scholarly journals Racial/ethnic Disparities on Inflammation and Response to Methylprednisolone in Severe Covid-19 Pneumonia

2021 ◽  
Author(s):  
Ronaldo C. Go ◽  
Themba Nyirenda ◽  
Maryam Bojarian ◽  
Davood Karimi Hosseini ◽  
Kevin Kim ◽  
...  
Keyword(s):  
Inflammatory Markers ◽  
Asian Indians ◽  
Low Dose ◽  
Ethnic Disparities ◽  
Prolonged Survival ◽  
High Dose ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
High Dose Methylprednisolone ◽  
Racial Ethnic

Abstract BACKGROUNDRacial/Ethnic minorities are at higher risk for Severe COVID-19. This may be related to social determinants that lead to chronic inflammatory states. The aims of the study were to determine if there are racial/ethnic differences between the inflammatory markers of survivors and non-survivors and if there was a dose dependent association of methylprednisolone to in hospital survival. METHODSThis was a secondary analysis of a retrospective cohort. Patients were older than 18 years of age and admitted for severe COVID-19 Pneumonia Between March to June 2020 in 13 Hospitals in New Jersey, United States. Comparison of inflammatory markers used Kruskal-Wallis followed by pairwise comparison using two-sided Wilcoxon rank sum test. A Youden Index Method was used to determine the cut-off between low dose and high dose methylprednisolone. For each racial/ethnic group, cox regression was used to determine the association to survival between no methylprednisolone and methylprednisolone (high dose versus low dose). RESULTSPropensity matched sample (n=759) between no methylprednisolone (n=380) and methylprednisolone (n=379) had 338 Whites, 102 Blacks, 61 Asian/Indians, and 251 Non-Black Non-White Hispanics. Interleukin-6, C-reactive protein, ferritin, and d-dimer values were higher in non-survivors compared to survivors except in Asian/Indian survivors who had higher ferritin values compared to non-survivors (median: 1,265 vs 418 ug/L, P=0.0211). Black and Hispanic survivors had persistently elevated C-reactive protein, (10.2 mg/mL) and (13.70 mg/mL) respectively. Low dose methylprednisolone was associated with prolonged 60 days in hospital survival over no methylprednisolone in Whites (P<0.0001), Asian/Indians (P=0.0180), and Hispanics (P=0.0004). Regardless of dose, methylprednisolone was not associated with prolonged survival in Blacks. High dose methylprednisolone was associated with worse survival in Hispanics. (P=0.0181). CONCLUSIONRacial/Ethnic disparities with inflammatory markers in survivors and non-survivors preclude the use of one marker as predictor of survival. Low dose methylprednisolone is associated with prolonged survival in Asian/Indians, Hispanics, and Whites. Methylprednisolone, regardless of dose, was not associated with prolonged survival in Blacks.

Does Single, Low-Dose Preoperative Dexamethasone Improve Outcomes after Colorectal Surgery Based on an Enhanced Recovery Protocol? Double-Blind, Randomized Clinical Trial

2008 ◽  
Vol 74 (2) ◽  
pp. 160-167 ◽  
Author(s):  
Turkay Kirdak ◽  
Aysun Yilmazlar ◽  
Sinan Cavun ◽  
Ilker Ercan ◽  
Tuncay Yilmazlar
Keyword(s):  
Colorectal Surgery ◽  
Hospital Stay ◽  
Interleukin 6 ◽  
Low Dose ◽  
Postoperative Outcomes ◽  
High Dose ◽  
C Reactive Protein ◽  
Double Blind ◽  
Reactive Protein ◽  
Pain Scores

Preoperative single, high-dose methylprednisolone administration improves postoperative outcomes after colonic surgery. Several randomized studies, including major surgeries, assessed various high-dose steroid regimens; however, evidence about the effect of administration of lower doses on postoperative outcomes in colorectal surgery is not available. The aim of the present study is to determine whether the administration of a single, low dose of dexamethasone before surgery would confer an outcome advantage after colorectal surgery. Thirty patients undergoing colorectal surgery were included in this randomized, double-blind study. Patients received 8 mg dexamethasone or serum physiologic preoperatively. Levels of Interleukin-6 and C-reactive protein, pain scores, postoperative nausea and vomiting, mobilization, complications, hospital stay, and readmissions were compared. Age, sex, indications, and operations were similar in both groups ( P > 0.05). C-reactive protein and Interleukin-6 levels increased significantly postoperatively in each group ( P < 0.05), but there were no differences between groups when compared ( P > 0.05). There were also no significant differences between pain scores, bowel functions, mobilization, hospital stay, complication rates, and readmission rates between the two groups ( P > 0.05). Preoperative 8 mg dexamethasone administration has no significant effect on reducing postoperative inflammatory response and also does not improve outcomes of colorectal surgery.

High and low dose atorvastatin effects on high sensivity C-reactive protein in patient with acute coronary syndrome

2017 ◽  
Vol 21 (4) ◽  
pp. 218-224 ◽  
Author(s):  
Ahmadnoor Abdi ◽  
◽  
Shafei Rahimi ◽  
Hossein Farshidi ◽  
Vahid VahdatKhah ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Low Dose ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Coronary Syndrome

Lymphocyte C-reactive protein ratio: A new biomarker to predict early complications after gastrointestinal oncologic surgery

2021 ◽  
pp. 1-9
Author(s):  
Murat Yildirim ◽  
Bulent Koca
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Inflammatory Markers ◽  
Operation Time ◽  
C Reactive Protein ◽  
Oncologic Surgery ◽  
Protein Ratio ◽  
Colorectal Cancer Surgery ◽  
Neutrophil Lymphocyte Ratio ◽  
Reactive Protein

BACKGROUND: Lymphocyte-to-C-reactive protein ratio (LCR) has been used as a post-surgical prognostic biomarker in patients with gastric and colorectal cancer. However, its relationship with early postoperative complications in these patients is unknown. In this study, we aimed to reveal the relationship between LCR and postoperative complications. METHODS: Eighty-one patients operated for stomach and colorectal cancer between January 2020 and August 2020 were prospectively analyzed. On preoperative and postoperative days 1, 3 and 5, other inflammatory parameters, mainly LCR, neutrophil lymphocyte ratio (NLR), were recorded. The patients were divided into two groups according to Clavien-Dindo classification as stage III and higher complications major, stage I-II/non-complication minor. RESULTS: Fifty seven patients were operated for colorectal cancer, 24 patients for gastric cancer. The mean age of the patients was 65.6 ± 12.6, 34.6% of them was women. Age, operation time and hospital stay were significantly different between the groups (p= 0.004, p= 0.002, p< 0.001). Major complications developed in 18 patients. On postoperative day 5, LCR found superior diagnostic accuracy in predicting major postoperative complications compared to other inflammatory markers. On the postoperative 5th day, the cut-off value of LCR was 0.0034, 88.8% (71.9–94.8) sensitivity, and 85.7% (73.6–95.4) selectivity. CONCLUSION: Among different inflammatory markers, postoperative LCR is a safe and effective predictor of postoperative complications, especially after gastric and colorectal cancer surgery on day 5.

scholarly journals Association between the C-reactive protein/albumin ratio and prognosis in patients with oral squamous cell carcinoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kenji Yamagata ◽  
Satoshi Fukuzawa ◽  
Naomi Ishibashi-Kanno ◽  
Fumihiko Uchida ◽  
Hiroki Bukawa
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Prognostic Marker ◽  
Squamous Cell ◽  
Inflammatory Markers ◽  
Outcome Variable ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Significant Difference

AbstractThe systemic inflammatory response is known to be associated with poor outcomes in patients with various types of cancer. The C-reactive protein (CRP)/albumin (Alb) ratio (CAR) has been reported as a novel inflammation-based prognostic marker. We have evaluated the prognostic value of inflammatory markers for patients with oral squamous cell carcinoma (OSCC). The study population included 205 patients treated with OSCC between 2013 and 2018. The primary predictor variable was the inflammatory markers. The primary outcome variable was overall survival (OS). Univariate and multivariate analyses were performed using a Cox proportional hazards model to identify independent prognostic factors. The CAR had the highest area under the curve (AUC) values compared with other markers in the receiver operating characteristic (ROC) curve analysis. The cutoff value for CAR was 0.032 (AUC 0.693, P < 0.001). There was a significant difference in OS when patients were stratified according to CAR, with 79.1% for CAR < 0.032 and 35% for CAR ≥ 0.032 (P < 0.001). Cox multivariate analysis identified independent predictive factors for OS: age (hazard ratio [HR] 2.155, 95% confidence interval [CI] 1.262–3.682; P = 0.005), stage (HR 3.031, 95% CI 1.576–5.827; P = 0.001), and CAR (HR 2.859, 95% CI 1.667–4.904; P < 0.001). CAR (≥ 0.032 vs. < 0.032) is a good prognostic marker in patients with OSCC in terms of age and stage.

scholarly journals Consumption of a high-fat meal containing cheese compared with a vegan alternative lowers postprandial C-reactive protein in overweight and obese individuals with metabolic abnormalities: a randomised controlled cross-over study

2016 ◽  
Vol 5 ◽  
Author(s):  
Elieke Demmer ◽  
Marta D. Van Loan ◽  
Nancy Rivera ◽  
Tara S. Rogers ◽  
Erik R. Gertz ◽  
...  
Keyword(s):  
Test Meal ◽  
Inflammatory Markers ◽  
Cellular Adhesion ◽  
Metabolic Abnormalities ◽  
C Reactive Protein ◽  
High Fat ◽  
Reactive Protein ◽  
Amyloid A ◽  
Alternative Test ◽  
Randomised Controlled

AbstractDietary recommendations suggest decreased consumption of SFA to minimise CVD risk; however, not all foods rich in SFA are equivalent. To evaluate the effects of SFA in a dairy food matrix, as Cheddar cheese, v. SFA from a vegan-alternative test meal on postprandial inflammatory markers, a randomised controlled cross-over trial was conducted in twenty overweight or obese adults with metabolic abnormalities. Individuals consumed two isoenergetic high-fat mixed meals separated by a 1- to 2-week washout period. Serum was collected at baseline, and at 1, 3 and 6 h postprandially and analysed for inflammatory markers (IL-6, IL-8, IL-10, IL-17, IL-18, TNFα, monocyte chemotactic protein-1 (MCP-1)), acute-phase proteins C-reactive protein (CRP) and serum amyloid-A (SAA), cellular adhesion molecules and blood lipids, glucose and insulin. Following both high-fat test meals, postprandial TAG concentrations rose steadily (P < 0·05) without a decrease by 6 h. The incremental AUC (iAUC) for CRP was significantly lower (P < 0·05) in response to the cheese compared with the vegan-alternative test meal. A treatment effect was not observed for any other inflammatory markers; however, for both test meals, multiple markers significantly changed from baseline over the 6 h postprandial period (IL-6, IL-8, IL-18, TNFα, MCP-1, SAA). Saturated fat in the form of a cheese matrix reduced the iAUC for CRP compared with a vegan-alternative test meal during the postprandial 6 h period. The study is registered at clinicaltrials.gov under NCT01803633.

scholarly journals Interleukin-6, C-reactive protein, fibrinogen, and risk of recurrence after ischaemic stroke: Systematic review and meta-analysis

2021 ◽  
pp. 239698732098400
Author(s):  
JJ McCabe ◽  
E O’Reilly ◽  
S Coveney ◽  
R Collins ◽  
L Healy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Random Effects ◽  
Interleukin 6 ◽  
Inflammatory Markers ◽  
Recurrent Stroke ◽  
Meta Analysis ◽  
Randomised Trials ◽  
C Reactive Protein ◽  
Vascular Events ◽  
Reactive Protein

Background Recent randomised trials showed benefit for anti-inflammatory therapies in coronary disease but excluded stroke. The prognostic value of blood inflammatory markers after stroke is uncertain and guidelines do not recommend their routine measurement for risk stratification. Methods We performed a systematic review and meta-analysis of studies investigating the association of C-reactive protein (CRP), interleukin-6 (IL-6) and fibrinogen and risk of recurrent stroke or major vascular events (MVEs). We searched EMBASE and Ovid Medline until 10/1/19. Random-effects meta-analysis was performed for studies reporting comparable effect measures. Results Of 2,515 reports identified, 39 met eligibility criteria (IL-6, n = 10; CRP, n = 33; fibrinogen, n = 16). An association with recurrent stroke was reported in 12/26 studies (CRP), 2/11 (fibrinogen) and 3/6 (IL-6). On random-effects meta-analysis of comparable studies, CRP was associated with an increased risk of recurrent stroke [pooled hazard ratio (HR) per 1 standard-deviation (SD) increase in loge-CRP (1.14, 95% CI 1.06–1.22, p < 0.01)] and MVEs (pooled HR 1.21, CI 1.10–1.34, p < 0.01). Fibrinogen was also associated with recurrent stroke (HR 1.26, CI 1.07–1.47, p < 0.01) and MVEs (HR 1.31, 95% CI 1.15–1.49, p < 0.01). Trends were identified for IL-6 for recurrent stroke (HR per 1-SD increase 1.17, CI 0.97–1.41, p = 0.10) and MVEs (HR 1.22, CI 0.96–1.55, p = 0.10). Conclusion Despite evidence suggesting an association between inflammatory markers and post-stroke vascular recurrence, substantial methodological heterogeneity was apparent between studies. Individual-patient pooled analysis and standardisation of methods are needed to determine the prognostic role of blood inflammatory markers and to improve patient selection for randomised trials of inflammatory therapies.

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 The diagnostic value of white cell count, C-reactive protein and bilirubin in acute appendicitis and its complications

2013 ◽  
Vol 95 (3) ◽  
pp. 215-221 ◽  
Author(s):  
I G Panagiotopoulou ◽  
D Parashar ◽  
R Lin ◽  
S Antonowicz ◽  
AD Wells ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Cell Count ◽  
Inflammatory Markers ◽  
White Cell Count ◽  
Perforated Appendicitis ◽  
Diagnostic Value ◽  
White Cell ◽  
C Reactive Protein ◽  
Reactive Protein

Introduction Inflammatory markers such as white cell count (WCC) and C-reactive protein (CRP) and, more recently, bilirubin have been used as adjuncts in the diagnosis of appendicitis. The aim of this study was to determine the diagnostic accuracy of the above markers in acute and perforated appendicitis as well as their value in excluding the condition. Methods A retrospective analysis of 1,169 appendicectomies was performed. Patients were grouped according to histological examination of appendicectomy specimens (normal appendix = NA, acute appendicitis = AA, perforated appendicitis = PA) and preoperative laboratory test results were correlated. Receiver operating characteristic (ROC) curve area analysis (area under the curve [AUC]) was performed to examine diagnostic accuracy. Results ROC analysis of all laboratory variables showed that no independent variable was diagnostic for AA. Good diagnostic accuracy was seen for AA when all variables were combined (WCC/CRP/bilirubin combined AUC: 0.8173). In PA, the median CRP level was significantly higher than that of AA (158mg/l vs 30mg, p<0.0001). CRP also showed the highest sensitivity (100%) and negative predictive value (100%) for PA. CRP had the highest diagnostic accuracy in PA (AUC: 0.9322) and this was increased when it was combined with WCC (AUC: 0.9388). Bilirubin added no diagnostic value in PA. Normal levels of WCC, CRP and bilirubin could not rule out appendicitis. Conclusions CRP provides the highest diagnostic accuracy for PA. Bilirubin did not provide any discriminatory value for AA and its complications. Normal inflammatory markers cannot exclude appendicitis, which remains a clinical diagnosis.

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