P5610Inflammatory response after ExoVasc personalized external aortic root support (PEARS) procedure in patients with Marfan syndrome or non-Marfan genetic aortopathy

Abstract Background External aortic root support (PEARS) is a novel prophylactic aortic root surgery. Purpose The study aimed to determine the severity of inflammatory response after the personalized external aortic root support (PEARS) procedure in comparison to after the standard prophylactic aortic root surgery (SPARS). Materials and methods The study was a single-centre, retrospective, based on hospital record analysis of patients who underwent the PEARS procedure (PEARS group) or SPARS (SPARS group) during 1998–2017. C-reactive protein (CRP), white blood count (WBC), and echocardiography were routinely obtained. Fever was defined as body temperature ≥38°C. Diagnosis of pericarditis included a minimum of three signs from chest pain, pericardial effusion, ST elevation, elevated CRP, and body temperature. Results PEARS and SPARS groups consisted of 13 and 14 patients, respectively, scheduled for prophylactic aortic root surgery. A majority of patients in both groups had Marfan syndrome with causal mutation in the fibrillin 1 (FBN1) gene (62% vs 79%). Patient baseline characteristics were similar in the two groups, except aortic root was significantly larger in the SPARS group than in the PEARS group (60±12 mm vs 48±5 mm; P=0.003). All surgical procedures were successful and without major complications. The peak values of CRP and WBC were significantly higher in the PEARS group (264.5±84.4 mg/L vs 184.6±89.6 mg/L; P=0.034 and 15.2±3.8 109/L vs 11.9±3.3 109/L; P=0.029). Early and recurrent fever requiring hospital readmission was significantly more frequent in the PEARS group (77% vs 36%; P=0.032 and 46% vs 7%; P=0.020). Early and recurrent pericarditis requiring hospital readmission was also more frequent in the PEARS group (31% vs 0%; P=0.024 and 31% vs 0%; P=0.024). Inflammatory characteristics Postprocedural inflammatory characteristics PEARS group SPARS group P value (N=13) (N=14) Peak level of CRP (mg/L) 264.5±84.4 184.6±89.6 0.034 Peak WBC (109/L) 15.2±3.8 11.9±3.3 0.029 ST elevation (N) 11 (85) 6 (43) 0.024 Early fever (N) 10 (77) 5 (36) 0.032 Recurrent fever (N) 6 (46) 1 (7) 0.020 Early pericarditis (N) 4 (31) 0 (0) 0.024 Recurrent pericarditis (N) 4 (31) 0 (0) 0.024 CRP, C-reactive protein; WBC, white blood count. Echocardiography-signs of inflammation Conclusions The PEARS procedure is an extremely promising surgical technique, but the postoperative inflammatory response occurs frequently and more severely in comparison to SPARS. Clearly, these findings warrant further investigation.

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Diagnostic value of C- reactive protein and white blood count in patients with suspicious appendicitis

Medical Journal of Tabriz University of Medical Sciences and Health Services ◽

10.34172/mj.2019.041 ◽

2019 ◽

Vol 41 (4) ◽

pp. 17-24

Author(s):

Shiva Pakzad ◽

Mehryar Nahaei ◽

Siamak Farzaneh ◽

Rahim Mahmodlou ◽

Masoumeh Pourjabali

Keyword(s):

Blood Count ◽

Diagnostic Value ◽

White Blood Count ◽

C Reactive Protein ◽

Reactive Protein

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The Correlation between Complete Blood Count Parameters and Appendix Diameter for the Diagnosis of Acute Appendicitis

Healthcare ◽

10.3390/healthcare8010039 ◽

2020 ◽

Vol 8 (1) ◽

pp. 39 ◽

Cited By ~ 2

Author(s):

Emin Daldal ◽

Hasan Dagmura

Keyword(s):

Acute Appendicitis ◽

Laboratory Tests ◽

Blood Count ◽

Complete Blood Count ◽

Lymphoid Hyperplasia ◽

White Blood Count ◽

C Reactive Protein ◽

Distribution Width ◽

Lymphocyte Ratio ◽

Reactive Protein

Acute appendicitis is one of the most common causes of acute abdominal diseases seen between the ages of 10 and 19, mostly seen in males. The lifetime risk of developing acute appendicitis is 8.6% for males and 6.7% for females. We aimed to investigate the efficacy of the complete blood count parameters, C-reactive protein, and Lymphocyte-C-reactive Protein Ratio laboratory tests in the diagnosis of acute appendicitis, as well as their relationship with appendix diameter. We retrospectively examined all patients who underwent appendectomy between 1 January 2012 and 30 June 2019 in the General Surgery Clinic of Gaziosmanpasa University Faculty of Medicine. Laboratory tests, imaging findings, age, and gender were recorded. Lymphoid hyperplasia is considered as normal appendix—in other words, as negative appendicitis. The distribution of Lymphoid hyperplasia and appendicitis rates were statistically different in the groups formed according to appendix diameter (≤6 and >6 mm) (p < 0.001). We found a significant correlation between appendix diameter and WBC (White blood count), Lymphocyte, Neutrophil, RDW(Red blood cell distribution width), NLR(Neutrophil to lymphocyte ratio), and PLT/L (Platelet to lymphocyte ratio), MPV (Mean platelet volume) and RDW were significantly different in patients with an appendix diameter of ≤6 mm (p = 0.007, p = 0.006, respectively). WBC, Neutrophil, PDW, and NLR values were significantly different between appendicitis and hyperplasia groups in patients with an appendix diameter of >6 mm. The sensitivity of the NLR score (cutoff = 2.6057) in the diagnosis of appendicitis was 86.1% and selectivity was 50% in these patients. Complete blood count parameters evaluation with the clinical findings revealed that NLR is an important parameter that may help the diagnosis of acute appendicitis with an appendix diameter of >6 mm. In patients whose pathological results indicated acute appendicitis but who had a diameter of ≤6 mm, we found an elevated MPV and low RDW values.

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Correlation of serum C-reactive protein, white blood count and neutrophil percentage with histopathology findings in acute appendicitis

World Journal of Emergency Surgery ◽

10.1186/1749-7922-7-27 ◽

2012 ◽

Vol 7 (1) ◽

pp. 27 ◽

Cited By ~ 23

Author(s):

Shefki Xharra ◽

Lumturije Gashi-Luci ◽

Kumrije Xharra ◽

Fahredin Veselaj ◽

Besnik Bicaj ◽

...

Keyword(s):

Acute Appendicitis ◽

Blood Count ◽

White Blood Count ◽

C Reactive Protein ◽

Reactive Protein ◽

Neutrophil Percentage

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Can CRP Levels Predict Infection in Presumptive Aseptic Long Bone Non-Unions? A Prospective Cohort Study

Journal of Clinical Medicine ◽

10.3390/jcm10030425 ◽

2021 ◽

Vol 10 (3) ◽

pp. 425

Author(s):

Theodoros H. Tosounidis ◽

Colin Holton ◽

Vasileios P. Giannoudis ◽

Nikolaos K. Kanakaris ◽

Robert M. West ◽

...

Keyword(s):

Revision Surgery ◽

Blood Count ◽

Clinical Signs ◽

Long Bone ◽

White Blood Count ◽

Full Blood Count ◽

Low Grade ◽

Risk Of Infection ◽

C Reactive Protein ◽

Reactive Protein

Nonunion remains a major complication of the management of long bone fractures. The primary aim of the present study was to investigate whether raised levels of C-reactive protein (CRP) and white blood cell count (WBC), in the absence of clinical signs, are correlated with positive intraoperative tissue cultures in presumptive aseptic long-bone nonunions. Infection was classified as positive if any significant growth of microorganisms was observed from bone/tissue samples sent from the theater at the time of revision surgery. Preoperatively all patients were investigated with full blood count, white blood count differential as well as C-reactive protein (CRP). A total of 105 consecutive patients (59 males) were included in the study, with an average age of 46.76 years (range 16–92 years) at the time of nonunion diagnosis. The vast majority were femoral (56) and tibial (37) nonunions. The median time from the index surgical procedure to the time of nonunion diagnosis was 10 months (range 9 months to 10 years). Positive cultures revealed a mixed growth of microorganisms, with coagulase-negative Staphylococcus (56.4%) being the most prevalent microorganism, followed by Staphylococcusaureus (20.5%). Pseudomonas, Methicillin-Resistant Staphylococcus aureus (MRSA), coliforms and micrococcus were present in the remainder of the cases (23.1%). Overall, the risk of infection with normal CRP levels (<10 mg/L) was 21/80 = 0.26. Elevated CRP levels (≥10 mg/L) increased the risk of infection to 0.72. The relative risk given a positive CRP test was RR = 0.72/0.26 = 2.74. Overall, the WBC count was found to be an unreliable marker to predict infection. Solid union was achieved in all cases after an average of 6.5 months (3–24 months) from revision surgery. In patients with presumed aseptic long bone nonunion and normal CRP levels, the risk of underlying low-grade indolent infection can be as high as 26%. Patients should be made aware of this finding, which can complicate their treatment course and outcomes.

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C-Reactive Protein, Procalcitonin, and White Blood Count to Rule Out Neonatal Early-onset Sepsis Within 36 Hours: A Secondary Analysis of the Neonatal Procalcitonin Intervention Study

Clinical Infectious Diseases ◽

10.1093/cid/ciaa876 ◽

2020 ◽

Author(s):

Martin Stocker ◽

Wendy van Herk ◽

Salhab el Helou ◽

Sourabh Dutta ◽

Frank A B A Schuerman ◽

...

Keyword(s):

Antibiotic Therapy ◽

Early Onset ◽

Blood Count ◽

Intervention Study ◽

Secondary Analysis ◽

White Blood Count ◽

C Reactive Protein ◽

Reactive Protein ◽

Early Onset Sepsis ◽

Rule Out

Abstract Background Neonatal early-onset sepsis (EOS) is one of the main causes of global neonatal mortality and morbidity, and initiation of early antibiotic treatment is key. However, antibiotics may be harmful. Methods We performed a secondary analysis of results from the Neonatal Procalcitonin Intervention Study, a prospective, multicenter, randomized, controlled intervention study. The primary outcome was the diagnostic accuracy of serial measurements of C-reactive protein (CRP), procalcitonin (PCT), and white blood count (WBC) within different time windows to rule out culture-positive EOS (proven sepsis). Results We analyzed 1678 neonates with 10 899 biomarker measurements (4654 CRP, 2047 PCT, and 4198 WBC) obtained within the first 48 hours after the start of antibiotic therapy due to suspected EOS. The areas under the curve (AUC) comparing no sepsis vs proven sepsis for maximum values of CRP, PCT, and WBC within 36 hours were 0.986, 0.921, and 0.360, respectively. The AUCs for CRP and PCT increased with extended time frames up to 36 hours, but there was no further difference between start to 36 hours vs start to 48 hours. Cutoff values at 16 mg/L for CRP and 2.8 ng/L for PCT provided a sensitivity of 100% for discriminating no sepsis vs proven sepsis. Conclusions Normal serial CRP and PCT measurements within 36 hours after the start of empiric antibiotic therapy can exclude the presence of neonatal EOS with a high probability. The negative predictive values of CRP and PCT do not increase after 36 hours.

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Novel biomarkers of infection in the critically ill

10.1093/med/9780199600830.003.0282 ◽

2016 ◽

Author(s):

David T. Huang ◽

Ayan Sen

Keyword(s):

Blood Count ◽

Specific Treatment ◽

High Sensitivity ◽

Signs And Symptoms ◽

White Blood Count ◽

C Reactive Protein ◽

Reactive Protein ◽

Severe Infections ◽

Novel Biomarkers ◽

Diagnosis Of Infection

Over 25% of all annual deaths in the world are due to infection. Early diagnosis and risk stratification facilitate timely and specific treatment, but are complicated by the highly variable and non-specific nature of the signs and symptoms of sepsis. There is a lack of a ‘gold standard’ for the diagnosis of infection or sepsis, prognosis of severe infections, and sepsis. There are several biomarkers that have been investigated in literature like white blood count, C-reactive protein, procalcitonin, sTREM1, etc., with equivocal results. White blood count and C-reactive protein are elevated in states of inflammation without infection and sepsis. Therefore, they have low specificities for diagnosis of infection. The future is promising with development of high sensitivity assays, molecular strategies, and a ‘panel approach’, all of which need to be investigated in well-designed future studies. At present, there is insufficient evidence for the routine use of novel biomarkers in infection and sepsis.

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Correlation of serum C-reactive protein, white blood count, and neutrophil percentage with histopathological findings in acute appendicitis

Saudi Surgical Journal ◽

10.4103/ssj.ssj_43_19 ◽

2020 ◽

Vol 8 (4) ◽

pp. 167

Author(s):

WisamH Jamal ◽

FawazM Aldhafiri ◽

FahadM Aldhafiri ◽

Mubarak Alshahrani ◽

AdelD Almaymuni ◽

...

Keyword(s):

Acute Appendicitis ◽

Blood Count ◽

White Blood Count ◽

C Reactive Protein ◽

Histopathological Findings ◽

Reactive Protein ◽

Neutrophil Percentage

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A Case of Ignatzschineria indica Bacteremia following Maggot Colonization

Case Reports in Infectious Diseases ◽

10.1155/2017/3698124 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 4

Author(s):

Hugh Muse ◽

Rachel L. Jenkins ◽

Meredith B. Oliver ◽

Soomin Kim ◽

Richard L. Grantier ◽

...

Keyword(s):

Blood Count ◽

White Blood Count ◽

Routine Laboratory ◽

Negative Bacterium ◽

C Reactive Protein ◽

Decubitus Ulcers ◽

Reactive Protein ◽

Laboratory Procedures ◽

Immunological Changes ◽

Flesh Flies

Ignatzschineria indica is a Gram-negative bacterium that is commonly associated with the larvae of flesh flies. I. indica is difficult to isolate in routine laboratory procedures but has been associated with neglected wounds infested with maggots, fever, elevated white blood count and C-reactive protein, and polymicrobial culture results. Other specific hematological/immunological changes are not known. We present a case of I. indica bacteremia and polymicrobial osteomyelitis resulting from infected decubitus ulcers. The patient improved after treatment with cefepime followed by levofloxacin.

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