperative levels increased rapidly, with a 4-fold elevation after 2 h, reaching a peak 4 h later with a 5-fold increase over baseline. Thereafter, the levels gradually returned to 2-fold greater than the baseline level within 72 h. The peak levels of procalcitonin showed a significant positive correlation with operative durations (r=0.710, p<0.001 and procedures (rho=0.670, p<0.001. CONCLUSION: In patients without sepsis, tracheotomy induces a rapid release of serum procalcitonin, and the operative duration and procedure have significant impacts on the peak procalcitonin levels. Thus, the nonspecific increase in procalcitonin levels following tracheotomy needs to be considered when this measure is used to evaluate infection.

  10. The impact of tracheotomy on levels of procalcitonin in patients without sepsis: a prospective study

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    Dai, Xingui; Fu, Chunlai; Wang, Changfa; Cai, Yeping; Zhang, Sheng'an; Guo, Wei; Kuang, Daibing

    2015-01-01

    OBJECTIVE: Procalcitonin is a reliable biomarker of infection and sepsis. We aimed to determine whether tracheotomy influences the procalcitonin concentrations in patients without sepsis and assess whether operative duration and procedure affect the peak procalcitonin level. METHODS: A total of 38 non-septic patients who required a tracheotomy underwent either a percutaneous dilatational tracheotomy (n=19) or a surgical tracheotomy (n=19). Procalcitonin levels were measured at the beginning of the tracheotomy and at 2 h, 4 h, 8 h, 24 h, 48 h and 72 h after the procedure. RESULTS: The baseline procalcitonin concentration before the tracheotomy was 0.24±0.13 ng/mL. The postoperative levels increased rapidly, with a 4-fold elevation after 2 h, reaching a peak 4 h later with a 5-fold increase over baseline. Thereafter, the levels gradually returned to 2-fold greater than the baseline level within 72 h. The peak levels of procalcitonin showed a significant positive correlation with operative durations (r=0.710, p<0.001) and procedures (rho=0.670, p<0.001). CONCLUSION: In patients without sepsis, tracheotomy induces a rapid release of serum procalcitonin, and the operative duration and procedure have significant impacts on the peak procalcitonin levels. Thus, the nonspecific increase in procalcitonin levels following tracheotomy needs to be considered when this measure is used to evaluate infection. PMID:26375562

  11. Serum procalcitonin and cerebrospinal fluid cytokines level in children with meningitis

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    Erdal Taskın

    2004-01-01

    Full Text Available Aims: To determine the level of serum procalcitonin and cerebrospinal fluid cytokines in children with bacterial or viral meningitis and to document the use of these parameters in differential diagnosis.

  12. Procalcitonin levels associate with severity of Clostridium difficile infection.

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    Krishna Rao

    Full Text Available OBJECTIVE: Clostridium difficile infection (CDI is a major cause of morbidity and biomarkers that predict severity of illness are needed. Procalcitonin (PCT, a serum biomarker with specificity for bacterial infections, has been little studied in CDI. We hypothesized that PCT associated with CDI severity. DESIGN: Serum PCT levels were measured for 69 cases of CDI. Chart review was performed to evaluate the presence of severity markers and concurrent acute bacterial infection (CABI. We defined the binary variables clinical score as having fever (T >38°C, acute organ dysfunction (AOD, and/or WBC >15,000 cells/mm(3 and expanded score, which included the clinical score plus the following: ICU admission, no response to therapy, colectomy, and/or death. RESULTS: In univariate analysis log10 PCT associated with clinical score (OR 3.13, 95% CI 1.69-5.81, P0.2 ng/mL was 81% sensitive/73% specific for a positive clinical score and had a negative predictive value of 90%. CONCLUSION: An elevated PCT level associated with the presence of CDI severity markers and CDI was unlikely to be severe with a serum PCT level below 0.2 ng/mL. The extent to which PCT changes during CDI therapy or predicts recurrent CDI remains to be quantified.

  13. THE STUDY OF SERUM PROCALCITONIN LEVEL IN CORRELATION WITH SEPSIS

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    Girish M

    2016-09-01

    Full Text Available BACKGROUND Sepsis refers to the systemic response to serious infection. It can be response to the infection caused by any class of microorganism. The presence of bacteraemia is an indicator of disseminated infection and generally indicates a poorer prognosis when associated with localised disease. This study was undertaken to study the diagnostic and prognostic value of Procalcitonin (PCT in patients with sepsis. AIM To study the diagnostic and prognostic value of Procalcitonin (PCT in patients with sepsis. MATERIALS AND METHODS Fifty patients of age more than 18 years with sepsis admitted in KMC Hospitals, Mangalore, from August 2008 to June 2010 were subjects in the study after due permission from institution and informed consent from the patients. Diagnosis of sepsis was made according to criteria by ACCP/SCCM definition for sepsis. Definitive aetiological diagnosis requires isolation of microorganism from the blood and local site of infection, Gram stain and culture of the material from the primary site of infection for the microbial aetiology was taken. Other appropriate laboratory investigations depending upon requirement were done as mentioned in the investigations. RESULTS Out of total 50 patients, 23 patients were in group of sepsis, 14 were in group of severe sepsis while 13 had septic shock. Maximum number of the study patients were in the age group of 51-60 years. 52% of the study patients were male and 48% were female. Most common symptom in patients with sepsis was fever. Most common sign in the patient with sepsis is tachycardia followed by high temperature and then tachypnoea. Most common source of sepsis was respiratory infection followed by UTI. CONCLUSION Our data suggest the possibility that the addition of Procalcitonin into the standard workup of critically ill patients with suspected sepsis could increase diagnostic certainty and improve patient management.

  14. Diagnostic value of serum procalcitonin level in differentiating bacterial from nonbacterial meningitis in children.

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    Umran, Raid M R; Radhi, Nabeel Hashim

    2014-12-01

    Acute bacterial meningitis in pediatrics remains a serious and potentially lethal disease. Its prognosis is critically dependent on rapid diagnosis and treatment. The use of biological markers, like procalcitonin, has been proposed to facilitate the accuracy of the initial diagnosis of bacterial meningitis. The aim of this study was assessment the diagnostic values of serum procalcitonin (PCT) assay in the diagnosis and differentiation of acute bacterial from non bacterial meningitis. 45 patients with suspicion of meningitis were enrolled in the study and were clinically evaluated and investigated by lumbar punctures for cerebrospinal fluid analysis, C-reactive protein and differential leukocyte count. Patients with clinical and laboratory suggestion of bacterial causes were regarded as bacterial meningitis group (29 patients), and those who were suggestive of nonbacterial causes were regarded as nonbacterial group (16 patients). Serum procalcitonin levels were significantly higher in bacterial meningitis group (637±325 pg/ml) compared with non-bacterial meningitis (380±170 pg/ml); Pdiagnosis of bacterial meningitis. Elevated serum procalcitonin level could be a predictor of bacterial causes of meningitis and is more sensitive and specific than other diagnostic predictors.

  15. Levels of procalcitonin, C-reactive protein and neopterin in patients with advanced HIV-1 infection

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    P Bipath

    2012-06-01

    Full Text Available Objectives. To compare the value of procalcitonin, C-reactive protein (CRP and neopterin as indicators of immune deficiency, co-infection, efficacy of treatment, and disease progression, in patients with advanced HIV-1 infection. Design. Cross-sectional, investigating baseline blood measurements and clinical observations in 82 HIV-positive patients divided into an antiretroviral treatment (ART group and an ART-naïve group. Setting. Secondary general hospital in Pretoria. Results. Procalcitonin and CRP levels showed no significant differences between the ART and ART-naïve groups, and no correlations with CD4 counts or viral loads. CRP levels were significantly higher with TB co-infection (p<0.05. Neopterin levels were raised above normal in 92% of the ART-naïve group and in 75% of the ART group. The levels were significantly higher (p<0.05 in the ART- naïve group. Negative correlations were found between neopterin and CD4 counts for the total patient group (r=-0.482; p<0.001. Neopterin was significantly (p<0.05 higher in the HIV/TB co-infection group than in those without TB. Higher neopterin levels at baseline were associated with a decline in CD4 counts over the ensuing 6-month period, and patients with higher baseline neopterin levels developed more complications over the 6-month period. Conclusions. Compared with procalcitonin and CRP, neopterin appears to be associated with the degree of immunodeficiency and of co-infection with TB. Neopterin levels may be investigated further as a measure of disease progression or treatment response. S Afr J HIV Med 2012;13(2:78-82.

  16. Serum procalcitonin level in infectious and non- infectious systemic inflammatory response syndrome: a three- year study

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    Ahmadinejad Z

    2010-01-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Sepsis is the leading cause of hospital admission and mortality. One marker for differentiation between infectious and non-infectious diseases is serum procalcitonin (PCT level. The goal of this study was evaluation of serum procalcitonin level for differentiation among infectious & non infectious systemic inflammatory response syndrome (SIRS."n"nMethods: In a cross sectional study 263 patients with probable symptoms of sepsis that admitted to emergency department of Imam Khomeini Hospital Complex in Tehran, Iran, between 2006 and 2008, were evaluated for serum procalcitonin level by semi quantitative method. The clinical findings, demographic and laboratory data were identified by reviewing the medical notes."n"nResults: A total of 263 patients enrolled in the study. Mean age in study patients was 46.9 year (±20.7 and most of the patients were male (65.8%. In 104 patients (39.5% serum procalcitonin level was less than 0.5 (ng/ml, in 49 patients (18.6% was between 0.5 and 2 (ng/ml, in 74 patients (28.1% was between 2 and 10 (ng/ml and in 36 patients (13.8% was more than 10 (ng/ml. Sixty three patients (60.6% with PCT<0.5ng/ml, had non-infectious SIRS, while all patients with PCT≥10ng/ml, had infectious

  17. Procalcitonin levels in children aged 3-36 months with suspected serious bacterial infection

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    Tuty Herawaty

    2010-10-01

    Full Text Available Background Fever in children aged 3-36 months is usually caused by viral infection, however, 11-20% of cases may progress into serious bacterial infection (SBI. A good diagnostic tool is required to detect SBI to reduce mortality and avoid unnecessary use of antibiotics. Objectives To determine procaldtonin (peT levels, and etiology of bacteremia in febrile children aged 3-36 months old with suspected SBI. Methods A cross-sectional descriptive study was conducted in Cipto Mangunkusumo and Tangerang General Hospital during April-May 2010. Complete blood cells count and acute illness observation score (AIOS were perfonned on febrile children aged 3-36 months. Subjects meeting the inclusion criteria underwent blood culturing and testing of procalcitonin levels. Results There were 39 children met the criteria. Boys and girls ratio was 1.6 Mth median age of 10 months. Mean of AlOS was 20.5 (4.5 SD and mean of hemoglobin was 10.2 (SD 2.1 g/dL. Median of leukocyte and absolute neutrophyl count were 18,600/uL and 12,300/uL, respectively. Median of procaldtonin 1.8 (range 0.04-71.60 ng/mL, mean of procalc itonin in bacteremia subgroup 22.60 (SD 27.6 ng/mL and 6.38 in non-bacteremia subgroup (11.0 SB ng/mL. In children with severely ill appearance, the likelihood of procaldtonin levels ≥2 ng/mL was 8.67 times higher (95%CI 1.66 to 50.56 than in moderately or mildly ill-appearing children. In subjects Mth procalcitonin level of ≥2 ng/mL, the risk of bacteremia was 8.1 times (95% CI 2.9 to 1051.6 higher and the risk of sepsis was 55.47 times higher than in subjects Mth procalcitonin <2 ng/mL (95% CI 1.22 to 68.02. We observed bacteriemia in 11 of 39 subjects (28.2%. The pathogens isolated from these 11 subjects were Klebsiella pneumonia, Staphylococcus aureus, Eschericia coli, Serratia marcesens, Staphylococrus saprophyticus, and Serratia liqueafaciens. Conclusion The proportion of bacteremia in children aged 3-36 months old with suspected serious

  18. Serum Neopterin and Procalcitonin Levels in Relationship with Pediatric Burn Wound Infections.

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    Pilanci, Ozgur; Ergin, Sevgi; Sirekbasan, Serhat; Ersin, Idris; Habip, Zafer; Yuksel, Pelin; Kuvat, Nuray; Aslan, Mustafa; Dinc, Oyku; Saribas, Suat; Kocazeybek, Bekir

    2016-03-01

    Infection and septic complications in burn patients can be monitored by procalcitonin (PCT) and neopterin plasma values. The aim of the study was to investigate serum neopterin and PCT levels with WBC (white blood cell) and CRP (C-reactive protein) levels in patient group (PG) and healthy control group (HCG) and to investigate the relationship of these markers with burn wound infections (BWI). As the PG, 23 patients between 0-12 ages and up to 30% Total Body Surface Area (TBSA) burned and 15 HCG were included. PCT, neopterin, WBC, and CRP results on the first, the seventh, the fourteenth and the 21st day have been compared. During the follow-up period, 11 patients with BWI and 12 patients without BWI were classified as infected and non-infected patients, respectively. PCT and neopterin levels were detected higher in patients with BWI but no significant difference were present. Also, PCT and neopterin levels within the first 24 hours following the burn were detected higher in PG than HCG. CRP and WBC levels were detected high due to burn trauma. PCT and neopterin levels were increased in patients with BWI. PCT levels were increased during the pre-infectious period, while neopterin levels increased during the post-infectious period.

  19. Comparison on Serum Levels of Procalcitonin of Children with Viral and Bacterial Infection

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    Objective To compare and analyze serum levels of procalcitonin (PCT) of children with viral and bacterial infection and probe into the importance of determining the level of serum PCT in the diagnosis of bacterial infection in order to provide evidences of the clinical use of antibiotics. Methods A total of 85 cases of children with an average age of 8.9 years (10 months-12 years) were enrolled in this study, 53 cases were with viral infection and 32 cases with bacterial infection. We determined serum levels of PCT by semi-quantitative solid phase immunoassay, and the serum levels of PCT were divided into four grades as Results The serum level of PCT of the group with bacterial infection were signiifcantly higher than that of the group with viral infection (P Conclusions Serum PCT is a bacterial sensitive marker of bacterial infection in children, and the determination of the level of serum PCT is helpful for the diagnosis of bacterial infection, which can also be a basis for the use of antibiotics.

  20. Procalcitonin Test

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    ... CRP) , cultures (e.g., blood culture , urine culture ), lactate , blood gases , complete blood count (CBC) , and cerebrospinal ... of procalcitonin can be seen with medullary thyroid cancer , but the test is not used to diagnose ...

  1. Evaluation Of Sensitivity And Spesicity Of CSF Procalcitonin Levels In Differentiation Of Bacterial And Viral Meningitis,In Children Older Than Two Months

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    Rahimi H

    2005-06-01

    Full Text Available Background: Bacterial meningitis is a fatal disease with high mortality and morbidity that needs emergency management. But due to nonspecific signs and symptoms it's diagnosis in children is difficult. Recently procalcitonin has been used for diagnosis of serious bacterial infections like bacterial meningitis. We conducted a prospective study in children for evaluation of procalcitonin in differential diagnosis of acute bacterial and viral meningitis. Materials and Methods: In a prospective process research, we measured CSF procalcitonin levels in 43 children older than two months referred to Markaz Tebbi hospital. According to the results of universal PCR the patients were divided into two groups: bacterial meningitis (n=11 and nonbacterial meningitis (n=32. To analysis the results, Mann-Whitney test was used. Results: CSF procalcitonin level in bacterial meningitis was significantly higher than viral meningitis (1.72±0.9 ng/ml and 0.71±0.04ng/ml respectively,Pvalue= 0.00. A serum procalcitonin level >0.5 ng/ml had high sensitivity and specificity ( 90.1% and 97.1% respectively in the diagnosis of bacterial meningitis. Conclusion: CSF procalcitonin level seems to be a valuable marker in differentiating between bacterial and viral meningitis.

  2. Abnormal insulin levels and vertigo.

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    Proctor, C A

    1981-10-01

    Fifty patients with unexplained vertigo (36) or lightheadedness (14) are evaluated, all of whom had abnormal ENGs and normal audiograms. Five hour insulin glucose tolerance tests were performance on all patients, with insulin levels being obtained fasting and at one-half, one, two, and three hours. The results of this investigation were remarkable. Borderline or abnormal insulin levels were discovered in 82% of patients; 90% were found to have either an abnormal glucose tolerance test or at least borderline insulin levels. The response to treatment in these dizzy patients was also startling, with appropriate low carbohydrate diets improving the patient's symptoms in 90% of cases. It is, therefore, apparent that the earliest identification of carbohydrate imbalance with an insulin glucose tolerance test is extremely important in the work-up of the dizzy patients.

  3. Serum procalcitonin and CRP levels in non-alcoholic fatty liver disease: a case control study

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    Ersoz Galip

    2009-02-01

    Full Text Available Abstract Background Both C reactive protein (CRP and procalcitonin (PCT are well known acute phase reactant proteins. CRP was reported to increase in metabolic syndrome and type-2 diabetes. Similarly altered level of serum PCT was found in chronic liver diseases and cirrhosis. The liver is considered the main source of CRP and a source of PCT, however, the serum PCT and CRP levels in non-alcoholic fatty liver disease (NAFLD were not compared previously. Therefore we aimed to study the diagnostic and discriminative role of serum PCT and CRP in NAFLD. Methods Fifty NAFLD cases and 50 healthy controls were included to the study. Liver function tests were measured, body mass index was calculated, and insulin resistance was determined by using a homeostasis model assessment (HOMA-IR. Ultrasound evaluation was performed for each subject. Serum CRP was measured with nephalometric method. Serum PCT was measured with Kryptor based system. Results Serum PCT levels were similar in steatohepatitis (n 20 and simple steatosis (n 27 patients, and were not different than the control group (0.06 ± 0.01, 0.04 ± 0.01 versus 0.06 ± 0.01 ng/ml respectively. Serum CRP levels were significantly higher in simple steatosis, and steatohepatitis groups compared to healthy controls (7.5 ± 1.6 and 5.2 ± 2.5 versus 2.9 ± 0.5 mg/dl respectively p Conclusion Serum PCT was within normal ranges in patients with simple steatosis or steatohepatitis and has no diagnostic value. Serum CRP level was increased in NAFLD compared to controls. CRP can be used as an additional marker for diagnosis of NAFLD but it has no value in discrimination of steatohepatitis from simple steatosis.

  4. Serum procalcitonin level for the prediction of severity in women with acute pyelonephritis in the ED: value of procalcitonin in acute pyelonephritis.

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    Park, Jeong Ho; Wee, Jung Hee; Choi, Seung Pill; Park, Kyu Nam

    2013-07-01

    Predicting medical outcomes for acute pyelonephritis (APN) in women is difficult. Delay in diagnosis and treatment often results in rapid progression to circulatory collapse, multiple-organ failure, and death. The aim of this study was to investigate the value of procalcitonin (PCT) level in women with APN at ED. We conducted a prospective study of women with APN presenting to the ED. The authors measured inflammatory biomarkers, and the severity of pyelonephritis was assessed by 4 severity of disease classification system and stage of sepsis. We performed an analysis to assess the value of PCT for the prediction of 28-day mortality and disease severity. A total of 240 female patients with APN are included. Patients were divided into 4 groups on the basis of systemic inflammatory response syndrome criteria, organ dysfunction, and persistent hypotension. The median PCT level was higher in the septic shock group compared with other groups. Of the other inflammatory markers, only white blood cell count was significantly different among the groups, whereas high-sensitivity C-reactive protein level and erythrocyte sedimentation rate revealed no differences. The area under the curve for PCT in predicting 28-day mortality was 0.68. For predicting mortality, a cutoff value of 0.42 ng/mL had a sensitivity of 80% and a specificity of 50%. However, the disease classification systems were demonstrated to be superior to PCT in predicting 28-day mortality. Relative to other classic markers of inflammation, by distinguishing the severity of sepsis related to APN, PCT levels can provide additional aid to clinicians in disease severity classification and their decision of treatment at ED. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. High Level Serum Procalcitonin Associated Gouty Arthritis Susceptibility: From a Southern Chinese Han Population.

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    Wen Liu

    Full Text Available To study the serum Procalcitonin (PCT level in inflammatory arthritis including gouty arthritis (GA, Rheumatoid arthritis (RA, and ankylosing spondylitis (AS without any evidence of infection were evaluated the possible discriminative role of PCT in gouty arthritis susceptibility in southern Chinese Han Population.From Feb, 2012 to Feb, 2015, 51 patients with GA, 37 patients with RA, 41 patients with AS and 33 healthy control were enrolled in this study with no evidence of infections. The serum level of PCT (normal range < 0.05 ng/ml was measured by electrochemiluminescence immunoassay (ECLIA. Disease activity was determined by scores of VAS (4.07 ± 1.15, DAS28 (4.97 ± 1.12, and ASDAS (2.97 ± 0.81 in GA, RA and AS groups respectively. Other laboratory parameters such as, serum creatinine (CRE, erythrocyte sedimentation rate (ESR, C-reactive protein (CRP, uric acid (UA and white blood cells (WBC were extracted from medical record system.Serum PCT level was predominantly higher in gouty arthritis than in RA and AS patients, especially in the GA patients with tophi. PCT was significantly positively correlated with VAS, CRP and ESR in gouty arthritis and CRP in AS. PCT also had positive correlation-ship with ESR, DAS28 and ASDAS in RA and AS patients respectively, but significant differences were not observed.These data suggested that PCT is not solely a biomarker for infection, but also an indicator in inflammatory arthritis, especially in gouty arthritis.

  6. Usefulness of Serum Procalcitonin Levels in Predicting Tubo-Ovarian Abscess in Patients with Acute Pelvic Inflammatory Disease.

    Science.gov (United States)

    Erenel, Hakan; Yilmaz, Nevin; Oncul, Mahmut; Acikgoz, Abdullah Serdar; Karatas, Suat; Ayhan, Isil; Aslan, Berna; Tuten, Abdullah

    2016-09-03

    We aimed to investigate the clinical importance of serum procalcitonin (PCT) levels in the diagnosis of tubo-ovarian abscess (TOA). Patients diagnosed with pelvic inflammatory disease (PID; n = 36) and patients diagnosed with TOA (n = 42) were included in the study. Sociodemographic characteristics, laboratory and clinical parameters were compared between the 2 groups. Mean PCT level was higher in the TOA group (p = 0.004). Mean length of stay in hospital was longer in patients with TOA (p TOA. Serum PCT is a promising inexpensive marker for the diagnosis of TOA in PID patients.

  7. HIGH BLOOD LEVELS PROCALCITONIN AS SYSTEMIC IMFLAMATORY RESPONSE SYNDROME PREDICTOR IN SEVERE AND MODERATE HEAD INJURY

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    B. Sinaga

    2014-01-01

    Full Text Available BackgroundNumerous studies have shown that procalcitonin (PCT was not related to degree of trauma. High PCT serum levels have been found in patients with bacterial or fungal infection and also in acute phase of trauma. Currently, there has been no research discussed about changes in serum levels of PCT in particular head injuries and severe head injuries. Moderate and severe head injuries were common trauma cases in Emergency Room (ER and had high mortality rate. Based on Glasgow Coma Scale (GCS, moderate and severe head injuries were scored between 3 and 13. This research aim to determine whether high blood levels PCT can be used as a predictor of the occurrence of SIRS. Method: A cohort prospective study was applied in this research to determine high blood levels of PCT as a predictor for SIRS in moderate and severe head injury. This study was conducted from June 2013 - August 2013 at Sanglah General Hospital with 40 research subjects. Data was presented in tables and analyzed with Chi Square test at 95% CI and p <0.05% was considered significant. Results: From the 40 samples, there were 34 males (85% and 6 females (15%, 18 samples (45% had moderate head injury and 22 samples (65% had severe head injury. One sample (2.5 % was 0-10 years old, 15 samples (37.5% were 10-20 years old, 13 samples (32.5% were 20-40 years old, 7 samples (17.5% were 40-60 years old and 4 samples (10% were>60 years old. PCT levels in the blood obtained on day first were normal in 6 samples (15% and elevated in 34 samples (85%, SIRS (+ were found in 35 samples (87.5% and 5 samples (12.5% were SIRS (-. Using bivariate analysis between PCT levels and SIRS showed p = 0.000 (p < 0.05, and multivariate analysis of the control variables showed no significant correlation between variables with PCT levels. Conclusion: From 40 samples moderate head injury and severe head injury, there were 34 samples (85% with elevated PCT level on the first day, while 35 samples (87.5% had SIRS

  8. Diagnostic value of sTREM-1 and procalcitonin levels in the early diagnosis of sepsis

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    Aksaray, Sebahat; Alagoz, Pinar; Inan, Asuman; Cevan, Simin; Ozgultekin, Asu

    2016-01-01

    OBJECTIVE: Sepsis is still major cause of morbidity and mortality, despite improvements in diagnosis and treatment in modern medicine. Therefore, laboratory examinations that provide correct and rapid results are needed to support the diagnosis. This study was conducted to investigate value of immunological indicators procalcitonin (PCT) and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in differential diagnosis of patients with sepsis and systemic inflammatory response syndrome (SIRS), as well as to assess their importance in determining prognosis of patients with sepsis. METHODS: Total of 90 patients, 38 with SIRS and 52 with sepsis, who were between the ages 20 to 92, were included in this prospectively planned study. Blood sample was collected from the patients during hospitalization and again in follow-up visit. Enzyme-linked immunosorbent assay (MyBioSource, Inc., San Diego, CA, USA) was used to measure sTREM-1, and PCT was measured using mini VIDAS B.R.A.H.M.S PCT assay (Biomerieux, S.A., Marcy-l’Étoile, France). In addition, patients were clinically assessed using Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system. RESULTS: On day of intensive care unit admission, sTREM-1 and PCT levels, as well as APACHE II score were significantly higher in sepsis group than SIRS group (p=0.001, p=0.01, p=0.001, respectively). Values of sTREM-1 and APACHE II score were higher in the patients with positive blood cultures than those with negative culture results (p=0.002, p=0.006, respectively). PCT, C-reactive protein, and sTREM-1 levels were significantly higher in nonsurviving group. In differentiation of SIRS from sepsis, sTREM-1 cut-off value ≥133 pg/mL and PCT cut-off value of 1.57 ng/mL yielded sensitivity of 71.1% and 67.33%, and specificity of 73.3% and 65.79%, respectively. CONCLUSION: In patients with suspected sepsis, sTREM-1 and PCT can be used as indicators, in addition to scoring systems such as APACHE II and

  9. Procalcitonin as an indicator of urosepsis

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    Sugimoto K

    2013-03-01

    Full Text Available Koichi Sugimoto, Shogo Adomi, Hiroyuki Koike, Atsunobu Esa Department of Urology, NTT West Osaka Hospital, Osaka, Japan Background: Procalcitonin has been advocated as a marker of bacterial infection, so this study was carried out to determine the usefulness of serum procalcitonin in the early diagnosis of urosepsis. Methods: The subjects were 37 febrile patients with urinary tract infection in whom we examined the serum procalcitonin concentration at the start of treatment. Results: Thirty patients had acute pyelonephritis (16 simple, 14 complex, one had emphysematous pyelonephritis, five had acute prostatitis, and one had acute epididymitis. The procalcitonin level was <0.5 ng/mL in 18 patients, ≥0.5 ng/mL in one patient, ≥2 ng/mL in seven patients, and ≥10 ng/mL in 11 patients. Five of the 11 patients with procalcitonin levels ≥ 10 ng/mL had disseminated intravascular coagulation. All patients with urinary tract obstruction and disseminated intravascular coagulation had procalcitonin levels ≥ 10 ng/mL. Conclusion: Although this retrospective study comprised a small number of patients, we found that procalcitonin was a useful marker for urinary tract infection. Keywords: procalcitonin, urosepsis, urinary tract infection, urology

  10. Relationship of neutrophil gelatinase-associated lipocalin (NGAL) and procalcitonin levels with the presence and severity of the preeclampsia.

    Science.gov (United States)

    Artunc-Ulkumen, Burcu; Guvenc, Yesim; Goker, Asli; Gozukara, Ceyhun

    2015-11-01

    The aim of the present study was to evaluate changes in maternal serum neutrophil gelatinase-associated lipocalin (NGAL) and procalcitonin (PCT) concentrations in preeclampsia. This case-control study consisted of 40 preeclamptic and 40 healthy singleton pregnancies matched for age and body mass index. Serum NGAL and PCT levels were compared between the groups. Diagnostic performance and clinical association of these markers were evaluated. NGAL and PCT concentrations were significantly higher in preeclamptic group (p preeclampsia. There were significant positive correlation between these markers and mean arterial pressure (MAP) and spot urine protein excretion. There was negative correlation between NGAL and apgar scores and fetal birth weight. Pregnancies with higher NGAL (OR: 4.89; 95% CI: 1.81-13.21) and higher PCT (OR: 6.67; 95% CI: 2.44-18.21) concentrations had higher risk for preeclampsia. NGAL and PCT may be potential biomarkers for preeclampsia. Their levels increase significantly in preeclampsia and they are related to the severity of the disease. These results are in agreement with the generalized endothelial damage and persistant inflammatory status in preeclampsia. NGAL may also be an indicator for adverse neonatal outcomes with decreased placental hypoperfusion.

  11. Host response biomarkers in sepsis: the role of procalcitonin.

    Science.gov (United States)

    Vincent, Jean-Louis; Van Nuffelen, Marc; Lelubre, Christophe

    2015-01-01

    Procalcitonin is the prohormone of calcitonin and present in minute quantities in health. However, during infection, its levels rise considerably and are correlated with the severity of the infection. Several assays have been developed for measurement of procalcitonin levels; in this article, we will briefly present the PCT-sensitive Kryptor(®) test (Brahms, Hennigsdorf, Germany), one of the most widely used assays for procalcitonin in recent studies. Many studies have demonstrated the value of procalcitonin levels for diagnosing sepsis and assessing disease severity. Procalcitonin levels have also been successfully used to guide antibiotic administration. However, procalcitonin is not specific for sepsis, and values need to be interpreted in the context of a full clinical examination and the presence of other signs and symptoms of sepsis.

  12. Comparative Study of Plasma Endotoxin with Procalcitonin Levels in Diagnosis of Bacteremia in Intensive Care Unit Patients

    Institute of Scientific and Technical Information of China (English)

    Tao Wang; Yun-Liang Cui; Zhao-Fen Lin; De-Chang Chen

    2016-01-01

    Background: Both procalcitonin (PCT) and plasma endotoxin levels cannot be solely used for a definite diagnosis ofbacteremia or sepsis, and there has been few study comparing the values of the two biomarkers for the diagnosis of bacteremia.The aim of this study was to identify bacteria causing bacteremia and evaluate the role of the two biomarkers in the diagnosis ofbacteremia in Intensive Care Unit (ICU).Methods: The medical records of 420 patients in ICU were retrospectively reviewed.Patients (n =241) who met the inclusion criteria were subjected to blood culture (BC) for the analysis of the endotoxin or PCT levels.The exclusion criteria included the presence of infection with human immunodeficiency virus and/or AIDS, neutropenia without sepsis, pregnancy, treatment with immunosuppressive therapies, or blood diseases such as hematological tumors.Patients' BC episodes were divided into BC negative, Gram-negative (GN) bacteria, Gram-positive bacteria, and fungi groups.The PCT and plasma endotoxin levels were compared in the different groups.Results: A total of 241 patients with 505 episodes of BC were analyzed.The GN bacteria group showed higher levels of PCT and endotoxin than the BC negative, Gram-positive bacteria, and fungi groups.GN bacteremia was more prevalent than Gram-positive bacteremia.The GN bacteremia caused by non-Enterobacteriaceae infection presented higher endotoxin level than that by Enterobacteriaceae, but no significant difference in PCT levels was observed between the two groups.The plasma endotoxin significantly differed among different groups and was bacterial species dependent.Conclusions: Plasma endotoxin was more related to GN than to Gram-positive bacteremia, and that endotoxin level was species dependent, but PCT level remained relatively more stable within the GN bacteria caused bacteremia.Both GN and positive bacteria caused bacteremia in the ICU patients in different regions of China.And PCT is a more valuable biomarker than endotoxin

  13. Differential kinetics of plasma procalcitonin levels in cerebral malaria in urban Senegalese patients according to disease outcome

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    Babacar Mbengue

    2011-11-01

    Full Text Available P. falciparum malaria continues as the serial killer of over a million lives yearly, mainly for children in sub-Saharan Africa. For severe malaria, we are still on the quest for a prognostic marker of fatal outcome. We analysed the association between serum levels of Procalcitonin (PCT, a marker of septic inflammation, and clinical outcome in Senegalese patients admitted with confirmed cerebral malaria in the intensive care facility of Hopital Principal. A total of 98 patients living in the hypoendemic urban area of Dakar, Senegal, were enrolled during transmission seasons. Levels of PCT were compared between surviving vs the 26.5 % fatal cases in blood samples of the 3 days following hospitalisation. Mean PCT levels were elevated in patients with active infection, with a large range of values (0.1 to 280 nanog per mL, significantly higher on day 0 in fatal cases than in surviving (53.6 vs 27.3; P=0.01. No exact individual threshold level could indicate occurrence of fatality, however mortality could be most accurately predicted by PCT level above 69 nanog per ML and there was a very clear different profile of evolution of PCT levels on the 3 days of observation decreasing early from day 1 in surviving patients (P<10–3, contrary to fatal cases. These results indicate that PCT kinetic rather than intrinsic level could be of use to predict a reduced risk of fatality in patient with cerebral malaria and could serve as potential predicting marker for severe malaria.

  14. Placental loctogen levels associated with gross fetal abnormality.

    Science.gov (United States)

    Gau, G S; Cadle, G

    1977-02-01

    Four cases of severe congenital abnormality associated with persistently low maternal serum human placental lactogen levels are described. It is thought that this pattern might act as a warning of severe fetal abnormality.

  15. Procalcitonin levels in fresh serum and fresh synovial fluid for the differential diagnosis of knee septic arthritis from rheumatoid arthritis, osteoarthritis and gouty arthritis.

    Science.gov (United States)

    Wang, Chenggong; Zhong, DA; Liao, Qiande; Kong, Lingyu; Liu, Ansong; Xiao, Han

    2014-10-01

    Whether the levels of procalcitonin (PCT) in the serum and synovial fluid are effective indicators for distinguishing septic arthritis (SA) from non-infectious arthritis remains controversial. The present study aimed to evaluate whether PCT levels in fresh serum or fresh joint fluid may be used in the differential diagnosis of SA from rheumatoid arthritis (RA), osteoarthritis (OA) and gouty arthritis (GA). From January 2012 to June 2013, 23 patients with knee SA, 21 patients with RA, 40 patients with OA and 11 patients with GA were enrolled in the current study. The levels of PCT were measured within 24 h after specimen collection at room temperature. An enzyme-linked fluorescence assay (ELFA) was used to detect the levels of PCT in the serum and synovial fluid. The correlations between the levels of PCT in the serum and synovial fluid and the arthritic patient groups were determined by the Nemenyi test. Areas under the receiver operating characteristic (ROC) curve were calculated to evaluate the accuracy of the correlations. The levels of PCT in the serum and joint fluid of the patients in the SA group were higher compared with those of the other groups (Parthritis; however, the PCT levels in fresh synovial fluid are more sensitive and accurate indicators than PCT levels in fresh serum.

  16. Procalcitonin as a Diagnostic and Prognostic Factor for Tuberculosis Meningitis

    OpenAIRE

    Kim, Jinseung; Kim, Si Eun; Park, Bong Soo; Shin, Kyong Jin; Ha, Sam Yeol; Park, Jinse; Kim, Sung Eun; Park, Kang Min

    2016-01-01

    Background and Purpose We investigated the potential role of serum procalcitonin in differentiating tuberculosis meningitis from bacterial and viral meningitis, and in predicting the prognosis of tuberculosis meningitis. Methods This was a retrospective study of 26 patients with tuberculosis meningitis. In addition, 70 patients with bacterial meningitis and 49 patients with viral meningitis were included as the disease control groups for comparison. The serum procalcitonin level was measured ...

  17. Survey of serum procalcitonin in cirrhotic patients.

    Science.gov (United States)

    Rahimkhani, Monireh; Einollahi, Nahid; Khavari Daneshvar, Hossein; Dashti, Nasrin

    2013-04-06

    Procalcitonin (PCT) is a prohormone that has been used as a marker for the diagnosis of bacterial infections. The aim of this study was to survey PCT levels in patients with cirrhosis. Sixty-four patients with hepatic cirrhosis and 32 healthy blood donors were enrolled in this study. Serum PCT levels was detected using immunoluminometric assay. The rate of positive PCT was higher in patients with hepatitis C cirrhosis (92.8%) than the other groups. Among other cirrhotic patients, positive PCT levels were 77% for hepatitis B, 70% for cancer and 53.3% for unknown groups respectively. Serum procalcitonin levels were significantly higher in cirrhotic patients with bacterial infection (2.65±1.11 ng/ml) than those without infection (0.59±0.16 ng/ml, P=0.0001). PCT assay in cirrhotic patients may help diagnosis of sepsis and reduce unnecessary antibiotic use.

  18. Survey of Serum Procalcitonin in Cirrhotic Patients

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    Monireh Rahimkhani

    2013-03-01

    Full Text Available Procalcitonin (PCT is a prohormone that has been used as a marker for the diagnosis of bacterial infections. The aim of this study was to survey PCT levels in patients with cirrhosis. Sixty-four patients with hepatic cirrhosis and 32 healthy blood donors were enrolled in this study. Serum PCT levels was detected using immunoluminometric assay. The rate of positive PCT was higher in patients with hepatitis C cirrhosis (92.8% than the other groups. Among other cirrhotic patients, positive PCT levels were 77% for hepatitis B, 70% for cancer and 53.3% for unknown groups respectively. Serum procalcitonin levels were significantly higher in cirrhotic patients with bacterial infection (2.65±1.11 ng/ml than those without infection (0.59±0.16 ng/ml, P=0.0001. PCT assay in cirrhotic patients may help diagnosis of sepsis and reduce unnecessary antibiotic use

  19. Procalcitonin levels predict infectious complications and response to treatment in patients undergoing cytoreductive surgery for peritoneal malignancy.

    Science.gov (United States)

    Saeed, K; Dale, A P; Leung, E; Cusack, T; Mohamed, F; Lockyer, G; Arnaudov, S; Wade, A; Moran, B; Lewis, G; Dryden, M; Cecil, T; Cepeda, J A

    2016-02-01

    Cytoreductive-surgery for peritoneal-malignancy (PM) involves extensive intra-abdominal surgery and a massive post-operative systemic-inflammatory-response (SIRS). It is often challenging to differentiate SIRS that are solely surgery-associated from those of post-operative infections. White-Cell-Counts (WCC) and C-Reactive-Protein (CRP) are routinely used as markers for infection, but are non-specific and their elevation is often delayed in PM cases. Other markers need to be evaluated to assist early identification/prediction of post-operative infections. Prospective evaluation of serum procalcitonin (PCT), CRP and WCC in 50 patients pre-operatively (Day0), and on post-operative days (POD) 1, 3 & 6, following cytoreductive-surgery with or without splenectomy. Day0 PCT, CRP and WCC values were within normal limits, but increasing physiologically in post-operative period without infection, with noticeable higher PCT in splenectomized patients. In our cohort post-operative infections were diagnosed in 14 patients, often within 48 h. There was a trend for faster rise in serum PCT on POD1 compared to CRP and WCC, and faster PCT decline following appropriate therapy on POD3 and POD6 when infected cases were clinically resolving while WCC and CRP continued to rise, particularly in non-spelenectomised patients. The AUC on POD1 was significantly higher for PCT (0.689) vs. WCC (0.476) and CRP (0.477) (p = 0.04). Sensitivity, specificity, positive-predictive-value and negative-predictive-values for PCT ranged between (57%-100%), (22%-74%), (33%-47%) & (81%-100%), for CRP (28%-78%), (5.5%-86%), (18%-44.4%) & (40%-75.5%) and for WCC (14%-26.5%), (65.5-80.5%), (22%-25%), (67%-70%) respectively. PCT, like WCC and CRP, needs to be interpreted with extreme cautions in the context of infections post-cytoreductive-surgery and should only be used in association with other clinical and investigational findings. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Prognostic value of serum procalcitonin and C-reactive protein levels in critically ill patients who developed ventilator-associated pneumonia

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    Hakan Tanriverdi

    2015-01-01

    Full Text Available INTRODUCTION: Ventilator-associated pneumonia (VAP is an important cause of mortality and morbidity in critically ill patients. We sought to determine the prognostic value of procalcitonin (PCT and C-reactive protein (CRP kinetics in critically ill patients who developed VAP. METHODS: Patients who were admitted to the intensive care unit (ICU and developed VAP were eligible. Patients were followed for 28 days after the pneumonia diagnosis and blood samples for PCT and CRP were collected on the day of the pneumonia diagnosis (D0, and days 3 (D3 and 7 (D7 after the diagnosis. Patients were grouped as survivors and non-survivors, and the mean PCT and CRP values and their kinetics were assessed. RESULTS: In total, 45 patients were enrolled. Of them, 22 (48.8% died before day 28 after the pneumonia diagnosis. There was no significant difference between the survivor and non-survivor groups in terms of PCT on the day of pneumonia diagnosis or CRP levels at any point. However, the PCT levels days 3 and 7 were significantly higher in the non-survivor group than the survivor group. Whereas PCT levels decreased significantly from D0 to D7 in the survivor group, CRP did not. A PCT level above 1 ng/mL on day 3 was the strongest predictor of mortality, with an odds ratio of 22.6. CONCLUSION: Serum PCT was found to be a superior prognostic marker compared to CRP in terms of predicting mortality in critically ill patients who developed VAP. The PCT level on D3 was the strongest predictor of mortality in VAP.

  1. Plasma Procalcitonin Is Associated with Obesity, Insulin Resistance, and the Metabolic Syndrome

    NARCIS (Netherlands)

    Abbasi, Ali; Corpeleijn, Eva; Postmus, Douwe; Gansevoort, Ron T.; de Jong, Paul E.; Gans, Rijk O. B.; Struck, Joachim; Hillege, Hans L.; Stolk, Ronald P.; Navis, Gerjan; Bakker, Stephan J. L.

    2010-01-01

    Context: Procalcitonin, a well-known biomarker of sepsis and bacterial infections, is produced by adipose tissue and has potential as a marker for chronic low-grade inflammation. Objectives: The objective of this study was to investigate whether plasma procalcitonin levels in the normal range are as

  2. Prognostic value of procalcitonin in hospitalized patients with lower respiratory tract infections

    Science.gov (United States)

    Nobre, Vandack; Borges, Isabela

    2016-01-01

    Lower respiratory tract infections are common and potentially lethal conditions and are a major cause of inadequate antibiotic prescriptions. Characterization of disease severity and prognostic prediction in affected patients can aid disease management and can increase accuracy in determining the need for and place of hospitalization. The inclusion of biomarkers, particularly procalcitonin, in the decision taken process is a promising strategy. This study aims to present a narrative review of the potential applications and limitations of procalcitonin as a prognostic marker in hospitalized patients with lower respiratory tract infections. The studies on this topic are heterogeneous with respect to procalcitonin measurement techniques, cutoff values, clinical settings, and disease severity. The results show that procalcitonin delivers moderate performance for prognostic prediction in patients with lower respiratory tract infections; its predictive performance was not higher than that of classical methods, and knowledge of procalcitonin levels is most useful when interpreted together with other clinical and laboratory results. Overall, repeated measurement of the procalcitonin levels during the first days of treatment provides more prognostic information than a single measurement; however, information on the cost-effectiveness of this procedure in intensive care patients is lacking. The results of studies that evaluated the prognostic value of initial procalcitonin levels in patients with community-acquired pneumonia are more consistent and have greater potential for practical application; in this case, low procalcitonin levels identify those patients with a low risk of adverse outcomes. PMID:27305038

  3. Procalcitonine als biomarker voor infecties

    NARCIS (Netherlands)

    de Jonge, J C; de Lange, D W; Bij de Vaate, E A; van Leeuwen, H; Arends, J E

    2016-01-01

    - Inappropriate use of antibiotics in patients without bacterial infection contributes significantly to worldwide antibiotic resistance.- The goal of this review is to summarise evidence from randomised trials investigating the value of the biomarker procalcitonin (PCT) in patients with symptoms of

  4. CHANGES OF SEURM PROCALCITONIN LEVELS IN MIGRAINE PATIENTS%偏头痛患者血清降钙素原水平的变化

    Institute of Scientific and Technical Information of China (English)

    陈东平; 侯淑红; 张志坚; 陈衍贵; 陈明生

    2011-01-01

    Objective: To investigate the changes of serum procalcitonin (PCT) levels in patients with migraine and the underlying mechanism of migraine. Method: 163 adult patients with migraine were divided into two main groups: migraine during headache attack period (n = 80) and migraine during headache free period (n = 83). These patients were further divided into four subgroups according to with or without aura. The serum levels of PCT in all patients were measured. Result: PCT levels in patients with migraine during headache attack period were significantly higher than those during headache free period (P < 0.01). PCT levels in patients with migraine with aura and in patients with migraine without aura during headache attack period were also significantly higher than those during headache free period (P < 0.01). Conclusion: PCT may be an inflammatory marker for migraine attacks, and was response for one of the underlying mechanisms of migraine attacks.%目的:观察偏头痛患者血清降钙素原(PCT)水平的变化,探讨偏头痛可能的发病机制.方法:将163例偏头痛患者分成偏头痛发作期组(n=80)和偏头痛发作间期组(n=83).根据患者有无先兆症状进一步分成四个亚组:无先兆偏头痛的发作期组(n=68)、先兆偏头痛的发作期组(n=12)、无先兆偏头痛的发作间期组(n=70)、先兆偏头痛的发作间期组(n=13).测定每组患者血清PCT水平.结果:所有偏头痛患者中,偏头痛发作期PCT水平明显高于发作间期(P<0.01).在无先兆偏头痛或先兆偏头痛患者中,偏头痛发作期PCT水平也分别明显高于发作间期(P<0.01).结论:PCT可能是偏头痛发作的一个炎症标志,是偏头痛发作的潜在机制之一.

  5. Comparative Study of Plasma Endotoxin with Procalcitonin Levels in Diagnosis of Bacteremia in Intensive Care Unit Patients

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    Tao Wang

    2016-01-01

    Conclusions: Plasma endotoxin was more related to GN than to Gram-positive bacteremia, and that endotoxin level was species dependent, but PCT level remained relatively more stable within the GN bacteria caused bacteremia. Both GN and positive bacteria caused bacteremia in the ICU patients in different regions of China. And PCT is a more valuable biomarker than endotoxin in the diagnosis of bacteremia.

  6. Presepsin (soluble CD14 subtype) and procalcitonin levels for mortality prediction in sepsis: data from the Albumin Italian Outcome Sepsis trial

    Science.gov (United States)

    2014-01-01

    Introduction Sepsis, a leading cause of death in critically ill patients, is the result of complex interactions between the infecting microorganisms and the host responses that influence clinical outcomes. We evaluated the prognostic value of presepsin (sCD14-ST), a novel biomarker of bacterial infection, and compared it with procalcitonin (PCT). Methods This is a retrospective, case–control study of a multicenter, randomized clinical trial enrolling patients with severe sepsis or septic shock in ICUs in Italy. We selected 50 survivors and 50 non-survivors at ICU discharge, matched for age, sex and time from sepsis diagnosis to enrollment. Plasma samples were collected 1, 2 and 7 days after enrollment to assay presepsin and PCT. Outcome was assessed 28 and 90 days after enrollment. Results Early presepsin (day 1) was higher in decedents (2,269 pg/ml, median (Q1 to Q3), 1,171 to 4,300 pg/ml) than in survivors (1,184 pg/ml (median, 875 to 2,113); P = 0.002), whereas PCT was not different (18.5 μg/L (median 3.4 to 45.2) and 10.8 μg/L (2.7 to 41.9); P = 0.31). The evolution of presepsin levels over time was significantly different in survivors compared to decedents (P for time-survival interaction = 0.03), whereas PCT decreased similarly in the two groups (P = 0.13). Presepsin was the only variable independently associated with ICU and 28-day mortality in Cox models adjusted for clinical characteristics. It showed better prognostic accuracy than PCT in the range of Sequential Organ Failure Assessment score (area under the curve (AUC) from 0.64 to 0.75 vs. AUC 0.53 to 0.65). Conclusions In this multicenter clinical trial, we provide the first evidence that presepsin measurements may have useful prognostic information for patients with severe sepsis or septic shock. These preliminary findings suggest that presepsin may be of clinical importance for early risk stratification. PMID:24393424

  7. Role of serum procalcitonin level in early diagnosis of bacterial pneumonia in children, a hospital based study

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    Sheikh Mohd Saleem

    2016-05-01

    Conclusions: Serum PCT is an important biomarker for prompt diagnosis of bacterial infection and a sensitive indicator to distinguish bacterial from non-bacterial pneumonia. Evaluating serum PCT levels helps in early use of antibiotic therapy and prognosis of underlying disease. [Int J Res Med Sci 2016; 4(5.000: 1518-1521

  8. Diagnostic value of soluble CD163 serum levels in patients suspected of meningitis: comparison with CRP and procalcitonin

    DEFF Research Database (Denmark)

    Knudsen, Troels Bygum; Larsen, Klaus; Kristiansen, Thomas Birk

    2007-01-01

    The aim of the study was to evaluate and compare the diagnostic value of sCD163 serum levels with CRP and PCT in meningitis and bacterial infection. An observational cohort study was conducted between February 2001 and February 2005. The study population comprised 55 patients suspected of meningi...

  9. Diagnostic value of soluble CD163 serum levels in patients suspected of meningitis: comparison with CRP and procalcitonin

    DEFF Research Database (Denmark)

    Knudsen, Troels Bygum; Larsen, Klaus; Kristiansen, Thomas Birk;

    2007-01-01

    The aim of the study was to evaluate and compare the diagnostic value of sCD163 serum levels with CRP and PCT in meningitis and bacterial infection. An observational cohort study was conducted between February 2001 and February 2005. The study population comprised 55 patients suspected of meningi......The aim of the study was to evaluate and compare the diagnostic value of sCD163 serum levels with CRP and PCT in meningitis and bacterial infection. An observational cohort study was conducted between February 2001 and February 2005. The study population comprised 55 patients suspected...... of meningitis on admission to a 27-bed infectious disease department at a Danish university hospital. Biomarker serum levels on admission were measured. Sensitivity and specificity were evaluated at pre-specified cut-off values and overall diagnostic accuracies were compared using receiver......-operating characteristic AUCs (areas under curves). Patients were classified by 2 sets of diagnostic criteria into: A) purulent meningitis, serous meningitis or non-meningitis, and B) systemic bacterial infection, local bacterial infection or non-bacterial disease. An elevated serum level of sCD163 was the most specific...

  10. Abnormal plasma prothrombin (PIVKA-II) levels in hepatocellular carcinoma.

    Science.gov (United States)

    Kawaguchi, Y

    1989-05-01

    The concentration of abnormal prothrombin, or the protein induced by vitamin K absence or antagonist II (PIVKA-II) in 102 patients with hepatic disorders was measured by an enzyme immunoassay method. The concentration of PIVKA-II in the plasma was elevated in 11 out of 18 patients with hepatocellular carcinoma and also in a patient with hepatoblastoma. There was no correlation between serum alpha-fetoprotein and plasma PIVKA-II levels. The PIVKA-II level was normal in 11 patients who had metastatic carcinoma or cholangiocellular carcinoma. Moreover, benign diseases of the liver did not cause an elevation in PIVKA-II. PIVKA-II might be an useful marker of hepatocellular carcinoma because, like alpha-fetoprotein, its level changes in close relation to the effects of treatment.

  11. Ability of procalcitonin to discriminate infection from non-infective inflammation using two pleural disease settings.

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    Fiona J McCann

    Full Text Available Procalcitonin has been shown to be useful in separating infection from non-infective disorders. However, infection is often paralleled by tissue inflammation. Most studies supporting the use of procalcitonin were confounded by more significant inflammation in the infection group. Few studies have examined the usefulness of procalcitonin when adjusted for inflammation.Pleural inflammation underlies the development of most exudative effusions including pleural infection and malignancy. Pleurodesis, often used to treat effusions, involves provocation of intense aseptic pleural inflammation. We conducted a two-part proof-of-concept study to test the specificity of procalcitonin in differentiating infection using cohorts of patients with pleural effusions of infective and non-infective etiologies, as well as subjects undergoing pleurodesis.We measured the blood procalcitonin level (i in 248 patients with pleural infection or with non-infective pleural inflammation, matched for severity of systemic inflammation by C-reactive protein (CRP, age and gender; and (ii in patients before and 24-48 hours after induction of non-infective pleural inflammation (from talc pleurodesis.1 Procalcitonin was significantly higher in patients with pleural infection compared with controls with non-infective effusions (n = 32 each group that were case-matched for systemic inflammation as measured by CRP [median (25-75%IQR: 0.58 (0.35-1.50 vs 0.34 (0.31-0.42 µg/L respectively, p = 0.003]. 2 Talc pleurodesis provoked intense systemic inflammation, and raised serum CRP by 360% over baseline. However procalcitonin remained relatively unaffected (21% rise. 3 Procalcitonin and CRP levels did not correlate. In 214 patients with pleural infection, procalcitonin levels did not predict the survival or need for surgical intervention.Using a pleural model, this proof-of-principle study confirmed that procalcitonin is a biomarker specific for infection and is not affected by non

  12. Abnormal vitamin levels in patients receiving home total parenteral nutrition.

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    Mikalunas, V; Fitzgerald, K; Rubin, H; McCarthy, R; Craig, R M

    2001-01-01

    The administration of multivitamins to patients receiving home parenteral nutrition (HPN) was decreased from once daily to three times weekly during the parenteral multivitamin shortage in 1997. Blood vitamin levels were measured to examine whether the decrement in the infused vitamins affected the levels. Six patients with normal renal and liver function, receiving HPN for 6 months to 10 years, were studied 6 months after the institution of 10 mL of multivitamins thrice weekly. Two patients with renal insufficiency who required hemodialysis and HPN were also studied. Multivitamin administration was eliminated in one patient and was reduced to once weekly when elevated pyridoxine levels were found in association with possible neurotoxicity. Five of the six patients with normal renal function had low serum ascorbic acid levels. Serum riboflavin levels were found to be low in one patient, serum pyridoxine was low in one, serum retinoids were low in three, and serum niacin was low in one. There were no clinically obvious untoward effects caused by the vitamin deficiencies. Each of the dialysis patients had elevated serum pyridoxine levels and had some neurologic disturbance (peripheral neuropathy, involuntary movements). The serum pyridoxine levels fell to normal in each after the cessation or decrease of the multivitamin preparation. Ascorbic acid levels were low in one patient and fell into abnormally low levels in the other when the parenteral multivitamins were reduced, but they corrected with the separate administration of intravenous vitamin C. In conclusion, the reduced administration of multivitamins in 1997 resulted in diminished ascorbic acid levels in seven of eight patients receiving total parenteral nutrition. Less often, low levels of retinoids, niacin, pyridoxine, and riboflavin were seen. Patients with chronic renal failure receiving HPN with multivitamins may develop elevated pyridoxine levels, which might result in neurologic sequelae.

  13. Study on the changes of serum procalcitonin and interleukin - 6 levels among the neonates with sepsis%新生儿败血症患儿血清降钙素原及白介素-6水平变化研究

    Institute of Scientific and Technical Information of China (English)

    陆彩霞; 王海兰; 李春娥

    2012-01-01

    Objective; To explore the values of serum procalcitonin and interleukin -6 levels in early diagnosis of neonatal sepsis. Methods; Forty neonates with sepsis and forty healthy neonates were selected as research objects, the serum procalcitonin and interleukin - 6 levels during acute phase and recovery phase in sepsis group and control group were detected. Results: Hie serum procalcitonin and interleukin - 6 levels during acute phase in sepsis group were significantly higher than those in control group ( P 0. 05 ) . The serum procalcitonin and interleukin -6 levels during acute phase in sepsis group were significantly higher than those during recovery phase in sepsis group (P <0.05) . Conclusion: There is a positive correlation between serum procalcitonin and interleukin -6 levels and the degree of severity of neonatal sepsis, serum procalcitonin and interleukin -6 levels can be used as important indexes for early diagnosis and evaluation of prognosis in the neonates with sepsis.%目的:探讨血清降钙素原及白介素-6水平在新生儿败血症早期诊断中的价值.方法:选择40例败血症新生儿及40例健康新生儿作为研究对象,测定败血症组急性期、恢复期及健康对照组血清降钙素原及白介素-6水平.结果:败血症组急性期血清降钙素原及白介素-6水平显著高于对照组(P<0.05).败血症组恢复期和对照组血清降钙素原及白介素-6水平比较,差别无统计学意义(P>0.05).败血症组急性期血清降钙素原及白介素-6水平显著高于恢复期(P<0.05).结论:血清降钙素原及白介索-6水平和新生儿败血症严重程度呈正相关性,血清降钙素原及白介素-6水平可作为新生儿败血症早期诊断及评价预后的重要指标.

  14. The Value of C-Reactive Protein and Procalcitonin in Febrile Neutropenia

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    Solmaz Çelebi

    2009-06-01

    Full Text Available Aim: Febrile neutropenia is the major cause of mortality and morbidity in cancer patients. For this reason, early diagnosis of severe infections and appropriate antimicrobial therapy are very important. The aim of this study was to investigate the difference between C-reactive protein (CRP and procalcitonin in determining the sepsis and its severity. Materials and Method: A total of 30 children (35 episodes with febrile neutropenia who were hospitalized in the Uludag University, Pediatric Hematology and Oncology Unit were included in this prospective study. The blood samples for CRP and procalcitonin were collected daily between 0 to 5th days. Serum CRP and procalcitonin levels were compared with culture positivity, prolonged fever, mucositis and absolute granulosit count (AGC. Results: A total of 16 patients (56% diagnosed with acute leukemia and, 14 patients (46% having solid tumours were evaluated. In sequential analysis of febrile episodes, both the median of procalcitonin and the CRP concentrations showed the same tendency and there was no significant correlation between them (r=0.2, p>0.05. There was no significant association between CRP and procalcitonin among those having positive culture and mucositis. However, CRP values at the 3rd, 4th and 5th days were significantly higher in the patients with AGC100/mm3. Similarly, CRP values were significantly higher at the 1st, 2nd, 3rd and 4th days among the patients having prolonged fever. Conclusion: Our study suggests that there is no difference between CRP and procalcitonin in determining sepsis and its severity. Although procalcitonin is a valuable acute phase reactant in non-neutropenic patients, larger prospective investigations are needed to show the prognostic value of procalcitonin in neutropenic patients. (Journal of Current Pediatrics 2009; 7: 7-12

  15. Procalcitonin kinetics as a prognostic marker in severe sepsis/septic shock

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    Banani Poddar

    2015-01-01

    Full Text Available Background and Aims: To evaluate the prognostic value of change (fall in serum procalcitonin level (PCT in critically ill adults with severe sepsis/septic shock. Methods: This was a prospective observational study in a general purpose Intensive Care Unit of a teaching Institute. PCT was measured at admission (D0 and after 72-96 h (D4 by electrochemi-luminescence immunoassay (BRAHMS PCT kit in adults (>18 years admitted with severe sepsis or septic shock. Change in procalcitonin values from D0 to D4 was correlated with the primary outcome, that is, 28 days mortality. All results are reported as median (interquartile range. Results: A total of 171 (100 males of 181 patients were included. The median age was 46 years (range 19-79. 137 patients were in septic shock and 34 in severe sepsis. The sequential organ failure assessment (SOFA score in all patients was 11 (9-14.91 (53.2% patients survived at 28 days (survivors. The baseline procalcitonin was similar in two groups (3.48 [1.04-15.85] vs. 5.27 [1.81-23.57] ng/ml in survivors and nonsurvivors [NS] respectively. The procalcitonin change was 1.58 (0.20-8.52 in survivors and 0.28 (-1.38-6.17 in NS (P = 0.01. The C-statistic of percentage change in procalcitonin from D0 to D4 to predict survival was 0.73 (95% confidence interval [CI]: 0.65-0.82 when compared to 0.78 (95% CI: 0.71-0.86 for change of SOFA score. For an absolute fall in procalcitonin of >1 ng/ml, a 70% fall predicted survival with 75% sensitivity and 64% specificity. Conclusions: In critically ill-patients with severe sepsis/septic shock, change (fall in procalcitonin is associated with good outcome.

  16. Clinical practice of procalcitonin and hypersensitive c-reactive protein test in neonatal infection.

    Science.gov (United States)

    Yao, Aimei; Liu, Jingyan; Chang, Jing; Deng, Caiyan; Hu, Yulian; Yu, Fengqin; Ma, Zhanmin; Wang, Guangzhou

    2016-03-01

    To study the clinical practice of procalcitonin and hypersensitive c-reactive protein test in neonatal infection. Two hundred cases of our hospital treatment confirmed infection early newborn children were selected from February 2014 to March 2015. According to the condition, the children were divided into four groups as follows: severe infection group, local infection group, non-infection group and healthy newborns group. At the same time, the new healthy newborns were chosen as control group. The levels of serum procalcitonin and high-sensitivity C-reactive protein were detected in all children and the levels in severe infection group children before and after treatment were also quantitatively detected and the test results were analyzed. There was significant difference in procalcitonin among the four groups (pSinfection group has no significant difference compared with the non-infection group (p>0.05). But there was significant difference between the local infection group and healthy newborn group. As for the severe infection group, both the levels of procalcitonin and positive rate of high-sensitivity C-reactive protein had significant difference compared with the other groups. The detection of procalcitonin and high-sensitivity C-reactive protein could contribute to the diagnose of the early infection neonatal children and has important values in diagnosis and treatment of infectious diseases in the newborns.

  17. Value of soluble TREM-1, procalcitonin, and C-reactive protein serum levels as biomarkers for detecting bacteremia among sepsis patients with new fever in intensive care units: a prospective cohort study

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    Su Longxiang

    2012-07-01

    Full Text Available Abstract Background The purpose of this study was to explore the diagnostic value of soluble triggering receptor expressed on myeloid cells 1 (sTREM-1, procalcitonin (PCT, and C-reactive protein (CRP serum levels for differentiating sepsis from SIRS, identifying new fever caused by bacteremia, and assessing prognosis when new fever occurred. Methods We enrolled 144 intensive care unit (ICU patients: 60 with systemic inflammatory response syndrome (SIRS and 84 with sepsis complicated by new fever at more than 48 h after ICU admission. Serum sTREM-1, PCT, and CRP levels were measured on the day of admission and at the occurrence of new fever (>38.3°C during hospitalization. Based on the blood culture results, the patients were divided into a blood culture-positive bacteremia group (33 patients and blood culture-negative group (51 patients. Based on 28-day survival, all patients, both blood culture-positive and -negative, were further divided into survivor and nonsurvivor groups. Results On ICU day 1, the sepsis group had higher serum sTREM-1, PCT, and CRP levels compared with the SIRS group (P P Conclusions Serum sTREM-1, PCT, and CRP levels each have a role in the early diagnosis of sepsis. Serum sTREM-1, with the highest sensitivity and specificity of all indicators studied, is especially notable. sTREM-1, PCT, and CRP levels are of no use in determining new fever caused by bacteremia in ICU patients, but sTREM-1 levels reflect the prognosis of bacteremia. Trial registration ClinicalTrial.gov identifier NCT01410578

  18. Utility and safety of procalcitonin in an antimicrobial stewardship program (ASP) in patients with malignancies.

    Science.gov (United States)

    Liew, Y X; Lee, W; Cai, Y Y; Teo, J; Tang, S S-L; Ong, R W-Q; Lim, C L-L; Lingegowda, P B; Kwa, A L-H; Chlebicki, M P

    2012-11-01

    As data on procalcitonin utility in antibiotics discontinuation [under an antimicrobial stewardship program (ASP)] in patients with malignancies are lacking, we aimed to evaluate the utility of procalcitonin in an ASP in patients with malignancies. We conducted a retrospective review of the ASP database of all patients with malignancies in whom at least one procalcitonin level was taken and our ASP had recommended changes in carbapenem regimen, from January to December 2011. We compared clinical outcomes between two groups of patients: patients whose physicians accepted and those whose physicians rejected ASP interventions. There were 749 carbapenem cases reviewed. Ninety-nine were suggested to either de-escalate, discontinue antibiotics, or narrow the spectrum of empiric treatment, based on procalcitonin trends. While there was no statistical difference in the mortality within 30 days post-ASP intervention (accepted: 8/65 patients vs. rejected: 9/34 patients; p = 0.076), the median duration of carbapenem therapy was significantly shorter (5 vs. 7 days; p = 0.002). Procalcitonin use safely facilitates decisions on antibiotics discontinuation and de-escalation in patients with malignancies in the ASP.

  19. Use of a semiquantitative procalcitonin kit for evaluating severity and predicting mortality in patients with sepsis

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    Kenzaka T

    2012-05-01

    mortality in septic patients. Based on the level of semiquantitative procalcitonin measured in patients with suspected sepsis, a timely decision can be reliably made to transfer them to a tertiary hospital with an intensive care unit for optimal care.Keywords: sepsis, semiquantitative procalcitonin, Sequential Organ Failure Assessment, Acute Physiology and Chronic Health Evaluation II, mortality, procalcitonin

  20. BET 2: Can procalcitonin accurately diagnose serious bacterial infection in emergency department patients with SIRS?

    Science.gov (United States)

    Wilson, Joel; Baskerville, Jerry; Zarabi, Sahar

    2017-09-01

    A shortcut review was carried out to establish whether serum procalcitonin levels can be used to identify serious bacterial infection in ED patients with undifferentiated SIRS. 14 papers presented the best evidence to answer the clinical question. The review concludes that raised procalcitonin levels are associated with bacteraemia; however, there are no clinical management studies addressing this question in ED patients with SIRS. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. Limited diagnostic value of procalcitonin in early diagnosis of adult onset Still's disease.

    Science.gov (United States)

    Gowin, Ewelina; Wysocki, Jacek

    2016-01-01

    A 17-year-old female patient was referred to the Infectious Diseases Ward because of fever lasting for 14 days. On admission to the hospital the patient was in a generally good state, without any abnormalities on physical examination. Laboratory investigation revealed elevated inflammatory markers. Diagnostic imaging comprising chest X-ray, abdominal ultrasonography, and echocardiography showed no abnormalities. During the hospitalization, there occurred episodes of fever with skin rash and musculoskeletal pain of the lower limbs. Procalcitonin concentrations continued to increase. C-reactive protein concentrations decreased during therapy, starting from 191 mg/l. On the 23(rd) day of the disease, edema of the feet, ankles, and knees appeared. On the basis of the clinical picture and after excluding other possible causes of fever, the patient was diagnosed with adult onset Still's disease. The procalcitonin concentration was normalized after 5 days of steroid therapy. The patient was discharged under ambulatory rheumatologic supervision.

  2. Limited diagnostic value of procalcitonin in early diagnosis of adult onset Still’s disease

    Science.gov (United States)

    Wysocki, Jacek

    2016-01-01

    A 17-year-old female patient was referred to the Infectious Diseases Ward because of fever lasting for 14 days. On admission to the hospital the patient was in a generally good state, without any abnormalities on physical examination. Laboratory investigation revealed elevated inflammatory markers. Diagnostic imaging comprising chest X-ray, abdominal ultrasonography, and echocardiography showed no abnormalities. During the hospitalization, there occurred episodes of fever with skin rash and musculoskeletal pain of the lower limbs. Procalcitonin concentrations continued to increase. C-reactive protein concentrations decreased during therapy, starting from 191 mg/l. On the 23rd day of the disease, edema of the feet, ankles, and knees appeared. On the basis of the clinical picture and after excluding other possible causes of fever, the patient was diagnosed with adult onset Still’s disease. The procalcitonin concentration was normalized after 5 days of steroid therapy. The patient was discharged under ambulatory rheumatologic supervision. PMID:27826176

  3. Comparing the Morphological Changes in Burn Wound Tissues and the Procalcitonin Concentration

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    Ludmila I. Budkevich, PhD, ScD²

    2013-03-01

    Full Text Available The problem of early diagnostics of bacterial complications is particularly true for children with extensive burn trauma (BT. Procalcitonin concentration levels considerably facilitate the diagnosis of sepsis. In all, 50 children with severe burns were included in our research. We conducted histological tests of the burn wound tissues from 13 patients. On comparison of the results of the PCT-tests with the results of the morphological investigation, we observed that the depth of the penetration of the microorganisms in the damaged tissues quite precisely corresponded to changes in the procalcitonin concentration.

  4. Use of procalcitonin for the detection of sepsis in the critically ill burn patient: a systematic review of the literature.

    Science.gov (United States)

    Mann, Elizabeth A; Wood, Geri L; Wade, Charles E

    2011-06-01

    The purpose of this systematic review was to assess the evidence for use of routine procalcitonin testing to diagnose the presence of sepsis in the burn patient. The electronic databases MEDLINE, Cochrane, CINAHL, ProQuest, and SCOPUS were searched for relevant studies using the MeSH terms burn, infection, procalcitonin, and meta-analysis. The focus of the review was the adult burn population, but other relevant studies of critically ill patients were included as data specific to the patient with burns are limited. Studies were compiled in tabular form and critically appraised for quality and level of evidence. Four meta-analyses, one review of the literature, one randomized controlled trial, nine prospective observational, and three retrospective studies were retrieved. Six of these studies were specific to the burn population, with one specific to burned children. Only one meta-analysis, one adult burn and one pediatric burn study reported no benefit of procalcitonin testing to improve diagnosis of sepsis or differentiate sepsis from non-infectious systemic inflammatory response. The collective findings of the included studies demonstrated benefit of incorporating procalcitonin assay into clinical sepsis determination. Evaluation of the burn specific studies is limited by the use of guidelines to define sepsis and inconsistent results from the burn studies. Utility of the procalcitonin assay is limited due to the lack of availability of rapid, inexpensive tests. However, it appears procalcitonin assay is a safe and beneficial addition to the clinical diagnosis of sepsis in the burn intensive care unit.

  5. 脓毒症血清降钙素原与APACHEⅡ评分的相关性%CORRELATION BETWEEN SERUM LEVEL OF PROCALCITONIN AND APACHE Ⅱ SCORE IN PATIENTS WITH SEPSIS

    Institute of Scientific and Technical Information of China (English)

    袁东; 于海初

    2012-01-01

    目的 观察脓毒症病人血清降钙素原(PCT)水平与APACHEⅡ评分之间的相关性.方法 检测脓毒症病人74例(其中脓毒症28例,严重脓毒症25例,脓毒症休克21例)、非脓毒血症病人24例血清PCT及C反应蛋白(CRP)水平,行APACHEⅡ评分,分析PCT、CRP水平与APACHEⅡ评分相关性.结果 脓毒症、严重脓毒症和脓毒症休克病人的血清PCT、CRP水平和APACHEⅡ评分均高于非脓毒症病人,差异有显著意义(F=7.07~441.87,q=3.18~48.14,P<0.05).脓毒症病人PCT水平、APACHEⅡ评分随病情严重程度升高而升高,差异有显著性(q=10.06~48.14,P<0.05);PCT水平与APACHEⅡ评分呈正相关(r=0.68,P<0.05).结论 脓毒症病人PCT水平与APACHEⅡ评分有相关性,PCT在脓毒症诊断中的价值优于CRP.%Objective To study the correlation of serum level of procalcitonin (PCT) with score of APACHE Ⅱ in patients with sepsis. Methods Serum levels of PCT and C-reactive protein (CRP) in 74 patients with sepsis, which included sepsis (28 cases), severe sepsis (25) and septic shock (21) , and 24 patients with non-sepsis were detected. APACHE II score was done. The correlation of the score with PCT and C-reactive protein (CRP) was analyzed. Results Serum levels of PCT and CRP, and APACHE Ⅱ scores in patients with sepsis, severe sepsis and septic shock were significantly higher than that in the non-septic patients (F=7. 07-441. 87,q= 3.18 - 48.14,P<0. 05). PCT levels and APACHE D scores elevated along with the severity of the disease (q= 10. 06-48.14,P<0. 05). The level of PCT was positively correlated with APACHEⅡ (r=0. 68,P<0. 05). Conclusion There is a positive correlation of PCT with APACHE Ⅱ score in patients with sepsis. The serum level of PCT is superior to CRP in the diagnosis of sepsis

  6. [Clinical utility of measurement of procalcitonin for diagnosis of urosepsis].

    Science.gov (United States)

    Hosokawa, Yukinari; Takenaga, Maho; Itami, Yoshitaka; Shinohara, Masatake; Takada, Satoshi; Hayashi, Yoshiki; Hashimura, Masaya; Fujimoto, Kiyohide; Hirao, Yoshihiko

    2012-10-01

    We assessed the diagnostic value of procalcitonin (PCT) in urosepsis on 54 patients with urinary tract infections (UTI), suspected of having urosepsis. The results of urine culture, blood culture, and serum concentrations of PCT were analyzed. Overall, the sensitivity and specificity of PCT for bacteremia were as follows : 100 and 31.6% at concentrations of >0.5 ng/ml and 75.0 and 78.9% at concentrations of >10 ng/ml. we concluded that the PCT level could be a reliable early marker suggestive of urosepsis, and may be helpful when deciding whether to perform immediate urological intervention or not.

  7. 血清降钙素原水平在尿路感染中的定位作用研究%Study on Orientating Function of Serum Procalcitonin Level in Urinary Tract Infection

    Institute of Scientific and Technical Information of China (English)

    彭凯丰; 周志芳

    2012-01-01

    目的 探讨血清降钙素原(PCT)在尿路感染中的定位作用.方法 选取尿路感染患者106例,同期健康体检者100例,用化学发光免疫法测定血清中的PCT和C-反应蛋白(CRP)水平,同时检测患者外周血白细胞计数(WBC).结果 上尿路感染组患者血清PCT水平明显高于下尿路感染患者组(P<0.01),PCT对上尿路感染诊断的敏感性为81.1%,特异性为85.5%,阳性预测值为80.3%,阴性预测值为92.5%,均高于CRP和WBC.结论 血清PCT水平的测定对尿路感染有定位作用.%Objective To explore the location role of serum procalcitonin (PCT) in the diagnosis of urinary tract infection (UTI). Methods One hundred and six patients with urinary tract infection and 100 health examinees were enrolled in this study. The serum PCT and C- reactive protein (CRP) levels were measured by chemiluminescent immunoassay; meanwhile, peripheral white blood cells were counted. Results The serum level of PCT in upper urinary tract infection group was significantly higher than that in lower urinary tract infection group (P<0.01). The sensitivity and specificity of PCT in diagnosis of upper urinary tract infection were 81.1% and 85.5% respectively, positive predictive value was 80.3% and negative predictive value was 92.5 % , which were all higher than CRP and WBC. Conclusions The serum level of PCT can be used as a marker to differentially diagnose the upper and lower urinary tract infections.

  8. Prognostic value of procalcitonin (PCT) and/or interleukin-6 (IL-6) plasma levels after multiple trauma for the development of multi organ dysfunction syndrome (MODS) or sepsis.

    Science.gov (United States)

    Haasper, C; Kalmbach, M; Dikos, G D; Meller, R; Müller, C; Krettek, C; Hildebrand, F; Frink, M

    2010-01-01

    Despite recent advances in treatment of severe injured patients, e.g. due to damage control orthopaedics, multi organ dysfunction syndrome (MODS) and sepsis are major complications in daily practice. During one year 94 patients were prospectively collected. ISS 16, age 18-60 y, primary admission to our level-1 trauma center, survival > 48 hours after trauma. The development of MODS and sepsis were observed and different groups were formed (+/-). Demographic data revealed no significant differences between the subgroups. Comparing groups +MODS and -MODS significant differences on admission day were observed, when PCT showed first on day 2 after trauma differences. Regarding the development of sepsis PCT was advantageous to IL-6 showing significant higher plasma levels in group +sepsis from the first day after trauma. Serum levels of IL-6 and PCT could be useful in early identification of high risk patients to develop posttraumatic MODS. For sepsis PCT is the better prognostic factor.

  9. Structural and diffusional brain abnormality related to relatively low level alcohol consumption.

    Science.gov (United States)

    Sasaki, Hiroki; Abe, Osamu; Yamasue, Hidenori; Fukuda, Rin; Yamada, Haruyasu; Takei, Kunio; Suga, Motomu; Takao, Hidemasa; Kasai, Kiyoto; Aoki, Shigeki; Ohtomo, Kuni

    2009-06-01

    Chronic excessive alcohol intake results in alcohol-related brain damage. Many previous reports have documented alcohol-related global or local brain shrinkage or diffusional abnormalities among alcoholics and heavy to moderate drinkers; however, the influence of relatively low levels of alcohol consumption on brain structural or diffusional abnormality is unclear. We investigated structural or diffusional abnormalities related to lifetime alcohol consumption (LAC) using voxel-based morphometry (VBM) among Japanese non-alcohol-dependent individuals (114 males, 97 females). High-resolution three-dimensional magnetic resonance images and diffusion tensor imaging were acquired in all subjects. The collected images were normalized, segmented, and smoothed using SPM 5. Gray matter volume (GMV) and white matter volume (WMV) were normalized for each total intracranial volume (TIV), and partial correlation coefficients were estimated between normalized GMV or WMV and lifetime alcohol consumption (LAC) adjusted for age. To investigate regional GMV or WMV abnormalities related to LAC, multiple regression analyses were performed among regional GMV or WMV and LAC, age, and TIV. To investigate subtle regional abnormalities, multiple regression analyses were performed among fractional anisotropy (FA) or mean diffusivity (MD), and LAC and age. No LAC-related global or regional GMV or WMV abnormality or LAC-related regional FA abnormality was found among male or female subjects. Significant LAC-related MD increase was found in the right amygdala among female subjects only. The current results suggest female brain vulnerability to alcohol, and a relation between subtle abnormality in the right amygdala and alcohol misuse.

  10. IMPORTANCE OF SERUM PROCALCITONIN IN FEBRILE NEUTROPENIA

    Directory of Open Access Journals (Sweden)

    Mohd. Riyaz

    2014-07-01

    Full Text Available Febrile neutropenia is defined as a fever >101°F for 1 hour, with an absolute neutrophil count of ≤500 cells/microliter, or an ANC of ≤1000 cells/microliter with a projected nadir of ≤500 cells/microliter. In haematological malignancies it is the common complication and requires broad-spectrum antibacterial therapy. Clinical examination and cultures fail to detect a pathogen or an infectious focus in 25–50%, which are classified as pyrexia of unknown origin (PUO. Patient with pyrexia of unknown origin may receive long duration of antibiotic treatment as the cause is unclear of being infective or not. Febrile neutropenia is a common complication of many chemotherapeutic regimens for all types of cancers. Mortality and Morbidity is high particularly in elderly, immuno-compromised. Approximately 20- 40 % of patients with severe sepsis and 45-60% patients with septic shock die within 15-20 days. This study was done to know the sources of infection and to assess the diagnostic value of serum Procalcitonin and its relation with mortality in various stages of sepsis. Sepsis incidence was more in patient age more than 55yrs. the most common source of sepsis was respiratory tract infection. Serum PCT proved to be an indicator of sepsis in ill patients, with sensitivity of 91%. Presence of both persistent and profound neutropenia was associated with a much higher mortality. The occurrence of infection is directly proportional to the degree of neutropenia, at the onset of fever the PCT levels will not be helpful for the decision to start or stop the antibacterial therapy, and a PCT value higher than 0.5ng/ml in pyrexia of unknown origin might suggest a possibility of occult infection, i.e. with lacking microbiological and clinical documentation. A delayed PCT peak higher than0.5ng/ml contributes to the early diagnosis of fungal disease.

  11. Abnormal electrocardiographic findings in athletes: Correlation with intensity of sport and level of competition.

    Science.gov (United States)

    Dores, Hélder; Malhotra, Aneil; Sheikh, Nabeel; Millar, Lynne; Dhutia, Harshil; Narain, Rajay; Merghani, Ahmed; Papadakis, Michael; Sharma, Sanjay

    2016-11-01

    Athletes can exhibit abnormal electrocardiogram (ECG) phenotypes that require further evaluation prior to competition. These are apparently more prevalent in high-intensity endurance sports. The purpose of this study was to assess the association between ECG findings in athletes and intensity of sport and level of competition. A cohort of 3423 competitive athletes had their ECGs assessed according to the Seattle criteria (SC). The presence of abnormal ECGs was correlated with: (1) intensity of sport (low/moderate vs. at least one high static or dynamic component); (2) competitive level (regional vs. national/international); (3) training volume (≤20 vs. >20 hours/week); (4) type of sport (high dynamic vs. high static component). The same endpoints were studied according to the 'Refined Criteria' (RC). Abnormal ECGs according to the SC were present in 225 (6.6%) athletes, more frequently in those involved in high-intensity sports (8.0% vs. 5.4%; p=0.002), particularly in dynamic sports, and competing at national/international level (7.1% vs. 4.9%; p=0.028). Training volume was not significantly associated with abnormal ECGs. By multivariate analysis, high-intensity sport (OR 1.55, 1.18-2.03; p=0.002) and national/international level (OR 1.50, 95% CI 1.04-2.14; p=0.027) were independent predictors of abnormal ECGs, and these variables, when combined, doubled the prevalence of this finding. According to the RC, abnormal ECGs decreased to 103 (3.0%), but were also more frequent in high-intensity sports (4.2% vs. 2.0%; pintensity of sports and increased prevalence of ECG abnormalities. This relationship persists with the use of more restrictive criteria for ECG interpretation, although the number of abnormal ECGs is lower. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Levels of serum and cerebrospinal fluid procalcitonin in patients with encephalic infections%颅内感染患者血清和脑脊液降钙素原水平的观察

    Institute of Scientific and Technical Information of China (English)

    汪军亚; 郭玉香

    2013-01-01

    Objective To observe the levels of serum and cerebrospinal fluid (CSF) procalcitonin (PCT) in patients with meningitis and explore the clinical value for the diagnosis of meningitis.Methods Immunoturbidimetry was used to determine the levels of serum and CSF PCT in 42 patients with meningitis [18 Bacterial meningitis (BM),24 viral meningitis (VM)] and 20 control subjects.Results The levels of serum and CSF PCT of the observation group were significantly higher than the control group (P < 0.01) ; But no significant difference was found between the viral meningitis and control groups (P > 0.05).The PCT was not correlated to the white blood cell counts in CSF (r =0.161,P > 0.05),but slightly correlated to the protein amount in CSF and the PCT in CSF (r =0.465 and 0.570 respectively,P < 0.05).Conclusion The increased PCT level in CSF could be an indicater for encephalic infection,which may be helpful to the diagnosis of meningitis as a routine CSF test.%目的 研究降钙素原(PCT)在脑膜炎患者血清和脑脊液(CSF)中的水平,探讨其在脑膜炎诊断中的临床意义.方法 用免疫透射比浊法测定42例脑膜炎患者(细菌性脑膜炎18例、病毒性脑膜炎24例)急性期内血清和脑脊液PCT,并与CSF的常规生化指标作相关性分析;20例神经系统非感染性疾病为对照组.结果 细菌性脑膜炎患者血清和CSF中的PCT含量均显著高于病毒性脑膜炎和对照组(P<0.01);但病毒性脑膜炎患者与对照组之间的PCT水平差异无统计学意义(P>0.05).相关性分析显示,在CSF中PCT与白细胞数(r=0.161,P>0.05)无明显相关性,但与CSF蛋白含量和血清PCT水平呈弱相关性(r=0.465和0.570,P<0.05).结论 PCT升高是颅内细菌感染的标志之一;PCT可作为一项CSF的常规生化指标,有助于指导临床对脑膜炎的诊治.

  13. Maternal and cord serum vitamin E levels in normal and abnormal pregnancy.

    Science.gov (United States)

    von Mandach, U; Huch, R; Huch, A

    1994-01-01

    The purpose of this study was to ascertain whether there is an association between reduced vitamin E levels and an abnormal pregnancy. Levels were measured by HPLC in maternal and, where possible, in paired umbilical cord serum from normal and abnormal pregnancies at delivery and in serial serum samples from healthy women during gestation. Abnormal pregnancies were compared with normals. In normal pregnancies, mean vitamin E levels rose from 12.9 +/- 1.1 micrograms/ml in early pregnancy to 22.5 +/- 1.5 micrograms/ml at term (p or = 30 weeks & p or = 37 weeks were 21.3 +/- 0.6 and 3.8 +/- 0.1 micrograms/ml respectively (p 10 cig/day) were significantly lower (p < 0.05, n = 13 & p < 0.0005, n = 12); levels in women with a malformed infant (n = 6) were also reduced, but just barely below the level of significance (p = 0.06). Cord serum levels in complicated pregnancies, however, were unchanged. The results show lower maternal levels of vitamin E in abnormal pregnancies, suggesting a changed vitamin E metabolism.

  14. Analysis of using cerebrospinal fluid procalcitonin level to diagnose intracranial infection after craniotomy%开颅术后患者降钙素原对颅内感染的诊断分析

    Institute of Scientific and Technical Information of China (English)

    戴晶; 高杰善; 董江涛; 王刚刚; 朱立仓; 王业忠

    2014-01-01

    OBJECTIVE To explore the diagnostic accuracy of cerebrospinal fluid procalcitonin (PCT ) level in intracranial infection after craniotomy ,so as to provide a quick treatment for patients .METHODS According to diagnostic criteria of intracranial infection in hospital ,30 post-craniotomy patients with intracranial infection after craniotomy from May 2011 to May 2013 were selected as infected group and 30 post-craniotomy patients without intracranial infection after craniotomy from May 2011 to May 2013 were selected as disinfected group .Every patient′s serum and cerebrospinal fluid were taken to test the level of serum WBC ,PCT and CSF proteins ,WBC , PCT and all data were analyzed by SPSS13 .0 software .RESULTS Serum PCT and CSF proteins ,WBC ,PCT values in the infected group were significantly improved and higher than those in the disinfected group (P<0 .05) . The positive biomarkers of serum WBC was 10 × 109/L ,when the sensitivity ,specificity and accuracy were 72 .46% ,62 .13% and 69 .90% .The positive biomarkers of serum PCT was 100ng/L ,when the sensitivity ,speci-ficity and accuracy were 67 .55% ,83 .19% and 79 .59% .CONCLUSION CSF PCT has higher sensitivity and speci-ficity than others and had higher diagnostic accuracy in diagnosis of intracranial infection after craniotomy .%目的:探讨开颅患者术后降钙素原(PC T )对颅内感染的诊断的准确性,使患者得到及时治疗。方法根据医院颅内感染诊断标准,选择2011年5月-2013年5月开颅手术后颅内感染患者30例作为颅内感染组;另选择2011年5月-2013年5月开颅手术后无颅内感染患者30例作为非颅内感染组,采集每例患者的血液和脑脊液送检,检测血液白细胞数、PCT和脑脊液蛋白、白细胞数、PCT ,所有数据采用SPSS13.0进行统计分析。结果颅内感染组血液PC T、脑脊液蛋白、脑脊液白细胞数、脑脊液PC T含量均明显升高,与非颅内感染组相

  15. [Usefulness of Procalcitonin Measurement for the Detection of Sepsis].

    Science.gov (United States)

    Toh, Hiromi; Harada, Sadako; Kakudou, Tomoko; Era, Fumiyoshi; Tokushige, Chiemi; Yoshimura, Hisae; Kawashima, Hironobu; Ohkubo, Kumiko; Ishikura, Hiroyasu; Matsunaga, Akira

    2014-10-01

    Procalcitonin (PCT) is a frequently used marker for bacterial sepsis. The present study was aimed to assess the usefulness of PCT measurement in patient with sepsis. We studied the relationship between serum PCT level and blood culture in clinical 209 cases admitted from January 2010 through June 2010. We compared PCT level with blood culture results and other clinical data, and diagnosis such as sepsis and systemic inflammatory response syndrome (SIRS) were obtained from the medical records. In the case of patients with positive blood cultures and PCT sepsis. The PCT measurement could be performed and reported rapidly and provided valuable information before availability of culture results. In this study, we found that the PCT would be a useful biomarker for confirming and ruling out sepsis.

  16. 联合检测血清降钙素原、C反应蛋白、乳酸、D-二聚体水平在儿童脓毒症中的意义%Significance of combined detection of serum procalcitonin, C-reactive protein, lactic acid and D-dimer level in children with sepsis

    Institute of Scientific and Technical Information of China (English)

    陈晓锐; 彭俊旭; 郑华

    2016-01-01

    目的:探讨血清降钙素原、C反应蛋白、乳酸、D-二聚体水平在儿童脓毒症联合检测的意义。方法选取64例我院治疗的脓毒症,根据患儿病情情况,将脓毒症组分为一般脓毒症和重度脓毒症组,另选择32例健康儿童为正常对照组。于入院后1h内测定血清降钙素原、C反应蛋白、乳酸、D-二聚体水平。结果脓毒症患儿组血清降钙素原、C反应蛋白、乳酸、D-二聚体水平较正常儿童组明显升高,差异有统计学意义( P<0.01);重度脓毒组血清降钙素原、乳酸水平在诊断为脓毒症后的6 h、24 h、48 h比一般脓毒症组升高,差异有统计学意义(P<0.01),C反应蛋白水平在两组中比较差异无统计学意义(P>0.05);脓毒症组并发DIC者四项指标同时升高,且死亡组血清降钙素原、乳酸、D-二聚体水平比存活组更高,差异有统计学意义(P均<0.01)。结论在脓毒症患儿中联合检测血清降钙素原、C反应蛋白、乳酸、D-二聚体水平可能可以提高诊断早期脓毒症及判断病情严重程度及预后的水平。%Objective To explore the significance of combined detection of serum procalcitonin, C-reactive protein, lactic acid and D-dimer levels in children with sepsis.Methods 64 cases with sepsis according to their situation were divided into general sepsis and severe sepsis group, and 32 cases healthy children were selected as control group.Serum procalcitonin, C-reactive protein, lactic acid and D-dimer levels were detected within 1h after they were hospitalized.Results Serum procalcitonin, C-reactive protein, lactic acid and D-dimer levels in sepsis group were significantly higher (P0.05);All the four parameters in sepsis group complicated with DIC increased at the same time, and in death group, serum procalcitonin, lactic acid and D-dimer levels were significantly higher than the survival group ( P <0.01 ) . Conclusions

  17. Synergistic effects of elevated homocysteine level and abnormal blood lipids on the onset of stroke

    Institute of Scientific and Technical Information of China (English)

    Lu Hao; Zhenzhen Cheng; Qiang Wu; Shuzhang Li; Liming Chen; Xiaoyong Sai; Zhefeng Liu; Guang Yang; Rongzeng Yan; Lili Wang; Caiyun Fu; Xuan Xu

    2013-01-01

    Hyperhomocysteinemia and abnormal blood lipids are independent risk factors for stroke. However, whether both factors exert a synergistic effect in the onset of stroke remains unclear. The present study is a retrospective analysis of 2 089 cases of stroke and 2 089 control cases of simple inter-vertebral disk protrusion using a paired multivariate logistic regression method. Adjusting for known confounding variables including the patients’ age, gender, smoking status, alcohol consumption status, patient and family medical history, and clinical biochemical indices, elevated homocysteine level was related to the onset of stroke. Patients with elevated homocysteine levels and abnormal blood lipids showed a 40.9%increase in the risk for stroke compared to patients with normal ho-mocysteine levels and blood lipids (odds ratio 1.409;95%confidence interval 1.127-1.761). These results indicate that elevated homocysteine and abnormal blood lipids exert synergistic effects in the onset of stroke. Patients with elevated homocysteine levels and abnormal blood lipids are predis-posed to stroke.

  18. Data on copper level in the blood of patients with normal and abnormal angiography

    Directory of Open Access Journals (Sweden)

    Leila Amiri

    2016-12-01

    Full Text Available In this data article, we measured the levels of copper in the blood of patients undergoing coronary angiography. The samples were taken from patients with cardiovascular disease in Bushehr׳s university hospital, Iran. Patients were divided in two groups: normal angiography and abnormal angiography. After the chemical digestion of samples, the concentration levels of Cu in both groups were determined by using inductively coupled plasma optical spectrometry (ICP-OES.

  19. Data on copper level in the blood of patients with normal and abnormal angiography.

    Science.gov (United States)

    Amiri, Leila; Movahed, Ali; Iranpour, Dariush; Ostovar, Afshin; Raeisi, Alireza; Keshtkar, Mozhgan; Hajian, Najmeh; Dobaradaran, Sina

    2016-12-01

    In this data article, we measured the levels of copper in the blood of patients undergoing coronary angiography. The samples were taken from patients with cardiovascular disease in Bushehr׳s university hospital, Iran. Patients were divided in two groups: normal angiography and abnormal angiography. After the chemical digestion of samples, the concentration levels of Cu in both groups were determined by using inductively coupled plasma optical spectrometry (ICP-OES).

  20. Retrospective study on prognostic importance of serum procalcitonin and amino - terminal pro - brain natriuretic peptide levels as compared to Acute Physiology and Chronic Health Evaluation IV Score on Intensive Care Unit admission, in a mixed Intensive Care Unit population

    Directory of Open Access Journals (Sweden)

    Chitra Mehta

    2016-01-01

    Full Text Available Background: Timely decision making in Intensive Care Unit (ICU is very essential to improve the outcome of critically sick patients. Conventional scores like Acute Physiology and Chronic Health Evaluation (APACHE IV are quite cumbersome with calculations and take minimum 24 hours. Procalcitonin has shown to have prognostic value in ICU/Emergency department (ED in disease states like pneumonia, sepsis etc. NTproBNP has demonstrated excellent diagnostic and prognostic importance in cardiac diseases. It has also been found elevated in non-cardiac diseases. We chose to study the prognostic utility of these markers on ICU admission. Settings and Design: Retrospective observational study. Materials and Methods: A Retrospective analysis of 100 eligible patients was done who had undergone PCT and NTproBNP measurements on ICU admission. Their correlations with all cause mortality, length of hospital stay, need for ventilator support, need for vasopressors were performed. Results: Among 100 randomly selected ICU patients, 28 were non-survivors. NTproBNP values on admission significantly correlated with all cause mortality (P = 0.036, AUC = 0.643 and morbidity (P = 0.000, AUC = 0.763, comparable to that of APACHE-IV score. PCT values on admission did not show significant association with mortality, but correlated well with morbidity and prolonged hospital length of stay (AUC = 0.616, P = 0.045. Conclusion: The current study demonstrated a good predictive value of NTproBNP, in terms of mortality and morbidity comparable to that of APACHE-IV score. Procalcitonin, however, was found to have doubtful prognostic importance. These findings need to be confirmed in a prospective larger study.

  1. Gaucher disease: plasmalogen levels in relation to primary lipid abnormalities and oxidative stress.

    Science.gov (United States)

    Moraitou, Marina; Dimitriou, Evangelia; Dekker, Nick; Monopolis, Ioannis; Aerts, Johannes; Michelakakis, Helen

    2014-01-01

    Plasmalogens represent a unique class of phospholipids. Reduced red blood cell plasmalogen levels in Gaucher disease patients were reported, correlating to total disease burden. The relation between plasmalogen abnormalities in Gaucher disease patients and primary glycosphingolipid abnormalities, malonyldialdehyde levels, an indicator of lipid peroxidation, and the total antioxidant status was further investigated. Significant reduction of C16:0 and C18:0 plasmalogens in red blood cells of Gaucher disease patients was confirmed. In parallel, a significant increase in the glucosylceramide/ceramide ratio in red blood cell membranes, as well as an average 200-fold increase in plasma glucosylsphingosine levels was observed. Red blood cell malonyldialdehyde levels were significantly increased in patients, whereas their total antioxidant status was significantly reduced. A negative correlation between plasmalogen species and glucosylceramide, ceramide, glucosylceramide/ceramide ratio, glucosylsphingosine and malonyldialdehyde, significant for the C16:0 species and all the above parameters with the exception of malonyldialdehyde levels, was found along with a positive non-significant correlation with the total antioxidant status. Our results indicate that increased lipid peroxidation and reduced total antioxidant status exist in Gaucher disease patients. They demonstrate a clear link between plasmalogen levels and the primary glycolipid abnormalities characterizing the disorder and an association with the increased oxidative stress observed in Gaucher disease patients.

  2. [Association of metabolic syndrome markers with abnormal alanine aminotransferase levels in healthy children].

    Science.gov (United States)

    Arancibia, Gabriel; García, Hernán; Jaime, Francisca; Bancalari, Rodrigo; Harris, Paul R

    2012-07-01

    There is a high prevalence of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) among pediatric patients. The identification of clinical predictors of these conditions would allow a timely treatment. To evaluate the relationship between serum alanine aminotransferase levels and parameters of metabolic syndrome in asymptomatic school students without hepatic illness. A randomized sample of 175 children aged between 9 and 14 years (54% females) was selected, from a database of 3010 students living in Santiago, Chile. Weight, height, abdominal circumference, systolic and diastolic blood pressure were measured. A fasting blood sample was obtained to measure glucose, total cholesterol, HDL, LDL-cholesterol, triglycerides, alanine aminotransferase (ALT) and insulin levels. Forty percent of participants were obese, 17% had metabolic syndrome and 13.1% had abnormal ALT levels. Compared with children with normal ALT levels, the latter had significantly higher waist obesity, body mass index, systolic and diastolic blood pressure and triglycerides. However on multivariate analysis, only waist obesity was independently associated with abnormal ALT levels (adjusted odds ratio 3.93, 95% confidence intervals 1.44-10.78, p = 0.008). Only waist obesity was independently associated with abnormal ALT levels in this sample of children.

  3. Positive Reinforcement Training Moderates Only High Levels of Abnormal Behavior in Singly Housed Rhesus Macaques

    Science.gov (United States)

    Baker, Kate C.; Bloomsmith, Mollie; Neu, Kimberly; Griffis, Caroline; Maloney, Margaret; Oettinger, Brooke; Schoof, Valérie A. M.; Martinez, Marni

    2010-01-01

    This study evaluated the application of positive reinforcement training (PRT) as an intervention for abnormal behaviors in singly housed laboratory rhesus macaques at 2 large primate facilities. Training involved basic control behaviors and body-part presentation. The study compared baseline behavioral data on 30 adult males and 33 adult females compared with 3 treatment phases presented in counterbalanced order: 6 min per week of PRT, 20 or 40 min per week of PRT, and 6 min per week of unstructured human interaction (HI). Within-subject parametric tests detected no main or interaction effects involving experimental phase. However, among a subset of subjects with levels of abnormal in the top quartile of the range (n = 15), abnormal behavior was reduced from 35% to 25% of samples with PRT but not with HI. These results suggest that short durations of PRT applied as enrichment for this species and in this context may not in itself be sufficient intervention for abnormal behavior because levels remained high. However, it may be appropriate as an adjunct to other interventions and may be best targeted to the most severely affected individuals. PMID:20183477

  4. Positive reinforcement training moderates only high levels of abnormal behavior in singly housed rhesus macaques.

    Science.gov (United States)

    Baker, Kate C; Bloomsmith, Mollie; Neu, Kimberly; Griffis, Caroline; Maloney, Margaret; Oettinger, Brooke; Schoof, Valerie A M; Martinez, Marni

    2009-01-01

    This study evaluated the application of positive reinforcement training (PRT) as an intervention for abnormal behaviors in singly housed laboratory rhesus macaques at 2 large primate facilities. Training involved basic control behaviors and body-part presentation. The study compared baseline behavioral data on 30 adult males and 33 adult females compared with 3 treatment phases presented in counterbalanced order: 6 min per week of PRT, 20 or 40 min per week of PRT, and 6 min per week of unstructured human interaction (HI). Within-subject parametric tests detected no main or interaction effects involving experimental phase. However, among a subset of subjects with levels of abnormal in the top quartile of the range (n = 15), abnormal behavior was reduced from 35% to 25% of samples with PRT but not with HI. These results suggest that short durations of PRT applied as enrichment for this species and in this context may not in itself be sufficient intervention for abnormal behavior because levels remained high. However, it may be appropriate as an adjunct to other interventions and may be best targeted to the most severely affected individuals.

  5. The MsrA knockout mouse exhibits abnormal behavior and brain dopamine levels

    OpenAIRE

    Oien, Derek B.; Osterhaus, Greg L.; Latif, Shaheen A.; Pinkston, Jonathan W.; Fulks, Jenny; Johnson, Michael; Fowler, Stephen C.; Moskovitz, Jackob

    2008-01-01

    Oxidative stress can cause methionine oxidation that has been implicated in various proteins malfunctions, if not adequately reduced by the methionine sulfoxide reductase system. Recent evidence has found oxidized methionine residues in neurodegenerative conditions. Previously, we have described elevated levels of brain pathologies and an abnormal walking pattern in the methionine sulfoxide reductase A knockout (MsrA−/−) mouse. Here we show that MsrA−/− mice have compromised complex task lear...

  6. MsrA knockout mouse exhibits abnormal behavior and brain dopamine levels.

    Science.gov (United States)

    Oien, Derek B; Osterhaus, Greg L; Latif, Shaheen A; Pinkston, Jonathan W; Fulks, Jenny; Johnson, Michael; Fowler, Stephen C; Moskovitz, Jackob

    2008-07-15

    Oxidative stress can cause methionine oxidation that has been implicated in various proteins malfunctions, if not adequately reduced by the methionine sulfoxide reductase system. Recent evidence has found oxidized methionine residues in neurodegenerative conditions. Previously, we have described elevated levels of brain pathologies and an abnormal walking pattern in the methionine sulfoxide reductase A knockout (MsrA(-/-)) mouse. Here we show that MsrA(-/-) mice have compromised complex task learning capabilities relative to wild-type mice. Likewise, MsrA(-/-) mice exhibit lower locomotor activity and altered gait that exacerbated with age. Furthermore, MsrA(-/-) mice were less responsive to amphetamine treatment. Consequently, brain dopamine levels were determined. Surprisingly, relative to wild-type mice, MsrA(-/-) brains contained significantly higher levels of dopamine up to 12 months of age, while lower levels of dopamine were observed at 16 months of age. Moreover, striatal regions of MsrA(-/-) mice showed an increase of dopamine release parallel to observed dopamine levels. Similarly, the expression pattern of tyrosine hydroxylase activating protein correlated with the age-dependent dopamine levels. Thus, it is suggested that dopamine regulation and signaling pathways are impaired in MsrA(-/-) mice, which may contribute to their abnormal behavior. These observations may be relevant to age-related neurological diseases associated with oxidative stress.

  7. The MsrA knockout mouse exhibits abnormal behavior and brain dopamine levels

    Science.gov (United States)

    Oien, Derek B.; Osterhaus, Greg L.; Latif, Shaheen A.; Pinkston, Jonathan W.; Fulks, Jenny; Johnson, Michael; Fowler, Stephen C.; Moskovitz, Jackob

    2008-01-01

    Oxidative stress can cause methionine oxidation that has been implicated in various proteins malfunctions, if not adequately reduced by the methionine sulfoxide reductase system. Recent evidence has found oxidized methionine residues in neurodegenerative conditions. Previously, we have described elevated levels of brain pathologies and an abnormal walking pattern in the methionine sulfoxide reductase A knockout (MsrA−/−) mouse. Here we show that MsrA−/− mice have compromised complex task learning capabilities relative to wild-type mice. Likewise, MsrA−/− mice exhibit lower locomotor activity and altered gait that exacerbated with age. Furthermore, MsrA−/− mice were less responsive to amphetamine treatment. Consequently, brain dopamine levels were determined. Surprisingly, relative to wild-type mice, MsrA−/− brains contained significantly higher levels of dopamine up to 12 months of age, while lower level of dopamine was observed at 16 months of age. Moreover, striatal regions of MsrA−/− mice showed an increase of dopamine release parallel to observed dopamine levels. Similarly, the expression pattern of tyrosine hydroxylase activating protein correlated with the age-dependent dopamine levels. Thus, it is suggested that dopamine regulation and signaling pathway are impaired in MsrA−/− mice, which may contribute to their abnormal bio-behavior. These observations may be relevant to age-related neurological diseases associated with oxidative stress. PMID:18466776

  8. Method for the selective measurement of amino-terminal variants of procalcitonin.

    NARCIS (Netherlands)

    Struck, J.; Strebelow, M.; Tietz, S.; Alonso, C.; Morgenthaler, N.G.; Hoeven, J.G. van der; Pickkers, P.; Bergmann, A.

    2009-01-01

    BACKGROUND: Procalcitonin (PCT) is an established marker for diagnosing and monitoring bacterial infections. Full-length PCT [116 amino acids that make up procalcitonin (PCT1-116)] can be truncated, leading to des-Ala-Pro-PCT (des-Alanin-Prolin-Procalcitonin; PCT3-116). Current immunoassays for PCT

  9. Activin A Levels Are Associated With Abnormal Glucose Regulation in Patients With Myocardial Infarction

    Science.gov (United States)

    Andersen, Geir Ø.; Ueland, Thor; Knudsen, Eva C.; Scholz, Hanne; Yndestad, Arne; Sahraoui, Afaf; Smith, Camilla; Lekva, Tove; Otterdal, Kari; Halvorsen, Bente; Seljeflot, Ingebjørg; Aukrust, Pål

    2011-01-01

    OBJECTIVE On the basis of the role of activin A in inflammation, atherogenesis, and glucose homeostasis, we investigated whether activin A could be related to glucometabolic abnormalities in patients with acute myocardial infarction (MI). RESEARCH DESIGN AND METHODS Activin A measurement and oral glucose tolerance tests (OGTTs) were performed in patients (n = 115) with acute MI, without previously known diabetes, and repeated after 3 months. Release of activin A and potential anti-inflammatory effects of activin A were measured in human endothelial cells. Activin A effects on insulin secretion and inflammation were tested in human pancreatic islet cells. RESULTS 1) In patients with acute MI, serum levels of activin A were significantly higher in those with abnormal glucose regulation (AGR) compared with those with normal glucose regulation. Activin A levels were associated with the presence of AGR 3 months later (adjusted odds ratio 5.1 [95% CI 1.73–15.17], P = 0.003). 2) In endothelial cells, glucose enhanced the release of activin A, whereas activin A attenuated the release of interleukin (IL)-8 and enhanced the mRNA levels of the antioxidant metallothionein. 3) In islet cells, activin A attenuated the suppressive effect of inflammatory cytokines on insulin release, counteracted the ability of these inflammatory cytokines to induce mRNA expression of IL-8, and induced the expression of transforming growth factor-β. CONCLUSIONS We found a significant association between activin A and newly detected AGR in patients with acute MI. Our in vitro findings suggest that this association represents a counteracting mechanism to protect against inflammation, hyperglycemia, and oxidative stress. PMID:21464440

  10. Diagnostic approach to phlogoses: the validity of procalcitonin

    Directory of Open Access Journals (Sweden)

    E. Dimitri

    2013-12-01

    Full Text Available Aim. The aim of our study is to compare the potential usefulness of procalcitonin with the CRP as a diagnostic marker of pediatric diseases and to define the diagnostic accuracy and relation with the inflammation etiology and severity of procalcitonin. Methods. The analysis focused on a sample of 141 children, hospitalized for fever with bacterial, viral or inflammatory etiology, studied at the time of admission in the Hospital, and after defervescence. The sensitivity, the specificity, the positive and negative predictive value have been calculated for the both tests, explained above. Results. The diagnostic accuracy of procalcitonin is the same as the one of PCR in all cases. The result of the test has been positive in 85,7% of the serious infections and has been useful to identifiy the etiology of infections in almost 2/3 of patients. Conclusion. Procalcitonin seems to be a promising marker of infections because of its following features: a larger contribution in the monitoring phase (fast positivization and normalization; the diagnostic accuracy and a good correlation with the etiology and the severity of infections. Nonetheless, the routine use of procalcitonin is not recommended in the light of

  11. Relationship between serum sodium level and coronary artery abnormality in Kawasaki disease

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    Park, Sora; Kim, Ji Hong

    2017-01-01

    Purpose Kawasaki disease (KD) is an immune-related multisystemic vasculitis that occurs in children, especially ensuing from a coronary artery abnormality. Sodium level is known to be related to vascular injury, which could affect the progress of KD. The purpose of this study was to determine the serum sodium levels that could predict the occurrence of cardiac and coronary artery events in KD. Methods We conducted a retrospective review of medical records for 104 patients with KD from January 2015 to December 2015. Patients with serum Na levels of <135 mEq/L at the time of initial diagnosis were assigned to the hyponatremia group. Laboratory findings and echocardiographic data were analyzed for various aspects. Results Among the 104 patients with KD, 91 were included in the study, of whom 48 (52.7%) had hyponatremia. The degree of fever, white blood cell count, percentage of neutrophils, percentage of lymphocytes, total bilirubin level, brain natriuretic peptide level, erythrocyte sedimentation rate, and C-reactive protein level were higher in the patients with hyponatremia. They also demonstrated a trend of larger coronary artery diameters based on Z scores. Conclusion The severity of vascular inflammation in acute KD with hyponatremia might worsen the prognosis of coronary vasculature. Although no statistically significant correlation was found between the initial serum sodium levels and coronary arteriopathy in the patients with KD in this study, a long-term follow-up study with a larger number of enrolled patients should be designed in the future to elucidate the relationship between serum sodium level and coronary arteriopathy in patients with KD. PMID:28289432

  12. Clinical Presentation of a Patient with Congenital Cutis Laxa and Abnormal Thyroid Hormone Levels

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    Yan Ma

    2014-02-01

    Full Text Available We describe a case of generalized cutis laxa (CL in a 7-year-old female child. At 2 months of age, she was found to have a hoarse voice, and at 3 years, she was much smaller than her peers. Her aging face and short stature caught our attention, and the treatment of the patient was accepted by our hospital. She underwent a thorough examination. X-ray of the wrist bone showed a markedly delayed bone age, and thyroid function tests revealed significantly elevated free triiodothyronine 3 and free thyroxine 4 levels, but thyrotropin was within the normal range. Thyroid dysfunction and CL can be associated with lagged growth and development. Whether her abnormal development was due to thyroid dysfunction or CL could not be ascertained. CL is possibly more complex than it has been supposed so far, and is therefore worth to be further studied.

  13. Diagnostic and Prognostic Role of Procalcitonin in Infections

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    Maria Hatzistilianou

    2010-01-01

    Full Text Available Despite several consensus conferences, the criteria for the definition of sepsis are still considered too sensitive and insufficiently specific. The traditional clinical signs of infection and routine laboratory tests used to diagnose bacterial infection and sepsis lack diagnostic accuracy and can be misleading, particularly in patients with immunodeficiencies. The problems with sepsis definitions and diagnoses are indications of the need to focus on biochemical mediators capable not only of distinguishing the inflammatory response to infection from other types of inflammation, but also of indicating the severity and prognosis of the disease. Thus, physicians need an early and rapid marker for detecting bacterial infection and distinguishing it from viral infection. Several studies revealed that elevated procalcitonin (PCT levels in human blood could be detected in cases of sepsis and bacterial infection. PCT is a protein that can act as a hormone and a cytokine. It can be produced by several cell types and many organs in response to proinflammatory stimuli, particularly bacterial infection. It provides a rapid diagnostic test, available at the patient's bedside, and its half-life is suitable for daily monitoring of the disease progress.

  14. Deletion of PTH rescues skeletal abnormalities and high osteopontin levels in Klotho-/- mice.

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    Quan Yuan

    Full Text Available Maintenance of normal mineral ion homeostasis is crucial for many biological activities, including proper mineralization of the skeleton. Parathyroid hormone (PTH, Klotho, and FGF23 have been shown to act as key regulators of serum calcium and phosphate homeostasis through a complex feedback mechanism. The phenotypes of Fgf23(-/- and Klotho(-/- (Kl(-/- mice are very similar and include hypercalcemia, hyperphosphatemia, hypervitaminosis D, suppressed PTH levels, and severe osteomalacia/osteoidosis. We recently reported that complete ablation of PTH from Fgf23(-/- mice ameliorated the phenotype in Fgf23(-/-/PTH(-/- mice by suppressing serum vitamin D and calcium levels. The severe osteomalacia in Fgf23(-/- mice, however, persisted, suggesting that a different mechanism is responsible for this mineralization defect. In the current study, we demonstrate that deletion of PTH from Kl(-/- (Kl(-/-/PTH(-/- or DKO mice corrects the abnormal skeletal phenotype. Bone turnover markers are restored to wild-type levels; and, more importantly, the skeletal mineralization defect is completely rescued in Kl(-/-/PTH(-/- mice. Interestingly, the correction of the osteomalacia is accompanied by a reduction in the high levels of osteopontin (Opn in bone and serum. Such a reduction in Opn levels could not be observed in Fgf23(-/-/PTH(-/- mice, and these mice showed sustained osteomalacia. This significant in vivo finding is corroborated by in vitro studies using calvarial osteoblast cultures that show normalized Opn expression and rescued mineralization in Kl(-/-/PTH(-/- mice. Moreover, continuous PTH infusion of Kl(-/- mice significantly increased Opn levels and osteoid volume, and decreased trabecular bone volume. In summary, our results demonstrate for the first time that PTH directly impacts the mineralization disorders and skeletal deformities of Kl(-/-, but not of Fgf23(-/- mice, possibly by regulating Opn expression. These are significant new perceptions into

  15. Elevated levels of plasma phenylalanine in schizophrenia: a guanosine triphosphate cyclohydrolase-1 metabolic pathway abnormality?

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    Olaoluwa Okusaga

    Full Text Available BACKGROUND: Phenylalanine and tyrosine are precursor amino acids required for the synthesis of dopamine, the main neurotransmitter implicated in the neurobiology of schizophrenia. Inflammation, increasingly implicated in schizophrenia, can impair the function of the enzyme Phenylalanine hydroxylase (PAH; which catalyzes the conversion of phenylalanine to tyrosine and thus lead to elevated phenylalanine levels and reduced tyrosine levels. This study aimed to compare phenylalanine, tyrosine, and their ratio (a proxy for PAH function in a relatively large sample of schizophrenia patients and healthy controls. METHODS: We measured non-fasting plasma phenylalanine and tyrosine in 950 schizophrenia patients and 1000 healthy controls. We carried out multivariate analyses to compare log transformed phenylalanine, tyrosine, and phenylalanine:tyrosine ratio between patients and controls. RESULTS: Compared to controls, schizophrenia patients had higher phenylalanine (p<0.0001 and phenylalanine: tyrosine ratio (p<0.0001 but tyrosine did not differ between the two groups (p = 0.596. CONCLUSIONS: Elevated phenylalanine and phenylalanine:tyrosine ratio in the blood of schizophrenia patients have to be replicated in longitudinal studies. The results may relate to an abnormal PAH function in schizophrenia that could become a target for novel preventative and interventional approaches.

  16. Application of serum procalcitonin and C-reactive protein level in the diagnosis of emergency sepsis%血清降钙素原与C-反应蛋白联合检测在急诊脓毒症诊断中的价值分析

    Institute of Scientific and Technical Information of China (English)

    李娜; 余国宝; 刘毅; 刘电梅; 易珂苇; 刘翼超

    2014-01-01

    Objective:To investigate the application of the combined determination of serum procalcitonin (PCT) and C-reactive protein (CRP) in the diagnosis of emergency sepsis.Methods:Two hundred cases of emergency patients who were treated in our hospital from January 2012 to January 2014 were divided into a mild sepsis group (n=43), a severe sepsis group (n=25) and the other group (n=132), and 30 healthy subjects were selected as a control group. ELISA method was used to detect the change of serum PCT and CRP levels in patients and the values of serum PCT and CRP were used for predicting their relationship with emergency sepsis.Results:Serum PCT and CRP levels in the mild sepsis and severe sepsis groups were higher than those in other group and the control group, and PCT and CRP levels in severe sepsis group were higher than those in the mild sepsis group (P<0.05). PCT and CRP levels were positively correlated with sepsis severity (rPCT=7.453, rCRP=7.453, P<0.05). Logistic regression analysis showed that risk factors of emergency sepsis appeared as blood coagulation dysfunction and the enhanced levels of PCT and CRP.Conclusion:The determination values of serum procalcitonin and C-reactive protein levels are of signiifcance in the diagnosis of emergency sepsis, which can be used as indicators for the diagnosis of emergency sepsis .%目的:探讨血清降钙素原(PCT)与C-反应蛋白(CRP)联合检测在急诊脓毒症诊断中的应用。方法:将200例2012年1月至2014年1月期间我院收治的急诊患者根据病情分为轻度脓毒症组(n=43)、重度脓毒症组(n=25)和其他组(n=132),并选取同期健康者30例组成对照组。采用ELISA法检测患者血清PCT与CRP水平的变化并分析血清PCT与CRP对急诊脓毒症的预测作用。结果:轻度脓毒症组和、重度脓毒症组血清PCT与CRP水平均较其他组和对照组升高,重度脓毒症组PCT与CRP亦较轻度脓毒症组升高(P<0.05)。患者PCT与CRP

  17. The prognostic value of procalcitonin, C-reactive protein and cholesterol in patients with an infection and multiple organ dysfunction.

    Science.gov (United States)

    Tachyla, Siarhei Anatolevich; Marochkov, Alexey Viktorovich; Lipnitski, Artur Leonidovich; Nikiforova, Yulia Gennadevna

    2017-06-01

    To establish the prognostic value of procalcitonin, C-reactive protein and cholesterol levels for mortality in patients with an infection and multiple organ dysfunction. A prospective case-control study was performed, including 67 patients admitted to the intensive care unit with an infection and multiple organ dysfunction in whom cholesterol, procalcitonin, and C-reactive protein levels were measured on admission and during the course of treatment. The associations between in-hospital mortality and procalcitonin, C-reactive protein, and cholesterol levels were analyzed. Logistic regression analysis showed that cholesterol (odds ratio [OR], 1.858; 95% CI, 1.170-2.949; P = 0.009) and C-reactive protein (OR, 4.408; 95% CI, 2.019-9.624; P operating characteristic curve analysis yielded an area under the curve (AUC) of 0.774 and 95% CI of 0.693-0.855 (P system for mortality, these markers yielded an AUC of 0.845 and 95% CI of 0.770-0.921 (P system yielded high predictive value for mortality.

  18. Procalcitonin fails to predict bacteremia in SIRS patients: a cohort study.

    Science.gov (United States)

    Hoenigl, M; Raggam, R B; Wagner, J; Prueller, F; Grisold, A J; Leitner, E; Seeber, K; Prattes, J; Valentin, T; Zollner-Schwetz, I; Schilcher, G; Krause, R

    2014-10-01

    Procalcitonin (PCT) has previously been proposed as useful marker to rule out bloodstream-infection (BSI). The objective of this study was to evaluate the sensitivity of different PCT cut-offs for prediction of BSI in patients with community (CA)- and hospital-acquired (HA)-BSI. A total of 898 patients fulfilling systemic-inflammatory-response-syndrome (SIRS) criteria were enrolled in this prospective cohort study at the Medical University of Graz, Austria. Of those 666 patients had positive blood cultures (282 CA-BSI, 384 HA-BSI, enrolled between January 2011 and December 2012) and 232 negative blood cultures (enrolled between January 2011 and July 2011 at the emergency department). Blood samples for determination of laboratory infection markers (e.g. PCT) were collected simultaneously with blood cultures. Procalcitonin was significantly (p SIRS patients with bacteremia/fungemia than in those without. Receiver operating characteristic curve analysis revealed an area under the curve (AUC) value of 0.675 for PCT (95% CI 0.636-0.714) for differentiating patients with BSI from those without. AUC for IL-6 was 0.558 (95% CI 0.515-0.600). However, even at the lowest cut-off evaluated (i.e. 0.1 ng/ml) PCT failed to predict BSI in 7% (n = 46) of patients. In the group of patients with SIRS and negative blood culture 79% (n = 185) had PCT levels > 0.1. Procalcitonin was significantly higher in patients with BSI than in those without and superior to IL-6 and CRP. The clinical importance of this is questionable, because a suitable PCT threshold for excluding BSI was not established. An approach where blood cultures are guided by PCT only can therefore not be recommended. © 2014 John Wiley & Sons Ltd.

  19. Association between inflammatory biomarker serum procalcitonin and obesity in women with polycystic ovary syndrome.

    Science.gov (United States)

    Rashad, Nearmeen M; El-Shal, Amal S; Abdelaziz, Ahmed M

    2013-04-01

    Procalcitonin (PCT) is a potential biomarker of obesity-related, low-grade inflammation in polycystic ovary syndrome (PCOS). We aimed to investigate whether serum procalcitonin, high-sensitivity C-reactive protein (hs-CRP), white blood cell (WBC) and neutrophil counts are associated with polycystic ovary syndrome and with obesity. A case-control study included 107 women with PCOS and 93 healthy controls, they were then stratified according to their body mass index (BMI) into three subgroups; lean, overweight and obese. Serum PCT levels were measured using enzyme linked immunosorbent assay. PCOS patients had significantly higher levels of serum PCT, hs-CRP, WBC, and neutrophil counts than healthy women. In control and PCOS groups, serum PCT, hs-CRP levels, WBC, and neutrophil counts were significantly increased in overweight and obese women compared with lean subjects. Serum PCT levels were positively correlated with BMI, waist/hip ratio, total cholesterol, serum triglycerides, LH/FSH, hs-CRP values, WBC and neutrophil counts in PCOS women. We also observed that the increasing obesity was accompanied by a significant increase in the mean values of serum PCT and neutrophil counts in PCOS patients. We conclude that serum PCT is a novel biomarker for low-grade chronic inflammation in PCOS patients, especially in obese women. Thus, PCT is a promising useful marker for accurate diagnosis of the inflammatory activity of body fat and of PCOS. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  20. Procalcitonin in cerebrospinal fluid in meningitis : a prospective diagnostic study

    NARCIS (Netherlands)

    Alons, Imanda M E; Verheul, Rolf J; Kuipers, Irma; Jellema, Korné; Wermer, Marieke J H; Algra, Ale; Ponjee, Gabriëlle

    2016-01-01

    OBJECTIVES: Bacterial meningitis is a severe but treatable condition. Clinical symptoms may be ambiguous and current diagnostics lack sensitivity and specificity, complicating diagnosis. Procalcitonin (PCT) is a protein that is elevated in serum in bacterial infection. We aimed to assess the value o

  1. Hepatic glycogen deposition in a patient with anorexia nervosa and persistently abnormal transaminase levels.

    Science.gov (United States)

    Kransdorf, Lisa N; Millstine, Denise; Smith, Maxwell L; Aqel, Bashar A

    2016-04-01

    Anorexia nervosa and other eating disorders characterized by calorie restriction have been associated with a variety of hepatic abnormalities. Fatty steatosis has been described in eating disorder patients. We report the rare finding of glycogen accumulation in the liver in a patient with anorexia nervosa, which to our knowledge is only the second such case reported in the literature. This case highlights the importance of monitoring for liver abnormalities in patients with restrictive eating disorders.

  2. Utility of blood procalcitonin concentration in the management of cancer patients with infections

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    Durnaś B

    2016-01-01

    Full Text Available Bonita Durnaś,1,2 Marzena Wątek,1 Tomasz Wollny,1 Katarzyna Niemirowicz,3 Michał Marzec,4 Robert Bucki,2,3 Stanisław Góźdź1 1Holy Cross Oncology Center of Kielce, Artwinskiego, Kielce, Poland; 2Department of Physiology, Pathophysiology and Microbiology of Infections, The Faculty of Health Sciences of the Jan Kochanowski University in Kielce, Aleja IX Wieków Kielc, Kielce, Poland; 3Department of Microbiological and Nanobiomedical Engineering, Medical University of Bialystok, Bialystok, Poland; 4Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA Abstract: Diagnosis of infections in cancer patients is usually problematic since differentiating between infection and fever of unknown origin is often a considerable clinical challenge. In general, increase concentration of blood procalcitonin (PCT is associated with severe bacterial infection. PCT with an optimal cutoff level of 0.5 ng/mL seems to be the most helpful biochemical parameter in detecting severe infections, mainly bloodstream infection, in patients with hematological cancers. In all clinical situations, the elevated level of PCT should be carefully analyzed, always with a thorough physical examination and an appropriate microbiological assessment. Keywords: procalcitonin, cancer, infection

  3. Raised D-dimer levels in acute sickle cell crisis and their correlation with chest X-ray abnormalities

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    Hassan, Imad S. A.

    2010-01-01

    Full Text Available Objective: Quantitation of D-dimer level during a sickling crisis and its correlation with other clinical abnormalities. Design: Prospective longitudinal study. Setting: Armed Forces Hospital, Southern Region, Kingdom of Saudi Arabia. Patients: Adult patients (12 years and older admitted acutely with a sickle cell crisis who consent to taking part in the study. Candidates may re-participate if they are readmitted with a further acute painful crisis. Results: 36 patients with homozygous sickle cell disease consented to take part in the study. D-dimer levels were raised in 31 (68.9% of 45 episodes of painful crisis of whom 13 had an abnormal chest X-ray. Of those with a normal chest X-ray only one patient had a raised D-dimer level: sensitivity of 92.3%, specificity 40.6%, positive predictive value 38.7% and negative predictive value of 92.9% for an abnormal chest X-ray. Conclusion: D-dimer levels are frequently raised during an acute painful crisis. A normal level has a high negative predictive value for an abnormal chest X-ray.

  4. Delta Procalcitonin Is a Better Indicator of Infection Than Absolute Procalcitonin Values in Critically Ill Patients: A Prospective Observational Study

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    Domonkos Trásy

    2016-01-01

    Full Text Available Purpose. To investigate whether absolute value of procalcitonin (PCT or the change (delta-PCT is better indicator of infection in intensive care patients. Materials and Methods. Post hoc analysis of a prospective observational study. Patients with suspected new-onset infection were included in whom PCT, C-reactive protein (CRP, temperature, and leukocyte (WBC values were measured on inclusion (t0 and data were also available from the previous day (t-1. Based on clinical and microbiological data, patients were grouped post hoc into infection- (I- and noninfection- (NI- groups. Results. Of the 114 patients, 85 (75% had proven infection. PCT levels were similar at t-1: I-group (median [interquartile range]: 1.04 [0.40–3.57] versus NI-group: 0.53 [0.16–1.68], p=0.444. By t0 PCT levels were significantly higher in the I-group: 4.62 [1.91–12.62] versus 1.12 [0.30–1.66], p=0.018. The area under the curve to predict infection for absolute values of PCT was 0.64 [95% CI = 0.52–0.76], p=0.022; for percentage change: 0.77 [0.66–0.87], p<0.001; and for delta-PCT: 0.85 [0.78–0.92], p<0.001. The optimal cut-off value for delta-PCT to indicate infection was 0.76 ng/mL (sensitivity 80 [70–88]%, specificity 86 [68-96]%. Neither absolute values nor changes in CRP, temperature, or WBC could predict infection. Conclusions. Our results suggest that delta-PCT values are superior to absolute values in indicating infection in intensive care patients. This trial is registered with ClinicalTrials.gov identifier: NCT02311816.

  5. Levels of adipocytokines and vitamin D in a biracial sample of young metabolically healthy obese and metabolically abnormal obese women

    Science.gov (United States)

    Purpose: Adipocytokines and vitamin D (vitD) concentrations may contribute to cardiometabolic risk profiles in obese populations. The purpose was to determine if levels of adipocytokines and vitD differ between young metabolically healthy obese (MHO) and metabolically abnormal obese (MAO) black and ...

  6. Determining the Clinical Utility of an Absolute Procalcitonin Value for Predicting a Positive Culture Result.

    Science.gov (United States)

    Caffarini, Erica M; DeMott, Joshua; Patel, Gourang; Lat, Ishaq

    2017-05-01

    Various procalcitonin ranges have been established to guide antimicrobial therapy; however, there are no data that establish whether the initial procalcitonin value can determine the likelihood of a positive culture result. This study aimed to establish if the initial procalcitonin value, on clinical presentation, has a positive predictive value for any positive culture result. This was a retrospective study of 813 medical intensive care unit patients. Data collected included patient demographics, procalcitonin assay results, sources of infection, culture results, and lengths of stay. Patients were excluded if they were immunocompromised. The primary outcome of this study was to determine a procalcitonin value that would predict any positive culture. Secondary outcomes included the sensitivity, specificity, positive predictive value, and negative predictive value for procalcitonin. After exclusions, a total of 519 patient charts were reviewed to determine the impact of the initial procalcitonin value on culture positivity. In our analyses, the receiver operating characteristic values were 0.62 for all cultures, 0.49 for pulmonary infections, 0.43 for urinary tract infections, and 0.78 for bacteremia. A procalcitonin value of 3.61 ng/ml was determined to be the threshold value for a positive blood culture result (prevalence, 4%). For bacteremia, the sensitivity of procalcitonin was 75%, the specificity was 72%, the positive predictive value was 20%, and the negative predictive value was 97%. Procalcitonin was a poor predictor of culture positivity. An initial procalcitonin value of less than 3.61 ng/ml may be useful in predicting whether bacteremia is absent. Procalcitonin should not be used as the only predictor for determining initiation of antibiotic therapy. Copyright © 2017 American Society for Microbiology.

  7. Abnormal end-tidal carbon dioxide levels on emergency department arrival in adult and pediatric intubated patients.

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    Holmes, James; Peng, James; Bair, Aaron

    2012-01-01

    The utility of prehospital intubation is controversial, as uncontrolled studies in trauma patients suggest adverse outcomes with prehospital intubation, perhaps secondary to inappropriate ventilation once intubation is accomplished. The objectives were 1) to establish, immediately upon arrival to the emergency department (ED), the prevalence of abnormal end-tidal carbon dioxide (ETCO(2)) levels in patients with prehospital intubation and 2) to describe the relationship between abnormal ETCO(2) levels on ED arrival and mortality. This was a prospective, observational cohort study of patients with prehospital intubation. Patients were excluded if they underwent prehospital cardiopulmonary resuscitation (CPR). On ED arrival, the initial ETCO(2) measurement from the patient's endotracheal tube was immediately obtained prior to purposeful intervention in the patient's ventilation by using an Oridion Surestream Sure VentLine H Set with a Welch Allyn Propaq CS monitor. For each patient, the treating physician documented the ETCO(2) measurement, patient demographics, and details of the transport. The primary outcome was an abnormal ETCO(2) value (45 mmHg). The secondary outcome was mortality. One hundred eligible patients were enrolled, with a median age of 30 years (interquartile range [IQR] 15, 48 years). Esophageal intubations were identified in four cases, and those cases were excluded from further analysis. Mechanisms included trauma, 74; medical, 12; and burn, 10. The median ETCO(2) value was 32 mmHg (IQR 27, 38 mmHg), range 18-80 mmHg. Forty-six of 96 (48%, 95% confidence interval [CI] 38%, 58%) patients had abnormal ETCO(2) values, including 37 (39%, 95% CI 29%, 49%) with low ETCO(2) levels and nine (9%, 95% CI 4%, 17%) with high ETCO(2) levels. Death was higher in those trauma patients with abnormal ETCO(2) levels (10/33, 30%, 95% CI 16%, 49%) than in those with normal ETCO(2) levels (2/41, 5%, 95% CI 0.6%, 17%), relative risk = 6.2 (95% CI 1.5, 26.4), p = 0

  8. Assessment of Antibiotic Prescribing Based on Serum Procalcitonin (PCT) Level for Acute Exacerbation of Chronic Obstructive Pulmonary Disease%降钙素原在慢性阻塞性肺疾病急性加重期的临床研究

    Institute of Scientific and Technical Information of China (English)

    梁旭满; 陈永钢; 梁知锐

    2016-01-01

    目的:探讨降钙素原(PCT)对慢性阻塞性肺疾病急性加重期(AECOPD)应用抗生素的指导作用。方法:选取2014年2月-2015年3月本院呼吸科收治的200例AECOPD患者作为研究对象,按照随机数字表法将其平均分为两组,每组100例。观察组的抗生素使用依据血清PCT水平进行,患者入院时、治疗第5、7、10 d检测血清PCT水平,若PCT≥0.25μg/L则应用抗生素,PCT0.05)。观察组二重感染率为1.00%,显著低于对照组的18.00%,比较差异有统计学意义(P0.05)。结论:依据血清PCT水平决定抗生素的使用策略有利于降低AECOPD患者抗生素使用率,减少抗生素使用时间,缩短住院时间,值得临床推广使用。%Objective: To investigate appropriateness of antibiotic prescribing based on procalcitonin (PCT) level for acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Method: 200 AECOPD patients were selected in our hospital from February 2014 to March 2015, and they were randomly divided into observation group and control group according to random number table method, 100 cases in each group. In the observation group, antibiotic prescribing for different durations of therapy (admission day, 5, 7, and 10 days) was based on the serum PCT level, if the PCT≥0.25 μg/L, antibiotics was used, the PCT0.05). In addition, recurrent infection rate of the observation group was 1.00%, which was significantly lower than that of the control group (P0.05). Conclusion: Antibiotic prescribing based on serum PCT levels is relevant to reduce antibiotic usage for AECOPD patients, as well as shorten duration of therapy, it is worthy of using PCT level as guidelines for antibiotic prescribing.

  9. Pro-calcitonin and inflammation in chronic hemodialysis

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    Hernán Trimarchi

    2013-10-01

    Full Text Available Procalcitonin (PCT has emerged as a marker of infection, a frequent complication in hemodialysis (HD. We analyzed PCT levels in chronic non-acutely infected HD subjects, assessed its correlation with inflammatory and nutritional markers and propose a PCT reference value for non-infected HD patients.In an observational cross-sectional study, 48 chronic HD patients and 36 controls were analyzed. Variables: age, gender, time on HD; diabetes; vascular access, PCT, C-reactive protein (CRP, albumin, malnutrition inflammatory score (MIS, hematocrit, leukocyte count, and body mass index (BMI. Subsequently, control (G1, n = 36, 43% vs. non-infected patients (G2, n = 48, 57% groups were compared. In control subjects (G1, age: 54.3 ± 13.7 years, range (r: 30-81; males: 19 (53%; median PCT 0.034 ng/ml (r: 0.02-0.08; median CRP 0.80 mg/dl (r: 0.36-3.9; p95 PCT level: 0.063 ng/ml. In G2, age: 60.2 ± 15.2 years; males 32 (67%, time on HD: 27.0 ± 24.4; diabetics: 19 (32%; median PCT: 0.26 ng/ml (r: 0.09-0.82; CRP: 1.1 mg/dl (r: 0.5-6.2; p95 PCT level: 0.8 ng/ml. In control subjects, PCT and CRP were significantly lower than in G2: PCT: 0.034 vs. 0.26 ng/ml, p = 0.0001; CRP: 0.8 vs. 1.1 mg/dl, p = 0.0004. PCT-CRP correlation in G2: ρ = 0.287, p = 0.048. PCT and CRP concentrations are elevated in chronic non-acutely infected HD subjects, independently of infection, diabetes and vascular access. A p95 PCT level of 0.8 ng/ml may be considered as the upper normal reference value in non-acutely infected HD subjects. The PCT cut-off level in HD is yet to be determined in HD.

  10. Retrospective study on prognostic importance of serum procalcitonin and amino-terminal pro-brain natriuretic peptide levels as compared to Acute Physiology and Chronic Health Evaluation IV Score on Intensive Care Unit admission, in a mixed Intensive Care Unit population

    OpenAIRE

    2016-01-01

    Background: Timely decision making in Intensive Care Unit (ICU) is very essential to improve the outcome of critically sick patients. Conventional scores like Acute Physiology and Chronic Health Evaluation (APACHE IV) are quite cumbersome with calculations and take minimum 24 hours. Procalcitonin has shown to have prognostic value in ICU/Emergency department (ED) in disease states like pneumonia, sepsis etc. NTproBNP has demonstrated excellent diagnostic and prognostic importance in cardiac d...

  11. Procalcitonin and community-acquired pneumonia (CAP) in children.

    Science.gov (United States)

    Giulia, Bivona; Luisa, Agnello; Concetta, Scazzone; Bruna, Lo Sasso; Chiara, Bellia; Marcello, Ciaccio

    2015-12-07

    The role of procalcitonin (PCT) as a biomarker for sepsis in adults is well documented, while its role in infections affecting neonatal children remains controversial. Among these infections, Community-Acquired pneumonia (CAP) has been studied extensively, because it's the second cause of death in children in developing countries, and one of the most frequent causes of hospitalization in industrialized countries. The PubMed database and the Cochrane Library were used to search for the following keywords: CAP, procalcitonin, and children. Thirteen articles were studied to determine the role of PCT in CAP management, specifically its usefulness for distinguishing pneumococcal infections from viral and unknown infections, for predicting severity and the correct antibiotic treatment. This paper focuses on the studies performed to identify the best inflammatory biomarker for CAP management. Although there is an increase in studies confirming the usefulness of PCT in CAP management in children, further studies are needed to have better understanding of its role for pediatric CAP management.

  12. Procalcitonin use in a pediatric intensive care unit.

    Science.gov (United States)

    Cies, Jeffrey J; Chopra, Arun

    2014-09-01

    We evaluated whether procalcitonin (PCT) might aid diagnosing serious bacterial infections in a general pediatric intensive care unit population. Two-hundred and one patients accounted for 332 PCT samples. A PCT ≥1.45 ng/mL had a positive predictive value of 30%, a negative predictive value of 93% and a sensitivity of 72% and a specificity of 75%. These data suggest PCT can assist in identifying patients without serious bacterial infections and limit antimicrobial use.

  13. Adrenomedullin--A New Marker in Febrile Neutropenia: Comparison With CRP and Procalcitonin.

    Science.gov (United States)

    Demirkaya, Metin; Tugcu, Deniz; Akcay, Arzu; Aydogan, Gönül; Akıcı, Ferhan; Salcioglu, Zafer; Ekmekci, Hakan; Sevinir, Betül; Balci Ekmekci, Ozlem

    2015-01-01

    In this study, we aimed to determine serum adrenomedullin levels and compare them with levels of C-reactive protein (CRP) and procalcitonin (PCT). Cancer patients aged 0-18 years who experienced febrile neutropenia attacks were included in the study. Adrenomedullin, CRP, and PCT were analyzed at admission, day 3, and days 7-10 later. Fifty episodes of febrile neutropenia that developed in 37 patients were analyzed in this study. The mean age of the patients was 7.5 ± 4.7 (1-18) years. The patients had leukemia (73%), solid tumors (19%), and lymphoma (8%). The percentages of the patients in the clinically documented infection (CDI), fever of unknown origin (FUO), sepsis, and microbiological documented infection (MDI) categories were 34%, 34%, 20%, and 12%, respectively. During the study period, four patients were lost. In the MDI group, adrenomedullin levels on day 3 were significantly higher than those in the CDI and FUO groups. PCT levels were significantly higher in the sepsis group than those in the CDI group at admission, day 3, and days 7-10. In the sepsis group, PCT levels on days 7-10 days were significantly higher than those in the sepsis group. PCT values from the deceased patients on days 7-10 were significantly higher than those from patients who survived. CRP levels did not differ significantly among the febrile neutropenia groups. First, in our study, adrenomedullin was used as a biomarker in the febrile neutropenia episodes of children with cancer. Among adrenomedullin, CRP, and PCT, procalcitonin demonstrates the highest correlation with the severity of infection.

  14. The diagnostic accuracy of procalcitonin for bacteraemia: A systematic review and meta-analysis

    NARCIS (Netherlands)

    S.H. Hoeboer (Sandra); P.J. van der Geest (Patrick); D. Nieboer (Daan); A.B.J. Groeneveld (A.B. Johan)

    2015-01-01

    textabstractThe diagnostic use of procalcitonin for bacterial infections remains a matter of debate. Most studies have used ambiguous outcome measures such as sepsis instead of infection. We performed a systematic review and meta-analysis to investigate the diagnostic accuracy of procalcitonin for b

  15. Selection of abnormal neural oscillation patterns associated with sentence-level language disorder in Schizophrenia.

    Science.gov (United States)

    Xu, Tingting; Stephane, Massoud; Parhi, Keshab K

    2012-01-01

    Language disorder is one of the core symptoms in schizophrenia. We propose a new framework based on machine intelligence techniques to investigate abnormal neural oscillations related to this impairment. Schizophrenia patients and healthy control subjects were instructed to discriminate semantically and syntactically correct sentences from syntactically correct but semantically incorrect sentences presented visually, and 248-channel MEG signals were recorded with a whole head machine during the task performance. Oscillation patterns were extracted from the MEG recordings in 8 frequency sub-bands throughout sentence processing, which form a large feature set. A two-step feature selection algorithm combining F-score filtering and Support Vector Machine recursive feature elimination (SVM-RFE) was designed to pick out a small subset of features which could discriminate patients and controls with high accuracy. We achieved a 90.48% prediction accuracy based on the selected top features, following the leave-one-out cross validation procedure. These top features provide interpretable spectral, spatial, and temporal information about the electrophysiological basis of sentence processing abnormality in schizophrenia which may help understand the underlying mechanism of this disease.

  16. [Kinetics, diagnostic and prognostic value of procalcitonin after cardiac surgery].

    Science.gov (United States)

    Kallel, Samy; Abid, Mohamed; Jarraya, Anouar; Abdenadher, Mohamed; Mnif, Emna; Frikha, Imed; Ayadi, Fatma; Karoui, Abdelhamid

    2012-10-01

    Cardiac surgery with cardiopulmonary bypass (CPB) can cause a systemic inflammatory response (SIRS) making difficult the interpretation of inflammatory markers. Procalcitonin (PCT) is a marker of inflammation that appears to be a good early marker of infection after cardiac surgery. To study the kinetics of PCT after cardiac surgery with CPB and to determine its diagnostic and prognostic value. This is a prospective observational study including 40 adult patients consecutively operated for a coronary or valve surgery with CPB, so programmed or semi-urgent. The anesthetic protocol was standardized for all patients. A determination of PCT and CRP was performed before the CEC, at the decision of the CEC (H0), 4 hours after (H4), then H24, H48, H72 and H96. The rate of PCT and CRP increased significantly from the H4 until 4(th) day compared to baseline. (psurgery and they were significantly increased in cases of severe SIRS, late postoperative infection and postoperative renal dysfunction (PORD). However, the rates of CRP were not correlated with these complications. According to ROC curve analysis, a threshold value of 0.958 ng/mL PCT measured on the 1(st) day after surgery had a sensitivity of 85% and a specificity of 95% for the prediction of severe SIRS with organ dysfunction. For a threshold of 1.2 ng/mL measured at day 1 postoperatively, the PCT has a sensitivity of 100% and a specificity of 96% for predicting late infection. For a threshold value of 0.475 ng/mL measured at the decision of the CPB, the PCT has a sensitivity of 80% and a specificity of 69% for predicting PORD. PCT levels were correlated with severity scores. They were also correlated with length of stayin ICU. According to ROC curve analysis, a cutoff of 0.737 ng/mL measured at 1(st )postoperative day, the PCT has a sensitivity of 76% and a specificity of 91% for the prediction of an ICU stay of more 3 days with AUC=0.818. The PCT is a marker that has a fast kinetics and can early predict

  17. Diagnostic value of serum CRP and procalcitonin levels in children with bloodstream infection-associated sepsis and septic infection at other sites%C反应蛋白及降钙素原在小儿脓毒症血流感染及其他部位感染性疾病中的诊断价值

    Institute of Scientific and Technical Information of China (English)

    李玖军; 张涛

    2013-01-01

    目的 评估入住PICU 6 h内血清CRP及PCT水平在脓毒症血流感染及其他部位感染患儿临床诊断中的价值.方法 回顾性分析2010年1月至2012年1月期间,中国医科大学附属盛京医院PICU收治的30名明确诊断SIRS患儿,脓毒症血流感染及脓毒症其他部位感染患儿各15名,收集入住6h内的血清CRP、PCT及D-二聚体含量资料,进行差异性比较并通过ROC曲线分析其诊断价值.结果 脓毒症血流感染组患儿的血清CRP及PCT水平较脓毒症其他部位感染组显著升高(P<0.05),而血清D-二聚体水平在两组间差异无统计学意义(P>0.05).血清PCT水平较CRP水平在诊断与鉴别脓毒症血流感染与其他部位感染性疾病方面有明显优势,PCT<2 ng/mL时诊断脓毒症血流感染可能性不大(阴性预测值:100%),PCT> 10 ng/mL时诊断脓毒症血流感染具有较高的可信度(阳性预测值:77%).结论 入院6h内的血清PCT水平较CRP水平在早期鉴别入住PICU脓毒症血流感染与其他部位感染患儿具有更好的诊断价值;当血清PCT水平>10 ng/mL时,脓毒症血流感染的诊断可能性较大.%Objective To evaluate the diagnostic value of measuring serum C-reactive protein ( CRP) and procalcitonin (PCT) levels, within 6 hours after admission to the pediatric intensive care unit (PICU) in children with bloodstream infection ( BSI) -associated sepsis and septic infection at other sites. Methods A retrospective analysis was performed on 30 children with a confirmed diagnosis of systemic inflammatory response syndrome who were admitted to the Shengjing Hospital of China Medical University between January 2010 and January 2012. Clinical data on serum CRP, PCT and D-dimer levels were collected within 6 hours after admission. The diagnostic values of the indices were determined by comparative analysis. Results Serum CRP and PCT levels in children with BSI-associated sepsis were significantly higher than in children with

  18. 血清降钙素原在脓毒症患儿中的应用价值分析%Application Value Analysis of Detecting Serum Procalcitonin Levels in Sepsis Children

    Institute of Scientific and Technical Information of China (English)

    林青; 高菊兴; 史立凤; 丁思磊

    2012-01-01

    目的:探讨脓毒症患儿血清降钙素原(PCT)水平变化及临床应用价值.方法:对脓毒症组38例患儿(严重脓毒症组16例、非严重脓毒症组22侧)血清PCT、C反应蛋白(CRP)水平和白细胞(WBC)计数等指标进行检测,并与非脓毒症组的40例患儿进行比较分析.结果:脓毒症组患儿血清PCT、CRP水平及WBC计数均显著高于非脓毒症组,差异具有统计学意义(P<0.05);血清PCT、CRP水平对诊断脓毒症的敏感性差异无显著性(P>0.05),均显著高于WBC计数,差异具有统计学意义(P<0.05);血清PCT水平特异性、阳性预测值、阴性预测值及约登指数均显著高于CRP和WBC计数,差异具有统计学意义(P<0.05);严重脓毒症组患儿血清PCT水平显著高于非严重脓毒症组,差异具有统计学意义(P<0.05),而两组间血清CRP水平及WBC计数差异不显著(P>0.05).结论:PCT可作为敏感性的鉴别诊断患儿脓毒症的血清学指标,其效果优于CRP和WBC计数.%Objective: To explore the clinical significance of detecting the serum proealeitonin (PCT) level in children with sepsis. Methods: The serum PCT levels, C-reactive protein (CRP) levels and white blood cell (WBC) count were detected in 38 patients (16 children with severe sepsis, 22 children with non-severe sepsis), and compared with 40 children without sepsis. Results: The serum PCT levels, CRP and WBC count in the sepsis group were significantly higher than non-sepsis group, the difference was statistically significant (P<0.05). The sensitivity of PCT, CRP in the diagnosis of sepsis wasn't statistically significant (P>0.05), but it was significantly higher than WBC count, the difference was statistically significant (P<0.05). The specificity, positive predictive value, negative predictive value, Youden index of PCT were significantly higher than CRP and WBC count, the difference was statistically significant (P<0.05); The serum PCT level in the severe sepsis group

  19. Measurements of procalcitonin facilitate targeting of endotoxin adsorption treatment in febrile neutropenic patients suffering from shock.

    Science.gov (United States)

    Hara, Masaki; Tsuchiya, Ken; Nitta, Kosaku; Ando, Minoru

    2014-01-01

    Immediate initiation of hemoperfusion treatment with polymixin B immobilized fiber (PMX-DHP) is a potent strategy to improve hemodynamics in septic patients with critical circulatory failure. However, it is often difficult to accurately and rapidly differentiate between bacterial infections and non-infectious causes of shock in acutely critically-ill patients. Procalcitonin (PCT) measurements may assist in the early identification of bacterial infection/sepsis and determination of severity in such patients. We present two febrile neutropenic (FN) patients who developed severe shock after chemotherapy for hematological malignancies. PCT levels were markedly elevated in both patients (≥ 10 ng/ml), suggesting a high likelihood of bacterial infectious etiology as the cause of their shock, and thus they were promptly treated with PMX-DHP. Measurements of PCT may facilitate targeting of PMX-DHP treatment among FN patients suffering from shock, which may lead to better prognosis.

  20. Can delayed time to referral to a tertiary level urologist with an abnormal PSA level affect subsequent Gleason grade in the opportunistically screened population?

    LENUS (Irish Health Repository)

    O'Kelly, Fardod

    2013-09-01

    There is growing conflict in the literature describing the effect of delayed treatment on outcomes following radical prostatectomy. There is also evidence to suggest progression of low-risk prostate cancer to develop higher grades and volumes of prostate cancer during active surveillance. It is unknown as to what affect a delay in referral of those men with abnormal screened-PSA levels have on subsequent Gleason grade.

  1. Procalcitonin Identifies Cell Injury, Not Bacterial Infection, in Acute Liver Failure.

    Directory of Open Access Journals (Sweden)

    Jody A Rule

    Full Text Available Because acute liver failure (ALF patients share many clinical features with severe sepsis and septic shock, identifying bacterial infection clinically in ALF patients is challenging. Procalcitonin (PCT has proven to be a useful marker in detecting bacterial infection. We sought to determine whether PCT discriminated between presence and absence of infection in patients with ALF.Retrospective analysis of data and samples of 115 ALF patients from the United States Acute Liver Failure Study Group randomly selected from 1863 patients were classified for disease severity and ALF etiology. Twenty uninfected chronic liver disease (CLD subjects served as controls.Procalcitonin concentrations in most samples were elevated, with median values for all ALF groups near or above a 2.0 ng/mL cut-off that generally indicates severe sepsis. While PCT concentrations increased somewhat with apparent liver injury severity, there were no differences in PCT levels between the pre-defined severity groups-non-SIRS and SIRS groups with no documented infections and Severe Sepsis and Septic Shock groups with documented infections, (p = 0.169. PCT values from CLD patients differed from all ALF groups (median CLD PCT value 0.104 ng/mL, (p ≤0.001. Subjects with acetaminophen (APAP toxicity, many without evidence of infection, demonstrated median PCT >2.0 ng/mL, regardless of SIRS features, while some culture positive subjects had PCT values <2.0 ng/mL.While PCT appears to be a robust assay for detecting bacterial infection in the general population, there was poor discrimination between ALF patients with or without bacterial infection presumably because of the massive inflammation observed. Severe hepatocyte necrosis with inflammation results in elevated PCT levels, rendering this biomarker unreliable in the ALF setting.

  2. 肺炎合并脓毒症患者血清降钙素原、超敏C反应蛋白水平变化及其临床意义%Expression level and its clinical significance of serum procalcitonin and high sensitive C-reactive protein in patients with pneumonia complicated with sepsis

    Institute of Scientific and Technical Information of China (English)

    苑文雯; 李妍; 杨宁; 贾天野; 郭桐生

    2013-01-01

    Objective To explore the expression level and its clinical significance of serum procalcitonin ( PCT ) and high sensitive C-reactive protein ( hs-CRP ) in patients with pneumonia complicated with sepsis. Methods According to the severity of disease, 104 patients with pneumonia complicated with sepsis in ICU were divided into three groups, including 36 patients of the sepsis group, 37 patients of the severe sepsis group, 31 patients of the septic shock group. Besides, 40 pneumonia persons were taken as the control group. All patients were also divided into the survivor and death group according to whether they survived within 2 weeks. The levels of serum PCT and hs-CRP and APACHE Ⅱ scores were detected and compared. Results The levels of serum PCT and hs-CRP and APACHE Ⅱ scores in the three sepsis groups were significantly higher than those in control group, and the level of serum PCT and APACHE Ⅱ scores were increased with the aggravation of disease severity ( P 0. 05 ). Conclusion Serum PCT and hs-CRP show a high expression level, and the detection of serum PCT level can be used as an indicator for disease severity and prognosis in patients with pneumonia complicated with sepsis.%目的 分析肺炎合并脓毒症患者血清降钙素原(PCT)、超敏C反应蛋白(hsCRP)水平的变化及其意义.方法 将我院ICU住院的肺炎合并脓毒症104例患者根据病情分为脓毒症组36例,严重脓毒症组37例,脓毒性休克组31例,并选择同期单纯肺炎患者40例.同时根据脓毒症患者是否于2周内的存活情况分为存活组和死亡组.结果 三组脓毒血症患者血清PCT、hsCRP水平、APACHE Ⅱ评分较对照组明显升高,且随着病情的加重,患者血清PCT、APACHE Ⅱ评分依次增加(P0.05).结论 肺炎合并脓毒症患者血清PCT、hsCRP水平均呈高表达状态,PCT水平的检测可以作为肺炎合并脓毒血症患者的病情严重程度以及预后的评价指标.

  3. Effects of continuous blood purification on the level of procalcitonin in patients with severe pneumonia%连续性血液净化治疗对重症肺炎患者血清降钙素原水平的影响

    Institute of Scientific and Technical Information of China (English)

    刘振国; 王婷

    2016-01-01

    目的:动态监测连续性血液净化治疗(CBP)在治疗重症肺炎时血清降钙素原(PCT)水平的变化规律,探讨血清PCT水平与重症肺炎病情严重程度的关系及CBP对重症肺炎患者的临床疗效。方法回顾性分析重症肺炎患者共30例,分为常规治疗组(抗感染及呼吸机辅助通气等治疗)12例和CBP治疗组(在常规治疗基础上给予CBP )18例。比较2组死亡率,同时分析比较2组治疗前及治疗后24 h、48 h、72 h 各时间点急性生理与慢性健康评分( APACHEⅡ评分)及血清PCT的变化。结果常规治疗组死亡5例,CBP治疗组死亡2例;与治疗前比较,常规治疗组经治疗后各时间点患者APACHEⅡ评分及血清PCT水平变化不明显( P>0�05),而CBP治疗组治疗72 h后,患者APACHEⅡ评分及血清PCT水平均显著降低( P<0�01)。结论 CBP能降低重症肺炎患者早期血清PCT水平,降低重症肺炎的炎症反应,改善临床转归,是临床治疗重症肺炎患者的有效手段,具有重要临床应用价值。%Objective To investigate the efficacy of continuous blood purification (CBP) for severe pneumonia, and to investigate the relationship between the level of procalcitonin ( PCT) and the severity of severe pneumonia. Methods Thirty cases of severe pneumonia were analyzed retrospectively. They were divided into conventional treatment group ( 12 cases) and CBP treatment group ( 18 cases ) . Conventional treatment group received anti⁃infection therapy and the assistance ventilation, and CBP treatment group received conventional therapy and CBP treatment. The mortality of two groups was recorded and analyzed. The score of acute physiology and chronic health evaluationⅡ( APACHEⅡ) and the level of PCT before or 24 h, 48 h, 72 h after treatment were detected in two groups. Results Five cases died in conventional treatment group, while 2 cases died in CBP treatment group. The score of

  4. 血清降钙素原和C反应蛋白水平改变在支原体肺炎患儿中的临床意义%Changes of serum procalcitonin and C - reactive protein levels in children with mycoplasma pneumonia

    Institute of Scientific and Technical Information of China (English)

    张月明

    2014-01-01

    目的:探讨血清降钙素原和 C 反应蛋白水平改变在支原体肺炎患儿中的临床意义。方法选择支原体肺炎、细菌性肺炎患儿各67例为支原体肺炎组和细菌性肺炎组,选择健康体检儿童67例为健康对照组。检测各组血清降钙素原(PCT)和 C 反应蛋白(CRP)水平并分析。结果支原体肺炎组急性期血清 PCT 水平显著高于健康对照组,但显著低于细菌性肺炎组( P 均<0.05)。支原体肺炎组、细菌性肺炎组血清 CRP 水平显著高于健康对照组( P <0.05),但两者 CRP 水平比较无显著差异。治疗后发现恢复期支原体肺炎组血清 PCT、CRP 水平显著下降,与健康对照组无统计学差异( P 均﹥0.05)。结论早期联合检测呼吸道感染患儿 PCT 与 CRP 水平可帮助早期鉴别支原体感染肺炎和细菌性感染肺炎,并可作为疗效观察的参考依据。%Objective To investigate the changes of serum procalcitonin(PCT)and C - reactive protein(CRP)levels in children with mycoplasma pneumonia. Methods Serum PCT and CRP levels in each group of children with mycoplasma pneumonia(n = 67)or bacterial pneu-monia(n = 67),and healthy children(n = 67)were detected and analyzed. Results In acute phase,serum PCT level was significantly higher in mycoplasma pneumonia group than healthy control group,but significantly lower than bacterial pneumonia group(all P < 0. 05). Serum CRP level in mycoplasma pneumonia group and bacterial pneumonia group was significantly higher than healthy control group( P < 0. 05),but no sig-nificant difference between mycoplasma pneumonia group and bacterial pneumonia group. After treatment,serum PCT and CRP levels were signifi-cantly decreased in children with mycoplasma pneumonia,but not significantly different from those of control group(all P ﹥ 0. 05). Conclusion Combined early detection of serum PCT and CRP for children with respiratory infection may help early identification

  5. The Clinical Significance of Serum Procalcitonin Levels Detected in Patients with Sepsis%血清降钙素原水平检测在脓毒症患者中的临床意义

    Institute of Scientific and Technical Information of China (English)

    唐艳; 刘翠兰; 李娜

    2012-01-01

      Objective To study the clinical significance of PCT in patients with sepsis. Methods 100 patients with sepsis and 80 healthy volunteers were included into the study. PCT levels were studied in  sepsis patients and 80 control subjects. All the patients received routine treatment, additionally treated with ulinastatin. The PCT,CRP, APACHE-Ⅱ values were detected before treatment and after treatment.The relationship between the PCT, and APACHE-Ⅱwere studied. Results The PCT levels of Sepsis were significantly higher than control subjects(P<0.01). PCT level was gradually decreasing after treatment(P<0.05). The APACHE-Ⅱvalues were significantly decreased after treatment(P<0.05). The PCT levels was significant positive correlation with APACHE-Ⅱ(P < 0.05). Conclusion PCT may has a significant predictive value on sepsis severity.%  目的  探讨脓毒症患者检测血清降钙素原水平的临床意义.方法  收集脓毒症患者100例入脓毒症组及健康体检成年人80例为对照组,检测脓毒症组和对照组血清降钙素原水平.脓毒症患者予以Sepsis集束化治疗及乌司他丁治疗.检测治疗前及治疗后PCT、CRP水平,及APACHE Ⅱ评分,探讨PCT水平变化及其与APACHE Ⅱ评分的关系,探讨不同预后患者PCT水平的差异.结果  脓毒症患者血清PCT水平明显高于对照组(P <0.01),且随着治疗进展血浆PCT水平逐渐降低(P<0.01).死亡患者PCT水平明显高于存活患者(P<0.05)且PCT与APACHE Ⅱ评分呈正相关(P<0.05).结论  血浆PCT水平对脓毒症患者的诊断及严重程度评价有重要价值.

  6. Free testosterone level correlated with the metabolic abnormalities dependent on central obesity in women with polycystic ovary syndrome.

    Science.gov (United States)

    Dong, Z; Chen, X; Li, L; Huang, J; Yin, Q; Yang, D

    2012-06-01

    Women with polycystic ovary syndrome (PCOS) have increased risks of developing metabolic abnormalities compared with the women without PCOS. Hyperandrogenemia is one of the most important characteristics of PCOS. However, the correlations between hyperandrogenemia and metabolic disorders are uncertain. To elucidate the relationship between androgen indices and metabolic abnormalities in Chinese women with PCOS. A retrospective analysis of the anthropometric and biochemical records of 408 women with PCOS. The prevalence of metabolic syndrome (MetS) was 15.7% in women with PCOS. No association existed between total testosterone (TT) and metabolic profile. Free testosterone (FT) correlated with most of the metabolic variables by unadjusted correlation analyses. The women with elevated FT levels exhibited more unfavorable metabolic profiles compared with the women with normal FT levels. After adjusting for the confounding factors by multivariate logistic regression analysis, the women with elevated FT levels had higher prevalence of central obesity than the women with normal FT levels (odds ratio [OR] 2.346, p=0.042). Women with reduced sex hormone-binding globulin levels were more likely to have central obesity, overweight, raised fasting glucose, insulin resistance, and raised diastolic blood pressure. Raised dehydroepiandrosterone sulfate (DHEAS) level was associated with a lower probability of having central obesity (OR 0.293, p=0.001) and overweight (OR 0.47, p=0.023). FT has closer association with metabolic parameters than TT. FT can involve in the development of metabolic disorders dependent on central obesity. Raised DHEAS level can reduce the risks of central obesity and overweight. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.

  7. Serum Procalcitonin Level in Patients with ventilator-associated pneumonia: Clinical Significance of Its Dynamic Monitoring%动态监测呼吸机相关性肺炎患者血清降钙素原的临床意义

    Institute of Scientific and Technical Information of China (English)

    曲文秀; 谭昊; 郑伟; 李澎

    2012-01-01

    [目的]探讨动态监测呼吸机相关性肺炎患者血浆降钙素原对判断病情严重程度及预后的意义.[方法]对67例明诊断呼吸机相关性肺炎的患者进行第1、3、5、7天抽取静脉血标本,采用双抗体夹心法定量测量PCT浓度,同时进行相应APACHEII评分并观察患者预后情况.[结果]67例患者死亡21例,存活46例:死亡组第5、7天血清PCT水平(1.80±0.14)(2.87±0.21) ng/ml明显高于存活组(1.13±0.10)、(0.56±0.06)ng/ml,差异有统计学意义(P<0.05),且死亡组PCT水平呈持上升趋势,而存活组呈下降趋势;同时死亡组第5、7天APACHEII评分第5天(30.00±0.96)分,第7天(33.00±1.05)分明显高存活组第5天(21.50±0.61)分,第7天(18.59±0.58)分,差异有统计学意义(P<0.05).[结论]呼吸机相关性肺炎患者血清PC与疾病严重程度有明显的相关性,动态监测PCT水平变化趋势有助于预后的判断.%[Objective] To evaluate the value of severity assessment and prognosis by dynamic monitoring for serum procalcitonin( PCT) levels in patients with ventilator-associated pneumonia. [Methods] A total of 67 cases of with ventilator-associated pneumonia patients, the serum PCT was determined on the lst,3rd,5th and 7th day, the acute physiology health evaluation ( APACHEII) scores were conducted and evaluated, the condition of prognoses w as observed. [Results] There were 21 patients dead and 46 patients survived. The serum PCT level of the patients in the dead group [(1.80 ± 0.14) ,(2.87 ± 0.21) ng/ml] was significantly higher than that in the survived group [(1.13 ± 0.10) .(0.56 ± 0.06)] on 5th and 7th day( P< 0.05). The APACHEII scores of dead group(30.00 ± 0.96) on 5th and (33.00 ± 1.05) on 7th day were higher than that of survived group 5th(21.50 ± 0.61), 7th (18.59 ± 0.58). The differences were statistically significant. [Conclusion] The level of serum PCT is obviously correlated with the degree of critical illness, dynamic monitoring of

  8. Diastolic Dysfunction Induced by a High-Fat Diet Is Associated with Mitochondrial Abnormality and Adenosine Triphosphate Levels in Rats

    Directory of Open Access Journals (Sweden)

    Ki-Woon Kang

    2015-12-01

    Full Text Available BackgroundObesity is well-known as a risk factor for heart failure, including diastolic dysfunction. However, this mechanism in high-fat diet (HFD-induced obese rats remain controversial. The purpose of this study was to investigate whether cardiac dysfunction develops when rats are fed with a HFD for 10 weeks; additionally, we sought to investigate the association between mitochondrial abnormalities, adenosine triphosphate (ATP levels and cardiac dysfunction.MethodsWe examined myocardia in Wistar rats after 10 weeks of HFD (45 kcal% fat, n=6 or standard diet (SD, n=6. Echocardiography, histomorphologic analysis, and electron microscopy were performed. The expression levels of mitochondrial oxidative phosphorylation (OXPHOS subunit genes, peroxisome-proliferator-activated receptor γ co-activator-1α (PGC1α and anti-oxidant enzymes were assessed. Markers of oxidative stress damage, mitochondrial DNA copy number and myocardial ATP level were also examined.ResultsAfter 10 weeks, the body weight of the HFD group (349.6±22.7 g was significantly higher than that of the SD group (286.8±14.9 g, and the perigonadal and epicardial fat weights of the HFD group were significantly higher than that of the SD group. Histomorphologic and electron microscopic images were similar between the two groups. However, in the myocardium of the HFD group, the expression levels of OXPHOS subunit NDUFB5 in complex I and PGC1α, and the mitochondrial DNA copy number were decreased and the oxidative stress damage marker 8-hydroxydeoxyguanosine was increased, accompanied by reduced ATP levels.ConclusionDiastolic dysfunction was accompanied by the mitochondrial abnormality and reduced ATP levels in the myocardium of 10 weeks-HFD-induced rats.

  9. Outcomes of patients with altered level of consciousness and abnormal electroencephalogram: A retrospective cohort study.

    Science.gov (United States)

    Sanches, Paula Rodrigues; Corrêa, Thiago Domingos; Ferrari-Marinho, Taissa; Naves, Pedro Vicente Ferreira; Ladeia-Frota, Carol; Caboclo, Luís Otávio

    2017-01-01

    , respectively, p = 0.049]. Hospital LOS, in-hospital mortality and frequency of unfavorable outcomes did not differ between Ictal patients treated exclusively with AEDs or IVADs. In patients with acute altered consciousness and abnormal routine EEG, antiepileptic treatment did not improve outcomes regardless of the presence of periodic, rhythmic or ictal EEG patterns.

  10. Abnormal plasma levels of serine, methionine, and taurine in transient acute polymorphic psychosis

    NARCIS (Netherlands)

    D. Fekkes (Durk)

    1994-01-01

    textabstractThe present study explored the usefulness of plasma amino acid concentrations in discriminating a subgroup of patients with transient acute polymorphic psychoses characterized by psychosensory symptoms (APP+ patients). Levels of amino acids in the plasma of APP+ patients were compared

  11. GPR40/FFAR1 deficient mice increase noradrenaline levels in the brain and exhibit abnormal behavior

    Directory of Open Access Journals (Sweden)

    Fuka Aizawa

    2016-12-01

    Full Text Available The free fatty acid receptor 1 (GPR40/FFAR1 is a G protein-coupled receptor, which is activated by long chain fatty acids. We have previously demonstrated that activation of brain GPR40/FFAR1 exerts an antinociceptive effect that is mediated by the modulation of the descending pain control system. However, it is unclear whether brain GPR40/FFAR1 contributes to emotional function. In this study, we investigated the involvement of GPR40/FFAR1 in emotional behavior using GPR40/FFAR1 deficient (knockout, KO mice. The emotional behavior in wild and KO male mice was evaluated at 9–10 weeks of age by the elevated plus-maze test, open field test, social interaction test, and sucrose preference test. Brain monoamines levels were measured using LC–MS/MS. The elevated plus-maze test and open field tests revealed that the KO mice reduced anxiety-like behavior. There were no differences in locomotor activity or social behavior between the wild and KO mice. In the sucrose preference test, the KO mice showed reduction in sucrose preference and intake. The level of noradrenaline was higher in the hippocampus, medulla oblongata, hypothalamus and midbrain of KO mice. Therefore, these results suggest that brain GPR40/FFAR1 is associated with anxiety- and depression-related behavior regulated by the increment of noradrenaline in the brain.

  12. Renal Vein Thrombosis in a Newborn With Abnormal Factor VIII Level: Clinical Case Report.

    Science.gov (United States)

    Szafranska, Agnieszka; Pajak, Agata; Kilis-Pstrusinska, Katarzyna; Królak-Olejnik, Barbara

    2015-08-01

    Renal vein thrombosis (RVT) in neonates is a rare condition of low mortality but significant morbidity due to renal impairment.We report the case of a male term newborn with left RVT and elevated serum factor VIII (FVIII).The main symptoms of the patient and the important clinical findings: prompt diagnosis of RVT was possible because the classic clinical presentation of macroscopic hematuria, thrombocytopenia, and palpable flank mass were present in this newborn infant.The main diagnoses: finally, the reason of RVT was established when the infant was 3 months of age: the increased level of FVIII was confirmed. We discuss the diagnosis, therapy, and outcome of the patient and compare with the literature.Therapeutics interventions: however, despite anticoagulant therapy the left kidney developed areas of scarring and then atrophy.Conclusions and outcomes: Prothrombotic defects should be considered in all patients with perinatal RVT. Elevated factor VIII as a reason of RVT in neonatal period is particularly rare. Given a poor renal outcome in children associated with elevated levels of factor VIII, consideration could be given to more aggressive antithrombotic therapy in such cases.

  13. 液体复苏对感染性休克患者血清降钙素原、C反应蛋白含量的影响及其意义%Dynamic Changes of Serum Procalcitonin and C-reactive Protein Level During Fluid Resuscitation and Their Clinical Significances in Patients with Septic Shock

    Institute of Scientific and Technical Information of China (English)

    李珂; 刘少华

    2013-01-01

    目的 动态检测感染性休克患者液体复苏过程中不同时点血清降钙素原(PCT)及C反应蛋白(CRP)含量,分析其与相应时点累计复苏液体量的关系,探讨临床意义.方法 达标(中心静脉压8~12mmHg、平均动脉血压≥65mmHg)复苏21例符合本研究入选标准感染性休克患者.采用免疫化学发光法和散射比浊法检测12例健康体检者、休克患者复苏前及后12、24、48h血清PCT及CRP含量,比较其变化,进而分析其与各时点累计复苏液体总量的相关性.结果 21例感染性休克患者12、24及48h累计复苏液体总量分别为3618 ~ 7035、5320 ~ 11028、8125~13126ml,平均复苏液体量分别为4626±1485、7775±1735、9941±2546ml.纳入观察时患者血清PCT(μg/L)及CRP(mg/L)含量显著高于健康体检者(17.65±6.76 vs0.51±0.11、138.01±58.51 vs 9.18±3.67,P均<0.01);复苏治疗后明显降低、且随时程延长到后一时点降低比前一时点更加明显(PCT:17.65士6.76 vs 11.82±2.58 vs 10.19±3.18 vs 8.08 ±2.90,CRP:138.01士58.51 vs 82.67士21.99 vs 68.18士34.22 vs 43.52士22.42,P<0.01或<0.05).24h时PCT含量变化与累计复苏液体总量呈负相关(r=-0.441,P<0.05)、其余时点PCT及各时点CRP含量变化与相应时点累计复苏液体总量无相关性.结论 感染性休克患者血清PCT及CRP含量明显升高,复苏治疗后显著降低,24h时PCT的降低还负相关于复苏液体总量,其动态监测有助于患者病情、疗效及预后评估.%Objective To evaluate the effects of liquid resuscitation on serum procalcitonin (PCT) and C-reactive protein (CRP) level of patients with septic shock,and then to explore their clinical significances.Methods According to the target of resuscitation (centre venous pressure 8 ~ 12mmHg and mean arterial pressure ≥ 65mmHg),21 patients with septic shock received enough fluid or combined with dopamine\

  14. Association of Serum Ferritin Level with Risk of Incident Abnormal Glucose Metabolism in Southwestern China: a Prospective Cohort Study.

    Science.gov (United States)

    Zhou, Fangli; Zhao, Zhuoxian; Tian, Li; Zheng, Tianpeng; Gao, Yun; Chen, Tao; Yan, Fangfang; Tian, Haoming

    2016-01-01

    This prospective cohort study aimed to analyze the association between serum ferritin levels and the risk of abnormal glucose metabolism (AGM) in Southwestern Chinese population. The 383 subjects who are aged ≥20 years and free of AGM at baseline between in 2007 and in 2008 were included in Southwestern China, and their baseline serum ferritin levels were measured. Among these subjects, 140 subjects were developed into AGM during the follow-up (2008-2012). In logistic regression models, the relative risk in the top versus that in the lowest quartile of serum ferritin levels was 2.86 (p = 0.013) in females and 3.50 (p = 0.029) in males after adjusting the age, gender, family history of diabetes, current smoking, and alcohol; however, serum ferritin levels were not significantly associated with incident of AGM after controlling for metabolic factors (waist circumference, systolic pressure (SBP), triglyceride (TG), and homeostasis model assessment formula insulin resistance (HOMA-IR)). Elevated serum ferritin levels are associated with AGM but not an independent risk factor.

  15. Procalcitonin-guided antibiotic treatment of respiratory tract infections in a primary care setting

    DEFF Research Database (Denmark)

    Aabenhus, Rune; Jensen, Jens Ulrik Stæhr

    2011-01-01

    Clinical signs of infection do not allow for correct identification of bacterial and viral aetiology in acute respiratory infections. A valid tool to assist the clinician in identifying patients who will benefit from antibiotic therapy, as well as patients with a potentially serious infection......, could greatly improve patient care and limit excessive antibiotic prescriptions. Procalcitonin is a new marker of suspected bacterial infection that has shown promise in guiding antibiotic therapy in acute respiratory tract infections in hospitals without compromising patient safety. Procalcitonin...

  16. Retrospective study on prognostic importance of serum procalcitonin and amino-terminal pro-brain natriuretic peptide levels as compared to Acute Physiology and Chronic Health Evaluation IV Score on Intensive Care Unit admission, in a mixed Intensive Care Unit population

    Science.gov (United States)

    Mehta, Chitra; Dara, Babita; Mehta, Yatin; Tariq, Ali M.; Joby, George V.; Singh, Manish K.

    2016-01-01

    Background: Timely decision making in Intensive Care Unit (ICU) is very essential to improve the outcome of critically sick patients. Conventional scores like Acute Physiology and Chronic Health Evaluation (APACHE IV) are quite cumbersome with calculations and take minimum 24 hours. Procalcitonin has shown to have prognostic value in ICU/Emergency department (ED) in disease states like pneumonia, sepsis etc. NTproBNP has demonstrated excellent diagnostic and prognostic importance in cardiac diseases. It has also been found elevated in non-cardiac diseases. We chose to study the prognostic utility of these markers on ICU admission. Settings and Design: Retrospective observational study. Materials and Methods: A Retrospective analysis of 100 eligible patients was done who had undergone PCT and NTproBNP measurements on ICU admission. Their correlations with all cause mortality, length of hospital stay, need for ventilator support, need for vasopressors were performed. Results: Among 100 randomly selected ICU patients, 28 were non-survivors. NTproBNP values on admission significantly correlated with all cause mortality (P = 0.036, AUC = 0.643) and morbidity (P = 0.000, AUC = 0.763), comparable to that of APACHE-IV score. PCT values on admission did not show significant association with mortality, but correlated well with morbidity and prolonged hospital length of stay (AUC = 0.616, P = 0.045). Conclusion: The current study demonstrated a good predictive value of NTproBNP, in terms of mortality and morbidity comparable to that of APACHE-IV score. Procalcitonin, however, was found to have doubtful prognostic importance. These findings need to be confirmed in a prospective larger study. PMID:27052066

  17. Research on relationship between the levels of serum procalcitonin and C-reactive protein in children with meningitis%儿童脑膜炎患者血清降钙素原水平与血 C-反应蛋白的关系研究

    Institute of Scientific and Technical Information of China (English)

    武静; 于瑞杰

    2015-01-01

    目的:探讨儿童脑膜炎患者血清降钙素原(PCT)水平的变化及其与 C-反应蛋白(CRP)的关系。方法检测44例脑膜炎患儿血清 PCT 水平,其中化脓性脑膜炎患儿12例,病毒性脑膜炎患儿32例,同时测定其血 CRP、白细胞(WBC)及脑脊液相关指标[蛋白、WBC、氯化物及葡萄糖],并做统计学分析。结果化脓性脑膜炎组血清 PCT 水平为(9.30±20.47)μg/L,明显高于病毒性脑膜炎组[(0.37±0.27)μg/L](P <0.01);脑膜炎患儿血清 PCT 与 CRP、脑脊液蛋白、WBC 呈明显正相关[相关系数(r)分别为0.343、0.437、0.439,P 均<0.05),与氯化物呈负相关(r =-0.387,P <0.01);进一步多元回归分析显示,血 CRP(β=0.648,P <0.01)影响了40.5%的 PCT 变化,且 PCT 也是脑膜炎患儿 CRP 水平的决定因素之一。结论化脓性脑膜炎患儿血清 PCT 水平明显升高。升高的 PCT 与 CRP 的增加有一定关联,可能通过参与细菌感染诱导的炎症反应促进化脓性脑膜炎的发生、发展。%Objective To investigate the relationship between the level change of serum procalcitonin (PCT)and C-reactive protein (CRP)in children with meningitis.Methods The levels of serum PCT in 41 children with purulent(n=12)or viral(n=32)meningitis were determined,the levels of CRP,white blood cell (WBC)and cerebrospinal fluid related indicators[protein,WBC,chloride and glucose]were determined simultaneously,and the results were analyzed statistically.Results The PCT levels in purulent meningitis group [(9.30± 20.47)μg/L]were significantly higher than those in viral meningitis group [(0.37 ±0.27)μg/L](P <0.01).The PCT levels in children with meningitis were positively correlated with CRP,cerebrospinal fluid protein and WBC[correlation coefficient (r)= 0.343,0.437 and 0.439,P <0.05],and negatively with chloride (r=-0.387,P <0.01).Multiple linear

  18. Abnormal nociception and opiate sensitivity of STOP null mice exhibiting elevated levels of the endogenous alkaloid morphine

    Directory of Open Access Journals (Sweden)

    Aunis Dominique

    2010-12-01

    Full Text Available Abstract Background- Mice deficient for the stable tubule only peptide (STOP display altered dopaminergic neurotransmission associated with severe behavioural defects including disorganized locomotor activity. Endogenous morphine, which is present in nervous tissues and synthesized from dopamine, may contribute to these behavioral alterations since it is thought to play a role in normal and pathological neurotransmission. Results- In this study, we showed that STOP null brain structures, including cortex, hippocampus, cerebellum and spinal cord, contain high endogenous morphine amounts. The presence of elevated levels of morphine was associated with the presence of a higher density of mu opioid receptor with a higher affinity for morphine in STOP null brains. Interestingly, STOP null mice exhibited significantly lower nociceptive thresholds to thermal and mechanical stimulations. They also had abnormal behavioural responses to the administration of exogenous morphine and naloxone. Low dose of morphine (1 mg/kg, i.p. produced a significant mechanical antinociception in STOP null mice whereas it has no effect on wild-type mice. High concentration of naloxone (1 mg/kg was pronociceptive for both mice strain, a lower concentration (0.1 mg/kg was found to increase the mean mechanical nociceptive threshold only in the case of STOP null mice. Conclusions- Together, our data show that STOP null mice displayed elevated levels of endogenous morphine, as well as an increase of morphine receptor affinity and density in brain. This was correlated with hypernociception and impaired pharmacological sensitivity to mu opioid receptor ligands.

  19. Elevated postoperative serum procalcitonin is not indicative of bacterial infection in cardiac surgical patients

    Directory of Open Access Journals (Sweden)

    Murali Chakravarthy

    2015-01-01

    Full Text Available Background: Identifying infections early, commencing appropriate empiric antibiotic not only helps gain control early, but also reduces mortality and morbidity. Conventional cultures take about 5 days to identify infections. To identify the infections early biomarker like serum procalcitonin (SPC. Aims: We studied the correlation of an elevated level of SPC and positive culture in elective adult patients undergoing cardiac surgery. Methods: This prospective study was conducted from January to December 2013. SPC was checked in patients showing evidence of sepsis. Simultaneously, relevant culture was also undertaken. Correlation, specificity, and sensitivity of elevated SPC were checked. Results: A total of 819 adult patients were included in the study. 43 of them had signs of infection and SPC levels were checked. Based on the level of SPC criteria, 10 patients were diagnosed as "nil", out of them, 4 had culture-positive infections, 17 were suggested to have "mild infection," 3 out those had culture positivity. None among the eleven patients suggested to have "moderate infection," had a positive culture, and one among the five suggested to have a severe infection had a positive culture. The sensitivity was 50% and the specificity 17%. The positive predictive value was 12% and the negative predictive value 60%. Conclusions: We failed to elicit positive correlation between elevated SPC levels and postoperative infection in cardio surgical patients.

  20. Elevated postoperative serum procalcitonin is not indicative of bacterial infection in cardiac surgical patients.

    Science.gov (United States)

    Chakravarthy, Murali; Kavaraganahalli, Deepak; Pargaonkar, Sumant; Hosur, Rajathadri; Harivelam, Chidananda; Bharadwaj, Ashwin; Raghunathan, Aditi

    2015-01-01

    Identifying infections early, commencing appropriate empiric antibiotic not only helps gain control early, but also reduces mortality and morbidity. Conventional cultures take about 5 days to identify infections. To identify the infections early biomarker like serum procalcitonin (SPC). We studied the correlation of an elevated level of SPC and positive culture in elective adult patients undergoing cardiac surgery. This prospective study was conducted from January to December 2013. SPC was checked in patients showing evidence of sepsis. Simultaneously, relevant culture was also undertaken. Correlation, specificity, and sensitivity of elevated SPC were checked. A total of 819 adult patients were included in the study. 43 of them had signs of infection and SPC levels were checked. Based on the level of SPC criteria, 10 patients were diagnosed as "nil", out of them, 4 had culture-positive infections, 17 were suggested to have "mild infection," 3 out those had culture positivity. None among the eleven patients suggested to have "moderate infection," had a positive culture, and one among the five suggested to have a severe infection had a positive culture. The sensitivity was 50% and the specificity 17%. The positive predictive value was 12% and the negative predictive value 60%. We failed to elicit positive correlation between elevated SPC levels and postoperative infection in cardio surgical patients.

  1. Decreased levels of genuine large free hCG alpha in men presenting with abnormal semen analysis

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    Plas Eugen

    2011-08-01

    Full Text Available Abstract Background The pregnancy hormone human chorionic gonadotropin (hCG and its free subunits (hCG alpha, hCG beta are produced in the male reproductive tract and found in high concentrations in seminal fluid, in particular hCG alpha. This study aimed to elucidate changes in peptide hormone profiles in patients showing abnormal semen analyses and to determine the genuineness of the highly abundant hCG alpha. Methods Seminal plasma was obtained from 45 male patients undergoing semen analysis during infertility workups. Comprehensive peptide hormone profiles were established by a panel of immunofluorometric assays for hCG, hCG alpha, hCG beta and its metabolite hCG beta core fragment, placental lactogen, growth hormone and prolactin in seminal plasma of patients with abnormal semen analysis results (n = 29 versus normozoospermic men (n = 16. The molecular identity of large hyperglycosylated hCG alpha was analyzed by mass-spectrometry and selective deglycosylation. Results hCG alpha levels were found to be significantly lower in men with impaired semen quality (1346 +/- 191 vs. 2753 +/- 533 ng/ml, P = 0.022. Moreover, patients with reduced sperm count had reduced intact hCG levels compared with normozoospermic men (0.097 +/- 0.022 vs. 0.203 +/- 0.040 ng/ml, P = 0.028. Using mass-spectrometry, the biochemical identity of hCG alpha purified from seminal plasma was verified. Under non-reducing conditions in SDS-PAGE, hCG alpha isolated from seminal plasma migrated in a manner comparable with large free hCG alpha with an apparent molecular mass (Mr, app of 24 kDa, while hCG alpha dissociated from pregnancy-derived holo-hCG migrated at approximately 22 kDa. After deglycosylation with PNGase F under denaturing conditions, all hCG alpha variants showed an Mr, app of 15 kDa, indicating identical amino acid backbones. Conclusions The findings indicate a pathophysiological relevance of hCG, particularly its free alpha subunit, in spermatogenesis. The

  2. Do abnormal serum lipid levels increase the risk of chronic low back pain? The Nord-Trondelag Health Study.

    Directory of Open Access Journals (Sweden)

    Ingrid Heuch

    Full Text Available Cross-sectional studies suggest associations between abnormal lipid levels and prevalence of low back pain (LBP, but it is not known if there is any causal relationship.The objective was to determine, in a population-based prospective cohort study, whether there is any relation between levels of total cholesterol, high density lipoprotein (HDL cholesterol and triglycerides and the probability of experiencing subsequent chronic (LBP, both among individuals with and without LBP at baseline.Information was collected in the community-based HUNT 2 (1995-1997 and HUNT 3 (2006-2008 surveys of an entire Norwegian county. Participants were 10,151 women and 8731 men aged 30-69 years, not affected by chronic LBP at baseline, and 3902 women and 2666 men with LBP at baseline. Eleven years later the participants indicated whether they currently suffered from chronic LBP.Among women without LBP at baseline, HDL cholesterol levels were inversely associated and triglyceride levels positively associated with the risk of chronic LBP at end of follow-up in analyses adjusted for age only. Adjustment for the baseline factors education, work status, physical activity, smoking, blood pressure and in particular BMI largely removed these associations (RR: 0.96, 95% CI: 0.85-1.07 per mmol/l of HDL cholesterol; RR: 1.16, 95% CI: 0.94-1.42 per unit of lg(triglycerides. Total cholesterol levels showed no associations. In women with LBP at baseline and men without LBP at baseline weaker relationships were observed. In men with LBP at baseline, an inverse association with HDL cholesterol remained after complete adjustment (RR: 0.83, 95% CI: 0.72-0.95 per mmol/l.Crude associations between lipid levels and risk of subsequent LBP in individuals without current LBP are mainly caused by confounding with body mass. However, an association with low HDL levels may still remain in men who are already affected and possibly experience a higher pain intensity.

  3. 联合检测血清降钙素原、白细胞计数对脓毒症患儿感染情况及病情程度的诊断价值%The diagnostic value of combined detection of serum levels procalcitonin and white blood cell count in children with sepsis

    Institute of Scientific and Technical Information of China (English)

    曾明; 程樱; 付琼华; 王芳; 陈建昌

    2015-01-01

    目的:探究联合检测血清降钙素原(PCT)、白细胞计数(WBC)在脓毒症患儿感染情况及病情程度诊断中的应用价值。方法选取2013年1月—2014年1月收治的符合脓毒症诊断标准的患儿80例,按照病情严重程度分为脓毒症组和严重脓毒症组,每组40例。另选取同期住院的非脓毒症患儿36例作为对照组。患者入院后24h内均检测血清中PCT、WBC、C反应蛋白(CRP)水平并进行比较。比较PCT单独检测及PCT联合WBC检测诊断脓毒症的价值。结果严重脓毒症组患儿血清中PCT、WBC、CRP含量最高,分别为(2.88±1.31)μg/L、(17.0±6.6)×09/L、(124.8±15.9)mg/L,均明显高于其他2组(F=4.881、5.052、5.456,P<0.05),且患儿血清PCT阳性率为5.0%,高于脓毒症组患儿的57.5%和对照组的2.7%,3组患儿的PCT阳性率比较差异有统计学意义(F=7.34,<0.05)。PCT、WBC联合检测诊断脓毒症的敏感度、特异度、准确率、阳性预测值、阴性预测值、约登指数分别为7.5%、95.0%、91.3%、94.6%、88.4%、0.825,均明显高于PCT单独检测的57.5%、80.0%、68.8%、74.2%、65.3%、.375(P<0.05)。结论PCT在脓毒症的诊断中具有较高的应用价值,其与WBC计数联合检测后,诊断准确率明显提高。%Objective To explore the application value of combined detection of serum procalcitonin ( PCT) ,white blood cell count (WBC) in the diagnosis of sepsis in children with sepsis .Methods From January 2013 to January 2014, ac-cording to the severity of the disease , 80 children with sepsis were divided into sepsis group and severe sepsis group with 40 cases in each group .A control group of 36 patients with non sepsis patients were selected as the control group .The serum lev-els of PCT, WBC, CRP were detected in 24 h after admission.Results Severe sepsis group

  4. Efficiency of Fetuin-A and Procalcitonin in the Diagnosis of Infection in Patients with Febrile Seizure

    Directory of Open Access Journals (Sweden)

    Al-Hakeim Hussein Kadhem

    2016-03-01

    Full Text Available Fetuin-A is a negative acute phase reactant, while procalcitonin is an indicator of severe bacterial infection. Diagnosis of bacterial infection in febrile seizure (FS is important for choosing the most suitable treatment. In this study, serum fetuin-A was estimated, for the first time, in the inpatients with FS and compared with procalcitonin and blood culture tests.

  5. Impact of the use of procalcitonin assay in hospitalized adult patients with pneumonia at a community acute care hospital.

    Science.gov (United States)

    Kook, Janet L; Chao, Stephanie R; Le, Jennifer; Robinson, Philip A

    2012-04-01

    A retrospective, quasi-experimental cohort study compared antibiotic use before and after implementation of a procalcitonin assay at a community acute care hospital. This study demonstrated that the implementation of the procalcitonin assay was associated with a decrease in antibiotic days of therapy in adult patients with pneumonia.

  6. Waist circumference, body mass index, serum uric acid, blood sugar, and triglyceride levels are important risk factors for abnormal liver function tests in the Taiwanese population.

    Science.gov (United States)

    Hsieh, Meng-Hsuan; Lin, Wen-Yi; Chien, Hsu-Han; Chien, Li-Ho; Huang, Chao-Kuan; Yang, Jeng-Fu; Chang, Ning-Chia; Huang, Chung-Feng; Wang, Chao-Ling; Chuang, Wan-Long; Yu, Ming-Lung; Dai, Chia-Yen; Ho, Chi-Kung

    2012-09-01

    Several studies have found that metabolic syndrome and uric acid level are related to abnormal liver function test results. The aim of this study was to explore the associations of risk factors [including blood pressure, blood sugar, total cholesterol, triglyceride, uric acid, waist circumference and body mass index (BMI) measurements] with abnormal liver function in the Taiwanese population.In total, 11,411 Taiwanese adults were enrolled in this study. Blood pressure was assessed according to the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure criteria, fasting blood sugar level according to the Bureau of Health Promotion, Department of Health, R.O.C., criteria, total cholesterol and triglyceride levels according to the Third Report of the National Cholesterol Education Program Adult Treatment Panel III criteria, BMI according to the Asia-Pacific criteria, and waist circumference according to the Revised Diagnostic Criteria of Metabolic Syndrome in Taiwan. The prevalence of a past history of hypertension and diabetes mellitus was 17.7% and 6.5%, respectively, and the rates of abnormal measurements of blood pressure, BMI, waist circumference, fasting blood sugar, triglyceride, total cholesterol, uric acid (male/female), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were 76.2%, 67.6%, 40.0%, 28.6%, 30.6%, 57.3%, 37.9%/21.9%, 14.6% and 21.3%, respectively. Multivariate analysis showed that waist circumference, BMI, serum uric acid, blood sugar, and triglyceride levels were related to abnormal AST and ALT (pwaist circumference was larger than that for BMI. In conclusion, waist circumference, BMI, serum uric acid, blood sugar, and triglyceride levels are important risk factors for abnormal AST and ALT readings in Taiwanese adults. Waist circumference might be a better indicator of risk of abnormal liver function than BMI.

  7. Prognostic value of procalcitonin in pneumonia: A systematic review and meta-analysis.

    Science.gov (United States)

    Liu, Dan; Su, Long-Xiang; Guan, Wei; Xiao, Kun; Xie, Li-Xin

    2016-02-01

    This meta-analysis was performed to determine the accuracy of procalcitonin (PCT) in predicting mortality in pneumonia patients with different pathogenic features and disease severities. A systematic search of English-language articles was performed using PubMed, Embase, Web of Knowledge and the Cochrane Library to identify studies. The diagnostic value of PCT in predicting prognosis was determined using a bivariate meta-analysis model. The Q-test and I(2) index were used to test heterogeneity. A total of 21 studies comprising 6007 patients were included. An elevated PCT level was a risk factor for death from community-acquired pneumonia (CAP) (risk ratio (RR) 4.38, 95% confidence interval (CI) 2.98-6.43), particularly in patients with a low CURB-65 score. The commonly used cut-off, 0.5 ng/mL, had low sensitivity (SEN) and was not able to identify patients at high risk of dying. Furthermore, the PCT assay with functional SEN pneumonia (VAP) and patients with CAP.

  8. The role of procalcitonin as a marker of diabetic foot ulcer infection.

    Science.gov (United States)

    Massara, Mafalda; De Caridi, Giovanni; Serra, Raffaele; Barillà, David; Cutrupi, Andrea; Volpe, Alberto; Cutrupi, Francesco; Alberti, Antonino; Volpe, Pietro

    2017-02-01

    Foot ulcers are frequent in diabetic patients and are responsible for 85% of amputations, especially in the presence of infection. The diagnosis of diabetic foot ulcer infection is essentially based on clinical evaluation, but laboratory parameters such as erythrocyte sedimentation rate (ESR), white blood count (WBC), C-reactive protein (CRP) and, more recently, procalcitonin (PCT) could aid the diagnosis, especially when clinical signs are misleading. Fifteen diabetic patients with infected foot ulcers were admitted to our department and were compared with an additional group of patients with non-infected diabetic foot ulcers (NIDFUs). Blood samples were collected from all patients in order to evaluate laboratory markers. In the current study, the diagnostic accuracy of PCT serum levels was evaluated in comparison with other inflammatory markers such as CRP, ESR and WBC as an indicator to make the distinction between infected diabetic foot ulcers (IDFUs) and NIDFUs. CRP, WBC, ESR and especially PCT measurements represent effective biomarkers in the diagnosis of foot infections in diabetic patients particularly when clinical signs are misleading.

  9. [Roles of peroxisome proliferator-activated receptors polymorphisms, haplotypes, levels on C-reactive protein and their interactions with abnormal body weight].

    Science.gov (United States)

    Yu, Lu-gang; Zhou, Zheng-yuan; Guo, Zhi-rong; Wu, Ming; Gu, Shu-jun

    2013-10-01

    To explore the roles of peroxisome proliferator-activated receptors (PPARs) on the levels of serum C-reactive protein(CRP)and the interactions of PPARs haplotypes with abnormal body weight. Subjects(n = 644)were randomly selected from the cohort 'Prevention of Multiple metabolic disorders and Metabolic syndrome in Jiangsu province(PMMJS)' Variance test, t test and lineal regression were used to analyze the associations between PPARs polymorphisms and the levels of CRP. The association between PPARs haplotypes and serum CRP levels as well as the interaction of PPARs haplotypes with abnormal body weight were analyzed, under the SNPStats software. After adjusting for sex, age, blood pressure, cigarette smoking, alcohol drinking and so on, data showed that both rs1800206 and rs9794 were associated with the changes along with the levels of CRP (P PPARd appeared to be associated with the increase (P PPARγ were associated with the decrease of CRP levels (P PPARs polymorphisms and haplotypes were associated with CRP. Interaction between PPAR a/d and abnormal body weight might contribute to the levels of CRP.

  10. Value of procalcitonin, C-reactive protein, and neopterin in exacerbations of chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Alicia Lacoma

    2011-02-01

    Full Text Available Alicia Lacoma1,4, Cristina Prat1,4, Felipe Andreo2,4, Luis Lores3, Juan Ruiz-Manzano2,4, Vicente Ausina1,4, Jose Domínguez1,41Servei de Microbiologia, 2Servei de Pneumologia, Hospital Universitari Germans Trias i Pujol, Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain; 3Servei de Pneumologia, Hospital de Sant Boi, Sant Boi de Llobregat, Spain; 4CIBER Enfermedades Respiratorias (CIBERES, Instituto de Salud Carlos III, Madrid, SpainObjective: The identification of biological markers in order to assess different aspects of COPD is an area of growing interest. The objective of this study was to investigate whether levels of procalcitonin (PCT, C-reactive protein (CRP, and neopterin in COPD patients could be useful in identifying the etiological origin of the exacerbation and assessing its prognosis.Methods: We included 318 consecutive COPD patients: 46 in a stable phase, 217 undergoing an exacerbation, and 55 with pneumonia. A serum sample was collected from each patient at the time of being included in the study. A second sample was also collected 1 month later from 23 patients in the exacerbation group. We compared the characteristics, biomarker levels, microbiological findings, and prognosis in each patient group. PCT and CRP were measured using an immunofluorescence assay. Neopterin levels were measured using a competitive immunoassay.Results: PCT and CRP showed significant differences among the three patient groups, being higher in patients with pneumonia, followed by patients with exacerbation (P < 0.0001. For the 23 patients with paired samples, PCT and CRP levels decreased 1 month after the exacerbation episode, while neopterin increased. Neopterin showed significantly lower levels in exacerbations with isolation of pathogenic bacteria, but no differences were found for PCT and CRP. No significant differences were found when comparing biomarker levels

  11. 血清降钙素原在败血症早期诊断中的应用价值%The application value of serum procalcitonin in early diagnosis of sepsis

    Institute of Scientific and Technical Information of China (English)

    张昌武

    2015-01-01

    目的:探讨血清降钙素原在败血症早期诊断中的应用价值. 方法:随机选取2012年11月至2014年2月就诊治疗的60例败血症患者作为观察组,并以同期的60例健康体检者作为对照组,检测并比较两组血清降钙素原水平. 结果:观察组患者的血清降钙素原水平为(4.57 ±1.32)ng/mL,对照组为(0.19 ±0.08)ng/mL,观察组患者的血清降钙素原水平高于对照组( P<0. 05). 结论:血清降钙素原水平检测对于败血症的早期诊断有很好的临床应用价值.%Objective:To explore and evaluate the application value of serum procalcitonin in early diagnosis of sepsis. Methods:60 patients with sepsis treated from November 2012 to February 2014 were randomly selected as the research objects of the observation group, and 60 patients examined healthy of the same period as the control group, with the level of serum procalcitonin detected and compared be-tween the two groups. Results:The average level of serum procalcitonin in the observation group was (4. 57 ± 1. 32) ng/mL, which was significantly higher than that of the control group (0. 19 ± 0. 08) ng/mL ( P <0. 05). Conclusion:The detection of serum procalcitonin level is of high value in clinical application for the early diagnosis of sepsis.

  12. Ability of procalcitonin to diagnose bacterial infection and bacteria types compared with blood culture findings

    Directory of Open Access Journals (Sweden)

    Watanabe Y

    2016-09-01

    Full Text Available Yuji Watanabe,1,2 Nozomi Oikawa,1,2 Maya Hariu,1,2 Ryota Fuke,1 Masafumi Seki1 1Division of Infectious Diseases and Infection Control, 2Laboratory for Clinical Microbiology, Tohoku Medical and Pharmaceutical University Hospital, Sendai City, Miyagi, Japan Abstract: Procalcitonin (PCT and C-reactive protein serve as biomarkers of infection in patients with sepsis/bacteremia. The present study assessed the clinical characteristics of 280 patients with suspected sepsis who were admitted to Tohoku Medical and Pharmaceutical University Hospital between January 2012 and December 2013. Among the patients, 133 and 147 were positive and negative for PCT, respectively. Patients who were PCT positive were older and more frequently male, had reduced levels of platelets and albumin, and increased levels of aspartate aminotransferase, alanine aminotransferase, blood urea nitrogen, creatinine, and C-reactive protein. Patients who were PCT positive had significantly higher blood culture positivity compared with those who were PCT negative, and the sensitivity and specificity of PCT for detecting positive blood cultures were 74.5% and 59.1%, respectively. Escherichia coli was detected in PCT-positive patients, whereas Staphylococcus epidermidis and Staphylococcus lugdunensis were frequently detected in PCT-negative patients. Levels of PCT were higher in the patients infected with gram-negative rods than those with gram-positive cocci. Furthermore, extended-spectrum β-lactamase (ESBL-producing bacteria cases showed higher levels of PCT than those of non-ESBL cases. These results suggest that PCT may be a useful biomarker of sepsis, and it might serve as a strong tool to detect patients with severe gram-negative rod bacteremia including ESBL-producing bacteria cases early due to its relative high sensitivity. Keywords: biomarker, sepsis, Escherichia coli, gram-negative rods, ESBL

  13. Accurate diagnosis of acute abdomen in FMF and acute appendicitis patients: how can we use procalcitonin?

    Science.gov (United States)

    Kisacik, Bunyamin; Kalyoncu, Umut; Erol, M Fatih; Karadag, Omer; Yildiz, Mustafa; Akdogan, Ali; Kaptanoglu, Bugra; Hayran, Mutlu; Ureten, Kemal; Ertenli, Ihsan; Kiraz, Sedat; Calguneri, Meral

    2007-12-01

    This study was conducted to define the value of procalcitonin (PCT) levels in the differential diagnosis of abdominal familial Mediterranean fever (FMF) attacks from acute appendicitis. From October 2006 to January 2007, 28 FMF (12 males, 16 females) patients with acute abdominal attacks and 34 patients (18 males) with acute abdomen who underwent operation with the clinical diagnosis of acute appendicitis were consecutively enrolled in this study. FMF patients with concurrent infectious diseases were excluded. PCT values were measured by an immunofluorescent method using the B.R.A.H.M.S. PCT kit (B.R.A.H.M.S. Diagnostica, Berlin, Germany). Erythrocyte sedimentation rate (ESR), C-reactive proteins (CRP) and leucocyte levels were also noted. Mean disease duration in FMF patients was 9.6 +/- 8.1 years (range 2-33 years) and all were on colchicine therapy with a mean colchicine dosage of 1.2 +/- 0.4 mg/day. Among the operated patients, 5 were excluded: 3 patients had normal findings and 2 had intestinal perforation (PCT levels were 2.69 and 4.93 ng/ml, respectively) at operative and pathologic evaluation. There were no significant differences between the two groups with respect to gender and age (p was not significant (NS) for all). Acute phase reactants and PCT levels were increased in patients with FMF compared to patients with acute appendicitis (0.529[0.12 +/- 0.96] vs 0.095 [0.01-0.80] p FMF patients compared to 62% (18/29) of acute appendicitis patients (p FMF attacks from acute appendicitis, though it should not supplant more conventional investigations.

  14. Semen apoptotic M540 body levels correlate with testis abnormalities: a study in a cohort of infertile subjects.

    OpenAIRE

    Lotti F; Tamburrino L; Marchiani S; Muratori M; Corona G; Fino MG; Degl'innocenti S; Forti G; Maggi M; Baldi E.

    2012-01-01

    STUDY QUESTION: What are the associations between semen apoptotic M540 bodies and other parameters of semen quality and sonographic alterations of the male genital tract in a cohort of infertile subjects? SUMMARY ANSWER: In infertile subjects, semen M450 bodies are highly correlated with ultrasound and clinical signs of testis abnormalities but not with alterations of other parts of the male genital tract, suggesting a testicular origin of M540 bodies. WHAT IS KNOWN ALREADY:...

  15. Meiotic abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1993-12-31

    Chapter 19, describes meiotic abnormalities. These include nondisjunction of autosomes and sex chromosomes, genetic and environmental causes of nondisjunction, misdivision of the centromere, chromosomally abnormal human sperm, male infertility, parental age, and origin of diploid gametes. 57 refs., 2 figs., 1 tab.

  16. The Diagnostic Value of D-dimer, Procalcitonin and CRP in Acute Appendicitis

    Directory of Open Access Journals (Sweden)

    Bulent Kaya, Baris Sana, Cengiz Eris, Koray Karabulut, Orhan Bat, Riza Kutanis

    2012-01-01

    Full Text Available BACKGROUND: The early diagnosis of acute abdomen is of great importance. To date, several inflammatory markers have been used for the diagnosis of acute abdominal conditions, including acute appendicitis. The aim of this study was to evaluate the diagnostic utility of D-dimer, Procalcitonin (PCT and C-reactive protein (CRP measurements in the acute appendicitis.METHODS: This prospective study was conducted between March 1st, 2010 and July 1st, 2011. In this period, seventy-eight patients were operated with the diagnosis of acute appendicitis, and D-dimer, PCT and CRP levels of the patients were measured. The patients were grouped as phlegmonous appendicitis (Group 1, gangrenous appendicitis (Group 2, perforated appendicitis (Group 3 and negative appendectomy (Group 4 according to the surgical findings and histopathological results.RESULTS: Of 78 patients, 54 (69.2 % were male and 24 (30.8 % were female, and the mean age was 25.4 ± 11.1 years (range, 18 to 69 years. 66 (84.6 % patients had increased leukocyte count (white blood cell count. The PCT values were higher than the upper normal limit in 20 (25.6% patients, followed by D-dimer in 22 (28.2 % patients and CRP in 54 (69.2 % patients. The diagnostic value of leukocyte count and CRP in acute appendicitis was higher than that of the other markers, whereas leukocyte count showed very low specificity. CRP values were higher in perforated appendicitis when compared with the phlegmonous appendicitis (p<0.05. However, PCT and D-dimer showed lower diagnostic values (26% and 31%, respectively.CONCLUSION: An increase in CRP levels alone is not sufficient to make the diagnosis of acute appendicitis. However, CRP levels may differentiate between phlegmonous appendicitis and perforated appendicitis. Due to their low sensitivity and diagnostic value, PCT and D-dimer are not better markers than CRP for the diagnosis of acute appendicitis.

  17. Useulness of B Natriuretic Peptides and Procalcitonin in Emergency Medicine

    Directory of Open Access Journals (Sweden)

    P. Ray

    2008-01-01

    Full Text Available Congestive heart failure (CHF is the main cause of acute dyspnea in patients presented to an emergency department (ED, and it is associated with high morbidity and mortality. B-type natriuretic peptide (BNP is a polypeptide, released by ventricular myocytes directly proportional to wall tension, for lowering renin-angiotensin-aldosterone activation. For diagnosing CHF, both BNP and the biologically inactive NT-proBNP have similar accuracy. Threshold values are higher in elderly population, and in patients with renal dysfunction. They might have also a prognostic value. Studies demonstrated that the use of BNP or NT-proBNP in dyspneic patients early in the ED reduced the time to discharge, total treatment cost. BNP and NT-proBNP should be available in every ED 24 hours a day, because literature strongly suggests the beneficial impact of an early appropriate diagnosis and treatment in dyspneic patients. Etiologic diagnosis of febrile patients who present to an ED is complex and sometimes difficult. However, new evidence showed that there are interventions (including early appropriate antibiotics, which could reduce mortality rate in patients with sepsis. For diagnosing sepsis, procalcitonin (PCT is more accurate than C-reactive protein. Thus, because of its excellent specificity and positive predictive value, an elevated PCT concentration (higher than 0.5 ng/mL indicates ongoing and potentially severe systemic infection, which needs early antibiotics (e.g. meningitis. In lower respiratory tract infections, CAP or COPD exacerbation, PCT guidance reduced total antibiotic exposure and/or antibiotic treatment duration.

  18. Diagnostic accuracy of procalcitonin in critically ill immunocompromised patients

    Directory of Open Access Journals (Sweden)

    Legriel Stéphane

    2011-08-01

    Full Text Available Abstract Background Recognizing infection is crucial in immunocompromised patients with organ dysfunction. Our objective was to assess the diagnostic accuracy of procalcitonin (PCT in critically ill immunocompromised patients. Methods This prospective, observational study included patients with suspected sepsis. Patients were classified into one of three diagnostic groups: no infection, bacterial sepsis, and nonbacterial sepsis. Results We included 119 patients with a median age of 54 years (interquartile range [IQR], 42-68 years. The general severity (SAPSII and organ dysfunction (LOD scores on day 1 were 45 (35-62.7 and 4 (2-6, respectively, and overall hospital mortality was 32.8%. Causes of immunodepression were hematological disorders (64 patients, 53.8%, HIV infection (31 patients, 26%, and solid cancers (26 patients, 21.8%. Bacterial sepsis was diagnosed in 58 patients and nonbacterial infections in nine patients (7.6%; 52 patients (43.7% had no infection. PCT concentrations on the first ICU day were higher in the group with bacterial sepsis (4.42 [1.60-22.14] vs. 0.26 [0.09-1.26] ng/ml in patients without bacterial infection, P 0.5 ng/ml had 100% sensitivity but only 63% specificity for diagnosing bacterial sepsis. The area under the receiver operating characteristic (ROC curve was 0.851 (0.78-0.92. In multivariate analyses, PCT concentrations > 0.5 ng/ml on day 1 independently predicted bacterial sepsis (odds ratio, 8.6; 95% confidence interval, 2.53-29.3; P = 0.0006. PCT concentrations were not significantly correlated with hospital mortality. Conclusion Despite limited specificity in critically ill immunocompromised patients, PCT concentrations may help to rule out bacterial infection.

  19. Procalcitonin increase in early identification of critically ill patients at high risk of mortality

    DEFF Research Database (Denmark)

    Jensen, Jens Ulrik; Heslet, L; Jensen, TH;

    2006-01-01

    in the multivariate Cox regression analysis model. C-reactive protein and leukocyte increases did not show these qualities. The adjusted hazard ratio for procalcitonin increase for 1 day was 1.8 (95% confidence interval 1.3-2.7). The relative risk for mortality in the intensive care unit for patients...

  20. Guiding of serum procalcitonin-guided antibiotic in elderly early-onset stroke-associated pneumonia

    Institute of Scientific and Technical Information of China (English)

    龙威

    2013-01-01

    Objective To evaluate the effects of serum procalcitonin (PCT) -guided antibiotic therapy in elderly patients with early-onset stroke-associated pneumonia (EOP) .Methods Totally 179 eligible elderly patients with EOP were randomly devided into 2 groups:standard therapy

  1. Procalcitonin behaves as a fast responding acute phase protein in vivo and in vitro

    NARCIS (Netherlands)

    Nijsten, MWN; Olinga, P; The, TH; de Vries, EGE; Groothuis, GMM; Limburg, PC; ten Duis, HJ; Moshage, H; Hoekstra, HJ; Bijzet, J; Zwaveling, JH; Schraffordt Koops, H.

    2000-01-01

    Objectives: Procalcitonin (PCT) is a 13 kD protein of which plasma concentrations are strongly increased in inflammatory states, PCT concentrations are claimed to have a more powerful discriminatory value for bacterial infection than the acute phase proteins serum amyloid A (SAA) or C-reactive prote

  2. C-reactive protein and procalcitonin during febril attacks in PFAPA syndrome.

    Science.gov (United States)

    Yazgan, Hamza; Keleş, Esengül; Yazgan, Zerrin; Gebeşçe, Arzu; Demirdöven, Mehmet

    2012-08-01

    To assess the levels of procalcitonin (PCT) and C-reactive protein (CRP) in children diagnosed with PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis) during their febrile attacks. 23 patients with diagnosis of PFAPA included into the study prospectively during a three years period. In these patients, CRP and PCT values were recorded during 78 febrile episodes. Furthermore, 20 patients with diagnosis of pneumonia were chosen as a control group and their CRP and PCT values were measured. Normal reference values for CRP and PCT were 0-10 mg/L and 0-0.5 ng/mL, respectively. Mean CRP and PCT values of patients with PFAPA were 94.8±71.6 mg/L and 0.29±0.14 ng/mL, respectively. In control group, mean CRP value was 153.2±26 mg/L and PCT was 1.59±0.53 ng/mL. CRP and PCT were high in control group. CRP was detected high and PCT was normal in PFAPA. Compared to control group, in PFAPA group, CRP values were not significantly (p>0.05) and PCT values were significantly lower (p<0.001). During febrile episodes in the patients with diagnosis of PFAPA, CRP values were substantially elevated, whereas PCT values were within normal levels. Concomitant assessment of CRP and PCT in addition to clinical diagnostic criteria may be of help in making diagnosis and distinguishing febrile attacks from infections. However, studies in larger groups are required. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  3. Procalcitonin to guide antibiotic administration in COPD exacerbations: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Alexander G. Mathioudakis

    2017-02-01

    Full Text Available Challenges in the differentiation of the aetiology of acute exacerbations of chronic obstructive pulmonary disease (AECOPD have led to significant overuse of antibiotics. Serum procalcitonin, released in response to bacterial infections, but not viral infections, could possibly identify AECOPD requiring antibiotics. In this meta-analysis we assessed the clinical effectiveness of procalcitonin-based protocols to initiate or discontinue antibiotics in patients presenting with AECOPD. Based on a prospectively registered protocol, we reviewed the literature and selected randomised or quasi-randomised trials comparing procalcitonin-based protocols to initiate or discontinue antibiotics versus standard care in AECOPD. We followed Cochrane and GRADE (Grading of Recommendations, Assessment, Development and Evaluation guidance to assess risk of bias, quality of evidence and to perform meta-analyses. We included eight trials evaluating 1062 patients with AECOPD. Procalcitonin-based protocols decreased antibiotic prescription (relative risk (RR 0.56, 95% CI 0.43–0.73 and total antibiotic exposure (mean difference (MD −3.83, 95% CI (−4.32–−3.35, without affecting clinical outcomes such as rate of treatment failure (RR 0.81, 0.62–1.06, length of hospitalisation (MD −0.76, −1.95–0.43, exacerbation recurrence rate (RR 0.96, 0.69–1.35 or mortality (RR 0.99, 0.58–1.69. However, the quality of the available evidence is low to moderate, because of methodological limitations and small overall study population. Procalcitonin-based protocols appear to be clinically effective; however, confirmatory trials with rigorous methodology are required.

  4. "Jeopardy" in Abnormal Psychology.

    Science.gov (United States)

    Keutzer, Carolin S.

    1993-01-01

    Describes the use of the board game, Jeopardy, in a college level abnormal psychology course. Finds increased student interaction and improved application of information. Reports generally favorable student evaluation of the technique. (CFR)

  5. Abnormal auditory mismatch response in tinnitus sufferers with high-frequency hearing loss is associated with subjective distress level

    Directory of Open Access Journals (Sweden)

    Berg Patrick

    2004-03-01

    Full Text Available Abstract Background Tinnitus is an auditory sensation frequently following hearing loss. After cochlear injury, deafferented neurons become sensitive to neighbouring intact edge-frequencies, guiding an enhanced central representation of these frequencies. As psychoacoustical data 123 indicate enhanced frequency discrimination ability for edge-frequencies that may be related to a reorganization within the auditory cortex, the aim of the present study was twofold: 1 to search for abnormal auditory mismatch responses in tinnitus sufferers and 2 relate these to subjective indicators of tinnitus. Results Using EEG-mismatch negativity, we demonstrate abnormalities (N = 15 in tinnitus sufferers that are specific to frequencies located at the audiometrically normal lesion-edge as compared to normal hearing controls (N = 15. Groups also differed with respect to the cortical locations of mismatch responsiveness. Sources in the 90–135 ms latency window were generated in more anterior brain regions in the tinnitus group. Both measures of abnormality correlated with emotional-cognitive distress related to tinnitus (r ~ .76. While these two physiological variables were uncorrelated in the control group, they were correlated in the tinnitus group (r = .72. Concerning relationships with parameters of hearing loss (depth and slope, slope turned out to be an important variable. Generally, the steeper the hearing loss is the less distress related to tinnitus was reported. The associations between slope and the relevant neurophysiological variables are in agreement with this finding. Conclusions The present study is the first to show near-to-complete separation of tinnitus sufferers from a normal hearing control group based on neurophysiological variables. The finding of lesion-edge specific effects and associations with slope of hearing loss corroborates the assumption that hearing loss is the basis for tinnitus development. It is likely that some central

  6. PROCALCITONIN AS A BIOMARKER OF BACTERIAL INFECTION IN SICKLE CELL VASO-OCCLUSIVE CRISIS.

    Directory of Open Access Journals (Sweden)

    Dilip Kumar Patel

    2014-02-01

    Full Text Available Bacterial infection is an important trigger of vaso-occlusive crisis (VOC in sickle cell anaemia (SCA. SCA Patients with VOC have signs of inflammation and it is difficult to diagnose bacterial infection in them. This study was undertaken to evaluate serum procalcitonin (PCT as a biomarker of bacterial infection in acute sickle cell vaso-occlusive crisis. Hundred SCA patients were studied at Sickle Cell Clinic and Molecular Biology Laboratory, V.S.S. Medical College, Burla, Odisha, India. SCA was diagnosed by haemoglobin electrophoresis, HPLC and molecular analysis. Patients were divided into 3categories namely Category-A (VOC/ACS with fever but without evidence of bacterial infection-66 patients; Category-B (VOC with fever and documentedbacterial infection-24 patients; and Category-C (Patients in steady statewithout VOC/ACS or fever-10 patients. Investigations like complete blood count, C-reactive protein estimation and PCT measurement was done in all the cases. There was no significant difference in total leucocytes count and C-reactiveprotein values between category A and B. In category A the PCT level was 0.5ng/mL with 87.5% of cases having >2ng/mL. In category C, PCT value was 2ng/mL is indicative of bacterial infection necessitating antimicrobial therapy. Patients with indeterminate PCT value of0.5-2ng/mL, need a repeat PCT estimation or an empirical antibiotic therapyawaiting the availability of microbiological report as deemed necessary.

  7. [Ability of procalcitonin to predict bacteremia in patients with community acquired pneumonia].

    Science.gov (United States)

    Julián-Jiménez, Agustín; Timón Zapata, Jesús; Laserna Mendieta, Emilio José; Parejo Miguez, Raquel; Flores Chacartegui, Manuel; Gallardo Schall, Pablo

    2014-04-07

    To analyze the usefulness and ability of procalcitonin (PCT) to predict the presence of bacteremia in patients with community-acquired pneumonia (CAP) caused by Streptococcus pneumoniae (S. pneumoniae) or other bacteria. This is an observational, prospective and descriptive study involving patients who were diagnosed with CAP in our Emergency Department. Data collected included socio-demographic and comorbidity variables, Charlson index, stage in the Pneumonia Severity Index and criteria of severe NAC, microbiologic studies and biomarker determinations (PCT and C reactive protein). The follow-up was carried out during 30 days to calculate the predictive power and the diagnostic performance for bacteremia caused or not by S. pneumoniae. Four hundred and seventy-four patients were finally included in the study. Blood cultures were positive in 85 individuals (17.9%) and S. pneumoniae was identified as the responsible pathogen in 75 of them (88.4%) (in 5 cases together with another agent). The area under the Receiver Operating Characteristic curve for PCT to predict bacteremia (caused by S. pneumoniae or not) was 0.988 (95% confidence interval 0.908-0.995; P98% and>10, respectively. The most frequently isolated serotypes of S. pneumoniae were 19A, 7F, 1 and 3. The highest mean levels of PCT were found in serotypes 7F, 19A, 3 and 1, which showed statistically significant differences with regard to the others serotypes considered (P=.008). Serotypes associated with the highest percentage of severe sepsis-septic shock, 30-days mortality and multi-lobe or bilateral affection were 3, 1 and 19A; 1, 3 and 19A; and 3, 19A and 6A, respectively. PCT had a remarkable diagnostic ability to discard or suspect bacteremia and to guide the etiology of CAP caused by S. pneumoniae. Serotypes 1, 3, 19A and 7F showed greater frequency, systemic inflammatory response and clinical severity. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  8. Procalcitonin Impairs Liver Cell Viability and Function In Vitro: A Potential New Mechanism of Liver Dysfunction and Failure during Sepsis?

    Science.gov (United States)

    Ehler, Johannes; Wagner, Nana-Maria

    2017-01-01

    Purpose. Liver dysfunction and failure are severe complications of sepsis and result in poor outcome and increased mortality. The underlying pathologic mechanisms of hepatocyte dysfunction and necrosis during sepsis are only incompletely understood. Here, we investigated whether procalcitonin, a biomarker of sepsis, modulates liver cell function and viability. Materials and Methods. Employing a previously characterized and patented biosensor system evaluating hepatocyte toxicity in vitro, human hepatocellular carcinoma cells (HepG2/C3A) were exposed to 0.01–50 ng/mL procalcitonin for 2 × 72 h and evaluated for proliferation, necrosis, metabolic activity, cellular integrity, microalbumin synthesis, and detoxification capacity. Acetaminophen served as positive control. For further standardization, procalcitonin effects were confirmed in a cellular toxicology assay panel employing L929 fibroblasts. Data were analyzed using ANOVA/Tukey's test. Results. Already at concentrations as low as 0.25 ng/mL, procalcitonin induced HepG2/C3A necrosis (P < 0.05) and reduced metabolic activity, cellular integrity, synthesis, and detoxification capacity (all P < 0.001). Comparable effects were obtained employing L929 fibroblasts. Conclusion. We provide evidence for procalcitonin to directly impair function and viability of human hepatocytes and exert general cytotoxicity in vitro. Therapeutical targeting of procalcitonin could thus display a novel approach to reduce incidence of liver dysfunction and failure during sepsis and lower morbidity and mortality of septic patients. PMID:28255555

  9. The clinical application of procalcitonin in diagnosis of pneuminia in children%降钙素原在小儿肺炎诊断中的应用

    Institute of Scientific and Technical Information of China (English)

    蔡美珠; 何凤琼; 曹永东

    2008-01-01

    Objective To analyze the serum level of procalcitonin (PCT) in children with bacte-rial or viral pneumonia, explore its diagnostic value in diagnosis of bacterial pneuminia in children, and so as to provide evidence for clinical use of antibiotics. Methods A total of 42 children with pneumonia(mean age was 5.6 yrs, including 24 boys and 18 girls) were divided into viral neumonia group (n=25) and bacterial neumonia group (n=17). Semi-quantitative solid-phase immunoassay was applied to measuring serum procalcitonin. There were four PCT grades:/0.5 ng/mL、≥2 ng/mL和≥10 ng/mL4个等级,进行x2检验.结果 细菌性肺炎组患儿血清PCT水平高于病毒性肺炎组,差异有显著性意义(P<0.01).结论 血清PCT是小儿细菌性肺炎的敏感标志物之一,血清PCT检测有助于小儿肺炎的诊断及鉴别诊断,可作为临床抗生素的使用依据.

  10. Procalcitonin, C-reactive protein and serum lactate dehydrogenase in the diagnosis of bacterial sepsis, SIRS and systemic candidiasis.

    Science.gov (United States)

    Miglietta, Fabio; Faneschi, Maria Letizia; Lobreglio, Giambattista; Palumbo, Claudio; Rizzo, Adriana; Cucurachi, Marco; Portaccio, Gerolamo; Guerra, Francesco; Pizzolante, Maria

    2015-09-01

    The aim of this study was to evaluate procalcitonin (PCT), C-reactive protein (CRP), platelet count (PLT) and serum lactate dehydrogenase (LDH) as early markers for diagnosis of SIRS, bacterial sepsis and systemic candidiasis in intensive care unit (ICU) patients. Based on blood culture results, the patients were divided into a sepsis group (70 patients), a SIRS group (42 patients) and a systemic candidiasis group (33 patients). PCT, CRP, LDH and PLT levels were measured on day 0 and on day 2 from the sepsis symptom onset. PCT levels were higher in Gram negative sepsis than those in Gram positive sepsis, although the P value between the two subgroups is not significant (P=0.095). Bacterial sepsis group had higher PCT and CRP levels compared with the systemic candidiasis group, whereas PLT and LDH levels showed similar levels in these two subgroups. The AUC for PCT (AUC: 0.892, P SIRS and systemic candidiasis groups (P=0.093 N.S.). In conclusion, PCT can be used as a preliminary marker in the event of clinical suspicion of systemic candidiasis; however, low PCT levels (SIRS groups.

  11. Microvascular abnormalities in capillaroscopy correlate with higher serum IL-18 and sE-selectin levels in patients with type 1 diabetes complicated by microangiopathy

    Directory of Open Access Journals (Sweden)

    Maria Górska

    2011-04-01

    Full Text Available Microvascular abnormalities are one of the most important causes of persistent diabetic complications. The aim of this study was to compare microvascular changes examined by nailfold capillaroscopy with serum concentrations of soluble E-selectin (sE-selectin and IL-18 in type 1 diabetic patients with and without microangiopathy. Serum levels of sE-selectin and IL-18 were determined by an enzyme-linked immunosorbent assay in 106 patients with type 1 diabetes and in 40 healthy controls. All diabetic patients were evaluated by extensive clinical, laboratory and capillaroscopic studies. Morphological changes were observed by nailfold capillaroscopy in 86 out of 106 (81% diabetic patients. Severe capillaroscopic changes were seen in 32 out of 54 (59% patients with microangiopathy, but in only seven out of 52 (13% patients without microangiopathy. Higher serum levels of sE-selectin (p < 0.001 and IL-18 (p < 0.05 were demonstrated in diabetic patients compared to controls. Significant differences of sE-selectin (p < 0.001 and IL-18 (p < 0.01 serum concentrations were observed between diabetic patients with microangiopathy and controls. Moreover, comparison between patients with and without microangiopathic complications showed a significantly higher capillaroscopic score and sE-selectin serum concentration in the group with microangiopathy (p < 0.001. Furthermore, diabetic patients with severe microvascular changes in capillaroscopy showed significantly higher IL-18 (p < 0.001 and sE-selectin (p < 0.05 serum levels than subgroups without changes or with mild abnormalities. Our findings suggest that abnormalities in nailfold capillaroscopy may reflect the extent of microvascular involvement and are associated with higher sE-selectin and IL-18 serum levels, as well as with microangiopathic complications in diabetic patients. (Folia Histochemica et Cytobiologica 2011; Vol. 49, No. 1, pp. 104–110

  12. Procalcitonin as a predictor of sepsis and outcome in severe trauma patients: A prospective study

    Directory of Open Access Journals (Sweden)

    Nonika Rajkumari

    2013-01-01

    Full Text Available Introduction: Despite the advances in medical sciences, the morbidity and mortality due to sepsis in severe trauma patients remains high; hence the need for early and accurate diagnosis. Very few prospective studies are available in a country like India, which tried to analyze the prediction of sepsis using serum procalcitonin (PCT in such a large scale among trauma patients. This study explores the role of the biomarker PCT in early diagnosis of sepsis and prediction of outcomes in severe trauma cases. Materials and Methods: We studied the patient population prospectively in two different groups. One with acute trauma but no clinical evidence of sepsis and the second group with clinical evidence of sepsis and are followed. Bronchoalveolar lavage, tracheal aspirates, pus, urine, body fluids from sterile body sites, etc., were collected including blood for culture and serum for PCT assays. Such assays were done on samples collected on days 1 and 4 and then compared. Additionally, C-reactive protein (CRP and erythrocyte sedimentation rate (ESR levels were also tested. Antimicrobial sensitivity tests were carried out for all the isolates from the clinical samples and correlated with the clinically suspected cases of sepsis. Outcomes of the patients were noted. Results: Patients with high initial PCT levels (>2 ng/ml in severe trauma cases had poor outcomes and risk of developing complications. Its correlation with severe outcomes was better marked as compared with CRP and ESR levels. The difference in PCT levels between days 1 and 4 in group two patients was statistically significant (P = 0.006 but were not statistically significant for CRP (P = 0.646 and ESR (P = 0.935. The study also shows that PCT levels fall in response to appropriate antimicrobial treatment. Conclusion: PCT is a useful biomarker for early and accurate prediction of sepsis in severe trauma patients. If used in adjunct to clinical findings, it proves to be a good biomarker for

  13. Leukocyte abnormalities.

    Science.gov (United States)

    Gabig, T G

    1980-07-01

    Certain qualitative abnormalities in neutrophils and blood monocytes are associated with frequent, severe, and recurrent bacterial infections leading to fatal sepsis, while other qualitative defects demonstrated in vitro may have few or no clinical sequelae. These qualitative defects are discussed in terms of the specific functions of locomotion, phagocytosis, degranulation, and bacterial killing.

  14. A comparison of high-mobility group-box 1 protein, lipopolysaccharide-binding protein and procalcitonin in severe community-acquired infections and bacteraemia: a prospective study

    DEFF Research Database (Denmark)

    Gaïni, Shahin; Koldkjaer, Ole G; Møller, Holger J

    2008-01-01

    immune response when the host is challenged by bacterial pathogens. Procalcitonin (PCT) has been suggested as a marker of severe bacterial infections and sepsis. The aim of the present study was to investigate levels of HMGB1, LBP and PCT in a well-characterised sepsis cohort. The study plan included...... analysis of the levels of the inflammatory markers in relation to the severity of infection, to the prognosis and to the ability to identify patients with bacteraemia. METHODS: Patients suspected of having severe infections and admitted to a department of internal medicine were included in a prospective...... manner. Demographic data, comorbidity, routine biochemistry, microbiological data, infection focus, severity score and mortality on day 28 were recorded. Plasma and serum were sampled within 24 hours after admission. Levels of all studied markers (HMGB1, LBP, PCT, IL-6, C-reactive protein, white blood...

  15. Comparison of Therapeutic Response and Clinical Outcome between HCV Patients with Normal and Abnormal Alanine Transaminase Levels.

    Directory of Open Access Journals (Sweden)

    Cheng-Kung Wu

    Full Text Available Patients with chronic hepatitic C (HCV infection and normal serum alanine transaminase (ALT levels were considered to have mild disease. In Taiwan, these patients were not suggested for interferon (IFN based therapies. The aim of study is to compare therapeutic outcomes between HCV patients with normal and elevated ALT levels.We conducted a retrospective study on 3241 HCV patients treated by IFN based therapies. Patients with normal ALT levels were classified as group A (n = 186 while those with elevated ALT levels were group B (n = 3055.At baseline, incidence of diabetes mellitus, low platelet counts and cirrhosis were significantly higher in group B patients. The sustained virologic response (SVR rate was comparable between the 2 groups (65.3% vs. 65.3%, P = .993. But significantly higher incidence of HCC development after HCV treatment was observed in group B (7.4% vs. 3.2%, P = .032. No significant differences with respect to the outcome of liver decompensation, spontaneous bacterial peritonitis, and mortality were noted between 2 groups. Multivariate analysis showed younger age, female gender, non-HCV genotype 1, lower viral load, higher platelet counts and non-cirrhosis were favorable factors for achieving SVR, rather than ALT levels. Further analysis revealed older age, cirrhosis, lower platelet levels and non- peg-interferon treatment are risk factors of HCC development.HCV patients with normal ALT levels had similar response to antiviral therapy and low rate of HCC development after therapy. Antiviral therapies begun at early course of HCV infection may be beneficial to prevent disease progression.

  16. DIAGNOSTIC VALUE OF SIMULTANEOUS MEASUREMENT OF PROCALCITONIN, INTERLEUKIN-6 AND HS CRP IN PREDICTION OF EARLY-ONSET NEONATAL SEPSIS

    Directory of Open Access Journals (Sweden)

    alireza abdollahi

    2012-05-01

    Full Text Available Neonatal sepsis is a major cause of morbidities and mortalities mostly remarkable in the third world nations .We aimed to assess the value of simultaneous measurement of procalcitonin (PCT and interleukin-6 (IL-6 in association with high sensitive- C reactive protein in prediction of early neonatal sepsis. We performed a follow- up study on 95 neonates who were below 12 hours (h of age, had clinical signs of sepsis or maternal risk factors for sepsis. Neonates were assigned to 4 groups including “proven early-onset sepsis”, “clinical early-onset sepsis”, “negative infectious status”, and “uncertain infectious status”. Blood samples were obtained within the first 12 h of birth repeated between 24 hours and 36 hours of age for determination of serum levels of PCT, IL-6, high sensitivie- C Reactive Protein (hs-CRP, and white blood cell (WBC count. On admission, neonates with sepsis had a higher WBC count, IL-6, PCT, and hs-CRP levels compared with those neonates without sepsis. This remained significant even after 12-24 hours of admission. Also, patients with clinical evidences of sepsis had a higher serum level of PCT and IL-6 within 12-24 hours after admission compared to the patients with uncertain sepsis. In final The combination of IL-6, hs-CRP, and PCT seems to be predictive in diagnosis of early onset neonatal sepsis.

  17. Behavioral Abnormalities in a Mouse Model of Chronic Toxoplasmosis Are Associated with MAG1 Antibody Levels and Cyst Burden.

    Science.gov (United States)

    Xiao, Jianchun; Li, Ye; Prandovszky, Emese; Kannan, Geetha; Viscidi, Raphael P; Pletnikov, Mikhail V; Yolken, Robert H

    2016-04-01

    There is marked variation in the human response to Toxoplasma gondii infection. Epidemiological studies indicate associations between strain virulence and severity of toxoplasmosis. Animal studies on the pathogenic effect of chronic infection focused on relatively avirulent strains (e.g. type II) because they can easily establish latent infections in mice, defined by the presence of bradyzoite-containing cysts. To provide insight into virulent strain-related severity of human toxoplasmosis, we established a chronic model of the virulent type I strain using outbred mice. We found that type I-exposed mice displayed variable outcomes ranging from aborted to severe infections. According to antibody profiles, we found that most of mice generated antibodies against T. gondii organism but varied greatly in the production of antibodies against matrix antigen MAG1. There was a strong correlation between MAG1 antibody level and brain cyst burden in chronically infected mice (r = 0.82, p = 0.0021). We found that mice with high MAG1 antibody level displayed lower weight, behavioral changes, altered levels of gene expression and immune activation. The most striking change in behavior we discovered was a blunted response to amphetamine-trigged locomotor activity. The extent of most changes was directly correlated with levels of MAG1 antibody. These changes were not found in mice with less cyst burden or mice that were acutely but not chronically infected. Our finding highlights the critical role of cyst burden in a range of disease severity during chronic infection, the predictive value of MAG1 antibody level to brain cyst burden and to changes in behavior or other pathology in chronically infected mice. Our finding may have important implications for understanding the heterogeneous effects of T. gondii infections in human.

  18. Modeled nitrate levels in well water supplies and prevalence of abnormal thyroid conditions among the Old Order Amish in Pennsylvania.

    Science.gov (United States)

    Aschebrook-Kilfoy, Briseis; Heltshe, Sonya L; Nuckols, John R; Sabra, Mona M; Shuldiner, Alan R; Mitchell, Braxton D; Airola, Matt; Holford, Theodore R; Zhang, Yawei; Ward, Mary H

    2012-02-17

    Nitrate is a widespread contaminant of drinking water supplies, especially in agricultural areas. Nitrate intake from drinking water and dietary sources can interfere with the uptake of iodide by the thyroid, thus potentially impacting thyroid function. We assessed the relation of estimated nitrate levels in well water supplies with thyroid health in a cohort of 2,543 Old Order Amish residing in Lancaster, Chester, and Lebanon counties in Pennsylvania for whom thyroid stimulating hormone (TSH) levels were measured during 1995-2008. Nitrate measurement data (1976-2006) for 3,613 wells in the study area were obtained from the U.S. Geological Survey and we used these data to estimate concentrations at study participants' residences using a standard linear mixed effects model that included hydrogeological covariates and kriging of the wells' residuals. Nitrate levels estimated by the model ranged from 0.35 mg/L to 16.4 mg/L N-NO3(-), with a median value of 6.5 mg/L, which was used as the cutpoint to define high and low nitrate exposure. In a validation analysis of the model, we calculated that the sensitivity of the model was 67% and the specificity was 93%. TSH levels were used to define the following outcomes: clinical hyperthyroidism (n = 10), clinical hypothyroidism (n = 56), subclinical hyperthyroidism (n = 25), and subclinical hypothyroidism (n = 228). In women, high nitrate exposure was significantly associated with subclinical hypothyroidism (OR = 1.60; 95% CI: 1.11-2.32). Nitrate was not associated with subclinical thyroid disease in men or with clinical thyroid disease in men or women. Although these data do not provide strong support for an association between nitrate in drinking water and thyroid health, our results do suggest that further exploration of this hypothesis is warranted using studies that incorporate individual measures of both dietary and drinking water nitrate intake.

  19. Modeled nitrate levels in well water supplies and prevalence of abnormal thyroid conditions among the Old Order Amish in Pennsylvania

    Directory of Open Access Journals (Sweden)

    Aschebrook-Kilfoy Briseis

    2012-02-01

    Full Text Available Abstract Background Nitrate is a widespread contaminant of drinking water supplies, especially in agricultural areas. Nitrate intake from drinking water and dietary sources can interfere with the uptake of iodide by the thyroid, thus potentially impacting thyroid function. Methods We assessed the relation of estimated nitrate levels in well water supplies with thyroid health in a cohort of 2,543 Old Order Amish residing in Lancaster, Chester, and Lebanon counties in Pennsylvania for whom thyroid stimulating hormone (TSH levels were measured during 1995-2008. Nitrate measurement data (1976-2006 for 3,613 wells in the study area were obtained from the U.S. Geological Survey and we used these data to estimate concentrations at study participants' residences using a standard linear mixed effects model that included hydrogeological covariates and kriging of the wells' residuals. Nitrate levels estimated by the model ranged from 0.35 mg/L to 16.4 mg/L N-NO3-, with a median value of 6.5 mg/L, which was used as the cutpoint to define high and low nitrate exposure. In a validation analysis of the model, we calculated that the sensitivity of the model was 67% and the specificity was 93%. TSH levels were used to define the following outcomes: clinical hyperthyroidism (n = 10, clinical hypothyroidism (n = 56, subclinical hyperthyroidism (n = 25, and subclinical hypothyroidism (n = 228. Results In women, high nitrate exposure was significantly associated with subclinical hypothyroidism (OR = 1.60; 95% CI: 1.11-2.32. Nitrate was not associated with subclinical thyroid disease in men or with clinical thyroid disease in men or women. Conclusions Although these data do not provide strong support for an association between nitrate in drinking water and thyroid health, our results do suggest that further exploration of this hypothesis is warranted using studies that incorporate individual measures of both dietary and drinking water nitrate intake.

  20. Level of cytogenetic damage and morphological abnormalities in peripheral blood erythrocytes of fish from the Techa river

    Energy Technology Data Exchange (ETDEWEB)

    Tryapitsina, G. [Urals Research Center for Radiation Medicine - URCRM, Chelyabinsk State University (Russian Federation); Shaposhnikova, I. [Urals Research Center for Radiation Medicine - URCRM (Russian Federation); Rudolfsen, G. [Norwegian Radiation Protection Authority - NRPA, and University of Tromsoe (Norway); Obvintseva, N.; Pryakhin, E. [Urals Research Center for Radiation Medicine (Russian Federation); Akleyev, A. [Urals Research Center for Radiation Medicine and Chelyabinsk State University (Russian Federation)

    2014-07-01

    Low-level radioactive waste had been releasing to the Techa River from 1949 to 1956. Now it is a suitable water system to study the potential effect of chronic low level exposure of radiation. During that period over 76 million m{sup 3} of waste water was released into the river with total activity of 1.1 *10{sup 17} Bq. In 2012 we examined the erythrocytes in peripheral blood of fish (roach, perch, pike), inhabiting different part of the Techa River (Russia, Chelyabinsk region). Sampling was conducted twice a year (in May during spawning, and in August during feeding) at three stations with various levels of radioactive contamination: Station RT1 in the upper reach of the Techa River, station RT2 in the middle reach and station RT3 in the lower reach of the river. Determination of radionuclide concentrations in water, bottom sediments and fish was performed. An average above-background content of {sup 90}Sr in the body of fish inhabiting the Techa River is given in the table. Fish from the nearby Miass River was used as a control group. Blood was taken from the tail vein of live fish for the preparation of smears for determination of cytogenetic damage levels. 3,000 erythrocytes were analyzed for each fish on microscope Axioskop 50 (Carl Zeiss). Regression analyses found out significant dependency of the frequency of erythrocytes with micronuclei in blood on the burden of {sup 90}Sr in the body of roach in the summer period (F{sub 1,32}=4.6; p=0.04). The given data do not allow excluding the genotoxic influence of radiation on fish. Another important effect is an increase in the frequency of erythrocytes with cell division pathology: with an increase of the burden of {sup 90}Sr in the body, an increase in the frequency of amitoses and the sum of division pathologies are noted in the body. Regression analyses indicated a significant dependency of these parameters on the burden of {sup 90}Sr in the body of fish (for the frequency of amitoses F{sub 1,199}=6.3, p=0

  1. The effect of non-infectious diseases on serum procalcitonin concentrations in premature neonates%非感染因素对早产新生儿血清降钙素原浓度的影响

    Institute of Scientific and Technical Information of China (English)

    吴志新; 郭婕; 许靖; 武荣; 花少栋; 封志纯

    2015-01-01

    Objective To study the effect of non-infectious factors on serum procalcitonin(PCT) in preterm neonates.MethodThe premature infants of neonatal intensive care unit(NICU) in our hospital were chosen from gestational age ranged from 33 to 36 weeks, birth time less than 12 hours without premature rupture and hospitalization period from January 2012 to December 2012. All of the premature infants were drawn blood immediately admitted to hospital and C-reactive protein (CRP), blood cultures and procalcitonin were tested. The types of premature infants non-infectious diseases included intracranial hemorrhage (ICH), neonatal respiratory distress syndrome (NRDS), neonatal asphyxia and the control group (preterm infants) without disease. The blood routine , C-reactive protein, blood culture, procalcitonin and other infections indicators in each group were monitored dynamicly in order to study the impact of these non-infectious diseases on serum procalcitonin concentrations by statistical analysis.Results ① Compared with the current literature recommended serum procalcitonin concentrations (<0.5ng / ml), procalcitonin concentrations in preterm neonates singniifcantly increase (1.07± 0.76) ng / ml.②Compared with control group (1.07±0.76) ng/ml,the procalcitonin levels in intracranial hemorrhage group (2.12± 0.99) ng/ml, neonatal respiratory distress syndrome group (2.28±1.09) ng/ml and asphyxia group (3.64± 3.17) ng / ml signiifcantly increased (F= 10.462,P <0.05).There were no signiifcant differences (F= 0.173,P= 0.950) among the different levels of intracranial hemorrhage group; Compared with the ifrst grade NRDS , the procalcitonin leves in second grade and third grade NRDS groups were significantly increased (F=5.475,P= 0.010); The procalciton level in severe asphyxia group was signiifcantly higher than in mild asphyxia group (t= 5.245,P= 0.003). Conclusions The procalcitonin concentration physiologically increased after preterm neonates were born. Many factors

  2. Role of Procalcitonin in Differentiating between Infectious and Noninfectious Fevers among Patients with Lymphoma.

    Science.gov (United States)

    Wang, Xiao Jun; Tan, Thuan Tong; Lim, Soon Thye; Farid, Mohamad; Tao, Miriam; Quek, Richard; Chan, Alexandre; Tang, Tiffany

    2017-08-01

    The primary objective of this study is to prospectively evaluate the role of procalcitonin (PCT) in distinguishing infectious fever from noninfectious fever (NIF) among febrile lymphoma patients. The secondary objective is to evaluate the usefulness of PCT in distinguishing among bloodstream infections (BSI), local infections and unidentified infections (LIUI), and NIF. Patients with lymphoma and fever were prospectively recruited between August 2014 and November 2015. PCT was measured within 24 hours of fever onset (PCT1) and 24-72 hours thereafter (PCT2). The higher PCT value between PCT1 and PCT2 was also documented (PCTmax ). PCT levels (PCT1, PCT2, and PCTmax ) were compared for BSI, LIUI, and NIF. In addition, the difference between PCT1 and PCT2 was evaluated in patients with complete data on both PCT1 and PCT2. Of 108 eligible patients, 12 were diagnosed with BSI, 83 with LIUI, and 13 with NIF. PCTmax was statistically different between the infectious fever (BSI and LIUI combined) and NIF groups (median PCTmax : 0.44 ng/ml vs 0.19 ng/ml; p=0.026). PCT1 was not statistically different for patients with BSI, LIUI, and NIF (p=0.217). However, PCT2 and PCTmax were significantly higher in patients with BSI compared to those with NIF (p=0.026 and 0.002, respectively). Meanwhile, patients with BSI have significantly higher PCTmax values than those with LIUI (p=0.034). Among 90 cases with complete data on both PCT1 and PCT2, PCT2 was significantly higher than PCT1 in patients with BSI (median PCT: 0.98 ng/ml vs 0.47 ng/ml; p=0.045) and patients with LIUI (median PCT: 0.43 ng/ml vs 0.24 ng/ml; p=0.004), while not significant in patients with NIF (p=0.374). Two separate PCT measurements can differentiate between infectious fever and NIF and predict for BSI in lymphoma patients with fever. © 2017 Pharmacotherapy Publications, Inc.

  3. Abnormal levels of UV-induced unscheduled DNA synthesis in ataxia telangiectasia cells after exposure to ionizing radiation

    Energy Technology Data Exchange (ETDEWEB)

    Jaspers, N.G.J. (Erasmus Universiteit, Rotterdam (Netherlands). Dept. of Cell Biology and Genetics; Nederlandse Centrale Organisatie voor Toegepast Natuurwetenschappelijk Onderzoek, Rijswijk. Medical Biological Lab.); Bootsma, D. (Erasmus Universiteit, Rotterdam (Netherlands). Dept. of Cell Biology and Genetics)

    1982-01-01

    In cultured cells from normal individuals and from patients having ataxia telangiectasia (AT) the rate of unscheduled DNA synthesis (UDS) induced by UV light was investigated by autoradiography. The number of grains in 6 different AT cell strains was similar to that observed in normal cells. Exposure of normal cells to doses of X-rays up to 20 krad had no influence on the rate of UV-induced UDS. In contrast, the UV-induced UDS was significantly modified in AT cells by treatment with X-rays. In AT cell strains that were reported to have reduced levels of ..gamma..-ray-induced repair DNA synthesis ('excision-deficient' AT cells) the effect of X-rays on UV-induced UDS was inhibitory, whereas UV-induced UDS was stimulated by X-ray exposure in 'excision-proficient' AT cell strains. Different UV and X-ray dose-response relationships were seen in the two categories of AT cell strains.

  4. Long-term exposure to abnormal glucose levels alters drug metabolism pathways and insulin sensitivity in primary human hepatocytes

    Science.gov (United States)

    Davidson, Matthew D.; Ballinger, Kimberly R.; Khetani, Salman R.

    2016-06-01

    Hyperglycemia in type 2 diabetes mellitus has been linked to non-alcoholic fatty liver disease, which can progress to inflammation, fibrosis/cirrhosis, and hepatocellular carcinoma. Understanding how chronic hyperglycemia affects primary human hepatocytes (PHHs) can facilitate the development of therapeutics for these diseases. Conversely, elucidating the effects of hypoglycemia on PHHs may provide insights into how the liver adapts to fasting, adverse diabetes drug reactions, and cancer. In contrast to declining PHH monocultures, micropatterned co-cultures (MPCCs) of PHHs and 3T3-J2 murine embryonic fibroblasts maintain insulin-sensitive glucose metabolism for several weeks. Here, we exposed MPCCs to hypo-, normo- and hyperglycemic culture media for ~3 weeks. While albumin and urea secretion were not affected by glucose level, hypoglycemic MPCCs upregulated CYP3A4 enzyme activity as compared to other glycemic states. In contrast, hyperglycemic MPCCs displayed significant hepatic lipid accumulation in the presence of insulin, while also showing decreased sensitivity to insulin-mediated inhibition of glucose output relative to a normoglycemic control. In conclusion, we show for the first time that PHHs exposed to hypo- and hyperglycemia can remain highly functional, but display increased CYP3A4 activity and selective insulin resistance, respectively. In the future, MPCCs under glycemic states can aid in novel drug discovery and mechanistic investigations.

  5. 乌司他丁联合阿拓莫兰治疗感染性休克患者血清白细胞介素6、肿瘤坏死因子α及降钙素原水平的变化及预后观察%Changes levels of serum interleukin 6, tumor necrosis factor αand procalcitonin and prognosis of pa-tients with septic shock with the treatment of combination of ulinastatin and Atomolan

    Institute of Scientific and Technical Information of China (English)

    方向明; 潘嘉宇; 易高

    2016-01-01

    Objective To investigate the changes levels of serum interleukin 6(IL⁃6),tumor necrosis factor α( TNF⁃α) and procalcitonin( PCT) and prognosis of patients with septic shock with the treatmentof uli⁃nastatin and Atomolan. Methods Sixty cases patients with septic shock in Fifth Hospital Affiliated to Guang⁃zhou Medical University from May 2015 to April 2016 were selected,and divided into ulinastatin group,Atomolan group and combined group according to the table of random numbers,each group with 20 cases. Hospital stay in ICU,mechanical ventilation time,APACHEⅡ score after treatment,the level of IL⁃6,TNF⁃α,PCT,malondialde⁃hyde(MDA),superoxide dismutase(SOD) before and after treatment,and prognosis of patients of three groups were compared. Results Hospital stay in ICU,mechanical ventilation time,APACHEⅡ score after treatment of combined group were significantly lower than ulinastatin group and Atomolan group,the differences were statisti⁃cally significant( P0. 05). After treatment,the level of IL⁃6, TNF⁃α,PCT and MDA of the combined group were significantly lower than that of ulinastatin group and Atomo⁃lan group,while SOD was significantly higher than the other two groups,the differences were statistically signifi⁃ cant( P<0. 05 ) . The MODS incidence, mortality rates of ulinastatin group were 30. 00%( 6/20 ) , 20. 00%(4/20),of Atomolan group were 35. 00%(7/20),15. 00%(3/20),of combined group were 5. 00%(1/20), 5. 00%( 1/20) . The MODS incidence,mortality rates of combined group were lower than the other two groups( P<0. 05).Conclusion Ulinastatin combined with Atomolan in treatment of septic shock with remarkable results, can significantly improve the serum IL⁃6,TNF⁃α,PCT and other important factors,optimize the prognosis,it is worthy of promotion.%目的:探讨乌司他丁联合阿拓莫兰治疗感染性休克患者血清IL⁃6、肿瘤坏死因子α( TNF⁃α)及降钙素原( PCT)水平的

  6. Procalcitonin and C-reactive protein-based decision tree model for distinguishing PFAPA flares from acute infections.

    Science.gov (United States)

    Kraszewska-Głomba, Barbara; Szymańska-Toczek, Zofia; Szenborn, Leszek

    2016-03-10

    As no specific laboratory test has been identified, PFAPA (periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis) remains a diagnosis of exclusion. We searched for a practical use of procalcitonin (PCT) and C-reactive protein (CRP) in distinguishing PFAPA attacks from acute bacterial and viral infections. Levels of PCT and CRP were measured in 38 patients with PFAPA and 81 children diagnosed with an acute bacterial (n=42) or viral (n=39) infection. Statistical analysis with the use of the C4.5 algorithm resulted in the following decision tree: viral infection if CRP≤19.1 mg/L; otherwise for cases with CRP>19.1 mg/L: bacterial infection if PCT>0.65ng/mL, PFAPA if PCT≤0.65 ng/mL. The model was tested using a 10-fold cross validation and in an independent test cohort (n=30), the rule's overall accuracy was 76.4% and 90% respectively. Although limited by a small sample size, the obtained decision tree might present a potential diagnostic tool for distinguishing PFAPA flares from acute infections when interpreted cautiously and with reference to the clinical context.

  7. Procalcitonin and C-reactive protein-based decision tree model for distinguishing PFAPA flares from acute infections

    Directory of Open Access Journals (Sweden)

    Barbara Kraszewska-Głomba

    2016-03-01

    Full Text Available As no specific laboratory test has been identified, PFAPA (periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis remains a diagnosis of exclusion. We searched for a practical use of procalcitonin (PCT and C-reactive protein (CRP in distinguishing PFAPA attacks from acute bacterial and viral infections. Levels of PCT and CRP were measured in 38 patients with PFAPA and 81 children diagnosed with an acute bacterial (n=42 or viral (n=39 infection. Statistical analysis with the use of the C4.5 algorithm resulted in the following decision tree: viral infection if CRP≤19.1 mg/L; otherwise for cases with CRP>19.1 mg/L: bacterial infection if PCT>0.65ng/mL, PFAPA if PCT≤0.65 ng/mL. The model was tested using a 10-fold cross validation and in an independent test cohort (n=30, the rule’s overall accuracy was 76.4% and 90% respectively. Although limited by a small sample size, the obtained decision tree might present a potential diagnostic tool for distinguishing PFAPA flares from acute infections when interpreted cautiously and with reference to the clinical context.

  8. The Comparison of Procalcitonin Guidance Administer Antibiotics with Empiric Antibiotic Therapy in Critically Ill Patients Admitted in Intensive Care Unit

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    Atabak Najafi

    2015-10-01

    Full Text Available The empiric antibiotic therapy can result in antibiotic overuse, development of bacterial resistance and increasing costs in critically ill patients. The aim of the present study was to evaluate the effect of procalcitonin (PCT guide treatment on antibiotic use and clinical outcomes of patients admitted to intensive care unit (ICU with systemic inflammatory response syndrome (SIRS.  A total of 60 patients were enrolled in this study and randomly divided into two groups, cases that underwent antibiotic treatment based on serum level of PCT as PCT group (n=30 and patients who undergoing antibiotic empiric therapy as control group (n=30. Our primary endpoint was the use of antibiotic treatment. Additional endpoints were changed in clinical status and early mortality. Antibiotics use was lower in PCT group compared to control group (P=0.03. Current data showed that difference in SOFA score from the first day to the second day after admitting patients in ICU did not significantly differ (P=0.88. Patients in PCT group had a significantly shorter median ICU stay, four days versus six days (P=0.01. However, hospital stay was not statistically significant different between two groups, 20 days versus 22 days (P=0.23.  Early mortality was similar between two groups. PCT guidance administers antibiotics reduce antibiotics exposure and length of ICU stay, and we found no differences in clinical outcomes and early mortality rates between the two studied groups.

  9. Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections.

    Science.gov (United States)

    Schuetz, Philipp; Müller, Beat; Christ-Crain, Mirjam; Stolz, Daiana; Tamm, Michael; Bouadma, Lila; Luyt, Charles E; Wolff, Michel; Chastre, Jean; Tubach, Florence; Kristoffersen, Kristina B; Burkhardt, Olaf; Welte, Tobias; Schroeder, Stefan; Nobre, Vandack; Wei, Long; Bhatnagar, Neera; Bucher, Heiner C; Briel, Matthias

    2013-07-01

    Acute respiratory infections (ARIs) comprise a large and heterogeneous group of infections including bacterial, viral and other aetiologies. In recent years, procalcitonin - the prohormone of calcitonin - has emerged as a promising marker for the diagnosis of bacterial infections and for improving decisions about antibiotic therapy. Several randomised controlled trials (RCTs) have demonstrated the feasibility of using procalcitonin for starting and stopping antibiotics in different patient populations with acute respiratory infections and different settings ranging from primary care to emergency departments (EDs), hospital wards and intensive care units (ICUs). The aim of this systematic review based on individual patient data was to assess the safety and efficacy of using procalcitonin for starting or stopping antibiotics over a large range of patients with varying severity of ARIs and from different clinical settings. We searched the Cochrane Central Register of Controlled Trials (CENTRAL 2011, Issue 2) which contains the Acute Respiratory Infections Group's Specialised Register, MEDLINE (1966 to May 2011) and EMBASE (1974 to May 2011) to identify suitable trials. We included RCTs of adult participants with ARIs who received an antibiotic treatment either based on a procalcitonin algorithm or usual care/guidelines. Trials were excluded if they exclusively focused on paediatric patients or if they used procalcitonin for another purpose than to guide initiation and duration of antibiotic treatment. Two teams of review authors independently evaluated the methodology and extracted data from primary studies. The primary endpoints were all-cause mortality and treatment failure at 30 days. For the primary care setting, treatment failure was defined as death, hospitalisation, ARI-specific complications, recurrent or worsening infection, and patients reporting any symptoms of an ongoing respiratory infection at follow-up. For the ED setting, treatment failure was defined

  10. Prediction of high-grade vesicoureteral reflux after pediatric urinary tract infection: external validation study of procalcitonin-based decision rule.

    Directory of Open Access Journals (Sweden)

    Sandrine Leroy

    Full Text Available BACKGROUND: Predicting vesico-ureteral reflux (VUR ≥3 at the time of the first urinary tract infection (UTI would make it possible to restrict cystography to high-risk children. We previously derived the following clinical decision rule for that purpose: cystography should be performed in cases with ureteral dilation and a serum procalcitonin level ≥0.17 ng/mL, or without ureteral dilatation when the serum procalcitonin level ≥0.63 ng/mL. The rule yielded a 86% sensitivity with a 46% specificity. We aimed to test its reproducibility. STUDY DESIGN: A secondary analysis of prospective series of children with a first UTI. The rule was applied, and predictive ability was calculated. RESULTS: The study included 413 patients (157 boys, VUR ≥3 in 11% from eight centers in five countries. The rule offered a 46% specificity (95% CI, 41-52, not different from the one in the derivation study. However, the sensitivity significantly decreased to 64% (95%CI, 50-76, leading to a difference of 20% (95%CI, 17-36. In all, 16 (34% patients among the 47 with VUR ≥3 were misdiagnosed by the rule. This lack of reproducibility might result primarily from a difference between derivation and validation populations regarding inflammatory parameters (CRP, PCT; the validation set samples may have been collected earlier than for the derivation one. CONCLUSIONS: The rule built to predict VUR ≥3 had a stable specificity (ie. 46%, but a decreased sensitivity (ie. 64% because of the time variability of PCT measurement. Some refinement may be warranted.

  11. ABNORMAL INFLORESCENCE MERISTEM1 Functions in Salicylic Acid Biosynthesis to Maintain Proper Reactive Oxygen Species Levels for Root Meristem Activity in Rice.

    Science.gov (United States)

    Xu, Lei; Zhao, Hongyu; Ruan, Wenyuan; Deng, Minjuan; Wang, Fang; Peng, Jinrong; Luo, Jie; Chen, Zhixiang; Yi, Keke

    2017-03-01

    Root meristem activity determines root growth and root architecture and consequently affects water and nutrient uptake in plants. However, our knowledge about the regulation of root meristem activity in crop plants is very limited. Here, we report the isolation and characterization of a short root mutant in rice (Oryza sativa) with reduced root meristem activity. This root growth defect is caused by a mutation in ABNORMAL INFLORESCENCE MERISTEM1 (AIM1), which encodes a 3-hydroxyacyl-CoA dehydrogenase, an enzyme involved in β-oxidation. The reduced root meristem activity of aim1 results from reduced salicylic acid (SA) levels and can be rescued by SA application. Furthermore, reduced SA levels are associated with reduced levels of reactive oxygen species (ROS) in aim1, likely due to increased expression of redox and ROS-scavenging-related genes, whose increased expression is (at least in part) caused by reduced expression of the SA-inducible transcriptional repressors WRKY62 and WRKY76. Like SA, ROS application substantially increased root length and root meristem activity in aim1 These results suggest that AIM1 is required for root growth in rice due to its critical role in SA biosynthesis: SA maintains root meristem activity through promoting ROS accumulation by inducing the activity of WRKY transcriptional repressors, which repress the expression of redox and ROS-scavenging genes. © 2017 American Society of Plant Biologists. All rights reserved.

  12. [Analytical interference in determination of procalcitonin by PCT-Q (Brahms)].

    Science.gov (United States)

    Désidéri-Vaillant, C; Rouby, Y; Cardon, N; Vinsonneau, U; Laborde, J-P

    2006-05-01

    Procalcitonin (PCT) is a biological marker of infection. We present the cas of a patient who has presented a high concentration of PCT with PCT-Q test (Brahms). At the same time, the concentration of CRP is remained low, which is no physiological. Then, PCT concentration has been determinated with an automatic system (Kryptor-Brahms) and finded at low than 0.5 microg/l. Brahms company has searched an analytical interference: human anti-mouse antibodies (HAMA) were positive. If PCT concentration stay a marker of infection for the most part, this case show that biologists have to keep in mind that immunological assays remain submitted to interferences.

  13. Procalcitonin in early rule-in/rule-out of sepsis in SIRS patients admitted to a medical ward.

    Science.gov (United States)

    Fiotti, Nicola; Mearelli, Filippo; Ruscio, Maurizio; Altamura, Nicola; Vinci, Pierandrea; Fernandes, Giovanni; De Nardo, Margherita; Lombardi, Jacopo; Mamolo, Lorenza; Chendi, Enrico; Breglia, Andrea; Peretti, Alberto; Peric, Daniele; Orso, Daniele; Pivetti, Giulia; Biolo, Gianni

    2014-10-01

    A relevant amount of patients with clinical suspect of sepsis is admitted and treated in medical wards (MW). These patients have a better prognosis but are older and with more comorbidities compared to those admitted to intensive care units (ICU). Procalcitonin (PCT) is extensively used in emergency departments for the diagnosis of sepsis, but its accuracy in the setting of a MW has not been thoroughly investigated. Predicted low PCT levels also call for the comparison of immunomagnetic-chemiluminescent (L-PCT) and time-resolved amplified cryptate emission (TRACE, K-PCT) technologies, in PCT determination. In 80 patients with systemic inflammatory response syndrome (SIRS) diagnostic criteria and suspect of sepsis newly admitted to a MW, PCT was determined with L- and K-PCT method. Sixty patients were diagnosed as sepsis (20 microbiologically and 40 clinically proven) and 20 with non-infective SIRS. The sepsis group had significantly higher levels of both PCTs, with no differences between the clinically and microbiologically proven subgroups. The areas under ROC curves for L- and K-PCT were 0.72 and 0.78 (p<0.001 for each), respectively. Based on MW customized cut-off values of 0.150 (L-PCT) and 0.143 ng/mL (K-PCT), overall accuracies were 66.8 (95% CI 58.7-78.9) and 78.2% (69.8-87.2), respectively, compared to the 55% (44.2-66) of 0.5 ng/mL canonical cut-off. Neither PCT-L nor -K held prognostic value on survival. In MW patients, customized PCT cut-off levels provide better accuracy than customary levels adopted from ICU, and TRACE technology seems to offer a wider analysis range.

  14. White matter abnormalities at a regional and voxel level in focal and generalized epilepsy : A systematic review and meta-analysis

    NARCIS (Netherlands)

    Slinger, Geertruida; Sinke, Michel R T; Braun, Kees P J|info:eu-repo/dai/nl/207237239; Otte, Willem M.|info:eu-repo/dai/nl/168455706

    2016-01-01

    Objective Since the introduction of diffusion tensor imaging, white matter abnormalities in epilepsy have been studied extensively. However, the affected areas reported, the extent of abnormalities and the association with relevant clinical parameters are highly variable. We aimed to obtain a more

  15. Procalcitonin, interleukin 6 and systemic inflammatory response syndrome (SIRS): early markers of postoperative sepsis after major surgery.

    Science.gov (United States)

    Mokart, D; Merlin, M; Sannini, A; Brun, J P; Delpero, J R; Houvenaeghel, G; Moutardier, V; Blache, J L

    2005-06-01

    Patients who undergo major surgery for cancer are at high risk of postoperative sepsis. Early markers of septic complications would be useful for diagnosis and therapeutic management in patients with postoperative sepsis. The aim of this study was to investigate the association between early (first postoperative day) changes in interleukin 6 (IL-6), procalcitonin (PCT) and C-reactive protein (CRP) serum concentrations and the occurrence of subsequent septic complications after major surgery. Serial blood samples were collected from 50 consecutive patients for determination of IL-6, PCT and CRP serum levels. Blood samples were obtained on the morning of surgery and on the morning of the first postoperative day. Sixteen patients developed septic complications during the first five postoperative days (group 1), and 34 patients developed no septic complications (group 2). On day 1, PCT and IL-6 levels were significantly higher in group 1 (P-values of 0.003 and 0.006, respectively) but CRP levels were similar. An IL-6 cut-off point set at 310 pg ml(-1) yielded a sensitivity of 90% and a specificity of 58% to differentiate group 1 patients from group 2 patients. When associated with the occurrence of SIRS on day 1 these values reached 100% and 79%, respectively. A PCT cut-off point set at 1.1 ng ml(-1) yielded a sensitivity of 81% and a specificity of 72%. When associated with the occurrence of SIRS on day 1, these values reached 100% and 86%, respectively. PCT and IL-6 appear to be early markers of subsequent postoperative sepsis in patients undergoing major surgery for cancer. These findings could allow identification of postoperative septic complications.

  16. Effect of the level of cholecalciferol supplementation of broiler breeder hen diets on the performance and bone abnormalities of the progeny fed diets containing various levels of calcium or 25-hydroxycholecalciferol.

    Science.gov (United States)

    Atencio, A; Edwards, H M; Pesti, G M

    2005-10-01

    Four experiments were conducted using Ross x Ross chicks hatched from broiler breeder hens fed various levels of cholecalciferol (vitamin D3; 0 to 4,000 IU/kg of diet) to determine the effect of the maternal diet on the performance and leg abnormalities of the progeny. Chicks hatched from eggs laid by the hens at different ages were used in experiments 1 to 4. The studies were conducted in an ultraviolet light-free environment as split plot designs, with Ca levels or 25-hydroxycholecalciferol (25-OHD3) in the chicks' diet as the whole plot, and vitamin D3 in the maternal diet as a subplot. Chicks in experiments 1 and 2 were fed 2 levels of Ca (0.63% or 0.90%) and chicks in experiments 3 and 4 were fed 6 levels of 25-OHD3 (0 to 40 microg/kg of diet). Significant increases in body weight gain (BWG) of the progeny were observed in experiments 1, 2, and 4 as the vitamin D3 level in the maternal diet increased. Chicks hatched from eggs laid by hens fed the highest levels of D3 had the highest tibia ash. Significant reductions in Ca rickets incidence (experiments 1 and 2) and tibial dyschondroplasia (TD) incidence (experiment 1) were observed as the level of vitamin D3 in the maternal diet increased. Chicks fed lower levels of Ca had lower BWG and tibia ash and higher incidences of TD and Ca rickets than chicks fed higher levels of Ca. Increasing the level of 25-OHD3 in the chicks' diet significantly improved BWG, tibia ash, and plasma Ca and reduced TD and Ca rickets incidence. An overall evaluation of the study indicates that chicks from hens fed the highest levels of vitamin D3 and fed high levels of Ca or 25-OHD3 had the highest BWG, tibia ash, and plasma Ca, and the lowest incidences of TD and Ca rickets.

  17. Point-of-care procalcitonin test to reduce antibiotic exposure in patients hospitalized with acute exacerbation of COPD

    DEFF Research Database (Denmark)

    Corti, Caspar; Fally, Markus; Fabricius-Bjerre, Andreas

    2016-01-01

    BACKGROUND: This study was conducted to investigate whether point-of-care (POC) procalcitonin (PCT) measurement can reduce redundant antibiotic treatment in patients hospitalized with acute exacerbation of COPD (AECOPD). METHODS: One-hundred and twenty adult patients admitted with AECOPD were enr...

  18. Relationship of apelin, procalcitonin, and fetuin-A concentrations with carotid intima-media thickness in acromegaly.

    Science.gov (United States)

    Topsakal, S; Akin, F; Turgut, S; Yaylali, G F; Herek, D; Ayada, C

    2015-07-01

    Acromegaly is characterized by excess growth hormone and insulin-like growth factor-1 concentrations. There is conflicting evidence as to whether acromegaly is associated with an increased risk of atherosclerosis. Apelin is an adipose tissue-derived peptide that may be associated with hyperinsulinemia. Fetuin-A is a hepatocyte produced plasma glycoprotein that has an important role as a calcification inhibitor. The aim of this study was to examine apelin, fetuin-A, and procalcitonin concentrations and to assess their relationship with carotid intima medial thickness (cIMT) in subjects with acromegaly. Apelin, fetuin-A, and procalcitonin serum concentrations were measured in 37 (20 inactive and 17 active) subjects with acromegaly and 30 control subjects, along with carotid intima medial thickness. The concentrations of apelin, fetuin-A, and procalcitonin were increased in subjects with acromegaly. There were significant correlations between apelin, fetuin-A, and procalcitonin in subjects with acromegaly. Carotid intima medial thickness values were similar between control subjects and subjects with acromegaly. Carotid intima medial thickness was not increased in subjects with acromegaly. It is possible that the increased apelin and fetuin-A concentrations observed play a protective role against the development of atherosclerosis in subjects with acromegaly. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  19. The clinical application of procalcitonin, leukocyte count and C-reactive protein in elderly patients with infection

    Institute of Scientific and Technical Information of China (English)

    吴培

    2012-01-01

    Objective To analyze and compare the clinical application values of procalcitonin(PCT) ,leukocyte count (WBC) and C-reactive protein(CRP) in elder patients with infection. Methods In patients(age≥65 yrs,axillary temperature>38.0℃) with infection or suspected infection

  20. Changes in Circulating Procalcitonin Versus C-Reactive Protein in Predicting Evolution of Infectious Disease in Febrile, Critically Ill Patients

    NARCIS (Netherlands)

    S.H. Hoeboer (Sandra); A.B.J. Groeneveld (Johan)

    2013-01-01

    textabstractObjective:Although absolute values for C-reactive protein (CRP) and procalcitonin (PCT) are well known to predict sepsis in the critically ill, it remains unclear how changes in CRP and PCT compare in predicting evolution of: infectious disease, invasiveness and severity (e.g. developmen

  1. Relationship between long-term exposure to low-level arsenic in drinking water and the prevalence of abnormal blood pressure.

    Science.gov (United States)

    Zhang, Chuanwu; Mao, Guangyun; He, Suxia; Yang, Zuopeng; Yang, Wei; Zhang, Xiaojing; Qiu, Wenting; Ta, Na; Cao, Li; Yang, Hui; Guo, Xiaojuan

    2013-11-15

    Arsenic increases the risk and incidence of cardiovascular disease. To explore the impact of long-term exposure to low-level arsenic in drinking water on blood pressure including pulse pressure (PP) and mean arterial blood pressure (MAP), a cross-sectional study was conducted in 2010 in which the blood pressure of 405 villagers was measured, who had been drinking water with an inorganic arsenic content 63-3.35) increase in the group with >30-50 years of arsenic exposure and a 2.95-fold (95%CI: 1.31-6.67) increase in the group with >50 years exposure. Furthermore, the odds ratio for prevalence of abnormal PP and MAP were 1.06 (95%CI: 0.24-4.66) and 0.87 (95%CI: 0.36-2.14) in the group with >30-50 years of exposure, and were 2.46 (95%CI: 0.87-6.97) and 3.75 (95%CI: 1.61-8.71) for the group with >50 years exposure, compared to the group with arsenic exposure ≤ 30 years respectively. Significant trends for Hypertension (parsenic exposure population, and significantly increases with the duration of arsenic exposure.

  2. Clinical and Cost-Effectiveness of Procalcitonin Test for Prodromal Meningococcal Disease-A Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Jennifer M Bell

    Full Text Available Despite vaccines and improved medical intensive care, clinicians must continue to be vigilant of possible Meningococcal Disease in children. The objective was to establish if the procalcitonin test was a cost-effective adjunct for prodromal Meningococcal Disease in children presenting at emergency department with fever without source.Data to evaluate procalcitonin, C-reactive protein and white cell count tests as indicators of Meningococcal Disease were collected from six independent studies identified through a systematic literature search, applying PRISMA guidelines. The data included 881 children with fever without source in developed countries.The optimal cut-off value for the procalcitonin, C-reactive protein and white cell count tests, each as an indicator of Meningococcal Disease, was determined. Summary Receiver Operator Curve analysis determined the overall diagnostic performance of each test with 95% confidence intervals. A decision analytic model was designed to reflect realistic clinical pathways for a child presenting with fever without source by comparing two diagnostic strategies: standard testing using combined C-reactive protein and white cell count tests compared to standard testing plus procalcitonin test. The costs of each of the four diagnosis groups (true positive, false negative, true negative and false positive were assessed from a National Health Service payer perspective. The procalcitonin test was more accurate (sensitivity=0.89, 95%CI=0.76-0.96; specificity=0.74, 95%CI=0.4-0.92 for early Meningococcal Disease compared to standard testing alone (sensitivity=0.47, 95%CI=0.32-0.62; specificity=0.8, 95% CI=0.64-0.9. Decision analytic model outcomes indicated that the incremental cost effectiveness ratio for the base case was £-8,137.25 (US $ -13,371.94 per correctly treated patient.Procalcitonin plus standard recommended tests, improved the discriminatory ability for fatal Meningococcal Disease and was more cost

  3. Elevation of procalcitonin after implantation of an interventional lung assist device in critically ill patients.

    Science.gov (United States)

    Kott, Matthias; Bewig, Burkhard; Zick, Günther; Schaedler, Dirk; Becher, Tobias; Frerichs, Inéz; Weiler, Norbert

    2014-01-01

    A pumpless interventional arteriovenous lung assist device (iLA) facilitates the removal of carbon dioxide from the blood and is used as part of the lung-protective ventilation strategy in patients with acute respiratory distress syndrome (ARDS). In case of bacterial infection, delayed antimicrobial therapy increases the mortality in this group of high-risk critically ill patients, whereas overtreatment promotes bacterial resistance and leads to increased drug toxicity and costs. Besides clinical signs and symptoms, antimicrobial treatment is based on the kinetics of biomarkers such as procalcitonin (PCT). We hereby report an up to 10-fold increase in PCT serum concentrations in four mechanically ventilated patients with ARDS detected within 12-20 hours after iLA implantation in the absence of any infection. Procalcitonin concentrations returned to nearly baseline values in all patients on the fourth day after iLA implantation. We discuss the possible mechanisms of PCT induction in this specific patient population and recommend the onset of antibiotics administration after iLA implantation to be carefully considered in the context of other clinical findings and not solely based on the PCT kinetics. Repeated PCT measurements in short time intervals should be performed in these patients.

  4. Lipopolysaccharide Binding Protein, Soluble-Intercellular Adhesion Molecule-1, Procalcitonin, and Protein C Activity and Clinical Outcome in Systemic Inflammatory Response Syndrome (SIRS or Sepsis Patients

    Directory of Open Access Journals (Sweden)

    Dewi Muliaty

    2009-04-01

    Full Text Available BACKGROUND: Biochemical markers may be used in diagnosis, prognostic and monitoring treatment and therapy for sepsis patients. In this study we used Lipopolysacharide Binding Protein (LBP, serum-Intercellular Adhesion Molecule-1 (ICAM-1, Procalcitonin (PCT and protein C activity. LBP is related to lipopolysachharide or gram-negative bacterial endotoxin which bound to LBP and induced inflammatory response. ICAM-1 is associated with endothelial dysfunction in response to systemic inflammatory and septic condition. PCT increased in bacterial infection and in severe systemic inflammatory. Role of Protein C is protecting the intravascular system to systemic inflammation, sepsis and the concomitant intravascular coagulopathy. The aim of this study was to examine the associations between levels of serum LBP, sICAM-1, PCT, and protein C activity with the clinical outcome of SIRS or sepsis patients. METHODS: We included 19 post surgery patients with SIRS criteria from intensive care unit (ICU and evaluated the level of LBP serum with Chemiliuminescent Enzyme Immunoassay (Diagnostic Product Co., ICAM-1 with ELISA (R&D System, PCT with immunochromatography (BRAHMS, protein C activity with chromogenic method (Dade Behring. We performed the samples serially at the first admission of patients and after 72 hours. Data were analysed by non-parametric with Wilcoxon test and Mann-Whitney test. Correlation study between biomarkers calculated by Kendall’s tau and Spearman’s rho. RESULTS: Of 19 patients, 9 (47,4% died and 10 (52,6% surviving. The level of LBP serum decreased after 72 hours in surviving-sepsis patients, and increased in nonsurviving sepsis patients with significant different levels at 72 hours examination (p0.05. In all patients were found high level of PCT serum since the first admission examination, decreasing levels were occurred significantly in surviving patients after 72 hours (p0.05 both in surviving and non-surviving patients. CONCLUSIONS

  5. Occult abnormal pregnancies after first post-embryo transfer serum beta-human chorionic gonadotropin levels of 1.0-5.0 mIU/mL.

    Science.gov (United States)

    Maslow, Bat-Sheva L; Bartolucci, Alison; Sueldo, Carolina; Engmann, Lawrence; Benadiva, Claudio; Nulsen, John C

    2016-04-01

    To assess the occult pregnancy rate after "negative" first post-embryo transfer (ET) serum β-hCG results. Two-part retrospective cohort study and nested case series. University-based fertility center. A total of 1,571 negative first post-ET serum β-hCG results were included in the study; 1,326 results (primary cohort, June 2009-December 2013) were initially reported as <5 mIU/mL and 245 results (secondary cohort, January 2014-March 2015) were reported as discrete values from 1.0 to 5.0 mIU/mL. None. Rates of occult pregnancy, ectopic pregnancy, and complications after negative first post-ET serum β-hCG results. A total of 88.8% (1,178/1,326) of the negative first post-ET results reported as <5 were actually <1.0 mIU/mL. Occult pregnancy was incidentally identified in 1.2% (12/1,041) of subjects with follow-up. Six had ectopic pregnancies, and seven experienced serious complications; 11 (91.7%) of the 12 occult pregnancies had a first post-ET serum β-hCG level of 1.0-5.0 mIU/mL and 1 (8.3%) <1.0 mIU/mL. All pregnancies with serious complications had initial β-hCG levels of 1.0-5.0 mIU/mL. Of the 245 results reported as discreet values, occult pregnancies were diagnosed in 5.5% (9/163) of subjects with follow-up. One had an ectopic pregnancy, which was treated with methotrexate. There were no serious complications in the secondary cohort. The majority of negative first post-ET serum β-hCG levels are <1.0 mIU/mL. Results from 1.0 to 5.0 mIU/mL may fail to exclude abnormal pregnancy and are associated with poor outcomes compared with β-hCG levels <1.0 mIU/mL. Serial serum β-hCG may be warranted in this population. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  6. Procalcitonin and quantitative C-reactive protein role in the early diagnosis of sepsis in patients with febrile neutropenia

    Directory of Open Access Journals (Sweden)

    Mohsen Meidani

    2013-01-01

    Full Text Available Background: Neutropenia with fever is a common syndrome in patients with hematologic malignancies who have a high risk of infectious diseases. As early diagnosis of infection in such patients is really important, the aim of this study was to investigate the sensitivity and specificity of procalcitonin (PCT and C-reactive protein (CRP in the diagnosis of sepsis in febrile neutropenic patients in a referral malignant care center of Isfahan in 2010-2011. Materials and Methods: In this analytical cross-sectional study, all the febrile neutropenic patients who were admitted in the referral malignant care center in 2010-2011 were evaluated. The data from every individual, including sex, age, admission time, and duration of fever before taking antibiotics were collected. Sixty-four subjects were involved in the study. Blood samples of the subjects were obtained and the levels of PCT, CRP, Absolute neutrophil count (ANC, and white blood cell count were measured, and blood cultures were obtained. According to the test results, the 64 subjects were divided into two groups including patients with sepsis and without sepsis. Results: Mean value of PCT in the sepsis group was 28.65 ± 2.68 and in the non-sepsis group was 2.48 ± 0.66, with a P value of 0.000. In case of CRP, the sepsis group had a mean of 159.48 ± 9.73 and the non-sepsis group had a mean of 126.17 ± 10.63 (P = 0.015. Sensitivity and specificity were analyzed by using receiver operating characteristic (ROC curve and were found to be 92.5% and 97.3%, respectively, for PCT and 70.5% and 42.1%, respectively, for CRP. Conclusion: PCT can be considered as a predictive factor and a diagnostic marker for the diagnosis of sepsis in febrile neutropenic patients.

  7. 降钙素原对左心室射血分数正常心力衰竭患者病情预后判断价值%The prognosis evaluation of serum procalcitonin levels in heart failure patients with preserved ejection fraction

    Institute of Scientific and Technical Information of China (English)

    王浩; 李霞; 林良毅; 王萍; 林少华

    2015-01-01

    目的::探讨左心室射血分数正常心力衰竭(HFPEF)患者外周血清降钙素原(PCT)水平动态变化及其对预后的预测价值。方法:选择 HFPEF 患者125例,入院1、2、3、5 d 抽取肘静脉血检测 PCT 指标,并记录当日急性生理学与慢性健康状况评分系统Ⅱ(APACHE Ⅱ)、序贯器官衰竭评分( SOFA)。根据14 d 生存情况分为存活组和病死组,比较2组 PCT 水平及APACHE Ⅱ评分、SOFA 评分,并分析各指标之间的相关性。结果:病死组入院1、2 d 外周血 PCT 水平与存活组差异均无统计学意义(P >0.05),但入院3 d 和5 d PCT 水平与 APACHE Ⅱ、SOFA 评分均呈显著正相关关系(P 0. 05),but the positive statistical correlation was found between serum PCT levels and APACHE Ⅱ score,SOFA score in non-survivor group(P <0. 01). Receiver operator characteristic curve revealed serum PCT levels on the 3rd day could significantly predict the 14-day mortality, maximal area under the curve of serum PCT was 0. 815. Conclusions:Dynamic monitoring of serum PCT levels could help to assessment the prognosis of patients with HFPEF,also to predict the severity of the illness.

  8. Abnormal Uterine Bleeding FAQ

    Science.gov (United States)

    ... FREQUENTLY ASKED QUESTIONS FAQ095 GYNECOLOGIC PROBLEMS Abnormal Uterine Bleeding • What is a normal menstrual cycle? • When is bleeding abnormal? • At what ages is abnormal bleeding more ...

  9. 急性阑尾炎患者外周血LXA4与降钙素原水平的检测及研究%The research and testing of the level of blood LXA4 and procalcitonin in the Acute appendicitis pa-tients

    Institute of Scientific and Technical Information of China (English)

    朱克华; 张福

    2016-01-01

    目的:通过监测比较急性阑尾炎患者外周血脂氧素A4(LXA4)与降钙素元(PCT)水平,分析LXA4、PCT在急性阑尾炎患者的诊断中的作用及机制。方法:随机选取120例急性阑尾炎患者,均于手术前采用酶联免疫吸附法( ELISA)检测患者外周血LXA4、PCT水平,并进行相关性分析。对照组选取同期健康体检者50例。结果:120例急性阑尾炎患者,结合手术或(和)病理诊断结果分为单纯性阑尾炎(35例)、化脓性阑尾炎(47例)、穿孔性阑尾炎(21例)、坏疽性阑尾炎(17例)。急性阑尾炎患者各组血清LXA4、PCT水平均显著高于对照组( P﹤0.01);化脓性阑尾炎组、穿孔性阑尾炎组及坏疽性阑尾炎组血清LXA4、PCT水平均显著高于单纯性阑尾炎组( P﹤0.05);坏疽性阑尾炎组及穿孔性阑尾炎组血清PCT水平高于化脓性阑尾炎组( P﹤0.05);急性阑尾炎患者血清LXA4与PCT水平呈显著正相关( r=-0.718,P=0.002)。结论:在急性阑尾炎患者中血清LXA4与PCT的水平与患者的病情有较高的相关性,对急性阑尾炎的诊断、术前病情评估及是否手术均有一定的指导意义。%Objective Through the detection of the level of blood LXA4 and PCT in the Acute appendicitis patients to re-search the role and mechanism of LXA4 and PCT in the diagnosis of patients with acute appendicitis. Method 120 cases of pa-tients with acute appendicitis were randomly selected,the level of blood LXA4 and PCT were detected and analyzed before the surgery by using the method of enzyme-linked immunosorbent( ELISA). 50 cases of healthy check-up were selected as the control group. Results According to the surgery or( and)the pathological diagnosis,the cases of 120 patients with acute appendi-citis was divided into simple appendicitis(35 cases),suppurative appendicitis(47 cases),perforated appendicitis(21 cases) and gangrenous appendicitis(17

  10. Differential diagnosis value and practiced value of conducting using antibiotics of serum procalcitonin levels among old people with bacterial pneumonia and lung neoplasm%血清降钙素原检测在老年人细菌性肺炎与肺癌的鉴别诊断及指导用药中的价值

    Institute of Scientific and Technical Information of China (English)

    张德文; 何倩; 龙林会

    2016-01-01

    Objective To study differential diagnosis value and practiced value of conducting using antibiotics of serum procalci-tonin(PCT )levels among old people with bacterial pneumonia and lung neoplasm .Methods From January 2014 to September 2015 , a total of 50 patients with bacterial pneumonia ,40 patients with lung neoplasm ,and 100 healthy person were collected in this study , all the subjects were 60 or more than 60 years old .Chemiluminescence Immune Assay(CLIA)method was used to detect concentra-tions of serum PCT .Meanwhile morning sputum samples were collected and cultured ,then did drug sensitive test .50 patients with bacterial pneumonia were treated with second or third generation of cephalosporin antibiotics in 7 days ,and then detected PCT .Re-sults Serum PCT level in the bacterial pneumonia group before treatment ,after treating 7 days ,lung neoplasm group were (9 .960 ± 8 .540) ,(2 .420 ± 1 .280)and(0 .346 ± 0 .300)ng/mL ,which were all significant higher than(0 .027 ± 0 .010)ng/mL in the control group ,the differences were statistical significant(P< 0 .05) .Serum PCT level in the bacterial pneumonia group before treat-ment was significant higher than that of lung neoplasm group(P< 0 .05) .The serum PCT level of patients after treating 7 days de-creased significantly comparing with before treatment(P < 0 .05) .A total of 21 cases in 50 patients with bacterial pneumonia had positive sputum culture result ,the positive rate was 42 .0% .The serum PCT level of 21 patients with positive sputum culture result before treatment was(17 .620 ± 8 .460)ng/mL ,which increased significantly .Drug sensitive test showed one strain of pseudomonas aeruginosa isolated was multiple drug-resistant bacteria ,which was resistant to the cephalosporin .Conclusion Detecting PCT has value on differential diagnosis between bacterial pneumonia and lung neoplasm among old people ,combining with drug sensitive test is important for conducting the use of antibiotics .%目的:

  11. Procalcitonin and C-reactive protein in early diagnosis of sepsis caused by either Gram-negative or Gram-positive bacteria.

    Science.gov (United States)

    Liu, H H; Zhang, M W; Guo, J B; Li, J; Su, L

    2017-02-01

    Sepsis is the most frequent cause of systemic inflammatory response syndrome (SIRS). Procalcitonin (PCT) and C-reactive protein (CRP) are well-known predictors of sepsis. Serum PCT levels are associated with blood culture positivity in patients with sepsis, but the magnitude of elevation of PCT and CRP levels at the onset of sepsis is unknown in Gram-negative (GN) bacteremia and in Gram-positive (GP) bacteremia. To evaluate the PCT and CRP levels in 72 h at the onset of sepsis in GN and GP bacteremia. We retrospectively analyzed the data from 648 blood-positive specimens from three integrated teaching hospitals in Xiamen, China. One hundred and forty-seven adult patients with sepsis within 72 h enrolled in the study. Serum PCT and CRP level were assessed according GN or GP bacteremia. A total of 147 (22.68 %) patients were eligible for inclusion in the study, including 56 GP sepsis and 91 GN sepsis. PCT, but not CRP levels, was significantly higher in patients in the GP group than in the GN group (23.64 vs 6.18 ng/mL, p sepsis than GP sepsis in 72 h. There are not differences in CRP. The separation of PCT and CRP phenomenon is helpful for early diagnosis of GP sepsis.

  12. The clinical value of procalcitonin in patients with chemotherapy-induced febrile neutropenia%降钙素原在化疗致粒细胞减少伴发热患者中的临床意义

    Institute of Scientific and Technical Information of China (English)

    张忠伟; 申丽华; 傅凤鸣; 王朋妹; 朱彪

    2016-01-01

    Background and purpose:Previous researches have shown that procalcitonin differentiates infec-tious from non-infectious fever and assesses the severity of infectious diseases. This study aimed to investigate the clin-ical value of procalcitonin in patients with chemotherapy-induced febrile neutropenia.Methods:A total of 147 patients with chemotherapy-induced febrile neutropenia admitted to intensive care unit from Jan. 2012 to Dec. 2014 were di-vided into infectious group and fever of unknown origin group according to clinical symptoms, signs and etiology. The infectious group was divided into sepsis, severe sepsis, and septic shock groups according to the severity of infection. The procalcitonin levels were compared between different groups.Results:A procalcitonin cut-off value>0.935 ng/mL provided a sensitivity of 90.0%, speciifcity of 90.0% and AUC=0.905. The procalcitonin level of the infectious group was signiifcantly higher than that of the fever of unknown origin group [1.805 (1.268-2.523) ng/mLvs 0.555 (0.398-0.818) ng/mL,P<0.001]. There is a signiifcant difference between the severe sepsis group and the sepsis group [13.885 (7.600-17.961) ng/mLvs 1.805 (1.268-2.563) ng/mL,P<0.001]. Compared with the severe sepsis group, the value of procalcitonin in the septic shock group was signiifcantly higher [23.800 (20.050-30.478) ng/mLvs 13.885 (4.955-19.133) ng/mL,P<0.001].Conclusion:Plasma procalcitonin is a useful marker for diagnosing neutropenia in patients with infection. Meanwhile, procalcitonin can be used to assess the severity of infection in patients with neutropenia.%背景与目的:以往研究显示血清降钙素原可用于发热性疾病的诊断及其严重程度的评估。该研究旨在探讨血清降钙素原在化疗致粒细胞减少伴发热患者中的临床意义。方法:回顾性分析2012年1月—2014年12月以化疗致粒细胞减少伴发热收入复旦大学附属肿瘤医院ICU治疗的147例患者的临床资料。根据患

  13. 冠心病糖代谢异常患者血浆Ghrelin水平及临床意义%Plasma ghrelin level in patients with coronary heart disease with abnormal glucose metabolism and its clinical significance

    Institute of Scientific and Technical Information of China (English)

    庞军刚; 徐新; 唐良秋; 张社兵; 江志平

    2012-01-01

    目的:探讨冠心病糖代谢异常患者血浆胃饥饿素(Ghrelin)水平及其相关临床意义.方法:将纳入研究对象依据相关检验及检查结果分为正常对照组、冠心病组(冠心病糖代谢正常组和冠心病糖代谢异常组)、单纯糖代谢异常组.收集所有入选对象人院第2天清晨空腹血样,采用ELISA方法同批检测血浆Ghrelin水平.结果:①冠心病组及单纯糖代谢异常组血浆Ghrelin水平均显著低于正常对照组.②冠心病糖代谢异常组血浆Ghrelin水平显著低于冠心病糖代谢正常组及单纯糖代谢异常组.③析因分析结果显示:冠心病与糖代谢异常在对血浆Ghrelin水平影响方面不存在交互作用.然而,糖代谢异常比冠心病对血浆Ghrelin水平的影响更明显.结论:冠心病糖代谢异常患者血浆Ghrelin水平显著下降,且糖代谢异常对Ghrelin的影响更明显.%AIM: To study plasma ghrelin level distribution in patients with coronary heart disease (CHD) with abnormal glucose metabolism and to discuss its clinical significance. METHODS; According to laboratory examination results, subjects were divided into control group, coronary heart disease with normal glucose metabolism group, coronary heart disease with abnormal glucose metabolism group and abnormal glucose metabolism group. Fasting blood samples were collected the morning after admission with EDTA-2K anticoagulation tubes. Blood samples were then transferred to centrifuge tubes containing aprotinin and were centrifuged to extract plasma for cryopreservation. All blood plasma ghrelin levels were tested with ELISA. RESULTS: Compared with those in control group, ghrelin levels were significantly reduced in the group with CHD with normal glucose metabolism, group of CHD with abnormal glucose metabolism and group with abnormal glucose metabolism. Compared with those in the group of CHD with normal glucose metabolism, levels of ghrelin were significantly reduced in patients with

  14. [Cord blood procalcitonin in the assessment of early-onset neonatal sepsis].

    Science.gov (United States)

    Oria de Rueda Salguero, Olivia; Beceiro Mosquera, José; Barrionuevo González, Marta; Ripalda Crespo, María Jesús; Olivas López de Soria, Cristina

    2017-08-01

    Early diagnosis of early-onset neonatal sepsis (EONS) is essential to reduce morbidity and mortality. Procalcitonin (PCT) in cord blood could provide a diagnosis of infected patients from birth. To study the usefulness and safety of a procedure for the evaluation of newborns at risk of EONS, based on the determination of PCT in cord blood. Neonates with infectious risk factors, born in our hospital from October 2013 to January 2015 were included. They were processed according to an algorithm based on the values of cord blood procalcitonin (< 0.6ng/ml versus ≥0.6ng/ml). They were later classified as proved infection, probable, or no infection. Of the 2,519 infants born in the study period, 136 met inclusion criteria. None of 120 cases with PCT<0.6ng/ml in cord blood developed EONS (100% negative predictive value). On the other hand, of the 16 cases with PCT ≥0.6ng/ml, 10 were proven or probably infected (62.5% positive predictive value). The sensitivity of the PCT against infection was 100%, with a specificity of 95.2% (area under the receiver operator curve 0.969). The incidence of infection in the study group was 7.4%, and 26.1% in cases with maternal chorioamnionitis. 21 newborn (15.4%) received antibiotic therapy. The studied protocol has shown to be effective and safe to differentiate between patients with increased risk of developing an EONS, in those where the diagnostic and therapeutic approach was more interventionist, versus those with less likelihood of sepsis, who would benefit from a more conservative management. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. In Critically Ill Patients, Serum Procalcitonin Is More Useful in Differentiating between Sepsis and SIRS than CRP, Il-6, or LBP.

    Science.gov (United States)

    Meynaar, Iwan A; Droog, Wouter; Batstra, Manou; Vreede, Rolf; Herbrink, Paul

    2011-01-01

    We studied the usefulness of serum procalcitonin (PCT), interleukin-6 (IL-6), lipopolysaccharide binding protein (LBP) levels and C-reactive protein (CRP) levels, in differentiating between systemic inflammatory response syndrome (SIRS) and sepsis in critically ill patients. Methods. In this single centre prospective observational study we included all consecutive patients admitted with SIRS or sepsis to the ICU. Blood samples for measuring CRP, PCT, IL-6 and LBP were taken every day until ICU discharge. Results. A total of 76 patients were included, 32 with sepsis and 44 with SIRS. Patients with sepsis were sicker on admission and had a higher mortality. CRP, PCT, IL-6 and LBP levels were significantly higher in patients with sepsis as compared to SIRS. With PCT levels in the first 24 hours after ICU admission 10 ng/mL, sepsis with bacterial infection was very likely (positive predictive value 88%). PCT was best at discriminating between SIRS and sepsis with the highest area under the ROC curve (0.95, 95% CI 0.90-0.99). Discussion. This study showed that PCT is more useful than LBP, CRP and IL-6 in differentiating sepsis from SIRS.

  16. Procalcitonin: inflammatory biomarker for assessing the severity of community-acquired pneumonia--a clinical observation in geriatric patients.

    Science.gov (United States)

    Heppner, H J; Bertsch, T; Alber, B; Esslinger, A S; Dragonas, C; Bauer, J M; Sieber, C C

    2010-01-01

    Community-acquired pneumonia is a common disease of the elderly and involves a high mortality risk. Demographic developments are creating new challenges for acute medical treatment strategies in geriatric patients with their underlying multimorbidity. In addition to the diagnostic parameters recorded on hospital admission, such as white cell count and C-reactive protein, procalcitonin, more than the risk scores CRB- and CURB-65 evaluated to date, appears to be a promising parameter for assessing the severity of pneumonia in elderly patients to allow early detection of severe courses and initiation of suitable treatment. The decisive factor is the dynamic course of the procalcitonin values over 3 consecutive days, as demonstrated in this case series.

  17. Procalcitonin and pyuria-based algorithm reduces antibiotic use in urinary tract infections: a randomized controlled trial

    OpenAIRE

    Drozdov, Daniel; Schwarz, Stefanie; Kutz, Alexander; Grolimund, Eva; Rast, Anna Christina; Steiner, Deborah; Regez, Katharina; Schild, Ursula; Guglielmetti, Merih; Conca, Antoinette; Reutlinger, Barbara; Ottiger, Cornelia; Buchkremer, Florian; Haubitz, Sebastian; Blum, Claudine

    2015-01-01

    Background Urinary tract infections (UTIs) are common drivers of antibiotic use. The minimal effective duration of antibiotic therapy for UTIs is unknown, but any reduction is important to diminish selection pressure for antibiotic resistance, costs, and drug-related side-effects. The aim of this study was to investigate whether an algorithm based on procalcitonin (PCT) and quantitative pyuria reduces antibiotic exposure. Methods From April 2012 to March 2014, we conducted a factorial design ...

  18. Procalcitonin: Inflammatory Biomarker for Assessing the Severity of Community-Acquired Pneumonia – A Clinical Observation in Geriatric Patients

    OpenAIRE

    2013-01-01

    Community-acquired pneumonia is a common disease of the elderly and involves a high mortality risk. Demographic developments are creating new challenges for acute medical treatment strategies in geriatric patients with their underlying multimorbidity. In addition to the diagnostic parameters recorded on hospital admission, such as white cell count and C-reactive protein, procalcitonin, more than the risk scores CRB- and CURB-65 evaluated to date, appears to be a promising parameter for assess...

  19. Correlation Between Body Reproductive Hormone Level and Abnormal Uterine Bleeding After Drug Abortion%药物流产后机体生殖激素水平与子宫异常出血的相关性

    Institute of Scientific and Technical Information of China (English)

    冉丽萍; 冉爱冬

    2011-01-01

    Objective To explore the correlation between body reproductive hormone level and abnormal uterine bleeding after drug abortion. Methods The patients with uterine bleeding less than 16 days after drug abortion were selected as the normal group, while the patients with uterine bleeding more than 16 days were selected as the abnormal group. Surgical abortion women were served as the control group. The levels of E2, P, FSH, LH, and HCG in the women of three groups were continuously monitored during 10 ~ 22 days after abortion. Results The changes of E2 level in the three groups were generally identical and showed an ascendant trend. P level of the abnormal group was significantly higher than those of the control group and the normal group all the time (P<0.05). FSH levels of the three groups fluctuated repeatedly, and LH levels showed a decreased trend. HCG level in abnormal group was significantly higher than those in the control group and the normal group all the time (P<0.05). Conclusions The abnormal uterine bleeding after drug abortion is related to high levels of P and HCG, but irrelevant to the levels of E2, LH, and FSH.%目的 探讨药物流产后机体生殖激素水平与子宫异常出血的相关性.方法 选取药流后子宫出血小于16d者为正常组,子宫出血大于16 d者为异常组,手术流产妇女为对照组.连续监测三组妇女流产10~22 d的E2、P、FSH、LH、HCG水平.结果 三组E2水平变化基本相同,呈上升趋势;异常组P水平始终显著高于对照组和正常组(P<0.05);三组FSH水平均在反复波动,LH水平呈下降趋势;异常组HCG水平始终显著高于对照组和正常组(P<0.05).结论 药物流产后子宫异常出血与高水平的P和HCG有关,而与E2、LH、FSH无关.

  20. 染色体变异、畸变与男性生殖激素水平和精子生成的关系%Association between chromosome variations,abnormalities and male reproductive hormones level with spermatogenesis

    Institute of Scientific and Technical Information of China (English)

    刘浩; 耿春惠; 沈楷; 黄永祥; 张丽燕; 陈爱群

    2014-01-01

    目的:探讨染色体变异、畸变与男性生殖激素水平和精子生成的关系。方法对147例男性不育和复发性流产患者进行染色体核型、生殖激素和精液分析,并对其结果进行对比分析。结果染色体畸变组血清 FSH、LH 水平和无精子症发生率分别高于染色体变异组和正常组(P <0.05,P <0.01),血清 T 水平显著低于染色体变异组和正常组(P <0.05)。Y 染色体变异组血清 FSH 水平和少精子症发生率显著高于常染色体变异组(P <0.05),两组无精子症发生率差异无统计学意义(P >0.05)。性染色体畸变组血清 FSH、LH 水平和无精子症发生率显著高于常染色体畸变组(P <0.05),血清 T 水平显著低于常染色体畸变组(P <0.05)。结论染色体变异、畸变与生殖激素紊乱和生精功能障碍密切相关,性染色体变异和畸变导致男性血清 FSH、LH水平显著升高、T 水平显著降低可能是导致少精子症和无精子症的发病机制之一。%Objective To investigate the association between chromosome variations,abnormalities and male reproductive hor-mones level with spermatogenesis.Methods The chromosome karyotype,serum reproductive hormone including FSH,LH,T,PRL and E2,and semen were detected in 147 patients with male infertility or recurrent sponotaneous abortion.The results were per-formed the comparative analysis.Results Serum FSH,LH level and the incidence rate of azoospermia in the chromosome abnormal-ity group were significantly higher than those in the chromosome variation group and the normal group(P 0.05).Serum FSH,LH level and the incidence rate of azoospermia in the sex chromosome abnormality group were obviously higher than those in the autosomal abnormality group(P <0.05),the serum T level was signifi-cantly lower than that in the autosomal abnormality group(P <0.05).Conclusion The chromosome variation and abnormality are closely related with

  1. 血清降钙素原在细菌性脑膜炎诊断中的应用%The significance of serum procalcitonin in diagnosis of bacterial meningitis

    Institute of Scientific and Technical Information of China (English)

    田玉峰; 王家安

    2015-01-01

    Objective:To evaluate the clinical significance of serum procalcitonin in identification and diagnosis of bacterial meningitis.Methods:Among the 22 children bacterial meningitis and 15 children bacterial meningitis,serum procalcitonin(PCT)、C-reactive protein(CRP) concentration levels were measured. And 20 outpatients were measured as normal control.Results:The level of PCT and CRP was significantly higher in the bacterial meningitis group than the viral meningitis group and normal control, there were significant differences in the two groups(P6 ng/ ml as a threshold for the diagnosis of children bacterial meningitis, the sensitivity is 95% and specificity is 99%. However, take serum CRP >25mg/L as a threshold for the diagnosis of children bacterial meningitis, the sensitivity is 83% and specificity is 87%. Conclusions:It suggested that serum procalcitonin can be useful in identification and diagnosis of severe acute pancreatitis,better than CRP.%目的:评价血清降钙素原在细菌性脑膜炎鉴别诊断中的临床意义。方法:对22例儿童细菌性脑膜炎和15例儿童病毒性脑膜炎进行血清降钙素原、C-反应蛋白检测,同时以20例正常体检人群做对照。结果:细菌性脑膜炎组血清降钙素原和C-反应蛋白明显高于病毒性脑膜炎组和对照组,差异均具有统计学差异(P<0.05),PCT能显著区分开细菌性和病毒性脑膜炎,CRP在两组间存在浓度重叠,无法完全区分开细菌性和病毒性脑膜炎。PCT诊断细菌性脑膜炎的灵敏度和特异性为95%,99%,CRP诊断细菌性脑膜炎的灵敏度和特异性为83%,87%。结论:血清降钙素原对于细菌性脑膜炎具有优异的鉴别和诊断效果,优于C-反应蛋白。

  2. Abnormal Uterine Bleeding

    Science.gov (United States)

    ... first few months of a normal pregnancy. Some birth control pills or the intrauterine device (IUD) can also cause ... this type can significantly reduce abnormal bleeding. Like birth control pills, sometimes IUDs can actually cause abnormal bleeding. Tell ...

  3. Urine - abnormal color

    Science.gov (United States)

    ... medlineplus.gov/ency/article/003139.htm Urine - abnormal color To use the sharing features on this page, please enable JavaScript. The usual color of urine is straw-yellow. Abnormally colored urine ...

  4. Procalcitonin and C-reactive protein cannot differentiate bacterial or viral infection in COPD exacerbation requiring emergency department visits

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    Chang CH

    2015-04-01

    Full Text Available Chih-Hao Chang,1 Kuo-Chien Tsao,2,3 Han-Chung Hu,1,4 Chung-Chi Huang,1,4 Kuo-Chin Kao,1,4 Ning-Hung Chen,1,4 Cheng-Ta Yang,1,4 Ying-Huang Tsai,4,5 Meng-Jer Hsieh4,51Department of Pulmonary and Critical Care Medicine, Linkou Chang-Gung Memorial Hospital, Chang-Gung Medical Foundation, Chang-Gung University College of Medicine, Taoyuan, Taiwan; 2Department of Laboratory Medicine, Linkou Chang-Gung Memorial Hospital, Chang-Gung Medical Foundation; 3Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan, Taiwan; 4Department of Respiratory Therapy, Chang-Gung University, Taoyuan, Taiwan; 5Department of Pulmonary and Critical Care Medicine, Chiayi Chang-Gung Memorial Hospital, Chang-Gung Medical Foundation, Puzi City, TaiwanBackground: Viral and bacterial infections are the most common causes of chronic obstructive pulmonary disease (COPD exacerbations. Whether serum inflammatory markers can differentiate bacterial from virus infection in patients with COPD exacerbation requiring emergency department (ED visits remains controversial.Methods: Viral culture and polymerase chain reaction (PCR were used to identify the viruses in the oropharynx of patients with COPD exacerbations. The bacteria were identified by the semiquantitative culture of the expectorated sputum. The peripheral blood white blood cell (WBC counts, serum C-reactive protein (CRP, procalcitonin (PCT, and clinical symptoms were compared among patients with different types of infections.Results: Viruses were isolated from 16 (22.2% of the 72 patients enrolled. The most commonly identified viruses were parainfluenza type 3, influenza A, and rhinovirus. A total of 30 (41.7% patients had positive bacterial cultures, with the most commonly found bacteria being Haemophilus influenzae and Haemophilus parainfluenzae. Five patients (6.9% had both positive sputum cultures and virus identification. The WBC, CRP, and PCT levels of the bacteria-positive and bacteria

  5. Procalcitonin as a marker of serious bacterial infections in febrile children younger than 3 years old.

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    Mahajan, Prashant; Grzybowski, Mary; Chen, Xinguang; Kannikeswaran, Nirupama; Stanley, Rachel; Singal, Bonita; Hoyle, John; Borgialli, Dominic; Duffy, Elizabeth; Kuppermann, Nathan

    2014-02-01

    There is no perfectly sensitive or specific test for identifying young, febrile infants and children with occult serious bacterial infections (SBIs). Studies of procalcitonin (PCT), a 116-amino-acid precursor of the hormone calcitonin, have demonstrated its potential as an acute-phase biomarker for SBI. The objective of this study was to compare performance of serum PCT with traditional screening tests for detecting SBIs in young febrile infants and children. This was a prospective, multicenter study on a convenience sample from May 2004 to December 2005. The study was conducted in four emergency departments (EDs): one pediatric ED and three EDs with pediatric units, all with academic faculty on staff. A total of 226 febrile children 36 months old or younger who presented to the four participating EDs and were evaluated for SBI by blood, urine, and/or cerebral spinal fluid (CSF) cultures were included. The test characteristics (with 95% confidence intervals [CIs]) of the white blood cell (WBC) counts including neutrophil and band counts were compared with PCT for identifying SBI. Thirty children had SBIs (13.3%, 95% CI = 8.85 to 17.70). Four (13.3%) had bacteremia (including one with meningitis), 18 (60.0%) had urinary tract infections (UTIs), and eight (26.6%) had pneumonia. Children with SBIs had higher WBC counts (18.6 × 10(9)  ± 8.6 × 10(9) cells/L vs. 11.5 × 10(9)  ± 5.3 × 10(9) cells/L, p under the receiver operating characteristic (ROC) curve for PCT was the largest (0.80, 95% CI = 0.71 to 0.89). Procalcitonin is a more accurate biomarker than traditional screening tests for identifying young febrile infants and children with serious SBIs. Further study on a larger cohort of young febrile children is required to definitively determine the benefit of PCT over traditional laboratory screening tests for SBIs. © 2014 by the Society for Academic Emergency Medicine.

  6. Clinical value of C-reactive protein and procalcitonin in diagnosis of children′s infectious diseases%C-反应蛋白与降钙素原在儿童感染性疾病中的诊断价值

    Institute of Scientific and Technical Information of China (English)

    张福蓉; 刘瑶; 王方芳

    2015-01-01

    OBJECTIVE To detect content of C‐reactive protein and procalcitonin in children with sepsis ,blood‐stream infections and other infectious diseases ,so as to explore their clinical diagnostic values .METHODS From Mar .2013-to Mar .2014 ,totally 90 cases of children with systemic inflammatory response syndromes were se‐lected and divided into sepsis group and non‐sepsis group with 45 cases each .The content of C‐reactive protein and procalcitonin in these children were detected and the data were analyzed by SPSS 19 .0 software .RESULTS C‐reac‐tive protein content in the sepsis group was averagely (119 .34 ± 17 .34) mg/L ,and the procalcitonin was averagely (11 .92 ± 1 .59)μg/L .In the non‐sepsis group ,the average level of C‐reactive protein was (46 .12 ± 16 .60) mg/L ,and the average level of procalcitonin was (1 .41 ± 0 .42)μg/L .Sepsis group had a obviously higher C‐reactive protein level and procalcitonin level than non‐sepsis group (P<0 .05) .CONCLUSION C‐reactive protein and pro‐calcitonin is certainly effective in the early diagnosis of bloodstream infections and other infectious diseases in chil‐dren with sepsis ,especially procalcitonin .Hence they can be used widely in clinical practice .%目的:分析C‐反应蛋白与降钙素原在小儿脓毒症血流感染及其他部位感染性疾病中的含量,从而探讨其临床诊断价值。方法选取2013年3月-2014年3月小儿全身炎症反应综合征患儿90例,分为脓毒症组和非脓毒症组,患儿各45例;测定患儿C‐反应蛋白与降钙素原含量,数据采用SPSS 19.0软件进行统计分析。结果脓毒症组C‐反应蛋白为(119.34±17.34)m g/L、降钙素原为(11.92±1.59)μg/L ;非脓毒症组C‐反应蛋白为(46.12±16.60)m g/L、降钙素原为(1.41±0.42)μg/L ,脓毒症组明显高于非脓毒症组,差异有统计学意义( P<0.05)。结论 C‐反应蛋白与降钙

  7. The First Trimester Gravid Serum Regulates Procalcitonin Expression in Human Macrophages Skewing Their Phenotype In Vitro

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    Damiano Rami

    2014-01-01

    Full Text Available Procalcitonin (PCT is one of the best diagnostic and prognostic markers in clinical practice, widely used to evaluate the evolution of bacterial infections. Although it is mainly produced by thyroid, during sepsis almost all the peripheral tissues are involved in PCT production. Parenchymal cells have been suggested as the main source of PCT expression; however the contribution of macrophages is not clear yet. In response to environmental cues, tissue macrophages acquire distinct functional phenotypes, ranging from proinflammatory (M1 to anti-inflammatory (M2 phenotype. Macrophages at the fetal-maternal interface show immunosuppressive M2-like activities required for the maintenance of immunological homeostasis during pregnancy. This study aims to clarify the ability to synthesise PCT of fully differentiated (M0, polarized (M1/M2 macrophages and those cultured either in the presence of first trimester gravid serum (GS or pregnancy hormones. We found out that M1 macrophages upregulate PCT expression following LPS stimulation compared to M0 and M2. The GS downregulates PCT expression in macrophages, skewing them towards an M2-like phenotype. This effect seems only partially mediated by the hormonal milieu. Our findings strengthen the key role of macrophages in counteracting inflammatory stimuli during pregnancy, suggesting PCT as a possible new marker of M1-like macrophages.

  8. The first trimester gravid serum regulates procalcitonin expression in human macrophages skewing their phenotype in vitro.

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    Rami, Damiano; La Bianca, Martina; Agostinis, Chiara; Zauli, Giorgio; Radillo, Oriano; Bulla, Roberta

    2014-01-01

    Procalcitonin (PCT) is one of the best diagnostic and prognostic markers in clinical practice, widely used to evaluate the evolution of bacterial infections. Although it is mainly produced by thyroid, during sepsis almost all the peripheral tissues are involved in PCT production. Parenchymal cells have been suggested as the main source of PCT expression; however the contribution of macrophages is not clear yet. In response to environmental cues, tissue macrophages acquire distinct functional phenotypes, ranging from proinflammatory (M1) to anti-inflammatory (M2) phenotype. Macrophages at the fetal-maternal interface show immunosuppressive M2-like activities required for the maintenance of immunological homeostasis during pregnancy. This study aims to clarify the ability to synthesise PCT of fully differentiated (M0), polarized (M1/M2) macrophages and those cultured either in the presence of first trimester gravid serum (GS) or pregnancy hormones. We found out that M1 macrophages upregulate PCT expression following LPS stimulation compared to M0 and M2. The GS downregulates PCT expression in macrophages, skewing them towards an M2-like phenotype. This effect seems only partially mediated by the hormonal milieu. Our findings strengthen the key role of macrophages in counteracting inflammatory stimuli during pregnancy, suggesting PCT as a possible new marker of M1-like macrophages.

  9. Investigation of The Association between Salivary Procalcitonin Concentration and Chronic Periodontitis

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    Hojatollah Yousefimanesh

    2015-10-01

    Full Text Available Objective: Chronic periodontitis is the most common form of periodontal disease. Changes in biomarkers seem to be associated with the disease progression. Procalcitonin (PCT is one of these biomarkers that are altered during infection. This study was established to investigate the relationship between periodontitis as an infectious disease and salivary PCT. Materials and Methods: This case-control study was performed on 30 patients with generalized chronic periodontitis and 30 health individuals as control group who were referred to Dental School, Jundishapur University of Ahvaz, Ahvaz, Iran at Feb to Apr 2014. The saliva samples were collected and analyzed by the enzyme-linked immunosorbent assay (ELISA method. Data analysis was performed using t test with the SPSS (SPSS Inc., Chicago, IL, USA version 13. Results: In both groups, age and sex distribution values were not significantly different. The concentrations of salivary PCT in controls and patients ranged from 0.081 pg/ mL to 0.109 pg/mL and from 0.078 pg/mL to 0.114 pg/mL, respectively. The statistically significant differences between the two groups were not observed (P=0.17. Conclusion: It seems that salivary PCT concentration is not affected by disease progression. Therefore, PCT is not a valuable marker for the existence of periodontal disease.

  10. [Amebic colitis and liver abscess complicated by high serum procalcitonin in acute myeloid leukemia].

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    Oku, Eijiro; Nomura, Kei; Nakamura, Takayuki; Morishige, Satoshi; Seki, Ritsuko; Imamura, Rie; Hashiguchi, Michitoshi; Osaki, Kouichi; Mizuno, Shinichi; Nagafuji, Koji; Okamura, Takashi

    2012-11-01

    We present a case of amebic colitis and liver abscess complicated by acute myeloid leukemia (AML) with high serum procalcitonin (PCT). A 61-year-old Japanese man seen at our hospital for severe diarrhea and high fever was found to have multiple ulcers in the transverse and sigmoid colon and rectum by colonoscopy and biopsies were conducted. Immature leukocytes with mild anemia and thrombocytopenia were seen in peripheral blood, necessitating bone marrow aspiration and biopsy that yielded a diagnosis of AML (FAB M4Eo). Serum C-reactive protein and PCT were extremely elevated. Blood cultures for bacteria and fungi were negative. Multiple low-density areas in the liver were found in abdominal computed tomography. Histological colon biopsy findings revealed amebic colitis, strongly suggesting amebic liver abscess. Metronidazole treatment was initiated for amebiasis and subsequent standard chemotherapy for AML was followed after fever was lowered. Hematological and cytogenetic CR was maintained with good clinical condition. Few case reports have been published in Japan to date on amebic colitis and liver abscess complicated by AML and no reports have been made on PCT elevation caused by amebiasis. In conclusion, differential diagnosis of amebiasis is necessary in addition to that of bacterial or fungal infection in serum PCT elevation.

  11. Serum procalcitonin in Egyptian patients with acute meningitis and a negative direct cerebrospinal fluid examination.

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    Abdelkader, Nadia A; Mahmoud, Waheed A; Saber, Sally Mohamed

    2014-01-01

    To reduce the morbidity and mortality related to bacterial meningitis, it is important to discriminate bacterial meningitis from aseptic meningitis during the acute phase of the disease, when the clinical symptoms are often similar. To test the reliability of serum procalcitonin (PCT) to discriminate bacterial meningitis from aseptic meningitis in patients who have a negative direct cerebrospinal fluid (CSF) examination, and to evaluate the role of serum PCT to assess treatment efficacy compared with the total leukocyte count (TLC), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Forty patients with suspected acute meningitis and negative gram stains were included, and ten healthy persons were included as controls. According to the clinical examination and the CSF cytochemical analysis and cultures, the patients were divided into bacterial and aseptic groups. The measurements of serum PCT, ESR, CRP and TLC were performed. Patients in the bacterial group had a higher value of serum PCT at admission and at 3 days post-treatment than those in the aseptic group, with a highly significant difference between them. Serum PCT and, to a lesser extent, TLC had prognostic value in patients with acute meningitis, and PCT is more useful because it can be frequently measured for the diagnosis and follow-up of bacterial meningitis. Copyright © 2013 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  12. Procalcitonin as an early diagnostic and monitoring tool in urosepsis following percutaneous nephrolithotomy.

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    Zheng, Ji; Li, Qianwei; Fu, Weihua; Ren, Jing; Song, Siji; Deng, Guoxian; Yao, Jiwei; Wang, Yongquan; Li, Weibing; Yan, Junan

    2015-02-01

    To evaluate the value of procalcitonin (PCT) as an early marker for diagnosis and differentiation of without urosepsis, urosepsis, severe urosepsis, and uroseptic shock following PCNL and the ability of PCT to assess the effectiveness of antibiotic therapy in patients with urosepsis. From June 2012 to August 2013, 267 patients undergoing PCNL for renal calculi, and who fulfilled selection criteria, were recruited into our study. The patients' medical records were reviewed retrospectively. One of selection criteria was the scores of PCT and WBC were collected at operative day, postoperative day one, day two, day three, day five and day seven. The area under the ROC curve for the prediction of urosepsis was 0.960 for PCT and 0.634 for WBC. PCT concentrations were higher in patients with uroseptic shock versus severe urosepsis versus urosepsis versus without urosepsis following PCNL. WBC values showed no significant difference between patients with urosepsis, severe urosepsis and uroseptic shock following PCNL. With time, in patients with successfully treated urosepsis following PCNL, the PCT concentrations significantly declined and kept decreasing from postoperative day two to postoperative day seven and the WBC scores showed no significant change over the first postoperative 2 days and were decreased only after postoperative day three. PCT appears to be a useful early marker to diagnosis and discriminate urosepsis, severe urosepsis and uroseptic shock following PCNL. Daily PCT measurements may be a valuable tool in monitoring the effectiveness of antibiotic therapy in urosepsis following PCNL.

  13. Dual-Quantum-Dots-Labeled Lateral Flow Strip Rapidly Quantifies Procalcitonin and C-reactive Protein

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    Qi, XiaoPing; Huang, YunYe; Lin, ZhongShi; Xu, Liang; Yu, Hao

    2016-03-01

    In the article, a dual-quantum-dots-labeled (dual-QDs-labeled) lateral flow strip (LFS) method was developed for the simultaneous and rapid quantitative detection of procalcitonin (PCT) and C-reactive protein (CRP) in the blood. Two QD-antibody conjugates with different fluorescence emission spectra were produced and sprayed on the LFS to capture PCT and CRP in the blood. Furthermore, a double antibody sandwich method for PCT and, meanwhile, a competitive inhibition method for CRP were employed in the LFS. For PCT and CRP in serum assayed by the dual-QDs-labeled LFS, their detection sensitivities reached 0.1 and 1 ng/mL, respectively, and their linear quantitative detection ranges were from 0.3 to 200 ng/mL and from 50 to 250 μg/mL, respectively. There was little evidence that the PCT and CRP assays would be interfered with each other. The correlations for testing CRP and PCT in clinical samples were 99.75 and 97.02 %, respectively, between the dual-QDs-labeled LFS we developed and commercial methods. The rapid quantification of PCT and CRP on dual-QDs-labeled LFS is of great clinical value to distinguish inflammation, bacterial infection, or viral infection and to provide guidance for the use of antibiotics or other medicines.

  14. Procalcitonin Clearance for Early Prediction of Survival in Critically Ill Patients with Severe Sepsis

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    Mohd Basri Mat Nor

    2014-01-01

    Full Text Available Introduction. Serum procalcitonin (PCT diagnosed sepsis in critically ill patients; however, its prediction for survival is not well established. We evaluated the prognostic value of dynamic changes of PCT in sepsis patients. Methods. A prospective observational study was conducted in adult ICU. Patients with systemic inflammatory response syndrome (SIRS were recruited. Daily PCT were measured for 3 days. 48 h PCT clearance (PCTc-48 was defined as percentage of baseline PCT minus 48 h PCT over baseline PCT. Results. 95 SIRS patients were enrolled (67 sepsis and 28 noninfectious SIRS. 40% patients in the sepsis group died in hospital. Day 1-PCT was associated with diagnosis of sepsis (AUC 0.65 (95% CI, 0.55 to 0.76 but was not predictive of mortality. In sepsis patients, PCTc-48 was associated with prediction of survival (AUC 0.69 (95% CI, 0.53 to 0.84. Patients with PCTc-48 > 30% were independently associated with survival (HR 2.90 (95% CI 1.22 to 6.90. Conclusions. PCTc-48 is associated with prediction of survival in critically ill patients with sepsis. This could assist clinicians in risk stratification; however, the small sample size, and a single-centre study, may limit the generalisability of the finding. This would benefit from replication in future multicentre study.

  15. Are serum procalcitonin and interleukin-1 beta suitable markers for diagnosis of acute pyelonephritis in children?

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    Mahyar, Abolfazl; Ayazi, Parviz; Ahmadi, Reza; Daneshi-Kohan, Mohammad Mahdi; Hashemi, Hassan Jahani; Dalirani, Reza; Moshiri, Seyed Alireza; Habibi, Morteza; Sahmani, Mehdi; Sahmani, Ahmad Ali

    2014-01-01

    Rapid diagnosis of acute pyelonephritis is important because of its association with long-standing complications. This study was conducted to compare the reliability of serum procalcitonin (PCT) and interleukin-1 beta (IL-1β) with conventional laboratory parameters for diagnosis of acute pyelonephritis in children. Seventy nine children with urinary tract infection were divided into two groups based on the result of Tc-99m dimercaptosuccinic acid renal scan: acute pyelonephritis (n=33) and lower UTI (urinary tract infection) (n=46) groups. White blood cell (WBC) count, neutrophil count, erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP), PCT and IL-1β concentrations of both groups were measured and compared. WBC count, neutrophil count, ESR, serum CRP, PCT and IL-1β concentrations were higher in acute pyelonephritis patients than in the lower UTI group (Ppyelonephritis were 31, 84.7% and 27.2, 90% respectively (using a cut-point value of 0.5 ng/ml for PCT and 6.9 pg/ml for IL-1β). The sensitivity of PCT and IL-1β for diagnosis of acute pyelonephritis was less than that of conventional markers such as ESR and CRP. This study revealed that serum PCT and IL-1β are not good biologic markers for differentiating acute pyelonephritis from lower UTI. It seems that conventional inflammatory markers such as ESR and CRP besides the clinical findings are more reliable for the diagnosis of acute pyelonephritis in children.

  16. Neonatal Procalcitonin Intervention Study (NeoPInS): Effect of Procalcitonin-guided decision making on duration of antibiotic therapy in suspected neonatal early-onset sepsis: A multi-centre randomized superiority and non-inferiority Intervention Study.

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    Stocker, Martin; Hop, Wim C J; van Rossum, Annemarie M C

    2010-12-08

    Early diagnosis and treatment of the newborn infant with suspected sepsis are essential to prevent severe and life threatening complications. Diagnosis of neonatal sepsis is difficult because of the variable and nonspecific clinical presentation. Therefore, many newborns with nonspecific symptoms are started on antibiotic treatment before the presence of sepsis has been proven. With our recently published single-centre intervention study we were able to show that Procalcitonin determinations allowed to shorten the duration of antibiotic therapy in newborns with suspected early-onset sepsis. The study is designed as randomized controlled international multicenter intervention trial on the efficacy and safety of Procalcitonin guided treatment. Term and near-term infants (gestational age ≥ 34 0/7 weeks) with suspected sepsis in the first 3 days of life requiring empiric antibiotic therapy will be included. The duration of antibiotic therapy in the standard group is based on the attending physician's assessment of the likelihood of infection (infection unlikely, possible, probable or proven). In the Procalcitonin group, if infection is considered to be unlikely or possible, antibiotic therapy is discontinued when two consecutive Procalcitonin values are within the normal range. Co-primary outcome measures are the duration of antibiotic therapy (superiority aspect of the trial) and the proportion of infants with a recurrence of infection requiring additional courses of antibiotic therapy and/or death in the first month of life (safety of study intervention, non-inferiority aspect of the trial). The number of infants to be included equals 800 per arm. With these numbers the power of the study to demonstrate superiority for duration of antibiotic therapy as well as non-inferiority regarding safety, i.e. excluding a disadvantage difference larger than 2% for the experimental arm, will both be greater than 80%. Benefit of the study is a possible limitation of unnecessary

  17. Procalcitonin, C-reactive protein, and erythrocyte sedimentation rate for the diagnosis of acute pyelonephritis in children.

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    Shaikh, Nader; Borrell, Jessica L; Evron, Josh; Leeflang, Mariska M G

    2015-01-20

    In children with urinary tract infection (UTI), only those with pyelonephritis (and not cystitis) are at risk for developing long-term renal sequelae. If non-invasive biomarkers could accurately differentiate children with cystitis from children with pyelonephritis, treatment and follow-up could potentially be individualized. The objectives of this review were to 1) determine whether procalcitonin, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) can replace the acute DMSA scan in the diagnostic evaluation of children with UTI; 2) assess the influence of patient and study characteristics on the diagnostic accuracy of these tests, and 3) compare the performance of the three tests to each other. We searched MEDLINE, EMBASE, DARE, Web of Science, and BIOSIS Previews for this review. The reference lists of all included articles and relevant systematic reviews were searched to identify additional studies not found through the electronic search. We only considered published studies that evaluated the results of an index test (procalcitonin, CRP, ESR) against the results of an acute-phase DMSA scan (conducted within 30 days of the UTI) in children aged 0 to 18 years with a culture-confirmed episode of UTI. The following cutoff values were used for the primary analysis: 0.5 ng/mL for procalcitonin, 20 mg/L for CRP and 30 mm/h for ESR. Two authors independently applied the selection criteria to all citations and independently abstracted data. We used the bivariate model to calculate pooled random-effects pooled sensitivity and specificity values. A total of 24 studies met our inclusion criteria. Seventeen studies provided data for the primary analysis: six studies (434 children) included data on procalcitonin, 13 studies (1638 children) included data on CRP, and six studies (1737 children) included data on ESR (some studies had data on more than one test). The summary sensitivity estimates (95% CI) for the procalcitonin, CRP, ESR tests at the aforementioned

  18. Monitoring procalcitonin in febrile neutropenia: what is its utility for initial diagnosis of infection and reassessment in persistent fever?

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    James Owen Robinson

    Full Text Available BACKGROUND: Management of febrile neutropenic episodes (FE is challenged by lacking microbiological and clinical documentation of infection. We aimed at evaluating the utility of monitoring blood procalcitonin (PCT in FE for initial diagnosis of infection and reassessment in persistent fever. METHODS: PCT kinetics was prospectively monitored in 194 consecutive FE (1771 blood samples: 65 microbiologically documented infections (MDI, 33.5%; 49 due to non-coagulase-negative staphylococci, non-CNS, 68 clinically documented infections (CDI, 35%; 39 deep-seated, and 61 fever of unexplained origin (FUO, 31.5%. RESULTS: At fever onset median PCT was 190 pg/mL (range 30-26'800, without significant difference among MDI, CDI and FUO. PCT peak occurred on day 2 after onset of fever: non-CNS-MDI/deep-seated-CDI (656, 80-86350 vs. FUO (205, 33-771; p500 pg/mL distinguished non-CNS-MDI/deep-seated-CDI from FUO with 56% sensitivity and 90% specificity. PCT was >500 pg/ml in only 10% of FUO (688, 570-771. A PCT peak >500 pg/mL (1196, 524-11950 occurred beyond 3 days of persistent fever in 17/21 (81% invasive fungal diseases (IFD. This late PCT peak identified IFD with 81% sensitivity and 57% specificity and preceded diagnosis according to EORTC-MSG criteria in 41% of cases. In IFD responding to therapy, median days to PCT <500 pg/mL and defervescence were 5 (1-23 vs. 10 (3-22; p = 0.026, respectively. CONCLUSION: While procalcitonin is not useful for diagnosis of infection at onset of neutropenic fever, it may help to distinguish a minority of potentially severe infections among FUOs on day 2 after onset of fever. In persistent fever monitoring procalcitonin contributes to early diagnosis and follow-up of invasive mycoses.

  19. Abnormalities in liver enzyme levels during Salmonella enteritidis enterocolitis Alteraciones en los niveles séricos de enzimas hepáticos durante la enterocolitis por Salmonella enteritidis

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    A. González-Quintela

    2004-08-01

    Full Text Available Objective: to evaluate the prevalence, associated factors, and time-course changes of abnormal liver enzyme serum levels in adult patients with Salmonella enteritidis enterocolitis. Methods: the clinical records of 104 patients (age range 15-86 years, 46.2% males admitted to hospital because of S. enteritidis enterocolitis were reviewed. The prevalence of abnormal liver enzyme levels was evaluated, as well as its possible relationship to data of systemic inflammatory response, severe sepsis, and bacteremia. In addition, time-course changes in serum levels of liver enzymes were studied in 16 cases with available follow-up after hospital discharge. Results: in patients without a pre-existing cause for liver enzyme abnormalities (n = 84, the prevalence of serum AST elevation was 23.0% (95% CI 15.4-34.5%, of serum ALT elevation was 17.9% (95% CI 0.6-20.0%, and of GGT elevation was 19.0% (95% CI 11.6-29.3%. The prevalence of abnormality for any of these enzymes (AST, ALT, or GGT was 35.7% (95% CI 25.7-46.8%. The prevalence of altered serum alkaline phosphatase was lower. Alteration in liver enzyme serum levels was moderate in the majority of cases, and was found in association with the presence of fever. Serum enzyme levels decreased during the convalescence period after hospital discharge. Conclusions: abnormalities in liver enzyme levels are frequent during severe enterocolitis due to S. enteritidis in adult patients. These abnormalities are moderate and self-limited.Objetivo: evaluar la prevalencia, los factores asociados y la evolución de las anormalidades en los niveles séricos de enzimas hepáticos en pacientes adultos con enterocolitis por S. enteritidis. Métodos: se revisaron los historiales de 104 pacientes (de edades comprendidas entre 15 y 86 años, 46,2% varones, ingresados en un hospital por enterocolitis aguda por S. enteritidis. Se evaluó la prevalencia de alteración en los niveles séricos de enzimas hepáticos y su asociaci

  20. Serum Levels of Tissue Inhibitors of Metalloproteinase 2 in Patients With Systemic Sclerosis With Duration More Than 2 Years: Correlation With Cardiac and Pulmonary Abnormalities

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    Amira Shahin

    2006-01-01

    with elevated TIMP-2 levels was significantly higher than dSSc patients with normal levels (P=.013. Four patients out of five with elevated TIMP-2 levels showed diastolic dysfunction (80%, compared to 2 out of 15 lSSc patients with normal levels (13.3%, with P=.014. Our research, though involving a small group of patients, points to the probable role of TIMP-2 in the development of pulmonary lesions in dSSc patients and cardiac lesions in lSSc patients with duration equal to or more than 2 years.

  1. Level of urinary liver-type fatty acid-binding protein is associated with cardiac markers and electrocardiographic abnormalities in type-2 diabetes with chronic kidney disease stage G1 and G2.

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    Maeda, Yoshiteru; Suzuki, Atsushi; Ishii, Junnichi; Sekiguchi-Ueda, Sahoko; Shibata, Megumi; Yoshino, Yasumasa; Asano, Shogo; Hayakawa, Nobuki; Nakamura, Kazuhiro; Akiyama, Yasukazu; Kitagawa, Fumihiko; Sakuishi, Toshiaki; Fujita, Takashi; Hashimoto, Shuji; Ozaki, Yukio; Itoh, Mitsuyasu

    2015-05-01

    Urinary liver-type fatty acid-binding protein (L-FABP) reflects the degree of stress in proximal tubules of the kidney. We examined the level of L-FABP in type-2 diabetes mellitus (T2DM) patients with chronic kidney disease (CKD) stage G1 and G2, and its relationship with cardiac markers and electrocardiographic (ECG) abnormalities. T2DM patients whose estimated glomerular filtration rate (eGFR) was ≥60 mL/min/1.73 m(2) were recruited [n = 276 (165 males), mean age 64 years]. The median level of urinary L-FABP was 6.6 μg/gCr. Urinary L-FABP showed significant correlation with urinary albumin-to-creatinine ratio (ACR) (r = 0.51, p L-FABP ≤8.4 μg/gCr and ACR ≤30 mg/gCr; group 2, L-FABP ≤8.4 μg/gCr and ACR >30 mg/gCr; group 3, L-FABP >8.4 μg/gCr and ACR ≤30 mg/gCr; group 4, L-FABP >8.4 μg/gCr and ACR >30 mg/gCr). Compared with group 1, group 4 was significantly higher in systolic blood pressure, and eGFR using standardized serum cystatin C, high-sensitivity troponin T, and N-terminal pro-brain natriuretic peptide (NT-proBNP). Group 4 had significantly higher level of NT-proBNP than group 3. Groups 2, 3 and 4 showed more ECG abnormalities than group 1. These findings suggest that simultaneous measurement of urinary L-FABP and ACR should be useful to assess cardiovascular damage reflecting on the elevation of cardiac markers and ECG abnormalities in T2DM with CKD G1 and G2.

  2. 广东省成年体检人群异常血脂水平分布情况调查%Investigation of the distribution of abnormal blood lipid levels of health examination adults of all ages in Gangdong

    Institute of Scientific and Technical Information of China (English)

    李华; 魏莲; 陈佑明; 黄敬; 刘铁连; 刘京平

    2013-01-01

    OBJECTIVE To investigate the distribution of abnormal blood lipid levels of health examination adults in Guangdong Province. METHODS We investigated and statistically analyzed abnormal blood lipid levels of 28 447 people the age of 20 years and over during period of November 2009 and November 2010 in Guangdong Province. Investigated health examination adult at different ages and gender, and abnormal blood lipid composition. According to abnormal blood lipid sample, there were three groups including only high total cholesterols (group A) ; only high triglycerides (group B) ; both high total cholesterol and triglyceride (group C). RESULTS There were significantly age differences in the proportion of abnormal blood lipid levels in the other age groups (P = 0.000) , except the abnormal blood lipid level of age group of 50- years without gender differences ; And there were significant gender differences (P ≤ 0.05) in the composition of lipid abnormalities of male and female in other ages' groups, including in group A and group B, group A and group C group B and group C, except in 20- and over 40- age groups between group B and C; And there were significant differences {P - 0.000) of the composition of lipid abnormalities on genders between three groups; also there was a different distribution of abnormal blood lipid composition of men and women of all ages. CONCLUSION There are significantly differences on the composition of lipid abnormalities, ages and genders of Guangdong adult medical health examination groups of all ages, also there are significant differences in the incidence rate of abnormal blood lipid and proportion of mixed one of female in the 50-year-old, which is highly above male with the same age, and also highly above other ages female, suggesting that postmenopausal female should pay attention to regular blood checks, for which helps prevent and reduce the incidence of cardiovascular disease.%目的 调查广东省成年体检人群各年龄段男女

  3. Identification of 9 uterine genes that are regulated during mouse pregnancy and exhibit abnormal levels in the cyclooxygenase-1 knockout mouse

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    Soper Jessica

    2007-07-01

    Full Text Available Abstract Background Preterm birth is the leading cause of all infant mortality. In 2004, 12.5% of all births were preterm. In order to understand preterm labor, we must first understand normal labor. Since many of the myometrial changes that occur during pregnancy are similar in mice and humans and mouse gestation is short, we have studied the uterine genes that change in the mouse during pregnancy. Here, we used microarray analysis to identify uterine genes in the gravid mouse that are differentially regulated in the cyclooxygenase-1 knockout mouse model of delayed parturition. Methods Gestational d18.0 uteri (n = 4 were collected from pregnant wild-type and cyclooxygenase-1 knockout mice. Part of the uterus was used for frozen sections and RNA was isolated from the remainder. Microarray analysis was performed at the Indiana University School of Medicine Genomic Core and analyzed using the Microarray Data Portal. Northern analysis was performed to confirm microarray data and the genes localized in the gravid uterus by in situ hybridization. Results We identified 277 genes that are abnormally expressed in the gravid d18.0 cyclooxygenase-1 knockout mouse. Nine of these genes are also regulated in the normal murine uterus during the last half of gestation. Many of these genes are involved in the immune response, consistent with an important role of the immune system in parturition. Expression of 4 of these genes; arginase I, IgJ, Tnfrsf9 and troponin; was confirmed by Northern analysis to be mis-regulated during pregnancy in the knockout mouse. In situ hybridization of these genes demonstrated a similar location in the gravid wild-type and Cox-1 knockout mouse uteri. Conclusion To our knowledge, this is the first work to demonstrate the uterine location of these 4 genes in the mouse during late pregnancy. There are several putative transcription factor binding sites that are shared by many of the 9 genes identified here including; estrogen and

  4. Prospective Evaluation of Procalcitonin, Soluble Triggering Receptor Expressed on Myeloid Cells-1 and C-Reactive Protein in Febrile Patients with Autoimmune Diseases

    Science.gov (United States)

    Lin, Chou-Han; Hsieh, Song-Chou; Keng, Li-Ta; Lee, Ho-Sheng; Chang, Hou-Tai; Liao, Wei-Yu; Ho, Chao-Chi; Yu, Chong-Jen

    2016-01-01

    Background Both procalcitonin (PCT) and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) have been investigated separately as indicators of infection in patients with autoimmune diseases. Our study simultaneously evaluated both PCT and sTREM-1 along with C-reactive protein (CRP) in febrile patients with autoimmune diseases. Methods Fifty-nine patients were enrolled in the study. The patients were categorized into the infection group (n = 24) or the disease flare group (n = 35). sTREM-1, PCT and CRP concentrations at fever onset were compared between the two groups of patients. Results sTREM-1 and CRP did not differ between the two groups. PCT [median (range), ng/ml] was higher in the infection group than in the disease flare group [0.53 (0.02–12.85) vs. 0.12 (0.02–19.23), p = 0.001]. The area under the receiver-operating characteristic (ROC) for diagnosis of infection was 0.75 for PCT (p = 0.001), 0.63 for CRP (p = 0.09) and 0.52 for sTREM-1 (p = 0.79). Using 0.2 ng/ml as the cutoff value for PCT, sensitivity was 0.75 and specificity was 0.77. Negative predictive values for PCT were 92%, 87% and 82% for a prevalence of infection of 20%, 30%, and 40%, respectively. Neither immunosuppressants nor biomodulators affected the level of the three biomarkers. However, in patients treated with corticosteroids, the levels of sTREM-1 and CRP were significantly decreased compared with the untreated patients. Conclusions Setting PCT at a lower cutoff value could provide useful information on excluding infection in febrile patients with autoimmune diseases. The possible effect of corticosteroids on the level of sTREM-1 as an infection marker deserves further study. PMID:27096761

  5. Copeptin, procalcitonin and routine inflammatory markers-predictors of infection after stroke.

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    Felix Fluri

    Full Text Available BACKGROUND: Early predictors for the development of stroke-associated infection may identify patients at high risk and reduce post-stroke infection and mortality. METHODS: In 383 prospectively enrolled acute stroke patients we assessed time point and type of post-stroke infections (i.e. pneumonia, urinary tract infection (UTI other infection (OI. Blood samples were collected on admission, and days 1, and 3 to assess white blood cells (WBC, monocytes, C-reactive protein (CRP, procalcitonin (PCT, and copeptin. To determine the magnitude of association with the development of infections, odds ratios (OR were calculated for each prognostic blood marker. The discriminatory ability of different predictors was assessed, by calculating area under the receiver operating characteristic curves (AUC. Prognostic models including the three parameters with the best performance were identified. RESULTS: Of 383 patients, 66 (17.2% developed an infection after onset of stroke. WBC, CRP, copeptin and PCT were all independent predictors of any infection, pneumonia and UTI developed at least 24 hours after measurements. The combination of the biomarkers WBC, CRP and copeptin (AUC: 0.92 and WBC, CRP and PCT (AUC: 0.90 showed a better predictive accuracy concerning the development of pneumonia during hospitalization compared to each marker by itself (p-Wald <0.0001. CONCLUSION: Among ischemic stroke patients, copeptin, PCT, WBC and CRP measured on admission were predictors of infection in general, and specifically for pneumonia and UTI within 5 days after stroke. The combination of these biomarkers improved the prediction of patients who developed an infection.

  6. PROCALCITONIN AND INTERLEUKIN-6 AS MARKERS OF SEVERE INFECTION IN CHILDREN WITH FEBRILE NEUTROPENIA

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    Lidija Kitanovski

    2004-12-01

    Full Text Available Background. The results of the study conducted to determine whether procalcitonin (PCT and interleukin-6 (IL-6 are more sensitive and specific markers of severe infection in children with febrile neutropenia (FN than routinelly used C-reactive protein (CRP are presented in the article. 68 episodes of FN experienced by 32 patients were divided into three groups according to the site of infection. Group 1: episodes of bacteraemia and/or clinical sepsis (n = 16, group 2: episodes of focal infection (n = 16 and group 3: episodes of fever of unknown origin (FUO (n = 36. Blood samples for further PCT and IL-6 determination were collected on three consecutive days. CRP concentrations were measured daily in each patient until the resolution of fever. PCT, IL-6 and CRP concentrations were measured on one occassion in each of the 18 afebrile patients with malignant disase forming the reference group. Serum PCT and IL-6 concentrations were measured by immunochemiluminometric and immunoenzymatic assay. Receiver Operating Characteristic (ROC curves were used to determine optimum sensitivity, specificity, positive and negative predictive values and diagnostic accuracy of the studied parameters.Conclusions. PCT and IL-6 were found to be earlier and more sensitive markers of severe infection in neutropenic patients than CRP. The erliest one was IL-6, followed by PCT and CRP. Sequential determination of PCT up to 72 hours improved its diagnostic value, which was not the case for IL-6.In patients with gramnegative bacteraemias PCT concentracions were 3–5 times higher comparing to grampositive, whereas IL-6 concentrations were comparable in both groups.

  7. CHROMOSOME ABNORMALITIES IN INFERTILITY

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    Mateja Smogavec

    2009-08-01

    Conclusions Chromosomal analysis is an important method in diagnostic procedures of infertility, because chromosomal abnormalities could play the important role in etiology of infertility and are more frequently detected in this group of patients compared to general population. In the infertile couples balanced chromosomal abnormalities are the main cause of spontaneous abortions. Sex chromosome aneuploidies are highly correlated to infertility of females and males.

  8. Hereditary urea cycle abnormality

    Science.gov (United States)

    ... vitro so the specific genetic cause is known. Teamwork between parents, the affected child, and doctors can help prevent severe illness. Alternative Names Abnormality of the urea cycle - hereditary; Urea cycle - hereditary abnormality Images Male urinary system Urea cycle References Lichter-Konecki ...

  9. Is serum procalcitonin measurement a useful addition to a rheumatologist's repertoire? A review of its diagnostic role in systemic inflammatory diseases and joint infections

    NARCIS (Netherlands)

    Shaikh, Muddassir Muhammad; Hermans, Lucas Etienne; Van Laar, Jacob M.

    2015-01-01

    Early differentiation between infection and aseptic inflammation is difficult and is a challenge often faced in the rheumatology practice. Procalcitonin (PCT) is a biomarker that is preferentially induced in patients with bacterial infections, and a growing body of evidence supports its use for impr

  10. Efficacy and safety of procalcitonin guidance in reducing the duration of antibiotic treatment in critically ill patients : a randomised, controlled, open-label trial

    NARCIS (Netherlands)

    de Jong, Evelien; van Oers, Jos A; Beishuizen, Albertus; Vos, Piet; Vermeijden, Wytze J; Haas, Lenneke E; Loef, Bert G; Dormans, Tom; van Melsen, Gertrude C; Kluiters, Yvette C; Kemperman, Hans; van den Elsen, Maarten J; Schouten, Jeroen A; Streefkerk, Jörn O; Krabbe, Hans G; Kieft, Hans; Kluge, Georg H; van Dam, Veerle C; van Pelt, Joost; Bormans, Laura; Otten, Martine Bokelman; Reidinga, Auke C; Endeman, Henrik; Twisk, Jos W; van de Garde, Ewoudt M W; de Smet, Anne Marie G A; Kesecioglu, Jozef; Girbes, Armand R; Nijsten, Maarten W; de Lange, Dylan W

    2016-01-01

    BACKGROUND: In critically ill patients, antibiotic therapy is of great importance but long duration of treatment is associated with the development of antimicrobial resistance. Procalcitonin is a marker used to guide antibacterial therapy and reduce its duration, but data about safety of this reduct

  11. Determining the concentration of procalcitonin using a magnetic particles-based chemiluminescence assay for the clinical diagnosis of sepsis.

    Science.gov (United States)

    Qi, Suwen; Li, Qiaoliang; Rao, Wei; Liu, Xinyu; Yin, Li; Zhang, Huisheng

    2013-01-01

    Our objective is to develop an assay based on magnetic particles (MPs) to determine the concentration of procalcitonin (PCT) using a chemiluminescence immunoassay (CLIA). Fluorescein isothiocyanate (FITC) and N-(aminobutyl)-N-(ethylisoluminol) (ABEI) were used to label two different anti-procalcitonin (PCT) monoclonal antibodies. The labeled antibodies, the PCT antigen, and the anti-FITC antibody-coated MPs formed a double-sandwiched immunocomplex. The measured relative light units (RLUs) of ABEI in the substrate solution were directly proportional to the amount of PCT present in the samples. The proposed method was linear to 600 ng/mL with a detection limit of 0.03 ng/mL. The coefficient of variation (CV) was <5% and <6% for the intra- and inter-assay precision, respectively. The average recoveries were between 95 and 107%. The linearity-dilution effect gave a linear correlation coefficient of 0.9912. This proposed assay provided an alternative method to quantitatively measure PCT in serum for the diagnosis of sepsis.

  12. Diagnostic usefulness of sCD163, procalcitonin and neopterin for sepsis risk assessment in critically ill patients.

    Science.gov (United States)

    Sapa, Agnieszka; Rak, Alina; Wybieralska, Magdalena; Machoń, Jakub; Krzywonos-Zawadzka, Anna; Zawadzki, Kamil; Wełna, Marek; Woźniak, Mieczysław

    2017-01-01

    Sepsis is one of the most common causes of hospitalization and it is characterized by a high mortality rate in spite of the great progress in diagnosis and treatment achieved in recent years. Early diagnosis of sepsis is one of the most important elements of effective treatment. The clinical symptoms are not specific and biomarkers are considered to be useful tools in sepsis diagnostics. The aim of our study was to evaluate the diagnostic value of sCD163 as a marker of sepsis and a comparison of it with procalcitonin and neopterin in ICU patients. Concentrations of PCT, sCD163 and NPT were measured in 52 serum samples collected from 30 patients of the Department of Anesthesiology and Intensive Therapy of the University Hospital in Wroclaw. Venous blood was collected on the 1st and 3rd day of hospitalization. The Human CD163 Quantikine ELISA Kit was used to determine the concentrations of sCD163. Neopterin concentrations were measured by a Neopterin ELISA kit. PCT was measured at the University Center of Laboratory Diagnostics in Wroclaw using an automatic VIDAS® B.R.A.H.M.S. PCT assay. Our study showed that there was a significant difference between the values obtained in the study and the reference group for PCT (p sepsis, and their value in the diagnosis of sepsis in critically ill patients may be comparable to procalcitonin.

  13. Procalcitonin guided antibiotic therapy and hospitalization in patients with lower respiratory tract infections: a prospective, multicenter, randomized controlled trial

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    Henzen Christoph

    2007-07-01

    Full Text Available Abstract Background: Lower respiratory tract infections like acute bronchitis, exacerbated chronic obstructive pulmonary disease and community-acquired pneumonia are often unnecessarily treated with antibiotics, mainly because of physicians' difficulties to distinguish viral from bacterial cause and to estimate disease-severity. The goal of this trial is to compare medical outcomes, use of antibiotics and hospital resources in a strategy based on enforced evidence-based guidelines versus procalcitonin guided antibiotic therapy in patients with lower respiratory tract infections. Methods and design: We describe a prospective randomized controlled non-inferiority trial with an open intervention. We aim to randomize over a fixed recruitment period of 18 months a minimal number of 1002 patients from 6 hospitals in Switzerland. Patients must be >18 years of age with a lower respiratory tract infections Discussion: Use of and prolonged exposure to antibiotics in lower respiratory tract infections is high. The proposed trial investigates whether procalcitonin-guidance may safely reduce antibiotic consumption along with reductions in hospitalization costs and antibiotic resistance. It will additionally generate insights for improved prognostic assessment of patients with lower respiratory tract infections. Trial registration: ISRCTN95122877

  14. Prolactin Levels Correlate with Abnormal B Cell Maturation in MRL and MRL/lpr Mouse Models of Systemic Lupus Erythematosus-Like Disease

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    Maria Victoria Legorreta-Haquet

    2013-01-01

    Full Text Available Prolactin (PRL plays an important role in modulating the immune response. In B cells, PRL enhances antibody production, including antibodies with self-specificity. In this study, our aims were to determine the level of PRL receptor expression during bone-marrow B-cell development and to assess whether the presence of high PRL serum concentrations influences absolute numbers of developing populations and disease outcome in lupus-prone murine models. We observed that the PRL-receptor is expressed in early bone-marrow B-cell; the expression in lupus-prone mice, which had the highest level of expression in pro-B cells and immature cells, differed from that in wild-type mice. These expression levels did not significantly change in response to hyperprolactinemia; however, populations of pro-B and immature cells from lupus-prone strains showed a decrease in the absolute numbers of cells with high PRL-receptor expression in response to PRL. Because immature self-reactive B cells are constantly being eliminated, we assessed the expression of survival factor BIRC5, which is more highly expressed in both pro-B and immature B-cells in response to PRL and correlates with the onset of disease. These results identify an important role of PRL in the early stages of the B-cell maturation process: PRL may promote the survival of self-reactive clones.

  15. Prolactin Levels Correlate with Abnormal B Cell Maturation in MRL and MRL/lpr Mouse Models of Systemic Lupus Erythematosus-Like Disease

    Science.gov (United States)

    Legorreta-Haquet, Maria Victoria; Flores-Fernández, Rocio; Blanco-Favela, Francisco; Fuentes-Pananá, Ezequiel M; Chávez-Sánchez, Luis; Hernández-González, Rafael; Tesoro-Cruz, Emiliano; Arriaga-Pizano, Lourdes; Chávez-Rueda, Adriana Karina

    2013-01-01

    Prolactin (PRL) plays an important role in modulating the immune response. In B cells, PRL enhances antibody production, including antibodies with self-specificity. In this study, our aims were to determine the level of PRL receptor expression during bone-marrow B-cell development and to assess whether the presence of high PRL serum concentrations influences absolute numbers of developing populations and disease outcome in lupus-prone murine models. We observed that the PRL-receptor is expressed in early bone-marrow B-cell; the expression in lupus-prone mice, which had the highest level of expression in pro-B cells and immature cells, differed from that in wild-type mice. These expression levels did not significantly change in response to hyperprolactinemia; however, populations of pro-B and immature cells from lupus-prone strains showed a decrease in the absolute numbers of cells with high PRL-receptor expression in response to PRL. Because immature self-reactive B cells are constantly being eliminated, we assessed the expression of survival factor BIRC5, which is more highly expressed in both pro-B and immature B-cells in response to PRL and correlates with the onset of disease. These results identify an important role of PRL in the early stages of the B-cell maturation process: PRL may promote the survival of self-reactive clones. PMID:24454471

  16. Abnormal menstrual periods (image)

    Science.gov (United States)

    ... may have a variety of causes, such as endometrial hyperplasia, endometrial polyps, uterine fibroids, and abnormal thyroid or ... the endometrium becomes unusually thick it is called endometrial ... Hyperplasia may cause profuse or extended menstrual bleeding.

  17. Chromosomal Abnormalities in ADHD

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    J Gordon Millichap

    2002-07-01

    Full Text Available The prevalence of fragile X syndrome, velocardiofacial syndrome (VCFS, and other cytogenetic abnormalities among 100 children (64 boys with combined type ADHD and normal intelligence was assessed at the NIMH and Georgetown University Medical Center.

  18. Chromosomal abnormalities and autism

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    Farida El-Baz

    2016-01-01

    Conclusion: Chromosomal abnormalities were not detected in the studied autistic children, and so the relation between the genetics and autism still needs further work up with different study methods and techniques.

  19. Abnormal protein aggregationand neurodegenerativediseases

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Abnormal protein aggregation or amyloid is the major cause ofmany neurodegenerative disorders. The present review focuses on the correlation between sequence and structure features of proteins related to the diseases and abnormal protein aggregation. Recent progress has improved our knowledge on understand-ing the mechanism of amyloid formation. We suggest a nucleation model for ordered protein aggregation, which can also explain pathogenesis mechanisms of these neurodegenerative diseases in vivo.

  20. Concentrations of procalcitonin and C-reactive protein, white blood cell count, and the immature-to-total neutrophil ratio in the blood of neonates with nosocomial infections: Gram-negative bacilli vs coagulase-negative staphylococci

    OpenAIRE

    Kordekag, A.

    2011-01-01

    Abstract This study was undertaken to determine whether concentrations of procalcitonin in the blood of neonates with nosocomial infections depend on the type of pathogen. Qualification for the study group was based on the clinical signs of infection. We found that infections with Gram-positive (chiefly coagulase-negative staphylococci) and Gram-negative bacteria are accompanied by elevated concentrations of procalcitonin. In the case of Gram-positive bacteria, other laboratory sig...

  1. Clinical Usefulness of Procalcitonin and C-Reactive Protein as Outcome Predictors in Critically Ill Patients with Severe Sepsis and Septic Shock.

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    Jeong-Am Ryu

    Full Text Available Sepsis is a major cause of mortality and morbidity in critically ill patients. Procalcitonin (PCT and C-reactive protein (CRP are the most frequently used biomarkers in sepsis. We investigated changes in PCT and CRP concentrations in critically ill patients with sepsis to determine which biochemical marker better predicts outcome. We retrospectively analyzed 171 episodes in 157 patients with severe sepsis and septic shock who were admitted to the Samsung Medical Center intensive care unit from March 2013 to February 2014. The primary endpoint was patient outcome within 7 days from ICU admission (treatment failure. The secondary endpoint was 28-day mortality. Severe sepsis was observed in 42 (25% episodes from 41 patients, and septic shock was observed in 129 (75% episodes from 120 patients. Fifty-five (32% episodes from 42 patients had clinically-documented infection, and 116 (68% episodes from 99 patients had microbiologically-documented infection. Initial peak PCT and CRP levels were not associated with treatment failure and 28-day mortality. However, PCT clearance (PCTc and CRP (CRPc clearance were significantly associated with treatment failure (p = 0.027 and p = 0.030, respectively and marginally significant with 28-day mortality (p = 0.064 and p = 0.062, respectively. The AUC for prediction of treatment success was 0.71 (95% CI, 0.61-0.82 for PCTc and 0.71 (95% CI, 0.61-0.81 for CRPc. The AUC for survival prediction was 0.77 (95% CI, 0.66-0.88 for PCTc and 0.77 (95% CI, 0.67-0.88 for CRPc. Changes in PCT and CRP concentrations were associated with outcomes of critically ill septic patients. CRP may not be inferior to PCT in predicting outcome in these patients.

  2. Serum Concentrations of Interleukin-6, Procalcitonin, and C-Reactive Protein: Discrimination of Septical Complications and Systemic Inflammatory Response Syndrome after Pediatric Surgery.

    Science.gov (United States)

    Neunhoeffer, Felix; Plinke, Swantje; Renk, Hanna; Hofbeck, Michael; Fuchs, Jörg; Kumpf, Matthias; Zundel, Sabine; Seitz, Guido

    2016-04-01

    Early differentiation between sepsis and systemic inflammatory response syndrome (SIRS) is useful for therapeutic management in neonates and infants after surgery. To compare the early (first 2 days) diagnostic value of interleukin-6 (IL-6), procalcitonin (PCT), and C-reactive protein (CRP) after surgery in the differentiation of subsequent SIRS and septic complications. IL-6, PCT, and CRP were measured 0, 24, and 48 hours after surgery in neonates and infants with clinical suspicion of postoperative sepsis. Sensitivity, specificity, and predictive values for SIRS/septic complications were calculated. A total of 31 out of 205 neonates and infants showed clinical signs for postoperative sepsis and underwent sepsis work-up. Nine patients developed septic complications, sixteen patients met criteria for SIRS, and six patients showed an uneventful postoperative course during the first five postoperative days. IL-6, PCT, and CRP levels increased in all subgroups after surgery and were significantly higher in the sepsis group (p surgery. Sensitivity and specificity (area under the curve) for IL-6 (cutoff 673 ng/dL) were 94.4 and 75% (86.2%), for CRP (cutoff 1.48 mg/dL) 76.2 and 75.0% (88.1%), and for PCT (cutoff 16.1 mg/L) 66.7 and 57.1% (65.6%). IL-6 appears to be an early marker for severe bacterial infections with high sensitivity. IL-6 and CRP were the most reliable markers for the discrimination between SIRS and sepsis within the postoperative period. Georg Thieme Verlag KG Stuttgart · New York.

  3. Abnormal Changes of Brain Cortical Anatomy and the Association with Plasma MicroRNA107 Level in Amnestic Mild Cognitive Impairment

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    Tao eWang

    2016-05-01

    Full Text Available MicroRNA107 (Mir107 has been thought to relate to the brain structure phenotype of Alzheimer’s disease. In this study, we evaluated the cortical anatomy in amnestic mild cognitive impairment (aMCI and the relation between cortical anatomy and plasma levels of Mir107 and beta-site amyloid precursor protein cleaving enzyme 1 (BACE1. 20 aMCI and 24 cognitively normal control (NC subjects were recruited, and T1-weighted MR images were acquired. Cortical anatomical measurements, including cortical thickness (CT, surface area (SA, and local gyrification index (LGI, were assessed. Quantitative RT-PCR was used to examine plasma expression of Mir107, BACE1 mRNA. Thinner cortex was found in aMCI in areas associated with episodic memory and language, but with thicker cortex in other areas. SA decreased in aMCI in the areas associated with working memory and emotion. LGI showed a significant reduction in aMCI in the areas involved in language function. Changes in Mir107 and BACE1 messenger RNA plasma expression were correlated with changes in CT and SA. We found alterations in key left brain regions associated with memory, language, and emotion in aMCI that were significantly correlated with plasma expression of mir107 and BACE1 mRNA. This combination study of brain anatomical alterations and gene information may shed lights on our understanding of the pathology of AD.

  4. Procalcitonin is not sufficiently reliable to be the sole marker of neonatal sepsis of nosocomial origin

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    Moro Serrano Manuel

    2006-05-01

    Full Text Available Abstract Background It has recently been suggested that serum procalcitonin (PCT is of value in the diagnosis of neonatal sepsis, with varying results. The aim of this prospective multicenter study was to assess the usefulness of PCT as a marker of neonatal sepsis of nosocomial origin. Methods One hundred infants aged between 4 and 28 days of life admitted to the Neonatology Services of 13 acute-care teaching hospitals in Spain over 1-year with clinical suspicion of neonatal sepsis of nosocomial origin were included in the study. Serum PCT concentrations were determined by a specific immunoluminometric assay. The reliability of PCT for the diagnosis of nosocomial neonatal sepsis at the time of suspicion of infection and at 12–24 h and 36–48 h after the onset of symptoms was calculated by receiver-operating characteristics (ROC curves. The Youden's index (sensitivity + specificity - 1 was used for determination of optimal cutoff values of the diagnostic tests in the different postnatal periods. Sensitivity, specificity, and the likelihood ratio of a positive and negative result with the 95% confidence interval (CI were calculated. Results The diagnosis of nosocomial sepsis was confirmed in 61 neonates. Serum PCT concentrations were significantly higher at initial suspicion and at 12–24 h and 36–48 h after the onset of symptoms in neonates with confirmed sepsis than in neonates with clinically suspected but not confirmed sepsis. Optimal PCT thresholds according to ROC curves were 0.59 ng/mL at the time of suspicion of sepsis (sensitivity 81.4%, specificity 80.6%; 1.34 ng/mL within 12–24 h of birth (sensitivity 73.7%, specificity 80.6%, and 0.69 ng/mL within 36–48 h of birth (sensitivity 86.5%, specificity 72.7%. Conclusion Serum PCT concentrations showed a moderate diagnostic reliability for the detection of nosocomial neonatal sepsis from the time of suspicion of infection. PCT is not sufficiently reliable to be the sole marker of

  5. Procalcitonin is not sufficiently reliable to be the sole marker of neonatal sepsis of nosocomial origin

    Science.gov (United States)

    López Sastre, José B; Pérez Solís, David; Roqués Serradilla, Vicente; Fernández Colomer, Belén; Coto Cotallo, Gil D; Krauel Vidal, Xavier; Narbona López, Eduardo; García del Río, Manuel; Sánchez Luna, Manuel; Belaustegui Cueto, Antonio; Moro Serrano, Manuel; Urbón Artero, Alfonso; Álvaro Iglesias, Emilio; Cotero Lavín, Ángel; Martínez Vilalta, Eduardo; Jiménez Cobos, Bartolomé

    2006-01-01

    Background It has recently been suggested that serum procalcitonin (PCT) is of value in the diagnosis of neonatal sepsis, with varying results. The aim of this prospective multicenter study was to assess the usefulness of PCT as a marker of neonatal sepsis of nosocomial origin. Methods One hundred infants aged between 4 and 28 days of life admitted to the Neonatology Services of 13 acute-care teaching hospitals in Spain over 1-year with clinical suspicion of neonatal sepsis of nosocomial origin were included in the study. Serum PCT concentrations were determined by a specific immunoluminometric assay. The reliability of PCT for the diagnosis of nosocomial neonatal sepsis at the time of suspicion of infection and at 12–24 h and 36–48 h after the onset of symptoms was calculated by receiver-operating characteristics (ROC) curves. The Youden's index (sensitivity + specificity - 1) was used for determination of optimal cutoff values of the diagnostic tests in the different postnatal periods. Sensitivity, specificity, and the likelihood ratio of a positive and negative result with the 95% confidence interval (CI) were calculated. Results The diagnosis of nosocomial sepsis was confirmed in 61 neonates. Serum PCT concentrations were significantly higher at initial suspicion and at 12–24 h and 36–48 h after the onset of symptoms in neonates with confirmed sepsis than in neonates with clinically suspected but not confirmed sepsis. Optimal PCT thresholds according to ROC curves were 0.59 ng/mL at the time of suspicion of sepsis (sensitivity 81.4%, specificity 80.6%); 1.34 ng/mL within 12–24 h of birth (sensitivity 73.7%, specificity 80.6%), and 0.69 ng/mL within 36–48 h of birth (sensitivity 86.5%, specificity 72.7%). Conclusion Serum PCT concentrations showed a moderate diagnostic reliability for the detection of nosocomial neonatal sepsis from the time of suspicion of infection. PCT is not sufficiently reliable to be the sole marker of sepsis, but would be

  6. Efficacy and Safety of Procalcitonin-Guided Antibiotic Therapy in Lower Respiratory Tract Infections

    Directory of Open Access Journals (Sweden)

    Werner C. Albrich

    2013-01-01

    Full Text Available Background: In 14 randomized controlled studies to date, a procalcitonin (PCT-based algorithm has been proven to markedly reduce the use of antibiotics along with an unimpaired high safety and low complication rates in patients with lower respiratory tract infections (LRTIs. However, compliance with the algorithm and safety out of controlled study conditions has not yet been sufficiently investigated. Methods: We performed a prospective international multicenter observational post-study surveillance of consecutive adults with community-acquired LRTI in 14 centers (Switzerland (n = 10, France (n = 3 and the United States (n = 1. Results: Between September 2009 and November 2010, 1,759 patients were enrolled (median age 71; female sex 44.4%. 1,520 (86.4% patients had a final diagnosis of LRTI (community-acquired pneumonia (CAP, 53.7%; acute exacerbation of chronic obstructive pulmonary disease (AECOPD, 17.1%; and acute bronchitis, 14.4%. Compliance with the PCT-guided therapy (overall 68.2% was highest in patients with bronchitis (81.0% vs. AECOPD, 70.1%; CAP, 63.7%; p < 0.001, outpatients (86.1% vs. inpatients, 65.9%; p < 0.001 and algorithm-experienced centers (82.5% vs. algorithm-naive, 60.1%; p < 0.001 and showed significant geographical differences. The initial decision about the antibiotic therapy was based on PCT value in 72.4%. In another 8.6% of patients, antibiotics were administered despite low PCT values but according to predefined criteria. Thus, the algorithm was followed in 81.0% of patients. In a multivariable Cox hazard ratio model, longer antibiotic therapy duration was associated with algorithm-non-compliance, country, hospitalization, CAP vs. bronchitis, renal failure and algorithm-naïvety of the study center. In a multivariable logistic regression complications (death, empyema, ICU treatment, mechanical ventilation, relapse, and antibiotic-associated side effects were significantly associated with increasing CURB65-Score, CAP

  7. Abnormal lipoprotein(a) levels predict coronary artery calcification in Southeast Asians but not in Caucasians: use of noninvasive imaging for evaluation of an emerging risk factor.

    Science.gov (United States)

    Sharma, Abhinav; Kasim, Manoefris; Joshi, Parag H; Qian, Zhen; Krivitsky, Eric; Akram, Kamran; Rinehart, Sarah; Vazquez, Gustavo; Miller, Joseph; Rohman, Mohammad Saifur; Voros, Szilard

    2011-08-01

    Subclinical atherosclerosis can be quantified by coronary artery calcium (CAC) scoring. Due to its high specificity for atherosclerosis, CAC is an excellent phenotypic tool for the evaluation of emerging risk markers. Lipoprotein(a) [Lp(a)] is atherogenic due to the presence of apoB and may be thrombogenic through its apo(a) component. Lp(a) has been linked to cardiovascular events in Caucasians; however, its link to atherosclerosis in various ethnicities remains unclear. We evaluated the ability of Lp(a) mass to predict subclinical atherosclerosis in Southeast Asians and Caucasians, as measured by CAC. Traditional lipid measurements, Lp(a) measurements, and CAC by 64-slice multidetector computed tomography was performed in 103 consecutive patients in the USA and in 104 consecutive patients in Jakarta, Indonesia. Proportion of positive CAC and median CAC in Southeast Asians and in Caucasians was 61.5% and 63.1%, and 23.5 (interquartile range, 0-270) and 13 (interquartile range, 0-388), respectively. Significantly higher proportion of Southeast Asians had elevated Lp(a) levels, compared to Caucasians (51.0% vs. 29.2%; p = 0.005). In Southeast Asians, Lp(a) remained an independent predictor of CAC with an odds ratio of 4.97 (95% confidence interval, 1.56-15.88; p Southeast Asians. This translated to 7% of Southeast Asians reclassified to correct CAC status. Lp(a) measurements may have a role in risk stratification of Southeast Asians. Ethnic variation should be taken into account when considering the use of Lp(a) measurements in risk assessment.

  8. 中枢神经系统感染患儿脑脊液降钙素原测定的意义%The significance of procalcitonin in cerebrospinal fluid in children with central nervous system infection

    Institute of Scientific and Technical Information of China (English)

    王文徽; 韩虹; 杜丽君; 武运红; 孙浩; 杨银升; 朱镭; 郭伟立

    2016-01-01

    Objective To explore the changes of procalcitonin in cerebrospinal fluid of children with central nervous system infection and its clinical significance.Methods The levels of procalcitonin in cerebrospinal fluid of 108 children with central nervous system infection and 40 lumbar anesthesia children without central nervous sys‐tem diseases were measured by enzyme‐linked fluorescent assay .Differences in the levels of cerebrospinal fluid procalcitonin between the group with bacterial meningitis ,viral meningitis and the control group ,the severe group and ordinary group with bacterial meningitis ,the group in acute stage and recovery period were compared .Results Patients with bacterial meningitis had significantly higher serum PCT than those with viral meningitis and the control group[(0 .57 ± 0 .88) vs (0 .06 ± 0 .04) ,(0 .07 ± 0 .03)μg/L ,P <0 .01] .The PCT levels of children in the severe group were significantly higher than those in the ordinary group with bacterial meningitis ( P <0 .01) ,and the PCT levels of children in acute stage were higher than those in recovery period of the severe group ( P <0.01) .Conclusion The cerebrospinal fluid procalcitonin levels of children with bacterial meningitis relates to de‐gree of severity .Detection of procalcitonin of the children with central nervous system infection contributes not only to identify the nature of central nervous system infection ,and assess the severe degree ,but also to predict their prognosis .%目的:探讨中枢神经系统感染患儿脑脊液降钙素原变化的临床意义。方法108例中枢神经系统感染患儿和40例无神经系统疾病儿需腰麻的外科手术患儿采用酶联荧光分析(ELFA )技术检测患者脑脊液降钙素厚(PC T )。比较化脓性脑膜炎组、病毒性脑炎组和对照组、化脓性脑膜炎重症组和普通组、化脓性脑膜炎重症组急性期和恢复期脑脊液降钙素原水平的差异。结果化脓性脑膜炎组

  9. 三级监控降低卡介苗接种后异常反应发生率的探讨%THE DISCUSSION OF THREE-LEVEL MONITORING TO REDUCE THE ABNORMAL REACTION INCIDENCE RATE AFTER BCG VACCINATION

    Institute of Scientific and Technical Information of China (English)

    陈立群; 邵丽文; 江爱玉

    2012-01-01

    Objective To discuss the effect of three -level monitoring to reduce the abnormal reaction incidence rate after bacillus calmette - guerin( BCG ) vaccination. Methods A total of 4 346 cases of newborn who were born in 2009 were assigned into control group ,3 999 cases of newborn born in 2010 into experimental group. Experimental group was given three-level monitoring on response after BCG vaccination and control group was observed traditionaly after the BCG vaccinaLion. The abnormal reaction incidence rate after BCG vaccination and the parents' satisfaction of BCG vaccination work were observed. Results The abnormal reactions of experimental group occurred at a rate of 1.50 per thousand, and the control group was 3.91 per thousand, the difference was statistically significant( P < 0. 05 ). The satisfaction of parents at discharge in experimental group was 96. 17% and control group was 94. 22% ; When the babies were six months old the satisfacLion of parenLs in experimental group was 91. 42% and control group was 88.47% with a significant difference( P<0.05 ). Conclusion Implementation of the three-level monitoring reduces the abnormal reaction incidence rate after vaccination, improves the parenLs'satisfaction with BCG vaccination work.%目的 探讨三级监控降低卡介苗接种后异常反应发生率的效果.方法 以2009年出生的新生儿4 346例为对照组,2010年出生的3 999例为试验组.试验组实施卡介苗接种后反应的三级监控,对照组采用传统的卡介苗接种后的观察.观察2组卡介苗接种后异常反应发生率及家长对卡介苗接种工作满意度.结果 试验组的异常反应发生率为1.50‰,对照组发生率为3.91‰,差异有统计学意义(P>0.05).出院时家长满意度试验组为96.17%,对照组为94.22%,婴儿6个月时满意度试验组为91.42%,对照组为88.47%,差异有统计学意义(P<0.01).结论 实施三级监控降低了接种后异常反应发生率,提高了家长对卡介苗预防接种工作的满意度.

  10. [CHROMOSOMAL ABNORMALITIES IN PATIENTS WITH INFERTILITY].

    Science.gov (United States)

    Pylyp, L Y; Spinenko, L O; Verhoglyad, N V; Kashevarova, O O; Zukin, V D

    2015-01-01

    To assess the frequency and structure of chromosomal abnormalities in patients with infertility, a retrospective analysis of cytogenetic studies of 3414 patients (1741 females and 1673 males), referred to the Clinic of reproductive medicine "Nadiya" from 2007 to 2012, was performed. Chromosomal abnormalities were detected in 2.37% patients: 2.79% in males and 1.95% in females. Balanced structural chromosomal abnormalities prevailed over numerical abnormalities and corresponded to 80.2% of all chromosomal abnormalities detected in the studied group. Sex chromosome abnormalities made up 23.5% of chromosomal pathology (19/81) and included gonosomal aneuploidies in 84% of cases (16/19) and structural abnormalities of chromosome Y in 16% of cases (3/19). The low level sex chromosome mosaicism was detected with the frequency of 0.55%. Our results highlight the importance of cytogenetic studies in patients seeking infertility treatment by assisted reproductive technologies, since an abnormal finding not only provide a firm diagnosis to couples with infertility, but also influences significantly the approach to infertility treatment in such patients.

  11. [Hair shaft abnormalities].

    Science.gov (United States)

    Itin, P H; Düggelin, M

    2002-05-01

    Hair shaft disorders may lead to brittleness and uncombable hair. In general the hair feels dry and lusterless. Hair shaft abnormalities may occur as localized or generalized disorders. Genetic predisposition or exogenous factors are able to produce and maintain hair shaft abnormalities. In addition to an extensive history and physical examination the most important diagnostic examination to analyze a hair shaft problem is light microscopy. Therapy of hair shaft disorders should focus to the cause. In addition, minimizing traumatic influences to hair shafts, such as dry hair with an electric dryer, permanent waves and dyes is important. A short hair style is more suitable for such patients with hair shaft disorders.

  12. Stop Antibiotics on guidance of Procalcitonin Study (SAPS) : a randomised prospective multicenter investigator-initiated trial to analyse whether daily measurements of procalcitonin versus a standard-of-care approach can safely shorten antibiotic duration in intensive care unit patients - calculated sample size: 1816 patients

    NARCIS (Netherlands)

    Assink-de Jong, Evelien; de lange, Dylan W.; van Oers, Jos A.; Nijsten, Maarten W.; Twisk, Jos W.; Beishuizen, Albertus

    2013-01-01

    Background: Unnecessary long-term use of broad-spectrum antibiotics is linked to the emergence and selection of resistant bacteria, prolonged hospitalisation and increased costs. Several clinical trials indicate that the biomarker procalcitonin (PCT) can guide antibiotic therapy. Some of these trial

  13. Abnormal immune parameters in HIV-seronegative haemophilic patients

    NARCIS (Netherlands)

    Allersma, DP; Smid, WM; Briet, E

    In HIV-seronegative haemophiliac patients abnormal immune parameters have been demonstrated. In this review data on these abnormalities, their aetiology and clinical consequences are summarized and discussed. The data reviewed show abnormalities at different levels of the adaptive immune system.

  14. Abnormal immune parameters in HIV-seronegative haemophilic patients

    NARCIS (Netherlands)

    Allersma, DP; Smid, WM; Briet, E

    1996-01-01

    In HIV-seronegative haemophiliac patients abnormal immune parameters have been demonstrated. In this review data on these abnormalities, their aetiology and clinical consequences are summarized and discussed. The data reviewed show abnormalities at different levels of the adaptive immune system. Mos

  15. Continuous Detection of Procalcitonin and Blood Culture in the United Diagnosis of Bacteremia%血清降钙素原联合血培养连续检测对菌血症的诊断价值

    Institute of Scientific and Technical Information of China (English)

    马莉; 孙光伟; 王厚照

    2011-01-01

    Objective To discuss the value of continuous detection of procalcitonin and blood culture in the united diagnosis of bacteremia. Methods 76 patients with bacteremia ( bacteremia group) , 32 patients with tumor fever (tumor group) and 20 healthy subjects (healthy control group) were delected for the serum levels of PCT in the first visit. Bacteremia group received blood culture every 24 h and detected for both indicators. The levels of PCT in the 3 groups were compared, the diagnosis value of continuous detections was analyzed. And the results of PCT in bacteremia group were observed before and after antibiotics treatment. Results Positive rate of PCT in the 3 groups were 82. 89% , 15. 62% , and 0 at the first test, and there were significant differences between the 3 groups( P <0. 01); The positive rate of blood culture in bacteremia group was 22.36% at the first test, and it increased with the increase of blood culture; the level of PCT decreased when bacteremia was controlled. Conclusion ContinuouH detections of procalcitonin and blood culture can not only increase the diagnosis rate of bacteremia, but also can be used in the prognosis of bacteremia. Clinicians should choose the best time of blood culture to improve the diagnosis rate of bacteremia according to the the length of heat time.%目的 探讨血清降钙素原( Procalcitonin,PCT)联合血培养连续检测对菌血症的诊断价值.方法 对76例菌血症(菌血症组)、32例肿瘤热(肿瘤组)和20例健康体检(健康对照组)在首诊时检测血清PCT,并对菌血症组进行血培养,每隔24h重复检测以上两指标,比较3组的血清PCT水平,分析连续检测对菌血症的诊断价值,并对菌血症组应用抗生素前后血清PCT检测结果进行分析.结果 首次检测PCT,3组的阳性率分别为82.89%、15.62%、0%,菌血症组与肿瘤组、健康对照组比较差异均有统计学意义(P<0.01);菌血症组首次血培养阳性率22.36%,随着培养次数的增加,

  16. Influence of procalcitonin and C-reactive protein on prognosis of patients with postoperative severe sepsis%降钙素原与 C-反应蛋白对术后重度脓毒血症患者预后的影响

    Institute of Scientific and Technical Information of China (English)

    龙涛; 白蓉蓉; 李智; 黄磊; 王雪

    2015-01-01

    OBJECTIVE To explore the influence of procalcitonin and C‐reactive protein on the prognosis of the pa‐tients with postoperative sepsis and observe the association with the prognosis of the sepsis patients .METHODS A total of 60 patients with postoperative sepsis who underwent the thoracic or abdominal surgery from Aug 2012 to Aug 2013 were randomly enrolled in the study ,totally 54 cases were included ,6 cases were not eligible for the study and excluded .The blood specimens were extracted from the patients with severe sepsis on day 1 ,2 ,3 ,5 , 7 ,and 10 after the experiment ;the inflammatory indicators including the procalcitonin and C‐reactive protein were detected ,and the results of the experiments were recorded and analyzed .RESULTS There was no significant differ‐ence in the procalcitonin ,C‐reactive protein ,or APACHEⅡ score among the patients with various prognosis in the first three days after the experiment ;there was significant difference in the procalcitonin ,C‐reactive protein , or APACHEⅡ score among the patients with various prognosis on day 7 and 10 after the experiment (P<0 .05) . The area under curve (AUC) for prognosis evaluation of the sepsis patients within 4 weeks after the experiments relative to the procalcitonin ,C‐reactive protein ,and APACHEⅡ score on day 7 were as follows :the procalcitonin 0 .689 ,the C‐reactive protein 0 .691 ,the APACHEⅡ score 0 .651 .CONCLUSION The change of disease of the pa‐tients with postoperative severe sepsis is highly associated with the levels of procalcitonin and C‐reactive protein on day 7 ,therefore ,the joint detection of procalcitonin with C‐reactive protein plays an important role in the prognos‐tic diagnosis of the patients with postoperative severe sepsis ,and it is worthy to be promoted in the hospital .%目的:探讨检测降钙素原以及C‐反应蛋白对于手术后脓毒血症患者的预后影响,判断其在脓毒血症患者预后的

  17. Níveis de hemoglobina glicosilada e anomalias cardíacas em fetos de mães com diabetes mellitus Glycosylated hemoglobin levels and cardiac abnormalities in fetuses of diabetic mothers

    Directory of Open Access Journals (Sweden)

    Ivo Behle

    1998-06-01

    Full Text Available Avaliou-se, prospectivamente, a existência de relação entre o controle glicêmico materno, na primeira metade da gestação, com a ocorrência de anomalias cardíacas fetais, em gestantes com diabetes mellitus. O nível da hemoglobina glicosilada (HbA1c foi determinado em 127 grávidas, por ocasião da primeira visita pré-natal. Nove eram portadoras de diabetes do tipo I, 77 do tipo II e 41 de Diabetes mellitus gestacional (DMG. Todas foram submetidas a ecocardiografia fetal detalhada na 28ª (±4,1 semana da gestação. Em 31 dos 127 fetos (24,4% foram detectadas anomalias cardíacas. Em 10 (7,87%, foram diagnosticadas anomalias cardíacas estruturais e, em 21 (16,53%, miocardiopatia hipertrófica como anomalia cardíaca isolada. A média das dosagens de HbA1c no grupo de gestantes sem anomalias cardíacas (5,6% foi estatisticamente diferente da média das HbA1c do grupo com anomalias (10,1% (pWe analyze prospectively the existence of a relationship between the mother's glycemic control, in the first half of pregnancy, and the occurrence of abnormal fetal cardiac abnormalities, in pregnant women with diabetes mellitus. In 127 pregnant women, the level of glycosylated hemoglobin was determined on the first visit during prenatal care. Nine patients had type I diabetes, 77 type II and 41 gestational diabetes mellitus (GDM. All mothers were submitted to detailed fetal echocardiography, during the 28th ± 4.127 week of gestation. In 31 (24.4% of the 127 fetuses cardiac anomalies were detected. In 10 (7.87% an isolated cardiac anomaly was identified. Mean HbA1c in the group of pregnant women without cardiac anomalies (5.64% was statistically different from the group with anomalies (10.14% (p<0.0001. The receiver-operator characteristic, representing the balance between sensitivity (92.83% and specificity (98.92% in the diagnosis of structural cardiac abnormalities, showed a cut-off point at the 7.5% HbA1c level. In nine of ten fetuses with

  18. Chromosomal abnormalities and autism

    African Journals Online (AJOL)

    Farida El-Baz

    2015-06-19

    Jun 19, 2015 ... Received 19 April 2015; accepted 11 May 2015 ... Methods: This cross sectional study was conducted at the Child Psychiatry Clinic, ... Males are affected more than females, only one case had ... communication, repetitive behavior, abnormal movement ... course, age, sex and consanguinity of the patients.

  19. Cortical Abnormalities in ADHD

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2003-12-01

    Full Text Available Grey-matter abnormalities at the cortical surface and regional brain size were mapped by high-resolution MRI and surface-based, computational image analytical techniques in a group of 27 children and adolescents with attention deficit hyperactivity disorder (ADHD and 46 controls, matched by age and sex, at the University of California at Los Angeles.

  20. Neurological abnormalities predict disability

    DEFF Research Database (Denmark)

    Poggesi, Anna; Gouw, Alida; van der Flier, Wiesje

    2014-01-01

    To investigate the role of neurological abnormalities and magnetic resonance imaging (MRI) lesions in predicting global functional decline in a cohort of initially independent-living elderly subjects. The Leukoaraiosis And DISability (LADIS) Study, involving 11 European centres, was primarily aimed...

  1. Lacrimal system abnormalities.

    Science.gov (United States)

    Moore, B D

    1994-03-01

    This report outlines several of the more important abnormalities of the lacrimal system in infants and young children. Although rare, alacrima can be a very difficult clinical problem to treat. The most common cause of alacrima is the Riley-Day syndrome. Nasolacrimal duct obstruction is a very common anomaly in children. The clinical appearance and treatment of this disorder are discussed.

  2. Abnormalities of gonadal differentiation.

    Science.gov (United States)

    Berkovitz, G D; Seeherunvong, T

    1998-04-01

    Gonadal differentiation involves a complex interplay of developmental pathways. The sex determining region Y (SRY) gene plays a key role in testis determination, but its interaction with other genes is less well understood. Abnormalities of gonadal differentiation result in a range of clinical problems. 46,XY complete gonadal dysgenesis is defined by an absence of testis determination. Subjects have female external genitalia and come to clinical attention because of delayed puberty. Individuals with 46,XY partial gonadal dysgenesis usually present in the newborn period for the valuation of ambiguous genitalia. Gonadal histology always shows an abnormality of seminiferous tubule formation. A diagnosis of 46,XY true hermaphroditism is made if the gonads contain well-formed testicular and ovarian elements. Despite the pivotal role of the SRY gene in testis development, mutations of SRY are unusual in subjects with a 46,XY karyotype and abnormal gonadal development. 46,XX maleness is defined by testis determination in an individual with a 46,XX karyotype. Most affected individuals have a phenotype similar to that of Klinefelter syndrome. In contrast, subjects with 46,XX true hermaphroditism usually present with ambiguous genitalia. The majority of subjects with 46,XX maleness have Y sequences including SRY in genomic DNA. However, only rare subjects with 46,XX true hermaphroditism have translocated sequences encoding SRY. Mosaicism and chimaerism involving the Y chromosome can also be associated with abnormal gonadal development. However, the vast majority of subjects with 45,X/46,XY mosaicism have normal testes and normal male external genitalia.

  3. Serum procalcitonin elevation in elderly patients with coronary heart disease at the onset of septic shock caused by either Gram negative or Gram positive bacteremia

    Institute of Scientific and Technical Information of China (English)

    HUANG Dao-zheng; MA Huan; WANG Shou-hong; WU Yan; QIN Tie-he; TAN Ning

    2016-01-01

    Background Septic shock caused by bacteremia is a life-threatening infection whose prognosis is highly dependent on early recognition and appropriate treatment.Procalcitonin (PCT) has been shown to accurately and quickly distinguish bacteremia from noninfectious inflammatory states in critically severe patients.However,the extent of PCT magnitude elevation according to the Gram stain result in elderly patients with coronary heart disease (CHD) at the onset of septic shock caused by bacteremia varies,and has not been clearly elucidated.Methods The medical records of advanced age (non-neutropenic) patient with CHD and septic shock between Mar 2013 and Jun 2015 who had bacteremia caused by either Gram-positive (GP) bacteria or Gram-negative (GN) bacteria were reviewed,and the levels of PCT,C-reactive (CRP) protein and white blood cells count (WBC) in both groups were analyzed.Results 75 episodes of either GN bacteremia (n =40) or GP bacteremia (n =35) were enrolled.PCT levels were found to be markedly higher in patients with GN bacteremia than in those with GP bacteremia [(8.93 ± 17.58) vs.(64.42 ± 58.56) ng/L (P < 0.001)],whereas there was no significant difference in CRP and WBC (P > 0.05).Moreover,a high PCT level was found to be independently associated with GN bacteremia in this study population.A PCT level of 19.69 ng/mL yielded a 72.5% sensitivity,a 91.4% specificity,an 8.43 positive likelihood ratio and a 0.30 negative likelihood ratio for GN-related bacteremia in the study cohort [AUROCC =0.870 (0.041),95% CI (0.790-0.949)].Conclusion In an elderly patient (non-neutropenic)with CHD and septic shock,GN bacteremia could be associated with higher PCT values than those found in GP bacteremia (PCT > 19.69 ng/mL).

  4. Early changes of procalcitonin predict bacteremia in patients with intensive care unit-acquired new fever

    Institute of Scientific and Technical Information of China (English)

    SHI Yan; DU Bin; XU Ying-chun; RUI Xi; DU Wei; WANG Yao

    2013-01-01

    Background Rapid detection of bacteremia is important for critically ill patients.Procalcitonin (PCT) has emerged as a marker of sepsis,but its characterization for predicting bacteremia is still unclear.This study aimed to investigate the role of change of PCT within 6 to 12 hours after new fever in predicting bacteremia.Methods An observational study was conducted in the ICU of our hospital from January 2009 to March 2010.Adult patients with new fever were included and grouped as bacteremia and non bacteremia group.Serum PCT concentration was measured at admission and within 6 to12 hours after new fever (designated PCT0 and PCT1).Other results of laboratory tests and therapeutic interventions were recorded.Multivariate Logistic regression analysis was used to identify the risk factors of bacteremia.The area under the ROC curve (AUC) was constructed to evaluate the discriminative power of variables to predict bacteremia.Results Totally 106 patients were enrolled,60 of whom had bacteremia and 46 did not have bacteremia,.The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and sequential organ failure assessment (SOFA) scores were 13.1±7.8 and 5.0±2.2 at admission,respectively.There was no significant difference in PCT0 between the bacteremia group and nonbacteremia group; 1.27μg/L (range,0.10-33.3) vs.0.98μg/L (range,0.08-25.7),(P=-0.157).However,the PCT1 and the rate of change of PCT were significantly higher in bacteremia group; PCT1 was 6.73μg/L (1.13-120.10)vs.1.17μg/L (0.10-12.10) (P=0.001),and the rate of change was 5.62 times (1.05-120.6) vs.0.07 times (-0.03-0.18)(P<0.001).The area under the ROC curve (AUC; 95% confidence interval) of the rate of change of PCT was better for predicting bacteremia than that of PCT1; 0.864 (range,0.801-0.927) vs.0.715 (range,0.628-0.801),(P<0.05).The AUCs of PCT0 and other parameters (such as WBC count,granulocyte percentage and temperature) were not significantly different (all P>0

  5. A Study of China's Gold Futures Margin Levels---Based on Abnormal Distributions%中国黄金期货保证金水平--基于非正态分布下的研究

    Institute of Scientific and Technical Information of China (English)

    陈秋雨; Jang Woo PARK

    2014-01-01

    中国目前静态的期货保证金水平只是一个经验数字,对价格波动并不敏感,大部分时间投资者资金被过度占用,当市场波动剧烈时又不能覆盖足够的风险。本文研究了基于非正态分布下黄金期货保证金水平,利用广义极值分布和广义帕累托分布来拟合尾部风险。结果显示:黄金期货存在尖峰厚尾现象,在考虑流动性风险后,现有的保证金水平有下调空间,应设定为4.38%,当风险加大时应提高到5.15%。%The static level of futures margin in China presently is only an empirical figure, and it is not sensitive to fluc-tuations.Sometimes, this margin level cannot cover the risk sufficiently when the market fluctuates severely.This paper is a research on the margin levels of China's gold futures based on abnormal distributions.Generalized Extreme Value ( GEV) dis-tribution and Pareto distribution are used to capture the risks of the tail of the gold futures.Results show that in combination with liquidity risks, the normal margin level should be 4.38%and should increase to 5.15%when the risk increases.

  6. Relationship of serum vitamin D levels with obesity and metabolic abnormalities%血清维生素D水平与肥胖及代谢异常关系的研究

    Institute of Scientific and Technical Information of China (English)

    汪英; 袁莉; 陆春丽; 李小雅

    2013-01-01

    Objective To investigate the relationship of serum vitamin D with obesity and metabolic abnormalities. Methods A total of 300 adults who visited Wuhan Union Hospital for a general health checkup from January to December 2009 participated in the study- They were divided into hypovitaminosis D group and control group, 150 in each, according to their serum 25-(OH) D levels. The comparisons of somatometric index, blood pressure, plasma glucose, blood lipid, and the related metabolic diseases of the two groups were carried out The serum 25-(OH)D concentration was detected with Enzyme-linked immunosorbent assay. Result In the hypovitaminosis D group, the levels of BMI, TG, and LDL were all higher than those in the control group (all P<0.05). There was no significant difference in WC, SBP, DBP, FBG, TC, and HDL between the two groups. Compared with the control group, the prevalence of obesity (P= 0.015), central obesity (P= 0.004) and hypertension (P = 0.002) were higher in the hypovitaminosis D group. Conclusion Hypovitaminosis D is associated with obesity and metabolic abnormalities, and LDL-C is its independent risk factor.%目的 探讨血清VitD水平与肥胖及代谢异常的关系. 方法 300例受试者均为2009年1~12月于我院进行健康体检的非体力劳动者.根据血清25-(OH)D水平将受试者分为VitD下降(HD)组和对照(NC)组,对两组患者BMI、血压、血脂、血糖水平及相关代谢疾病的患病情况进行比较.血清25-(OH)D水平采用ELISA检测. 结果 HD组BMI、TG、LDL-C均高于NC组(P均<0.05),两组WC、SBP、DBP、FPG、TC、HDL-C差异无统计学意义.与NC组相比,HD组肥胖、腹型肥胖及高血压患病率也显著增高(P值分别为0.015、0.004、0.002). 结论 血清VitD水平下降与肥胖及其代谢异常密切相关,血LDL-C是血VitD下降的独立危险因素.

  7. Liver abnormalities in pregnancy.

    Science.gov (United States)

    Than, Nwe Ni; Neuberger, James

    2013-08-01

    Abnormalities of liver function (notably rise in alkaline phosphatase and fall in serum albumin) are common in normal pregnancy, whereas rise in serum bilirubin and aminotransferase suggest either exacerbation of underlying pre-existing liver disease, liver disease related to pregnancy or liver disease unrelated to pregnancy. Pregnant women appear to have a worse outcome when infected with Hepatitis E virus. Liver diseases associated with pregnancy include abnormalities associated hyperemesis gravidarum, acute fatty liver disease, pre-eclampsia, cholestasis of pregnancy and HELLP syndrome. Prompt investigation and diagnosis is important in ensuring a successful maternal and foetal outcome. In general, prompt delivery is the treatment of choice for acute fatty liver, pre-eclampsia and HELLP syndrome and ursodeoxycholic acid is used for cholestasis of pregnancy although it is not licenced for this indication. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Nitrofurantoin and congenital abnormalities

    DEFF Research Database (Denmark)

    Czeizel, A.E.; Rockenbauer, M.; Sørensen, Henrik Toft;

    2001-01-01

    Objective: To study human teratogenic potential of oral nitrofurantoin treatment during pregnancy. Materials and Methods: Pair analysis of cases with congenital abnormalities and matched population controls in the population-based dataset of the Hungarian Case-Control Surveillance of Congenital...... or fetuses with Down’s syndrome (patient controls), 23 (2.8%) pregnant women were treated with nitrofurantoin. The above differences between population controls and cases may be connected with recall bias, because the case-control pair analysis did not indicate a teratogenic potential of nitrofurantoin use...... during the second and the third months of gestation, i.e. in the critical period for major congenital abnormalities. Conclusion: Treatment with nitrofurantoin during pregnancy does not present detectable teratogenic risk to the fetus....

  9. Diagnostic value of selected biochemical markers in the detection of recurrence of medullary thyroid cancer - comparison of calcitonin, procalcitonin, chromogranin A, and carcinoembryonic antigen.

    Science.gov (United States)

    Woliński, Kosma; Kaznowski, Jarosław; Klimowicz, Aleksandra; Maciejewski, Adam; Łapińska-Cwojdzińska, Dagny; Gurgul, Edyta; Car, Adrian D; Fichna, Marta; Gut, Paweł; Gryczyńska, Maria; Ruchała, Marek

    2017-01-01

    Medullary thyroid cancer (MTC) is a malignancy of the thyroid gland, which derives from parafollicular C cells. Periodic measurement of biochemical markers of MTC remains a crucial part of patient follow-up and disease monitoring. The aim of the study was to compare the diagnostic value of four selected markers - calcitonin (Ct), procalcitonin (PCT), chromogranin A (CgA), and carcinoembryonic antigen (CEA). Patients with histopathologically confirmed MTC hospitalised in a single department between January 2015 and December 2015 were included in the study. Patients were subdivided into two groups: a remission group and an active disease group, based upon serum markers of MTC and imaging. Levels of Ct, PCT, CgA, and CEA were compared between the groups. Forty-four patients were included; 20 patients presented active disease and 24 were in remission. All patients with active disease had Ct exceeding the upper limit of normal range (10 pg/mL) - for that threshold the sensitivity was 100.0% and the specificity was 73.9%; for the best-fit threshold of 121.0 pg/mL the specificity was 95.8% with sensitivity 100.0%. There was significant correlation between Ct and PCT - p < 0.000001, r = 0.93. All patients with active disease exceeded the upper limit of the normal range (0.5 ng/mL) - for that threshold the sensitivity was 100.0% and the specificity was 83.3%; for the best-fit threshold of 0.95 ng/mL the specificity was 95.8% with sensitivity 100.0%. In case of CEA for the best-fit threshold of 12.66 ng/mL the specificity was 100.0% with sensitivity 57.9%; for CgA the best-fit threshold was 75.66 ng/mL with specificity 83.3% and sensitivity 75.0%. Our study confirms that PCT can be considered as an equivalent alternative for measurement of calcitonin. On the other hand, it is also worth noting that MTC can be a rare cause of very high levels of PTC not resulting from infectious diseases. The diagnostic value of CEA and chromogranin A is much lower and can be within the

  10. Procalcitonina em crianças com sepse e choque séptico Procalcitonin in children with sepsis and septic shock

    Directory of Open Access Journals (Sweden)

    José R. Fioretto

    2007-08-01

    Full Text Available OBJETIVOS: Estudar o comportamento da procalcitonina e verificar se é capaz de diferenciar crianças com quadros sépticos. MÉTODOS: Crianças de 28 dias a 14 anos de idade, admitidas de 01/2004 a 12/2005 na unidade de tratamento intensivo pediátrica da UNESP com sepse ou choque séptico, foram incluídas prospectivamente. Dois grupos foram constituídos: grupo sepse (GS; n = 47 e grupo choque séptico (GCS; n = 43. Procalcitonina foi medida à admissão (T0 e depois de 12 h (T12h, e os resultados apresentados em classes: 0,5 a 2 a 10 = choque séptico. RESULTADOS: No T0, foi maior a freqüência de pacientes do GCS na classe mais alta de procalcitonina, comparada às crianças do GS [GCS: 30 (69,7% > GS: 14 (29,8%; p 10 = 69,7%; > 2 a 0,5 a OBJECTIVES: To study the behavior of procalcitonin and to verify whether it can be used to differentiate children with septic conditions. METHODS: Children were enrolled prospectively from among those aged 28 days to 14 years, admitted between January 2004 and December 2005 to the pediatric intensive care unit at Universidade Estadual Paulista UNESP with sepsis or septic shock. The children were classified as belonging to one of two groups: the sepsis group (SG; n = 47 and the septic shock group (SSG; n = 43. Procalcitonin was measured at admission (T0 and again 12 hours later (T12h, and the results classed as: 0.5 to 2 to 10 = septic shock. RESULTS: At T0 there was a greater proportion of SSG patients than SG patients in the highest PCT class [SSG: 30 (69.7% > SG: 14 (29.8%; p 10 = 69.7%; > 2 to 0.5 to < 2 = 11.6%; < 0.5 = 0.0%; p < 0.05. The behavior of procalcitonin at T12h was similar to at T0. The pediatric risk of mortality (PRISM scores for the SSG patients in the highest procalcitonin class were more elevated than for children in the SG [SSG: 35.15 (40.5-28.7 vs. SG: 18.6 (21.4-10.2; p < 0.05]. CONCLUSIONS: Procalcitonin allows sepsis to be differentiated from septic shock, can be of aid when

  11. Abnormal pressures as hydrodynamic phenomena

    Science.gov (United States)

    Neuzil, C.E.

    1995-01-01

    So-called abnormal pressures, subsurface fluid pressures significantly higher or lower than hydrostatic, have excited speculation about their origin since subsurface exploration first encountered them. Two distinct conceptual models for abnormal pressures have gained currency among earth scientists. The static model sees abnormal pressures generally as relict features preserved by a virtual absence of fluid flow over geologic time. The hydrodynamic model instead envisions abnormal pressures as phenomena in which flow usually plays an important role. This paper develops the theoretical framework for abnormal pressures as hydrodynamic phenomena, shows that it explains the manifold occurrences of abnormal pressures, and examines the implications of this approach. -from Author

  12. [Molecular abnormalities in lymphomas].

    Science.gov (United States)

    Delsol, G

    2010-11-01

    Numerous molecular abnormalities have been described in lymphomas. They are of diagnostic and prognostic value and are taken into account for the WHO classification of these tumors. They also shed some light on the underlying molecular mechanisms involved in lymphomas. Overall, four types of molecular abnormalities are involved: mutations, translocations, amplifications and deletions of tumor suppressor genes. Several techniques are available to detect these molecular anomalies: conventional cytogenetic analysis, multicolor FISH, CGH array or gene expression profiling using DNA microarrays. In some lymphomas, genetic abnormalities are responsible for the expression of an abnormal protein (e.g. tyrosine-kinase, transcription factor) detectable by immunohistochemistry. In the present review, molecular abnormalities observed in the most frequent B, T or NK cell lymphomas are discussed. In the broad spectrum of diffuse large B-cell lymphomas microarray analysis shows mostly two subgroups of tumors, one with gene expression signature corresponding to germinal center B-cell-like (GCB: CD10+, BCL6 [B-Cell Lymphoma 6]+, centerine+, MUM1-) and a subgroup expressing an activated B-cell-like signature (ABC: CD10-, BCL6-, centerine-, MUM1+). Among other B-cell lymphomas with well characterized molecular abnormalies are follicular lymphoma (BCL2 deregulation), MALT lymphoma (Mucosa Associated Lymphoid Tissue) [API2-MALT1 (mucosa-associated-lymphoid-tissue-lymphoma-translocation-gene1) fusion protein or deregulation BCL10, MALT1, FOXP1. MALT1 transcription factors], mantle cell lymphoma (cycline D1 [CCND1] overexpression) and Burkitt lymphoma (c-Myc expression). Except for ALK (anaplastic lymphoma kinase)-positive anaplastic large cell lymphoma, well characterized molecular anomalies are rare in lymphomas developed from T or NK cells. Peripheral T cell lymphomas not otherwise specified are a heterogeneous group of tumors with frequent but not recurrent molecular abnormalities

  13. Feeling Abnormal: Simulation of Deviancy in Abnormal and Exceptionality Courses.

    Science.gov (United States)

    Fernald, Charles D.

    1980-01-01

    Describes activity in which student in abnormal psychology and psychology of exceptional children classes personally experience being judged abnormal. The experience allows the students to remember relevant research, become sensitized to the feelings of individuals classified as deviant, and use caution in classifying individuals as abnormal.…

  14. Salivary and serum procalcitonin and C-reactive protein as biomarkers of periodontitis in United States veterans with osteoarthritis or rheumatoid arthritis.

    Science.gov (United States)

    Redman, R S; Kerr, G S; Payne, J B; Mikuls, T R; Huang, J; Sayles, H R; Becker, K L; Nylén, E S

    2016-01-01

    Serum procalcitonin (ProCT) is elevated in response to bacterial infections, whereas high sensitivity C-reactive protein (hsCRP) is a nonspecific inflammatory marker that is increased by excess adipose tissue. We examined the efficacy of ProCT and hsCRP as biomarkers of periodontitis in the saliva and serum of patients with arthritis, which is characterized by variable levels of systemic inflammation that potentially can confound the interpretation of inflammatory biomarkers. Blood and unstimulated whole saliva were collected from 33 patients with rheumatoid arthritis (RA) and 50 with osteoarthritis (OA). Periodontal status was assessed by full mouth examination and patients were categorized as having no/mild, moderate or severe periodontitis by standard parameters. Salivary and serum ProCT and hsCRP concentrations were compared. BMI, diabetes, anti-inflammatory medications and smoking status were ascertained from the patient records. Differences between OA and RA in proportionate numbers of patients were compared for race, gender, diabetes, adiposity and smoking status. Serum ProCT was significantly higher in arthritis patients with moderate to severe and severe periodontitis compared with no/mild periodontitis patients. There were no significant differences in salivary ProCT or salivary or serum hsCRP in RA patients related to periodontitis category. Most of the OA and RA patients were middle aged or older, 28.9% were diabetic, 78.3% were overweight or obese, and slightly more than half were either current or past smokers. The OA and RA groups differed by race, but not gender; blacks and males were predominant in both groups. The OA and RA groups did not differ in terms of controlled or uncontrolled diabetes, smoking status or BMI. The RA patients had been prescribed more anti-inflammatory medication than the OA patients. Our results demonstrate that circulating ProCT is a more discriminative biomarker for periodontitis than serum hsCRP in patients with

  15. Kinetics of changes in serum concentrations of procalcitonin, interleukin-6, and C- reactive protein after elective abdominal surgery. Can it be used to detect postoperative complications?

    Science.gov (United States)

    Barbić, Jerko; Ivić, Dubravka; Alkhamis, Tamara; Drenjancević, Domagoj; Ivić, Josip; Harsanji-Drenjancević, Ivana; Turina, Ivana; Vcev, Aleksandar

    2013-03-01

    Postoperative increase in inflammation biologic markers is associated with a nonspecific inflammatory response to a surgical injury. We investigated the kinetics of changes in serum concentrations of procalcitonin (PCT), C-reactive protein (CRP) and interleukin-6 (IL-6) after abdominal surgeries and we focused on the behaviour of those markers in the case of development of the systemic inflammatory response syndrome (SIRS). In the single centre we conducted a prospective observational study and we included patients admitted to the ICU after elective abdominal surgery. A total of 41 patients were included and 8 (19.5%) of them had clinical and laboratory signs of SIRS. Sepsis was confirmed in one of the patients, a 72-year old patient operated due to having an abdominal aortic aneurysm. Plasma concentrations of PCT, CRP and IL-6 were measured in all the patients before surgery and at the postoperative day 1 (POD1), postoperative day 2 (POD2) and postoperative day 3 (POD3). Systemic release of PCT, CRP and IL-6 was present in all the measured time points after the abdominal surgery. Median concentrations of IL-6 (100.4 pg/mL) and PCT (1, 17 pg/mL) production were measured highest at POD1 and the median of CRP (147 mg/L) was measured at highest POD2. A larger increase of all three measured markers was found in patients with SIRS compared to those without. IL-6 at POD1 and POD2 was a good predictor of SIRS (areas under curves were 0.71 and 0.765, respectively), showing the highest accuracy among investigated markers at those time points. CRP at POD3 was a good predictor of SIRS (AUC was 0.76). A cut-off of 95 mg/mL in the level of CRP at POD3 yielded a sensitivity of 87.5% and specificity of 66.7% in detecting SIRS. IL-6 and CRP were the best in detecting postoperative SIRS after abdominal surgery with the highest area under ROC curve. This study is showing that PCT is not a good marker of SIRS caused only by surgical injury without sepsis.

  16. The clinical significance of procalcitonin in patients with intracranial infection%降钙素原在颅内感染患者中的临床意义

    Institute of Scientific and Technical Information of China (English)

    方浩威; 黄晓芸; 梅志忠; 余映丽; 林菡

    2012-01-01

    Objective To investigate the values and clinical significance of procalcitonin(PCT)determination in the diagnosis of intracranial infection.Methods 62 patients with acute meningitis were divided into bacterial meningitis group and viral meningitis group according to the type of infection.Serum PCT levels were detected at different stages of meningitis and cerebrospinal fluid was analyzed.Results PCT levels were(26.43±15.32)μg/L in the acute phase of bacterial meningitis and significantly higher than the normal level;after treatment,they were(5.85±5.43)/ag/L on day 3,(0.21±0.26)μg/L on day 5,and(0.06±0.12)μg/L on day 7,being significantly reduced(P<0.05).PCT levels were(1.64±3.25)μg/L in the acute phase and(0.83±3.12)μg/L on day 3 in viral encephalitis group,which were significantly lower than those in bacterial meningitis group(P<0.05).CRP levels did not differ significantly between the two groups[(28.3±15.3)(5-110)mg/L vs.(27.3±16.4)(0-45)mg/L,P>0.05].There were significant differences between the two groups in leukocyte count and protein level in CSF[(287±15)(24-590)×lO6 vs.(17±5)(6-120)×l06 and(1.68±0.36)(0.4-4.8)mg/L vs.(0.67±0.32)(O.1-2.5)mg/L,P<0.05],but there was a overlap in the two groups.Conclusions Serum procalcitonin determination has important clinical significance in the early differential diagnosis of bacterial meningitis with viral encephalitis.%目的 探讨降钙素原(PCT)的测定在颅内感染患者中的诊断价值和临床意义.方法 随机抽取急性脑膜炎患者62例作为研究对象,并按照其感染类型不同分为细菌性脑膜炎组和病毒性脑膜炎组,分不同时期测定其血清降钙素原(PCT)数值以及脑脊液分析.结果 细菌性脑膜炎在急性发病期,PCT值为(26.43±15.32)μg/L,显著高于正常值,经过治疗后3d、5d、7d,其PCT值分别为(5.85±5.43)μg/L、(0.21±0.26)μg/L、(0.06±0.12)μg/L,较治疗前明显降低(Jp<0.05).而病毒性脑炎组PCT在

  17. Russia: An Abnormal Country

    Directory of Open Access Journals (Sweden)

    Steven Rosefielde

    2005-06-01

    Full Text Available Andrei Shleifer and Daniel Treisman recently rendered a summary verdict on the post Soviet Russian transition experience finding that the Federation had become a normal country with the west's assistance, and predicting that it would liberalize and develop further like other successful nations of its type. This essay demonstrates that they are mistaken on the first count, and are likely to be wrong on the second too. It shows factually, and on the norms elaborated by Pareto, Arrow and Bergson that Russia is an abnormal political economy unlikely to democratize, westernize or embrace free enterprise any time soon

  18. Abnormal ionization in sonoluminescence

    Science.gov (United States)

    Zhang, Wen-Juan; An, Yu

    2015-04-01

    Sonoluminescence is a complex phenomenon, the mechanism of which remains unclear. The present study reveals that an abnormal ionization process is likely to be present in the sonoluminescing bubble. To fit the experimental data of previous studies, we assume that the ionization energies of the molecules and atoms in the bubble decrease as the gas density increases and that the decrease of the ionization energy reaches about 60%-70% as the bubble flashes, which is difficult to explain by using previous models. Project supported by the Research Fund for the Doctoral Program of Higher Education of China (Grant No. 20120002110031) and the National Natural Science Foundation of China (Grant No. 11334005).

  19. The predictive value of soluble biomarkers (CD14 subtype, interleukin-2 receptor, human leucocyte antigen-G) and procalcitonin in the detection of bacteremia and sepsis in pediatric oncology patients with chemotherapy-induced febrile neutropenia.

    Science.gov (United States)

    Urbonas, Vincas; Eidukaitė, Audronė; Tamulienė, Indrė

    2013-04-01

    Prediction of bacteremia/sepsis in childhood oncology patients with febrile neutropenia still remains a challenge for the medical community due to the lack of reliable biomarkers, especially at the beginning of infectious process. The objective of this study was to evaluate diagnostic value of soluble biomarkers (CD14 subtype, interleukin-2 receptor, HLA-G) and procalcitonin (PCT) in the identification of infectious process at the beginning of a febrile episode in pediatric oncology patients. A total of 62 episodes of febrile neutropenia in 37 childhood oncology patients were enrolled in this study. Serum samples were collected at presentation after confirmation of febrile neutropenia and analyzed according to recommendations of manufacturers. Patients were classified into bacteremia/sepsis and fever of unknown origin groups. Median of PCT and sIL-2R were considerably higher in bacteremia/sepsis group compared to fever of unknown origin group, whereas median of sHLA-G and presepsin levels between investigated groups did not differ sufficiently. PCT and sIL-2R determination might be used as an additional diagnostic tool for the detection of bacteremia/sepsis in childhood oncology patients with febrile neutropenia. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. Concentrations of procalcitonin and C-reactive protein, white blood cell count, and the immature-to-total neutrophil ratio in the blood of neonates with nosocomial infections: Gram-negative bacilli vs coagulase-negative staphylococci.

    Science.gov (United States)

    Kordek, A

    2011-03-01

    This study was undertaken to determine whether concentrations of procalcitonin in the blood of neonates with nosocomial infections depend on the type of pathogen. Qualification for the study group was based on the clinical signs of infection. We found that infections with Gram-positive (chiefly coagulase-negative staphylococci) and Gram-negative bacteria are accompanied by elevated concentrations of procalcitonin. In the case of Gram-positive bacteria, other laboratory signs of infection studied by us (concentration of C-reactive protein, white blood cell count, immature-to-total neutrophil ratio) were not discriminatory, confirming the diagnostic usefulness of procalcitonin measurements in nosocomial infections of the neonate with Gram-negative or Gram-positive bacteria.

  1. Diagnosis of regional cerebral blood flow abnormalities using SPECT: agreement between individualized statistical parametric maps and visual inspection by nuclear medicine physicians with different levels of expertise in nuclear neurology

    Energy Technology Data Exchange (ETDEWEB)

    Rocha, Euclides Timoteo da, E-mail: euclidestimoteo@uol.com.b [Fundacao Pio XII, Barretos, SP (Brazil). Hospital de Cancer. Dept. de Medicina Nuclear; Buchpiguel, Carlos Alberto [Hospital do Coracao, Sao Paulo, SP (Brazil). Dept. de Medicina Nuclear; Nitrini, Ricardo [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Medicina. Dept. de Neurologia; Tazima, Sergio [Hospital Alemao Oswaldo Cruz (HAOC), Sao Paulo, SP (Brazil). Dept. de Medicina Nuclear; Peres, Stela Verzinhase [Fundacao Pio XII, Barretos, SP (Brazil). Hospital de Cancer; Busatto Filho, Geraldo [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Medicina. Div. de Medicina Nuclear

    2009-07-01

    Introduction: visual analysis is widely used to interpret regional cerebral blood flow (rCBF) SPECT images in clinical practice despite its limitations. Automated methods are employed to investigate between-group rCBF differences in research studies but have rarely been explored in individual analyses. Objectives: to compare visual inspection by nuclear physicians with the automated statistical parametric mapping program using a SPECT dataset of patients with neurological disorders and normal control images. Methods: using statistical parametric mapping, 14 SPECT images from patients with various neurological disorders were compared individually with a databank of 32 normal images using a statistical threshold of p<0.05 (corrected for multiple comparisons at the level of individual voxels or clusters). Statistical parametric mapping results were compared with visual analyses by a nuclear physician highly experienced in neurology (A) as well as a nuclear physician with a general background of experience (B) who independently classified images as normal or altered, and determined the location of changes and the severity. Results: of the 32 images of the normal databank, 4 generated maps showing rCBF abnormalities (p<0.05, corrected). Among the 14 images from patients with neurological disorders, 13 showed rCBF alterations. Statistical parametric mapping and physician A completely agreed on 84.37% and 64.28% of cases from the normal databank and neurological disorders, respectively. The agreement between statistical parametric mapping and ratings of physician B were lower (71.18% and 35.71%, respectively). Conclusion: statistical parametric mapping replicated the findings described by the more experienced nuclear physician. This finding suggests that automated methods for individually analyzing rCBF SPECT images may be a valuable resource to complement visual inspection in clinical practice. (author)

  2. Procalcitonin neutralizes bacterial LPS and reduces LPS-induced cytokine release in human peripheral blood mononuclear cells

    Directory of Open Access Journals (Sweden)

    Matera Giovanni

    2012-05-01

    Full Text Available Abstract Background Procalcitonin (PCT is a polypeptide with several cationic aminoacids in its chemical structure and it is a well known marker of sepsis. It is now emerging that PCT might exhibit some anti-inflammatory effects. The present study, based on the evaluation of the in vitro interaction between PCT and bacterial lipopolisaccharide (LPS, reports new data supporting the interesting and potentially useful anti-inflammatory activity of PCT. Results PCT significantly decreased (p Salmonella typhimurium (rough chemotype and Escherichia coli (smooth chemotype. Subsequently, the in vitro effects of PCT on LPS-induced cytokine release were studied in human peripheral blood mononuclear cells (PBMC. When LPS was pre-incubated for 30 minutes with different concentrations of PCT, the release of interleukin-10 (IL-10 and tumor necrosis factor alpha (TNFα by PBMC decreased in a concentration-dependent manner after 24 hours for IL-10 and 4 hours for TNFα. The release of monocyte chemotactic protein-1 (MCP-1 exhibited a drastic reduction at 4 hours for all the PCT concentrations assessed, whereas such decrease was concentration-dependent after 24 hours. Conclusions This study provides the first evidence of the capability of PCT to directly neutralize bacterial LPS, thus leading to a reduction of its major inflammatory mediators.

  3. Procalcitonin Improves the Glasgow Prognostic Score for Outcome Prediction in Emergency Patients with Cancer: A Cohort Study

    Directory of Open Access Journals (Sweden)

    Anna Christina Rast

    2015-01-01

    Full Text Available The Glasgow Prognostic Score (GPS is useful for predicting long-term mortality in cancer patients. Our aim was to validate the GPS in ED patients with different cancer-related urgency and investigate whether biomarkers would improve its accuracy. We followed consecutive medical patients presenting with a cancer-related medical urgency to a tertiary care hospital in Switzerland. Upon admission, we measured procalcitonin (PCT, white blood cell count, urea, 25-hydroxyvitamin D, corrected calcium, C-reactive protein, and albumin and calculated the GPS. Of 341 included patients (median age 68 years, 61% males, 81 (23.8% died within 30 days after admission. The GPS showed moderate prognostic accuracy (AUC 0.67 for mortality. Among the different biomarkers, PCT provided the highest prognostic accuracy (odds ratio 1.6 (95% confidence interval 1.3 to 1.9, P<0.001, AUC 0.69 and significantly improved the GPS to a combined AUC of 0.74 (P=0.007. Considering all investigated biomarkers, the AUC increased to 0.76 (P<0.001. The GPS performance was significantly improved by the addition of PCT and other biomarkers for risk stratification in ED cancer patients. The benefit of early risk stratification by the GPS in combination with biomarkers from different pathways should be investigated in further interventional trials.

  4. Procalcitonin for the differential diagnosis of infectious and non-infectious systemic inflammatory response syndrome after cardiac surgery.

    Science.gov (United States)

    Zhao, Dong; Zhou, Jianxin; Haraguchi, Go; Arai, Hirokuni; Mitaka, Chieko

    2014-01-01

    This study was performed to assess the value of procalcitonin (PCT) for the differential diagnosis between infectious and non-infectious systemic inflammatory response syndrome (SIRS) after cardiac surgery. Patients diagnosed with SIRS after cardiac surgery between April 1, 2011 and March 31, 2013 were retrospectively studied. A total of 142 patients with SIRS, infectious (n = 47) or non-infectious (n = 95), were included. The patients with infectious SIRS included 11 with sepsis, 12 with severe sepsis without shock, and 24 with septic shock. PCT, C-reactive protein (CRP), and the white blood cell (WBC) count were significantly higher in the infectious SIRS group than in the non-infectious SIRS group. PCT had the highest sensitivity and specificity for differential diagnosis, with a cut-off value for infectious SIRS of 0.47 ng/mL. PCT was more reliable than CRP in diagnosing severe sepsis without shock, but it was not useful for diagnosing septic shock. The PCT cut-off value for diagnosing severe sepsis without shock was 2.28 ng/mL. PCT was a useful marker for the diagnosis of infectious SIRS after cardiac surgery. The optimal PCT cut-off value for diagnosing infectious SIRS was 0.47 ng/mL.

  5. A Rare Stapes Abnormality

    Directory of Open Access Journals (Sweden)

    Hala Kanona

    2015-01-01

    Full Text Available The aim of this study is to increase awareness of rare presentations, diagnostic difficulties alongside management of conductive hearing loss and ossicular abnormalities. We report the case of a 13-year-old female reporting progressive left-sided hearing loss and high resolution computed tomography was initially reported as normal. Exploratory tympanotomy revealed an absent stapedius tendon and lack of connection between the stapes superstructure and footplate. The footplate was fixed. Stapedotomy and stapes prosthesis insertion resulted in closure of the air-bone gap by 50 dB. A review of world literature was performed using MedLine. Middle ear ossicular discontinuity can result in significant conductive hearing loss. This can be managed effectively with surgery to help restore hearing. However, some patients may not be suitable or decline surgical intervention and can be managed safely conservatively.

  6. 黄龙汤对脓毒症大鼠内毒素及降钙素原的影响%Impacts of Huanglong Decoction on Endotoxin and Procalcitonin in the Rats of Sepsis

    Institute of Scientific and Technical Information of China (English)

    付瑜; 黄煜; 姜树民

    2015-01-01

    Objective To explore the impacts of huanglong decoction on endotoxin and procalcito-nin in the rats of sepsis. Methods Fifty-five Wistar rats were randomized into a sham-operation group,a model control group,a western medicine group and an integrated Chinese and western medicine group. In the model control group,western medicine group and treatment group,the model of intestinal mucosal barrier in-duced by sepsis of abdominal infection was established. After successful duplication of model,the physical sa-line was used for gastric perfusion at 2 ml/time in the sham-operation group and the model control group. The intraperitoneal injection of meropenem,50 mg/time,twice a day was applied in the western medicine group every day. In the integrated Chinese and western medicine group,the intraperitoneal injection of mero-penem was applied,50 mg/time,twice a day;additionally,huanglong decoction was fed,twice a day. In 4 days of modeling,blood was collected via abdominal aorta for detection. Results The endotoxin and procalcitonin in peripheral blood in the model group were increased significantly as compared with the sham-operation group(P<0. 01). Those in the western medicine group and the integrated Chinese and western medicine group were lower apparently than those in the model group(P<0. 01). The levels of endotoxin and procalci-tonin in the integrated Chinese and western medicine group were lower than those in the western medicine group(P<0. 05,P<0. 01). Conclusion The combined medication of huanglong decoction and meropenem reduces the levels of plasma endotoxin and procalcitonin,effectively decreases the concentration of inflamma-tory medium in blood and relieves excessive inflammatory reaction in the treatment of enterogenous sepsis.%目的:探讨黄龙汤对脓毒症大鼠血清内毒素及降钙素原的影响。方法将55只wist-ar大鼠随机分为假手术组、模型对照组、西药组和中西药联合治疗组,模型对照组、西药

  7. The prevalence of chromosomal abnormalities in subgroups of infertile men.

    Science.gov (United States)

    Dul, E C; Groen, H; van Ravenswaaij-Arts, C M A; Dijkhuizen, T; van Echten-Arends, J; Land, J A

    2012-01-01

    The prevalence of chromosomal abnormalities is assumed to be higher in infertile men and inversely correlated with sperm concentration. Although guidelines advise karyotyping infertile men, karyotyping is costly, therefore it would be of benefit to identify men with the highest risk of chromosomal abnormalities, possibly by using parameters other than sperm concentration. The aim of this study was to evaluate several clinical parameters in azoospermic and non-azoospermic men, in order to assess the prevalence of chromosomal abnormalities in different subgroups of infertile men. In a retrospective cohort of 1223 azoospermic men and men eligible for ICSI treatment, we studied sperm parameters, hormone levels and medical history for an association with chromosomal abnormalities. The prevalence of chromosomal abnormalities in the cohort was 3.1%. No association was found between chromosomal abnormalities and sperm volume, concentration, progressive motility or total motile sperm count. Azoospermia was significantly associated with the presence of a chromosomal abnormality [15.2%, odds ratio (OR) 7.70, P chromosomal abnormalities (OR 2.96, P = 0.013). Azoospermic men with a positive andrologic history had a lower prevalence of chromosomal abnormalities than azoospermic men with an uneventful history (OR 0.28, P = 0.047). In non-azoospermic men, we found that none of the studied variables were associated with the prevalence of chromosomal abnormalities. We show that the highest prevalence of chromosomal abnormalities is found in hypergonadotrophic azoospermic men with an uneventful andrologic history.

  8. Dopaminergic system abnormalities Etiopathogenesis of dystonia

    Institute of Scientific and Technical Information of China (English)

    Shuhui Wu; Huifang Shang; Xiaoyi Zou

    2008-01-01

    etiopathogenesis of several primary dystonias has been observed at the molecular level. CONCLUSION: Various abnormalities of the dopaminergic system exist for different forms of dystonia; therefore, much more research is needed in this area. At the molecular level, relationships between abnormalities of the dopaminergic system and etiopathogenesis of the following syndromes have been observed: dopa-responsive dystonia, early-onset torsion dystonia, X-linked dystonia-parkinsonism syndrome, myoclonus dystonia syndrome, primary cervical dystonia, and focal dystonia blepharospasm.

  9. Biochemical abnormalities in Pearson syndrome.

    Science.gov (United States)

    Crippa, Beatrice Letizia; Leon, Eyby; Calhoun, Amy; Lowichik, Amy; Pasquali, Marzia; Longo, Nicola

    2015-03-01

    Pearson marrow-pancreas syndrome is a multisystem mitochondrial disorder characterized by bone marrow failure and pancreatic insufficiency. Children who survive the severe bone marrow dysfunction in childhood develop Kearns-Sayre syndrome later in life. Here we report on four new cases with this condition and define their biochemical abnormalities. Three out of four patients presented with failure to thrive, with most of them having normal development and head size. All patients had evidence of bone marrow involvement that spontaneously improved in three out of four patients. Unique findings in our patients were acute pancreatitis (one out of four), renal Fanconi syndrome (present in all patients, but symptomatic only in one), and an unusual organic aciduria with 3-hydroxyisobutyric aciduria in one patient. Biochemical analysis indicated low levels of plasma citrulline and arginine, despite low-normal ammonia levels. Regression analysis indicated a significant correlation between each intermediate of the urea cycle and the next, except between ornithine and citrulline. This suggested that the reaction catalyzed by ornithine transcarbamylase (that converts ornithine to citrulline) might not be very efficient in patients with Pearson syndrome. In view of low-normal ammonia levels, we hypothesize that ammonia and carbamylphosphate could be diverted from the urea cycle to the synthesis of nucleotides in patients with Pearson syndrome and possibly other mitochondrial disorders.

  10. Pró-calcitonina e proteína C reativa em processos infecciosos graves Procalcitonin and C-reactive protein in septic patients

    Directory of Open Access Journals (Sweden)

    Adagmar Andriolo

    2004-06-01

    Full Text Available Marcadores bioquímicos da resposta inflamatória são necessários para a obtenção de evidências objetivas da existência de processos infecciosos. A proteína C reativa (PCR tem sido utilizada para essa finalidade, com baixa especificidade. A pró-calcitonina (PCT foi proposta como marcador mais específico, mas seu valor prognóstico ainda não está bem estabelecido. Avaliamos qual desses marcadores teria maior poder em prever a evolução clínica de pacientes com sepse. Dosamos PCT e PCR no soro de 19 pacientes internados na unidade de tratamento intensivo do Hospital São Paulo, na Escola Paulista de Medicina (EPM, a pró-calcitonina por ensaio imunoluminométrico (LUMItest PCT, Brahms Diagnostica GmbH, Berlin, Germany e a proteína C reativa por imunonefelometria (High Sensitivity CRP, Dade Behring, Marburg, Germany. As concentrações de PCT foram significativamente mais elevadas no grupo de pacientes que faleceram do que no grupo dos que tiveram alta hospitalar (p Biochemical markers for septic processes are necessary in order to obtain objective evidence of sepsis. The C-reactive protein (CRP has been used to that, despite its low specificity. The procalcitonin (PCT was proposed as a more specific marker, but its predictive value is not yet well established. We evaluated which one of that markers could anticipate the clinical output of septic patients. Determination of PCT/CRP was performed in 19 sera from patients from ITU of Hospital São Paulo/EPM. Procalcitonin was measured by immunoluminometric assay (LUMItest PCT, Brahms Diagnostica GmB, Berlin, Germany and C-reactive protein by immunonephelometric assay (N High Sensitivity CRP, Dade Behring, Marburg, Germany. The PCT concentrations are significantly higher in non-survivors than in survivors group (p < 0.002, what did not occur with CRP. We did not observe significant correlation between procalcitonin and C-reactive protein concentrations as in non-survival as survival group

  11. Procalcitonin as a biomarker for severe Plasmodium falciparum disease: a critical appraisal of a semi-quantitative point-of-care test in a cohort of travellers with imported malaria

    Directory of Open Access Journals (Sweden)

    Petit Pieter

    2009-09-01

    Full Text Available Abstract Background Imported malaria occurs as a relatively rare event in developed countries. As a consequence, most clinicians have little experience in making clinical assessments of disease severity and decisions regarding the need for parenteral therapy or high-level monitoring. In this study, the diagnostic accuracy of procalcitonin (PCT for severe Plasmodium falciparum disease was assessed in a cohort of 100 consecutive travellers with various species of imported malaria. Methods and results In all patients, PCT was measured on admission with a semi-quantitative 'point-of-care' test. Patients with severe P. falciparum malaria had significantly higher median PCT levels on admission as compared with patients with uncomplicated P. falciparum disease. In addition, PCT levels in patients with non-falciparum malaria were also higher compared with patients with non-severe falciparum malaria but lower compared with severe P. falciparum malaria. At a cut-off point of 10 ng/mL, PCT had a sensitivity of 0,67 and a specificity of 0,94 for severe falciparum disease. However, at lower cut-off points the specificity and positive predictive value were rather poor although the sensitivity and negative predictive value remained high. Discussion Potential drawbacks in the interpretation of elevated PCT levels on admission may be caused by infections with non-falciparum species and by concomitant bacterial infections. Conclusion Semi-quantitative determination of PCT on admission is of limited use in the initial clinical assessment of disease severity in travellers with imported malaria, especially in settings with limited experience with the treatment of malaria.

  12. Autoshaping of abnormal children.

    Science.gov (United States)

    Deckner, C W; Wilcox, L M; Maisto, S A; Blanton, R L

    1980-09-01

    Three experimentally naive abnormal children were exposed to a terminal operant contingency, i.e., reinforcement was delivered only if the children pressed a panel during intervals when it was lighted. Despite the absence of both successive approximation and manual shaping, it was found that each child began to respond discriminatively within a small number of trials. These data replicated previous animal studies concerned with the phenomena of autoshaping and signal-controlled responding. It was also found, however, that one type of autoshaping, the classical conditioning procedure, had a powerful suppressive effect on the discriminative responding. An experimental analysis that consisted procedure, had a powerful suppressive effect on discriminative responding. An experimental analysis that consisted of intrasubject reversal an multiple baseline designs established the internal validity of the findings. The finding of rapid acquisition of signal-controlled responding obtained with the initial procedure is suggessted to have practical significance. The disruptive effects of the classical form of autoshaping are discussed in terms of negative behavioral contrast.

  13. Communication and abnormal behaviour.

    Science.gov (United States)

    Crown, S

    1979-01-01

    In this paper the similarities between normal and abnormal behaviour are emphasized and selected aspects of communication, normal and aberrant, between persons are explored. Communication in a social system may be verbal or non-verbal: one person's actions cause a response in another person. This response may be cognitive, behavioural or physiological. Communication may be approached through the individual, the social situation or social interaction. Psychoanalysis approaches the individual in terms of the coded communications of psychoneurotic symptoms or psychotic behaviour; the humanist-existential approach is concerned more with emotional expression. Both approaches emphasize the development of individual identity. The interaction between persons and their social background is stressed. Relevant are sociological concepts such as illness behaviour, stigma, labelling, institutionalization and compliance. Two approaches to social interactions are considered: the gamesplaying metaphor, e.g. back pain as a psychosocial manipulation--the 'pain game'; and the 'spiral of reciprocal perspectives' which emphasizes the interactional complexities of social perceptions. Communicatory aspects of psychological treatments are noted: learning a particular metaphor such as 'resolution' of the problem (psychotherapy), learning more 'rewarding' behaviour (learning theory) or learning authenticity or self-actualization (humanist-existential).

  14. Abnormally dark or light skin

    Science.gov (United States)

    Hyperpigmentation; Hypopigmentation; Skin - abnormally light or dark ... Normal skin contains cells called melanocytes. These cells produce melanin , the substance that gives skin its color. Skin with ...

  15. Role of serum procalcitonin in clinical diagnosis of severe pneumonia%血清降钙素原在重症肺炎中的临床诊断意义

    Institute of Scientific and Technical Information of China (English)

    朱蕾; 徐爱群; 聂荷香; 张亚文

    2013-01-01

      目的探讨血清降钙素原在重症肺炎中的临床诊断意义.方法对2009年11月-2011年9月我院46例重症肺炎患者、40例轻症肺炎患者和50例健康体检者的血清降钙素原(procalcitonin,PCT)和其他项目进行检验分析.结果 PCT重症肺炎组(17.34±12.32) ng/ml,轻症肺炎组(9.34±3.34) ng/ml、对照组(0.23±0.06) ng/ml,差异有统计学意义(P<0.05);细菌性肺炎组PCT为(19.34±8.85) ng/ml,病毒性肺炎组(6.43±0.32) ng/ml、支原体肺炎组(5.34±0.16) ng/ml、对照组,差异有统计学意义(P<0.01),而各组其他指标(C反应蛋白、白细胞计数、中性粒细胞百分比)虽高于对照组,但敏感性和特异性均不如PCT,而且PCT不受非感染因素的影响,能反映肺炎患者的严重程度,成为区分细菌感染、病毒感染及支原体感染的有效指标.结论血清PCT对重症肺炎诊断、鉴别诊断及病情严重程度评估有指导意义.%Objective To study the role of serum procalcitonin (PCT) in clinical diagnosis of severe pneumonia. Methods Serum PCT level, and C-reactive protein level, number of white blood cells, percentage of neutrophils in 46 severe pneumonia patients, 40 mild pneumonia patients and 50 controls admitted to our hospital from November 2009 to September 2011 were analyzed. Results The serum PCT level was 17.34±12.32 ng/ml in severe pneumonia patients, which was significantly higher than that in mild pneumonia patients (9.34±3.34) ng/ml and controls (0.23±0.06) ng/ml (P<0.05). The serum PCT level was 19.34±8.85 ng/ml in bacterial pneumonia patients, which was significantly higher than that in viral pneumonia patients (6.43±0.32) ng/ml, mycoplasma pneumonia patients (5.34±0.16) ng/ml and controls (P<0.01). Although the C-reaction protein level, number of white blood cells, percentage of neutrophils were higher in pneumonia patients, their sensitivity and specificity were lower than those of PCT. The serum PCT level was not influenced by

  16. Effectiveness and safety of procalcitonin evaluation for reducing mortality in adults with sepsis, severe sepsis or septic shock.

    Science.gov (United States)

    Andriolo, Brenda Ng; Andriolo, Regis B; Salomão, Reinaldo; Atallah, Álvaro N

    2017-01-18

    Serum procalcitonin (PCT) evaluation has been proposed for early diagnosis and accurate staging and to guide decisions regarding patients with sepsis, severe sepsis and septic shock, with possible reduction in mortality. To assess the effectiveness and safety of serum PCT evaluation for reducing mortality and duration of antimicrobial therapy in adults with sepsis, severe sepsis or septic shock. We searched the Central Register of Controlled Trials (CENTRAL; 2015, Issue 7); MEDLINE (1950 to July 2015); Embase (Ovid SP, 1980 to July 2015); Latin American Caribbean Health Sciences Literature (LILACS via BIREME, 1982 to July 2015); and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; EBSCO host, 1982 to July 2015), and trial registers (ISRCTN registry, ClinicalTrials.gov and CenterWatch, to July 2015). We reran the search in October 2016. We added three studies of interest to a list of 'Studies awaiting classification' and will incorporate these into formal review findings during the review update. We included only randomized controlled trials (RCTs) testing PCT-guided decisions in at least one of the comparison arms for adults (≥ 18 years old) with sepsis, severe sepsis or septic shock, according to international definitions and irrespective of the setting. Two review authors extracted study data and assessed the methodological quality of included studies. We conducted meta-analysis with random-effects models for the following primary outcomes: mortality and time spent receiving antimicrobial therapy in hospital and in the intensive care unit (ICU), as well as time spent on mechanical ventilation and change in antimicrobial regimen from a broad to a narrower spectrum. We included 10 trials with 1215 participants. Low-quality evidence showed no significant differences in mortality at longest follow-up (risk ratio (RR) 0.81, 95% confidence interval (CI) 0.65 to 1.01; I(2) = 10%; 10 trials; N = 1156), at 28 days (RR 0.89, 95% CI 0.61 to 1.31; I(2

  17. Is procalcitonin to C-reactive protein ratio useful for the detection of late onset neonatal sepsis?

    Science.gov (United States)

    Hahn, Won-Ho; Song, Joon-Hwan; Kim, Ho; Park, Suyeon

    2017-02-21

    Procalcitonin (PCT) has been reported as a sensitive marker for neonatal bacterial infections. Recently, small numbers of studies reported usefulness of PCT/C-reactive protein (CRP) ratio in detection of infectious conditions in adults. Thus, we conducted this study to evaluate PCT/CRP ratio in late onset neonatal sepsis. Serum PCT and CRP was measured in blood samples from 7-60 days after birth in 106 of neonates with late onset sepsis and 212 of controls who were matched with gestational age, postnatal age, birth weight and gender. Areas under ROC curve (AUC) were calculated and pairwise comparisons between ROC curves were performed. As a result, CRP (AUC 0.96) showed best performance in detection of sepsis from healthy controls compared with PCT (AUC 0.87) and PCT/CRP ratio (AUC 0.62); CRP > PCT > PCT/CRP ratio in pairwise comparison (Psepsis from healthy controls compared with PCT/CRP ratio (AUC 0.54); CRP = PCT > PCT/CRP ratio in pairwise comparison (Pdetection of blood culture proven sepsis from suspected sepsis, PCT (AUC 0.70) and PCT/CRP ratio (AUC 0.73) showed better performance compared with CRP (AUC 0.51); PCT = PCT/CRP ratio > CRP in pairwise comparison (Psepsis and healthy controls. However, PCT/CRP ratio seems to be helpful in distinguishing proven sepsis from suspected sepsis together with PCT. Further studies are warranted to elucidate the efficacy of PCT/CRP ratio with enrollment of enough numbers of infants.

  18. Abnormal pressure in hydrocarbon environments

    Science.gov (United States)

    Law, B.E.; Spencer, C.W.

    1998-01-01

    Abnormal pressures, pressures above or below hydrostatic pressures, occur on all continents in a wide range of geological conditions. According to a survey of published literature on abnormal pressures, compaction disequilibrium and hydrocarbon generation are the two most commonly cited causes of abnormally high pressure in petroleum provinces. In young (Tertiary) deltaic sequences, compaction disequilibrium is the dominant cause of abnormal pressure. In older (pre-Tertiary) lithified rocks, hydrocarbon generation, aquathermal expansion, and tectonics are most often cited as the causes of abnormal pressure. The association of abnormal pressures with hydrocarbon accumulations is statistically significant. Within abnormally pressured reservoirs, empirical evidence indicates that the bulk of economically recoverable oil and gas occurs in reservoirs with pressure gradients less than 0.75 psi/ft (17.4 kPa/m) and there is very little production potential from reservoirs that exceed 0.85 psi/ft (19.6 kPa/m). Abnormally pressured rocks are also commonly associated with unconventional gas accumulations where the pressuring phase is gas of either a thermal or microbial origin. In underpressured, thermally mature rocks, the affected reservoirs have most often experienced a significant cooling history and probably evolved from an originally overpressured system.

  19. Systemic abnormalities in liver disease

    Institute of Scientific and Technical Information of China (English)

    Masami Minemura; Kazuto Tajiri; Yukihiro Shimizu

    2009-01-01

    Systemic abnormalities often occur in patients with liver disease. In particular, cardiopulmonary or renal diseases accompanied by advanced liver disease can be serious and may determine the quality of life and prognosis of patients. Therefore, both hepatologists and non-hepatologists should pay attention to such abnormalities in the management of patients with liver diseases.

  20. The Levels of Zn2+ and Prostate Specific Antigen in the Semen with Abnormal Liquefaction and Their Relationship with Spermatozoa Motility%精浆锌和前列腺特异性抗原含量与精液液化及精子活力的关系

    Institute of Scientific and Technical Information of China (English)

    周蓉; 肖敦振; 胡波

    2009-01-01

    目的 探讨精浆锌(Zn~(2+))和前列腺特异性抗原(PSA)与精液液化及精子活力的关系.方法 筛选精液液化异常患者(异常组)和精液液化正常男性(正常组)各30例,精液常规分析后提取精浆,-20℃保存.采用原子吸收光谱法测定精浆Zn~(2+)含量,ELISA法测定精浆PSA含量,对比分析两组测定结果.结果 异常组精浆Zn~(2+)、PSA含量均明显低于正常组.异常组精浆Zn~(2+)平均含量为(82.50±0.72)μg/ml,正常组为(120.43±0.52)μg/ml,两者差异有统计学意义(P<0.01).异常组精浆PSA平均含量为(0.68±0.14)mg/ml,正常组为(1.21±0.21)mg/ml,两者差异有统计学意义(P<0.05).异常组精子活力较正常组低(P<0.05).结论 精浆中Zn~(2+)及PSA含量均偏低致精液液化异常并影响精子活力.%Objective To investigate the levels of seminal zinc and prostate specific antigen in abnormal liquefaction sperm and their relationship with spermatozoa motility. Methods Thirty cases of abnormal liquefaction sperm (abnormal group)and 30 cases of normal semen ]iquefaction(normal group)were selected. The semens were analyzed by the CASA,and the seminal plasma was separated and preserved at - 20℃. The levels of seminal zinc were measured by atomic absorption spectrometry. The levels of PSA in seminal plasma were detected by ELISA. Results Zn~(2+) and PSA levels in abnormal group were significantly lower than in normal group(P<0. 05). The levels of seminal Zn~(2+) in abnormal group and normal group were (82. 50±0. 72)and (120. 43±0. 52) fig/ml respectively,with the difference being significant between two group(P<0. 05). The levels of seminal PSA in abnormal group and normal group were (0. 68±0. 14) and (1. 21±0. 21) mg/ml respectively, with the difference being significant between two groups(P<0. 05). Sperm motility in abnormal group was lower than in normal group (P<0. 05). Conclusion The levels of seminal Zn~(2+) and PSA in the semens with abnormal liquefaction is low

  1. Diagnostic value of procalcitonin in bacterial infection%降钙素原在细菌性感染中的诊断价值

    Institute of Scientific and Technical Information of China (English)

    王珊; 刘双

    2009-01-01

    In diagnosing bacterial infection, it is critical for a favorable outcome that rapid identification of bacteremia brings out at an early stage of the disease. Furthermore,it is important that exact information on the stages of the disease is rapidly obtained in order to choose and initiate appropriate therapy. In recent years,many new techniques have been applied for the diagnosis of bacterial infection. The study of procalcitonin has gained many progresses. This review focuses on the diagnostic value of procalcitonin in bacterial infection.%在细菌性感染的诊断过程中,在疾病早期快速检出菌血症的存在对患者预后有很大帮助.而且,在疾病的不同阶段快速获得精确信息对临床治疗具有指导意义.近年来,很多新技术应用于细菌性感染的诊断,降钙素原的相关研究在近些年来取得进展.本文就降钙素原在细菌性感染中的诊断价值作一综述.

  2. 血清降钙素原对急性重度脑卒中患者并感染的预测价值研究%The predictive value of procalcitonin in severe acute cerebral apoplexy complicated infection

    Institute of Scientific and Technical Information of China (English)

    马晓红

    2013-01-01

    Objective To evaluation the predictive value of serum procalcitonin (PCT) in severe acute cerebral apoplexy complicated infection. Methods Severe brain damage due to acute stroke, need access to ICU care of 48 patients, Detect when admitted to ICU, 3rd-, 5th-day PCT, and serum c-reactive protein (CRP) levels and occurrence of infections. Results Compared with non-infected group, Infected patients into icu and 3 days, 5 days serum PCT level significantly higher, The difference has statistics significance (P 0.05). Conclusion PCT determination contributed to early prediction of occurrence of severe infection in patients with acute cerebral apoplexy.%目的评估严重急性脑卒中患者的血清降钙素原(PCT)预测感染的临床价值。方法对急性脑卒中导致的严重脑损伤,需要进入ICU监护的患者48例,检测其入住ICU时第3天、第5天血清PCT和C反应蛋白(CRP)水平及感染发生情况。结果与非感染组相比,感染组患者入ICU时及第3天、第5天时血清PCT水平明显升高,差异有统计学意义(P0.05)。结论PCT测定有助于早期预测严重急性脑卒中患者感染的发生。

  3. 降钙素原与C反应蛋白联合检测的临床意义%Clinical Significance of Procalcitonin and C Reactive Protein Detection

    Institute of Scientific and Technical Information of China (English)

    郭艳

    2013-01-01

    Objective To investigate the clinical significance of serum procalcitonin and C reactive protein detection in clinical diagnosis and severe infection and sepsis. Methods Using chemilumin-escence and immune scat er turbidimetry respectively:The procalcitonin and C reactive were tested to 30 cases of patients with sepsis and 40 cases of patients with moderate or sever localized infection and 20 cases of healthy people by using chemiluminescence and immune scat er turbidimetry. Result 30 cases of patients with sepsis procalcitonin and C reactive protein test results were significantly high than those of 20 cases of healthy people; 40 patients with moderate, severe localized bacterial infectionpatients procalcitonin test results and 20 healthy persons test results showed no significant dif erence, no statistical significance (P>0.05), but the C reactive protein test results were significantly higher than that of healthy subjects test results, significant dif erence was statistical y significant (P < 0.01). Conclusion The combined detection of serum procalcitonin and C reactive protein is helpful to clinical diagnosis of moderate or severeinfection and sepsis .%目的:探讨血清降钙素原与C反应蛋白联合检测对临床诊断中、重度局部感染和脓毒血症的临床意义。方法采用化学发光法和散射免疫比浊法分别对:30例脓毒血症患者,40例中、重度局部细菌感染患者,20例健康体检者进行降钙素原和C反应蛋白检测。结果30例脓毒症患者降钙素原和 C反应蛋白检测结果显著高于20例健康体检者检测结果,差异显著,有统计学意义(P<0.01);40例中、重度局部细菌感染患者降钙素原检测结果与20例健康体检者检测结果相比无显著差异,无统计学意义(P>0.05),但C反应蛋白检测结果显著高于健康体检者检测结果,差异显著有统计学意义(P<0.01)。结论血清降钙素原与 C反应蛋白联合检测有助于

  4. 降钙素原测定对危重支气管哮喘急性发作抗生素使用的指导作用%Procalcitonin Guidance of Antibiotic Therapy in Acute Exacerbations of Severe Asthma

    Institute of Scientific and Technical Information of China (English)

    龙威; 邓星奇; 张学敏; 谢娟; 杨敬业; 钟远

    2012-01-01

    Objective To investigate the value of procalcitonin-guided treatment on antibiotic use in severe acute exacerbations of asthma.Methods From April 2008 to December 2010, a total of 77 patients with severe acute exacerbations of asthma were randomly assigned into a PCT group(n = 38 ) and a control group(n = 39).The serum concentration of procalcitonin(PCT) were measured in all patients.On the base of similar routine treatment, the control group received antibiotics based on the physician' s decision.Meanwhile the PCT group were treated with antibiotics according to serum PCT levels: antibiotic treatment was applied with PCT level = 0.25ng/mL and was discontinoued with PCT level 0.05 ).Conclusion PCT guidance can reduce antibiotic duration and antibiotic cost in treatment of acute severe exacerbations of asthma.%目的 研究血清降钙素原(PCT)检测在危重支气管哮喘急性发作患者对使用抗生素的指导作用.方法 选取2008年4月至2010年12月间收治的危重哮喘急性加重患者77例,随机分配到两组:PCT指导治疗组38例(PCT组)和常规治疗组39例(对照组),检测血清PCT水平.在相同常规治疗基础上,对照组由经治医师按照抗生素使用指南决定抗生素疗程,PCT组按照血清PCT水平决定何时停用抗生素,在血清PCT≥0.25 ng/mL时,进行抗生素治疗,PCT<0.25 ng/mL时,停止抗生素治疗.观察两组患者的抗生素疗程,抗生素费用及住院时间.结果 PCT组抗生素疗程[7(5~11)d]短于对照组[11(7~16)d](Z值=-2.26,P=0.025),抗生素费用[2125( 1560~4347)元]低于对照组[3588(2677 ~5280)元](Z值=-2.01,P=0.033),两组的住院时间及预后无明显差异.结论 危重支气管哮喘急性发作患者根据PCT使用抗生素,能够缩短抗生素疗程,减少抗生素费用.

  5. Procalcitonin guidance on antibiotic therapy in the treatment of AECOPD patients%血清降钙素原对AECOPD抗生素使用的指导价值

    Institute of Scientific and Technical Information of China (English)

    张金龙; 谭亚萍; 敬鸿博; 侯雪飞

    2014-01-01

    Objective To investigate the guidance value of procalcitonin on antibiotic use in the treatment of AECOPD patients. Methods 63 patients with AECOPD were randomly divided into the PCT group (n=32) and the control group (n=31). The serum concentration of procalcitonin (PCT) were measured in all patients. On the base of similar routine treatment, the control group received antibiotics based on the physician 's decision, and the PCT group were treated with antibiotics according to serum PCT levels. The antibiotic treatment was applied when the level of PCT was higher than 0. 25ng/mL and stopped when the level of PCT was lower than 0. 25ng/mL. The duration of antibiotics use and hospital stay was observed. Results The duration of antibiotics use was shorter in the PCT group [7(5~11)d] than in the control group [13(7~16)d] (P=0. 03), and the cost of antibiotics in the PCT group was lower than that in the control group (P=0. 001). There was no significant difference in clinical efficacy and du-ration of hospital stay in the two groups (P>0. 05). Conclusion PCT guidance can reduce antibiotic duration and antibiotic cost in the treatment of AECOPD patients.%目的:研究血清降钙素原( PCT)检测在慢性阻塞性肺疾病急性加重期( AECOPD)对使用抗生素的指导价值。方法选取收治的AECOPD患者63例,随机分配成两组:PCT指导治疗组32例(简称 PCT组)和常规治疗组31例(简称对照组),检测血清PCT水平。在常规治疗的基础上,对照组按照临床抗生素使用指南决定抗生素疗程,PCT组按照血清PCT水平决定抗生素的使用,当血清PCT≥0.25ng/mL时,进行抗生素治疗,当PCT<0.25 ng/mL时,则停止使用抗生素。并观察两组患者抗生素的使用疗程,抗生素所用费用及住院时间。结果 PCT组抗生素疗程[7(5~11)d]短于对照组[13(7~16)d](P=0.03);PCT组抗生素费用低于对照组(P=0.001),两组的住院时间及预后无明显差异。结论 AECOPD患者根据PCT水

  6. Endocrine abnormalities in dilated cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Ankit Jain

    2015-01-01

    Full Text Available Background: Progress has been made in the understanding of cellular and molecular mechanisms of hormone action and its effects on the cardiac tissue. There is evidence from observational studies that patients with postpartum cardiomyopathy improve after inhibition of release of prolactin from the pituitary by bromocriptine. This has renewed interest in the role of hormones in the pathogenesis of cardiomyopathy, especially in women. We intended to assess the hormonal changes in female patients with dilated cardiomyopathy (DCM. Methods: Twenty female patients aged 20-40 years old (mean age 29 ΁ 5.6 years with a diagnosis of idiopathic DCMP with left ventricular ejection fraction [EF] <35% and a stable clinical course in the last 3 months were included in the study. All the patients were in New York Heart Association (NYHA Class II or III. All the patients underwent clinical evaluation followed by blood sampling for hormonal analysis. Blood was taken after overnight fasting and analyzed for thyroid stimulating hormone (TSH, T3, T4, insulin-like growth factor I (IGF-I, prolactin, insulin, parathyroid hormone (PTH, and 25 (OH Vitamin D. The results were compared with twenty age and sex matched controls. Results: The mean EF of the twenty patients was 24.4 ΁ 5.3% and duration of symptoms was 29.1 ΁ 24 months. Insulin growth factor 1 levels were significantly lower than normal. Fifty percent of the patients had levels lower than normal, but there was no correlation of IGF-I with NYHA class and EF. Testing of the thyroid hormones revealed that TSH levels were similar between patient and controls though 40% of the patients had elevated TSH levels. Of these patients, 5% (1 had hypothyroid. In addition to this, 10% (2 had isolated low T3, suggestive of the low T3 syndrome. None of the thyroid abnormalities showed a correlation with NYHA class or EF. All other hormone concentrations were comparable in both groups. Conclusion: In this cohort of female

  7. Semen abnormalities with SSRI antidepressants.

    Science.gov (United States)

    2015-01-01

    Despite decades of widespread use, the adverse effect profile of "selective" serotonin reuptake inhibitor (SSRI) antidepressants has still not been fully elucidated. Studies in male animals have shown delayed sexual development and reduced fertility. Three prospective cohort studies conducted in over one hundred patients exposed to an SSRI for periods ranging from 5 weeks to 24 months found altered semen param-eters after as little as 3 months of exposure: reduced sperm concentration, reduced sperm motility, a higher percentage of abnormal spermatozoa, and increased levels of sperm DNA fragmentation. One clinical trial showed growth retardation in children considered depressed who were exposed to SSRls. SSRls may have endocrine disrupting properties. Dapoxetine is a short-acting serotonin reuptake inhibitor that is chemically related to fluoxetine and marketed in the European Union for men complaining of premature ejaculation. But the corresponding European summary of product characteristics does not mention any effects on fertility. In practice, based on the data available as of mid-2014, the effects of SSRI exposure on male fertility are unclear. However, it is a risk that should be taken into account and pointed out to male patients who would like to father a child or who are experiencing fertility problems.

  8. Spinal cord injury without radiographic abnormality

    Directory of Open Access Journals (Sweden)

    Singh Anil

    2006-01-01

    Full Text Available Spinal cord injury without radiological abnormality is rare in adults. Below we present a case report of 20 yrs old male with isolated cervical cord injury, without accompanying vertebral dislocation or fracture involving the spinal canal rim. He fell down on plain and smooth ground while carrying 40 kg weight overhead and developed quadriparesis with difficulty in respiration. Plain radiographs of the neck revealed no fractures or dislocations. MRI showed bulky spinal cord and an abnormal hyper intense signal on the T2W image from C2 vertebral body level to C3/4 intervertebral disc level predominantly in the anterior aspect of the cord The patient was managed conservatively with head halter traction and invasive ventilatory support for the initial 7 days period in the ICU. In our patient recovery was good and most of the neurological deficit improved over 4 weeks with conservative management.

  9. Imaging findings of sternal abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Franquet, T. [Dept. of Radiology, Hospital de Sant Pau, Universidad Autonoma de Barcelona (Spain); Gimenez, A. [Dept. of Radiology, Hospital de Sant Pau, Universidad Autonoma de Barcelona (Spain); Alegret, X. [Dept. of Radiology, Hospital de Sant Pau, Universidad Autonoma de Barcelona (Spain); Sanchis, E. [Dept. of Radiology, Hospital de Sant Pau, Universidad Autonoma de Barcelona (Spain); Rivas, A. [Dept. of Radiology, Hospital Vall d`Hebron, Universidad Autonoma de Barcelona (Spain)

    1997-05-01

    Radiographic findings in the sternal abnormalities are often nonspecific, showing appearances from a localized benign lesion to an aggressive lesion as seen with infections and malignant neoplasms. A specific diagnosis of sternal abnormalities can be suggested on the basis of CT and MR characteristics. Familiarity with the presentation and variable appearance of sternal abnormalities may aid the radiologist is suggesting a specific diagnosis. We present among others characteristic radiographic findings of hemangioma, chondrosarcoma, hydatid disease, and SAPHO syndrome. In those cases in which findings are not specific, cross-sectional imaging modalities may help the clinician in their management. (orig.)

  10. Clinical application analysis of serum procalcitonin in NICU%血清降钙素原在NICU的临床应用分析

    Institute of Scientific and Technical Information of China (English)

    李凯; 刘超; 王娟

    2014-01-01

    Objective To investigate the application value of serum procalcitonin (PCT) detection on neonatal intensive care unit(NICU).Methods The 178 cases of critical newborns in our NICU were divided into three groups:the bacterial infection group(n =68),viral infection group(n =56)and non-infection group(n =54).The serum PCT levels were retrospectively analyzed.The effects of non-antibiotic therapy and empirical use of antibiotics on PCT-negative bacterial infections in critically ill late neonatal were compared.Results In bacterial infection group,viral infection group and non-infection group,the positive rates of PCT were 73.5%,12.5% and 13.0%.Compared with viral infection group and non-infection group,the positive rate of PCT in bacterial infection group was significantly different (P < 0.01).There were no significant differences in the effects of non-antibiotic therapy and empirical use of antibiotics on PCT-negative bacterial infections in critically ill late neonate (P > 0.05).Conclusions Serum PCT may be used as differential diagnosis indicators of bacterial infection and virus infection in the NICU,and can guide clinical rational use of antibiotics,reduce the use of antibiotics and the multiple resistant bacteria.%目的 探讨血清降钙素原检测在新生儿重症监护病房的应用价值.方法 将178例危重晚期新生儿分为三组:细菌感染组68例,病毒感染组56例,非感染组54例.回顾性分析危重晚期新生儿血清降钙素原(PCT)水平,比较PCT检测阴性的非细菌感染危重晚期新生儿不用抗生素治疗与经验性使用抗生素治疗的疗效差异.结果 细菌感染组、病毒感染组和非感染组PCT阳性率分别为73.5%、12.5%和13.0%,细菌感染组和病毒感染组、非感染组差异有统计学意义(P<0.01).PCT检测阴性的非细菌感染危重晚期新生儿不用抗生素治疗与经验性使用抗生素治疗的疗效差异无统计学意义(P>0.05).结论 在NICU病房,血

  11. Abnormal Retained Earnings Around The World

    OpenAIRE

    Alves, Paulo; Silva,Paulo

    2017-01-01

    Using a firm-level survey database covering 50 countries we evaluate firms´ abnormal retained earnings. The results of our work indicate that firms located in emerging markets retain more earnings than firms from developed countries. On the other hand, firms located on common law based countries retain earnings above the expected and higher than firms placed on civil law based countries. A possible explanation, according to our results, can be seen in the economic growth that these countries ...

  12. Uniphasic Blanching of the Fingers, Abnormal Capillaroscopy in Nonsymptomatic Digits, and Autoantibodies: Expanding Options to Increase the Level of Suspicion of Connective Tissue Diseases beyond the Classification of Raynaud's Phenomenon.

    Science.gov (United States)

    Ingegnoli, Francesca; Gualtierotti, Roberta; Orenti, Annalisa; Schioppo, Tommaso; Marfia, Giovanni; Campanella, Rolando; Mastaglio, Claudio; Meroni, Pier Luigi; Boracchi, Patrizia

    2015-01-01

    In patients with Raynaud's phenomenon (RP), the role of medical history, capillaroscopy, and autoantibodies in order to provide an early diagnosis of connective tissue disease (CTD) were examined. 115 consecutive adults with uni-, bi-, or triphasic colour changes of the fingers were studied. RP was bilateral in 92.7% of patients. The middle finger was significantly more affected. A lack of association between fingers affected by RP and fingers with capillary abnormalities was observed OR = 0.75 (0.34-1.66). RP with the cyanotic phase had a higher risk at capillaroscopy to have hemorrhages OR = 4.46 (1.50-13.30) and giant capillaries OR = 24.85 (1.48-417.44). The thumb and triphasic involvement have an OR of 1.477 and 1.845, respectively. RP secondary to systemic sclerosis (SSc) had greater value of VAS pain (p = 0.011). The presence of anti-centromere antibodies was significantly associated with a higher risk of SSc (p blanching of the fingers, and among these, 27% was diagnosed as having an overt or suspected CTD. Markers of a potential development of CTDs include severe RP symptoms, positive autoantibodies, and capillary abnormalities. These data support the proposal to not discharge patients with uniphasic blanching of the fingers to avoid missing the opportunity of an early diagnosis.

  13. Pregnancy Complications: Umbilical Cord Abnormalities

    Science.gov (United States)

    ... defects. These tests may include a detailed ultrasound, amniocentesis (to check for chromosomal abnormalities) and in some ... the provider may recommend additional tests, such as amniocentesis and a detailed ultrasound, to diagnose or rule ...

  14. Clinical Significance of Procalcitonin (PCT) in Locating the Infection Position in Urinary Tract Infection%降钙素原在尿路感染定位中的临床意义

    Institute of Scientific and Technical Information of China (English)

    王社盈; 罗莉

    2012-01-01

    目的 探讨降钙素原(PCT)在尿路感染定位中的临床意义. 方法 用免疫定量法测定114例尿路感染患者及40例健康者的降钙素原(PCT)、C反应蛋白(CRP). 结果 上尿路感染组患者血清降钙素原(PCT)水平明显高于下尿路感染患者组(P<0.01),PCT对上尿路感染诊断的敏感性为81.1%,特异性为85.5%,阳性预测值为80.3%,阴性预测值为92.5%,均高于CRP. 结论 PCT对尿路感染的定位有临床意义.%Objective To explore the clinical significance of procalcitonin (PCT) in the infection location of urinary tract infection (UTI). Methods The concenstrations of PCT and C- reactive protein (CRP) in serum from 114 patients with UTI were detected by immunolumino- metric assay. Results The serum PCT level in patients with upper urinary tract infection was significantly higher than that in those with lower urinary tract infection (P < 0.01). The sensitivity, specificity, positive predictive value and negative predictive value of PCT for diagnosis of upper urinary tract infection were 81.1%, 85.5 % , 80.3% and 92.5% respectively, which were all higher than thoseof CRP. Conclusions Serum PCT can be used as a marker to differentiate the upper and lower urinary tract infection.

  15. The value of procalcitonin and the SAPS II and APACHE III scores in the differentiation of infectious and non-infectious fever in the ICU: a prospective, cohort study.

    Science.gov (United States)

    Jeon, Eun Ju; Jung, Jae Woo; Choi, Jae Chol; Shin, Jong Wook; Park, In Won; Choi, Byoung Whui; Park, Ae Ja; Kim, Jae Yeol

    2010-11-01

    Early and accurate differentiation between infectious and non-infectious fever is vitally important in the intensive care unit (ICU). In the present study, patients admitted to the medical ICU were screened daily from August 2008 to February 2009. Within 24 hr after the development of fever (>38.3℃), serum was collected for the measurement of the procalcitonin (PCT) and high mobility group B 1 levels. Simplified Acute Physiology Score (SAPS) II and Acute Physiology And Chronic Health Evaluation (APACHE) III scores were also analyzed. Sixty-three patients developed fever among 448 consecutive patients (14.1%). Fever was caused by either infectious (84.1%) or non-infectious processes (15.9%). Patients with fever due to infectious causes showed higher values of serum PCT (7.8±10.2 vs 0.5±0.2 ng/mL, P=0.026), SAPS II (12.0±3.8 vs 7.6±2.7, P=0.006), and APACHE III (48±20 vs 28.7±13.3, P=0.039) than those with non-infectious fever. In receiver operating characteristic curve analysis, the area under the curve was 0.726 (95% CI; 0.587-0.865) for PCT, 0.759 (95% CI; 0.597-0.922) for SAPS II, and 0.715 (95% CI; 0.550-0.880) for APACHE III. Serum PCT, SAPS II, and APACHE III are useful in the differentiation between infectious and non-infectious fever in the ICU.

  16. Procalcitonin as a Marker of Neonatal Sepsis in Intensive Care Units

    Directory of Open Access Journals (Sweden)

    Mohammed Ibrahim Aboud

    2010-09-01

    Full Text Available Background: The appropriateness of using serum levels ofprocalcotonin (PCT for early diagnosis of newborn sepsis isstill controversial. Therefore, the objective of the present studywas to compare the usefulness of PCT with those of serumlevels of C-reactive protein (CRP and white blood cell(WBC counts in the diagnosis and response to treatment ofneonatal sepsis.Methods: A total of 47 neonates (1-30 days old were assignedto two control (n=22 and sepsis (n=25 groups. Bloodsamples were obtained at the outset and after 7 days of treatmentfor blood culture, measurement of serum levels of PCTand CRP as well as WBC counts. Data were analyzed usingwithin and between group comparisons.Results: Serum levels of PCT were significantly higher insepsis group (14.1±18.7 ng/ml than that in the control group(0.38±0.43 ng/ml. In addition, after 7 days of treatment neonateswho had achieved clinical recovery had a significantlylower serum PCT levels (0.26±0.37 ng/ml than that of thesame group at the beginning of the study. At a cut-off value of≥ 0.8 ng/ml, the sensitivity, specificity, positive predictivevalue of, and negative predictive value of PCT were 84%,86%, 86% and 84%, respectively.Conclusion: The findings of the present study suggest that serumlevels of PCT might be a more reliable marker of infectionthan serum levels of CRP, or WBC counts in the early diagnosisand responses to antibiotic therapy of neonatal sepsis.

  17. Abnormal erythrocyte metabolism in hepatic disease.

    Science.gov (United States)

    Smith, J R; Kay, N E; Gottlieb, A J; Oski, F A

    1975-12-01

    Erythrocyte (RBC) metabolic studies were done on 114 patients with severe hepatic disease. Heinz body formation after incubation of RBCs with acetyl phenylhydrazine was found to be significantly higher in patients than in controls. RBC-reduced glutathione levels were lower than those of controls both before and after incubation with acetyl phenylhydrazine, and patients with the highest Heinz body counts had the lowest reduced glutathione levels. RBC methylene blue-stimulated hexose monophosphate (HMP) shunt metabolism and glucose recycling through the shunt were significantly lower in patients with active hepatic disease than in controls. There was no difference in resting HMP shunt activity or in resting recycling of glucose. Despite impairment of shunt metabolism, total glucose consumption was greater in patients than in controls. The patients with the lowest stimulated HMP shunt metabolism and glucose recycling had the highest Heinz body counts, lowest reduced glutathione, and highest total glucose consumption. A continuum of abnormal shunt metabolism was seen, from a mild reduction of stimulated HMP shunt activity to a severe combined decrease in both the HMP shunt and glucose recycling. When measured, glutathione reductase, glutathione peroxidase, glucose-6-phosphate dehydrogenase, and transketolase were normal or increased. Sequential studies were done on 11 patients who had abnormal metabolic studies. Coincident with improvement of HMP shunt metabolism, the Heinz body counts became lower, reduced glutathione higher, hematocrit higher, and liver function improved. Impaired HMP shunt metabolism appears to be a common, acquired RBC abnormality in patients with severe, active liver disease.

  18. Memetics clarification of abnormal behavior

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: Biological medicine is hard to fully and scientifically explain the etiological factor and pathogenesis of abnormal behaviors; while, researches on philosophy and psychology (including memetics) are beneficial to better understand and explain etiological factor and pathogenesis of abnormal behaviors. At present, the theory of philosophy and psychology is to investigate the entity of abnormal behavior based on the views of memetics.METHODS: Abnormal behavior was researched in this study based on three aspects, including instinctive behavior disorder, poorly social-adapted behavior disorder and mental or body disease associated behavior disorder. Most main viewpoints of memetics were derived from "The Meme Machine", which was written by Susan Blackmore. When questions about abnormal behaviors induced by mental and psychological diseases and conduct disorder of teenagers were discussed, some researching achievements which were summarized by authors previously were added in this study, such as aggressive behaviors, pathologically aggressive behaviors, etc.RESULTS: The abnormal behaviors mainly referred to a part of people's substandard behaviors which were not according with the realistic social environment, culture background and the pathologic behaviors resulted from people's various psychological diseases. According to the theory of "meme", it demonstrated that the relevant behavioral obstacles of various psychological diseases, for example, the unusual behavior of schizophrenia, were caused, because the old meme was destroyed thoroughly but the new meme was unable to establish; psychoneurosis and personality disorder were resulted in hard establishment of meme; the behavioral obstacles which were ill-adapted to society, for example, various additional and homosexual behaviors, were because of the selfish replications and imitations of "additional meme" and "homosexual meme"; various instinct behavioral and congenital intelligent obstacles were not significance

  19. [Diagnosticum of abnormalities of plant meiotic division].

    Science.gov (United States)

    Shamina, N V

    2006-01-01

    Abnormalities of plant meiotic division leading to abnormal meiotic products are summarized schematically in the paper. Causes of formation of monads, abnormal diads, triads, pentads, polyads, etc. have been observed in meiosis with both successive and simultaneous cytokinesis.

  20. Thyroid abnormality in perimenopausal women with abnormal uterine bleeding

    Directory of Open Access Journals (Sweden)

    Prasanna Byna

    2015-11-01

    Full Text Available Background: AUB is a common but complicated clinical presentation and occurs in 15-20% of women between menarche to menopause and significantly affects the women's health. Women with thyroid dysfunction often have menstrual irregularities, infertility and increased morbidity during pregnancy. The objective of present study is to find the correlation between thyroid disorders and AUB in perimenopausal women attending gynecology OPD. Methods: In the present study, fifty five patients with AUB were included and were evaluated for the cause including thyroid abnormality. Thyroid function tests were done in all patients. Results: Among 55 patients, 12 patients were diagnosed as hypothyroidism and 7 as hyperthyroidism, women with AUB 36 (65.4% were euthyroid. Among 19 women with thyroid abnormality, heavy menstrual bleeding was seen in 8 (42% women, 6 (31.57% had polymenorrhagia, 5 (26.31% had oligomenorrhoea. The frequent menstrual abnormality in women with hypothyroidism (12 women was heavy menstrual bleeding in 5 (41.6% women, 3 (25% had oligomennorhoea, 4 (33.3% had polymenorrhagia. Out of 7 women with hyperthyroidism, 2 (28.57% had oligomenorrhoea, 3 (42.8% had heavy menstrual bleeding, 2 (28.57% had polymenorrhagia. In a total of 55 patients with AUB, 11 (20% had structural abnormalities in uterus and ovaries. 5 (9% had adenomyosis, 3 (5.4% had ovarian cysts, 3 (5.4% had fibroids. Conclusions: It is important to screen all women for thyroid abnormality who are presenting with AUB especially with non-structural causes of AUB. Correction of thyroid abnormalities also relieves AUB. This will avoid unnecessary hormonal treatment and surgery. [Int J Res Med Sci 2015; 3(11.000: 3250-3253

  1. Kidney transplantation in abnormal bladder

    Directory of Open Access Journals (Sweden)

    Shashi K Mishra

    2007-01-01

    Full Text Available Structural urologic abnormalities resulting in dysfunctional lower urinary tract leading to end stage renal disease may constitute 15% patients in the adult population and up to 20-30% in the pediatric population. A patient with an abnormal bladder, who is approaching end stage renal disease, needs careful evaluation of the lower urinary tract to plan the most satisfactory technical approach to the transplant procedure. Past experience of different authors can give an insight into the management and outcome of these patients. This review revisits the current literature available on transplantation in abnormal bladder and summarizes the clinical approach towards handling this group of difficult transplant patients. We add on our experience as we discuss the various issues. The outcome of renal transplant in abnormal bladder is not adversely affected when done in a reconstructed bladder. Correct preoperative evaluation, certain technical modification during transplant and postoperative care is mandatory to avoid complications. Knowledge of the abnormal bladder should allow successful transplantation with good outcome.

  2. Antibiotic treatment interruption of suspected lower respiratory tract infections based on a single procalcitonin measurement at hospital admission-a randomized trial

    DEFF Research Database (Denmark)

    Kristoffersen, K B; Schmeltz Søgaard, Ole; Wejse, Christian

    2009-01-01

    Recent studies have suggested that procalcitonin (PCT) is a safe marker for the discrimination between bacterial and viral infection, and that PCT-guided treatment may lead to substantial reductions in antibiotic use. The present objective was to evaluate the effect of a single PCT measurement...... to either PCT-guided treatment or standard treatment. Antibiotic treatment duration in the PCT group was based on the serum PCT value at admission. The cut-off point for recommending antibiotic treatment was PCT >/=0.25 mug/L. Physicians could overrule treatment guidelines. The mean duration of hospital...... disease patients, the mean length of stay was reduced from 7.1 days in the control group to 4.8 days in the PCT group (p 0.009). It was concluded that the determination of a single PCT value at admission in patients with suspected LRTIs can lead to a reduction in the duration of antibiotic treatment by 25...

  3. C-Reactive Protein and Procalcitonin Diagnostic Value in Congenital Infection in Newborns with Extremely Low and Very Low Birth Weight

    Directory of Open Access Journals (Sweden)

    O. V. Mikhaylova

    2015-01-01

    Full Text Available The high frequency of infectious complications in the early neonatal period of adaptation in infants with extremely low (ELBW and very low birth weight (VLBW attracts particular attention. The aim of our study was to evaluate the sensitivity (Se and specificity (Sp of C-reactive protein and procalcitonin in congenital pneumonia and congenital sepsis in newborn infants with extremely low and very low birth weight.Methods. In 160 preterm newborns that were included in our prospective study, 33 had early neonatal sepsis, 42 children had congenital pneumonia, and 85 infants were without neonatal infection. A comprehensive clinical and laboratoryinstrumental examination of the newborn was done, including determining the concentration of C-reactive protein and procalcitonin at the age of 48–72 hours of life. Results. Low sensitivity of CRP at the age of 48–72 hours of life in congenital sepsis and congenital pneumonia was observed. However, under these pathological conditions CRP and PCT are characterized by high specificity. It should also be noted that PCT has a high sensitivity in children with congenital sepsis aged 48–72 hours. Moreover, PCT also has a high specificity (Sp 80,6%, which determines its advantage in the use of sepsis diagnosis in extremely premature infants compared to CRP.Conclusion. Maximum specificity reaches 100%, co-located with the assessment of CRP and PCT, which determines the feasibility of using this combination for verification of congenital infectious conditions such as sepsis and pneumonia in children ELBW and VLBW aged 48–72 hours.

  4. Use of procalcitonin for the diagnosis of pneumonia in patients presenting with a chief complaint of dyspnoea: results from the BACH (Biomarkers in Acute Heart Failure) trial

    Science.gov (United States)

    Maisel, Alan; Neath, Sean-Xavier; Landsberg, Judd; Mueller, Christian; Nowak, Richard M.; Peacock, W. Frank; Ponikowski, Piotr; Möckel, Martin; Hogan, Christopher; Wu, Alan H.B.; Richards, Mark; Clopton, Paul; Filippatos, Gerasimos S.; Di Somma, Salvatore; Anand, Inder; Ng, Leong L.; Daniels, Lori B.; Christenson, Robert H.; Potocki, Mihael; McCord, James; Terracciano, Garret; Hartmann, Oliver; Bergmann, Andreas; Morgenthaler, Nils G.; Anker, Stefan D.

    2012-01-01

    Aims Biomarkers have proven their ability in the evaluation of cardiopulmonary diseases. We investigated the utility of concentrations of the biomarker procalcitonin (PCT) alone and with clinical variables for the diagnosis of pneumonia in patients presenting to emergency departments (EDs) with a chief complaint of shortness of breath. Methods and results The BACH trial was a prospective, international, study of 1641 patients presenting to EDs with dyspnoea. Blood samples were analysed for PCT and other biomarkers. Relevant clinical data were also captured. Patient outcomes were assessed at 90 days. The diagnosis of pneumonia was made using strictly validated guidelines. A model using PCT was more accurate [area under the curve (AUC) 72.3%] than any other individual clinical variable for the diagnosis of pneumonia in all patients, in those with obstructive lung disease, and in those with acute heart failure (AHF). Combining physician estimates of the probability of pneumonia with PCT values increased the accuracy to >86% for the diagnosis of pneumonia in all patients. Patients with a diagnosis of AHF and an elevated PCT concentration (>0.21 ng/mL) had a worse outcome if not treated with antibiotics (P = 0.046), while patients with low PCT values (<0.05 ng/mL) had a better outcome if they did not receive antibiotic therapy (P = 0.049). Conclusion Procalcitonin may aid in the diagnosis of pneumonia, particularly in cases with high diagnostic uncertainty. Importantly, PCT may aid in the decision to administer antibiotic therapy to patients presenting with AHF in which clinical uncertainty exists regarding a superimposed bacterial infection. Trial registration: NCT00537628 PMID:22302662

  5. Relationship of levels of seminal plasma lipoprotein (a),Zn2 + and prostate specific antigen in the semen with abnormal semen liquefaction%精浆脂蛋白(a)、锌和前列腺特异性抗原含量与精液液化的关系

    Institute of Scientific and Technical Information of China (English)

    张健清; 王东; 黄楚梅; 张式鸿; 蔡丹

    2015-01-01

    Objectives:To explore the relationship of levels of seminal plasma lipoprotein (a),Zn2 +and prostate specific antigen in the semen with abnormal semen liquefaction.Methods:200 patients with abnormal se-men liquefaction and 200 men with semen liquefaction were selected.The level of seminal zinc was detected by color-developing method.The level of PSA in seminal was measured by ELISA and the lipoprotein (a)was measured by latex enhanced immunoturbidimetric assay.Results:The levels of Zn2 + in abnormal group and normal group were (90.0 ±35.1 )μg/mL and (1 25.1 ±25.5)μg/mL respectively,with significant difference (P <0.01 ).The levels of lipoprotein (a)in abnormal group and normal group were (550 ±250)μg/mL and (301 ±98)μg/mL re-spectively,with significant difference (P <0.01 ).The levels of PSA in abnormal group and normal group were (0.81 ±0.21 )mg/mL and (1 .31 ±0.30)mg/mL respectively,with significant difference (P <0.05).Conclu-sion:The levels of seminal lipoprotein (a),Zn2 + and PSA should be taken into account in the diagnosis of male in-fertility caused by abnormal liquefaction.%目的:探讨精浆脂蛋白(a)、锌和前列腺特异性抗原(PSA)与精液液化的关系。方法:筛选精液液化异常患者和精液液化正常男性各200例,显色法测定精浆锌离子(Zn2+),酶联免疫法测定 PSA,乳胶增强免疫透射比浊法测定脂蛋白(a),对比分析两组测定结果。结果:异常组精浆 Zn2+平均含量为(90.0±35.1)μg/mL,脂蛋白(a)水平为(550±250)μg/mL;正常组精浆 Zn2+平均含量为(125.1±25.5)μg/mL,脂蛋白(a)水平为(301±98)μg/mL,两者差异有统计学意义(均 P <0.01)。异常组精浆 PSA 含量为(0.81±0.21)mg/mL,正常组精浆 PSA 含量为(1.31±0.30)mg/mL,两者差异有统计学意义(P <0.05)。结论:精液液化异常可能与精浆脂

  6. Hereditary sideroblastic anemia with associated platelet abnormalities.

    Science.gov (United States)

    Soslau, G; Brodsky, I

    1989-12-01

    A 62 year old male (R.H.) presented with a mild anemia (Hb 11-12 gm%) and a history of multiple hemorrhagic episodes. The marrow had 40-50% sideroblasts. Marrow chromosomes were normal. His wife was hematologically normal, while one daughter, age 30 years, had a sideroblastic anemia (Hb 11-12 gm%) with 40-50% sideroblasts in the marrow. Her anemia was first noted at age 15 years. Administration of vitamin B6 did not correct the anemia in either the father or daughter. Platelet abnormalities inherited jointly with this disorder are described for the first time. Both R.H. and his daughter had prolonged bleeding times, with normal PTT, PT times, fVIII:C, fVIII:Ag levels, and vWF multimers, which may rule out a von Willebrand's disease. They have normal platelet numbers but abnormally low platelet adhesiveness and greatly depressed ADP, collagen, and epinephrine responsiveness. Response to ristocetin was in the low normal range, and aggregation with thrombin was normal. While desmopressin completely normalized R.H.'s bleeding time, none of these platelet parameters were improved. No differences in the SDS PAGE protein patterns of RH platelets could be detected in comparison to normal samples. His platelets took up and released serotonin (5HT) normally, and electron micrographs defined no morphological abnormalities. However, no ATP was released from platelets activated with collagen, and when followed by thrombin about fourfold greater ATP was released by control platelets as compared to RH platelets. The dense granule fraction derived from RH platelets contained about 20% the level of ATP, 40% the level of ADP, and 50% the level of 5HT detected in a normal sample. The results indicate that the bleeding disorder is related to a non-classical heritable storage pool defect. The connection between the inherited sideroblastic anemia and platelet defects is obscure.

  7. The clinical value of procalcitonin for sepsis in differential diagnosis and prognostic monitoring%降钙素原对脓毒症鉴别诊断及预后监测的方法评价

    Institute of Scientific and Technical Information of China (English)

    张天卿; 沈淑男; 胡哲清

    2015-01-01

    目的 评价血清降钙素原(PCT)在脓毒症鉴别诊断及预后监测的价值.方法 76例脓毒症患者,其中早期脓毒症43例,严重脓毒症患者20例,脓毒症休克患者13例.采用免疫荧光法检测血清中PCT和CRP水平.结果 脓毒症休克组与严重脓毒症组相比、严重脓毒症组和早期脓毒症组相比,PCT、CRP、APACHE Ⅱ评分之间均有统计学意义(P<O.05);脓毒症患者血清PCT与APACHEⅡ评分之间存在显著正相关(r=0.57,P<0.05);在使用抗生素治疗后血清PCT可快速下降,出院前恢复到正常水平,而CRP在细菌感染被控制后仍维持在高水平,出院前浓度仍高于正常水平,其回落速度慢于血清PCT.结论对于鉴别不同程度的脓毒症,PCT是一个很好的血清指标,还可进行脓毒症预后的监测.%Objective Evaluation of serum procalcitonin (PCT) in sepsis differential diagnosis and prognostic monitoring value.Methods 76 cases of sepsis patients,including 43 cases of early sepsis,severe sepsis patients in 20 cases,13 cases of patients with septic shock.Immunofluorescence is used on the detection of serum PCT and CRP levels.Results Septic shock group compared with severe sepsis,severe sepsis group compared with early sepsis group,PCT,CRP,APACHE Ⅱ was statistically significant (P < 0.05) ; there is a significant positive correlation between sepsis patients serum PCT and APACHE Ⅱ score (r =0.57,P < 0.05); after antibiotic treatment,serum PCT can be decreased rapidly,before discharge returned to normal levels,while the CRP after being controlled is still maintained at a high level,before discharge concentration was still higher than normal level,slowly than serum PCT.Conclusion For the identification of different degree of sepsis,PCT is a good index for monitoring the serum,also can make the sepsis prognosis.

  8. Cardiac abnormalities after subarachnoid hemorrhage

    NARCIS (Netherlands)

    Bilt, I.A.C. van der

    2016-01-01

    Aneurysmal subarachnoid hemorrhage(aSAH) is a devastating neurological disease. During the course of the aSAH several neurological and medical complications may occur. Cardiac abnormalities after aSAH are observed often and resemble stress cardiomyopathy or Tako-tsubo cardiomyopathy(Broken Heart Syn

  9. Congenital abnormalities in methylmercury poisoning

    Energy Technology Data Exchange (ETDEWEB)

    Gilani, S.H.

    1975-04-01

    This study was undertaken to determine the teratogenic potential of methylmercury on chick embryogenesis. Methylmercuric chloride was dissolved in sodium bicarbonate (0.2%) and administered to the chick embryos at doses ranging from 0.0009 to 0.010 mg per egg. The injections were made at days 2 and 3 on incubation (Groups A and B). All the embryos including controls were examined on the 7th day of incubation. Methylmercury poisoning was observed to be both embryolethal and teratogenic. Within the two groups, embryolethality was higher in Group A. The following congenital abnormalities were observed: exencephaly, shortened and twisted limbs, microphthalmia, shortened and twisted neck, beak abnormalities, everted viscera, reduced body size and hemorrhage all over the body. Exencephaly and limb abnormalities were very common. No differences in the incidence and types of gross abnormalities within both the groups (A and B) were noted. The incidence of malformations among the controls was low. The results of present investigation show that methylmercury poisoning is both embryolethal and teratogenic to early chick embryogenesis. (auth)

  10. Chromosome abnormalities in Indonesian patients with short stature

    Directory of Open Access Journals (Sweden)

    Paramayuda Chrysantine

    2012-08-01

    Full Text Available Abstract Background Short stature is associated with several disorders including wide variations of chromosomal disorders and single gene disorders. The objective of this report is to present the cytogenetic findings in Indonesian patients with short stature. Methods G-banding and interphase/metaphase FISH were performed on short stature patients with and without other clinical features who were referred by clinicians all over Indonesia to our laboratory during the year 2003–2009. Results The results of chromosomal analysis of ninety seven patients (mean age: 10.7 years old were collected. The group of patients with other clinical features showed sex chromosome abnormalities in 45% (18/40 and autosomal abnormalities in 10% (4/40, whereas those with short stature only, 42.1% (24/57 had sex chromosome abnormalities and 1.75% (1/57 had autosomal abnormalities. The autosomal chromosomal abnormalities involved mostly subtelomeric regions. Results discrepancies between karyotype and FISH were found in 10 patients, including detection of low-level monosomy X mosaicism in 6 patients with normal karyotype, and detection of mosaic aneuploidy chromosome 18 in 1 patient with 45,XX,rob(13;14(q10;q10. Statistical analysis showed no significant association between the groups and the type of chromosomal abnormalities. Conclusion Chromosome abnormalities account for about 50% of the short stature patients. Wide variations of both sex and autosomal chromosomes abnormalities were detected in the study. Since three out of five patients had autosomal structural abnormalities involving the subtelomeric regions, thus in the future, subtelomeric FISH or even a more sensitive method such as genomic/SNP microarray is needed to confirm deletions of subtelomeric regions of chromosome 9, 11 and 18. Low-level mosaicism in normal karyotype patients indicates interphase FISH need to be routinely carried out in short stature patients as an adjunct to karyotyping.

  11. Liver abnormalities and endocrine diseases.

    Science.gov (United States)

    Burra, Patrizia

    2013-08-01

    The liver and its pleotropic functions play a fundamental role in regulating metabolism, and is also an inevitable target of multiple metabolic disorders. The numerous and constant relationships and feedback mechanisms between the liver and all endocrine organs is reflected by the fact that an alteration of one oftentimes results in the malfunction of the other. Hypo- and hyperthyroidism are frequently associated with hepatic alterations, and thyroid diseases must be excluded in transaminase elevation of unknown cause. Drugs such as propylthiouracil, used in the treatment of hyperthyroidism, may induce liver damage, and other drugs such as amiodarone, carbamazepine, and several chemotherapeutic agents can lead to both thyroid and liver abnormalities. Liver diseases such as hepatitis, hepatocellular carcinoma, and cirrhosis may cause altered levels of thyroid hormones, and alcoholic liver disease, both due to the noxious substance ethanol as well as to the hepatic damage it causes, may be responsible for altered thyroid function. Both excess and insufficiency of adrenal function may result in altered liver function, and adrenocortical dysfunction may be present in patients with cirrhosis, especially during episodes of decompensation. Again an important player which affects both the endocrine system and the liver, alcohol may be associated with pseudo-Cushing syndrome. Sex hormones, both intrinsic as well as extrinsically administered, have an important impact on liver function. While oestrogens are related to cholestatic liver damage, androgens are the culprit of adenomas and hepatocellular carcinoma, among others. Chronic liver disease, on the other hand, has profound repercussions on sex hormone metabolism, inducing feminization in men and infertility and amenorrhoea in women. Lastly, metabolic syndrome, the pandemia of the present and future centuries, links the spectrum of liver damage ranging from steatosis to cirrhosis, to the array of endocrine alterations

  12. Systemic Inflammatory Response and Serum Lipopolysaccharide Levels Predict Multiple Organ Failure and Death in Alcoholic Hepatitis

    Science.gov (United States)

    Michelena, Javier; Altamirano, José; Abraldes, Juan G.; Affò, Silvia; Morales-Ibanez, Oriol; Sancho-Bru, Pau; Dominguez, Marlene; García-Pagán, Juan Carlos; Fernández, Javier; Arroyo, Vicente; Ginès, Pere; Louvet, Alexandre; Mathurin, Philippe; Mehal, Wajahat Z.; Caballería, Juan; Bataller, Ramón

    2015-01-01

    Alcoholic hepatitis (AH) frequently progresses to multiple organ failure (MOF) and death. However, the driving factors are largely unknown. At admission, patients with AH often show criteria of systemic inflammatory response syndrome (SIRS) even in the absence of an infection. We hypothesize that the presence of SIRS may predispose to MOF and death. To test this hypothesis, we studied a cohort including 162 patients with biopsy-proven AH. The presence of SIRS and infections was assessed in all patients, and multivariate analyses identified variables independently associated with MOF and 90-day mortality. At admission, 32 (19.8%) patients were diagnosed with a bacterial infection, while 75 (46.3%) fulfilled SIRS criteria; 58 patients (35.8%) developed MOF during hospitalization. Short-term mortality was significantly higher among patients who developed MOF (62.1% versus 3.8%, P <0.001). The presence of SIRS was a major predictor of MOF (odds ratio = 2.69, P=0.025) and strongly correlated with mortality. Importantly, the course of patients with SIRS with and without infection was similar in terms of MOF development and short-term mortality. Finally, we sought to identify serum markers that differentiate SIRS with and without infection. We studied serum levels of high-sensitivity C-reactive protein, procalcitonin, and lipopolysaccharide at admission. All of them predicted mortality. Procalcitonin, but not high-sensitivity C-reactive protein, serum levels identified those patients with SIRS and infection. Lipopolysaccharide serum levels predicted MOF and the response to prednisolone. Conclusion In the presence or absence of infections, SIRS is a major determinant of MOF and mortality in AH, and the mechanisms involved in the development of SIRS should be investigated; procalcitonin serum levels can help to identify patients with infection, and lipopolysaccharide levels may help to predict mortality and the response to steroids. PMID:25761863

  13. 药物流产后异常子宫出血患者血清雌激素、孕激素和人绒毛促性腺激素水平%Estrogen, Progesterone, and Human Chorionic Gonadotrophin Levels in Patients with Abnormal Uterine Bleeding after Drug Abortion

    Institute of Scientific and Technical Information of China (English)

    陈永红; 王素平

    2013-01-01

    Objective: To investigate the relationship of estrogen (E2) , progesterone (P) , and human chorionic gonadotrophin (hCG) levels with abnormal uterine bleeding in patients with drug abortion. Methods: A total of 59 patients taking mifepristone plus misoprostol for abortion were divided into two groups. In the control group (29 cases, group C) , the time of uterine bleeding was less than 14 days; in the abnormal uterine bleeding (30 cases, group A) , the time of uterine bleeding was more than 14 days. The levels of E2, P and hCG of the 2 groups in 14, 18 and 22 days after initiation of bleeding were compared. Results: There was no significant difference of E2 levels between the 2 groups (P >0.05); On the 14th day, P level of group A was higher than that of group C (P < 0.05); On the 14th , 18th , and 22nd days, the hCG levels in group A were significantly higher than those in group C (P <0. 05). Conclusion: The abnormal uterine bleeding in patients with medical abortion is related with P and hCG levels.%目的:研究药物流产后患者体内雌激素(E2)、孕激素(P)及人绒毛促性腺激素(hCG)水平与异常子宫出血的关系.方法:59例患者口服米非司酮配伍米索前列醇药物终止早期妊娠,将子宫出血时间超过14 d的30例患者作为异常子宫出血组,子宫出血时间少于14 d的29例患者作为对照组,比较2组外周静脉血清中E2、P及hCG水平.结果:两组患者体内E2差异无显著性(P>0.05),在出血第14天时,异常子宫出血组患者体内P明显高于对照组(P<0.05),在第14、18和22天hCG均高于对照组(P<0.05).结论:药物流产后异常子宫出血与患者体内P和hCG水平有关.

  14. Nail abnormalities in rheumatoid arthritis.

    Science.gov (United States)

    Michel, C; Cribier, B; Sibilia, J; Kuntz, J L; Grosshans, E

    1997-12-01

    Many nail abnormalities have traditionally been described in association with rheumatoid arthritis (RA), but their specificity has never been assessed in a controlled study. Our purpose was to evaluate the frequency and the specificity of nail changes associated with RA in a case-controlled study including 50 patients suffering from RA and 50 controls. For each patient, a general skin examination was performed and the 20 nails were examined. The nail features were noted and classified. A chi 2 test or a Fisher test was used to compare the two groups. The only nail abnormalities significantly associated with RA were longitudinal ridging on nine or 10 finger nails (29 patients in the RA group vs. three in the controls, chi 2: P nail (24 patients vs. 10, chi 2: P nail changes were noticed but were not frequent enough to be significant. The presence of longitudinal ridging on the finger nails was significantly associated with RA.

  15. Neuroendocrine abnormalities in Parkinson's disease.

    Science.gov (United States)

    De Pablo-Fernández, Eduardo; Breen, David P; Bouloux, Pierre M; Barker, Roger A; Foltynie, Thomas; Warner, Thomas T

    2017-02-01

    Neuroendocrine abnormalities are common in Parkinson's disease (PD) and include disruption of melatonin secretion, disturbances of glucose, insulin resistance and bone metabolism, and body weight changes. They have been associated with multiple non-motor symptoms in PD and have important clinical consequences, including therapeutics. Some of the underlying mechanisms have been implicated in the pathogenesis of PD and represent promising targets for the development of disease biomarkers and neuroprotective therapies. In this systems-based review, we describe clinically relevant neuroendocrine abnormalities in Parkinson's disease to highlight their role in overall phenotype. We discuss pathophysiological mechanisms, clinical implications, and pharmacological and non-pharmacological interventions based on the current evidence. We also review recent advances in the field, focusing on the potential targets for development of neuroprotective drugs in Parkinson's disease and suggest future areas for research.

  16. Mastoid abnormalities in Down syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Glass, R.B.J.; Yousefzadeh, D.K.; Roizen, N.J.

    1989-06-01

    Hearing loss and otitis media are commonly associated with Down syndrome. Hypoplasia of the mastoids is seen in many affected children and sclerosis of mastoid bones is not uncommon in Down syndrome. Awareness and early recognition of mastoid abnormality may lead to appropriate and timely therapy, thereby preserving the child's hearing or compensating for hearing loss; factors which are important for learning and maximum development.

  17. Computed tomography of thymic abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Schnyder, P.; Candardjis, G.

    1987-05-01

    Computed tomographic examinations of 38 patients with surgically and histologically proven diagnosis were reviewed. Twenty subjects (52%) had an invasive thymoma and 16% an hyperplastic thymus. Myasthenia gravis was present in 6 cases (16%) of thymic abnormalities, four (10,5%) with invasive thymoma and two (5%) with thymic hyperplasia. Graves' disease was also present in one case of thymic hyperplasia. We emphasize the contribution of CT to the diagnosis and the prognosis.

  18. Manganese Abnormity in Holocene Sediments of the Bohai Sea

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Manganese abnormity has been observed in the Holocene sediments of the mud area of Bohai Sea. On the basis of grain size, chemical composition, heavy mineral content and accelerator mass spectrometry (AMS) 14C dating of foraminifer, relationships between manganese abnormity and sedimentation rates, material source, hydrodynamic conditions are probed. Manganese abnormity occurred during the Middle Holocene when sea level and sedimentation rates were higher than those at present. Sedimentary hiatus was not observed when material sources and hydrodynamic conditions were quite similar. Compared with the former period, the latter period showed a decrease in reduction environment and an inclination toward oxidation environment with high manganese content, whereas provenance and hydrodynamic conditions showed only a slight change. From the above observations, it can be concluded that correlation among manganese abnormity, material source, and hydrodynamic conditions is not obvious. Redox environment seems to be the key factor for manganese enrichment, which is mainly related to marine authigenic process.

  19. Meiotic abnormalities in infertile males.

    Science.gov (United States)

    Egozcue, J; Sarrate, Z; Codina-Pascual, M; Egozcue, S; Oliver-Bonet, M; Blanco, J; Navarro, J; Benet, J; Vidal, F

    2005-01-01

    Meiotic anomalies, as reviewed here, are synaptic chromosome abnormalities, limited to germ cells that cannot be detected through the study of the karyotype. Although the importance of synaptic errors has been underestimated for many years, their presence is related to many cases of human male infertility. Synaptic anomalies can be studied by immunostaining of synaptonemal complexes (SCs), but in this case their frequency is probably underestimated due to the phenomenon of synaptic adjustment. They can also be studied in classic meiotic preparations, which, from a clinical point of view, is still the best approach, especially if multiplex fluorescence in situ hybridization is at hand to solve difficult cases. Sperm chromosome FISH studies also provide indirect evidence of their presence. Synaptic anomalies can affect the rate of recombination of all bivalents, produce achiasmate small univalents, partially achiasmate medium-sized or large bivalents, or affect all bivalents in the cell. The frequency is variable, interindividually and intraindividually. The baseline incidence of synaptic anomalies is 6-8%, which may be increased to 17.6% in males with a severe oligozoospermia, and to 27% in normozoospermic males with one or more previous IVF failures. The clinical consequences are the production of abnormal spermatozoa that will produce a higher number of chromosomally abnormal embryos. The indications for a meiotic study in testicular biopsy are provided.

  20. Procalcitonina como biomarcador de prognóstico da sepse grave e choque séptico Procalcitonin as a prognostic biomarker of severe sepsis and septic shock

    Directory of Open Access Journals (Sweden)

    José Raimundo Araujo de Azevedo

    2012-12-01

    como, redução do PCT-c 24 horas, associaram-se à elevação expressiva da mortalidade de pacientes com sepse grave e choque séptico.OBJECTIVE: To evaluate the tendency of the plasma concentration and clearance of procalcitonin (PCT-c as biomarkers of prognosis of patients with severe sepsis and septic shock, compared to another early prognosis marker, the number of SIRS criteria at sepsis diagnosis. METHODS: We conducted a prospective, observational, cohort study, with patients with severe sepsis and septic shock. The serum procalcitonin was determined at diagnosis of sepsis and after 24 and 48 hours. Demographic data, APACHE IV, SOFA score on arrival, number of SIRS criteria at diagnosis, site of infection and microbiological results were recorded. RESULTS: Twenty-eight patients were included, 19 clinical and nine surgical. In 13 (46.4% the source of sepsis was pulmonary, abdominal in seven (25.0%, urinary in five (17.9% and soft tissue in three cases (10.7%. Fifteen patients had severe sepsis and 13 septic shock. Overall mortality was 17.9% (five patients, three with septic shock. Twenty-eight PCT determinations were performed at sepsis diagnosis, 27 after 24 hours and 26 after 48 hours. The initial concentration was not significantly different between survivors and non-survivors groups, but the differences between the two groups after 24 and 48 hours were statistically significant. There was no difference in the number of SIRS criteria. The 24-hour procalcitonin clearance proved to be significantly higher in the group of survivors (-3.0 versus -300.0, p = 0.028. Although the 48-hour procalcitonin clearance has shown to be higher in the group of survivors when compared to non-survivors, the difference did not reach statistical significance. CONCLUSION: Persistently high procalcitonin concentrations in plasma, as well as reduced 24-hours PCT clearence, were associated with a significant increase in mortality in patients with severe sepsis and septic shock.

  1. 血清降钙素原判断儿童脓毒症病原学的作用%The role of serum procalcitonin in etiology diagnosis of sepsis in children

    Institute of Scientific and Technical Information of China (English)

    隆彩霞; 曾晓辉; 胥志跃; 刘萍萍; 范江花

    2014-01-01

    Objective To investigate the serum procalcitonin (PCT) levels in sepsis caused by the bacteria,virus and mycoplasma and explore the role of PCT in etiology diagnosis of sepsis in children.Methods Three hundreds and thirty critically ill children with sepsis caused by bacteria,virus and mycoplasma admitted in PICU of Hunan Children' s Hospital from Feb 1,2011 to Sep 1,2012 were reviewed and analyzed.The PCT levels were measured at admission and day 3.The differences in accidence of sepsis caused by bacteria,viruses and mycoplasma according to different serum PCT levels were analyzed.The differences of PCT levels at admission and day 3 in sepsic children caused by bacteria,viruses and mycoplasma were analyzed.Results The level of serum PCT in sepsis caused by bacterial infection were distinctly increased,caused by virus and mycoplasma infections was not obvious but the increases of serum PCT [0.71 (8.14)ng/ml,0.15 (1.68) ng/ml,0.28 (1.89) ng/ml].According to various PCT levels(0.05 ~ ng/ml,0.5 ~ng/ml,2 ~ ng/ml,10 ~ 300 ng/ml),the differences of accidence of sepsis caused by bacteria,virus and mycoplasma were also statistically significant(x2 =84.50,P < 0.01).The PCT level of septic children caused by bacterial infection in day 3 was significantly decreased compared with that at admission [0.32 (5.68) ng/ml vs 0.71 (8.14) ng/ml] (U =19.34,P <0.05).Conclusion PCT plays a certain role in etiology diagnosis of sepsis in children.The increased PCT levels which can be reduced by anti-inflammatory treatment indicate the likelihood of bacterial infection and sepsis.The increase of PCT induced by viral and mycoplasma infections is not obvious,but bacterial infection can not be completely ruled out.%目的 了解细菌、病毒及支原体感染引起脓毒症血清降钙素原(procalcitonin,PCT)的水平,明确血清PCT判断引起儿童脓毒症常见病原的作用.方法 回顾性分析2011年2月1日至2012年9月1日入住湖南省儿童医院PICU确诊细

  2. 降钙素原在输尿管结石继发尿脓毒血症中的应用价值%Application value of procalcitonin for urosepsis secondary to ureteral calculus

    Institute of Scientific and Technical Information of China (English)

    杨泽松; 王芳; 林忠应; 陈从其; 许庆均; 叶烈夫

    2015-01-01

    目的 研究降钙素原(procalcitonin,PCT)在输尿管结石继发尿脓毒血症中的应用价值.方法 2010年12月至2014年9月68例怀疑尿脓毒血症的单侧输尿管结石患者,行血常规、C反应蛋白(C-reactive protein,CRP)、PCT、尿沉渣、血培养及尿培养.68例患者根据尿脓毒血症诊断标准分为尿脓毒血症组29例和非尿脓毒血症组39例,比较两组患者的年龄、性别、结石部位、结石大小、血白细胞(WBC)计数值、CRP值、PCT值及尿WBC计数值,并对比尿脓毒血症组治疗前后的PCT值.结果 尿脓毒血症组患者年龄、结石大小明显大于非尿脓毒血症组,尿脓毒血症组及非尿脓毒血症组第一时间血清PCT水平分别为(19.09±25.15)和(2.09±1.85) μg/L,组间比较差异有统计学意义(P<0.05).两组血WBC值(×109/L)分别为11.00±3.47及10.27±2.32,CRP值分别为(17.41±15.24)及(15.02±4.94) mg/L,尿WBC值(/HPF)中位数分别为54及47,组间比较差异均无统计学意义(P>0.05).尿脓毒血症组治疗后PCT值为(1.06±0.56) μg/L,与治疗前比较差异有统计学意义(P<0.05).结论 PCT在早期诊断尿脓毒血症、评估病情及指导治疗方面具有较高的临床价值.%Objective To investigate the value of procalcitonin (PCT) for urosepsis secondary to ureteral calculus.Methods Samples of 68 ureteral calculi patients who were suspected of urosepsis were obtained for PCT level,C-reactive protein (CRP) level,blood routine examination,urinary sediment,blood culture and urine culture.Sixty-eighy patients were divided into urosepsis group and non-urosepsis group based on the urosepsis diagnostic standard.The age sex,stone location,stone size,blood WBC count,CRP level,PCT level and urine WBC count were compared between the 2 groups.PCT levels before and after treatment were also compared.Results The age,stone size in urosepsis group were significantly higher than those in non-urosepsis group.The PCT levels of patients in

  3. Circulating levels of hydrogen sulfide and substance P in patients with sepsis.

    Science.gov (United States)

    Gaddam, Ravinder Reddy; Chambers, Stephen; Murdoch, David; Shaw, Geoffrey; Bhatia, Madhav

    2017-10-01

    To determine alterations of circulating levels of hydrogen sulfide and substance P in patients with sepsis compared to non-sepsis patients with similar disease severity and organ dysfunction. This study included 23 septic and 14 non-septic patients during 2015-16 study period at the Christchurch Hospital Intensive Care Unit, Christchurch, New Zealand. Blood samples were collected from the time of admission to 96 h, with collection at different time points (0 h, 12 h, 24 h, 48 h, 72 h and 96 h) and subjected to measurement of hydrogen sulfide, substance P, procalcitonin, C-reactive protein, interleukin-6 and lactate levels. Patients with sepsis showed higher circulating hydrogen sulfide and substance P levels compared to patients without sepsis. Hydrogen sulfide levels were significantly higher at 12 h (1.45 vs 0.75 μM; p p P levels were higher at 48 h (0.55 vs 0.31 ng/mL; p P levels in septic patients were associated with increased levels of inflammatory mediators - procalcitonin, C-reactive protein and interleukin-6. These results provide evidence that higher circulating levels of hydrogen sulfide and substance P are associated with increased inflammatory response in patients with sepsis. Copyright © 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  4. 糖耐量异常对急性脑梗死患者血浆Hcy和血清hs-CRP水平的影响%The Influence of Abnormal Glucose Tolerance on the Levels of Plasma Homocysteine and Serum High-sensitivity C-reactive Protein in Patients with Acute Cerebral Infarction(ACI)

    Institute of Scientific and Technical Information of China (English)

    赵红东; 陆敏; 唐冰

    2012-01-01

    Objective To observe the influence of abnormal glucose tolerance on the levels of homocysteine and high-sensitivity C-reactive protein in patients with acute cerebral infarction( AGI). Methods 756 patients with AGI were divided into normal glucose tolerance group (NGT, 33 leases) , abnormal glucose tolerance group(IGT,142cases) ,and diabetes mellitus group (DM,283 scase) ac-cording to the result of oral glucose tolerance test( OGTT). The serum levels of Hcy and hs-GRP were measured in 24 hours after ad-mission. Result The both levels of Hey and hs-GRP in IGT group(19.17 9.35juno]/L,20.46 10.56μmol/L) and DM group (8.0 2.9 mg/L,7.7 2.3 mg/L) were higher than the NGT group with no difference between each other. Conclusion The levels of Hey and hs-GRP in patients with AGI and abnormal glucose tolerance rise significantly,which indicate the presence of chronic low-grade inflammation and atherosclerosis in the stage of abnormal glucose tolerance. The results showed abnormal glucose tolerance is the risk factor of atherosclerosis as diabetes mellitus,and the OGTT test is valuable in screening risk factors of AGI and stroke prevention.%目的:观察糖耐量异常对急性脑梗死(acute cerebral infarction,ACI)患者的同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)水平的影响.方法:756例ACI患者按葡萄糖耐量试验(OGTT)结果分为糖耐量正常组(NGT,331例)、单纯性糖耐量异常组(IGT,142例)、2型糖尿病组(DM2,283例).在入院24h之内测定血清Hcy、hs-CRP水平并进行组间比较.结果:IGT组及DM2组的Hcy水平(19.17±9.35)μmol/L、(20.46±10.56)μmol/L以及hs-CRP水平(8.0±2.9)mg/L、(7.7±2.3)mg/L明显高于NGT组(16.17±7.35)μmol/L、(3.5±1.2)mg/L.IGT组及DM2组两组之间的Hcy、hs-CRP水平差异均无统计学意义(P>0.05、P>0.05).结论:单纯性糖耐量异常的ACI患者血清Hcy、hs-CRP水平明显升高,表明在糖耐量异常阶段,已经出现了慢性低水平炎症和动脉粥样硬化的发生.提

  5. Skeletal muscle abnormalities in patients with fibromyalgia.

    Science.gov (United States)

    Olsen, N J; Park, J H

    1998-06-01

    Widespread muscle pain and tender points are the most common complaints of fibromyalgia patients, and the underlying mechanisms responsible for these symptoms have been studied intensively during the past decade. It has been suggested that fatigue and pain may lead to decreased levels of physical activity in many patients. The resulting deconditioned state may itself contribute to muscle abnormalities. Associated symptoms such as disturbed sleep, anxiety, depression, or irritable bowel also may have a negative impact on muscle function and level of daily activities. The important interactions between the central nervous and musculoskeletal systems may involve another element, the neuroendocrine stress-response system. This review will consider both the current state of knowledge and also future studies which might be designed to answer more effectively the outstanding questions regarding the underlying pathogenesis of fibromyalgia.

  6. 降钙素原对社区获得性肺炎死亡率及病情评估的价值%Value of procalcitonin in predicting mortality and severity of community-acquired pneumonia

    Institute of Scientific and Technical Information of China (English)

    张俨; 李文强

    2015-01-01

    Objective To study the value of procalcitonin (PCT) level in predicting mortality and severity of community-acquired pneumonia (CAP) in the emergency department. Methods The general clinical data and in-flammatory biomarker of 114 patients with CAP were collected. The severity of CAP was assessed by PSI and CURB65 score. An analysis was performed to assess the value of PCT, WBC counts, high-sensitivity C-reactive pro-tein (hs-CRP), and erythrocyte sedimentation rate (ESR) for the prediction of mortality and severity. Results 14 high-risk patients died within 28 days. Compared with the survival group, the death group had significantly increased PCT level (2. 96 ± 1. 54 vs 0. 38 ± 0. 24 ng/ mL, P < 0. 01) and hs-CRP(194. 61 ± 72. 80 vs 101. 26 ± 65. 98 mg/ L, P < 0. 01). The PCT level was significantly higher in the severe group than in the moderate group according to PSI and CURB65 score. Through logistic regression analyses, the area under the receiver operating characteristic curve (ROC) of PCT level were 0. 81. The area under ROC increased significantly while it used PCT combined with PSI and CURB65 score to predict the mortality and severity of CAP. Conclusion The level of PCT is a more versatile tool for predicting mortality and severity of CAP in the emergence department, and the level of procalcitonin as an ad-junct to CAP prediction rules may be valuable for prognosis and severity assessment.%目的:探索降钙素原(PCT)对社区获得性肺炎(CAP)患者的死亡率和病情评估的价值。方法前瞻性研究在急诊科通过症状和 X 线检查诊断为 CAP 的114例患者,收集患者的一般临床资料及炎症标志物。采用肺炎严重性指数(PSI)、CURB65评分评估 CAP 患者的疾病严重性,分析血沉(ESR)、白细胞计数、高敏 C 反应蛋白(Hs-CRP)及 PCT 预测 CAP 患者死亡率和疾病严重性的价值。结果114例患者中14例高危患者28天内死亡。死亡组较存活组 PCT 和 Hs-CRP

  7. 降钙素原检测在新生儿败血症中的临床意义%Clinical significance of procalcitonin detection in neonatal sepsis

    Institute of Scientific and Technical Information of China (English)

    黄晓华; 吴绮; 陈健

    2014-01-01

    目的:探讨降钙素原(PCT)检测在新生儿败血症中的临床意义。方法将46例败血症新生儿作为观察组,入院时及恢复期行血清PCT及C反应蛋白(CRP)检测,并与同期出生的46例正常新生儿作为对照组进行比较。结果观察组患儿入院时PCT、CRP显著高于对照组(P<0.05),恢复期降至正常,与对照组相比无明显差异(P>0.05);观察组入院时PCT检测的阳性率为93.4%,与CRP阳性率78.3%相比差异具有统计学意义(P<0.05)。结论降素钙原检测在新生儿败血症的早期诊断、疗效观察中具有重要的临床应用价值,值得推广。%Objective To investigate the clinical significance of procalcitonin(PCT) detection in neonatal sepsis. Methods Forty-six sepsis neonates of the observation group received serum PCT and C-reactive protein(CRP) detection at admission and in the recovery phase and were compared to 46 normal neonates of the control group born in the corresponding period. Results The observation group had significantly higher PCT and CRP than the control group at admission(P 0.05);The positive rate of PCT detection of the observation group at admission was 93.4%,which had statistically significant difference from the 78.3% of CRP positive rate(P < 0.05). Conclusion Procalcitonin detection shows important clinical application value in the early diagnosis and efficacy observation of neonatal sepsis,thereby worthy of promotion.

  8. Computer simulation modeling of abnormal behavior: a program approach.

    Science.gov (United States)

    Reilly, K D; Freese, M R; Rowe, P B

    1984-07-01

    A need for modeling abnormal behavior on a comprehensive, systematic basis exists. Computer modeling and simulation tools offer especially good opportunities to establish such a program of studies. Issues concern deciding which modeling tools to use, how to relate models to behavioral data, what level of modeling to employ, and how to articulate theory to facilitate such modeling. Four levels or types of modeling, two qualitative and two quantitative, are identified. Their properties are examined and interrelated to include illustrative applications to the study of abnormal behavior, with an emphasis on schizophrenia.

  9. Low-set ears and pinna abnormalities

    Science.gov (United States)

    Low-set ears; Microtia; "Lop" ear; Pinna abnormalities; Genetic defect-pinna; Congenital defect-pinna ... conditions: Abnormal folds or location of the pinna Low-set ears No opening to the ear canal ...

  10. Relationship among sera lipoprotein abnormalities in healthy ...

    African Journals Online (AJOL)

    Relationship among sera lipoprotein abnormalities in healthy individuals with background of diabetic sibling. ... As the prevalence of lipoprotein abnormalities in adolescents is increasing dramatically, the identification of ... Article Metrics.

  11. Abnormal Cervical Cancer Screening Test Results

    Science.gov (United States)

    ... FREQUENTLY ASKED QUESTIONS FAQ187 GYNECOLOGIC PROBLEMS Abnormal Cervical Cancer Screening Test Results • What is cervical cancer screening? • What causes abnormal cervical cancer screening test results? • ...

  12. [Phenomenology of abnormal body perceptions].

    Science.gov (United States)

    Schäfer, M L

    1983-01-01

    The present paper deals with the problematic nature of the phenomenological grasping of the consciousness of the body and its pathological modifications. The reasoning is oriented by the doctrine of Husserl of the so-called sentiments as the fundamentals of the experience of the own body. This basic approach does not only seem to be basically for a psychology of the consciousness of the body, but also to give the theoretical-conceptual structure for a great number of psychopathological modifications. Subsequent to a criticism of the conventional use of the term 'hallucination of the body' we attempt to chart elements of a scheme of the abnormal consciousness of the body.

  13. Foot abnormalities of wild birds

    Science.gov (United States)

    Herman, C.M.; Locke, L.N.; Clark, G.M.

    1962-01-01

    The various foot abnormalities that occur in birds, including pox, scaly-leg, bumble-foot, ergotism and freezing are reviewed. In addition, our findings at the Patuxent Wildlife Research Center include pox from dove, mockingbird, cowbird, grackle and several species of sparrows. Scaly-leg has been particularly prevalent on icterids. Bumble foot has been observed in a whistling swan and in a group of captive woodcock. Ergotism is reported from a series of captive Canada geese from North Dakota. Several drug treatments recommended by others are presented.

  14. Abnormal tyrosine metabolism in chronic cluster headache.

    Science.gov (United States)

    D'Andrea, Giovanni; Leone, Massimo; Bussone, Gennaro; Fiore, Paola Di; Bolner, Andrea; Aguggia, Marco; Saracco, Maria Gabriella; Perini, Francesco; Giordano, Giuseppe; Gucciardi, Antonina; Leon, Alberta

    2017-02-01

    Objective Episodic cluster headache is characterized by abnormalities in tyrosine metabolism (i.e. elevated levels of dopamine, tyramine, octopamine and synephrine and low levels of noradrenalin in plasma and platelets.) It is unknown, however, if such biochemical anomalies are present and/or constitute a predisposing factor in chronic cluster headache. To test this hypothesis, we measured the levels of dopamine and noradrenaline together with those of elusive amines, such as tyramine, octopamine and synephrine, in plasma of chronic cluster patients and control individuals. Methods Plasma levels of dopamine, noradrenaline and trace amines, including tyramine, octopamine and synephrine, were measured in a group of 23 chronic cluster headache patients (10 chronic cluster ab initio and 13 transformed from episodic cluster), and 16 control participants. Results The plasma levels of dopamine, noradrenaline and tyramine were several times higher in chronic cluster headache patients compared with controls. The levels of octopamine and synephrine were significantly lower in plasma of these patients with respect to control individuals. Conclusions These results suggest that anomalies in tyrosine metabolism play a role in the pathogenesis of chronic cluster headache and constitute a predisposing factor for the transformation of the episodic into a chronic form of this primary headache.

  15. [ECG abnormalities in the MONICA Gent-Charleroi study population].

    Science.gov (United States)

    De Backer, G

    1989-01-01

    In a survey of a random sample of the adult population (aged 25-64 yr) from Ghent and Charleroi (n = 1693), 103 (6.1%) showed ECG-abnormalities suggestive of coronary heart disease (Minnesota code I, IV, or V); prevalence was equal in men (6.2%) as in women (6.0%). In men, 30% of ECG-abnormalities suggested an old myocardial infarction as compared to 23.4% in women. Men with abnormal ECG had a positive history of acute myocardial infarction in 23%, as compared to 23.4% in women. Multivariate discriminant function analysis shows that men with abnormal ECG are older, have a higher systolic blood pressure and were more often married. Women with ECG abnormalities were significantly older, had a lower HDL-level and were less educated. So, although the prevalence of ECG abnormalities is almost similar between sexes, they correlate differently with antecedents of infarction and are poorly related to different sets of risk factors in men as compared to women.

  16. Characterization of abnormal grain coarsening in Alloy 718

    Directory of Open Access Journals (Sweden)

    Watson Richard

    2014-01-01

    Full Text Available Even though the phenomenon of abnormal grain coarsening (AGC or “exploded grains” has been known to occur in Alloy 718 industrial forgings there is still no satisfactory explanation for it. For this reason, detailed microstructure analysis has been carried out in normal and abnormal regions. Electron Backscatter Diffraction (EBSD was employed to determine grain size, boundary distribution and measure stored energy, while backscattered imagining in a FEGSEM was used to measure δ precipitate size and morphology. It was found that abnormal regions show almost 3 times as many twin boundaries compared to a normal region. In addition, the δ phase morphologies differ very significantly when comparing these two different regions. Normal regions display δ phase with a plate like nature, whereas in abnormal regions, δ particles appear to be more spherical. Furthermore, there are clear indications of differences in δ volume fractions between the two regions. Whilst in normal regions the δ phase is found predominantly at grain boundaries, in abnormal regions the δ is also found within grains. Both backscatter images and EBSD scans indicate that there are higher levels of stored energy within the normal regions, compared to the abnormal regions. These observations suggest that AGC occurs in regions where dynamic recrystallization does not happen and where recrystallization during solution heat treatment is affected by the local particle distribution.

  17. The psychosocial impact of an abnormal cervical smear result.

    Science.gov (United States)

    Drolet, Mélanie; Brisson, Marc; Maunsell, Elizabeth; Franco, Eduardo L; Coutlée, François; Ferenczy, Alex; Fisher, William; Mansi, James A

    2012-10-01

    Data on the impact of abnormal cervical smear results on health-related quality of life (HrQoL) are scarce. We aimed to (i) prospectively assess the HrQoL of women who were informed of an abnormal smear result; (ii) identify predictors of greater negative psychosocial impact of an abnormal result; and (iii) prospectively estimate the quality-adjusted life-years (QALYs) lost following an abnormal result. Between 08/2006 and 08/2008, 492 women with an abnormal result and 460 women with a normal result, frequency matched for age and clinic, were recruited across Canada. HrQoL was measured at recruitment and 4 and 12 weeks later with the EuroQol, Short Form-12, short Spielberg State-Trait Anxiety Inventory (STAI) and HPV Impact Profile. Three blocks of potential predictors of higher psychosocial impact were tested by hierarchical modeling: (i) socio-demographics; (ii) sexual activity; and (iii) smear result severity, communication, and understanding. Receiving an abnormal result significantly increased anxiety (STAI mean difference between both groups = 8.3). Initial anxiety decreased over time for the majority of women. However, 35% of women had clinically meaningful anxiety at 12 weeks (i.e. STAI scores ≥0.5 standard deviation of the controls). These women reported a lower socio-economic level, did not completely understand the information about their result and perceived themselves at higher risk of cancer. QALY lost following an abnormal result were between 0.007 and 0.009. Receiving an abnormal smear has a statistically significant and clinically meaningful negative impact on mental health. However, this negative impact subsides after 12 weeks for the majority of women. Copyright © 2011 John Wiley & Sons, Ltd.

  18. 大肠癌术后早期胃管拔出对患者血浆降钙素原变化及对胃肠功能恢复的影响%Research on influence of early gastric tube extubation on plasma procalcitonin change and gastrointestinal function recov-ery after colorectal cancer operation

    Institute of Scientific and Technical Information of China (English)

    牟亚刚; 王建军; 张洪伟

    2015-01-01

    postoperative gastric tube ex‐tubation ,started to drink water at postoperative 6 h ,eat fluid diet at 12 h and transfered to the common diet on 3 d ;The control group(55 cases) adopted the conventional gastric tube extubation therapy ,pulled out the gastric tube ex‐tubation after postoperative exhaustion and defecation and then started to eat food .The plasma procalcitonin levels af‐ter operation ,before and after intervention were recorded ,meanwhile postoperative complications situation ,postopera‐tive exhaustion and defecation time ,hospital stay and hospital cost were recorded .Results (1)The plasma procalcito‐nin level after treatment in the two groups were significantly declined ,but the plasma procalcitonin level in the obser‐vation group was similar to that in the control group ,there was no statistically significant difference(P> 0 .05) ;(2) After treatment ,the exhaust time in the observation group was(50 .71 ± 6 .25)h ,defecation time was(66 .43 ± 5 .87) h ,length of hospital stay was(7 .17 ± 2 .31)d and hospitalization expenses were(41 562 .87 ± 274 .36)Yuan ,which were significantly lower than(65 .24 ± 6 .58 )h ,(74 .56 ± 5 .69)h ,(10 .24 ± 3 .15)d and(47 893 .57 ± 314 .82)Yuan in the control group ,the differences were statistically significant(P 0 .05) .Conclusion Early gastric tube extubation in the postoperative patients with colorectal cancer is conducive to promote the gastrointestinal function recovery and shorten the hospital stay without affecting the procalcitonin level and increasing the risk of complications occurrence ,which is worthy of clinical promo‐tion .

  19. The Research Progress of Procalcitonin Prognostic Value in Acute Coronary Syndrome and Cardiogenic Shock Patients%降钙素原在急性冠脉综合征和心源性休克中的预测价值研究进展

    Institute of Scientific and Technical Information of China (English)

    孙志军; 李虹伟

    2013-01-01

    Inflammation plays a key role in atherosclerosis. Acute coronary syndrome ( ACS ) is an inflammatory disease. The inflammatory markers in serum, such as interleukin ( IL ) - 6, IL - 8 and C - reactive protein ( CRP ), are used to evaluate patients with coronary artery disease. Procalcitonin ( PCT ) is inflammatory factor in acute period and has been widely used as markers of infection. So far, data on serum PCT levels in patients with ACS and cardiogenic shock is scarce and controversial. This paper will review PCT prognostic value and dynamics in acute coronary syndrome and cardiogenic shock patients in details.%急性冠脉综合征是一种炎症性疾病,血清中的炎症标志物如白介素(IL)-6、IL-8和C反应蛋白在临床上已经用于评价冠状动脉疾病患者.降钙素原(PCT)是一种急性期炎症因子,被广泛认为是感染的标志物.但目前急性冠脉综合征和心源性休克患者PCT水平的研究较少,而且存在很大争议.本文对近几年来PCT在急性冠脉综合征和心源性休克中的预测价值及其动态学变化作一综述.

  20. On Regularity of Abnormal Subriemannian Geodesics

    CERN Document Server

    Tan, Kanghai

    2012-01-01

    We prove the smoothness of abnormal minimizers of subriemannian manifolds of step 3 with a nilpotent basis. We prove that rank 2 Carnot groups of step 4 admit no strictly abnormal minimizers. For any subriemannian manifolds of step less than 7, we show all abnormal minimizers have no corner type singularities, which partly generalize the main result of Leonardi-Monti.

  1. Abnormal visuomotor processing in schizophrenia

    Directory of Open Access Journals (Sweden)

    Siân E. Robson

    2016-01-01

    Full Text Available Subtle disturbances of visual and motor function are known features of schizophrenia and can greatly impact quality of life; however, few studies investigate these abnormalities using simple visuomotor stimuli. In healthy people, electrophysiological data show that beta band oscillations in sensorimotor cortex decrease during movement execution (event-related beta desynchronisation (ERBD, then increase above baseline for a short time after the movement (post-movement beta rebound (PMBR; whilst in visual cortex, gamma oscillations are increased throughout stimulus presentation. In this study, we used a self-paced visuomotor paradigm and magnetoencephalography (MEG to contrast these responses in patients with schizophrenia and control volunteers. We found significant reductions in the peak-to-peak change in amplitude from ERBD to PMBR in schizophrenia compared with controls. This effect was strongest in patients who made fewer movements, whereas beta was not modulated by movement in controls. There was no significant difference in the amplitude of visual gamma between patients and controls. These data demonstrate that clear abnormalities in basic sensorimotor processing in schizophrenia can be observed using a very simple MEG paradigm.

  2. Chromosomal phenotypes and submicroscopic abnormalities

    Directory of Open Access Journals (Sweden)

    Devriendt Koen

    2004-01-01

    Full Text Available Abstract The finding, during the last decade, that several common, clinically delineated syndromes are caused by submicroscopic deletions or, more rarely, by duplications, has provided a powerful tool in the annotation of the human genome. Since most microdeletion/microduplication syndromes are defined by a common deleted/duplicated region, abnormal dosage of genes located within these regions can explain the phenotypic similarities among individuals with a specific syndrome. As such, they provide a unique resource towards the genetic dissection of complex phenotypes such as congenital heart defects, mental and growth retardation and abnormal behaviour. In addition, the study of phenotypic differences in individuals with the same microdeletion syndrome may also become a treasury for the identification of modifying factors for complex phenotypes. The molecular analysis of these chromosomal anomalies has led to a growing understanding of their mechanisms of origin. Novel tools to uncover additional submicroscopic chromosomal anomalies at a higher resolution and higher speed, as well as the novel tools at hand for deciphering the modifying factors and epistatic interactors, are 'on the doorstep' and will, besides their obvious diagnostic role, play a pivotal role in the genetic dissection of complex phenotypes.

  3. Incidental sinus abnormalities in 256 patients referred for brain MRI

    Directory of Open Access Journals (Sweden)

    Ghanaati H

    2007-06-01

    Full Text Available Background: Imaging abnormalities in the paranasal sinuses are regularly noted as incidental findings on MRI, however, little is known about their prevalence in the Iranian population. The purpose of this study was to classify these findings in the paranasal sinuses as seen on MRI and to investigate the prevalence, according to site and type of paranasal abnormality. Methods: In this cross-sectional study, the T2-weighted axial MRI of 256 patients with diseases unrelated to their paranasal sinuses were reviewed between May 2002 and June 2003. The findings were categorized according to the anatomic location and the imaging characteristics of the abnormality. The abnormalities recorded included total sinus opacification, mucoperiosteal thickening >5mm, air fluid levels and retention cysts or polyps. Unilateral or bilateral involvement and septal deviation were also noted. A sinus was considered normal if it was fully aerated and no soft-tissue density was apparent within the cavity. Results: Among our cases, 111 (43.5% were male and 145 (56.5% were female. Of these patients, abnormalities in one or more of the sinus groups were found in 110 subjects (42.9%, 55.5% of which were male and 44.5% were female (P=0.001. Maxillary sinus abnormalities were observed in 66.4% of the patients, while ethmoid sinus abnormalities were found in 63.6%. Of the ethmoid abnormalities, 21% were found in the anterior section, 9% in the middle ethmoid, and 8% in the posterior ethmoid. The most common abnormality found was mucosal thickening. Among our cases, 23.4% had septal deviation, which was significantly higher among those with sinusitis (29% versus 19.1%; P<0.01. Of those patients with sinus involvement, 16% were involved in the sphenoid sinus and 5% in the frontal sinus. The results obtained from the patients with sinus abnormality revealed that 85% suffered from cough, nasal obstruction, runny nose, facial pain and post nasal discharge and 24% had been diagnosed

  4. [Use of procalcitonine in intensive care units: comparison of semi quantitative PCT-Q Brahms assay with automated PCT-Kryptor assay].

    Science.gov (United States)

    Schuch, Géraldine; Duc-Marchand, Catherine; Venet, Cyrille; Mann, Hubert; Tixier, Anne; Bionda, Clara

    2011-01-01

    Procalcitonine (PCT) is recognized as a major and specific biomarker in diagnosis of bacterial infection. Used early in sepsis, it allows immediate administration of antibiotics and monitoring its effectiveness. Confronted on systemic inflammation response syndrom (SIRS), physicians must react quickly and effectively to evaluate bacterial infection and sepsis. The objective of this study was to compare analytical and clinical performances of semi-quantitative PCT-Q assay (Brahms) with quantitative and automated assay such on Kryptor (Brahms). Fifty blood samples of intensive care patients were compared. The analytical performance observed with PCT-Q assay is accurate: linear ratio kappa of 0.912 (95% CI 0.61, 0.97) and a good correlation between these techniques (p < 0.0001) (MedCalc software) were observed. Three discordances were observed and confirm the difficulties of reading for values close to 0.5 ng/mL. For these patients, PCT result showed its interest to discriminate local infection of a sepsis, to stop antibiotherapy with broad spectrum and to consolidate a therapeutic effectiveness in multi-visceral failure context. The semi-quantitative assay seems adapted for a fast and reliable evaluation of PCT in a general-purpose laboratory, not requiring neither dedicated analyzer, nor complex technicality but a control of the visual evaluation of results. It could be used for diagnosis of sepsis without monitoring precisely therapeutic follow-up.

  5. Clinical value of dual-phase 18F-FDG SPECT with serum procalcitonin for identification of etiology in tumor patients with fever of unknown origin.

    Science.gov (United States)

    Zhang, Qun; Shan, Chun; Wu, Pei; Huang, Xin-En

    2014-01-01

    The purpose of the study was to evaluate clinical value of dual-phase 18F-FDG SPECT with serum procalcitonin (PCT) in identifying cancers in patients with fever of unknown origin (FUO). PCT test and dual-phase 18F-FDG SPECT were sequentially performed on 50 consecutive patients with FUO. Two radiologists evaluated all 18F-FDG SPECT data independently. A consensus was reached if any difference of opinions existed. Final diagnosis was based on a comprehensive analysis of results for the PCT test, dual- phase 18F-FDG SPECT and bacterial cultivation, regarded as a gold standard. Among 50 patients, 34 demonstrated PCT ≥ 0.5 μg/L. Coincidence imaging showed in 37 patients with inflammatory lesions, and 13 with malignancy. Finally, 36 bacterial, 1 fungal and 1 viral infections, as well as 12 cancerous fevers were confirmed by dual-phase 18F-FDG SPECT with PCT, combined with bacterial cultivation and clinical follow-up. Our study demonstrated that dual-phase 18F-FDG SPECT in association with PCT could be a valuable tool for diagnosis in tumor patients with FUO.

  6. Neutrophil CD64, C-reactive protein, and procalcitonin in the identification of sepsis in the ICU - Post-test probabilities.

    Science.gov (United States)

    Jämsä, Joel; Ala-Kokko, Tero; Huotari, Virva; Ohtonen, Pasi; Savolainen, Eeva-Riitta; Syrjälä, Hannu

    2017-08-31

    We were interested in whether C-reactive protein (CRP) and procalcitonin (PCT) distinguish sepsis from non-septic controls and whether a combination of CRP, PCT, and neutrophil CD64 improves identification of sepsis in the intensive care unit (ICU). We analyzed the CRP and PCT concentrations from 27 patients with sepsis and 15 ICU controls. In addition, CD64 on neutrophils was measured using quantitative flow cytometry. We present a multiple marker analysis for sepsis diagnostics combining neutrophil CD64, CRP, and PCT using post-test analysis. The CRP and PCT values separated sepsis and non-septic ICU patients. In post-test analysis, CRP provided a positive probability of 0.48 and a negative probability of 0.053 for sepsis in the ICU; while, the corresponding values were 0.35 and 0.0059, respectively, for PCT and 0.62 and 0.0013, respectively, for neutrophil CD64. When neutrophil CD64 was analyzed with PCT and CRP, the probabilities were 0.98 and <0.001, respectively. Neutrophil CD64 expression was superior to PCT and CRP for the identification of sepsis in ICU. Positive post-test probability for any combinations of simultaneously analyzed CRP, PCT and CD64 showed improved diagnostic accuracy for sepsis. This approach may be useful for guiding antibiotic treatment in ICU. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Procalcitonin as a Serum Biomarker for Differentiation of Bacterial Meningitis From Viral Meningitis in Children: Evidence From a Meta-Analysis.

    Science.gov (United States)

    Henry, Brandon Michael; Roy, Joyeeta; Ramakrishnan, Piravin Kumar; Vikse, Jens; Tomaszewski, Krzysztof A; Walocha, Jerzy A

    2016-07-01

    Several studies have explored the use of serum procalcitonin (PCT) in differentiating between bacterial and viral etiologies in children with suspected meningitis. We pooled these studies into a meta-analysis to determine the PCT diagnostic accuracy. All major databases were searched through March 2015. No date or language restrictions were applied. Eight studies (n = 616 pediatric patients) were included. Serum PCT assay was found to be very accurate for differentiating the etiology of pediatric meningitis with pooled sensitivity and specificity of 0.96 (95% CI = 0.92-0.98) and 0.89 (95% CI = 0.86-0.92), respectively. The pooled positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio (DOR), and area under the curve (AUC) for PCT were 7.5 (95% CI = 5.6-10.1), 0.08(95% CI = 0.04-0.14), 142.3 (95% CI = 59.5-340.4), and 0.97 (SE = 0.01), respectively. In 6 studies, PCT was found to be superior than CRP, whose DOR was only 16.7 (95%CI = 8.8-31.7). Our meta-analysis demonstrates that serum PCT assay is a highly accurate and powerful test for rapidly differentiating between bacterial and viral meningitis in children.

  8. Early detection of severe sepsis in the emergency room: diagnostic value of plasma C-reactive protein, procalcitonin, and interleukin-6.

    Science.gov (United States)

    Uusitalo-Seppälä, Raija; Koskinen, Pertti; Leino, Aila; Peuravuori, Heikki; Vahlberg, Tero; Rintala, Esa M

    2011-12-01

    To determine the diagnostic values of plasma C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6) using an electrochemiluminescence immunoassay (ECLIA) method (Roche Diagnostics GmbH, Mannheim, Germany) to identify severe sepsis in an emergency room (ER) setting. This was a single-centre prospective follow-up study of 539 consecutive adult patients admitted to the ER with suspected infection. Blood samples were taken concurrently with blood cultures at admission. Patients were divided into 5 groups on the basis of systemic inflammatory response syndrome (SIRS) criteria, documentation of bacterial infection, and organ dysfunction. Fifty-nine patients with no SIRS or bacterial infection, 68 patients with bacterial infection but no SIRS, 54 patients with SIRS but no bacterial infection, 309 patients with sepsis (SIRS and bacterial infection), and 49 patients with severe sepsis (sepsis and organ failure) were evaluated. In a logistic regression model, the odds ratio (OR) for PCT was 1.58 (95% confidence interval (CI) 1.37-1.82, p sepsis, but the difference in AUC was not significant between PCT and IL-6. In multivariate logistic regression analysis, after adjusting for confounders, PCT and IL-6 remained significant independent predictors of severe sepsis. PCT and IL-6 proved superior to CRP in detecting patients with severe sepsis. The findings thus support the use of either PCT or IL-6 as an early tool to diagnose severe sepsis. The automatic ECLIA method allows even night-shift measurements.

  9. CHROMOSOMAL ABNORMALITIES IN PATIENTS WITH RECURRENT MISCARRIAGE

    Directory of Open Access Journals (Sweden)

    Daniela Mierla

    2012-06-01

    Full Text Available Chromosomal abnormalities are involved in the etiology of recurrent spontaneous pregnancy loss and sub-fertility. The purpose of this study was to determine the frequency and contribution of chromosomal abnormalities in recurrent miscarriages. The results obtained and literature review are helpful in understanding the importance of cytogenetics analysis of female infertility. To investigate the distribution of chromosomal abnormalities in the Romanian population with recurrent miscarriage, karyotype analysis by G-banding was performed from peripheral blood in 967 women infertility. Results: Chromosomal abnormalities were found to 79 women (8,17%. The percentage of chromosomal abnormalities in the studied population correlates with the data in the literature. Chromosomal abnormalities could play the important role in etiology of infertility and are more frequently detected in this group of patients compared to general population. In the infertile couples balanced chromosomal abnormalities are the main cause of spontaneous abortions.

  10. States of 13C with abnormal radii

    Directory of Open Access Journals (Sweden)

    Demyanova A.S.

    2016-01-01

    Full Text Available Differential cross-sections of the elastic and inelastic 13C + α scattering were measured at E(α = 90 MeV. The root mean-square radii( of 13C nucleus in the states: 8.86 (1/2−, 3.09 (1/2+ and 9.90 (3/2− MeV were determined by the Modified diffraction model (MDM. The radii of the first two levels are enhanced compared to that of the ground state of 13C, confirming the suggestion that the 8.86 MeV state is an analogue of the Hoyle state in 12C and the 3.09 MeV state has a neutron halo. Some indications to the abnormally small size of the 9.90 MeV state were obtained.

  11. Abnormal Returns and Contrarian Strategies

    Directory of Open Access Journals (Sweden)

    Ivana Dall'Agnol

    2003-12-01

    Full Text Available We test the hypothesis that strategies which are long on portfolios of looser stocks and short on portfolios of winner stocks generate abnormal returns in Brazil. This type of evidence for the US stock market was interpreted by The Bondt and Thaler (1985 as reflecting systematic evaluation mistakes caused by investors overreaction to news related to the firm performance. We found evidence of contrarian strategies profitability for horizons from 3 months to 3 years in a sample of stock returns from BOVESPA and SOMA from 1986 to 2000. The strategies are more profitable for shorter horizons. Therefore, there was no trace of the momentum effect found by Jagadeesh and Titman (1993 for the same horizons with US data. There are remaing unexplained positive returns for contrarian strategies after accounting for risk, size, and liquidity. We also found that the strategy profitability is reduced after the Real Plan, which suggests that the Brazilian stock market became more efficient after inflation stabilization.

  12. Use of Drama Students as "Clients" in Teaching Abnormal Psychology.

    Science.gov (United States)

    Gilliland, Kirby

    1982-01-01

    Describes the use of drama students to role play subjects of case studies in simulations of standard interviews in a college-level abnormal psychology class. Graduate drama students role-played clients in interviews with instructors or student panels. After the interviews, class discussion covered alternative possible diagnoses and possible…

  13. Obstructive Sleep Apnea and Lipid Abnormalities

    Science.gov (United States)

    Karkinski, Dimitar; Georgievski, Oliver; Dzekova-Vidimliski, Pavlina; Milenkovic, Tatjana; Dokic, Dejan

    2017-01-01

    BACKGROUND: There has been a great interest in the interaction between obstructive sleep apnea (OSA) and metabolic dysfunction, but there is no consistent data suggesting that OSA is a risk factor for dyslipidemia. AIM: The aim of this cross-sectional study was to evaluate the prevalence of lipid abnormalities in patients suspected of OSA, referred to our sleep laboratory for polysomnography. MATERIAL AND METHODS: Two hundred patients referred to our hospital with suspected OSA, and all of them underwent for standard polysomnography. All patients with respiratory disturbance index (RDI) above 15 were diagnosed with OSA. In the morning after 12 hours fasting, the blood sample was collected from all patients. Blood levels of triglycerides, total cholesterol, high-density lipoprotein cholesterol (HDL) and low-density lipoprotein cholesterol (LDL), were determined in all study patients. In the study, both OSA positive and OSA negative patients were divided according to the body mass index (BMI) in two groups. The first group with BMI ≤ 30 kg/m^2 and the second group with BMI > 30 kg/m^2. RESULTS: OSA positive patients with BMI ≤ 30 kg/m^2 had statistically significant higher levels of triglycerides and total cholesterol, and statistically significant lower level of HDL compared to OSA negative patients with BMI ≤ 30. There were no statistically significant differences in age and LDL levels between these groups. OSA positive patients with BMI > 30 kg/m^2 had higher levels of triglycerides, total cholesterol and LDL and lower levels of HDL versus OSA negative patients with BMI > 30 kg/m^2, but without statistically significant differences. CONCLUSION: OSA and obesity are potent risk factors for dyslipidemias. OSA could play a significant role in worsening of lipid metabolism in non-obese patients. But in obese patients, the extra weight makes the metabolic changes of lipid metabolism, and the role of OSA is not that very important like in non-obese patients. PMID

  14. Detection of abnormalities in a human gait using smart shoes

    Science.gov (United States)

    Kong, Kyoungchul; Bae, Joonbum; Tomizuka, Masayoshi

    2008-03-01

    Health monitoring systems require a means for detecting and quantifying abnormalities from measured signals. In this paper, a new method for detecting abnormalities in a human gait is proposed for an improved gait monitoring system for patients with walking problems. In the previous work, we introduced a fuzzy logic algorithm for detecting phases in a human gait based on four foot pressure sensors for each of the right and left foot. The fuzzy logic algorithm detects the gait phases smoothly and continuously, and retains all information obtained from sensors. In this paper, a higher level algorithm for detecting abnormalities in the gait phases obtained from the fuzzy logic is discussed. In the proposed algorithm, two major abnormalities are detected 1) when the sensors measure improper foot pressure patterns, and 2) when the human does not follow a natural sequence of gait phases. For mathematical realization of the algorithm, the gait phases are dealt with by a vector analysis method. The proposed detection algorithm is verified by experiments on abnormal gaits as well as normal gaits. The experiment makes use of the Smart Shoes that embeds four bladders filled with air, the pressure changes in which are detected by pressure transducers.

  15. Fibrillin abnormalities and prognosis in Marfan syndrome and related disorders

    Energy Technology Data Exchange (ETDEWEB)

    Aoyama, T.; Furthmayr, H.; Francke, U.; Gasner, C. [Stanford Univ. Medical Center, CA (United States)

    1995-08-28

    Marfan syndrome (MFS), a multisystem autosomal-dominant disorder, is characterized by mutations of the fibrillin-1 (FBN1) gene and by abnormal patterns of synthesis, secretion, and matrix deposition of the fibrillin protein. To determine the sensitivity and specificity of fibrillin protein abnormalities in the diagnosis of MFS, we studied dermal fibroblasts from 57 patients with classical MFS, 15 with equivocal MFS, 8 with single-organ manifestations, and 16 with other connective tissue disorders including homocystinuria and Ehlers-Danlos syndrome. Abnormal fibrillin metabolism was identified in 70 samples that were classified into four different groups based on quantitation of fibrillin synthesis and matrix deposition. Significant correlations were found for phenotypic features including arachnodactyly, striae distensae, cardiovascular manifestations, and fibrillin groups II and IV, which included 70% of the MFS patients. In addition, these two groups were associated with shortened {open_quotes}event-free{close_quotes} survival and more severe cardiovascular complications than groups I and III. The latter included most of the equivocal MFS/single manifestation patients with fibrillin abnormalities. Our results indicate that fibrillin defects at the protein level per se are not specific for MFS, but that the drastically reduced fibrillin deposition, caused by a dominant-negative effect of abnormal fibrillin molecules in individuals defined as groups II and IV, is of prognostic and possibly diagnostic significance. 25 refs., 3 figs., 6 tabs.

  16. Hemostatic abnormalities in liver cirrhosis

    Directory of Open Access Journals (Sweden)

    Kendal YALÇIN

    2009-06-01

    Full Text Available In this study, 44 patients with liver cirrhosis were investigated for hemostatic parameters. Patients with spontaneous bacterial peritonitis, hepatocellular carcinoma, hepatorenal syndrome and cholestatic liver diseases were excluded. Patients were classified by Child-Pugh criterion and according to this 4 patients were in Class A, 20 in Class B and 20 in C. Regarding to these results, it was aimed to investigate the haematological disturbances in liver cirrhotic patients.In the result there was a correlation between activated partial thromboplastin time, serum iron, ferritin, transferrin, haptoglobin and Child-Pugh classification. Besides there was no correlation between prothrombin time, factor 8 and 9, protein C and S, anti-thrombin 3, fibrinogen, fibrin degradation products, serum iron binding capacity, hemoglobin, leukocyte, mean corpuscular volume and Child-Pugh classification.There were significant difference, in terms of AST, ferritin, haptoglobulin, sex and presence of ascites between groups (p0.05. In the summary, we have found correlation between hemostatic abnormalities and disease activity and clinical prognosis in patients with liver cirrhosis which is important in the management of these patients. This is also important for identification of liver transplant candidiates earlier.

  17. 甲状腺功能异常患者血糖、血脂、血尿酸水平变化的相关分析%Variation of serum glucose, lipid and uric acid level in patients with abnormal thyroid function

    Institute of Scientific and Technical Information of China (English)

    费扬; 李红

    2011-01-01

    Objective To investigate the variation of serum glucose, lipid and uric acid level in patients with abnormal thyroid function. Methods 105 patients with abnormal thyroid function were included and divided into three groups according to their thyroid function: clinical hyperthyroidism, clinical hypothyroidism and subclinical hypothyroidism. Their fast glucose (GLU),total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL- C) and uric acid (UA) levels were measured and compared with 46 healthy controls. Rsults After adjusting for age, sex, blood pressure and body weight, we got the following res ults: 1. fast glucose level was higher in patients with clinical hyperthyroidism (P <0.01 ) and lower in those with clinical hypothyroidism (P <0.05) compared to healthy controls; patients with subclinical hypothyroidism had lower glucose level but without significant difference compared to normal controls; 2. serum lipid level including TG, TC and LDL- C, decreased in patients with clinical hyperthyroidism (P <0.01 ) and increased in those with those with clinical hypothyroidism (P <0.01 ); patients with subclinical hypothyroidism had in creased lipid level but no significant difference was found when compared to control group; 3. serum uric acid level increased in all the three groups (P<0.01) compared to healthy controls, but no difference was found among these three groups. Conclusion Besides serum glucose and lipid levels, physicians should also pay attention to serum uric acid level of patients with abnormalthyroid function which changes significantly.%目的 探讨甲状腺功能异常患者血糖、血脂、血尿酸水平变化及临床意义.方法 根据甲状腺功能测定结果将105例甲状腺功能异常患者分为临床甲亢组、亚临床甲减组和临床甲减组,并设健康对照组46例,同时分别测定各组空腹血糖(FPG)和血总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C

  18. 降钙素原对感染性休克患者预后判断的价值%Prognostic value of procalcitonin in patients with septic shock

    Institute of Scientific and Technical Information of China (English)

    郜杨; 康凯; 左姝; 于凯江

    2014-01-01

    Objective The present study aims to evaluatethe prognostic value of peripheral blood procalcitonin ( PCT ) in ICU patients with septic shock .Methods This retrospective analysis consist of 102 cases of septic shock patients from January 2012 to January 2013 in the intensive care unit of the Second Affiliated Hospital of Harbin Medical University . Peripheral blood PCT levels were continuously determined on admission 1,2,3,4,5 day.The patients were divided into survival group and death group according to 28 d survival.PCT levels, APACHEⅡ score and SOFA score were compared and the correlations were analyzed between the two groups . Results There were no significant differences of PCT on admission 1 d, 2 d and 3 d between survival group and death group , but PCT of the death group on admission 4 d and 5 d were significantly higher than the survival group (P<0.05). Lactic acid, SOFA score and APACHEⅡscore of the death group were significantly higher than those of the survival group(P<0.05).PCT levels in patients on admission 4 d and 5 d were positively correlated with SOFA score and APACHEⅡscore (R were 0.389 and 0.393 on admission 4 d;R were 0.649 and 0.658 on admission 5 d;P<0.01).PCT was 2.0μg/L when the sensitivity was 81.2%and specificity of 72.8%.Conclusion Dynamic monitoring PCT levels can effectively assess the prognosis of patients with septic shock .%目的:评价外周血降钙素原( PCT)对ICU感染性休克患者预后判断的价值。方法回顾性分析2012-01~2013-01入住ICU的102例感染性休克患者,记录其入院第1、2、3、4、5天外周血PCT水平,根据28 d生存情况分为存活组和死亡组,比较两组患者的PCT水平,并评价其与APACHEⅡ评分、SOFA评分的相关性。结果存活组和死亡组患者第1、2、3天PCT水平比较差异无统计学意义,但死亡组患者第4、5天PCT水平明显高于存活组(P<0.05);死亡组乳酸、SOFA评分、APACHEⅡ

  19. Change and clinical significance of procalcitonin and blood culture in exertional heatstroke patients%劳力性热射病患者血清降钙素原血培养的变化及其临床意义

    Institute of Scientific and Technical Information of China (English)

    杨巧云; 刘文明; 俞建峰; 曾景福; 许峂嵘

    2015-01-01

    目的:探讨劳力性热射病( EHS)患者血清降钙素原( PCT)、血培养的变化及其临床意义。方法采取前瞻性研究方法,收集劳力性热射病患者34例,同时随机收集同期在ICU住院的32例伴有高热的脓毒症( sepsis)患者,比较两组患者血清PCT水平及血培养阳性率。结果热射病组血清PCT水平与伴有高热的脓毒症组患者比较差异有统计学意义(P<0.05),热射病组血培养阳性率高于伴有高热的脓毒症组患者,但差异无统计学意义(P>0.05);同样,EHS患者中血培养阳性组血清PCT水平高于血培养阴性组,但差异无统计学意义( P>0.05)。结论劳力性热射病患者即使没有细菌感染存在,血清PCT依然可被诱导释放。在血清PCT水平明显升高或血培养阳性患者中,即使找不到细菌感染的直接病灶,也应该使用抗菌药物。%Objective To investigate the change and clinical significance of procalcitonin and blood culture in exertional heatstroke patients.Methods We adopted a prospective study.We collected 34 cases of exertional heatstroke and collected 32 cases of sepsis patients with high fever hospitalized in ICU in the same period.T -test was used to compare the difference of serum PCT levels between two groups.χ2 -test was used to compare the difference of positive rate of blood culture between two gropes. Results The difference of serum PCT levels between two groups was obviously significant(P0.05).The serum PCT levels of exertional heatstroke patients with positive blood culture was higher than that with negative blood culture, but the difference was not statistically significant (P >0.05).Conclusion PCT can be induced to release in exertional heatstroke patients even absence of bacterial infection.Exertional heatstroke patients with higher serum PCT level or positive blood culture should use antibacterials, even if we can't find original lesions of

  20. The value of serum procalcitonin in treatment of community acquired pneumonia in outpatient%血清降钙素原监测在门诊治疗社区获得性肺炎中的作用

    Institute of Scientific and Technical Information of China (English)

    龙威; 邓星奇; 唐建国; 谢娟; 张奕翠; 张羽; 高育瑶; 陆刚

    2009-01-01

    目的 探讨血清降钙素原(PCT)监测在门诊接受治疗的社区获得性肺炎(CAP)患者的抗生素使用中的临床意义.方法 选2006年11月-2008年2月符合CAP诊断标准的门诊接受治疗的CAP患者127例,随机分为PCT监测组(63例)和常规治疗组(64例),人选患者监测血清PCT水平.在相旧常规治疗的基础上,常规治疗组由经治医师按照我国CAP治疗指南决定抗生素治疗方案;PCT监测组按照血清PCT水平决定是否使用抗生素,在血清PCT≥0.25μg/L时进行抗生素治疗,PCT0.05),PCT监测组的抗生素使用率、抗生素疗程及抗生素费用均低于常规治疗组(P值均小于0.05),2组患者的预后无明显差异.结论 门诊接受治疗的CAP患者可以依据PCT水平指导抗生素应用,能够减少抗生素用量,缩短抗生素疗程,降低抗生素费用.%Objective To evaluate the value of serum procalcitonin (PCT)on antibiotic use in treatment of community acquired pneumonia (CAP) in outpatient. Methods From November 2006 to February 2008, a total of 127 patients with CAP in outpatient were randomly assigned into two groups:PCT group(n=63)and control group(n =64). PCT levels of all patients were measured after study admission. On the base of similarly normal treatment, the control group received antibiotics according to the attending physicians and the PCT group were treated with antibiotics according to serum PCT levels: antibiotic treatment was applied with PCT level ≥ 0. 25 μg/L and was discouraged with PCT level 0.05) ;rate and costs of antibiotics use was lower, antibiotic duration of the PCT group was shorter than that ofthecontroigroup(P<0.05,P<0.001,P<0.001).Conclusion PCT could be used in treatment of CAP for antibiotic use in outpatient, which may reduce antibiotic use, shorten antibiotic duration and lower costs of antibiotic.

  1. 合并糖代谢异常的冠心病患者血浆脂联素水平变化及其临床意义%Plasma level of adiponectin in coronary heart disease patients combined with abnormal glucose metabolism

    Institute of Scientific and Technical Information of China (English)

    夏珂; 郭兰燕; 赵震宇; Ali Sheikh Md Sayed; 李非; 杨天伦

    2012-01-01

    Objective: To examine the plasma adiponectin concentration in coronary heart disease (CHD)patients combined with abnormal glucose metabolism, and to explore the clinical significance ofadiponectin.Methods: Eighty-seven hospitalized CHD patients confirmed by coronary angiography fromAugust 2009 to April 2010 at Xiangya Hospital were enrolled and divided into 3 groups according to their glucose metabolic state: 31 patients were selected as a simple CHD group, 28 were selected as a CHD combined with impaired glucose tolerance group (CHD+IGT group), and the other 28 as a CHD combined with diabetes mellitus group (CHD+DM group). The 31 healthy subjects who got health checkup at the same time were enrolled as a normal control group (NC group). Plasma adiponectin was measured by enzyme linked immunosorbent assay. The height, weight, waistline and blood pressure of all the subjects were checked, and the fasting blood glucose (FBG), insulin, lipids, high-sensitivity C-reactive protein (hs-CRP), free fatty acids (FFA), the liver function and the renal function were checked as well. The body mass index and the homeostasis model were assessed for insulin resistance.Results: 1) Plasma adiponectin in the CHD group, the CHD+IGT group, and the CHD+DM group was all lower than that in the NC group (P<0.05); 2) Compared with the CHD group, the plasma adiponectin in the CHD+DM group was the lowest, followed by the CHD+IGT group, and there was significant difference in the 3 groups (P<0.05); 3) Plasma adiponectin level was positively related with the high density lipoprotein cholesterol-C (HDL-C) (r=0.483, P<0.01), while it was negatively related with the hs-CRP and Gensini score (r=-0.489, P<0.05; r=-0.252, P<0.05). Conclusion: Plasma adiponectin concentration is reduced in the CHD patients, and significantly reduced in CHD patients combined with abnormal glucose metabolism. Plasma adiponectin concentration decreases significantly with the severity of abnormal glucose metabolism. CHD

  2. 降钙素原的动态变化对老年重症社区获得性肺炎预后的评估价值%Role of procalcitonin on the evaluation of prognosis in aged patients with severe community-acquired pneumonia

    Institute of Scientific and Technical Information of China (English)

    唐伦先; 叶海燕; 张常晶; 马少林

    2011-01-01

    目的 研究血清降钙素原(procalcitonin,PCT)对老年重症社区获得性肺炎(severe community-acquired pneumonia,SCAP)预后的评估价值.方法 对40例老年SCAP患者进行急性生理和慢性健康状况评分Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)和临床肺部感染评分(clinical pulmonary infection score,CPIS),测定入组时、24 h和72 h血清PCT水平,根据28 d预后分为生存组和死亡组,绘制受试者生存曲线,计算曲线下面积.结果 所有患者随访28 d,死亡率22.5%.生存组入组时APACHEⅡ评分、CPIS评分及PCT水平均显著低于死亡组(P<0.05或P<0.01).生存组入组后24、72 h PCT水平均显著低于死亡组(P均<0.01).患者入组时PCT水平预测28 d死亡结局的曲线下面积为0.864(95%CI 0.753~0.975),与入组时及24 h PCT水平比较,72 h PCT水平对死亡预测的准确性最高,曲线下面积为0.953(95%CI 0.893~0.982),取截断值为0.275 ng/mL时,敏感性为97.1%,特异性为83.9%.结论 血清PCT的动态变化可在一定程度上预测老年SCAP的预后.%Objective To study the value of serum procalcitonin ( PCT) in evaluating the prognosis of aged patients with severe community - acquired pneumonia( SCAP) . Methods In 40 aged SCAP patients, the scores of acute physiology and chronic health evaluation Ⅱ ( APACHE Ⅱ ) and clinical pulmonary infection score ( CPIS) were evaluated. The serum PCT levels were measured at baseline, 24 and 72 h after admission. The patients were divided into the survivor group and the non -survivor group according 28 - day prognosis. The value of plasma PCT in predicting the outcome was evaluated, and the receiver operating characteristic ( ROC) curve was constructed. Results All the patients were followed for 28 days, the mortality rate was 22.5% . Survivors had significantly lower APACHEII scores,CPIS and PCT levels compared with the non - survivor group( P < 0.05 or P <0.001). Levels of PCT at baseline

  3. Altered fetal growth, placental abnormalities, and stillbirth.

    Science.gov (United States)

    Bukowski, Radek; Hansen, Nellie I; Pinar, Halit; Willinger, Marian; Reddy, Uma M; Parker, Corette B; Silver, Robert M; Dudley, Donald J; Stoll, Barbara J; Saade, George R; Koch, Matthew A; Hogue, Carol; Varner, Michael W; Conway, Deborah L; Coustan, Donald; Goldenberg, Robert L

    2017-01-01

    Worldwide, stillbirth is one of the leading causes of death. Altered fetal growth and placental abnormalities are the strongest and most prevalent known risk factors for stillbirth. The aim of this study was to identify patterns of association between placental abnormalities, fetal growth, and stillbirth. Population-based case-control study of all stillbirths and a representative sample of live births in 59 hospitals in 5 geographic areas in the U.S. Fetal growth abnormalities were categorized as small (90th percentile) for gestational age at death (stillbirth) or delivery (live birth) using a published algorithm. Placental examination by perinatal pathologists was performed using a standardized protocol. Data were weighted to account for the sampling design. Among 319 singleton stillbirths and 1119 singleton live births at ≥24 weeks at death or delivery respectively, 25 placental findings were investigated. Fifteen findings were significantly associated with stillbirth. Ten of the 15 were also associated with fetal growth abnormalities (single umbilical artery; velamentous insertion; terminal villous immaturity; retroplacental hematoma; parenchymal infarction; intraparenchymal thrombus; avascular villi; placental edema; placental weight; ratio birth weight/placental weight) while 5 of the 15 associated with stillbirth were not associated with fetal growth abnormalities (acute chorioamnionitis of placental membranes; acute chorioamionitis of chorionic plate; chorionic plate vascular degenerative changes; perivillous, intervillous fibrin, fibrinoid deposition; fetal vascular thrombi in the chorionic plate). Five patterns were observed: placental findings associated with (1) stillbirth but not fetal growth abnormalities; (2) fetal growth abnormalities in stillbirths only; (3) fetal growth abnormalities in live births only; (4) fetal growth abnormalities in stillbirths and live births in a similar manner; (5) a different pattern of fetal growth abnormalities in

  4. [Renal abnormalities in ankylosing spondylitis].

    Science.gov (United States)

    Samia, Barbouch; Hazgui, Faiçal; Abdelghani, Khaoula Ben; Hamida, Fethi Ben; Goucha, Rym; Hedri, Hafedh; Taarit, Chokri Ben; Maiz, Hedi Ben; Kheder, Adel

    2012-07-01

    We will study the epidemiologic, clinical, biological, therapeutic, prognostic characteristics and predictive factors of development of nephropathy in ankylosing spondylitis patients. We retrospectively reviewed the medical record of 32 cases with renal involvement among 212 cases of ankylosing spondylitis followed in our service during the period spread out between 1978 and 2006. The renal involvement occurred in all patients a mean of 12 years after the clinical onset of the rheumatic disease. Thirty-two patients presented one or more signs of renal involvement: microscopic hematuria in 22 patients, proteinuria in 23 patients, nephrotic syndrome in 11 patients and decreased renal function in 24 patients (75%). Secondary renal amyloidosis (13 patients), which corresponds to a prevalence of 6,1% and tubulointerstitial nephropathy (7 patients) were the most common cause of renal involvement in ankylosing spondylitis followed by IgA nephropathy (4 patients). Seventeen patients evolved to the end stage renal disease after an average time of 29.8 ± 46 months. The average follow-up of the patients was 4,4 years. By comparing the 32 patients presenting a SPA and renal disease to 88 with SPA and without nephropathy, we detected the predictive factors of occurred of nephropathy: tobacco, intense inflammatory syndrome, sacroileite stage 3 or 4 and presence of column bamboo. The finding of 75% of the patients presented a renal failure at the time of the diagnosis of renal involvement suggests that evidence of renal abnormality involvement should be actively sought in this disease. Copyright © 2011 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

  5. Platelet enzyme abnormalities in leukemias

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    S Sharma

    2011-01-01

    Full Text Available Aim of the Study: The aim of this study was to evaluate platelet enzyme activity in cases of leukemia. Materials and Methods: Platelet enzymes glucose-6-phosphate dehydrogenase (G6PD, pyruvate kinase (PK and hexokinase (HK were studied in 47 patients of acute and chronic leukemia patients, 16 patients with acute myeloid leukemia (AML(13 relapse, three in remission, 12 patients with acute lymphocytic leukemia (ALL (five in relapse, seven in remission, 19 patients with chronic myeloid leukemia (CML. Results: The platelet G6PD activity was significantly low in cases of AML, ALL and also in CML. G6PD activity was normalized during AML remission. G6PD activity, although persistently low during ALL remission, increased significantly to near-normal during remission (P < 0.05 as compared with relapse (P < 0.01. Platelet PK activity was high during AML relapse (P < 0.05, which was normalized during remission. Platelet HK however was found to be decreased during all remission (P < 0.05. There was a significant positive correlation between G6PD and PK in cases of AML (P < 0.001 but not in ALL and CML. G6PD activity did not correlate with HK activity in any of the leukemic groups. A significant positive correlation was however seen between PK and HK activity in cases of ALL remission (P < 0.01 and CML (P < 0.05. Conclusions: Both red cell and platelet enzymes were studied in 36 leukemic patients and there was no statistically significant correlation between red cell and platelet enzymes. Platelet enzyme defect in leukemias suggests the inherent abnormality in megakaryopoiesis and would explain the functional platelet defects in leukemias.

  6. Procalcitonin and BISAP score versus c-reactive protein and APACHE II score in early assessment of severity and outcome of acute pancreatitis

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    Bezmarević Mihailo

    2012-01-01

    Full Text Available Background/Aim. Early assessment of severity and continuous monitoring of patients are the key factors for adequate treatment of acute pancreatitis (AP. The aim of this study was to determine the value of procalcitonin (PCT and Bedside Index for Severity in Acute Pancreatitis (BISAP scoring system as prognostic markers in early stages of AP with comparison to other established indicators such as Creactive protein (CRP and Acute Physiology and Chronic Health Evaluation (APACHE II score. Methods. This prospective study included 51 patients (29 with severe AP. In the first 24 h of admission in all patients the APACHE II score and BISAP score, CRP and PCT serum concentrations were determined. The values of PCT serum concentrations and BISAP score were compared with values of CRP serum concentrations and APACHE II score, in relation to the severity and outcome of the disease. Results. Values of PCT, CRP, BISAP score and APACHE II score, measured at 24 h of admission, were significantly elevated in patients with severe form of the disease. In predicting severity of AP at 24 h of admission, sensitivity and specificity of the BISAP score were 74% and 59%, respectively, APACHE II score 89% and 69%, respectively, CRP 75% and 86%, respectively, and PCT 86% and 63%, respectively. It was found that PCT is highly significant predictor of the disease outcome (p < 0,001. Conclusion. In early assessment of AP severity, PCT has better predictive value than CRP, and similar to the APACHE II score. APACHE II score is a stronger predictor of the disease severity than BISAP score. PCT is a good predictor of AP outcome.

  7. Multi-marker approach using procalcitonin, presepsin, galectin-3, and soluble suppression of tumorigenicity 2 for the prediction of mortality in sepsis.

    Science.gov (United States)

    Kim, Hanah; Hur, Mina; Moon, Hee-Won; Yun, Yeo-Min; Di Somma, Salvatore

    2017-12-01

    Biomarker could be objective and reliable tools to predict mortality in sepsis. We explored the prognostic utilities of emerging biomarkers in septic patients and questioned whether adding biomarkers to the clinical variables would improve the prediction of mortality in sepsis. This retrospective study included 157 septic patients (112 patients with sepsis; 45 patients with septic shock). Procalcitonin (PCT), presepsin, galectin-3, and soluble suppression of tumorigenicity 2 (sST2) concentrations were analyzed in relation to the 30-day all-cause mortality. Their value added on top of Sequential (Sepsis-related) Organ Failure Assessment (SOFA) score, high-sensitivity C-reactive protein, and white blood cells was also analyzed. PCT could not predict 30-day mortality. Univariate hazard ratio [HR with 95% confidence interval (CI)] of the other dichotomized variables was: 1.33 (0.55-3.194) for presepsin; 7.87 (2.29-26.96) for galectin-3; 1.55 (0.71-3.38) for sST2; and 2.18 (1.01-4.75) for SOFA score. The risk of 30-day mortality increased stepwise as the number of biomarkers above optimal cutoff values increased, and the highest risk was observed when all four biomarkers and SOFA score increased (HR = 14.5). Multi-marker approach predicted 30-day mortality better than SOFA score [area under the curves (95% CI), 0.769 (0.695-0.833) vs. 0.615 (0.535-0.692)]. In reclassification analyses, adding biomarkers to clinical variables improved the prediction of mortality. This study demonstrated a possible prognostic utility of PCT, presepsin, galectin-3, and sST2 in sepsis. Multi-marker approach could be beneficial for an optimized management of patients with sepsis.

  8. 降钙素原在颅内感染患者中测定意义%Procalcitonin Measurement in Patients with Significant Intracranial Infection

    Institute of Scientific and Technical Information of China (English)

    罗雯媛

    2011-01-01

    Objective: To evaluate the clinical significance of PCT test in intracranial infection treatment. Method: We choosed 60 patients with intracranial infection randomly, tested and analysed the value of PCT in different periods by immunofiuorescence. Result: In the acute step of the patients with meningitis,the value of PCT has a significant raise, and it will go down and turn well after using antibiotics. Compared with the PCT value of viral encephalitis, it showed no raise significantly. Conclusion: Test of serum procalcitonin can be used as index of early diagnosis of purulent meningitis and viral encephalitis, and it has magnificent meaning to recognize and cure purulent meningitis.%目的:探讨降钙素原(PCT)的测定在治疗颅内感染患者中的临床意义.方法:随机抽取我院治疗颅内感染患者60例,分不同时期采用免疫发光分析法测定其血清降钙素原(PCT)数值并加以分析.结果:通过检测得知,化脓性脑膜炎患者在急性发病期,PCT水平明显升高,经过有效抗生素治疗后,PCT水平明显下降,恢复效果较好;而与之对比的病毒性脑炎在PCT的监测中,无明显升高迹象.结论:血清降钙素原的测定可作为早期鉴别化脓性脑膜炎和病毒性脑炎的依据,同时,对临床诊疗化脓性脑膜炎有重要的应用意义.

  9. Diagnostic value of lactate, procalcitonin, ferritin, serum-C-reactive protein, and other biomarkers in bacterial and viral meningitis: A cross-sectional study.

    Science.gov (United States)

    Sanaei Dashti, Anahita; Alizadeh, Shekoofan; Karimi, Abdullah; Khalifeh, Masoomeh; Shoja, Seyed Abdolmajid

    2017-09-01

    There are many difficulties distinguishing bacterial from viral meningitis that could be reasonably solved using biomarkers. The aim of this study was to evaluate lactate, procalcitonin (PCT), ferritin, serum-CRP (C-reactive protein), and other known biomarkers in differentiating bacterial meningitis from viral meningitis in children.All children aged 28 days to 14 years with suspected meningitis who were admitted to Mofid Children's Hospital, Tehran, between October 2012 and November 2013, were enrolled in this prospective cross-sectional study. Children were divided into 2 groups of bacterial and viral meningitis, based on the results of cerebrospinal fluid (CSF) culture, polymerase chain reaction, and cytochemical profile. Diagnostic values of CSF parameters (ferritin, PCT, absolute neutrophil count [ANC], white blood cell count, and lactate) and serum parameters (PCT, ferritin, CRP, and erythrocyte sedimentation rate [ESR]) were evaluated.Among 50 patients with meningitis, 12 were diagnosed with bacterial meningitis. Concentrations of all markers were significantly different between bacterial and viral meningitis, except for serum (P = .389) and CSF (P = .136) PCT. The best rates of area under the receiver operating characteristic (ROC) curve (AUC) were achieved by lactate (AUC = 0.923) and serum-CRP (AUC = 0.889). The best negative predictive values (NPV) for bacterial meningitis were attained by ANC (100%) and lactate (97.1%).The results of our study suggest that ferritin and PCT are not strong predictive biomarkers. A combination of low CSF lactate, ANC, ESR, and serum-CRP could reasonably rule out the bacterial meningitis.

  10. COMPARATIVE STUDY OF LRINEC SCORE: PROCALCITONIN AND LRINEC SCORE: C-REACTIVE PROTEIN IN PREDICTING DURATION OF HOSPITAL STAY AND SEVERITY IN NECROTISING FASCIITIS

    Directory of Open Access Journals (Sweden)

    Manoj Gowda

    2016-06-01

    Full Text Available BACKGROUND Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC score is a simple laboratory tool used to distinguish between Necrotizing Soft-Tissue Infections (NSTI and other soft-tissue infections. A LRINEC score of ≥6 is considered as denoting a high risk of necrotizing fasciitis. A very high LRINEC score might also be associated with mortality and other outcomes of patients with NSTI. METHODS A review of the medical charts of patients was carried out in a tertiary academic Centre. All adult patients with necrotizing softtissue infections from 2010 to 2011 were selected and LRINEC scores were calculated for each patient. The enrolled patients had sufficient information to determine the LRINEC score. Serum Procalcitonin (PCT was used in place of serum C-Reactive Protein (CRP to improve the efficacy of LRINEC score. Serum PCT was considered positive if the value was >0.56 ng/mL. LRINEC score-PCT and LRINEC score-CRP were compared in predicting duration of hospital stay and severity. RESULTS In this study of 50 patients 64% of them were males, majority of the patients were between the age group of 40-80 years. LRINEC score PCT had better predictability for severity and duration of hospital stay when compared to LRINEC score with CRP. Pearson correlation of LRINEC score PCT vs LRINEC score, CRP was statistically significant with LRINEC score, PCT having 30% of patients with longer duration of hospital stay in comparison to LRINEC score CRP which had 12%. CONCLUSION LRINEC score: PCT had better probability in predicting severity and duration of hospital stay when compared to LRINEC score: CRP.

  11. Diagnostic value of serum procalcitonin for acute pyelonephritis in infants and children with urinary tract infections: an updated meta-analysis.

    Science.gov (United States)

    Zhang, Huhai; Yang, Jurong; Lin, Lirong; Huo, Bengang; Dai, Huanzi; He, Yani

    2016-03-01

    The aims were to assess (1) the diagnostic value of serum procalcitonin (PCT) for acute pyelonephritis (APN) in infants and children with urinary tract infections (UTIs) and (2) to compare the performance of two commonly used cutoff values. A meta-analysis of serum PCT in the diagnosis of APN among pediatrics with lower UTIs was conducted. The process of search strategy, publications selection and data analysis was in accordance with the preferred reporting items for systematic reviews and meta-analyses guidelines. Eighteen high-quality studies with a total of 831 APN patients and 651 individuals with lower UTIs were analyzed. The overall performance of serum PCT ≥ 0.5 ng/mL was as follows: pooled sensitivity of 0.86 (95 % CI 0.73-0.93), pooled specificity of 0.76 (95 % CI 0.66-0.83), DOR of 18.90 (95 % CI 6.78-52.71) and AUROC of 0.86 (95 % CI 0.83-0.89), with significant heterogeneity. However, use of 1.0 ng/mL as a cutoff value produced an improved specificity of 0.91 (95 % CI 0.86-0.94), a DOR of 55.06 (95 % CI 22.57-115.48) and an AUROC of 0.94 (95 % CI 0.92-0.96), without obvious heterogeneity. In pediatrics with UTIs, the cutoff value of serum PCT, 1.0 ng/mL, has a preferable diagnostic performance compared with 0.5 ng/mL for APN. Additional prospective studies that propose an appropriate cutoff value and validate the performance of PCT for young with APN are needed in the future.

  12. Clinical value of procalcitonin in identification of different types of meningitis%降钙素原在鉴别不同类型脑膜炎中的临床价值分析

    Institute of Scientific and Technical Information of China (English)

    闫青; 余玲; 刘江; 夏芳

    2016-01-01

    目的:探讨降钙素原(PC T )在鉴别细菌性脑膜炎和病毒性脑膜炎的临床应用价值,为临床诊断提供依据。方法选取2011年12月-2016年1月医院收治的急性脑膜炎患者90例,将患者根据细菌培养及脑脊液细胞学检查结果分为细菌性脑膜炎组42例与病毒性脑膜炎组48例,于患者入院前及治疗后分别对两组患者的PC T、外周血C‐反应蛋白(CRP)及血常规白细胞计数进行测定。结果治疗前,与病毒性脑炎组比较,细菌性脑膜炎患者血清PCT水平及脑脊液PCT水平均明显提高,差异有统计学意义(P<0.05);与治疗前比较,细菌性脑膜炎患者经抗菌药物治疗后其血清PCT水平明显降低,差异有统计学意义(P<0.05)。结论对细菌性脑膜炎和病毒性脑膜炎进行PC T检测有助于不同病原体的早期诊断,并且通过PC T 的检测能够判定细菌性脑膜炎的治疗效果,在临床上具有重要的应用价值。%OBJECTIVE To explore the clinical value of procalcitonin (PCT ) in differentiating bacterial meningitis from viral meningitis so as to provide guidance for clinical diagnosis .METHODS A total of 90 patients with acute meningitis who were treated in the hospital from Dec 2011 to Jan 2016 were enrolled in the study and divided into the bacterial meningitis group with 42 cases and the viral meningitis group with 48 cases according to the results of bacterial culture and cerebrospinal fluid cytological examination .The levels of PCT and peripheral blood C‐reactive protein as well as white blood cell counts were determined before the admission and after the treatment .RESULTS The levels of serum PCT and cerebrospinal fluid PCT of the bacterial meningitis group were significantly higher than those of the viral meningitis group before the treatment(P<0 .05) .The level of serum PCT of the patients with bacterial meningitis was significantly lower after the antibiotic

  13. Comparison of the results between quantitative procalcitonin detection and blood culture%血清降钙素原定量检测与血培养结果的比较

    Institute of Scientific and Technical Information of China (English)

    王凯飞; 沈定霞; 刘朝军; 叶丽艳; 王磊利; 张有江

    2012-01-01

    目的 探讨降钙素原(PCT)定量检测在血流感染患者中的临床应用价值.方法 采用回顾性研究,对解放军总医院1066例患者同时送检血液培养和PCT检测的结果进行分析,其中有效结果1010例.比较血培养结果与血清PCT浓度的关系及PCT浓度在革兰阴性细菌、革兰阳性细菌及假丝酵母菌之间的差异.并且对33例进行过多次PCT检测的血培养阳性患者预后进行了分析.三组间PCT值差异比较采用Mann-Whitney U检验;死亡率比较采用Fisher's精确概率法.结果 血培养阴性患者PCT为0.37(0.11 ~1.67) μg/L.血培养阳性患者PCT水平为2.24(0.57~11.59)μg/L;PCT在革兰阴性细菌、革兰阳性细菌及假丝酵母菌中的阳性率分别为86.6%、72.0%及75.7%.在33例多次PCT检测的血培养阳性患者中,PCT进行性减低者预后较好,PCT均值>5 μg/L者预后较差.结论 定量检测PCT可作为快速排除和诊断血流感染的辅助检测手段.观察PCT变化趋势对预后判断有一定的参考价值.%Objective To evaluate the application value of the quantitative procalcitonin (PCT) test in bloodstream infection.Methods Of 1066 patients with blood culture and PCT detection were collected in our hospital,retrospectively,1010 were effective cases.The relationship between blood culture results and serum PCT levels was investigated.PCT levels in gram-negative bacterial infection,gram-positive bacterial infection and candidiasis were compared.The prognosis of 33 blood culture positive patients with repeated PCT detection results were analyzed.Mann-Whitney U test was used to compare the PCT value among the three groups,and Fisher' s test was used to compare the death rate among the three groups.Results In the patients with negative blood culture results,the median of PCT was 0.37 (0.11 - 1.67) μg/L.But in the patients with positive blood culture results,the median of PCT were 2.24(0.57 -11.59) μg/L The positive rate of PCT in gram

  14. The effect of food shape abnormality on purchase intentions in China

    DEFF Research Database (Denmark)

    Loebnitz, Natascha; Grunert, Klaus G

    2015-01-01

    The assumption that consumers prefer cosmetically perfect fruits and vegetables contributes to global food waste, because food retailers refuse to offer abnormally shaped food. This study empirically examines how food shape abnormality affects purchase intentions and how two individual difference...... variables, environmental concern and social trust, might moderate the food shape abnormality–purchase intention relationship for consumers in China. A representative sample of 212 Chinese consumers indicated their purchase intentions for two fruits and two vegetables with varying levels of food shape...... abnormality (normal, moderately abnormal, and extremely abnormal). The results demonstrate that food shape influences purchase intentions; consumers are more likely to purchase normally shaped fruits and vegetables than moderately or extremely abnormally shaped food. However, environmental concern and social...

  15. Drop Analysis in Infants with Bacterial Pneumonia in the Diagnosis of Procalcitonin Detection and Blood Culture%降钙素原检测与血培养在婴幼儿细菌性肺炎诊断中的作用分析

    Institute of Scientific and Technical Information of China (English)

    陈贵英

    2015-01-01

    Objective To compare the procalcitonin and blood culture results in the diagnosis of bacterial pneumonia in infants.Methods Choose 36 cases of infants with bacterial pneumonia,fasting blood,for procalcitonin detection,blood culture,the comparison results.Results Procalcitonin blood culture positive rate was 52.78%;the total positive rate was 25%.Conclusion In the diagnosis of infantile bacterial pneumonia,procalcitonin has more advantage.%目的对比降钙素原与血培养在婴幼儿细菌性肺炎诊断中效果。方法选取婴幼儿细菌性肺炎患儿36例,抽取空腹静脉血,行降钙素原、血培养检测,对比结果。结果降钙素原阳性率为52.78%;血培养总阳性率为25.00%。结论在婴幼儿细菌性肺炎诊断中,降钙素原检测具有更大的优势。

  16. Abnormal Raman spectral phenomenon of silicon nanowires

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    The Raman spectra of two one-dimensional silicon nanowire samples with different excitation wavelengths were measured and an abnormal phenomenon was discovered that the Raman spectral features change with the wavelengths of excitation. Closer analysis of the crystalline structure of samples and the changes in Raman spectral features showed that the abnormal behavior is the result of resonance Raman scattering selection effect.

  17. An Abnormal Vibrational Mode of Torsion Pendulum

    Institute of Scientific and Technical Information of China (English)

    赵亮; 涂英; 顾邦明; 胡忠坤; 罗俊

    2003-01-01

    In the experiment for the determination of the gravitational constant G, we found an abnormal vibrational mode of the torsion pendulum. The abnormal mode disappeared as a magnetic damper was introduced to the torsion pendulum system. Our experimental results also show that the magnetic damper can be used to suppress the high frequency vibrational noises to torsion pendulums effectively.

  18. Nail abnormalities in patients with vitiligo*

    Science.gov (United States)

    Topal, Ilteris Oguz; Gungor, Sule; Kocaturk, Ozgur Emek; Duman, Hatice; Durmuscan, Mustafa

    2016-01-01

    Background Vitiligo is an acquired pigmentary skin disorder affecting 0.1-4% of the general population. The nails may be affected in patients with an autoimmune disease such as psoriasis, and in those with alopecia areata. It has been suggested that nail abnormalities should be apparent in vitiligo patients. Objective We sought to document the frequency and clinical presentation of nail abnormalities in vitiligo patients compared to healthy volunteers. We also examined the correlations between nail abnormalities and various clinical parameters. Methods This study included 100 vitiligo patients and 100 healthy subjects. Full medical histories were collected from the subjects, who underwent thorough general and nail examinations. All nail changes were noted. In the event of clinical suspicion of a fungal infection, additional mycological investigations were performed. Results Nail abnormalities were more prevalent in the patients (78%) than in the controls (55%) (p=0.001). Longitudinal ridging was the most common finding (42%), followed by (in descending order): leukonychia, an absent lunula, onycholysis, nail bed pallor, onychomycosis, splinter hemorrhage and nail plate thinning. The frequency of longitudinal ridging was significantly higher in patients than in controls (p<0.001). Conclusions Nail abnormalities were more prevalent in vitiligo patients than in controls. Systematic examination of the nails in such patients is useful because nail abnormalities are frequent. However, the causes of such abnormalities require further study. Longitudinal ridging and leukonychia were the most common abnormalities observed in this study. PMID:27579738

  19. An Abnormal Psychology Community Based Interview Assignment

    Science.gov (United States)

    White, Geoffry D.

    1977-01-01

    A course option in abnormal psychology involves students in interviewing and observing the activities of individuals in the off-campus community who are concerned with some aspect of abnormal psychology. The technique generates student interest in the field when they interview people about topics such as drug abuse, transsexualism, and abuse of…

  20. Chromosomal abnormalities in patients with sperm disorders

    Directory of Open Access Journals (Sweden)

    L. Y. Pylyp

    2013-02-01

    Full Text Available Chromosomal abnormalities are among the most common genetic causes of spermatogenic disruptions. Carriers of chromosomal abnormalities are at increased risk of infertility, miscarriage or birth of a child with unbalanced karyotype due to the production of unbalanced gametes. The natural selection against chromosomally abnormal sperm usually prevents fertilization with sperm barring in cases of serious chromosomal abnormalities. However, assisted reproductive technologies in general and intracytoplasmic sperm injection in particular, enable the transmission of chromosomal abnormalities to the progeny. Therefore, cytogenetic studies are important in patients with male factor infertility before assisted reproduction treatment. The purpose of the current study was to investigate the types and frequencies of chromosomal abnormalities in 724 patients with infertility and to estimate the risk of chromosomal abnormalities detection in subgroups of patients depending on the severity of spermatogenic disruption, aiming at identifying groups of patients in need of cytogenetic studies. Karyotype analysis was performed in 724 blood samples of men attending infertility clinic. Chromosomal preparation was performed by standard techniques. At least 20 GTG-banded metaphase plates with the resolution from 450 to 750 bands per haploid set were analysed in each case. When chromosomal mosaicism was suspected, this number was increased to 50. Abnormal karyotypes were observed in 48 (6.6% patients, including 67% of autosomal abnormalities and 33% of gonosomal abnormalities. Autosomal abnormalities were represented by structural rearrangements. Reciprocal translocations were the most common type of structural chromosomal abnormalities in the studied group, detected with the frequency of 2.6% (n = 19, followed by Robertsonian translocation, observed with the frequency of 1.2% (n = 9. The frequency of inversions was 0.6% (n = 4. Gonosomal abnormalities included 14 cases

  1. 血清降钙素原检测对儿童细菌性肺炎抗生素使用的指导研究%Serum Procalcitonin Original Detection of Bacterial Pneumonia in Children Study the Guidance of Antibiotic Use

    Institute of Scientific and Technical Information of China (English)

    杨洪亮; 杨翠珍

    2014-01-01

    目的:研究儿童细菌性肺炎治疗中利用血清降钙素原水平指导临床抗生素使用的价值。方法将92例儿童细菌性肺炎患儿随机分为对照组和治疗组。对照组给予经验治疗,治疗组应用血清降钙素原含量指导抗生素应用治疗。比较两组抗生素使用时间、抗生素使用费用及细菌耐药率的差异。结果两组患儿在抗生素使用时间上,对照组(6.3±0.4)d与治疗组(3.6±0.5)d相比,差异有统计学意义(P<0.05);两组在抗生素使用费用上,对照组(951±85)元与治疗组(493±66)元相比,差异有统计学意义(P<0.05)。两组在平均细菌耐药率上,对照组平均20.5%与治疗组10.4%相比,差异有统计学意义(P<0.05)。结论儿童细菌性肺炎治疗中参考血清降钙素原水平用药,可以在达到更好治疗效果的同时减少抗生素的使用时间、费用和细菌耐药率。%Objective To study the bacterial pneumonia in children in the use of serum calcitonin original level to guide clinical antibiotics use value.Methods 92 patients with bacterial pneumonia in children were randomly divided into control group and treatment group.The contrd group was given experience treatment.The treatment group application Procalcitonin levels guide the application of antibiotics.Compare two groups of antibiotics use of time, Antibiotic use and bacterial resistance to diference.Results On antibiotic use time, two groups of children patients in the control group(6.3±0.4)d,compared with treatment group(3.6±0.5)d the difference was statisticaly significant(P<0.05);On antibiotic use,control group(951±85)yuan compared with treatment group (493±66) yuan,the difference was statisticaly significant(P<0.05).Two groups on the average bacterial resistance,the control group mas 20.5% compared with treatment group 10.4%,the difference was statisticaly significant(P<0.05).Conclusion Reference of Procalcitonin

  2. 产后抑郁症患者正性和负性音乐刺激下情绪反应及脑激活特征%Abnormal pleasure levels and neural processing in response to positive and negative music in postpartum depression: a preliminary functional magnetic resonance imaging study

    Institute of Scientific and Technical Information of China (English)

    王晓娟; 王健; 刘志宏

    2014-01-01

    目的 探讨产后抑郁症患者正、负性音乐刺激下的情绪反应及脑激活特征.方法 选取符合DSM-Ⅳ产褥期抑郁症诊断标准且爱丁堡产后抑郁量表评分≥9分的11例产后抑郁症患者(抑郁症组)和11名产后对照者(对照组),在正、负性音乐刺激下进行脑功能磁共振扫描,比较两组被试者的主观愉悦度评价(人像自评系统量表评分)和脑功能磁共振扫描激活脑区的差异.结果 抑郁症组对正、负性音乐的主观愉悦度评价[分别为:(6.23±1.01)、(3.08±0.64)分]均低于对照组[分别为:(7.00±0.63)、3.72 ±0.47)分],差异有统计学意义(t=-2.27,P=0.03;t=-2.79,P=0.01).在负性刺激下,与对照组相比,抑郁症组患者表现为海马的激活增强,并且右侧海马的激活与主观愉悦度评价水平呈负相关.结论 产后抑郁症患者对负性音乐的愉悦度评价更低,其可能与右侧海马的异常激活有关.%Objective To explore the neural activity of females with post-partum depression in response to negative and positive emotional music and further to examine the relationship between the psychological pleasure levels and the abnormal neural activity in post-partum depression.Methods Eleven postpartum healthy females and 11 unmediated depressed females underwent functional magnetic resonance imaging blood-oxygen-level-dependent acquisition during a block-designed emotional music.Results The depressed females showed lower pleasure levels both to the positive and negative music(6.23 ± 1.01,3.08 ± 0.64,respectively) than healthy ones (7.00 ± 0.63,3.72 ± 0.47,respectively),the difference was statistically significant(t =-2.27,P =0.03 ; t =-2.79,P =0.01).Postpartum depression patients exhibited significantly stronger hippocampus activation than the healthy subjects and there was a significant negative correlation between right hippocampus activity and psychological pleasure levels to negative music.Conclusion Postpartum depressied

  3. Who Buys Oddly Shaped Food and Why? Impacts of Food Shape Abnormality and Organic Labeling on Purchase Intentions

    DEFF Research Database (Denmark)

    Loebnitz, Natascha; Schuitema, Geertje; Grunert, Klaus G

    2015-01-01

    experimentally. A representative sample of 964 Danish consumers indicated their purchase intentions for two fruits and two vegetables with varying levels of food shape abnormality (normal, moderately abnormal, and extremely abnormal) and organic labels (organic label, no label). Food shape abnormalities...... influence consumers’ purchase intentions, but only if the food deviates extremely from the norm; no differences in purchase intentions emerge for moderately abnormal food. Awareness of food waste issues and proenvironmental self-identities also drive purchase intentions, such that participants with high...... levels of these traits express significantly higher purchase intentions for abnormally shaped food. Thus, increasing awareness of food waste issues, particularly among those with strong proenvironmental self-identities, might encourage more consumers to purchase abnormally shaped fruits and vegetables....

  4. Cortical thickness abnormalities associated with dyslexia, independent of remediation status.

    Science.gov (United States)

    Ma, Yizhou; Koyama, Maki S; Milham, Michael P; Castellanos, F Xavier; Quinn, Brian T; Pardoe, Heath; Wang, Xiuyuan; Kuzniecky, Ruben; Devinsky, Orrin; Thesen, Thomas; Blackmon, Karen

    2015-01-01

    Abnormalities in cortical structure are commonly observed in children with dyslexia in key regions of the "reading network." Whether alteration in cortical features reflects pathology inherent to dyslexia or environmental influence (e.g., impoverished reading experience) remains unclear. To address this question, we compared MRI-derived metrics of cortical thickness (CT), surface area (SA), gray matter volume (GMV), and their lateralization across three different groups of children with a historical diagnosis of dyslexia, who varied in current reading level. We compared three dyslexia subgroups with: (1) persistent reading and spelling impairment; (2) remediated reading impairment (normal reading scores), and (3) remediated reading and spelling impairments (normal reading and spelling scores); and a control group of (4) typically developing children. All groups were matched for age, gender, handedness, and IQ. We hypothesized that the dyslexia group would show cortical abnormalities in regions of the reading network relative to controls, irrespective of remediation status. Such a finding would support that cortical abnormalities are inherent to dyslexia and are not a consequence of abnormal reading experience. Results revealed increased CT of the left fusiform gyrus in the dyslexia group relative to controls. Similarly, the dyslexia group showed CT increase of the right superior temporal gyrus, extending into the planum temporale, which resulted in a rightward CT asymmetry on lateralization indices. There were no group differences in SA, GMV, or their lateralization. These findings held true regardless of remediation status. Each reading level group showed the same "double hit" of atypically increased left fusiform CT and rightward superior temporal CT asymmetry. Thus, findings provide evidence that a developmental history of dyslexia is associated with CT abnormalities, independent of remediation status.

  5. Cortical thickness abnormalities associated with dyslexia, independent of remediation status

    Directory of Open Access Journals (Sweden)

    Yizhou Ma

    2015-01-01

    Full Text Available Abnormalities in cortical structure are commonly observed in children with dyslexia in key regions of the “reading network.” Whether alteration in cortical features reflects pathology inherent to dyslexia or environmental influence (e.g., impoverished reading experience remains unclear. To address this question, we compared MRI-derived metrics of cortical thickness (CT, surface area (SA, gray matter volume (GMV, and their lateralization across three different groups of children with a historical diagnosis of dyslexia, who varied in current reading level. We compared three dyslexia subgroups with: (1 persistent reading and spelling impairment; (2 remediated reading impairment (normal reading scores, and (3 remediated reading and spelling impairments (normal reading and spelling scores; and a control group of (4 typically developing children. All groups were matched for age, gender, handedness, and IQ. We hypothesized that the dyslexia group would show cortical abnormalities in regions of the reading network relative to controls, irrespective of remediation status. Such a finding would support that cortical abnormalities are inherent to dyslexia and are not a consequence of abnormal reading experience. Results revealed increased CT of the left fusiform gyrus in the dyslexia group relative to controls. Similarly, the dyslexia group showed CT increase of the right superior temporal gyrus, extending into the planum temporale, which resulted in a rightward CT asymmetry on lateralization indices. There were no group differences in SA, GMV, or their lateralization. These findings held true regardless of remediation status. Each reading level group showed the same “double hit” of atypically increased left fusiform CT and rightward superior temporal CT asymmetry. Thus, findings provide evidence that a developmental history of dyslexia is associated with CT abnormalities, independent of remediation status.

  6. Cortical thickness abnormalities associated with dyslexia, independent of remediation status

    Science.gov (United States)

    Ma, Yizhou; Koyama, Maki S.; Milham, Michael P.; Castellanos, F. Xavier; Quinn, Brian T.; Pardoe, Heath; Wang, Xiuyuan; Kuzniecky, Ruben; Devinsky, Orrin; Thesen, Thomas; Blackmon, Karen

    2014-01-01

    Abnormalities in cortical structure are commonly observed in children with dyslexia in key regions of the “reading network.” Whether alteration in cortical features reflects pathology inherent to dyslexia or environmental influence (e.g., impoverished reading experience) remains unclear. To address this question, we compared MRI-derived metrics of cortical thickness (CT), surface area (SA), gray matter volume (GMV), and their lateralization across three different groups of children with a historical diagnosis of dyslexia, who varied in current reading level. We compared three dyslexia subgroups with: (1) persistent reading and spelling impairment; (2) remediated reading impairment (normal reading scores), and (3) remediated reading and spelling impairments (normal reading and spelling scores); and a control group of (4) typically developing children. All groups were matched for age, gender, handedness, and IQ. We hypothesized that the dyslexia group would show cortical abnormalities in regions of the reading network relative to controls, irrespective of remediation status. Such a finding would support that cortical abnormalities are inherent to dyslexia and are not a consequence of abnormal reading experience. Results revealed increased CT of the left fusiform gyrus in the dyslexia group relative to controls. Similarly, the dyslexia group showed CT increase of the right superior temporal gyrus, extending into the planum temporale, which resulted in a rightward CT asymmetry on lateralization indices. There were no group differences in SA, GMV, or their lateralization. These findings held true regardless of remediation status. Each reading level group showed the same “double hit” of atypically increased left fusiform CT and rightward superior temporal CT asymmetry. Thus, findings provide evidence that a developmental history of dyslexia is associated with CT abnormalities, independent of remediation status. PMID:25610779

  7. Prognostic value of procalcitonin and endotoxin concentrations for intra-abdominal sepsis%降钙素原及内毒素对腹腔感染脓毒症患者预后的评估

    Institute of Scientific and Technical Information of China (English)

    黄凤楼; 刁孟元; 钱海飞; 秦保东; 仲人前

    2014-01-01

    目的:探讨降钙素原(procalcitonin,PCT)及内毒素对于腹腔感染脓毒症患者预后的评估价值。方法回顾性分析腹腔感染脓毒症86例的临床资料,根据预后(存活和死亡)和病情严重程度(局部感染、脓毒症、严重脓毒症及脓毒症休克)分组,比较不同组别之间的PCT及内毒素水平,比较PCT和内毒素同急性生理和慢性健康状况评分Ⅱ( acute physiology and chronic health evaluation Ⅱ,APACHE Ⅱ)和脓毒症相关器官功能障碍评分( sepsis-related organ failure assessment score ,SO-FA)的相关性,并比较PCT、内毒素和两个临床评分系统对于患者预后的评估价值。结果根据不同评分及预后分组,各组之间PCT水平差异具有统计学意义,而内毒素水平差异无统计学意义。 PCT与两个评分系统具有很好的相关性,而内毒素与评分系统无显著相关。 PCT、内毒素、APACHE Ⅱ和SOFA评分对于预后的受试者工作特征曲线( ROC 曲线)下面积分别为85.7%、56.3%、86.7%和86.0%。结论 PCT较内毒素能更好地评价腹腔感染脓毒症患者的预后。%Objective To evaluate the value of serum procalcitonin and endotoxin concentrations in prognosis of intra -abdom-inal sepsis.Methods A total of 86 patients with intra-abdominal sepsis were included into the study .We compared PCT and endotoxin concentrations according to classification of different outcomes ( survivors and nonsurvivors ) and intra-abdominal sepsis ( local infec-tions,sepsis,severe sepsis and septic shock ).The correlation of PCT or endotoxin concentrations to APACHE Ⅱ or SOFA score were also analyzed ,then see their function in judging the prognosis of sepsis .Results Nonsurvivors had a higher level of PCT than survi-vors.PCT concentrations was higher in patients with severe sepsis and septic shock than that with sepsis or local infections .PCT concen-trations was associated with

  8. The value of procalcitonin in the discrimination between sepsis due to different bacterial%降钙素原对鉴别不同细菌感染所致脓毒症的诊断价值

    Institute of Scientific and Technical Information of China (English)

    王彦双; 何雅军

    2015-01-01

    Objective To explore the value of procalcitonin( PCT) in the discrimination between sepsis due to Gram-negative( GN) bacteria and duo to Gram-positive( GP) bacteria.Methods One hundred and one sepsis pa-tients with positive blood culture between January 2013 to May 2014 were collected in Guangzhou Red Cross Hospital. Among them, 56 patients were infected with GN bacteria and the other 45 patients were infected with GP bacteria. Serum PCT, hs-CRP and WBC count were detected.Drawing PCT ROC curve aimed to analyze the best cut-off score and the sensitivity and the specificity were made.Results Serum PCT levels were obviously higher in patients with GN bacteria(M=18 ng/ml)than those in patients with GP bacteria(M=3.6 ng/ml).According to the ROC curve, the best cut off was 3.22 ng/ml with the sensitivity 86% and the specificity 72% and the area under the curve (AUC) was 0.864.Conclusion PCT may be a sensitive index for discrimination between sepsis due to Gram-nega-tive bateria and due to Gram-positive bacteria.%目的:探讨降钙素原( PCT)对鉴别G-菌、G+菌所致血培养阳性脓毒症的诊断价值。方法收集2013-01~2014-05在广州市红十字会医院收治的血培养阳性脓毒症患者101例,其中G-菌组56例,G+菌组45例,分别检测患者血清PCT、超敏C反应蛋白( hs-CRP)水平及白细胞( WBC)计数并进行统计学分析,绘制PCT的ROC曲线,分析最佳截断点、敏感度和特异度。结果 G-菌组、G+菌组患者WBC计数和血清hs-CRP水平比较差异均无统计学意义(P>0.05)。 G-菌组血清PCT中位数为18 ng/ml,G+菌组为3.6 ng/ml,两组PCT水平比较差异有统计学意义( P<0.05)。通过绘制PCT的ROC曲线,得出曲线下面积AUC为0.864,最佳截断点PCT浓度为3.22 ng/ml,此时敏感度为86%,特异度为72%。结论 PCT在脓毒症中对区分G-菌、G+菌感染有一定的价值,可为临床早期使用抗生素提供参考。

  9. Early detection of abnormal patient arrivals at hospital emergency department

    KAUST Repository

    Harrou, Fouzi

    2015-10-21

    Overcrowding is one of the most crucial issues confronting emergency departments (EDs) throughout the world. Efficient management of patient flows for ED services has become an urgent issue for most hospital administrations. Handling and detection of abnormal situations is a key challenge in EDs. Thus, the early detection of abnormal patient arrivals at EDs plays an important role from the point of view of improving management of the inspected EDs. It allows the EDs mangers to prepare for high levels of care activities, to optimize the internal resources and to predict enough hospitalization capacity in downstream care services. This study reports the development of statistical method for enhancing detection of abnormal daily patient arrivals at the ED, which able to provide early alert mechanisms in the event of abnormal situations. The autoregressive moving average (ARMA)-based exponentially weighted moving average (EWMA) anomaly detection scheme proposed was successfully applied to the practical data collected from the database of the pediatric emergency department (PED) at Lille regional hospital center, France.

  10. Abnormalities in eelpout Zoarces viviparus upon chemical exposure.

    Science.gov (United States)

    Brande-Lavridsen, Nanna; Korsgaard, Bodil; Dahllöf, Ingela; Strand, Jakob; Tairova, Zhanna; Bjerregaard, Poul

    2013-12-01

    Elevated frequencies of abnormal embryos in female eelpout Zoarces viviparus have been demonstrated in Danish, Swedish and German monitoring programmes at certain geographic locations with high levels of anthropogenic input. Pollutants present in areas with high malformation frequencies were selected and tested in a controlled laboratory experiment for their potential to induce abnormalities among eelpout embryos upon injection into pregnant eelpout. Tributyltin, 2,3,7,8-tetrachlorodibenzo-p-dioxin, pyrene, nonylphenol, 2,2',4,4'-tetrabromophenylether and heptadecafluorooctanesulfonic acid were tested, either individually or combined. Generally, the chemicals were transferred to eggs and/or embryos. Some of the exposures increased the proportion of broods with more than 10% abnormal or 5% malformed embryos, although the average percentages of abnormal development were not affected. Spinal, cranial and eye deformities were evident, similarly to what is seen in nature. Some of the exposures resulted in increased percentages of females with as well a low reproductive capacity as embryos with a low condition index.

  11. Abnormal Event Detection Using Local Sparse Representation

    DEFF Research Database (Denmark)

    Ren, Huamin; Moeslund, Thomas B.

    2014-01-01

    We propose to detect abnormal events via a sparse subspace clustering algorithm. Unlike most existing approaches, which search for optimized normal bases and detect abnormality based on least square error or reconstruction error from the learned normal patterns, we propose an abnormality measurem...... is found that satisfies: the distance between its local space and the normal space is large. We evaluate our method on two public benchmark datasets: UCSD and Subway Entrance datasets. The comparison to the state-of-the-art methods validate our method's effectiveness....

  12. Numerically abnormal chromosome constitutions in humans

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1993-12-31

    Chapter 24, discusses numerically abnormal chromosome constitutions in humans. This involves abnormalities of human chromosome number, including polyploidy (when the number of sets of chromosomes increases) and aneuploidy (when the number of individual normal chromosomes changes). Chapter sections discuss the following chromosomal abnormalities: human triploids, imprinting and uniparental disomy, human tetraploids, hydatidiform moles, anomalies caused by chromosomal imbalance, 13 trisomy (D{sub 1} trisomy, Patau syndrome), 21 trisomy (Down syndrome), 18 trisomy syndrome (Edwards syndrome), other autosomal aneuploidy syndromes, and spontaneous abortions. The chapter concludes with remarks on the nonrandom participation of chromosomes in trisomy. 69 refs., 3 figs., 4 tabs.

  13. Chronic treatment with Ang-(1-7) reverses abnormal reactivity in the corpus cavernosum and normalizes diabetes-induced changes in the protein levels of ACE, ACE2, ROCK1, ROCK2 and omega-hydroxylase in a rat model of type 1 diabetes.

    Science.gov (United States)

    Yousif, Mariam H M; Makki, Batoul; El-Hashim, Ahmed Z; Akhtar, Saghir; Benter, Ibrahim F

    2014-01-01

    Angiotensin-(1-7) [Ang-(1-7)] may have beneficial effects in diabetes mellitus-induced erectile dysfunction (DMIED) but its molecular actions in the diabetic corpus cavernosum (CC) are not known. We characterized the effects of diabetes and/or chronic in vivo administration of Ang-(1-7) on vascular reactivity in the rat corpus cavernosum (CC) and on protein expression levels of potential downstream effectors of the renin-angiotensin-aldosterone system (RAAS) such as angiotensin-converting enzyme (ACE), ACE2, Rho kinases 1 and 2 (ROCK1 and ROCK2), and omega-hydroxylase, the cytochrome-P450 enzyme that metabolizes arachidonic acid to form the vasoconstrictor, 20-hydroxyeicosatetraenoic acid. Streptozotocin-treated rats were chronicically administered Ang-(1-7) with or without A779, a Mas receptor antagonist, during weeks 4 to 6 of diabetes. Ang-(1-7) reversed diabetes-induced abnormal reactivity to vasoactive agents (endothelin-1, phenylepherine, and carbachol) in the CC without correcting hyperglycemia. Six weeks of diabetes led to elevated ACE, ROCK1, ROCK 2, and omega-hydroxylase and a concomitant decrease in ACE2 protein expression levels that were normalized by Ang-(1-7) treatment but not upon coadministration of A779. These data are supportive of the notion that the beneficial effects of Ang-(1-7) in DMIED involve counterregulation of diabetes-induced changes in ACE, ACE2, Rho kinases, and omega-hydroxylase proteins in the diabetic CC via a Mas receptor-dependent mechanism.

  14. Chronic Treatment with Ang-(1-7 Reverses Abnormal Reactivity in the Corpus Cavernosum and Normalizes Diabetes-Induced Changes in the Protein Levels of ACE, ACE2, ROCK1, ROCK2 and Omega-Hydroxylase in a Rat Model of Type 1 Diabetes

    Directory of Open Access Journals (Sweden)

    Mariam H. M. Yousif

    2014-01-01

    Full Text Available Angiotensin-(1-7 [Ang-(1-7] may have beneficial effects in diabetes mellitus-induced erectile dysfunction (DMIED but its molecular actions in the diabetic corpus cavernosum (CC are not known. We characterized the effects of diabetes and/or chronic in vivo administration of Ang-(1-7 on vascular reactivity in the rat corpus cavernosum (CC and on protein expression levels of potential downstream effectors of the renin-angiotensin-aldosterone system (RAAS such as angiotensin-converting enzyme (ACE, ACE2, Rho kinases 1 and 2 (ROCK1 and ROCK2, and omega-hydroxylase, the cytochrome-P450 enzyme that metabolizes arachidonic acid to form the vasoconstrictor, 20-hydroxyeicosatetraenoic acid. Streptozotocin-treated rats were chronicically administered Ang-(1-7 with or without A779, a Mas receptor antagonist, during weeks 4 to 6 of diabetes. Ang-(1-7 reversed diabetes-induced abnormal reactivity to vasoactive agents (endothelin-1, phenylepherine, and carbachol in the CC without correcting hyperglycemia. Six weeks of diabetes led to elevated ACE, ROCK1, ROCK 2, and omega-hydroxylase and a concomitant decrease in ACE2 protein expression levels that were normalized by Ang-(1-7 treatment but not upon coadministration of A779. These data are supportive of the notion that the beneficial effects of Ang-(1-7 in DMIED involve counterregulation of diabetes-induced changes in ACE, ACE2, Rho kinases, and omega-hydroxylase proteins in the diabetic CC via a Mas receptor-dependent mechanism.

  15. Amphibian abnormalities on National Wildlife Refuges

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This fact sheet outlines a study done to 1) find the percentage of abnormal frogs and toads on the nation’s National Wildlife Refuges and 2) determine how the...

  16. On two abnormal sharks from Gujarat

    Digital Repository Service at National Institute of Oceanography (India)

    Gopalan, U.K.

    The description of the two abnormal sharks, Carchariaswalbeehmi and Eulamia dussumieri collected from Gujarat, India, is given Of these C walbeehmi was double-headed The other shark E dussumieri had thumb snouted albino...

  17. immunological arthritis Prevalence of biochemical and abnormalities ...

    African Journals Online (AJOL)

    1991-02-02

    Feb 2, 1991 ... immunological abnormalities noted were a positive rheumatoid factor (78,9%), positive ... Rheumatoid arthritis (RA) is a systemic disease characterised by the occurrence of articular and ..... treatment. Br Med] 1982; 285: ...

  18. The glycometabolism abnormality among schizophrenia patients

    Institute of Scientific and Technical Information of China (English)

    吴小立

    2013-01-01

    Objective To explore the potential glycometabolism abnormality and the related factors of schizophrenia patients in China. Methods This cross-sectional study included 44 healthy controls(group 1) and 178 inpatient

  19. Basilar artery migraine and reversible imaging abnormalities.

    Science.gov (United States)

    Maytal, J; Libman, R B; Lustrin, E S

    1998-01-01

    We report a case of a basilar artery migraine in a 17-year-old boy with transient CT and MR abnormalities after each of two migraine episodes. A repeat MR study 6 months after the last event showed complete resolution of the lesion. Transient abnormalities on brain images similar to those shown in our case have been reported in patients with migraine and other neurologic conditions and are most likely related to cerebral vasogenic edema.

  20. Abnormal Chromosome Segregation May Trigger Tumors

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    @@ Cancer is a primary threat to human health as it kills millions of people each year.Scientists have shown that 75% of human cancers have an abnormal number of chromosomes in cells,and the proportion of the cells with an abnormal chromosome number is tightly and positively related to malignance progression and metastasis of cancers. But the pathological mechanism behind the anomaly still remains unknown.

  1. Abnormal Asymmetry of Brain Connectivity in Schizophrenia

    OpenAIRE

    Ribolsi, Michele; Zafiris J Daskalakis; Siracusano, Alberto; Koch, Giacomo

    2014-01-01

    Recently, a growing body of data has revealed that beyond a dysfunction of connectivity among different brain areas in schizophrenia patients (SCZ), there is also an abnormal asymmetry of functional connectivity compared with healthy subjects. The loss of the cerebral torque and the abnormalities of gyrification, with an increased or more complex cortical folding in the right hemisphere may provide an anatomical basis for such aberrant connectivity in SCZ. Furthermore, diffusion tensor imagin...

  2. Heterotaxy syndromes and abnormal bowel rotation

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Beverley [Stanford University, Lucile Packard Children' s Hospital, Department of Radiology, Stanford, CA (United States); Koppolu, Raji; Sylvester, Karl [Lucile Packard Children' s Hospital at Stanford, Department of Surgery, Stanford, CA (United States); Murphy, Daniel [Lucile Packard Children' s Hospital at Stanford, Department of Cardiology, Stanford, CA (United States)

    2014-05-15

    Bowel rotation abnormalities in heterotaxy are common. As more children survive cardiac surgery, the management of gastrointestinal abnormalities has become controversial. To evaluate imaging of malrotation in heterotaxy with surgical correlation and provide an algorithm for management. Imaging reports of heterotaxic children with upper gastrointestinal (UGI) and/or small bowel follow-through (SBFT) were reviewed. Subsequently, fluoroscopic images were re-reviewed in conjunction with CT/MR studies. The original reports and re-reviewed images were compared and correlated with surgical findings. Nineteen of 34 children with heterotaxy underwent UGI, 13/19 also had SBFT. In 15/19 reports, bowel rotation was called abnormal: 11 malrotation, 4 non-rotation, no cases of volvulus. Re-review, including CT (10/19) and MR (2/19), designated 17/19 (90%) as abnormal, 10 malrotation (abnormal bowel arrangement, narrow or uncertain length of mesentery) and 7 non-rotation (small bowel and colon on opposite sides plus low cecum with probable broad mesentery). The most useful CT/MR findings were absence of retroperitoneal duodenum in most abnormal cases and location of bowel, especially cecum. Abnormal orientation of mesenteric vessels suggested malrotation but was not universal. Nine children had elective bowel surgery; non-rotation was found in 4/9 and malrotation was found in 5/9, with discrepancies (non-rotation at surgery, malrotation on imaging) with 4 original interpretations and 1 re-review. We recommend routine, early UGI and SBFT studies once other, urgent clinical concerns have been stabilized, with elective laparoscopic surgery in abnormal or equivocal cases. Cross-sectional imaging, usually obtained for other reasons, can contribute diagnostically. Attempting to assess mesenteric width is important in differentiating non-rotation from malrotation and more accurately identifies appropriate surgical candidates. (orig.)

  3. Prevalence of asymptomatic urinary abnormalities among adolescents

    Directory of Open Access Journals (Sweden)

    Mohamed Fouad

    2016-01-01

    Full Text Available To determine the prevalence of asymptomatic urinary abnormalities in adolescents, first morning clean mid-stream urine specimens were obtained from 2500 individuals and examined by dipstick and light microscopy. Adolescents with abnormal screening results were reexamined after two weeks and those who had abnormal results twice were subjected to systemic clinical examination and further clinical and laboratory investigations. Eight hundred and three (32.1% individuals had urinary abnormalities at the first screening, which significantly decreased to 345 (13.8% at the second screening, (P <0.001. Hematuria was the most common urinary abnormalities detected in 245 (9.8% adolescents who had persistent urine abnormalities; 228 (9.1% individuals had non glomerular hematuria. The hematuria was isolated in 150 (6% individuals, combined with leukocyturia in 83 (3.3% individuals, and combined with proteinuria in 12 (0.5% individuals. Leukocyturia was detected in 150 (6% of all studied adolescents; it was isolated in 39 (1.6% individuals and combined with proteinuria in 28 (1.1% of them. Asymp- tomatic bacteriuria was detected in 23 (0.9% of all studied adolescents; all the cases were females. Proteinuria was detected in 65 (2.6% of all the studied adolescents; 45 (1.8% indivi- duals had <0.5 g/day and twenty (0.8% individuals had 0.5-3 g/day. Asymptomatic urinary abnormalities were more common in males than females and adolescents from rural than urban areas (P <0.01 and (P <0.001, respectively. The present study found a high prevalence of asymptomatic urinary abnormalities among adolescents in our population.

  4. Nail abnormalities in patients with vitiligo

    OpenAIRE

    Topal, Ilteris Oguz; Gungor, Sule; Kocaturk, Ozgur Emek; Duman, Hatice; Durmuscan, Mustafa

    2016-01-01

    Abstract: Background: Vitiligo is an acquired pigmentary skin disorder affecting 0.1-4% of the general population. The nails may be affected in patients with an autoimmune disease such as psoriasis, and in those with alopecia areata. It has been suggested that nail abnormalities should be apparent in vitiligo patients. Objective: We sought to document the frequency and clinical presentation of nail abnormalities in vitiligo patients compared to healthy volunteers. We also examined the corre...

  5. Accuracy of serum procalcitonin for the diagnosis of sepsis in neonates and children with systemic inflammatory syndrome: a meta-analysis.

    Science.gov (United States)

    Pontrelli, Giuseppe; De Crescenzo, Franco; Buzzetti, Roberto; Jenkner, Alessandro; Balduzzi, Sara; Calò Carducci, Francesca; Amodio, Donato; De Luca, Maia; Chiurchiù, Sara; Davies, Elin Haf; Copponi, Giorgia; Simonetti, Alessandra; Ferretti, Elena; Di Franco, Valeria; Rasi, Virginia; Della Corte, Martina; Gramatica, Luca; Ciabattini, Marco; Livadiotti, Susanna; Rossi, Paolo

    2017-04-24

    A number of biomarkers have been studied for the diagnosis of sepsis in paediatrics, but no gold standard has been identified. Procalcitonin (PCT) was demonstrated to be an accurate biomarker for the diagnosis of sepsis in adults and showed to be promising in paediatrics. Our study reviewed the diagnostic accuracy of PCT as an early biomarker of sepsis in neonates and children with suspected sepsis. A comprehensive literature search was carried out in Medline/Pubmed, Embase, ISI Web of Science, CINAHL and Cochrane Library, for studies assessing PCT accuracy in the diagnosis of sepsis in children and neonates with suspected sepsis. Studies in which the presence of infection had been confirmed microbiologically or classified as "probable" by chart review were included. Studies comparing patients to healthy subjects were excluded. We analysed data on neonates and children separately. Our primary outcome was the diagnostic accuracy of PCT at the cut-off of 2-2.5 ng/ml, while as secondary outcomes we analysed PCT cut-offs 2.5 ng/ml. Pooled sensitivities and specificities were calculated by a bivariate meta-analysis and heterogeneity was graphically evaluated. We included 17 studies, with a total of 1408 patients (1086 neonates and 322 children). Studies on neonates with early onset sepsis (EOS) and late onset sepsis (LOS) were grouped together. In the neonatal group, we calculated a sensitivity of 0.85, confidence interval (CI) (0.76; 0.90) and specificity of 0.54, CI (0.38; 0.70) at the PCT cut-off of 2.0-2.5 ng/ml. In the paediatric group it was not possible to undertake a pooled analysis at the PCT cut-off of 2.0-2.5 ng/ml, due to the paucity of the studies. PCT shows a moderate accuracy for the diagnosis of sepsis in neonates with suspected sepsis at the cut-off of 2.0-2.5 ng/ml. More studies with high methodological quality are warranted, particularly in neonates, studies considering EOS and LOS separately are needed to improve specificity. PROSPERO Identifier

  6. Biochemical Abnormalities in Batten's Syndrome

    DEFF Research Database (Denmark)

    Clausen, Jytte Lene; Nielsen, Gunnar Gissel; Jensen, Gunde Egeskov

    1978-01-01

    The present data indicate that a group of ten patients with Batten's syndrome showed reduced activity of erythrocyte glutathione (GSH) peroxidase (Px) (glutathione: H2O2 oxidoreductase, EC 1.1.1.9.) using H2O2 as peroxide donor. Assay of erythrocyte GSHPx using H2O2, cumene hydroperoxide and t......-butyl hydroperoxide as donors also makes it possible biochemically to divide Batten's syndrome into two types: (1) one type with decreased values when H2O2 and cumene hydroperoxide are used, and (2) one type with increased values when t-butyl hydroperoxide is used. Furthermore an increased content of palmitic, oleic...... and of eicosatrienoic acid but decreased linoleic acid content was found in serum from patients with Batten syndrome. An inverse relationship between erythrocyte GSHPx and serum eicosatrienoic acid was found in the patients. Finally normal selenium levels were found in erythrocytes, but decreased values were traced...

  7. Serum Level of HMGB1 Protein and Inflammatory Markers in Patients with Secondary Peritonitis: Time Course and the Association with Clinical Status

    Directory of Open Access Journals (Sweden)

    Milić Ljiljana

    2017-01-01

    Full Text Available Background: Intra-abdominal infection in secondary peritonitis drives as excessive production of inflammatory mediators and the development of systemic inflammatory response syndrome (SIRS or sepsis. Finding a specific marker to distinguish SIRS from sepsis would be of immense clinical importance for the therapeutic approach. It is assumed that high-mobility group box 1 protein (HMGB1 could be such a marker. In this study, we examined the time course changes in the blood levels of HMGB1, C-reactive protein (CRP, procalcitonin (PCT and serum amyloid A (SAA in patients with secondary peritonitis who developed SIRS or sepsis.

  8. Prevalence of chromosomal abnormalities and Y chromosome microdeletion among men with severe semen abnormalities and its correlation with successful sperm retrieval.

    Science.gov (United States)

    Mascarenhas, Mariano; Thomas, Sumi; Kamath, Mohan S; Ramalingam, Ramya; Kongari, Ann Marie; Yuvarani, S; Srivastava, Vivi M; George, Korula

    2016-01-01

    To estimate the prevalence of chromosomal abnormalities and Y chromosome microdeletion among men with azoospermia and severe oligozoospermia and its correlation with successful surgical sperm retrieval. A prospective study in a tertiary level infertility unit. In a prospective observation study, men with azoospermia and severe oligozoospermia (concentration infertility center underwent genetic screening. Peripheral blood karyotype was done by Giemsa banding. Y chromosome microdeletion study was performed by a multiplex polymerase chain reaction. The study group consisted of 220 men, 133 of whom had azoospermia and 87 had severe oligozoospermia. Overall, 21/220 (9.5%) men had chromosomal abnormalities and 13/220 (5.9%) men had Y chromosome microdeletions. Chromosomal abnormalities were seen in 14.3% (19/133) of azoospermic men and Y chromosome microdeletions in 8.3% (11/133). Of the 87 men with severe oligozoospermia, chromosomal abnormalities and Y chromosome microdeletions were each seen in 2.3% (2/87). Testicular sperm aspiration was done in 13 men and was successful in only one, who had a deletion of azoospermia factor c. Our study found a fairly high prevalence of genetic abnormality in men with severe semen abnormalities and a correlation of genetic abnormalities with surgical sperm retrieval outcomes. These findings support the need for genetic screening of these men prior to embarking on surgical sperm retrieval and assisted reproductive technology intracytoplasmic sperm injection.

  9. Prevalence of chromosomal abnormalities and Y chromosome microdeletion among men with severe semen abnormalities and its correlation with successful sperm retrieval

    Directory of Open Access Journals (Sweden)

    Mariano Mascarenhas

    2016-01-01

    Full Text Available AIM: To estimate the prevalence of chromosomal abnormalities and Y chromosome microdeletion among men with azoospermia and severe oligozoospermia and its correlation with successful surgical sperm retrieval. SETTING AND DESIGN: A prospective study in a tertiary level infertility unit. MATERIALS AND METHODS: In a prospective observation study, men with azoospermia and severe oligozoospermia (concentration <5 million/ml attending the infertility center underwent genetic screening. Peripheral blood karyotype was done by Giemsa banding. Y chromosome microdeletion study was performed by a multiplex polymerase chain reaction. RESULTS: The study group consisted of 220 men, 133 of whom had azoospermia and 87 had severe oligozoospermia. Overall, 21/220 (9.5% men had chromosomal abnormalities and 13/220 (5.9% men had Y chromosome microdeletions. Chromosomal abnormalities were seen in 14.3% (19/133 of azoospermic men and Y chromosome microdeletions in 8.3% (11/133. Of the 87 men with severe oligozoospermia, chromosomal abnormalities and Y chromosome microdeletions were each seen in 2.3% (2/87. Testicular sperm aspiration was done in 13 men and was successful in only one, who had a deletion of azoospermia factor c. CONCLUSIONS: Our study found a fairly high prevalence of genetic abnormality in men with severe semen abnormalities and a correlation of genetic abnormalities with surgical sperm retrieval outcomes. These findings support the need for genetic screening of these men prior to embarking on surgical sperm retrieval and assisted reproductive technology intracytoplasmic sperm injection.

  10. Biliary manometry in choledochal cyst with abnormal choledochopancreatico ductal junction.

    Science.gov (United States)

    Iwai, N; Tokiwa, K; Tsuto, T; Yanagihara, J; Takahashi, T

    1986-10-01

    Intraoperative manometry of the biliary tract and measurement of amylase levels in choledochal cysts were performed in seven patients, aged 14 months to 5 years, with choledochal cysts, in an investigation of the pathophysiology of the biliary tract. An abnormal choledochopancreatico ductal junction was observed in these seven patients by preoperative endoscopic retrograde cholangiopancreaticography (ERCP) or intraoperative cholangiograms. All six patients examined showed a high amylase level in the choledochal cyst (5,450 to 46,500 Somogyi Units). The intraoperative manometry of the biliary tract showed that a remarkable high pressure zone as was found in the area of sphincter of Oddi was not found in the area of abnormal choledochopancreatico ductal junction. The pressure recordings also demonstrated that the sphincter of Oddi pressure in the patient with choledochal cyst was increased by gastrin stimulation. On the contrary, no pressure reaction to gastrin or secretin was found in the area of abnormal choledochopancreatic ductal junction. From these results it seems that free reflux of pancreatic juice into the biliary system occurs, and the reflux stream depends upon the pressure gradient between pancreatic ductal pressure and common bile duct pressure because of the lack of a sphincter function at the choledochopancreatico ductal junction.

  11. Prothrombin Segovia: a new congenital abnormality of prothrombin.

    Science.gov (United States)

    Rocha, E; Paramo, J A; Bascones, C; Fisac, P R; Cuesta, B; Fernandez, J

    1986-05-01

    A family with a new congenital dysprothrombinemia is presented. The propositus is a 21-yr-old man who presented simultaneously with hemartrosis of the left knee and an extensive hematoma following a minor trauma. Prothrombin time and activated partial thromboplastin time were prolonged. Prothrombin activity was very low when measured by biological assay using physiological activators (7% by one-stage method and 20% by two-stage method) or a Russel's viper venom-cephalin mixture (23%), Notechis scutatus scutatus venom (15%) and Echis carinatus venom (17%); in contrast, the level was found to be borderline to normal using Taipan viper venom (64%) and normal by both staphylocoagulase and immunologic methods. Family studies revealed consanguinity between the propositus' mother and father and both presented a 50% reduced prothrombin level when physiological activators or Echis carinatus viper venom were used. A line of identity between normal and abnormal prothrombin was observed on immunodiffusion. The migration of the abnormal prothrombin was less anodic and was not changed by the addition of calcium. The patient's serum showed 3 bands in the bidimensional immunoelectrophoresis system, whereas normal serum showed only 2 bands. The term prothrombin Segovia is proposed to define this new prothrombin abnormality.

  12. Fetal calcifications are associated with chromosomal abnormalities.

    Directory of Open Access Journals (Sweden)

    Ellika Sahlin

    Full Text Available The biological importance of calcifications occasionally noted in fetal tissues (mainly liver at autopsy or ultrasound is largely unexplored. Previous reports hint at an association to infection, circulatory compromise, malformations or chromosomal abnormalities. To identify factors associated with calcifications, we have performed a case-control study on the largest cohort of fetuses with calcifications described thus far.One-hundred and fifty-one fetuses with calcifications and 302 matched controls were selected from the archives of the Department of Pathology, Karolinska University Hospital. Chromosome analysis by karyotyping or quantitative fluorescence-polymerase chain reaction was performed. Autopsy and placenta reports were scrutinized for presence of malformations and signs of infection.Calcifications were mainly located in the liver, but also in heart, bowel, and other tissues. Fetuses with calcifications showed a significantly higher proportion of chromosomal abnormalities than controls; 50% vs. 20% (p<0.001. The most frequent aberrations among cases included trisomy 21 (33%, trisomy 18 (22%, and monosomy X (18%. A similar distribution was seen among controls. When comparing cases and controls with chromosomal abnormalities, the cases had a significantly higher prevalence of malformations (95% vs. 77%, p=0.004. Analyzed the other way around, cases with malformations had a significantly higher proportion of chromosomal abnormalities compared with controls, (66% vs. 31%, p<0.001.The presence of fetal calcifications is associated with high risk of chromosomal abnormality in combination with malformations. Identification of a calcification together with a malformation at autopsy more than doubles the probability of detecting a chromosomal abnormality, compared with identification of a malformation only. We propose that identification of a fetal tissue calcification at autopsy, and potentially also at ultrasound examination, should infer

  13. Electrocardiographic abnormalities and serum magnesium in patients with subarachnoid hemorrhage

    NARCIS (Netherlands)

    van den Bergh, Walter M; Algra, Ale; Rinkel, Gabriël J E

    2004-01-01

    BACKGROUND AND PURPOSE: ECG abnormalities and hypomagnesemia frequently occur after aneurysmal subarachnoid hemorrhage (SAH). Because hypomagnesemia is associated with several ECG abnormalities, we studied whether hypomagnesemia mediates ECG abnormalities after SAH. METHODS: We prospectively studied

  14. Chromosomal abnormalities in men with pregestational and gestational infertility in northeast China.

    Science.gov (United States)

    Li, Dingyang; Zhang, Hongguo; Wang, Ruixue; Zhu, Haibo; Li, Linlin; Liu, Ruizhi

    2012-08-01

    To detect incidences and the types of chromosomal abnormalities in Chinese men with infertility and determine chromosomal factors association with various phenotypes. Semen analysis and karyotype analysis by G-banding were carried out in 4,659 idiopathic infertile males; additionally, multiplex PCR using nine specific sequence-tagged sites (STSs) was used to detect azoospermia factor (AZF) microdeletions in 412 patients with Y chromosomal abnormalities. Male infertility was divided into pregestational infertility, characterized by failure to produce a fertilized ovum, and gestational infertility, characterized by embryo loss after fertilization. The former can result from azoospermia, oligozoospermia or oligoasthenozoospermia syndrome, while the latter is associated with developmental early pregnancy loss, habitual miscarriage and stillbirth. Among 4,659 male patients, 412 (8.84 %) showed abnormal chromosomal karyotypes, including 314 (6.74 %) with sex chromosomal abnormalities and 98 (2.10 %) with autosomal abnormalities. The prevalences of numerical and structural abnormalities among patients with chromosomal abnormalities were 259/412 (62.86 %) and 153/412 (37.14 %), respectively. Furthermore, structural sex chromosomal abnormalities were represented by various phenotypic profiles (46,XX, 47,XYY and 45,X/46,XY), and a prevalence of AZF microdeletions of 19/79 (24.05 %). AZF microdeletions were highly associated with Y chromosomal abnormalities (P = 0.018). Various chromosomal abnormalities that result in male infertility could affect spermatogenesis or embryonic development at different levels. Sex chromosomal and autosomal abnormalities were highly associated with pregestational and gestational infertility, respectively. AZF microdeletions may play an important role in lowering the stability of the Y chromosome.

  15. ADEPT - Abnormal Doppler Enteral Prescription Trial

    Directory of Open Access Journals (Sweden)

    McCormick Kenny

    2009-10-01

    Full Text Available Abstract Background Pregnancies complicated by abnormal umbilical artery Doppler blood flow patterns often result in the baby being born both preterm and growth-restricted. These babies are at high risk of milk intolerance and necrotising enterocolitis, as well as post-natal growth failure, and there is no clinical consensus about how best to feed them. Policies of both early milk feeding and late milk feeding are widely used. This randomised controlled trial aims to determine whether a policy of early initiation of milk feeds is beneficial compared with late initiation. Optimising neonatal feeding for this group of babies may have long-term health implications and if either of these policies is shown to be beneficial it can be immediately adopted into clinical practice. Methods and Design Babies with gestational age below 35 weeks, and with birth weight below 10th centile for gestational age, will be randomly allocated to an "early" or "late" enteral feeding regimen, commencing milk feeds on day 2 and day 6 after birth, respectively. Feeds will be gradually increased over 9-13 days (depending on gestational age using a schedule derived from those used in hospitals in the Eastern and South Western Regions of England, based on surveys of feeding practice. Primary outcome measures are time to establish full enteral feeding and necrotising enterocolitis; secondary outcomes include sepsis and growth. The target sample size is 400 babies. This sample size is large enough to detect a clinically meaningful difference of 3 days in time to establish full enteral feeds between the two feeding policies, with 90% power and a 5% 2-sided significance level. Initial recruitment period was 24 months, subsequently extended to 38 months. Discussion There is limited evidence from randomised controlled trials on which to base decisions regarding feeding policy in high risk preterm infants. This multicentre trial will help to guide clinical practice and may also

  16. Cerebral abnormalities in adults with ataxia-telangiectasia.

    Science.gov (United States)

    Lin, D D M; Barker, P B; Lederman, H M; Crawford, T O

    2014-01-01

    Ataxia-telangiectasia, an autosomal recessive disorder caused by defect of the ataxia-telangiectasia mutated gene, is characterized by progressive neurologic impairment with cerebellar atrophy, ocular and cutaneous telangiectasia, immunodeficiency, heightened sensitivity to ionizing radiation and susceptibility to developing lymphoreticular malignancy. Supratentorial brain abnormalities have been reported only rarely. In this study, brain MRI was performed in 10 adults with ataxia-telangiectasia having stable neurologic impairment. Intracerebral telangiectasia with multiple punctate hemosiderin deposits were identified in 60% of subjects. These lesions were apparently asymptomatic. They are similar in appearance to radiation-induced telangiectasia and to cryptogenic vascular malformations. Also noted, in the 2 oldest subjects, was extensive white matter T2 hyperintensity, and in 1 of these a space-occupying fluid collection consistent with transudative capillary leak and edema as evidenced by reduced levels of metabolites on MR spectroscopic imaging. Asymptomatic supratentorial vascular abnormalities appear to be common in adults with ataxia-telangiectasia.

  17. Ossification of the Achilles tendon: imaging abnormalities in 12 patients

    Energy Technology Data Exchange (ETDEWEB)

    Yu, J.S. [Dept. of Radiology, Veterans Administration Medical Center, San Diego, CA (United States); Witte, D. [Dept. of Radiology, Veterans Administration Medical Center, San Diego, CA (United States); Resnick, D. [Dept. of Radiology, Veterans Administration Medical Center, San Diego, CA (United States); Pogue, W. [Dept. of Radiology, AMI Valley Medical Center, El Cajon, CA (United States)

    1994-02-01

    Ossification of the Achilles tendon is a rare clinical entity that is characterized by the presence of an ossific mass contained within the fibrocartilaginous substance of the tendon. Because the radiographic features of this condition have not been documented entirely and the magnetic resonance (MR) imaging findings have not been determined, a review of 16 affected tendons in 12 patients was performed in an attempt to characterize the imaging abnormalities associated with this process. MR imaging was performed in three Achilles tendons which demonstrated thickening of the tendons at the level of the ossifications and a lack of intratendinous signal abnormalities compatible with acute tendinitis. Signal intensity similar to that of bone marrow was present in the ossifications. (orig.)

  18. Characteristics of serum endocan levels in infection.

    Directory of Open Access Journals (Sweden)

    Kazunori Seo

    Full Text Available Endocan is a newly recognized biomarker of sepsis. However, there have been no studies of the trends in endocan levels during infection and their associations with other clinical factors. The aim of this study was to assess the time course of endocan levels and the associations of endocan with clinical factors during infection by comparison with other biomarkers.Serum samples and blood cultures were obtained from patients who were diagnosed with infection from June 2013 to March 2014. Serum endocan, C-reactive protein (CRP, and procalcitonin (PCT levels during four periods during infection were measured (day 0, day 1-2, day 3-5, and day 6-10.A total of 78 patients were enrolled in this study. The median endocan level decreased by only 23% during infection, whereas both serum CRP and PCT levels decreased by more than 80%. Endocan levels were correlated to neither CRP levels nor PCT levels in each period. Endocan levels at day 0 in patients with bacteremia were higher than those without bacteremia (1.09 ng/mL vs 0.82 ng/mL, P=0.002, but neither CRP levels nor PCT levels at day 0 were different between the two groups. Areas under the receiver operator characteristic (ROC curves of endocan, CRP, and PCT at day 0 were 0.662, 0.343, and 0.563, respectively. Positive blood cultures tended to be related to high endocan levels, but not significantly (odds ratio: 4.24, 95% CI: 0.99-10.34, P=0.05.In bacteremic cases, serum endocan levels in bacteremia tended to be higher than in non-bacteremic cases. Although endocan level was not identified as a prognostic factor of bacteremia, further prospective study concerning the relationship between serum endocan level and bacteremia would be needed.

  19. Ocular abnormalities in multi-transfused beta-thalassemia patients

    Directory of Open Access Journals (Sweden)

    Reza Jafari

    2015-01-01

    Full Text Available Aims: The aim of this study was to assess ocular changes in thalassemia patients who have received multiple transfusions and chelate binding therapy in order to avoid iron accumulation. Settings and Design: A cross-sectional study. Subjects and Methods: A total of 54 thalassemia major patients were selected as case group, and 54 age- and sex-matched healthy subjects were regarded as a control group. Ocular examination included visual acuity, refraction testing, slit lamp examination, funduscopy, tonometry, perimetry, tear break-up time test, and color vision testing were performed for all the participants. We computed the frequency and duration of blood transfusion, the mean serum ferritin level, pretransfusion hemoglobin concentration, and type, duration, and daily dose of chelation therapy for thalassemia patients based on their records. Statistical Analysis Used: All data analysis was performed using SPSS, version 19. Results: All the thalassemic patients were asymptomatic, but abnormal ocular findings (dry eye (33.3%, cataract (10.2%, retinal pigment epithelium degeneration (16.7%, color vision deficiency (3.7%, and visual field defects (33.7% were seen in 68.5% of thalassemic group. The prevalence of ocular abnormalities in normal group was 19.4%, which was significantly lower than that in thalassemia patients (P = 0.000. No significant correlation was found between ocular abnormalities and mean serum ferritin level (P = 0.627 and mean hemoglobin concentration (P = 0.143. Correlation of number of blood transfusion with the presence of ocular abnormalities was found to be statistically significant (P = 0.005. Conclusions: As life expectancy for beta-thalassemia patients extends, regular ophthalmological evaluation to detect early changes in their ocular system is recommended.

  20. Development of evaluation tool for the risk level of abnormal glucose metabolism morbidity in middle-aged and elder populations%中老年人群糖代谢异常患病危险度评估工具的开发研究

    Institute of Scientific and Technical Information of China (English)

    黄晓波; 黄斌; 魏东; 曾伟; 欧阳凌云; 刘雅; 栾荣生; 张廷杰; 徐俊波; 赵思勤; 李秀钧

    2010-01-01

    目的 研究开发适合中老年人群的糖代谢异常患病危险度评估工具.方法 于2008年4至11月采用分层整群抽样的方法,在成都城乡地区40~79岁中老年人口中开展问卷调查,并进行血压、空腹血糖、葡萄糖75 g餐后血糖、血脂、血尿酸、身高、体质量、腰围等检测,共获取有效调查资料5205份.进行判别分析及多因素Logistic回归分析,建立量化评分体系,ROC分析筛选量化评分体系的界点,336例体检人群验证简易评分模型判别效能.结果 判别分析男女模型准确度分别为79.04%和81.35%.年龄、工作体力强度、体育锻炼、家族史、兄弟姐妹糖尿病史、体质指数、腹型肥胖和高血压病史8个指标构成男性简易评分模型;年龄、工作体力强度、体育锻炼、家族史、兄弟姐妹糖尿病史、体质指数、腹型肥胖、高血压病史、分娩次数和妊娠糖尿病史构成女性简易评分模型.ROC曲线下面积男性模型为0.702,女性模型为0.728.在其他人群应用中男性模型灵敏度和特异度分别为86.86%和65.12%,女性模型灵敏度和特异度分别为88.89%和72.97%.结论 初步开发的中老年人群糖代谢异常患病危险度评估工具简便可行,有一定实用性,可应用于中老年人群糖代谢异常的筛查.%Objective To develop the evaluation tool for the risk level of abnormal glucose metabolism morbidity in the middle-aged and elder populations. Methods By the stratified cluster sampling method, a survey was conducted in middle-aged and elder populations aged 40 -70 years old in urban and rural areas of Chengdu during April-November 2008. The parameters included blood pressure, fasting blood glucose, blood glucose after oral administration of 75 g glucose, blood lipid, blood uric acid, height, body weight and waistline, etc. A total of 5205 valid copies of questionnaires were obtained. A discriminant analysis and a multifactorial logistic regression

  1. Tall gastrodis tuber combined with antiepileptic drugs repairs abnormal perfusion foci in focal epilepsy

    Institute of Scientific and Technical Information of China (English)

    Weimin Wang; Zhenyu Fan; Yongqin Zhang; Yuxia Yang; Yaqing Liu; Xiaoli Dang; Wenjun Song; Yinping Wu; Jiang Ye

    2013-01-01

    One hundred patients with focal epilepsy were recruited for the present study and their seizures controlled with antiepileptic drugs. The patients then orally received a capsule of tall gastrodis tuber powder, a traditional Chinese drug, and underwent single photon emission computed tomography, long-term electroencephalogram, and CT/MRI. Blood drug levels were monitored throughout the study. Before treatment with tall gastrodis tuber, 35 of the 100 cases had abnormal CT/MRI scans; 79 cases had abnormal single photon emission computed tomography images; 86 cases had abnormal electroencephalogram; and a total of 146 abnormal perfusion foci were observed across the 100 subjects. After treatment, the number of patients with normal single photon emission computed tomography images increased by 12; normal electroencephalogram was observed in an additional 27 cases and the number of patients with epileptiform discharge decreased by 29 (34% of 86); the total number of abnormal perfusion foci decreased by 52 (36%) and changes in abnormal foci were visible in 65 patients. These changes indicate that the administration of tall gastrodis tuber in combination with antiepileptic drugs repairs abnormal perfusion foci in patients with focal epilepsy. Our results demonstrate that traditional Chinese drugs can repair abnormal perfusion foci and, as such, are a promising new pathway in the treatment of focal epilepsy.

  2. Prevalence of Abnormity of Blood Lipid and Associated Factors in Health Examination Population in Beijing

    Institute of Scientific and Technical Information of China (English)

    Wei-ming Kang; Jie-shi Zhang; Xin-xin Liu; Min-shan Wang; Ming-li Zhao; Jian-chun Yu

    2009-01-01

    Objective To investigate the prevalence of abnormity of blood lipid and associated factors in healthy population in Beijing.Methods Totally,38462 individuals who received health examination were enrolled in our study.We divided them into eight groups according to their ages.The levels of serum total cholesterol,triglyceride,high density lipoprotein cholesterol,and low density lipoprotein cholesterol were tested,and the relationship of blood lipid abnormity with body mass index(BMI)and fasting blood glucose was analyzed.Results The incidences of hypercholesterolemia,hyperglyceridemia,low high-density lipoprotein cholesterolemia,and hyper low-density lipoprotein cholesterolemia presented increasing trend in this population.The incidence rate of abnormity of blood lipid in health examination population increased with BMI increase.The incidence of abnormity of blood lipid in overweight and obesity population was significantly higher than that in low weight and normal weight populations(P<0.05).Meanwhile,the trend of abnormal blood lipid incidence coincided with that of abnormal fasting blood glucose.Conclusions The prevalence of overweight,obesity,and abnormity of blood lipid in Beijing presents increasing trend.The incidence of abnormity of blood lipid increases with BMI increase,in coincidence with that of fasting blood glucose.

  3. MRI of fetal GI tract abnormalities.

    Science.gov (United States)

    Veyrac, C; Couture, A; Saguintaah, M; Baud, C

    2004-01-01

    We describe the magnetic resonance (MR) patterns of a variety of fetal gastrointestinal (GI) abnormalities. Thirty-two fetuses between 23 and 38 weeks' gestation with abnormal appearance of the GI tract by ultrasound underwent MR imaging with T1- and T2-weighted sequences. The MR aspect of intestinal atresia (duodenal atresia, one case; small bowel atresia, nine cases) included dilatation of the bowel loops, accurate assessment of the normal bowel distal to the atresia (except in the patient with multiple atresia and apple-peel syndrome), and micro-rectum with decreased T1 signal (except in the patient with duodenal atresia). Megacystis-microcolon-intestinal hypoperistalsis syndrome (one case) was indicated by an abnormal signal of the entire bowel and an abnormal pattern for the urinary tract. Meconium pseudocysts (two cases) were easily differentiated from enteric cysts (two cases). High anorectal malformations with (two cases) o