scholarly journals Evaluating the Use of Serum Inflammatory Markers for Preoperative Diagnosis of Infection in Patients with Nonunions

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Song Wang ◽  
Peng Yin ◽  
Chenliang Quan ◽  
Kamran Khan ◽  
Guoqi Wang ◽  
...  
Keyword(s):  
Predictive Value ◽  
Inflammatory Markers ◽  
Positive Culture ◽  
Serum Levels ◽  
Infected Nonunion ◽  
Reactive Protein ◽  
Number Of Patients ◽  
Sensitivity Specificity ◽  
Diagnosis Of Infection ◽  
Serum Inflammatory Markers

Purpose. The aim of this study is to evaluate the effectiveness of laboratory serum tests in the diagnosis of infected nonunion.Methods. Forty-two patients suspected of having infected nonunion were investigated in the study. The serum levels of white blood-cell count (WBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and interleukin-6 (IL-6) were measured. A positive diagnosis of infection was made on the basis of the positive culture results. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each test were calculated.Results. The sensitivity and specificity of CRP both were higher than IL-6: 60.0% versus 57.1% and 85.7% versus 57.1%, respectively. With one, two, three, and four positive tests, the predicted probabilities of infection were 66.7%, 90.9%, 100%, and 100%, respectively, but the number of patients who had three or four positive tests was small.Conclusions. The diagnostic utility of IL-6 is inferior to CRP and the finding conflicts with previous conclusions drawn from periprosthetic infections. Laboratory analysis of serum inflammatory markers alone is not an effective screening tool for patients suspected of having an infected nonunion.

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 Evaluation of Inflammatory Markers in Pregnant Women at Risk, for the Prediction of Preeclampsia

2014 ◽  
Vol 60 (3) ◽  
pp. 94-98 ◽  
Author(s):  
Mihaela Daniela Oancea ◽  
N. Costin ◽  
Daria Maria Pop ◽  
R. Ciortea ◽  
Ioana Trif ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Inflammatory Markers ◽  
High Sensitivity ◽  
Serum Levels ◽  
Second Trimester ◽  
Prospective Longitudinal Study ◽  
Reactive Protein ◽  
Group I ◽  
Hs Crp ◽  
Prospective Longitudinal

Abstract Introduction: A low degree of inflammation has been associated with complications in pregnancies, including preeclampsia (PE). The aim of our study was to determine the serum values of high sensitivity C Reactive Protein (hs-CRP) and Interleukin-6 (IL-6) in the first and second trimesters of pregnancy in pregnant women with risk factors for the development of PE, and to evaluate their relevance for the prediction of this disorder. Material and methods: We performed a prospective longitudinal study on 120 pregnant women, who were divided based on the pregnancy evolution, into two groups: group I - 26 pregnant women who developed preeclampsia and group II - 94 pregnant women with physiological evolution of pregnancy. Results: Our study has shown an increase in serum levels of hs-CRP and IL-6 in the first and second trimester of pregnancy in patients from group I, significant values being revealed only in the second trimester of pregnancy. The predictive power of the selected inflammatory markers was significant only for values of hs-CRP in the second trimester of pregnancy, while the association with IL-6 increased the prediction. Conclusions: Increased values of hs-CRP and IL-6 in the second trimester of pregnancy are associated with higher risk for preeclampsia, however the study provided only a modest efficiency of the prediction capacity.

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.

Therapeutic drug monitoring of adalimumab in RA: no predictive value of adalimumab serum levels and anti-adalimumab antibodies for prediction of response to the next bDMARD

2020 ◽  
Vol 79 (7) ◽  
pp. 867-873
Author(s):  
Evy Ulijn ◽  
Nathan den Broeder ◽  
Maike Wientjes ◽  
Noortje van Herwaarden ◽  
Inger Meek ◽  
...  
Keyword(s):  
Predictive Value ◽  
Evidence Synthesis ◽  
Serum Levels ◽  
Subsequent Treatment ◽  
Therapeutic Drug ◽  
Test Accuracy ◽  
Serum Samples ◽  
Best Evidence Synthesis ◽  
Adalimumab Treatment ◽  
Sensitivity Specificity

BackgroundAfter adalimumab treatment failure, tumour necrosis factor inhibition (TNFi) and non-TNFi biological disease-modifying anti-rheumatic drugs (bDMARDs) are equally viable options on a group level as subsequent treatment in rheumatoid arthritis (RA) based on the current best evidence synthesis. However, preliminary data suggest that anti-adalimumab antibodies (anti-drug antibodies, ADA) and adalimumab serum levels (ADL) during treatment predict response to a TNFi as subsequent treatment.ObjectiveTo validate the association of presence of ADA and/or low ADL with response to a subsequent TNFi bDMARD or non-TNFi bDMARD. Sub-analyses were performed for primary and secondary non-responders.MethodsA diagnostic test accuracy retrospective cohort study was done in consenting RA patients who discontinued adalimumab after >3 months of treatment due to inefficacy and started another bDMARD. Inclusion criteria included the availability of (random timed) serum samples between ≥8 weeks after start and ≤2 weeks after discontinuation of adalimumab, and clinical outcome measurements Disease Activity Score in 28 joints - C-reactive protein (DAS28-CRP) between 3 to 6 months after treatment switch. Test characteristics for EULAR (European League Against Rheumatism) good response (DAS28-CRP based) after treatment with the next (non-)TNFi bDMARD were assessed using area under the receiver operating characteristic and sensitivity/specificity.Results137 patients were included. ADA presence was not predictive for response in switchers to a TNFi (sensitivity/specificity 18%/75%) or a non-TNFi (sensitivity/specificity 33%/70%). The same was true for ADL levels in patients that switched to a TNFi (sensitivity/specificity 50%/52%) and patients that switched to a non-TNFi (sensitivity/specificity 32%/69%). Predictive value of ADA and ADL were similar for both primary and secondary non-responders to adalimumab.ConclusionsIn contrast to earlier research, we could not find predictive value for response to a second TNFi or non-TNFi for either ADA or random timed ADL.

Baseline high-sensitivity C-reactive protein to predict progression-free survival in metastatic renal cell carcinoma patients treated with first-line sunitinib.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15527-e15527
Author(s):  
Ryuichi Mizuno ◽  
Go Kimura ◽  
Tsunenori Kondo ◽  
Takeshi Ueda ◽  
Hidehiko Hara ◽  
...  
Keyword(s):  
Interleukin 6 ◽  
Inflammatory Markers ◽  
Progression Free Survival ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
First Line ◽  
Free Survival ◽  
Reactive Protein ◽  
Hs Crp ◽  
Serum Inflammatory Markers

e15527 Background: Predicting the efficacy of tyrosine kinase inhibitors (TKI) would be of clinical value in patients with metastatic renal cell carcinoma (mRCC). We tested the hypothesis that serum inflammatory markers are associated with clinical outcome in mRCC patients at favorable or intermediate prognostic risk treated with first-line sunitinib. Methods: Eighty-nine mRCC patients were prospectively monitored at baseline (day 0) during sunitinib treatment. Serum interleukin-6 and 8 levels were determined by CLEIA and ELISA, respectively. A high-sensitivity C-reactive protein (hs-CRP) levels were measured using laser nephelometry. Correlations between baseline interleukin-6, 8, hs-CRP levels and response to sunitinib, and progression-free survival (PFS) were examined. Results: Median PFS was 9.2 months. Clinical benefit rate (CBR; percent complete responses+partial responses +stable disease 24 weeks) was 57.3%. Baseline interleukin-8 (P=0.0240) and hs-CRP (P=0.0060) was associated with CBR. No association between baseline interleukin-6 and 8 with PFS was observed. However, baseline hs-CRP were associated with PFS (P=0.0016; unit risk 1.010; 95% CI 1.004 to 1.017). Conclusions: Baseline serum inflammatory markers could be of clinical interest in sunitinib-treated mRCC patiens to predict outcome. Baseline hs-CRP serum levels warrant further study. Clinical trial information: UMIN000009622.

scholarly journals Ultrasound for Appendicitis: Performance and Integration with Clinical Parameters

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Fanny Löfvenberg ◽  
Martin Salö
Keyword(s):  
Predictive Value ◽  
Negative Likelihood Ratio ◽  
C Reactive Protein ◽  
Suspected Appendicitis ◽  
Reactive Protein ◽  
First Choice ◽  
Sensitivity Specificity ◽  
Surgery Center ◽  
Appendicitis Score ◽  
Higher Sensitivity

Objective. To evaluate the performance of ultrasound in pediatric appendicitis and the integration of US with the pediatric appendicitis score (PAS) and C-reactive protein (CRP).Method. An institution-based, retrospective study of children who underwent abdominal US for suspected appendicitis between 2012 and 2015 at a tertiary pediatric surgery center. US results were dichotomized, with a nonvisualized appendix considered as a negative examination.Results. In total, 438 children were included (mean 8.5 years, 54% boys), with an appendicitis rate of 29%. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for US were 82%, 97%, 92%, and 93%, respectively, without significant age or gender differences. Pediatric radiologists had significantly higher sensitivity compared to general radiologists, 88% and 71%, respectively (p<0.01), but no differences were seen for specificity, PPV, and NPV. The sensitivity, NPV, and negative likelihood ratio for the combination of negative US, PAS < 5, and CRP < 5 mg/L were 98%, 98%, and 0.05 (95% CI 0.03–0.15).Conclusion. US may be a useful tool for evaluating children with suspected appendicitis, regardless of age or gender, and should be the first choice of imaging modalities. Combining US with PAS and CRP may reduce several unnecessary admissions for in-hospital observation.

scholarly journals Calprotectin as a Biomarker for Melioidosis Disease Progression and Management

2017 ◽  
Vol 55 (4) ◽  
pp. 1205-1210 ◽  
Author(s):  
Mohan Natesan ◽  
Enoka Corea ◽  
Shivankari Krishnananthasivam ◽  
Harindra Darshana Sathkumara ◽  
Jennifer L. Dankmeyer ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Burkholderia Pseudomallei ◽  
Unmet Need ◽  
Serum Levels ◽  
C Reactive Protein ◽  
Intravenous Antibiotic ◽  
Content Type ◽  
Protein Levels ◽  
Reactive Protein ◽  
Number Of Patients

ABSTRACT Melioidosis is a neglected tropical disease that is caused by the bacterium Burkholderia pseudomallei and is underreported in many countries where the disease is endemic. A long and costly administration of antibiotics is needed to clear infections, and there is an unmet need for biomarkers to guide antibiotic treatment and increase the number of patients that complete therapy. We identified calprotectin as a lead biomarker of B. pseudomallei infections and examined correlations between this serum protein and the antibiotic treatment outcomes of patients with melioidosis. Serum levels of calprotectin and C-reactive protein were significantly higher in patients with melioidosis and nonmelioidosis sepsis than in healthy controls. Median calprotectin levels were higher in patients with melioidosis than in those with nonmelioidosis sepsis, whereas C-reactive protein levels were similar in both groups. Notably, intensive intravenous antibiotic treatment of patients with melioidosis resulted in lower levels of calprotectin and C-reactive protein ( P < 0.0001), coinciding with recovery. The median percent reduction of calprotectin and C-reactive protein was 71% for both biomarkers after antibacterial therapy. In contrast, we found no significant differences in calreticulin levels between the two melioidosis treatment phases. Thus, reductions in serum calprotectin levels were linked to therapeutic responses to antibiotics. Our results suggest that calprotectin may be a sensitive indicator of melioidosis disease activity and illustrate the potential utility of this biomarker in guiding the duration of antibiotic therapy.

scholarly journals Inflammatory markers in a randomised soya intervention among men

2008 ◽  
Vol 101 (12) ◽  
pp. 1740-1744 ◽  
Author(s):  
Gertraud Maskarinec ◽  
Robert Oum ◽  
Ann K. Chaptman ◽  
Simona Ognjanovic
Keyword(s):  
Body Weight ◽  
Inflammatory Markers ◽  
Serum Levels ◽  
Repeated Measurements ◽  
Intervention Effect ◽  
Reactive Protein ◽  
Markers Of Inflammation ◽  
Inflammatory Protein ◽  
Macrophage Inflammatory Protein ◽  
Multiplex Bead

The present analysis investigated the effect of soya foods on serum levels of six inflammatory markers, leptin, adiponectin, monocyte attractant protein 1 (MCP-1), macrophage inflammatory protein-1b (MIP-1b), IL-6 and C-reactive protein (CRP), and their relationship with BMI and lifetime soya intake. We randomised twenty-four men to a high- (two daily servings with 30–35 mg isoflavones per serving) or a low-soya diet for 3 months. After a 1-month washout period, the men crossed over to the other treatment. We used a multiplex bead immunoassay to measure leptin, adiponectin, MCP-1 and MIP-1b and ELISA assays for IL-6 and CRP. The statistical analysis applied mixed models that incorporated the four repeated measurements. The men had a mean age of 58·7 (sd 7·2) years and a mean BMI of 28·4 (sd 4·9) kg/m2. We observed no significant intervention effect of the soya treatment on any of the six markers. After adjustment for age and ethnicity, highly significant associations of BMI and body weight with leptin and MCP-1 emerged. Men with high soya intake early in life also had higher levels of leptin and MCP-1, whereas no association was seen for soya intake during adulthood. MIP-1b, adiponectin, IL-6 and CRP were not related to BMI, body weight or soya intake at any time in life. No intervention effect of soya foods on markers of inflammation was observed in this small study, but adiposity and early-life soya intake were related to higher leptin and MCP-1 levels.

The Use of the NMP22 BladderChek Test for Bladder Cancer to Optimise Investigations in a One-Stop Haematuria Clinic

2008 ◽  
Vol 1 (3) ◽  
pp. 126-130 ◽  
Author(s):  
Simon Bott ◽  
Malek Chanawani ◽  
Hugh Mostafid
Keyword(s):  
Predictive Value ◽  
Point Of Care ◽  
Financial Impact ◽  
General Anaesthetic ◽  
Genitourinary System ◽  
Flexible Cystoscopy ◽  
Number Of Patients ◽  
Urothelial Malignancy ◽  
One Stop ◽  
Sensitivity Specificity

Objective: We assessed the value of the NMP22 BladderChek point-of-care (POC) test (Kyowa Hakko UK Ltd., Slough, UK) in a one-stop haematuria clinic to optimise the choice of further investigations. Patients and methods: Over 34 months from 2005 until 2007, 590 patients presenting to a haematuria clinic were initially assessed with the NMP22 POC test. Patients with a positive NMP22 were counselled and offered further investigation with upper tract imaging and a general anaesthetic cystoscopy without first undergoing flexible cystoscopy (FC). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the NMP22 POC test in this setting were calculated. The financial impact of this policy was assessed. Results: In total 58 of 590 men were NMP22 positive. Urothelial malignancy was identified in 22 patients and 5 had a non-urothelial malignancy of the genitourinary system. The sensitivity of the NMP22 test in detecting urothelial malignancy in newly presenting patients was 56.4%, specificity 93.5%, PPV 38.0% and NPV 97.0%. Eleven had no abnormality and none have subsequently developed a malignancy. The number of patients requiring FC fell by 10% resulting in significant financial savings. Conclusion: The NMP22 POC test can be used as the first test in a haematuria clinic to optimise the choice of subsequent investigations resulting in financial savings.

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