PROCALCITONIN DAN INTERLEUKIN-6 PADA SEPSIS DENGAN GEJALA SYSTEMIC INFLAMMATORY RESPONSE SYNDROME (SIRS)

Sepsis is the cause of patient’s death in the intensive care unit. Sepsis is an inflammatory response to infections. Infection whencontinued can cause systemic inflammatory response syndrome (SIRS). Clinical signs and pathology of SIRS are similar to sepsis, thusclinical as well as laboratory examination is needed to distinguish these. Culture result usually can be seen at least 24 hours aftersampling. In this case a test is needed to diagnose sepsis quickly so that the patient does not experience more severe conditions. Theindicator used in the diagnostic procedure is to know the diagnostic value of procalcitonin (PCT) levels as well as of interleukin-6 (IL-6)for the diagnosis of sepsis. Thirty-two blood samples of patients treated in the Department of SIRS. Dr. Kariadi Semarang were takenconsecutively from November 2011 up to January 2012. PCT levels are determined by ELFA, levels of IL-6 were determined by ELISAmethod. To determine the sensitivity, specificity, positive predictive value and negative predictive value, 2 × 2 table was used. The ROCcurve (receiver operating characteristic) showed an area under the curve of PCT of 0.83 (95% CI = 0.66 to 0.99), cut-off 5.1 ng/mL wasused as an indicator of sepsis. PCT diagnostic test results showed 88.9% sensitivity, 73.9% specificity, 57.1% positive predictive value andnegative predictive value of 94.4%. The area under the curve for IL-6 was 0.67 (95% CI = 0.47 to 0.86), cut off 47.2 pg/mL as an indicatorof sepsis. Diagnostic tests results showed 77.8% sensitivity, 60.9% specificity, 43.7% positive predictive value and negative predictive valueof 87.5%. It can be concluded that the examination of serum PCT levels can be used as a diagnostic test (screening test) for sepsis.

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Immunocytochemistry Test of Protein BRAF Expression for Diagnosis of Well Differentiated Thyroid Carcinoma

Case Reports in Oncology ◽

10.1159/000495029 ◽

2018 ◽

Vol 11 (3) ◽

pp. 843-849 ◽

Cited By ~ 1

Author(s):

I. Wayan Sudarsa ◽

Elvis Deddy Kurniawan Pualillin ◽

Putu Anda Tusta Adiputra ◽

Ida Bagus Tjakra Wibawa Manuaba

Keyword(s):

Positive Predictive Value ◽

Thyroid Carcinoma ◽

Negative Predictive Value ◽

Diagnostic Test ◽

Predictive Value ◽

Preoperative Diagnosis ◽

Area Under The Curve ◽

Diagnostic Value ◽

Differentiated Thyroid Carcinoma ◽

Inclusion Criteria

Background: Thyroid carcinoma generally has a good prognosis. The main focus of current research on thyroid carcinoma is to increase the accuracy of preoperative diagnosis of thyroid nodules. When the result of fine needle aspiration biopsy (FNAB) is indeterminate, clinicians often have doubts in determining the surgical management. Objective: Protein BRAF expression analysis can help improve the accuracy of FNAB and optimize the management of differentiated thyroid carcinoma. Methods: This study is a diagnostic test performed from October 2016 at Sanglah General Hospital with 38 patients as subjects who fulfilled the inclusion criteria. Data is being presented in descriptive form before diagnostic test is done to determine sensitivity, specificity, positive predictive value, negative predictive value and the accuracy of immunocytochemistry test for BRAF on indeterminate thyroid nodule. Results: Thirty-eight samples met the inclusion criteria during the study period. Three samples were male (7.9%) and 35 samples (92.1%) were female. The mean age of the sample was 45.21 years (SD ±10.910 years) with ages ranging from 23 to 66 years. Of the 12 samples undergoing isthmolobectomy, 7 samples (58.4%) were determined to be malignant from histopathological results. The sensitivity value of BRAF immunocytochemistry test is 45.45% with a specificity value of 81.25%, a positive predictive value of 76.92%, a negative predictive value of 52% and an accuracy of 60.50%. Analysis of the receiver operator (ROC) curve shows the area under the curve (AUC) of 63.4% with a confidence interval of 45.5–81.2%. Conclusion: Immunocytochemistry BRAF test have a reliable diagnostic value and can be taken into consideration in the preoperative diagnosis of thyroid malignancies.

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Interleukin-6 significantly improves predictive value of systemic inflammatory response syndrome for predicting severe acute pancreatitis

Pancreatology ◽

10.1016/j.pan.2018.05.002 ◽

2018 ◽

Vol 18 (5) ◽

pp. 500-506 ◽

Cited By ~ 9

Author(s):

Saransh Jain ◽

Shallu Midha ◽

Soumya Jagannath Mahapatra ◽

Swatantra Gupta ◽

Manish Kumar Sharma ◽

...

Keyword(s):

Acute Pancreatitis ◽

Systemic Inflammatory Response Syndrome ◽

Inflammatory Response ◽

Severe Acute Pancreatitis ◽

Interleukin 6 ◽

Predictive Value ◽

Systemic Inflammatory Response

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Procalcitonin and Interleukin-6 for predicting culturenegative and culture positive bacterial sepsis in critically ill patients with systemic inflammatory response syndrome

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v15i1.1353 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Mohd Basri Mat Nor ◽

Azrina Md Ralib

Keyword(s):

Systemic Inflammatory Response Syndrome ◽

Inflammatory Response ◽

Critically Ill ◽

Critically Ill Patients ◽

Interleukin 6 ◽

Systemic Inflammatory Response ◽

Bacterial Sepsis ◽

Saps Ii Score ◽

Culture Positive ◽

Culture Negative

Introduction: Differentiation between culture-negative bacterial sepsis (BS), culturepositive BS and non-infectious systemic inflammatory response syndrome (SIRS) among critically ill patients remains a diagnostic challenge to the intensive care unit (ICU) physicians. This study aimed to evaluate the role of procalcitonin (PCT) and interleukin-6 (IL-6) in predicting non-infectious SIRS, culture-negative BS and culture-positive BS in the ICU. Methods: This prospective observational study was conducted in a tertiary ICU in Pahang. The patients were divided into sepsis and non-infectious SIRS based on clinical assessment with or without positive cultures. Patients with positive cultures were further divided into bacteraemia and positive other culture. The PCT and IL-6 were measured daily over the first 3 days. Results: Two hundred and thirty nine consecutive patients diagnosed with SIRS were recruited, of whom 164 (69%) had sepsis. Among sepsis patients, there were 62 (37.8%) culture positive and 102 (62.2%) culture negative. Of these, 27 (16.5%) develop bacteraemia. The most common site of infection was respiratory (34.4%). Post-LSD analyses showed significant difference in the PCT between culture negative sepsis and SIRS (p=0.01); and positive other culture and SIRS (p=0.04). On the other hand IL-6 cannot differentiate between SIRS and negative culture sepsis (p=0.06). Both PCT and IL-6 predicted bacteraemia with an AUC of 0.70 (0.57 to 0.82) and 0.68 (0.53 to 0.70). IL-6 is independently associated with bacteraemia and other culture after adjusting for age, sex, hypertension, SAPS II score and day 1 PCT. Conclusions: Procalcitonin but not Interleukin-6 is able to differentiate SIRS from culture-negative BS. However, IL-6 is independently associated with bacteraemia and other culture.

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Early identification of patients at risk of acute severe pancreatitis with Systemic Inflammatory Response Syndrome score at admission

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v8i2.28171 ◽

2019 ◽

Vol 8 (2) ◽

pp. 92-95

Author(s):

Uttam Laudari ◽

Abishek Thapa ◽

Tanka Prasad Bohara ◽

Shail Rupakheti ◽

Mukund Raj Joshi

Keyword(s):

Acute Pancreatitis ◽

Systemic Inflammatory Response Syndrome ◽

Inflammatory Response ◽

Predictive Value ◽

College Teaching ◽

Systemic Inflammatory Response ◽

P Value ◽

Predictive Values ◽

Acute Severe Pancreatitis ◽

Severe Pancreatitis

Background: Clinically, the Systemic Inflammatory Response Syndrome (SIRS) is identified by two or more symptoms including fever or hypothermia, tachycardia, tachypnea and change in blood leukocyte count. The relationship between SIRS symptoms at the time of presentation and severity of pancreatitis is yet to be determined though progression of SIRS in subsequent days has already been correlated.Objectives: To determine the severity of pancreatitis with SIRS score at the time of admission.Methodology: A retrospective cohort study of patients admitted to Department of Surgery, Kathmandu Medical College Teaching Hospital (KMCTH) with diagnosis of Acute Pancreatitis (AP) from December 2014 to January 2016 was conducted. Clinical, biochemical and imaging data were collected from the medical record section. Patients with diagnosis of acute pancreatitis as per Revised Atlanta Classification 2012 were included in the study. SIRS score at time of admission was correlated with Modified Marshall scoring system for organ dysfunction. Patients were grouped into severe and nonsevere group. Sensitivity, specificity and predictive values of SIRS score at admission for organ failure were calculated.Results: Among the 41 patients admitted with diagnosis of acute pancreatitis irrespective of cause, the sensitivity of SIRS score ≥2 at admission in predicting severe pancreatitis was 60 %, specificity was 20%, positive predictive value was 28% and negative predictive value was 20 %, with p-value of 0.52 and odds ratio of 1.6 (CI: 0.376-6.808).Conclusion: SIRS score at admission cannot be solely used in predicting acute severe pancreatitis. Patients can be stratified in resource deficit setting for timely referral to tertiary centre.

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