Comment on Sigmund et al. “Inferior performance of established and novel serum inflammatory markers in diagnosing periprosthetic joint infections”

2021 ◽  
Author(s):  
Nan Jiang ◽  
Bin Yu
Keyword(s):  
Inflammatory Markers ◽  
Joint Infections ◽  
Serum Inflammatory Markers

scholarly journals Inferior performance of established and novel serum inflammatory markers in diagnosing periprosthetic joint infections

2020 ◽  
Author(s):  
Irene Katharina Sigmund ◽  
Johannes Holinka ◽  
Kevin Staats ◽  
Florian Sevelda ◽  
Richard Lass ◽  
...  
Keyword(s):  
Platelet Count ◽  
Inflammatory Markers ◽  
Volume Ratio ◽  
Diagnostic Value ◽  
C Reactive Protein ◽  
Platelet Volume ◽  
Reactive Protein ◽  
Joint Infections ◽  
Serum Crp ◽  
Serum Inflammatory Markers

Abstract Purpose Besides other diagnostic test methods, established serum inflammatory markers such as serum C-reactive protein or leukocyte count are widely used preoperatively to aid in diagnosing periprosthetic joint infections (PJI). Although low accuracies were reported, these parameters are easily accessible and routinely available. Novel biomarkers with promising results in diagnosing PJI (platelet count to mean platelet volume ratio) or other infectious conditions (percentage of neutrophils, neutrophils to lymphocytes ratio) were described. The purpose of this study was to investigate the diagnostic value of established and novel serum inflammatory biomarkers for the diagnosis of PJI so as to compare the results to find the serum inflammatory marker with the best performance. Methods In 177 patients with a previous total hip (n = 91) or knee (n = 86) arthroplasty and indicated revision surgery, the diagnostic value of the routinely available serum inflammatory markers C-reactive protein (CRP), white blood cell count (WBC), percentage of neutrophils (%N), neutrophils to lymphocytes ratio (NLR), fibrinogen and platelet count to mean platelet volume ratio (PC/mPV) were examined retrospectively via receiver operating characteristic curve analysis (AUC). The curves were compared using the z-test. Results Sensitivities of serum CRP, WBC, %N, NLR, fibrinogen and PC/mPV were calculated with 68%, 36%, 66%, 63%, 69% and 43%, respectively. Specificities were 87%, 89%, 67%, 73%, 89% and 81%, respectively. Serum CRP (0.78) and fibrinogen (0.79) showed significantly better AUCs compared with serum WBC (0.63), %N (0.67), NLR (0.68) and PC/mPV (0.62) (p < 0.0001). Patients with PJI caused by a low-virulent microorganism (median CRP: 17.6 mg/L) obtained lower CRP levels compared with infections caused by high-virulent microorganisms (median CRP: 49.2 mg/L; p = 0.044). The combination of CRP and fibrinogen showed a better sensitivity (77%) with similar specificity (83%) than one method alone but not at a significant level (CRP (p = 0.200); fibrinogen (p = 0.437)). Conclusion Serum CRP and fibrinogen showed the best accuracies among these widely available serum inflammatory parameters. However, due to the insufficient performance, these biomarkers can only be recommended as suggestive criteria in diagnosing PJI. The preoperative workup should always be complemented by more specific tests such as synovial fluid analysis.

scholarly journals Prognostic significance of bone marrow and spleen 18F-FDG uptake in patients with colorectal cancer

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jae-Hoon Lee ◽  
Hye Sun Lee ◽  
Soyoung Kim ◽  
Eun Jung Park ◽  
Seung Hyuk Baik ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Bone Marrow ◽  
Inflammatory Markers ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Uptake Ratio ◽  
Liver Uptake ◽  
Fdg Uptake ◽  
Standardized Uptake Values ◽  
Serum Inflammatory Markers

AbstractSerum inflammatory markers are used in the prognostication of colorectal cancer (CRC); however, the corresponding role of positron emission tomography (PET)-derived inflammatory markers remains unclear. This study aimed to investigate the prognostic value of 18F-fluorodeoxyglucose (FDG) uptake in the bone marrow and spleen of patients with CRC and evaluate the relationship between FDG uptake estimates in these organs and serum inflammatory markers. In total, 411 patients who underwent preoperative FDG PET/computed tomography (CT) within 1 month of surgery were enrolled. The mean standardized uptake values of the bone marrow and spleen were normalized to the value of the liver, thereby generating bone marrow-to-liver uptake ratio (BLR) and spleen-to-liver uptake ratio (SLR) estimates. The value of BLR and SLR in predicting overall survival (OS) was assessed using the Cox proportional hazards model. The correlation between BLR or SLR and neutrophil-to-lymphocyte ratio (NLR) was evaluated. The predictive accuracy of BLR alone and in combination with SLR was compared using the integrated area under the receiver operating characteristic curves (iAUC). In the univariate analysis, BLR (> 1.06) and SLR (> 0.93) were significant predictors of OS. In the multivariate analysis, BLR was an independent predictor of OS (hazard ratio = 5.279; p < 0.001). Both BLR and SLR were correlated with NLR (p < 0.001). A combination of BLR and SLR was better than BLR alone at CRC prognostication (iAUC, 0.561 vs. 0.542). FDG uptake estimates in the bone marrow and spleen may be useful imaging-derived biomarkers of systemic inflammation, supporting CRC prognostication.

Diagnostic accuracy of serum inflammatory markers in late fracture-related infection

2018 ◽  
Vol 100-B (12) ◽  
pp. 1542-1550 ◽  
Author(s):  
J. van den Kieboom ◽  
P. Bosch ◽  
J. D. J. Plate ◽  
F. F. A. IJpma ◽  
R. Kuehl ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Inflammatory Markers ◽  
Meta Analysis ◽  
Diagnostic Value ◽  
Mixed Effects Models ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Serum Inflammatory Markers

Aims To assess the diagnostic value of C-reactive protein (CRP), leucocyte count (LC), and erythrocyte sedimentation rate (ESR) in late fracture-related infection (FRI). Materials and Methods PubMed, Embase, and Cochrane databases were searched focusing on the diagnostic value of CRP, LC, and ESR in late FRI. Sensitivity and specificity combinations were extracted for each marker. Average estimates were obtained using bivariate mixed effects models. Results A total of 8284 articles were identified but only six were suitable for inclusion. Sensitivity of CRP ranged from 60.0% to 100.0% and specificity from 34.3% to 85.7% in all publications considered. Five articles were pooled for meta-analysis, showing a sensitivity and specificity of 77.0% and 67.9%, respectively. For LC, this was 22.9% to 72.6%, and 73.5% to 85.7%, respectively, in five articles. Four articles were pooled for meta-analysis, resulting in a 51.7% sensitivity and 67.1% specificity. For ESR, sensitivity and specificity ranged from 37.1% to 100.0% and 59.0% to 85.0%, respectively, in five articles. Three articles were pooled in meta-analysis, showing a 45.1% sensitivity and 79.3% specificity. Four articles analyzed the value of combined inflammatory markers, reporting an increased diagnostic accuracy. These results could not be pooled due to heterogeneity. Conclusion The serum inflammatory markers CRP, LC, and ESR are insufficiently accurate to diagnose late FRI, but they may be used as a suggestive sign in its diagnosis.

scholarly journals Serum inflammatory markers as predictors of neurological status in patients with stroke in the course of hypertension: a two-center study

2018 ◽  
Vol 22 (2) ◽  
pp. 87-94
Author(s):  
Martyna Anna Nowak ◽  
Maria Magdalena Nowak ◽  
Paula Irmina Walczak ◽  
Maciej Wojciech Olszewski ◽  
Natalia Niedziela MD, PhD ◽  
...  
Keyword(s):  
Inflammatory Markers ◽  
Neurological Status ◽  
Serum Inflammatory Markers ◽  
Center Study

Effects of Metformin-Single Therapy on the Level of Inflammatory Markers in Serum of Non-Obese T2DM Patients with NAFLD

2021 ◽  
Vol 21 ◽  
Author(s):  
Bojan Mitrovic ◽  
Zoran Gluvic ◽  
Djuro Macut ◽  
Milan Obradovic ◽  
Emina Sudar-Milovanovic ◽  
...  
Keyword(s):  
Fatty Liver ◽  
Inflammatory Markers ◽  
Liver Steatosis ◽  
Diagnostic Procedures ◽  
Abdominal Ultrasound ◽  
C Reactive Protein ◽  
Subsequent Increase ◽  
Alcoholic Fatty Liver ◽  
Reactive Protein ◽  
Serum Inflammatory Markers

Background and Objectives : Non-alcoholic fatty liver disease (NAFLD) is associated with inflammation and subsequent increase in cardiovascular risk. Because of its widespread presence and distribution, invasive diagnostic procedures (i.e., liver biopsy) are reserved for a limited number of subjects. With liver ultrasound, Fatty liver index (FLI) and fibrosis-4 (FIB-4) scores non-invasively assess liver steatosis and fibrosis. We aimed to evaluate the changes in inflammatory markers and FLI/FIB-4 scores in non-obese metformin-treated type 2 diabetes patients (T2DM) with NAFLD. Methods: All subjects underwent abdominal ultrasound aiming for NAFLD stratification (grade 1 to 3 according to its severity). Metabolic parameters (morning glycaemia, HbA1C, lipids, liver function tests) and serum inflammatory markers (C-reactive protein, ferritin, and nitric oxide), and FLI/FIB-4 are calculated. Results: FLI score and ultrasound NAFLD grades correlated (p<0.05). We observed a significant correlation between the levels of ferritin and C-reactive protein (CRP) (p<0.05), and the FLI (p<0.05). Body weight (BW) (p<0.05), waist circumference (WC) (p<0.05), the levels of HbA1c (p<0.05), transferrin (p<0.05), insulin (p<0.05), and FLI score (p<0.05) significantly differed between groups defined by the severity of NAFLD. Conclusion: This pilot study suggests that the serum inflammatory markers at the average normal values point to the sufficiency of metformin-single therapy in inflammation control in non-obese T2DM patients with NAFLD.

scholarly journals Acute elevation of serum inflammatory markers predicts symptom recovery after concussion

Neurology ◽  
2019 ◽  
Vol 93 (5) ◽  
pp. e497-e507 ◽  
Author(s):  
Morgan E. Nitta ◽  
Jonathan Savitz ◽  
Lindsay D. Nelson ◽  
T. Kent Teague ◽  
James B. Hoelzle ◽  
...  
Keyword(s):  
Inflammatory Markers ◽  
Assessment Tool ◽  
Characteristic Curve ◽  
Serum Levels ◽  
Outcome Variable ◽  
Duration Of Symptoms ◽  
Severity Scores ◽  
Symptom Recovery ◽  
Factor C ◽  
Serum Inflammatory Markers

ObjectiveTo test the hypothesis that acute elevations in serum inflammatory markers predict symptom recovery after sport-related concussion (SRC).MethodsHigh school and collegiate football players (n = 857) were prospectively enrolled. Forty-one athletes with concussion and 43 matched control athletes met inclusion criteria. Serum levels of interleukin (IL)–6, IL-1β, IL-10, tumor necrosis factor, C-reactive protein, interferon-γ, and IL-1 receptor antagonist and Sport Concussion Assessment Tool, 3rd edition (SCAT3) symptom severity scores were collected at a preinjury baseline, 6 and 24–48 hours postinjury, and approximately 8, 15, and 45 days following concussion. The number of days that athletes were symptomatic following SRC (i.e., duration of symptoms) was the primary outcome variable.ResultsIL-6 and IL-1RA were significantly elevated in athletes with concussion at 6 hours relative to preinjury and other postinjury visits, as well as compared to controls (ps ≤ 0.001). IL-6 and IL-1RA significantly discriminated concussed from control athletes at 6 hours postconcussion (IL-6 area under receiver operating characteristic curve 0.79 [95% confidence interval (CI) 0.65–0.92], IL-1RA AUC 0.79 [95% CI 0.67–0.90]). Further, IL-6 levels at 6 hours postconcussion were significantly associated with the duration of symptoms (hazard ratio for symptom recovery = 0.61 [95% CI 0.38–0.96], p = 0.031).ConclusionsResults support the potential utility of IL-6 and IL-1RA as serum biomarkers of SRC and demonstrate the potential of these markers in identifying athletes at risk for prolonged recovery after SRC.Classification of evidenceThis study provides Class III evidence that serum levels of IL-6 and IL-1RA 6 hours postconcussion significantly discriminated concussed from control athletes.

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