scholarly journals Proadrenomedullin as a prognostic biomarker for critically-ill septic children

2020 ◽  
Author(s):  
Emad E. Ghobrial ◽  
Mervat M Khorshied ◽  
Sally B Adly ◽  
Miriam Magdy Aziz
Keyword(s):  
Critically Ill ◽  
Pediatric Intensive Care ◽  
Diagnostic Value ◽  
Control Group ◽  
P Value ◽  
Future Studies ◽  
Promising Tool ◽  
Risk Of Mortality ◽  
New Biomarkers ◽  
Group Serum

Abstract Background: The use of new biomarkers is a promising tool to assess risk of mortality among septic children. The aim of the study was to confirm prognostic and diagnostic value of pro-ADM as a marker in critically ill septic children. Methods: This study was conducted on 40 patients who were admitted at pediatric intensive care unit (PICU), diagnosed as sepsis in addition to 40 patients enrolled as control group. Serum pro-ADM level was measured for both cases and controls. Results: The level of pro-ADM was significantly higher in cases than controls (p-value <0.001). However, no correlation between level of pro-ADM and outcome (p value 0.720) was found. Conclusion: The pro-ADM level was higher in cases than control, thus proved its diagnostic value but can’t be used as prognostic factor. Future studies are recommended and daily measurements are warranted to study its prognostic value.

scholarly journals Diagnostic Value of Serum Leptin Level in Critically Ill Septic Child

2020 ◽  
pp. 129-135
Author(s):  
Asmaa A. Abo El Yazeed ◽  
Ahmed I. Harkan ◽  
Amira Y. Ahmed ◽  
Ahmed A. Abo Elezz
Keyword(s):  
Immune Responses ◽  
Critically Ill ◽  
Pediatric Intensive Care ◽  
Diagnostic Value ◽  
Sepsis Group ◽  
Control Group ◽  
Case Group ◽  
Healthy Children ◽  
Serum Leptin ◽  
Apparently Healthy

Introduction: Diagnosis of sepsis is important to reduce morbidity and mortality. Leptin is an important immunoregulatory hormone that enhances a number of immune responses in sepsis. Objective: to assess serum leptin in diagnosing sepsis in critically ill pediatric patients. Subjects and Methods: This study was carried out on 50 children divided into a case group included 40 critically ill patients initially sepsis free and fulfilling 2 of 4 criteria of SIRS admitted to the Pediatric Intensive Care Unit, children hospital, Tanta university and a control group included 10 apparently healthy children. According to the presence or absence of infection, our patients were classified into SIRS group and sepsis group. For all studied patients; serum leptin, CRP and others indicators of sepsis were measured at admission and 72h later, while were measured one time only for control group. Results: patients who developed sepsis had significantly higher serum leptin levels than those of the control group and SIRS (33.9 ± 20.8 vs. 1.9 ± 0.4, 21.5+ 10.1 respectively, p>0.05). Conclusion: Serum leptin may have a role in early diagnosis of sepsis.

THE LEVEL OF CYTOKINES IN THE SALIVA OF PATIENTS WITH BREAST CANCER

2019 ◽  
Vol 65 (6) ◽  
pp. 825-831
Author(s):  
Lyudmila Belskaya ◽  
Viktor Kosenok
Keyword(s):  
Breast Cancer ◽  
Control Group ◽  
Early Stages ◽  
Promising Tool ◽  
Urgent Task ◽  
Advanced Stages ◽  
New Biomarkers ◽  
Histological Verification ◽  
Control Study ◽  
Biochemical Examination

Currently, the urgent task is to search for new biomarkers as a promising tool for early detection and monitoring of breast cancer. The aim of the study was to study the level of cytokines in the saliva of patients with breast cancer. In the case-control study volunteers participated, which were divided into 3 groups: the main (breast cancer, n = 43), the comparison group (fibroadenoma, n = 32) and the control group (conditionally healthy, n = 39). All participants were questioned; biochemical examination of saliva, histological verification of the diagnosis was carried out. Intergroup differences are estimated by a nonparametric criterion. It is shown that in the context of breast cancer, the level of cytokines (IL-2, IL-4, IL-6, IL-10 and IL-18) is increasing, except for IL-8, the content of which decreases compared to the control group. When the disease progresses by the nature of the dynamics, the parameters are divided into two groups: IL-2, IL-4, IL-18 and IL-6, IL-8, IL-10. For the first group of cytokines, there was a decrease in content during the transition from the early stages to the more common ones. For the second group, when passing from stages T1-2N0M0 to T1-2NjM0, the level of cytokines remains practically constant. In the future, the level of cytokines is observed for stage T3_4N0_2M0, and for IL-2, IL-4 and IL-10, the level of cytokines reaches values corresponding to early stages, whereas for IL-6, IL-8 and IL-18 in the same direction, a significant increase in indicators was noted. Additionally, the IL-6/IL-8 ratio was calculated depending on the tumor size, as well as the presence / absence of metastasis. It is shown that this ratio is statistically significantly increased in the advanced stages of the disease. Particularly interesting is the increase in this ratio in saliva at the initial stages of the disease.

Evaluation of the New Centers for Disease Control and Prevention Ventilator-Associated Event Module and Criteria in Critically Ill Children in Greece

2016 ◽  
Vol 37 (10) ◽  
pp. 1162-1166 ◽  
Author(s):  
Elias Iosifidis ◽  
Elpis Chochliourou ◽  
Asimenia Violaki ◽  
Elisavet Chorafa ◽  
Stavroula Psachna ◽  
...  
Keyword(s):  
Disease Control ◽  
Critically Ill ◽  
Pediatric Intensive Care ◽  
Critically Ill Children ◽  
Ventilator Associated Pneumonia ◽  
Poor Agreement ◽  
Mechanically Ventilated ◽  
Risk Of Mortality ◽  
Control And Prevention ◽  
Centers For Disease Control

OBJECTIVETo evaluate the new adult Centers for Disease Control and Prevention (CDC) ventilator-associated event (VAE) module in critically ill children and compare with the traditionally used CDC definition for ventilator-associated pneumonia (VAP).DESIGNRetrospective observational study of mechanically ventilated children in a pediatric intensive care unit in Greece January 1-December 31, 2011.METHODSAssessment of new adult CDC VAE module including 3 definition tiers: ventilator-associated condition (VAC), infection-related VAC, and possible/probable ventilator-associated pneumonia (VAE-VAP); comparison with traditional CDC criteria for clinically defined pneumonia in mechanically ventilated children (PNEU-VAP). We recorded Pediatric Risk of Mortality score at admission (PRISM III), number of ventilator-days, and outcome.RESULTSAmong 119 patients with mechanical ventilation (median [range] number of ventilator-days, 7 [1–183]), 19 patients experienced VAC. Criteria for VAE-VAP were fulfilled in 12 of 19 patients with VAC (63%). Children with either VAC or VAE-VAP were on ventilation more days than patients without these conditions (16.5 vs 5 d, P=.0006 and 18 vs 5 d, P<.001, respectively), whereas PRISM-III score was similar between them. Mortality was significant higher in patients with new VAE-VAP definition (50%), but not in patients with VAC (31.6%), than the patients without new VAE-VAP (14%, P=.007) or VAC (15%, P=.1), respectively. No significant association was found between PNEU-VAP and death. Incidences of PNEU-VAP and VAE-VAP were similar, but the agreement was poor.CONCLUSIONSVAE-VAP and PNEU-VAP found similar prevalence in critically ill children but with poor agreement. However, excess of death was significantly associated only with VAE-VAP.Infect Control Hosp Epidemiol 2016:1–5

scholarly journals Serum Dihydropyrimidinase-Like 3 Concentration in Patients with Gastric Cancer and Its Diagnostic Value

2021 ◽  
Author(s):  
Huiqiu Zhong ◽  
Xiaojiang Luo
Keyword(s):  
Gastric Cancer ◽  
Diagnostic Value ◽  
Control Group ◽  
Case Group ◽  
Serum Concentrations ◽  
Medical College ◽  
Healthy Control ◽  
Serum Cea ◽  
Gastric Cancer Patients ◽  
Group Serum

Background: We aimed to investigate the serum concentration of dihydropyrimidinase-like 3 (DPYSL3) in patients with gastric cancer and its clinical significance. Methods: Seventy four patients with gastric cancer from Wuhan Central Hospital, Tongji Medical College, Huazhong University of Science and Technology, China from October 2018 to April 2019 were selected as the case group. Sixty patients with normal gastric mucosa or mild non-atrophic gastritis were selected as the control group. Serum DPYSL3, CA72-4 and CEA concentrations were measured in both groups. Results: The serum DPYSL3 concentration in the case group was significantly higher than that in the healthy control group (22.04±9.22 vs. 8.36±4.19 μg/L, P<0.001). The serum DPYSL3 concentration in patients with advanced gastric cancer was significantly higher than that in early gastric cancer (27.09±9.12 vs. 13.04±8.22 μg/L, P<0.01); serum DPYSL3 concentration was significantly correlated with tumor size, TNM stage and differentiation (P<0.05). When the cutoff value was 20.98 μg/L, the serum DPYSL3 concentration could differentiate the gastric cancer with ROCAUC 0.882 (95% CI: 0.828-0.937) with sensitivity and specificity of 75% and 94%, respectively. Serum CA72-4 concentration could differentiate the gastric cancer from health controls with ROCAUC 0.812 (95% CI: 0.734-0.834), serum CEA concentration could differentiate gastric cancer with ROCAUC 0.612 (95% CI: 0.534 ~ 0.634). The serum concentrations of DPYSL3, CA72-4 and CEA in gastric cancer patients were increased compared to health controls. Conclusion: Three serological markers have complementary diagnostic value for gastric cancer. Serum DPYSL3 is a new potential molecular marker for gastric cancer.

scholarly journals Neuron-Specific Enolase, Serum-100B, Electroencephalogram as Indicators of Extent of Brain Damage in Post Cardiac Arrest Patients

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M Y Elseify ◽  
A R Ahmed ◽  
M O Shattah ◽  
S A Salaheldin
Keyword(s):  
Cardiac Arrest ◽  
Prospective Observational Study ◽  
Pediatric Patients ◽  
Neuron Specific Enolase ◽  
Pediatric Intensive Care ◽  
P Value ◽  
Study Group ◽  
Significant Relation ◽  
Mortality And Morbidity ◽  
Risk Of Mortality

Abstract Background Post cardiac arrest patients have high risk of mortality and morbidity. Brain injury plays an important role in determining patients’ outcome. Aim of the Work: To correlate the levels of Neuron-specific enolase (NSE), Serum-100B (S100B) and Electroencephalogarm patterns in post cardiac arrest pediatric patients with cardiac arrest circumstances and patients’ outcome. Patients and Methods: This prospective observational study was conducted in Pediatric Intensive Care Unit, Ain Shams University. It included 41 post cardiac arrest patients who underwent serum sampling for NSE, Serum 100B and Electroencephalogram. Results: In our study, 19.5% of patients survived to hospital discharge. Convulsions and sepsis were present in 21.9% and 82.9% of the study group respectively. Convulsions and sepsis were associated with higher mortality with relative risk 1.33 and 1.99 respectively. Serum NSE and serum 100B showed no statistically significant relation with outcome. NSE levels were positively correlated with duration of arrest. EEG patterns showed statistically significant differences when related to outcome with p value of 0.01. Conclusion: Post cardiac arrest patients need intense care especially regarding sepsis and convulsions. NSE levels are related to duration of arrest but not survival. S100B levels aren’t related to survival or duration of arrest. Different EEG Patterns are related to patients’ outcome.

Outcome of Lactoferrin Supplementation In Critically Ill Septic Children With Acute Gut Failure

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hanan M Ibrahim ◽  
Eriny E Sabery ◽  
Sondos M Magdy
Keyword(s):  
Critically Ill ◽  
Intestinal Failure ◽  
Clinical Syndrome ◽  
Control Group ◽  
P Value ◽  
University Hospitals ◽  
Citrulline Level ◽  
Gut Barrier Function ◽  
Significant Difference ◽  
Group 2

Abstract Background Sepsis is a clinical syndrome caused by many infections. Septic patients may suffer from Gut failure resulting in severe complications. To improve Gut function, the effect of lactofferin supplementation has been studied. Objective To test the effect of lactoferrin supplementation on improving gut barrier function by using plasma citrulline level as a marker of functional enterocytic mass. Patients and Methods This double armed single blinded therapeutic clinical trial study was conducted on 40 children admitted to (PICUs) of Ain Shams University Hospitals. By diagnosis sepsis and gut failure, twenty of them weren't supplemented with LF (group 1) and the other twenty were supplemented (group 2). All critically ill septic patients diagnosed with acute gut failure admitted from October 2018 to 2019 were subjected to citrulline level measurement by (ELISA). Results We found that citrulline concentration was significantly lower in patients (9.52 nmol/L) than control group (122 nmol/L) and lowered in non survivors (5.13 nmol/L) than survivors (30.68 nmol/L) with p value of 0.027 and 0.034 respectively and a cut off value ≤ 7.82 mmol/L. There was no significant difference between the groups 1 and 2 in treatment of sepsis with gut failure. Conclusion (1) Citrulline level can be used as a predictor of intestinal failure severity and mortality. (2) Lactoferrin supplementation was not beneficial in pediatric septic patient with gut failure and did not improve outcome or prognosis of patients.

scholarly journals The Diagnostic Value of Monocyte Chemoattractant Protein-1, Compared with Procalcitonin, C-reactive Protein, and Lactate in Bacteremia Estimation for Patients with Febrile Neutropenia

2020 ◽  
Vol 28 (4) ◽  
pp. 419-426
Author(s):  
İlker Ödemiş ◽  
Şükran Köse ◽  
Süheyla Serin Senger ◽  
İlkay Akbulut ◽  
Didem Çelik
Keyword(s):  
Blood Culture ◽  
Febrile Neutropenia ◽  
Diagnostic Value ◽  
Control Group ◽  
P Value ◽  
C Reactive Protein ◽  
Monocyte Chemoattractant Protein 1 ◽  
Monocyte Chemoattractant ◽  
Reactive Protein ◽  
Monocyte Chemoattractant Protein

AbstractBacteremia in the febrile neutropenic patients significantly increases the mortality. It takes a long time to complete the blood culture for the diagnosis of bacteremia. Therefore, quick and specific markers are needed for the prediction of bacteremia. The purpose of this study are to compare the diagnostic value of lactate, procalcitonin, C-reactive protein (CRP) and monocyte chemoattractant protein-1 (MCP-1) levels in a patient with febrile neutropenia, and to evaluate its usefulness in predicting bacteremia. This study was designed to be prospective case-control study. Forty-eight patients and forty control cases aged 18 years or older who were monitored between May 2016 and May 2017 were included in the study. P-value as <0.05 was accepted to be significant. Significantly increased values were determined by the level of inflammatory markers of patients compared to the control group. The highest diagnostic odds ratio were found to be in MCP-1. For patients with febrile neutropenia, CRP (83.3%), and MCP-1 (81.2%) were the most sensitive markers while lactate (85.0%), MCP-1 (75%), and procalcitonin (75%) were the most specific markers. CRP was the only beneficial biomarker in the estimation of bacteremia. No significant results were observed for any biomarker for the prediction of the gram positive/negative discrimination of bacteria in the blood culture. We believe that CRP, MCP-1, and lactate levels can be taken into consideration for diagnosis, and CRP can be beneficial in the estimation of bacteremia.

Estimation of Intestinal Fatty Acid Binding Protein Level as a Marker of Gut Failure in Critically ILL Pediatric Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hanan M Ibrahim ◽  
Christina E Hermina ◽  
Sondos M Magdy
Keyword(s):  
Critically Ill ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
P Value ◽  
University Hospitals ◽  
Rapid Reduction ◽  
Cross Sectional ◽  
Fatty Acid Binding ◽  
Gut Barrier Function ◽  
Egyptian Children

Abstract Background Sepsis is a life-threatening condition and frequently associated with gut failure manifestations. Gut failure was defined as a rapid reduction of smallbowel enterocytic function. Gut barrier function has been studied using serum IFABP level as a marker of functional enterocytic mass. Objective To estimate the serum IFABP level in septic pediatric cases associated with gut failure. Patients and Methods This cross-sectional study was conducted on 40 Egyptian children admitted to Pediatric Intensive Care Units (PICUs) of Ain Shams University Hospitals. Serum IFABP level was measured in plasma using enzyme-linked immunosorbent assay (ELISA). All critically ill septic patients diagnosed with acute gut failure admitted in the period from 1/4/2018 to 1/5/2019 were subjected to serum IFABP level measurement at the first and the tenth day of diagnosis. Results The serum IFABP median levels on day one and day ten were higher in patients group (5.08 µmol/ml - 9.34 µmol/ml) than control group (0 1.7 µmol/ml – 1.7 µmol/ml) with p value 0.014, 0.020 respectively. Also it was higher in survivors group (17.78 µmol/ml) than non survivors group (3.39µmol/ml) with p value 0.047. SOFA score was lower in survivors (5) than non survivors (8) with p value 0.020. Conclusion IFABP serum level can be a promising marker to detect early intestinal wall and enterocyte damage, taking into consideration time of sampling and inotropes administration.

Performance of Pediatric Risk of Mortality Score Among Critically Ill Children With Heart Disease

2017 ◽  
Vol 8 (4) ◽  
pp. 427-434 ◽  
Author(s):  
Rebecca A. Russell ◽  
Mallikarjuna Rettiganti ◽  
Nancy Brundage ◽  
Howard E. Jeffries ◽  
Punkaj Gupta
Keyword(s):  
Cardiac Surgery ◽  
Heart Disease ◽  
Critically Ill ◽  
Severity Of Illness ◽  
Pediatric Intensive Care ◽  
Critically Ill Children ◽  
Medical Patients ◽  
Entire Cohort ◽  
C Statistic ◽  
Risk Of Mortality

Objective: To evaluate the performance of the Pediatric Risk of Mortality 3 (PRISM-3) score in critically ill children with heart disease. Methods: Patients <18 years of age admitted with cardiac diagnoses (cardiac medical and cardiac surgical) to one of the participating pediatric intensive care units in the Virtual Pediatric Systems, LLC, database were included. Performance of PRISM-3 was evaluated with discrimination and calibration measures among both cardiac surgical and cardiac medical patients. Results: The study population consisted of 87,993 patients, of which 49% were cardiac medical patients (n = 43,545) and 51% were cardiac surgical patients (n = 44,448). The ability of PRISM-3 to distinguish survivors from nonsurvivors was acceptable for the entire cohort (c-statistic 0.86). However, PRISM-3 did not perform as well when stratified by varied severity of illness categories. Pediatric Risk of Mortality 3 underpredicted mortality among patients with lower severity of illness categories (quintiles 1-4) whereas it overpredicted mortality among patients with greatest severity of illness category (fifth quintile). When stratified by Society of Thoracic Surgeons–European Association for Cardiothoracic Surgery (STS-EACTS) categories, PRISM-3 overpredicted mortality among the STS-EACTS mortality categories 1, 2, and 3 and underpredicted mortality among the STS-EACTS mortality categories 4 and 5. Pediatric Risk of Mortality 3 overpredicted mortality among centers with high cardiac surgery volume whereas it underpredicted mortality among centers with low cardiac surgery volume. Conclusion: Data from this large multicenter study do not support the use of PRISM-3 in cardiac surgical or cardiac medical patients. In this study, the ability of PRISM-3 to distinguish survivors from nonsurvivors was fair at best, and the accuracy with which it predicted death was poor.

scholarly journals Hypoalbuminemia as a Predictor of Adverse Outcome in Critically Ill Children: A Prospective Cohort Study

2021 ◽  
Author(s):  
Abeer Yehia El-shamy ◽  
Ahmed Anwar Khattab ◽  
Alyaa Ahdy Adbel-Aziz
Keyword(s):  
Cohort Study ◽  
High Risk ◽  
Critically Ill ◽  
Prospective Cohort ◽  
Poor Prognosis ◽  
Pediatric Patients ◽  
Albumin Level ◽  
Critically Ill Children ◽  
P Value ◽  
Risk Of Mortality

Abstract Background hypoalbuminemia is a common finding in critically ill patients associated with a high risk of mortality, but there is lack of data on its role in pediatric patients. The aim of this study is to investigate the effect of low albumin levels in pediatric patients on poor prognosis and high risk of mortality in the pediatric intensive care unit (PICU). Methods This was a prospective cohort study conducted at the PICU at El-Bagour hospital from November 2018 to November 2020. The aim was to evaluate low albumin level as a predictor of poor prognosis and clinical outcome in 150 critically ill children aged one month up to 18 years. ROC curve was used to assess the discriminatory ability of scoring systems for patients’ mortality. Results 148 patients were included in the final analysis where the incidence of hypoalbuminemia in the 1st 48-h postadmission was 44.6% with an overall mean serum albumin level of 3.34 ± 0.78. Hypoalbuminemia was an independent factor of mortality prediction. Moreover, we found children with hypoalbuminemia had higher mortality rate (p-value < 0.001), higher PICU stays (p-value = 0.016), lower galscow coma score (GSC) (p-value = 0.0017), and more need of mechanical ventilation (p-value < 0.001). Conclusion hypoalbuminemia may be used as a significant predictor of mortality and risk assessment in critically ill children.

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