scholarly journals Factors Influencing Culture Positivity in Pyogenic Vertebral Osteomyelitis Patients with Prior Antibiotic Exposure

2015 ◽  
Vol 59 (4) ◽  
pp. 2470-2473 ◽  
Author(s):  
Chung-Jong Kim ◽  
Seung-Ji Kang ◽  
Doran Yoon ◽  
Myung Jin Lee ◽  
Moonsuk Kim ◽  
...  
Keyword(s):  
Tissue Culture ◽  
Confidence Interval ◽  
Vertebral Osteomyelitis ◽  
C Reactive Protein ◽  
Surgical Biopsy ◽  
Reactive Protein ◽  
Factors Influencing ◽  
Culture Positivity ◽  
Open Surgical Biopsy ◽  
Pyogenic Vertebral Osteomyelitis

ABSTRACTWe conducted a retrospective cohort study to evaluate factors influencing tissue culture positivity in patients with pyogenic vertebral osteomyelitis exposed to antibiotics before diagnosis. Tissue culture was positive in 48.3% (28/58) of the patients, and the median antibiotic-free period was 1.5 days (range, 0.7 to 5.7 days). In a multivariate analysis, a higher C-reactive protein (CRP) level (adjusted odds ratio [aOR], 1.18; 95% confidence interval, 1.07 to 1.29) and open surgical biopsy (aOR, 6.33; 95% confidence interval, 1.12 to 35.86) were associated with tissue culture positivity.

scholarly journals Serum Cathepsin S Is Associated with Serum C-Reactive Protein and Interleukin-6 Independently of Obesity in Elderly Men

2010 ◽  
Vol 95 (9) ◽  
pp. 4460-4464 ◽  
Author(s):  
E. Jobs ◽  
U. Risérus ◽  
E. Ingelsson ◽  
J. Helmersson ◽  
E. Nerpin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Confidence Interval ◽  
Regression Coefficient ◽  
Normal Weight ◽  
Cathepsin S ◽  
C Reactive Protein ◽  
Elderly Men ◽  
Community Based ◽  
Reactive Protein

Objective: Cathepsin S has been suggested provide a mechanistic link between obesity and atherosclerosis, possibly mediated via adipose tissue-derived inflammation. Previous data have shown an association between circulating cathepsin S and inflammatory markers in the obese, but to date, community-based reports are lacking. Accordingly, we aimed to investigate the association between serum levels of cathepsin S and markers of cytokine-mediated inflammation in a community-based sample, with prespecified subgroup analyses in nonobese participants. Methods: Serum cathepsin S, C-reactive protein (CRP), and IL-6 were measured in a community-based cohort of elderly men (Uppsala Longitudinal Study of Adult Men; mean age 71 years, n = 991). CRP and IL-6 were also measured at a reexamination after 7 yr. Results: After adjustment for age, body mass index, fasting plasma glucose, diabetes treatment, systolic blood pressure, diastolic blood pressure, hypertension treatment, serum cholesterol, serum high-density lipoprotein cholesterol, prior cardiovascular disease, smoking, and leisure time physical activity, higher cathepsin S was associated with higher CRP (regression coefficient for 1 sd increase, 0.13; 95% confidence interval 0.07–0.19; P < 0.001) and higher serum IL-6 (regression coefficient for 1 sd increase, 0.08; 95% confidence interval 0.01–0.14; P = 0.02). These associations remained similar in normal-weight participants (body mass index <25 kg/m2, n = 375). In longitudinal analyses, higher cathepsin S at baseline was associated with higher serum CRP and IL-6 after 7 yr. Conclusions: These results provide additional evidence for the interplay between cathepsin S and inflammatory activity and suggest that this association is present also in normal-weight individuals in the community.

scholarly journals Eosinophilic Granulomatosis Polyangiitis (EGPA) Masquerading as a Mycotic Aneurysm of the Abdominal Aorta: Case Report and Review of Literature

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Pooja Kumari ◽  
Debendra Pattanaik ◽  
Claire Williamson
Keyword(s):  
Abdominal Aorta ◽  
Mycotic Aneurysm ◽  
Review Of Literature ◽  
C Reactive Protein ◽  
Surgical Biopsy ◽  
Axillofemoral Bypass ◽  
Case Presentation ◽  
Reactive Protein ◽  
Eosinophilic Granulomatosis ◽  
Infrarenal Abdominal Aorta

Introduction. Aortic involvement leading to aortitis in eosinophilic granulomatosis polyangiitis (EGPA) is infrequent, and only 2 cases have been reported so far in the literature. Even more so, aortic aneurysm, secondary to EGPA, has never been reported and remains a diagnostic and therapeutic challenge. Case Presentation. We present a 63-year-old Caucasian male patient with a prior diagnosis of EGPA presenting with abdominal pain, nausea, and loose stools to the emergency department. Physical examination showed periumbilical tenderness. He had no peripheral eosinophilia but had high C-reactive protein and procalcitonin levels. CT abdomen revealed a mycotic aneurysm involving the infrarenal abdominal aorta. The patient declined surgical repair initially and was treated with IV antibiotics only. Unfortunately, 24 hours later, the aneurysm ruptured, leading to emergent axillofemoral bypass surgery. Surgical biopsy showed aortitis, periaortitis, and active necrotizing vasculitis. Conclusion. Abdominal aneurysms should be considered a complication of EGPA, and earlier immunosuppressive therapy should be considered to prevent further complications.

#54: Sensitivity and Specificity of Procalcitonin vs C Reactive Protein in Identifying Pediatric Bacterial infections

2021 ◽  
Vol 10 (Supplement_2) ◽  
pp. S16-S16
Author(s):  
Sara Kim ◽  
Avni Bhatt ◽  
Silvana Carr ◽  
Frances Saccoccio ◽  
Judy Lew
Keyword(s):  
Urinary Tract ◽  
Sensitivity And Specificity ◽  
Urinary Tract Infections ◽  
Bacterial Infections ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Culture Positivity ◽  
Serious Bacterial Infections ◽  
Tract Infections ◽  
Culture Positive

Abstract Background Procalcitonin (PCT) and c-reactive protein (CRP) have been utilized in children to assess risk for serious bacterial infections. However, there have been different cut-offs reported for PCT and CRP, which yield different sensitivity and specificity. This study aims to compare the sensitivity and specificity of PCT and CRP in detecting serious bacterial infections (SBIs), specifically urinary tract infections, bacteremia and meningitis. Methods In this retrospective, single center cohort study from January 2018 to June 2019, we analyzed children with a fever greater than 38C with both PCT and CRP value within 24 hours of admission. Each patient had a blood, urine and/or cerebrospinal fluid culture collected within 48 hours of admission. No antibiotics were administered from the admitting hospital prior to collection of the PCT or CRP. Our gold standard was a positive culture obtained from blood, cerebrospinal fluid, or urine. The statistical analysis included categorical variables as percentages and compared them using the Fisher exact test. The optimal cutoff values for PCT or CRP were based on ROC curve analysis and Youden Index. Sensitivity and specificity analysis were based on literature review cut offs and ROC curves cut offs. Results Among 202 children, we had 45 culture positive patients (11 urinary tract infections, 4 meningitis, and 32 bacteremia). The patients with culture positivity had higher PCT levels (7.9 ng/mL vs 2.5 ng/mL, P=0.0111), CRP levels (110.9 mg/L vs 49.6 mg/L, P<0.0001) and temperature (39.2C vs 39C, P<0.0052). The area under the curve (AUC) comparing culture positivity vs negativity for all culture types was 0.72 (p<0.0001) for PCT and 0.66 (p=0.001) for CRP. In Figure 1, the AUC for culture positive bacteremia was 0.68 (p=0.0011) for PCT and 0.70 (p=0.0003). The AUC for culture positive urinary tract infections (UTI) only was 0.86 (p=0.0001) for PCT and 0.70 (p=0.3607). For the cut-off value for PCT at 0.5 ng/mL, the sensitivity and specificity was 64% (95% confidence interval [CI] 0.5–0.77) and 70% (95% CI 0.62–0.77) respectively in identifying children with bacterial infection. For the cut-off value for CRP at 20 mg/L, the sensitivity and specificity was 67% (95% CI 0.52–0.79) and 52% (95% CI 0.44–0.59) respectively in identifying children with bacterial infection. Conclusion In this study, PCT and CRP are nearly equivalent classifiers for detecting SBIs as a group and bacteremia, but PCT is statistically better for urinary tract infections; however, the clinical utility is unknown.

The characteristics associated with alcohol co-ingestion in patients visited to the emergency department with deliberate self-poisoning: retrospective study

2021 ◽  
Keyword(s):  
Emergency Department ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Blood Alcohol Concentration ◽  
Alcohol Concentration ◽  
Self Report ◽  
C Reactive Protein ◽  
Alcohol Group ◽  
Reactive Protein ◽  
History Of

Objective: The aim of this study was to investigate the characteristics associated with alcohol co-ingestion by measuring blood alcohol concentration in patients visited to the emergency department with deliberate self-poisoning. Also, it was to evaluate the accuracy of self-reported alcohol ingestion. Methods: The initial assessment forms, medical records and laboratory tests of patients visited to the ED after DSP between March 2017 and June 2020 were retrospectively reviewed. Based on the patients’ BAC, two groups were formed: the non-alcohol group and the alcohol group. Results: This study included 286 patients (56.6%, n = 162) in the non-alcohol group and 43.4% (n = 124) in the alcohol group. In multivariate logistic analysis, alcohol co-ingestion was independently associated with no history of psychiatric admission (Odds Ratio = 6.222, 95% Confidence Interval = 1.148-33.716, P = 0.034), lactate (mg/dL)(Odds Ratio = 1.961, 95% Confidence Interval = 1.274-3.019, P = 0.002), and C-reactive protein level (mg/dL) (Odds Ratio = 0.003, 95% Confidence Interval = 0.000-0.897, P = 0.046). The receiver operating characteristics analysis of lactate value for the association with alcohol co-ingestion showed a cutoff value of 1.45, with 88.1% sensitivity, 71.6%specificity, and an area under the curve of 0.845. There was no statistically significant difference in emergency department disposition between the two groups. Using the 261 subjects who completed the self-report of alcohol co-ingestion, self-report resulted in 77.6% sensitivity and 76.6% specificity for the assessment of alcohol co-ingestion. The positive and negative predictive values for self-reporting were 72.6% and 81.0%, respectively. Conclusions: Alcohol co-ingestion was associated with no history of psychiatric ward admission, high lactate levels, and low C-reactive protein values in patients who visited the emergency department with deliberate self-poisoning. This study showed that self-reported alcohol co-ingestion was not a substitute for the blood alcohol concentration test.

scholarly journals The evaluation of the clinical, laboratory and the radiological fi ndings of the fi ft y-fi ve cases diagnosed with tuberculous, brucellar and pyogenic spondylodiscitis

2012 ◽  
Vol 03 (01) ◽  
pp. 17-20 ◽  
Author(s):  
Kadriye Yasar ◽  
Filiz Pehlivanoglu ◽  
Gulten Cicek ◽  
Gonul Sengoz
Keyword(s):  
Clinical Laboratory ◽  
C Reactive Protein ◽  
Radiological Findings ◽  
Previous Surgery ◽  
Reactive Protein ◽  
Pyogenic Spondylodiscitis ◽  
Culture Positivity ◽  
Biochemical Laboratory ◽  
Lowenstein Jensen ◽  
History Of

ABSTRACTObjective: In this study, the evaluation of the clinical, laboratory and radiological findings belonging to 55 cases that were hospitalized in our clinic to be followed-up and were diagnosed with tuberculous, brucellar and pyogenic spondylodiscitis (SD) was aimed. Materials and Methods: The cases with SD were evaluated retrospectively. Hematological, serological, biochemical laboratory tests and imaging technics were used for diagnosis. Results: Of 55 cases aged ranging between 25 to 79, 33 (59%) were female. The cases with tuberculous SD (TBSD), brucellar SD (BSD) and pyogenic SD (PSD) were found in 24 (43%), 12 (21%) and in 19 (34%) patients.Erytrocyte sedimentation rate, increased C-reactive protein, and leucocytosis were present in 51 (91%), 22 (39%) and 8 (14%) cases. The number of the cases with history of previous surgery or trauma was 14 (25%). Diagnosis of TBSD was established by acid fast bacilli positiveness and Löwenstein Jensen culture positiveness, in two and seven patients, respectively. While all 12 cases with BSD had positive standard tube aglutination test, only 3 (25%) had hemoculture positivity. In PSDs, diagnosis was confirmed with culture positivity in 9 of 19 cases.Of the cases in our study, 89% responded to medical treatment while three required surgery and three died (5.5% and 5.5%, respectively). Conclusion: SD may develop secondary to infections or following spinal surgical procedures and traumas. Also, the importance of endemicity should be kept in mind, beside the helpful diagnostic findings while treatment regulation.

scholarly journals Impact of Chronic Kidney Disease on Cardiovascular and Renal Events in Patients Undergoing Percutaneous Coronary Intervention with Everolimus-Eluting Stent: Risk Stratification with C-Reactive Protein

2018 ◽  
Vol 8 (2) ◽  
pp. 151-159 ◽  
Author(s):  
Kazuhiro Dan ◽  
Toru Miyoshi ◽  
Makoto Nakahama ◽  
Tomofumi Mizuno ◽  
Kenzo Kagawa ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Kidney Disease ◽  
Coronary Angiography ◽  
Confidence Interval ◽  
Coronary Intervention ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Percutaneous Coronary

Background: Chronic kidney disease (CKD) and inflammation play critical roles in atherosclerosis. There is limited evidence regarding the relationship between CKD and patients receiving second-generation drug-eluting stents for coronary artery disease. Objective: This study aimed to investigate the effect of CKD on cardiovascular and renal events in patients undergoing percutaneous coronary intervention (PCI) with everolimus-eluting stents (EES). Methods: We analyzed 504 consecutive patients with stable angina pectoris and significant coronary artery stenosis treated with EES. CKD was defined as an estimated glomerular filtration rate < 60 mL/min/1.73 m2 before coronary angiography. The primary outcome was the occurrence of major adverse renal and cardiovascular events (MARCE) including cardiac death, revascularization, heart failure, cerebral infarction, worsening renal function > 25% from baseline, and renal replacement therapy at 1 year. Results: Patients were divided into the a MARCE (n = 126) and a non-MARCE (n = 378) group. The incidence of CKD was 51% in all subjects (including those on hemodialysis) and was significantly higher in the MARCE group than in the non-MARCE group (p = 0.00001). Multivariate logistic regression analysis identified that CKD was independently associated with MARCE (adjusted odds ratio 2.03, 95% confidence interval 1.21–3.39, p = 0.007). Patients were divided into four groups based on CKD and C-reactive protein (CRP) level prior to initial coronary angiography. Cox proportional hazards analysis revealed that patients with CKD and high CRP (≥0.3 mg/dL) had the worst prognosis (hazard ratio 4.371, 95% confidence interval 2.634–7.252, p = 0.00001) compared to patients without CKD and with low CRP. Conclusion: CKD combined with CRP predicted more clinical events in patients undergoing PCI with EES.

scholarly journals Can the simplified magnetic resonance index of activity be used to evaluate the degree of activity in Crohn's disease?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yongli Tao ◽  
Hong Li ◽  
Han Xu ◽  
Wen Tang ◽  
Guohua Fan ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Confidence Interval ◽  
Sedimentation Rate ◽  
Fecal Calprotectin ◽  
Left Colon ◽  
C Reactive Protein ◽  
Right Colon ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Highly Correlated

Abstract Background and aims A simplified magnetic resonance index of activity (MaRIAs) was recently proposed. Our aim was to verify whether MaRIAs can accurately assess the activity degree of CD. Methods We retrospectively analyzed the MRI, ileocolonoscopy, fecal calprotectin (FC), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) data of 93 CD patients. With the SES-CD as the gold standard, MaRIAs’ accuracy, the correlation of MaRIAs and SES-CD, FC, ESR, CRP, and interevaluator reliability were assessed. Results MaRIAs ≥ 1 detected segments with active CD with 90.80% specificity and 81.37% sensitivity (area under the curve was 0.91, 95% confidence interval 0.87–0.94). MaRIAs score of 2 or more detected severe lesions with 88.89% specificity and 95.12% sensitivity (AUC was 0.96, 95% confidence interval was 0.94–0.98). The MaRIAs score showed a high correlation with the SES-CD in the terminal ileum, transverse colon, right colon, and left colon (r = 0.85, 0.91, 0.88, 0.86, P < 0.001) and a moderate correlation with the SES-CD in the rectum (r = 0.74, P < 0.001). The global MaRIAs score was highly correlated with the global SES-CD (r = 0.90, P < 0.001). The global MaRIAs score was positively correlated with the fecal calprotectin (FC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) (r = 0.77, r = 0.64, and r = 0.68). The intragroup correlation coefficient (ICC) of the two physicians was nice in the terminal ileum, the right colon, the transverse colon, the left colon and was moderately good in the rectum. Conclusion MaRIAs can accurately evaluate the disease activity level of CD and are highly correlated with SES-CD and biomarkers. The interrater reliability of the two physicians was moderately good to nice.

scholarly journals Validity of Clinical Assessment Using Clinical Symptoms and C-Reactive Protein for Therapeutic Response in Pyogenic Vertebral Osteomyelitis: Analysis Based on 18F-FDG-PET

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 809
Author(s):  
Ikchan Jeon ◽  
Dongwoo Yu ◽  
Eunjung Kong
Keyword(s):  
Antibiotic Therapy ◽  
Clinical Assessment ◽  
Fdg Pet ◽  
Therapeutic Response ◽  
Clinical Symptoms ◽  
Vertebral Osteomyelitis ◽  
Parenteral Antibiotic ◽  
Reactive Protein ◽  
Pyogenic Vertebral Osteomyelitis ◽  
18F Fdg

Backgroundand objectives: The clinical assessment of therapeutic response in pyogenic vertebral osteomyelitis (PVO) has been usually performed based on the changes of clinical symptoms and blood inflammatory markers. Recently, 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) has emerged as an alternative independent method. We analyzed the validity of the clinical assessment for detecting residual PVO based on 18F-FDG-PET. Materials and Methods: This study was conducted with 53 patients confirmed as lumbar PVO under retrospective design. All patients underwent clinical assessment using clinical symptoms and C-reactive protein (CRP) for therapeutic response after parenteral antibiotic therapy, which led to the decision of placement in the uncontrolled (group UC) or controlled (group C) group. The validity of clinical assessment was analyzed based on the cut-off values of FDG uptake for detecting residual PVO as references, which are already established in the previous literature. Results: The mean duration of parenteral antibiotic therapy and recurrence rate were 42.19 ± 15.84 (21–89) days and 9.4% (5/53), respectively. 18F-FDG-PETs were performed at 80 rounds of clinical assessment on 37.40 ± 13.15 (21–83) days of parenteral antibiotic therapy and divided: 31 into group UC and 49 into group C, according to the decisions of clinical assessment. Based on the cut-off values of FDG uptake, clinical assessment showed 48.4–58.1% of false positive for residual PVO in group UC. However, 18F-FDG-PET showed 8.2% (4/49) of false negative for residual PVO in group C, which led to recurrences. Conclusions: Clinical assessment using clinical symptoms and CRP for evaluating therapeutic response in PVO is still a useful method in terms of similar recurrence rate compared to 18F-FDG-PET. However, the high rate of false positive for residual PVO can prolong the use of unnecessary antibiotics and overall treatment period.

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