Reply to “Mid-regional pro-adrenomedullin (MR-proADM): An even better prognostic biomarker than C reactive protein to predict short-term survival in patients with decompensated cirrhosis at risk of infection?”

Inflammatory markers including C-Reactive Protein (CRP) are increasingly used within research and clinical settings. Yet, varying methodologies for cleaning immunoassay data with out of range (OOR) samples may alter characteristic levels of CRP, thereby obscuring interpretation and reliability. This study investigated the influence of eight immunoassay OOR data treatment techniques on salivary CRP (sCRP) samples from at-risk adolescents. Participants from the ‘Sleep and Education: learning New Skills Early’ (SENSE) Study were 86 adolescents at-risk for depression (50 female), aged 14.29 years (SD=1.04). ANOVA results showed no statistically significant differences in average morning (F(7, 590)=1.24, p=.28) and evening (F(7, 599)=1.29, p=.25) values produced by each OOR data cleaning technique. However, varying techniques produced differences in the magnitude of Pearson’s correlations between consecutive saliva samples (r’s between .27 – .78), and influenced the significance of a sCRP diurnal pattern; two techniques produced statistically higher morning than evening sCRP levels (t(85)=2.70, p=.01 and t(85)=2.67, p=.01), whereas six techniques failed to find statistical differences between morning and evening sCRP levels (p’s >.05). Varying techniques also produced statistically divergent associations between sCRP and age and depressive symptoms. Results from this study provide evidence for the temporal stability of sCRP among adolescents, show winsorization as an effective OOR data management technique, and highlight the influence of methodological decisions in cleaning salivary biomarker data and the need for consistency within the field.

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Faculty Opinions recommendation of Complement factor H binding of monomeric C-reactive protein downregulates proinflammatory activity and is impaired with at risk polymorphic CFH variants.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726209963.793516084 ◽

2016 ◽

Author(s):

Toshiyuki Miyata

Keyword(s):

At Risk ◽

Factor H ◽

Complement Factor H ◽

Complement Factor ◽

C Reactive Protein ◽

Reactive Protein ◽

Proinflammatory Activity

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Short term effect of atorvastatin on plasma levels of MCP-1, ICAM-1 and C-reactive protein in patients with coronary artery disease

Atherosclerosis ◽

10.1016/s0021-9150(00)80209-9 ◽

2000 ◽

Vol 151 (1) ◽

pp. 46

Author(s):

A Figueredo ◽

L Reinares ◽

A Rueda ◽

A Rodriguez ◽

M Ruiz-Yagüe ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Plasma Levels ◽

Term Effect ◽

C Reactive Protein ◽

Short Term ◽

Short Term Effect ◽

Reactive Protein ◽

Artery Disease

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Influence of age and shock severity on short-term survival in patients with cardiogenic shock

European Heart Journal Acute Cardiovascular Care ◽

10.1093/ehjacc/zuaa035 ◽

2021 ◽

Author(s):

Jacob C Jentzer ◽

Benedikt Schrage ◽

David R Holmes ◽

Salim Dabboura ◽

Nandan S Anavekar ◽

...

Keyword(s):

Cardiogenic Shock ◽

Mayo Clinic ◽

Older Patients ◽

Cox Proportional Hazards ◽

Circulatory Support ◽

Short Term ◽

Term Survival ◽

Risk Of Death ◽

Coronary Syndrome ◽

Short Term Survival

Abstract Aims Cardiogenic shock (CS) is associated with poor outcomes in older patients, but it remains unclear if this is due to higher shock severity. We sought to determine the associations between age and shock severity on mortality among patients with CS. Methods and results Patients with a diagnosis of CS from Mayo Clinic (2007–15) and University Clinic Hamburg (2009–17) were subdivided by age. Shock severity was graded using the Society for Cardiovascular Angiography and Intervention (SCAI) shock stages. Predictors of 30-day survival were determined using Cox proportional-hazards analysis. We included 1749 patients (934 from Mayo Clinic and 815 from University Clinic Hamburg), with a mean age of 67.6 ± 14.6 years, including 33.6% females. Acute coronary syndrome was the cause of CS in 54.0%. The distribution of SCAI shock stages was 24.1%; C, 28.0%; D, 33.2%; and E, 14.8%. Older patients had similar overall shock severity, more co-morbidities, worse kidney function, and decreased use of mechanical circulatory support compared to younger patients. Overall 30-day survival was 53.3% and progressively decreased as age or SCAI shock stage increased, with a clear gradient towards lower 30-day survival as a function of increasing age and SCAI shock stage. Progressively older age groups had incrementally lower adjusted 30-day survival than patients aged <50 years. Conclusion Older patients with CS have lower short-term survival, despite similar shock severity, with a high risk of death in older patients with more severe shock. Further research is needed to determine the optimal treatment strategies for older CS patients.

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Parenteral Nutrition and Oxidant Load in Neonates

Nutrients ◽

10.3390/nu13082631 ◽

2021 ◽

Vol 13 (8) ◽

pp. 2631

Author(s):

Kandeepan Karthigesu ◽

Robert F. Bertolo ◽

Robert J. Brown

Keyword(s):

Parenteral Nutrition ◽

Storage Temperature ◽

Oral Feeding ◽

Published Data ◽

Short Term ◽

Antioxidant Defences ◽

Term Survival ◽

Nutrient Sources ◽

Short Term Survival

Neonates with preterm, gastrointestinal dysfunction and very low birth weights are often intolerant to oral feeding. In such infants, the provision of nutrients via parenteral nutrition (PN) becomes necessary for short-term survival, as well as long-term health. However, the elemental nutrients in PN can be a major source of oxidants due to interactions between nutrients, imbalances of anti- and pro-oxidants, and environmental conditions. Moreover, neonates fed PN are at greater risk of oxidative stress, not only from dietary sources, but also because of immature antioxidant defences. Various interventions can lower the oxidant load in PN, including the supplementation of PN with antioxidant vitamins, glutathione, additional arginine and additional cysteine; reduced levels of pro-oxidant nutrients such as iron; protection from light and oxygen; and proper storage temperature. This narrative review of published data provides insight to oxidant molecules generated in PN, nutrient sources of oxidants, and measures to minimize oxidant levels.

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