scholarly journals Comparison of Clinical Features between the High and Low Serum KL-6 Patients with Acute Exacerbation of Interstitial Lung Diseases

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Yoichi Tagami ◽  
Yu Hara ◽  
Kota Murohashi ◽  
Ryo Nagasawa ◽  
Yurika Nishikawa ◽  
...  
Keyword(s):  
Acute Exacerbation ◽  
Clinical Features ◽  
Lung Diseases ◽  
Serum Lactate ◽  
Interstitial Lung Diseases ◽  
High Serum ◽  
Charlson Comorbidity Index Score ◽  
Serum Lactate Dehydrogenase ◽  
Significant Difference ◽  
Low Serum

Background. Serum Krebs von den Lungen-6 (KL-6) measurement is widely used to assess disease activity or prognosis in patients with interstitial lung diseases (ILDs). However, the clinical differences between high and low serum KL-6 levels at the time of acute exacerbation (AE) of ILD are not well known. Methods. Clinical parameters including age, sex, Charlson Comorbidity Index score (CCIS), blood biomarkers, high-resolution CT findings, and disease mortality were retrospectively compared between high and low KL-6 (cutoff value: 1000 U/mL) patients at the time of diagnosis of AE of ILDs. Results. Thirty-eight high serum KL-6 and 57 low serum KL-6 patients were included. There was no significant difference in 6-month mortality between them ( P  = 0.685), whereas serum lactate dehydrogenase was a significant predictor of 6-month mortality in the high serum KL-6 patients (odds ratio (OR): 1.006; 95% confidence interval (CI): 1.003–1.009; P  < 0.001), and CCIS (OR: 1.502; 95% CI: 1.242–1.838; P  < 0.001) and sex (OR: 5.751; 95% CI: 1.121–105.163; P  = 0.033) were significant predictors in low serum KL-6 patients. In addition, the incidences of congestive heart failure, symptomatic chronic pulmonary disease, cerebrovascular disease, and second metastatic solid tumours were significantly higher in nonsurvivors with low serum KL-6 than in other groups ( P  < 0.05). Conclusions. The clinical features in patients with AEs of ILDs may differ depending on the serum KL-6 level, and clinicopathological examination according to this subtyping guided by the serum KL-6 level is essential.

scholarly journals Clinical subtyping for patients with acute exacerbations of interstitial lung diseases guided by serum KL-6 measurement

2021 ◽  
Author(s):  
Yoichi Tagami ◽  
Yu Hara ◽  
Kota Murohashi ◽  
Ryo Nagasawa ◽  
Yurika Nishikawa ◽  
...  
Keyword(s):  
Lung Diseases ◽  
Serum Lactate ◽  
Interstitial Lung Diseases ◽  
High Serum ◽  
Charlson Comorbidity Index Score ◽  
Serum Lactate Dehydrogenase ◽  
Disease Mortality ◽  
Significant Difference ◽  
Acute Exacerbations ◽  
Low Serum

Abstract Introduction: Serum Krebs von den Lungen-6 (KL-6) measurement is widely used to assess disease activity or prognosis in patients with interstitial lung diseases (ILDs). However, the clinical differences between high and low serum KL-6 levels at the time of acute exacerbation (AE) of ILD are not well known.Methods: Clinical parameters including age, sex, Charlson Comorbidity Index score (CCIS), blood biomarkers, high-resolution CT findings, and disease mortality were retrospectively compared between high and low KL-6 (cut-off value: 1000 U/mL) patients at the time of diagnosis of AE of ILDs.Results: 38 high serum KL-6 and 57 low serum KL-6 patients were included. There was no significant difference in 6-month mortality between them (P = 0.685). Whereas serum lactate dehydrogenase was a significant predictor of 6-month mortality in the high serum KL-6 patients (odds ratio (OR), 1.006; 95% confidence interval (CI), 1.003-1.009; P < 0.001), CCIS (OR, 1.502; 95% CI, 1.242-1.838; P < 0.001) and sex (OR, 5.751; 95% CI, 1.121-105.163; P = 0.033) were significant predictors in low serum KL-6 patients. In addition, the incidences of congestive heart failure, symptomatic chronic pulmonary disease, cerebrovascular disease, and second metastatic solid tumours were significantly higher in non-survivors with low serum KL-6 than in other groups (p < 0.05).Conclusions: The clinical features in patients with AEs of ILDs may differ depending on the serum KL-6 level, and clinicopathological examination according to this subtyping guided by the serum KL-6 level is essential.

The extent of honeycombing on computed tomography cannot predict the treatment outcome of patients with acute exacerbations of interstitial lung disease (Retrospective cohort study)

2021 ◽  
Author(s):  
Yurika Nishikawa ◽  
Yu Hara ◽  
Yoichi Tagami ◽  
Ryo Nagasawa ◽  
Kota Murohashi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ground Glass Opacity ◽  
Pulse Therapy ◽  
Serum Lactate ◽  
Interstitial Lung Diseases ◽  
Charlson Comorbidity Index Score ◽  
Serum Lactate Dehydrogenase ◽  
Significant Difference ◽  
Acute Exacerbations ◽  
The Difference

Abstract Background: The purpose of this retrospective study was to clarify whether the presence of honeycombing on computed tomography (CT) can affect the prognosis of patients with acute exacerbations (AEs) of interstitial lung diseases (ILDs).Methods: Clinical parameters including age, sex, Charlson Comorbidity Index score (CCIS), blood biomarkers, and 3-month mortality were retrospectively compared between the CT honeycombing present and absent groups at the diagnosis of AEs of ILDs.Results: Ninety-five patients who were on corticosteroid pulse therapy were assessed. Though log-rank tests showed that Kaplan-Meier survival curves of the high and low ground-glass opacity (GGO) score groups differed significantly in 3-month mortality in patients with AEs of idiopathic ILDs (P = 0.007) and overall patients (P = 0.045), there was no significant difference between the CT honeycombing present and absent groups in patients with AEs of idiopathic ILDs (P = 0.600) and AEs of secondary ILDs (P = 0.472), as well as of overall patients (P = 0.905). In addition, whereas CCIS (OR, 1.436; 95% CI, 1.119-1.938; P = 0.004) and age (OR, 1.097; 95% CI, 1.119-1.212; P = 0.026) were significant predictors of 3-month mortality in the CT honeycombing absent group, serum lactate dehydrogenase (OR, 1.004; 95% CI, 1.002-1.007; P = 0.001) and sex (OR, 6.381; 95% CI, 0.821-49.602; P = 0.023) were significant predictors in the CT honeycombing present groupConclusions: The clinical features of patients with or without honeycombing may differ due to the difference in prognostic factors, but these groups were found to have similar prognoses 3 months after AE onset, and clinicopathological examinations according to these groups are essential.

scholarly journals The Role of Transthoracic Ultrasound in the Study of Interstitial Lung Diseases: High-Resolution Computed Tomography Versus Ultrasound Patterns: Our Preliminary Experience

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 439
Author(s):  
Donato Lacedonia ◽  
Giulia Scioscia ◽  
Angelamaria Giardinelli ◽  
Carla Maria Irene Quarato ◽  
Ennio Vincenzo Sassani ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Lung Diseases ◽  
Interstitial Lung Diseases ◽  
High Resolution Computed Tomography ◽  
Pleural Line ◽  
Complementary Role ◽  
Number Of Patients ◽  
Significant Difference ◽  
Transthoracic Ultrasound

Transthoracic ultrasound (TUS) is a readily available imaging tool that can provide a quick real-time evaluation. The aim of this preliminary study was to establish a complementary role for this imaging method in the approach of interstitial lung diseases (ILDs). TUS examination was performed in 43 consecutive patients with pulmonary fibrosis and TUS findings were compared with the corresponding high-resolution computed tomography (HRCT) scans. All patients showed a thickened hyperechoic pleural line, despite no difference between dominant HRCT patterns (ground glass, honeycombing, mixed pattern) being recorded (p > 0.05). However, pleural lines’ thickening showed a significant difference between different HRCT degree of fibrosis (p < 0.001) and a negative correlation with functional parameters. The presence of >3 B-lines and subpleural nodules was also assessed in a large number of patients, although they did not demonstrate any particular association with a specific HRCT finding or fibrotic degree. Results allow us to suggest a complementary role for TUS in facilitating an early diagnosis of ILD or helping to detect a possible disease progression or eventual complications during routine clinical practice (with pleural line measurements and subpleural nodules), although HRCT remains the gold standard in the definition of ILD pattern, disease extent and follow-up.

scholarly journals Gas-Forming Pyogenic Liver Abscess with Septic Shock

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Muhammad S. Khan ◽  
Muhammad K. Ishaq ◽  
Kellie R. Jones
Keyword(s):  
Septic Shock ◽  
Liver Abscess ◽  
Clinical Course ◽  
Pyogenic Liver Abscess ◽  
Blood Stream ◽  
Serum Lactate ◽  
High Serum ◽  
Serum Lactate Dehydrogenase ◽  
Indirect Bilirubin ◽  
Serum Haptoglobin

The pyogenic liver abscess caused byClostridium perfringens(C. perfringens) is a rare but rapidly fatal infection. The main virulence factor of this pathogen is itsα-toxin (lecithinase), which decomposes the phospholipid in cell membranes leading to cell lysis. Once the bacteria are in blood stream, massive intravascular hemolysis occurs. This can present as anemia on admission with evidence of hemolysis as indicated by low serum haptoglobin, high serum lactate dehydrogenase (LDH), elevated indirect bilirubin, and spherocytosis. The clinical course ofC. perfringenssepticemia is marked by rapidly deteriorating course with a mortality rate ranging from 70 to 100%. The very rapid clinical course makes it difficult to diagnose on time, and most cases are diagnosed at autopsy. Therefore it is important to considerC. perfringensinfection in any severely ill patient with fever and evidence of hemolysis. We present a case of seventy-seven-year-old male with septic shock secondary to pyogenic liver abscess with a brief review of existing literature onC. perfringens.

scholarly journals Clinical significance of respiratory virus detection in patients with acute exacerbation of interstitial lung diseases

2018 ◽  
Vol 136 ◽  
pp. 88-92 ◽  
Author(s):  
Takeshi Saraya ◽  
Hirokazu Kimura ◽  
Daisuke Kurai ◽  
Masaki Tamura ◽  
Yukari Ogawa ◽  
...  
Keyword(s):  
Acute Exacerbation ◽  
Clinical Significance ◽  
Lung Diseases ◽  
Respiratory Virus ◽  
Virus Detection ◽  
Interstitial Lung Diseases

scholarly journals LDH LEVEL IN ACUTE ORGANOPHOSPHORUS POISONING AND ITS RELATION WITH SEVERITY AND MORTALITY: A TERTIARY CARE HOSPITAL EXPERIENCE

2021 ◽  
Vol 5 (4) ◽  
Author(s):  
Suresh Kumar Nagar ◽  
Maniram Kumhar ◽  
V. B. Singh ◽  
Mayank Srivastav
Keyword(s):  
Organophosphorus Compounds ◽  
Tertiary Care ◽  
Crop Protection ◽  
Serum Lactate ◽  
Spectrophotometric Analysis ◽  
Serum Lactate Dehydrogenase ◽  
Care Hospital ◽  
Significant Difference ◽  
Organophosphorus Poisoning ◽  
Acute Organophosphorus Poisoning

Background: Organophosphorus compounds have been widely used for a few decades in agriculture for crop protection and pest control. In India Organophosphorus poisoning is the most common. The objective of our study was to measure the  LDH Level in acute organophosphorus poisoning Methods: This study was conducted among minimum 100 patients acute organophosphorus poisoning admitted in Casualty ward, MICU and attending medical ward of JLN hospital, Ajmer during Aug 2018 to July 2020. Serum lactate dehydrogenase estimation by spectrophotometric analysis using Beckman Coalter AU 680 Results: These were significantly higher among deaths on day 1 and 3(810±372.99 and 1027.09±458.26, respectively) in comparison to survivors on day 1 and 3 (538.18±300.42 and 365.19±175.49, respectively). Significant difference was found between mean values of different levels of severity of LDH on day 1 and 3. Conclusion: In conclusion, this study found that Serum LDH can be used as biomarker in diagnosis or stratifying severity of acute OP poisoning, as it is cheap and easily available, especially in developing countries. Serial measurements of serum LDH levels in acute OP poisoning can predict the prognosis. Keywords: LDH, OP poisoning, Severity

Urinary creatine: biochemical indicator for evaluation of sickle cell crises.

1985 ◽  
Vol 31 (7) ◽  
pp. 1232-1234 ◽  
Author(s):  
C Beyer ◽  
L W Statius van Eps ◽  
J J Kastelein ◽  
D P Brandjes ◽  
W M Mairuhu ◽  
...  
Keyword(s):  
Lactate Dehydrogenase ◽  
Sickle Cell ◽  
Excretion Rate ◽  
Serum Lactate ◽  
High Serum ◽  
Serum Lactate Dehydrogenase ◽  
Muscle Involvement ◽  
Biochemical Indicator ◽  
Excretion Rates ◽  
Sickle Cell Crises

Abstract In a patient with known sickle cell beta 0-thalassemia we measured serum lactate dehydrogenase (LD) activity and 24-h urinary creatine excretion rate as markers to evaluate sickle cell crises. We believe that a distinction based on biochemical findings can be made between hemolytic and painful vaso-occlusive sickle cell crises with muscular involvement. To assess hemolytic crises by objective biochemical measures, we have used assay of LD activity, and to assess painful crises with muscular involvement objectively, the 24-h urinary creatine excretion rate. We conclude that hemolytic crises are characterized by high serum LD activities. Furthermore, we conclude that--at least in this patient--painful crises are accompanied by high 24-h urinary creatine excretion rates. Our findings suggest that muscle involvement may play an important role in painful vaso-occlusive sickle cell crises.

Treatment of Indolent B-Cell Nonfollicular Lymphomas: Final Results of the LL01 Randomized Trial of the Gruppo Italiano per lo Studio dei Linfomi

2003 ◽  
Vol 21 (8) ◽  
pp. 1459-1465 ◽  
Author(s):  
Luca Baldini ◽  
Maura Brugiatelli ◽  
Stefano Luminari ◽  
Marco Lombardo ◽  
Francesco Merli ◽  
...  
Keyword(s):  
B Cell ◽  
Univariate Analysis ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
Progression Free Survival ◽  
Serum Lactate ◽  
Serum Lactate Dehydrogenase ◽  
High Dose ◽  
Free Survival ◽  
Significant Difference

Purpose: To evaluate the effect of epirubicin on therapeutic response and survival in patients with indolent nonfollicular B-cell lymphomas (INFL) treated with pulsed high-dose chlorambucil. Patients and Methods: A total of 170 untreated patients with advanced/active INFL were randomly assigned to receive either eight cycles of high-dose chlorambucil (15 mg/m2/d) plus prednisone (100 mg/d) for 5 days (HD-CHL-P; arm A) or eight cycles of HD-CHL-P plus epirubicin 60 mg/m2 intravenous on day 1 (arm B). The responding patients were randomly assigned to either maintenance therapy with interferon alfa (IFNα-2a; 3 MU, three times weekly) for 12 months or observation. Results: There were 160 assessable patients (82 males, 78 females; median age, 63 years; range, 33 to 77 years); 77 patients were assigned to arm A, and 83 were assigned to arm B. Induction therapy led to 47 complete responses (CRs; 29.4%) and 68 partial responses (PRs; 42.5%), with no significant difference between the two arms (60 CR + PR in arm A [77.9%] and 55 CR + PR in arm B [66.3%]; P = .07). After a median follow-up of 38 months (range, 2 to 103 months), there was no between-group difference in overall survival (OS; P = .45), failure-free survival (P = .07), or progression-free survival (PFS; P = .5). Eighty-eight patients were randomly assigned to either IFNα-2a (n = 43) or observation (n = 45), without any difference in 3-year PFS (44% and 42%, respectively). Univariate analysis showed that OS was influenced by age, anemia, serum lactate dehydrogenase levels, and International Prognostic Index distribution; multivariate analysis identified age and anemia as having influence on OS. Conclusion: HD-CHL-P treatment outcome in INFL patients was good (50% 3-year PFS, minimal toxicity, and low costs); epirubicin did not add any advantage. One-year IFNα maintenance treatment did not prolong response duration.

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