scholarly journals Improved Early Detection of Focal Brucellosis Complications with Anti-Brucella IgG

2020 ◽  
Vol 58 (10) ◽  
Author(s):  
Nannan Xu ◽  
Xiaomeng Dong ◽  
Yongyuan Yao ◽  
Yanyan Guan ◽  
Fengzhe Chen ◽  
...  

ABSTRACT To evaluate the associations of inflammatory factors and serological test results with complicated brucellosis, we recruited 285 patients with a diagnosis of brucellosis between May 2016 and September 2019. The patients were subsequently classified into two groups according to the presence of complications. We collected demographic and clinical information and routine laboratory test results in addition to anti-Brucella IgG and IgM levels. Anti-Brucella IgG and IgM were uniformly tested using enzyme-linked immunosorbent assays (ELISAs) in this study. Among the 285 patients with brucellosis, 111 (38.95%) had complicated brucellosis. Osteoarthritis occurred more often in the subacute and chronic stages than in the acute stage (P = 0.002). Genital infection occurred more frequently in the acute stage than in the other stages (P = 0.023). Fever was not frequently observed in complicated cases (P < 0.001). The erythrocyte sedimentation rate (ESR) and the C-reactive protein (CRP) and anti-Brucella IgM and IgG levels were higher in complicated-brucellosis patients than in uncomplicated-brucellosis patients (P < 0.001). Anti-Brucella IgG, with an area under the curve of 0.885 (95% confidence interval [CI], 0.847 to 0.924), was the most robust indicator of complicated brucellosis. Positive culture, anti-Brucella IgM, the ESR, and CRP could be considered indicators, but their efficacy was weaker than that of IgG. In conclusion, a high ESR, high CRP, high anti-Brucella IgM and IgG levels, and positive culture were indicators of complicated brucellosis; among these, anti-Brucella IgG was the most robust biomarker.

2021 ◽  
Author(s):  
Jin Hui Paik ◽  
Jung-Soo Kim ◽  
Man-Jong Lee ◽  
Mi Hwa Park ◽  
Areum Durey ◽  
...  

Abstract Background: The duration of mechanical ventilation (MV) required by patients admitted to the emergency department (ED) is difficult to predict. We investigated the duration of MV in ED-admitted patients, as well as their clinical progress.Methods: We investigated the duration of MV in adult patients (aged ≥18 years) who were attached to ventilators in our ED between January and December 2017. The patients were divided into two groups; MV <7 days and MV ≥7 days. The patients’ demographic characteristics, diagnoses, clinical features, and underlying diseases were compared between two groups.Results: The study comprised 282 patients including 142 in the MV <7 days group and 140 in the MV ≥7 days group. The MV ≥7 days group had more patients diagnosed with metabolic disorder, pneumonia, neurological disease, sepsis, and multiple trauma, and also had a greater proportion of patients with dementia or stroke as the underlying disease. The mean C-reactive protein level in the MV ≥7 days group was 6.4 mg/dL, which was higher than that in the MV <7 days group. The risk factors for requiring ≥7 days of MV were identified as a diagnosis of stroke as well as having the underlying diseases of cancer and stroke or dementia. Among the laboratory test results, pH, HCO3- , and albumin <3.5 g/dL were identified as factors influencing the duration of MV.Conclusions: MV for ≥7 days is predicted to be required for patients admitted for a stroke; those with underlying cancer or stroke; and those with adverse pH, HCO3-, and albumin blood test results.


2020 ◽  
Author(s):  
Zhikang Yu ◽  
Heming Wu ◽  
Qingyan Huang ◽  
Xuemin Guo ◽  
Zhixiong Zhong

Abstract BackgroundAt present, SARS-CoV-2 epidemic in the world rapidly spread. It is a serious global public health emergency.MethodsHere we described the clinical characteristics of 11 SARS-CoV-2 infected patients hospitalized in the Meizhou People's Hospital. And viral genome sequences of SARS-CoV-2 from these patients were analyzed.ResultsOf the 11 patients, six cases developed fever, nine cases developed cough, and two cases developed headache and chills. Four patients (36.4%) had underlying diseases. Pneumonia is the most common complication. The laboratory test results showed that there was no adult patients with increased LYM/LYM%. Most patients had normal total protein (TP) and albumin (ALB), but only two patients had decreased. Most patients had increased or normal levels of erythrocyte sedimentation rate (ESR), C reactive protein (CRP), activated partial thromboplastin time (APTT), fibrinogen (FIB), creatine kinase isoenzymes (CK-MB), and lactate dehydrogenase (LDH). Neutrophil (NEU) (r=0.664, P=0.026), CK-MB (r=0.655, P=0.029), blood urea nitrogen (BUN) (r=0.682, P=0.021) and SARS-CoV-2 virus cycle threshold (Ct) value were significantly correlated. Multiple sequence alignment (MSA) shows that we identified two different SNPs at positions 8781 and 28144, and have a completely linked genetic form of 8781C-28144T and 8781T-28144C.ConclusionsThe reports of these 11 cases in our hospital will provide useful information for the diagnosis, treatment and drug development of SARS-CoV-2.


2021 ◽  
Vol 2 (3) ◽  
pp. 1032-1042
Author(s):  
Yunita Liana ◽  
Pariyana ◽  
Mariana

Abstract.   Coronavirus disease 2019 (COVID-19) is a highly contagious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. The increase in the number of COVID-19 cases is progressing quickly and has been spread between countries. As of October 14, 2020, there are 213 countries/regions around the world that have reported Covid-19 with a total of 38,002,699 confirmed cases of which 1,083,234 died. The purpose of this study was to determine the relationship between mortality factors and mortality in COVID-19 patients to predict the patient's prognosis. This research method is a systematic review through a literature review on mortality factors in COVID-19 patients Literature searches were accessed through internet searches using the Pubmed database based on the preferred reporting items for systemic review and meta-analysis (PRISMA). A systematic search was carried out on 18 October - 20 October 2020 with the keywords “COVID-19” AND “Death” OR “Decease” AND “Factor Associated”. There were 8 literature selected that met the inclusion and exclusion criteria. Based on the findings of the eight journals, mortality is old age, male, has a clinical condition of hypertension, obesity, diabetes, cardiovascular disease, lung disease, neurological disease, lymphophenia laboratory test results, hyperlactate dehydrogenase, increased procalcitonin, increased neutrophils, increased C-reactive protein, and increased D-dimer. All literature reported that a p value <0.05 was obtained from the analysis of the relationship between mortality factors and cases of death in COVID-19 patients. There is a significant relationship between mortality factors and the death of COVID-19 patients, where the mortality factors are elderly, male, have a clinical condition of hypertension, obesity, diabetes, cardiovascular disease, lung disease, neurological disease, lymphophenia laboratory test results, hyperlactate dehydrogenase, increase in procalcitonin, increase in neutrophils, increase in C-reactive protein, and increase in D-dimers in which the prognosis of patients who have mortality factors tends to be worse. Keywords: Mortality, Coronavirus, COVID-19


2021 ◽  
Author(s):  
Jin Hui Paik ◽  
Jung-Soo Kim ◽  
Man-Jong Lee ◽  
Mi Hwa Park ◽  
Areum Durey ◽  
...  

Abstract Background The duration of mechanical ventilation (MV) required by patients admitted to the emergency department (ED) is difficult to predict. We investigated the duration of MV in ED-admitted patients, as well as their clinical progress.Methods We investigated the duration of MV in adult patients (aged ≥18 years) who were attached to ventilators in our ED between January and December 2017. The patients were divided into two groups; MV <7 days and MV ≥7 days. The patients’ demographic characteristics, diagnoses, clinical features, and underlying diseases were compared between two groups.Results The study comprised 282 patients including 142 in the MV <7 days group and 140 in the MV ≥7 days group. The MV ≥7 days group had more patients diagnosed with metabolic disorder, pneumonia, neurological disease, sepsis, and multiple trauma, and also had a greater proportion of patients with dementia or stroke as the underlying disease. The mean C-reactive protein level in the MV ≥7 days group was 6.4 mg/dL, which was higher than that in the MV <7 days group. The risk factors for requiring ≥7 days of MV were identified as a diagnosis of stroke as well as having the underlying diseases of cancer and stroke or dementia. Among the laboratory test results, pH, HCO3- , and albumin <3.5 g/dL were identified as factors influencing the duration of MV.Conclusion MV for ≥7 days is predicted to be required for patients admitted for a stroke; those with underlying cancer or stroke; and those with adverse pH, HCO3-, and albumin blood test results.


2015 ◽  
Vol 66 (4) ◽  
pp. 188-195 ◽  
Author(s):  
Chao Wu ◽  
Xinying Wang ◽  
Wenkui Yu ◽  
Feng Tian ◽  
Sitong Liu ◽  
...  

Objective: To assess the incidence of hypermetabolism, defined as high resting energy expenditure, in severe sepsis ICU patients, and evaluate the suitability of excessive resting energy expenditure (REE) as a risk factor of their clinical outcome. Methods: In a single-center, prospective, six-month observational study in China, the measured REE (MREE) was estimated daily using indirect calorimetry (IC) for the first 5 days of ICU admission. The predicted REE (PREE) was determined using the Harris-Benedict equation. ICU severity criteria (APACHE II and SOFA scores), baseline and health characteristics, and laboratory test results, were compared between the hyper-metabolic (MREE/PREE ratio ≥1.3) and the normometabolic (MREE/PREE ratio <1.3) groups, and between the survivor and non-survivor groups, classified according to 28-day mortality. Results: Of the 62 included ICU patients (age, 57.1 ± 19.5 years), 34 patients (55%) were hypermetabolic. The 28-day mortality rate in the hypermetabolic and normometabolic groups was 35 and 18%, respectively (p < 0.001). The MREE/PREE ratio and C-reactive protein (CRP) plasma concentration were significantly higher in non-survivors than survivors (p = 0.017), and were significantly (p < 0.05) associated with 28-day mortality (ORMREE/ PREE = 1.018, 95% CI, 1.010-2.544, p = 0.031 and ORCRP = 1.010, 95% CI, 1.005-2.173, p = 0.025, respectively). Conclusion: In critical sepsis patients admitted to ICU, the MREE/PREE ratio may be a valuable evaluation index of the clinical outcome.


Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 829
Author(s):  
Yana Kogan ◽  
Edmond Sabo ◽  
Majed Odeh

Objectives: The role of serum C-reactive protein (CRPs) and pleural fluid CRP (CRPpf) in discriminating uncomplicated parapneumonic effusion (UCPPE) from complicated parapneumonic effusion (CPPE) is yet to be validated since most of the previous studies were on small cohorts and with variable results. The role of CRPs and CRPpf gradient (CRPg) and of their ratio (CRPr) in this discrimination has not been previously reported. The study aims to assess the diagnostic efficacy of CRPs, CRPpf, CRPr, and CRPg in discriminating UCPPE from CPPE in a relatively large cohort. Methods: The study population included 146 patients with PPE, 86 with UCPPE and 60 with CPPE. Levels of CRPs and CRPpf were measured, and the CRPg and CRPr were calculated. The values are presented as mean ± SD. Results: Mean levels of CRPs, CRPpf, CRPg, and CRPr of the UCPPE group were 145.3 ± 67.6 mg/L, 58.5 ± 38.5 mg/L, 86.8 ± 37.3 mg/L, and 0.39 ± 0.11, respectively, and for the CPPE group were 302.2 ± 75.6 mg/L, 112 ± 65 mg/L, 188.3 ± 62.3 mg/L, and 0.36 ± 0.19, respectively. Levels of CRPs, CRPpf, and CRPg were significantly higher in the CPPE than in the UCPPE group (p < 0.0001). No significant difference was found between the two groups for levels of CRPr (p = 0.26). The best cut-off value calculated by the receiver operating characteristic (ROC) analysis for discriminating UCPPE from CPPE was for CRPs, 211.5 mg/L with area under the curve (AUC) = 94% and p < 0.0001, for CRPpf, 90.5 mg/L with AUC = 76.3% and p < 0.0001, and for CRPg, 142 mg/L with AUC = 91% and p < 0.0001. Conclusions: CRPs, CRPpf, and CRPg are strong markers for discrimination between UCPPE and CPPE, while CRPr has no role in this discrimination.


2021 ◽  
Author(s):  
Bailin Chenilin Chen ◽  
Jian Cao ◽  
Chengwei Yan ◽  
Chao Zheng ◽  
Jingyu Chen ◽  
...  

Abstract Background: The most critical concern for management of childhood intussusception is the bowel resection due to the intestinal ischemia and necrocis. It is of great importance for early prediction of this problem. We investigate the value of various combinations of inflammatory factors to predict the intestinal necrocis and resection.Methods: We retrospectively reviewed the medical records of pediatric patients with intussusception, which undergone surgical management. During the research period, 47 patients undergone intestinal resection due to intestinal necrocis and 68 patients without intestinal resection were enrolled. We evaluated the diagnostic values of various combination of inflammatory markers from preoperative period laboratory analyses using the receiver operating characteristic (ROC) method.Results: In the current cohort, 115 patients were operated for intussusception, among them, 47 patients (40.9%) undergone intestinal resections. In patients with intestinal resections, neutrophil count(p=0.013), CRP(p=0.002), platelet–lymphocyte ratio(PLR, p=0.008), NLR(neutrophil–lymphocyte ratio, p=0.026), and LCR(lymphocyte–CRP ratio, p<0.001) values were significantly higher than those in the patients without any resections. Receiver operating characteristic (ROC) analysis results showed that the combination of lymphocytic count along with C-reactive protein levels (LCR) demonstrated the highest correlation with intestinal resection due to intussusception compared with other parameters in patients, with sensitivity of 0.82(0.73–0.86) and specifficity of 0.80(0.57–0.94) for the diagnosis of strangulation. Conclusion: The preoperative LCR level is a useful marker to predict the need for intestinal resection due to intestinal necrosis in patients with intussusception.


2012 ◽  
Vol 39 (4) ◽  
pp. 728-734 ◽  
Author(s):  
HYOUN-AH KIM ◽  
JA-YOUNG JEON ◽  
JEONG-MI AN ◽  
BO-RAM KOH ◽  
CHANG-HEE SUH

Objective.C-reactive protein (CRP), S100A8/A9, and procalcitonin have been suggested as markers of infection in patients with systemic lupus erythematosus (SLE). We investigated the clinical significance of these factors for indication of infection in SLE.Methods.Blood samples were prospectively collected from 34 patients with SLE who had bacterial infections and 39 patients with SLE who had disease flares and no evidence of infection. A second set of serum samples was collected after the infections or flares were resolved.Results.CRP levels of SLE patients with infections were higher than those with flares [5.9 mg/dl (IQR 2.42, 10.53) vs 0.06 mg/dl (IQR 0.03, 0.15), p < 0.001] and decreased after the infection was resolved. S100A8/A9 and procalcitonin levels of SLE patients with infection were also higher [4.69 μg/ml (IQR 2.25, 12.07) vs 1.07 (IQR 0.49, 3.05) (p < 0.001) and 0 ng/ml (IQR 0–0.38) vs 0 (0–0) (p < 0.001), respectively]; these levels were also reduced once the infection disappeared. In the receiver-operating characteristics analysis of CRP, S100A8/A9, and procalcitonin, the area under the curve was 0.966 (95% CI 0.925–1.007), 0.732 (95% CI 0.61–0.854), and 0.667 (95% CI 0.534–0.799), respectively. CRP indicated the presence of an infection with a sensitivity of 100% and a specificity of 90%, with a cutoff value of 1.35 mg/dl.Conclusion.Our data suggest that CRP is the most sensitive and specific marker for diagnosing bacterial infections in SLE.


1993 ◽  
Vol 39 (2) ◽  
pp. 293-297 ◽  
Author(s):  
T Nakayama ◽  
S Sonoda ◽  
T Urano ◽  
T Yamada ◽  
M Okada

Abstract We examined serum amyloid protein A (SAA) and C-reactive protein (CRP) as inflammatory markers of viral and bacterial infections. Both acute-phase reactants increased in the acute stage and thereafter decreased in the convalescent stage. In viral infections, the mean serum concentrations of SAA during the acute stage were 141 mg/L in infections with adenovirus, 77 mg/L with measles virus, 63 mg/L with influenza virus, 55 mg/L with parainfluenza virus, 31 mg/L with respiratory syncytial virus, and 31 mg/L in aseptic meningitis. The mean serum concentration of CRP was 19 mg/L for adenovirus infection and &lt; 7 mg/L in all other viral infections. The SAA concentrations were 5- to 11-fold greater than the CRP concentrations. Both the SAA and the CRP concentrations were higher in bacterial infections than in viral infections. Changes in the concentrations of serum SAA paralleled those in serum CRP in bacterial infection; during the course of viral infection, however, serum SAA tended to disappear more quickly than CRP did. SAA appears to be a clinically useful marker of inflammation in acute viral infections, with or without significant changes in the CRP concentration.


2020 ◽  
Vol 5 (2) ◽  
pp. 89-95 ◽  
Author(s):  
Pascale Bémer ◽  
Céline Bourigault ◽  
Anne Jolivet-Gougeon ◽  
Chloé Plouzeau-Jayle ◽  
Carole Lemarie ◽  
...  

Abstract. Introduction: The diagnosis of prosthetic joint infections (PJIs) can be difficult in the chronic stage and is based on clinical and paraclinical evidence. A minimally invasive serological test against the main pathogens encountered during PJI would distinguish PJI from mechanical loosening.Methods: We performed a prospective, multicentre, cross-sectional study to assess the contribution of serology in the diagnosis of PJI. Over a 2-year period, all patients undergoing prosthesis revision were included in the study. A C-reactive protein assay and a serological test specifically designed against 5 bacterial species (Staphylococcus aureus, S. epidermidis, S. lugdunensis, Streptococcus agalactiae, Cutibacterium acnes) were performed preoperatively. Five samples per patient were taken intraoperatively during surgery. The diagnosis of PJI was based on clinical and bacteriological criteria according to guidelines.Results: Between November 2015 and November 2017, 115 patients were included, 49 for a chronic PJI and 66 for a mechanical problem. Among patients with PJI, a sinus tract was observed in 32.6% and a C-reactive protein level ≥10 mg/L in 74.5%. The PJI was monomicrobial in 43 cases (targeted staphylococci, 24; S. agalactiae, 1; C. acnes, 2; others, 16), and polymicrobial in 6 cases (12.2%). Sensitivity, specificity, positive predictive value and negative predictive value were 75.0%, 82.1%, 58.3% and 90.8%, respectively, for targeted staphylococci. Specificity/negative predictive value was 97.3%/100% for S. agalactiae and 83.8% /96.9% for C. acnes.Conclusions: The serological tests are insufficient to affirm the diagnosis of PJI for the targeted bacteria. Nevertheless, the excellent NPV may help clinicians to exclude PJI.


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