scholarly journals The frequency of occult solid malignancy in patients with polymyalgia rheumatica-like symptoms

2021 ◽  
Vol 13 ◽  
pp. 1759720X2098427
Author(s):  
André Ramon ◽  
Caroline Guillibert-Karras ◽  
Laurence Milas-Julien ◽  
Jean-François Garrot ◽  
Jean-Francis Maillefert ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Early Stage ◽  
Specific Antigen ◽  
Real Life ◽  
Ampullary Carcinoma ◽  
Systematic Screening ◽  
Solid Malignancy ◽  
Protein Levels ◽  
Reactive Protein ◽  
Kidney Carcinoma

Aims: We aim to evaluate the clinical usefulness of systematic screening for occult cancer in patients with polymyalgia rheumatic (PMR)-like symptoms in real-life practice. Methods: All patients seen by rheumatologists in Burgundy, France, between March 2016 and December 2018 for new-onset PMR that met the 2012 ACR/EULAR classification criteria were prospectively included. Patients underwent systematic screening including determination of the erythrocyte sedimentation rate, serum C-reactive protein levels, thoracic, abdominal and pelvic computed tomography (CT-TAP) and, in men, serum prostate-specific antigen. The standardized incidence ratio (SIR) for cancers was calculated using 2012 national estimates of cancer incidence. Potential predictive factors for the diagnosis of cancer were then evaluated using univariate and multivariate analyses. Results: Among the 118 patients included, nine cases of cancer were confirmed and diagnosed with CT-TAP: kidney carcinoma ( n = 4), lung cancer ( n = 2), pancreatic, colon, and ampullary carcinoma ( n = 1 each). Among these cancers, five were localized (four kidney, and one ampullary carcinoma) and were treated with complete surgical resection. The expected incidence of cancer in the general population was 1.95, leading to an overall SIR of 4.6 (95% CI 2.4–8.9, p < 0.0001). An additional analysis was performed for the kidney carcinoma, and it showed a highly significant increase in SIR: 80.8 (95% CI 30.3–215.4). In 80% of patients, the PMR-like syndrome regressed during cancer treatment. No other predictive factors for cancer were found. Conclusion: Systematic screening for cancer including CT-TAP in real-life practice revealed occult solid malignancy, mostly early-stage cancer, in a relevant proportion of patients presenting PMR-like symptoms. The high proportion of kidney cancer (40%) is worth highlighting, especially considering that it is not one of the most frequent cancers after 50 years of age.

scholarly journals Evaluation of the role of CRP as an early predictor of chorioamnionitis in PPROM

2018 ◽  
Vol 7 (4) ◽  
pp. 1351 ◽  
Author(s):  
Amika Aggarwal ◽  
Sangeeta Pahwa
Keyword(s):  
Predictive Value ◽  
Early Stage ◽  
Control Group ◽  
Total Leucocyte Count ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein ◽  
A Prospective Study ◽  
Early Predictor

Background: Preterm birth is one of the most important cause of perinatal morbidity and mortality. PROM is defined as spontaneous rupture of membranes before the onset of uterine contraction. Objective of present study was to evaluate the role of CRP as an early predictor of Chorioamnionitis in PPROM.Methods: A prospective study was done on 50 cases with PPROM and 50cases of control group without PPROM. All mothers and babies were observed from the time of admission to the time of discharge.Results: C-reactive protein appears to be the most sensitive acute phase protein; rising of less than 24 hours makes it suitable to serve as a marker for diagnosing an infective process in early stage. On comparing C-reactive protein levels with other laboratory tests and indicators of infection (e.g. total leucocyte count DLC, maternal fever, maternal tachycardia, fetal tachycardia) we found CRP level to be more sensitive (100%) but less specific (69.56%) in identifying clinical Chorioamnionitis. The positive predictive value was 22.22% and negative predictive value was 100%.Conclusions: In cases of PPROM, raised CRP is an early predictor of clinical Chorioamnionitis as well as histological Chorioamnionitis.

A systematic review of the number needed to screen for active TB among people living with HIV

2021 ◽  
Vol 25 (6) ◽  
pp. 427-435
Author(s):  
L. H. Chaisson ◽  
F. Naufal ◽  
P. Delgado-Barroso ◽  
H. S. Alvarez-Manzo ◽  
K. O. Robsky ◽  
...  
Keyword(s):  
Screening Tools ◽  
High Yield ◽  
People Living With Hiv ◽  
Weighted Mean ◽  
Systematic Screening ◽  
Protein Levels ◽  
Reactive Protein ◽  
Number Needed To Screen ◽  
Chest X Ray ◽  
Living With Hiv

BACKGROUND: Systematic screening for active TB is recommended for all people living with HIV (PLWH); however, case detection remains poor globally. We investigated the yield of active case finding (ACF) by calculating the number needed to screen (NNS) to detect a case of active TB among PLWH.METHODS: We identified studies reporting ACF for TB among PLWH published from November 2010 to February 2020. We calculated crude NNS for Xpert- or culture-confirmed TB and weighted mean NNS stratified by screening approach, population/risk group, and country TB burden.RESULTS: Of the 27,221 abstracts screened, we identified 58 studies eligible for inclusion, including 5 in low/moderate TB incidence settings and 53 in medium/high incidence settings. Populations screened for TB included inpatients, outpatients not receiving antiretroviral therapy (ART), outpatients receiving ART, those with CD4 < 200 cells/µL, children aged ≤15 years, pregnant PLWH, and PLWH in prisons. Screening tools included symptom-based screening, chest X-ray, C-reactive protein levels, and Xpert. The weighted mean NNS varied across groups but was consistently low, ranging from 4 among inpatients in moderate/high TB burden settings to 137 among pregnant PLWH in moderate/high TB burden settings.CONCLUSIONS: ACF is a high yield intervention among PLWH. Approaches to screening should be tailored to local epidemiological and health-system contexts, and sensitive screening tools such as Xpert should be implemented where feasible.

scholarly journals Comparison of C-reactive Protein Levels in Patients with Lung Cancer and Chronic Obstructive Pulmonary Disease

Medicina ◽  
2011 ◽  
Vol 47 (8) ◽  
pp. 421 ◽  
Author(s):  
Neringa Vagulienė ◽  
Marius Žemaitis ◽  
Skaidrius Miliauskas ◽  
Daiva Urbonienė ◽  
Brigita ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Early Stage ◽  
Chronic Obstructive ◽  
C Reactive Protein ◽  
Early Stage Lung Cancer ◽  
Obstructive Pulmonary Disease ◽  
Protein Levels ◽  
Reactive Protein ◽  
Copd Patients ◽  
Stage Lung Cancer

Objective. The aim of this study was to establish C-reactive protein (CRP) levels in serum of patients with lung cancer and chronic obstructive pulmonary disease (COPD) and evaluate the associations of CRP levels with clinicopathological characteristics. Materials and Methods. In total, 140 persons were included in the study: 43 patients with lung cancer, 34 patients with lung cancer and COPD, 42 patients with COPD, and 21 healthy subjects. CRP analysis was performed with a serum protein analyzer using commercially available highsensitivity reagent kits. Results. The C-reactive protein levels were significantly higher in the lung cancer patients with or without COPD compared with the COPD patients or the control group (20.42±1.95 and 22.49±2.31 vs. 8.37±0.91 and 2.49±0.47 mg/L, respectively; P<0.01). The patients with advanced lung cancer had higher CRP levels compared with the patients suffering from early stage lung cancer (23.11±1.72 vs. 14.59±2.23 mg/L, P<0.01). The CRP levels were significantly higher in the patients with early stage lung cancer compared with the COPD patients (14.59±2.23 mg/L vs. 8.37±0.91 mg/L, P<0.05). No association was found between CRP and histology, lung function, and smoking status in the patients with lung cancer. Conclusions. Chronic inflammation plays an important role in both diseases: lung cancer and COPD. However, it seems that inflammation is more pronounced in patients with lung cancer, as the CRP levels were significantly higher in these patients than other groups.

Positive correlation between neovascularization degree of carotid atherosclerosis determined by contrast-enhanced ultrasound and level of serum C-reactive protein

VASA ◽  
2015 ◽  
Vol 44 (3) ◽  
pp. 0187-0194 ◽  
Author(s):  
Xiaoni Chang ◽  
Jun Feng ◽  
Litao Ruan ◽  
Jing Shang ◽  
Yanqiu Yang ◽  
...  
Keyword(s):  
Contrast Enhancement ◽  
Rank Correlation ◽  
Artery Stenosis ◽  
Contrast Enhanced Ultrasound ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein ◽  
Contrast Enhanced ◽  
Grade 3 ◽  
Axis View

Background: Neovascularization is one of the most important risk factors for unstable plaque. This study was designed to correlate plaque thickness, artery stenosis and levels of serum C-reactive protein with the degree of intraplaque enhancement determined by contrast-enhanced ultrasound. Patients and methods: Contrast-enhanced ultrasound was performed on 72 carotid atherosclerotic plaques in 48 patients. Contrast enhancement within the plaque was categorized as grade 1, 2 or 3. Maximum plaque thickness was measured in short-axis view. Carotid artery stenosis was categorized as mild, moderate or severe. Results: Plaque contrast enhancement was not associated with the degree of artery stenosis or with plaque thickness. Serum C-reactive protein levels were positively correlated with the number of new vessels in the plaque. C-reactive protein levels increased in the three groups(Grade 1: 3.72±1.79mg/L; Grade 2: 7.88±4.24 mg/L; Grade 3: 11.02±3.52 mg/L), with significant differences among them (F=10.14, P<0.01), and significant differences between each two groups (P<0.05). Spearman’s rank correlation analysis showed that serum C-reactive protein levels were positively correlated with the degree of carotid plaque enhancement (Rs =0.69, P<0.01). Conclusions: The combination of C-reactive protein levels and intraplaque neovascularization detected by contrast-enhanced ultrasound may allow more accurate evaluation of plaque stability.

Sign in / Sign up

Export Citation Format

Share Document