scholarly journals Role of Manual Immature to Total Neutrophil (I/T) Ratio and Automated Immature Granulocyte Count (IGC) and Percentage (IG%) in the Early Diagnosis of Neonatal Sepsis

2021 ◽  
Author(s):  
Nalika Jayasekara ◽  
Chandima Kulathilake ◽  
Saraji Wijesekara ◽  
Indira Wijesiriwardena
Keyword(s):  
Neonatal Sepsis ◽  
Cross Sectional Study ◽  
Reference Intervals ◽  
Full Blood Count ◽  
Cross Sectional ◽  
Granulocyte Count ◽  
Reactive Protein ◽  
Immature Granulocyte ◽  
Low Sensitivity

Abstract Background: The diagnosis of neonatal sepsis is challenging due to non-specific and subtle clinical features, low sensitivity and delay in routine laboratory tests. Current study was conducted to evaluate the role of manual immature/total (I/T) neutrophil ratio and automated immature granulocyte count (IGC) and immature granulocyte percentage (IG%) in the diagnosis of neonatal sepsis. Materials and Methods: An analytical cross-sectional study was done during a period of 6 months with a sample of 55 neonates admitted to Colombo South Teaching Hospital, Sri Lanka. A combination of clinical and laboratory parameters including full blood count, C-reactive protein and blood culture were used to identify the neonates with probable sepsis. The population was subcategorized into five (5) groups and manual immature/total neutrophil (I/T) ratio, immature granulocyte count (IGC) and immature granulocyte%(IG%) were done in each neonate. Results: The sensitivity of manual I/T ratio was 93.75% and negative predictive value (NPV) was 95.24%. The sensitivity for lower cut off values, IGC of 0.03x103/µL and IG% of 0.5% was 80% and 73.33% respectively. The NPV for above cut-off values were 25% and 0.5% respectively. The NPV was improved with higher cut-off values with 70.90% for IGC 0.3 and 70.59% for IG 3%, but sensitivity remained low with 40% and 33.33% respectively.Conclusion: Manual I/T ratio remains as a useful diagnostic tool in diagnosing and excluding neonatal sepsis with a very good sensitivity and NPV. However, further studies and well defined reference intervals are required in automated IGC and IG%.

scholarly journals The role of education in the association between self-rated health and levels of C-reactive protein: a cross-sectional study in rural areas of China

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e027659 ◽  
Author(s):  
Raoping Tu ◽  
Kuan-Yu Pan ◽  
Guoxi Cai ◽  
Taro Yamamoto ◽  
Hui-Xin Wang
Keyword(s):  
Rural Areas ◽  
Protein A ◽  
Cross Sectional Study ◽  
Linear Regression Models ◽  
Sectional Study ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Self Rated Health

ObjectivesThis study aims to examine the association between self-rated health (SRH) and levels of C-reactive protein (CRP) among adults aged 45 to 101 years old in rural areas of China, and to explore the role of education in the association.DesignCross-sectional study.SettingThe study population was derived from two databases in China: Nanping project (NP) and the China Health and Retirement Longitudinal Study (CHARLS).ParticipantsThere were 646 participants from a rural area of Nanping (NP) and 8555 rural participants from a national representative sample of China (CHARLS).MethodsCRP was measured using a high sensitivity sandwich enzyme immunoassay in the NP and immunoturbidimetric assay in the CHARLS. SRH was assessed by SRH questionnaires and categorised into good and poor. Education was measured by the maximum years of schooling and dichotomised into illiterate and literate. Multivariate linear regression models were used to study the associations.ResultsCompared to people with good SRH, those with poor SRH had higher levels of CRP in NP (β=0.16, 95% CI −0.02 to 0.34) and in CHARLS (β=0.07, 95% CI 0.02 to 0.11) after adjusting for potential confounders. Similar findings were observed in the pooled population (β=0.08, 95% CI 0.03 to 0.12), especially in men (β=0.13, 95% CI 0.06 to 0.20) and in literate people (β=0.12, 95% CI 0.06 to 0.18).ConclusionPoor SRH may be a predicator of elevated levels of CRP among middle-aged and older people in rural areas, especially in men and literate people.

TLR2 and TLR4 expressions in late-onset neonatal sepsis: Is it a potential novel biomarker?

2020 ◽  
pp. 1-7
Author(s):  
R. Rohsiswatmo ◽  
M. Azharry ◽  
T.T. Sari ◽  
Y. Bahasoan ◽  
D. Wulandari
Keyword(s):  
Blood Culture ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Complete Blood Count ◽  
Late Onset ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Tlr4 Expression ◽  
Cross Sectional ◽  
Reactive Protein

BACKGROUND: Late-onset neonatal sepsis (LONS) detection is problematic as no single examinations (blood culture, c-reactive protein (CRP), procalcitonin (PCT)) are reliable. Toll-like receptors (TLRs), which detect the presence of pathogen-associated molecular patterns is a promising novel biomarker, but less studied in LONS. This study aimed to determine neutrophils and monocytes TLR2 and TLR4 expression in LONS and their diagnostic value. METHODS: A cross-sectional study conducted in May and June 2017 involving 52 neonates with clinical late-onset (>72 hours of age) sepsis. We examine complete blood count, I/T ratio, CRP, PCT, as well as TLR2 and TLR4 expression to compared with blood culture as the gold standard. We classified cases into proven or unproven sepsis. RESULT: The incidence of LONS was 32.6% in the subjects. The expression of TLR2 was low in LONS, while TLR4 was high. TLR4 neutrophil expression has 88.2% sensitivity, 20% specificity, 34.9% positive predictive value (PPV), 77.8% negative predictive value (NPV), and an AUC of 0.541. TLR4 monocyte expression has 92.1% sensitivity, 11.4% specificity, 34% PPV, 80% NPV, and an AUC of 0.528. The AUC of CRP is increased from 0.608 to 0.843 after combination with TLR4, comparable with CRP + PCT (AUC 0.829). CONCLUSION: The increase in TLR4 expression has good sensitivity but low specificity. TLR4 expression, in combination with CRP, could become a reliable biomarker for the diagnosis of LONS.

scholarly journals Risk Factors Associated with Mild Cognitive Impairment аmong Apparently Healthy People and the Role of MicroRNAs

2019 ◽  
Vol 7 (19) ◽  
pp. 3253-3261 ◽  
Author(s):  
Iman I. Salama ◽  
Somia I. Salama ◽  
Dalia M. Elmosalami ◽  
Rehan M. Saleh ◽  
Hanaa Rasmy ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Sensitivity And Specificity ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Logistic Analysis ◽  
Modifiable Factors ◽  
Low Sensitivity

BACKGROUND: Mild cognitive impairment (MCI) is a stage between the expected cognitive decline of normal ageing and the serious decline of dementia. AIM: To identify risk factors and role of miRNAs associated with mild cognitive impairment (MCI) among employees. SUBJECTS AND METHOD: A cross-sectional study was carried out on 186 employees aged between 40 and 65 years. Cognitive function was evaluated using ACEIII, MoCA, and Quick cognitive tests. Medical history and lifestyle were assessed. Family 132 & 134 miRNA expressions were assessed by real-time PCR. RESULTS: MCI was detected among 14 / 186 (7.5%). miRNA 132 expression was the only significant miRNAs to detect MCI with low sensitivity and specificity (70%). The logistic analysis revealed that higher miRNA132 expressions, low monthly intake of; vegetables, unroasted nuts, low education and higher ALT levels were predicting factors for MCI with AOR 1.1 (1.01-3.3), 1.2 (1.04-1.43), 0.8 (0.8-0.98), 2.7 (1.9-7.4) and 1.6 (1.1-2.3) respectively. CONCLUSION: MiRNAs expression showed low sensitivity and specificity in detecting MCI; only miRNA 132 might be used. Several modifiable factors seem to reduce the risk of MCI.

scholarly journals Cerebrospinal fluid in COVID-19 neurological complications: no cytokine storm or neuroinflammation

2021 ◽  
Author(s):  
Maria A. Garcia ◽  
Paula V. Barreras ◽  
Allie Lewis ◽  
Gabriel Pinilla ◽  
Lori J. Sokoll ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
High Sensitivity ◽  
Neurological Complications ◽  
Cross Sectional Study ◽  
Neurofilament Light Chain ◽  
Cross Sectional ◽  
Neurofilament Light ◽  
Reactive Protein ◽  
D Dimer

ABSTRACTBACKGROUNDNeurological complications occur in COVID-19. We aimed to examine cerebrospinal fluid (CSF) of COVID-19 subjects with neurological complications and determine presence of neuroinflammatory changes implicated in pathogenesis.METHODSCross-sectional study of CSF neuroinflammatory profiles from 18 COVID-19 subjects with neurological complications categorized by diagnosis (stroke, encephalopathy, headache) and illness severity (critical, severe, moderate, mild). COVID-19 CSF was compared with CSF from healthy, infectious and neuroinflammatory disorders and stroke controls (n=82). Cytokines (IL-6, TNFα, IFNγ, IL-10, IL-12p70, IL-17A), inflammation and coagulation markers (high-sensitivity-C Reactive Protein [hsCRP], ferritin, fibrinogen, D-dimer, Factor VIII) and neurofilament light chain (NF-L), were quantified. SARS-CoV2 RNA and SARS-CoV2 IgG and IgA antibodies in CSF were tested with RT-PCR and ELISA.RESULTSCSF from COVID-19 subjects showed a paucity of neuroinflammatory changes, absence of pleocytosis or specific increases in pro-inflammatory markers or cytokines (IL-6, ferritin, or D-dimer). Anti-SARS-CoV2 antibodies in CSF of COVID-19 subjects (77%) were observed despite no evidence of SARS-CoV2 viral RNA. A similar increase of pro-inflammatory cytokines (IL-6, TNFα, IL-12p70) and IL-10 in CSF of COVID-19 and non-COVID-19 stroke subjects was observed compared to controls. CSF-NF-L was elevated in subjects with stroke and critical COVID-19. CSF-hsCRP was present almost exclusively in COVID-19 cases.CONCLUSIONThe paucity of neuroinflammatory changes in CSF of COVID-19 subjects and lack of SARS-CoV2 RNA do not support the presumed neurovirulence of SARS-CoV2 or neuroinflammation in pathogenesis of neurological complications in COVID-19. Elevated CSF-NF-L indicates neuroaxonal injury in COVID-19 cases. The role of CSF SARS-CoV2 IgG antibodies is still undetermined.FUNDINGThis work was supported by NIH R01-NS110122 and The Bart McLean Fund for Neuroimmunology Research.

scholarly journals Role of biomarkers in predicting prognosis of Coronavirus disease 2019 (COVID-19): A retrospective cross-sectional study: Perspective of a tertiary care hospital in India

2021 ◽  
Vol 11 (1) ◽  
pp. 081-090
Author(s):  
Arushi Mohan ◽  
Padmini SN ◽  
Brunda MS ◽  
Abhinaya Shekhar ◽  
Paul Matthew ◽  
...  
Keyword(s):  
Inflammatory Markers ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
C Reactive Protein ◽  
Oxygen Requirement ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Significant Difference ◽  
D Dimer

Background: COVID-19 is a novel disease triggered by the SARS-CoV-2 virus, a beta coronavirus similar to MERS-CoV and SARS CoV. Inflammatory markers have a vital role in the pathogenesis of nCOVID 19; understanding the importance of these inflammatory markers in determining disease status is essential given the impact of the disease on healthcare. Thus, being able to triage cases with minimal tests is momentous to capture, which we have investigated as per our study guidelines of the role of inflammatory markers such as D-dimer, CRP (C - reactive protein), Ferritin, LDH (Lactate Dehydrogenase) in patients with COVID 19. In addition, limited data is available comparing the utility of these inflammatory markers to predict the following parameters as the need for ICU, oxygen support requirement, and duration of in-hospital stay, which can help guide the management protocol. Aim: This study aims to determine markers associated with poor prognosis in patients with Coronavirus disease 2019 (COVID-19). Objectives: 1) To assess the inflammatory markers that are routinely investigated in COVID- 19 patients. 2) To determine the most probable factor to estimate severity in COVID- 19 and thus predict prognosis. Methods: This is a retrospective cross-sectional observational study of patients who tested SARS COV 2 positive by RT PCR. The laboratory inflammatory markers, namely Lactate Dehydrogenase, C reactive protein, D-dimer, Ferritin, were assessed in the selected patients, and their clinical data and demographic details were taken into account. The parameters considered for contributing to the severity included the number of days of stay in the hospital, oxygen requirement, and ICU needs. Analyses relied upon analysis of variance for cross-sectional study design and a P< 0.05 statistical significance criterion. Results: There was a statistically significant difference found between oxygen requirement and D dimer (p<0.001), LDH (p= 0.002), and CRP (p= 0.024). There was a statistically significant difference found between admission to ICU and D Dimer (p= 0.001). Conclusion: A statistically significant association between the increasing D-dimer levels and all the outcome measures considered was found. The D-dimer, LDH, and CRP help predict oxygen requirement, and all the inflammatory markers can predict the number of days of stay in the hospital.

scholarly journals MATERNAL C-REACTIVE PROTEIN IN PREGNANCY AND ITS RELATION WITH EARLY ONSET NEONATAL SEPSIS

2021 ◽  
Vol 71 (4) ◽  
pp. 1130-33
Author(s):  
Muhammad Zahid ◽  
Saeed Zaman ◽  
Sohail Shahzad ◽  
Sajid Ali Shah ◽  
Sana Javed ◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
Early Onset ◽  
Signs And Symptoms ◽  
Cross Sectional Study ◽  
Military Hospital ◽  
P Value ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Increased Risk

Objective:To determine association of early-onset neonatal sepsis (EONS) in newborns of serum C-reactive protein positive mothers. Study Design:  Cross sectional study Place and duration of study:  Department of Pediatrics, Combined Military Hospital Quetta, Pakistan from September 2016 to March 2018. Material and Methods: 105 neonates (both gender) of all mothers who were C - reactive protein positive were enrolled in this study using inclusion and exclusion criteria.Neonatal sepsis was diagnosed by clinical examination, which was carried out by senior pediatrician, blood complete picture and c reactive protein. Neonates were treated as per departmental protocol. Stratification was done in regard to gestational age, birth weight and age of neonates in hours. Post stratification chi square test was applied and p-value less than 0.05 was considered significant. Results:Out of total 105 patients, 46 (44%) were male and 59 (56%)were female neonates. Amongst the babies of 105 CRP positive mothers, 79 babies were having signs and symptoms of neonatal sepsis and 26 babies were having no signs and symptoms of neonatal sepsis with statistically significant relation between maternal CRP and neonatal sepsis of p value <0.05. Conclusion:Increased maternal CRP level is associated with increased risk of neonatal sepsis. Maternal CRP may be used as a good screening tool for early detection of neonatal sepsis.

scholarly journals Role of Pleural Fluid C-Reactive Protein in the Aetiological Diagnosis of Exudative Pleural Effusion

2020 ◽  
Author(s):  
Praveen Radhakrishnan ◽  
S Mathanraj
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Cross Sectional Study ◽  
Direct Access ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Aetiological Diagnosis ◽  
Exudative Pleural Effusion

Introduction: Pleural effusions, the result of the accumulation of fluid in the pleural space, are a major diagnostic problem due to its anatomical nature with no direct access. There is variation in management, depending on the pleural disease. The pleural effusion can either exhibit specific or nonspecific characteristics. Aim: To determine the clinical significance and diagnostic role of pleural fluid C-Reactive Protein (CRP) level in the aetiological diagnosis of exudative pleural effusion. Materials and Methods: This was a cross-sectional study performed during the study period of September 2013 to December 2014. A total of 53 Patients identified with pleural effusion were recruited in the study and pleural fluid was subjected for the measurement of CRP level. Pleural fluid CRP was assessed with CRP-Turbilatex-Quantitative turbidimetric immunoassay method which is based on the principle agglutination reaction. The data was subjected to statistical analysis using Epi info software version 3.4.3. The Receiver Operating Characteristic (ROC) curve was plotted to illustrate the diagnostic ability. The smallest cut-off value was the minimum observed test value minus 1, and the largest cut-off value was the maximum observed test value plus 1. All the other cut-off values were the averages of two consecutive ordered observed test values. Results: Among the 53 patients in the study, 42 had exudative effusions (79.20%) and 11 had transudative effusions (20.80%). The common cause of exudative effusion was tuberculosis 26 (61.90%), followed by 9 malignancy (21.40%) and 7 parapneumonic effusion (16.70%). In our study, the pleural fluid CRP was statistically significant (p<0.001) marker to differentiate exudative effusions with CRP-value <30 suggestive of malignancy, CRP-value 30-50 mg/L suggestive of tuberculosis and CRP-value >70 mg/L suggestive of parapneumonic effusions. Conclusion: Determination of pleural fluid CRP is a useful diagnostic marker for differentiating exudative and transudative effusions. Also, Pleural fluid CRP is a statistically significant marker in differentiating tubercular effusions from nontubercular exudative effusions.

scholarly journals Evaluation of Procalcitonin, C-Reactive Protein, and Interleukin-6 as Early Markers for Diagnosis of Neonatal Sepsis

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Emad A. Morad ◽  
Rehab A. Rabie ◽  
Mohamed A. Almalky ◽  
Manar G. Gebriel
Keyword(s):  
16S Rdna ◽  
Interleukin 6 ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Cross Sectional Study ◽  
Sepsis Group ◽  
C Reactive Protein ◽  
University Hospitals ◽  
Cross Sectional ◽  
Reactive Protein

Background. Neonatal sepsis diagnosis is a challenge because of its nonspecific presentation together with low sensitivity of the time-consuming bacterial cultures. So, many sepsis markers, like C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6), are emerging to improve its diagnosis. Aim. This study was done to investigate the role of CRP, PCT, and IL-6 in promoting the early diagnosis of neonatal sepsis in an attempt to decrease morbidity and mortality. Methods. This cross-sectional study was conducted on 50 neonates suspected with sepsis enrolled from the neonatal intensive care unit (NICU) of Zagazig University Hospitals, Egypt. Blood cultures for these neonates were done before starting antibiotics. Also, bacterial DNA was revealed from the blood by broad-range 16S rDNA polymerase chain reaction (PCR). Measurements of CRP using the immunoturbidimetry method, PCT using fluorescence immunoassay quantitative method, and IL-6 using commercially available ELISA kit were done to all enrolled neonates. Results. Forty-one neonates with proved sepsis were found to be positive in blood culture and/or PCR for bacterial 16S rDNA. The most common isolated organisms were Klebsiella (61.3%), followed by E. coli (9.7%) and CONS (9.7%). We detected much significant higher levels of PCT, CRP, and IL-6 in the proved sepsis group than the suspected neonatal sepsis cases (p≤0.001, 0.001, and 0.004, respectively). Serum PCT levels showed the highest sensitivity, specificity, PPV, NPV, and accuracy of 97.6%, 89%, 97%, 88.9%, and 96% than other studied sepsis markers. Conclusion. PCT has satisfactory characteristics as a good marker than IL-6 and CRP for the diagnosis of neonatal sepsis.

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