scholarly journals Clinical impact of severe chronic kidney disease in patients with non-HIV pulmonary cryptococcosis

2020 ◽  
Author(s):  
Hiroki Tashiro ◽  
Tetsuro Haraguchi ◽  
Koichiro Takahashi ◽  
Hironori Sadamatsu ◽  
Ryo Tajiri ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Blood Cell ◽  
Cell Count ◽  
White Blood Cell Count ◽  
Clinical Characteristics ◽  
C Reactive Protein ◽  
Pulmonary Cryptococcosis ◽  
Blood Cell Count ◽  
Reactive Protein

Abstract BackgroundPulmonary cryptococcosis is an uncommon infectious disease that can develop in both immunocompromised and immunocompetent patients. Severity of chronic kidney disease (CKD) was reported to be one of the risk factors for pulmonary cryptococcosis, but its clinical characteristics have not been fully assessed. The purpose of this study is to clarify clinical characteristics of severe CKD in patients with pulmonary cryptococcosis.MethodsThe present study retrospectively investigated 56 patients who had pulmonary cryptococcosis with non-human immunodeficiency virus (HIV) infection and were treated at Saga University Hospital between 2005 and 2018. The clinical characteristics were evaluated and compared between patients with estimated glomerular filtration rate (eGFR) >45 mL/min/1.73m2 (n = 42) (preserved eGFR) and those with eGFR <45 mL/min/1.73m2 (n = 14) (declined eGFR).ResultsCompared with patients with preserved eGFR, those with declined eGFR had significantly higher rate of disseminated cryptococcosis (p = 0.03); higher percentage of patients who did not recover after treatment (p = 0.02); and more frequent clinical features of fever (p <0.01), pleural effusion (p = 0.03), high white blood cell count (p <0.01) and C-reactive protein (p <0.01), and low level of albumin (p <0.01). Multivariate analysis adjusted by immunosuppressive drug use indicated significant differences of fever (p <0.01), high white blood cell count (p = 0.03), C-reactive protein (p = 0.01) and low level of albumin (p <0.01) in patients with eGFR <45 mL/min/1.73m2.ConclusionSevere CKD is associated with poor clinical characteristics and outcomes in patients with non-HIV pulmonary cryptococcosis.

scholarly journals Clinical impact of advanced chronic kidney disease in patients with non-HIV pulmonary cryptococcosis

2020 ◽  
Author(s):  
Hiroki Tashiro ◽  
Tetsuro Haraguchi ◽  
Koichiro Takahashi ◽  
Hironori Sadamatsu ◽  
Ryo Tajiri ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Blood Cell ◽  
Serum Albumin ◽  
Cell Count ◽  
Clinical Characteristics ◽  
C Reactive Protein ◽  
Pulmonary Cryptococcosis ◽  
Blood Cell Count ◽  
Reactive Protein

Abstract Background Pulmonary cryptococcosis is an uncommon infectious disease that can develop in both immunocompromised and immunocompetent patients. The severity of chronic kidney disease (CKD) was reported to be one of the risk factors for pulmonary cryptococcosis, but its clinical characteristics have not been fully assessed. The purpose of this study was to clarify the clinical characteristics of advanced CKD in patients with pulmonary cryptococcosis. Methods The present study retrospectively investigated 56 patients who had non-human immunodeficiency virus (HIV) pulmonary cryptococcosis and were treated at Saga University Hospital between 2005 and 2018.The clinical characteristics were evaluated and compared between patients with estimated glomerular filtration rate (eGFR) >45 mL/min/1.73 m2 (n = 42, early CKD) and those with eGFR <45 mL/min/1.73 m2 (n = 14, advanced CKD. Results Compared with patients with early CKD, those with advanced CKD had significantly higher rate of disseminated cryptococcosis (21.4% vs. 2.4%, p = 0.03); lower percentage of patients who recovered after treatment (63.6% vs. 92.5%, p = 0.02); and more frequent clinical features of fever (57.1% vs. 19.0%, p <0.01), pleural effusion (21.4% vs. 2.4%, p = 0.03), high white blood cell count (8550/mL vs. 6150/mL, p = 0.01) and C-reactive protein (CRP) (2.1 mg/dL vs. 0.2 mg/dL, p = 0.02), and low level of serum albumin (3.0 g/dL vs. 3.8 g/dL, p <0.01). Multivariate analysis adjusted by immunosuppressive drug use indicated the significant factors of fever (odds ratio or β value [95% confidence interval] 6.4 [1.65 – 20.09], p <0.01), high white blood cell count (1293.2 [110.2 – 2476.2], p = 0.03), C-reactive protein (0.89 [0.18 – 1.59], p = 0.01) and low level of serum albumin (- 0.34 [-0.54 – -0.14], p <0.01) in patients with eGFR <45 mL/min/1.73m2. Conclusion Advanced CKD was associated with poor clinical characteristics and outcomes in patients with non-HIV pulmonary cryptococcosis.

scholarly journals Clinical impact of advance chronic kidney disease in patients with non-HIV pulmonary cryptococcosis

2020 ◽  
Author(s):  
Hiroki Tashiro ◽  
Tetsuro Haraguchi ◽  
Koichiro Takahashi ◽  
Hironori Sadamatsu ◽  
Ryo Tajiri ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Blood Cell ◽  
Serum Albumin ◽  
Cell Count ◽  
Clinical Characteristics ◽  
C Reactive Protein ◽  
Pulmonary Cryptococcosis ◽  
Blood Cell Count ◽  
Reactive Protein

Abstract Background: Pulmonary cryptococcosis is an uncommon infectious disease that can develop in both immunocompromised and immunocompetent patients. Severity of chronic kidney disease (CKD) was reported to be one of the risk factors for pulmonary cryptococcosis, but its clinical characteristics have not been fully assessed. The purpose of this study is to clarify clinical characteristics of advance CKD in patients with pulmonary cryptococcosis.Methods: The present study retrospectively investigated 56 patients who had pulmonary cryptococcosis with non-human immunodeficiency virus (HIV) infection and were treated at Saga University Hospital between 2005 and 2018. The clinical characteristics were evaluated and compared between patients with estimated glomerular filtration rate (eGFR) >45 mL/min/1.73m2 (n = 42) (early CKD) and those with eGFR <45 mL/min/1.73m2 (n = 14) (advance CKD).Results: Compared with patients with early CKD, those with advance CKD had significantly higher rate of disseminated cryptococcosis (21.4% vs 2.4%, p = 0.03); lower percentage of patients who recovered after treatment (63.6% vs 92.5%, p = 0.02); and more frequent clinical features of fever (57.1% vs 19.0%, p < 0.01), pleural effusion (21.4% vs 2.4%, p = 0.03), high white blood cell count (8550/ml vs 6150/ml, p = 0.01) and C-reactive protein (2.1 mg/dl vs 0.2 mg/dl, p = 0.02), and low level of serum albumin (3.0 g/dl vs 3.8 g/dl, p <0.01). Multivariate analysis adjusted by immunosuppressive drug use indicated significant differences of fever (odds ratio or β value [95% confidence interval] 6.4 [1.65 – 20.09], p <0.01), high white blood cell count (1293.2 [110.2 – 2476.2], p = 0.03), C-reactive protein (0.89 [0.18 – 1.59], p = 0.01) and low level of serum albumin (- 0.34 [-0.54 – -0.14], p <0.01) in patients with eGFR <45 mL/min/1.73m2.Conclusion: Advance CKD is associated with poor clinical characteristics and outcomes in patients with non-HIV pulmonary cryptococcosis.

scholarly journals C-Reactive Protein and White Blood Cell Count in Non-Infective Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis

2021 ◽  
Vol 10 (8) ◽  
pp. 1610
Author(s):  
Marcin Wnuk ◽  
Justyna Derbisz ◽  
Leszek Drabik ◽  
Agnieszka Slowik
Keyword(s):  
Ischemic Stroke ◽  
Blood Cell ◽  
Acute Ischemic Stroke ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
Intravenous Thrombolysis ◽  
C Reactive Protein ◽  
Blood Cell Count ◽  
Reactive Protein

Background: Previous studies on inflammatory biomarkers in acute ischemic stroke (AIS) produced divergent results. We evaluated whether C-reactive protein (CRP) and white blood cell count (WBC) measured fasting 12–24 h after intravenous thrombolysis (IVT) were associated with outcome in AIS patients without concomitant infection. Methods: The study included 352 AIS patients treated with IVT. Excluded were patients with community-acquired or nosocomial infection. Outcome was measured on discharge and 90 days after stroke onset with the modified Rankin scale (mRS) and defined as poor outcome (mRS 3–6) or death (mRS = 6). Results: Final analysis included 158 patients (median age 72 years (interquartile range 63-82), 53.2% (n = 84) women). Poor outcome on discharge and at day 90 was 3.8-fold and 5.8-fold higher for patients with CRP ≥ 8.65 mg/L (fifth quintile of CRP), respectively, compared with first quintile (<1.71 mg/L). These results remained significant after adjustment for potential confounders (odds ratio (OR) on discharge = 10.68, 95% CI: 2.54–44.83, OR at day 90 after stroke = 7.21, 95% CI: 1.44–36.00). In-hospital death was 6.3-fold higher for patients with fifth quintile of CRP as compared with first quintile and remained independent from other variables (OR = 4.79, 95% CI: 1.29–17.88). Independent predictors of 90-day mortality were WBC < 6.4 × 109 /L (OR = 5.00, 95% CI: 1.49–16.78), baseline National Institute of Health Stroke Scale (NIHSS) score (OR = 1.13 per point, 95% CI: 1.01–1.25) and bleeding brain complications (OR = 5.53, 95% CI: 1.59–19.25) but not CRP ≥ 8.65 mg/L. Conclusions: Non-infective CRP levels are an independent risk factor for poor short- and long-term outcomes and in-hospital mortality in AIS patients treated with IVT. Decreased WBC but not CRP is a predictor for 90-day mortality.

scholarly journals Predictive values of Alvarado score, serum C-reactive protein, and white blood cell count in the diagnosis of acute appendicitis: a prospective study

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Ademola Olusegun Talabi ◽  
Tewogbade Adeoye Adedeji ◽  
Oludayo Adedapo Sowande ◽  
Olusanya Adejuyigbe
Keyword(s):  
Acute Appendicitis ◽  
Blood Cell ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
C Reactive Protein ◽  
Blood Cell Count ◽  
Alvarado Score ◽  
Reactive Protein ◽  
Wbc Count

Abstract Background The diagnosis of acute appendicitis in children is quite challenging as the rate of negative appendectomy varies between 15 and 57%. Increased utilization of imaging diagnostic facilities in advanced countries seems to have reduced the incidence of operating on normal appendix to a single digit. In low- and middle-income countries, the incidence remains unacceptably high (double digits). Inflammatory markers and scoring systems may be a suitable adjunct to increase diagnostic yield in most third world countries. Thus, the aim of this study was to evaluate the diagnostic value of Alvarado score, white blood cell count, and serum C-reactive protein in children with acute appendicitis. Results The ages of patients ranged between 4 and 15 years with a mean of 11.2 ± 2.8 years. The male to female ratio was 1.4 to 1.0. Nineteen percent of patients had negative appendiceal findings on histological examination. The sensitivity and specificity of Alvarado score, C-reactive protein estimation, total white blood cell count in diagnosing acute appendicitis were 86.4% and 63.2%, 98.8% and 36.8%, and 51.9% and 89.5% respectively. Alvarado score has the highest area under ROC curve analysis 0.824, 95% CI of 0.724 to 0.924 compared with CRP, 0.769. 95% CI of = 0.647 to 0.891 and WBC count, 0.765, 95% CI of 0.643 to 0.887. Both CRP and WBC count showed higher discriminatory values between complicated and uncomplicated appendicitis, p < 0.001. Conclusion Alvarado score outperformed other tests in setting the diagnosis of acute appendicitis. However, none of the tests can be relied on wholly for operative decision. Clinical judgement remains the bedrock for diagnosis and operative management.

Misinterpretation of C reactive protein level and white blood cell count are behind the overuse of antibiotics in acute pancreatitis

Pancreatology ◽  
2017 ◽  
Vol 17 (3) ◽  
pp. S109
Author(s):  
Eszter Tóth ◽  
Tamás Lantos ◽  
Dóra Illés ◽  
Szilárd Gódi ◽  
Ákos Szűcs ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Blood Cell ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
Protein Level ◽  
C Reactive Protein ◽  
Blood Cell Count ◽  
Reactive Protein
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