scholarly journals Procalcitonin as New Proinflammatory Marker in Burn Patients

2021 ◽  
Vol 11 (1) ◽  
pp. 58-62
Author(s):  
Amer A. Khaleel ◽  
Ruqaya M. Al-Barzinji
Keyword(s):  
Serum Concentration ◽  
Inflammatory Marker ◽  
Total Body Surface Area ◽  
Control Group ◽  
Burn Patients ◽  
Amino Acid Peptide ◽  
Diagnosis And Prognosis ◽  
Healthy Control ◽  
Total Body

Procalcitonin (PCT) is a 116 amino acid peptide with a sequence identical to that of prohormone of calcitonin but devoid of hormonal activity. The aim of this study was to determine PCT and it using as a new prognostic pro-inflammatory marker in burn patients and determine the role of PCT level as a mortality indicator in survival and non-survival burn patients. The burn patients in this study were divided into four groups according to the percentage of total body surface area burned carry out on (50) burn patients admitted to the burn unit in West Erbil Emergency Hospital in Erbil governorate and (20) apparently the healthy non-burn individuals who regarded as healthy control group (HC) in this study from February 2012 to April 2012. Out of 50 burnt patients, 20 patients were second sampled to follow-up their immune profile. Regarding PCT there were significant differences (P < 0.05) observed between the mean serum concentration of PCT belong to 18 burn patients of 1st group (G1) (1.24 ± 0.82), 23 patients of 2nd group (G2) (1.52 ± 0.76), six patients of 3rd group (G3) (2. 16 ± 0.11), and three burn patients of 4th group (G4) (6.5 ± 2.87) with mean serum concentration of 18 HC (0.02 ± 0.006). Significant differences obtained when compared to G3 (2.16 ± 0.11) versus G4 (6.5 ± 2.87) using the F-test and t-test. Results show that PCT is a highly productive laboratory parameter involving an easy and rapid beside test for diagnosis and prognosis mortality in burn patients.

Outcomes with the Use of Recombinant Human Erythropoietin in Critically Ill Burn Patients

2010 ◽  
Vol 76 (9) ◽  
pp. 951-956 ◽  
Author(s):  
Jonathan B. Lundy ◽  
Katherine Hetz ◽  
Kevin K. Chung ◽  
Evan M. Renz ◽  
Christopher E. White ◽  
...  
Keyword(s):  
Recombinant Human Erythropoietin ◽  
Total Body Surface Area ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Control Group ◽  
Burn Patients ◽  
Human Erythropoietin ◽  
Transfusion Requirements ◽  
Total Body ◽  
Injured Patients

Recent data demonstrate a possible mortality benefit in traumatically injured patients when given subcutaneous recombinant human erythropoietin (rhEPO). The purpose of this report is to examine the effect of rhEPO on mortality and transfusion in burn patients. We conducted a review of burn patients (greater than 30% total body surface area, intensive care unit [ICU] days greater than 15) treated with 40,000u rhEPO over an 18-month period (January 2007 to July 2008). Matched historical controls were identified and a contemporaneous cohort of subjects not administered rhEPO was used for comparison (NrhEPO). Mortality, transfusions, ICU and hospital length of stay were assessed. A total of 105 patients were treated (25 rhEPO, 53 historical control group, 27 NrhEPO). Hospital transfusions (mean 13,704 ± mL vs 13,308 ± mL; P = 0.42) and mortality (29.6 vs 32.0%; P = 0.64) were similar. NrhEPO required more blood transfusions (13,308 ± mL vs 6,827 ± mL; P = 0.004). No difference in mortality for the rhEPO and NrhEPO (32.0 vs 22.2%; P = 0.43) was found. Thromboembolic complications were similar in all three groups. No effect was seen for rhEPO treatment on mortality or blood transfusion requirements in the severely burned.

9 The Potential for Mitochondrial Respiration and Circulating mtDNA Levels for Early Diagnosis of Sepsis in Burn Patients

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S9-S9
Author(s):  
David M Burmeister ◽  
Belinda Gomez ◽  
Tiffany Heard ◽  
Tony Chao ◽  
Kevin Akers ◽  
...  
Keyword(s):  
Mitochondrial Function ◽  
Mitochondrial Respiration ◽  
Total Body Surface Area ◽  
Burn Patients ◽  
Closed Chamber ◽  
Compensatory Response ◽  
Sepsis Diagnosis ◽  
Molecular Pattern ◽  
Healthy Control ◽  
Total Body

Abstract Introduction Sepsis is a common consequence of burns associated with greater morbidity. While early treatment of sepsis in burn patients improves outcomes identifying sensitive biomarkers has proven difficult. In burns, sepsis often occurs in the absence of positive blood cultures, and associated inflammation precludes the use of inflammatory markers. We hypothesized that lymphocyte mitochondrial bioenergetics and/or circulating mtDNA (a Damage-Associated Molecular Pattern) may serve as novel sepsis biomarkers in burn patients. Methods Whole blood was obtained from adult patients (19–73 years of age) with 34–75% total body surface area burns admitted to the Burn Intensive Care Unit or healthy volunteers. Samples were categorized into one of three groups: 1) Healthy control, 2) Non-septic, or 3) Septic. The amount of mtDNA (NADH dehydrogenase 3 gene) was assessed by real-time PCR. Lymphocyte mitochondrial respiration was measured in a closed-chamber high-resolution respirometry Oxygraph-2k (Oroboros Instruments) with the addition of substrates to measure routine, leak, and maximum oxidative flux (MOF). Results Routine respiration was not different between non-septic and septic (27.0±30.0 and 27.2±10.8 pmol O2/mg/s) samples however, both were greater than healthy (13.1±5.00 pmol O2/mg/s; P≤0.05). Leak respiration was not different amongst groups. MOF (maximum capacity of the electron transport chain when not limited by ATP synthase/uncoupling) was different (P≤0.05) between populations with healthy (12.0±2.6 pmol O2/mg/s) having the lowest values, followed by septic (26.3±13.9 pmol O2/mg/s) and non-septic patients (34.7±23.1 pmol O2/mg/s). mtDNA levels were elevated in septic patients (70,061±65,975 copies/µL) when compared with non-septic and healthy patients (3,738±1,701 and 6,848±5,893 copies/µL, respectively; P=0.017). Levels of bacterial 16S DNA were not detected. Conclusions Taken together, increases in lymphocyte mitochondrial respiration may represent a compensatory response. Moreover, these data support the notion that mtDNA may trigger the onset of sepsis in burn patients in the absence of bacterial DNA. Investigating mitochondrial function/circulating DNA levels as they correlate with the onset/progression of sepsis in burn patients may beget useful biomarkers for early sepsis diagnosis. Applicability of Research to Practice Markers of mitochondrial function and damage in the burn patient may reveal powerful diagnostic targets to allow for interventions to stop sepsis before it occurs.

Bloodstream infection as a predictor for mortality in severe burn patients: an 11-year study

2013 ◽  
Vol 142 (10) ◽  
pp. 2172-2179 ◽  
Author(s):  
D. EGOZI ◽  
K. HUSSEIN ◽  
S. FILSON ◽  
T. MASHIACH ◽  
Y. ULLMANN ◽  
...  
Keyword(s):  
Bloodstream Infection ◽  
Univariate Analysis ◽  
Total Body Surface Area ◽  
Smoke Inhalation ◽  
Resistant Bacteria ◽  
Burn Patients ◽  
Severe Burn ◽  
Prediction Of Mortality ◽  
Total Body

SUMMARYIn this study we collected and analysed data of the severe burn patients at our institution over an 11-year period in order to shed light on the controversial role of bloodstream infection (BSI) as a predictive factor for mortality in this burn population. The factors examined were age, total body surface area, smoke inhalation, presence of BSI, and BSI with resistant bacteria. In total 1081 burn patients were hospitalized from 2001 to 2011, of whom 4% died. We focused here on 158 severe burn patients, 74 of whom developed BSI, and 35 who died. Using univariate analysis, it appeared that the BSI group had a threefold greater chance of mortality compared to the non-BSI group. Patients with a Ryan score 3 had a 100% chance of mortality and those with a score 0 had 0%. Thus, focusing only on Ryan score 1 and score 2 patients, BSI did not contribute to mortality, nor was it shown to contribute to mortality in a multivariate analysis in which the score and BSI were included together. When BSI did occur, it predicted longer hospitalization periods. We conclude that BSI predicts longer length of hospitalization stay but does not contribute to the prediction of mortality beyond that offered by the Ryan score in a severe burn population.

Pathological Alternations of Mediastinal Fat-Associated Lymphoid Cluster and Lung in a Streptozotocin-Induced Diabetic Mouse Model

2020 ◽  
pp. 1-14
Author(s):  
Yaser H.A. Elewa ◽  
Osamu Ichii ◽  
Teppei Nakamura ◽  
Yasuhiro Kon
Keyword(s):  
Endothelial Cells ◽  
Lung Injury ◽  
Mouse Model ◽  
Immune Cells ◽  
Inflammatory Markers ◽  
Inflammatory Marker ◽  
Diabetic Mouse ◽  
Control Group ◽  
Injury Progression

Diabetes is a devastating global health problem and is considered a predisposing factor for lung injury progression. Furthermore, previous reports of the authors revealed the role of mediastinal fat-associated lymphoid clusters (MFALCs) in advancing respiratory diseases. However, no reports concerning the role of MFALCs on the development of lung injury in diabetes have been published. Therefore, this study aimed to examine the correlations between diabetes and the development of MFALCs and the progression of lung injury in a streptozotocin-induced diabetic mouse model. Furthermore, immunohistochemical analysis for immune cells (CD3+ T-lymphocytes, B220+ B-lymphocytes, Iba1+ macrophages, and Gr1+ granulocytes), vessels markers (CD31+ endothelial cells and LYVE-1+ lymphatic vessels “LVs”), and inflammatory markers (TNF-α and IL-5) was performed. In comparison to the control group, the diabetic group showed lung injury development with a significant increase in MFALC size, immune cells, LVs, and inflammatory marker, and a considerable decrease of CD31+ endothelial cells in both lung and MFALCs was observed. Furthermore, the blood glucose level showed significant positive correlations with MFALCs size, lung injury, immune cells, inflammatory markers, and LYVE-1+ LVs in lungs and MFALCs. Thus, we suggest that the development of MFALCs and LVs could contribute to lung injury progression in diabetic conditions.

scholarly journals HMGB1, anti-HMGB1 antibodies, and ratio of HMGB1/anti-HMGB1 antibodies as diagnosis indicator in fever of unknown origin

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mingkun Chen ◽  
Li Zhu ◽  
Miao Xue ◽  
Rongrong Zhu ◽  
Liling Jing ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Autoimmune Disease ◽  
Serum Concentration ◽  
Malignant Tumor ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Healthy Control Group ◽  
Control Group ◽  
Elisa Kit ◽  
Healthy Control

AbstractTo evaluate the feasibility of serum HMGB1, anti-HMGB1 antibodies, and HMGB1/anti-HMGB1 ratio as a diagnosis indicator of initial clinical classification in patients with fever of unknown origin (FUO). Ninety-four patients with classical FUO and ninety healthy controls were enrolled in this study. The subjects’ clinical data and serum were collected. The serum concentration of HMGB1 was detected by a commercial HMGB1 ELISA kit, while the serum concentration of anti-HMGB1 antibodies were detected by an in-house built anti-HMGB1 antibodies ELISA kit and further confirmed by immunoblotting. According to the hospital diagnosis on discharge, ninety-four FUO patients were divided into four groups, Infectious disease subgroup, autoimmune disease subgroup, malignant tumor subgroup, and undetermined subgroup. The concentrations of HMGB1 in the infectious disease subgroup and autoimmune disease subgroup were higher than those in the malignant tumor subgroup, undetermined subgroup, and healthy control group. The concentration of anti-HMGB1 antibodies in autoimmune disease subtype group was higher than those in other subgroups as well as healthy control group. According to the distribution of HMGB1 and anti-HMGB1 in scatter plots of the patients with FUO, we found that the ratio of serum HMGB1/anti-HMGB1 is an ideal clinical indicator for differential diagnosis of different subtypes of FUO. The best cut-off was 0.75, and the sensitivity, specificity, and AUC were 66.67%, 87.32%, and 0.8, respectively. Correlation analysis showed that serum concentration of HMGB1 was moderately correlated with CRP in infectious diseases subgroup, and the serum concentration of anti-HMGB1 antibodies was strongly correlated with erythrocyte sedimentation rate in autoimmune disease subgroup. Our study had showed that serum HMGB1/anti-HMGB1 antibodies ratio can help clinicians identify FUO subtypes, thereby avoiding many unnecessary examinations and tests, and improving the effectiveness of clinical diagnosis and treatment of FUO.

5 -Year Retrospective Analysis of a Vented Mobility Algorithm in the Burn ICU

2022 ◽  
Author(s):  
Audrey Marie O'Neil ◽  
Cassandra Rush ◽  
Laura Griffard ◽  
David Roggy ◽  
Allison Boyd ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Recent Literature ◽  
Total Body Surface Area ◽  
Early Mobilization ◽  
Burn Patients ◽  
Mechanically Ventilated ◽  
Line Placement ◽  
Total Body ◽  
Stage 1 ◽  
Significant Attention

Abstract Early mobilization with mechanically ventilated patients has received significant attention within recent literature, however limited research has focused specifically on the burn population. The purpose of this single center, retrospective analysis was to review the use of a burn critical care mobility algorithm, to determine safety and feasibility of a burn vented mobility program, share limitations preventing mobility progression at our facility, and discuss unique challenges to vented mobility with intubated burn patients. A retrospective review was completed for all intubated burn center admissions between January 2015 to December 2019. Burn Therapy notes were then reviewed for data collection, during the intubation period, using stages of the mobility algorithm. In 5 years following initial implementation, the vented mobility algorithm was utilized on 127 patients with an average total body surface area of 22.8%. No adverse events occurred. Stage 1 (Range of motion) was completed with 100% of patients (n=127). Chair mode of bed, stage 2a, was utilized in 39.4%(n=50) of patients, while 15.8% (n=20) of patients were dependently transferred to the cardiac chair in stage 2b. Stage 3 (sitting on the edge-of-bed) was completed with 25% (n=32) of patients, with 11% (n=14) progressing to stage 5 (standing), and 3.9% (n=5) actively transferring to a chair. In 5 years, only 4.7% (n=6) reached stage 6 (ambulation). The most common treatment limitations were medical complications (33%) and line placement (21%). Early mobilization during mechanical ventilation is safe and feasible within the burn population, despite challenges including airway stability, sedation, and line limitations.

scholarly journals Studying the Role of C-Reactive Protein in Patients with Sleeve Gastrectomy in Baghdad

2021 ◽  
Vol 3 (1) ◽  
pp. 55-60
Author(s):  
Mohammed Abbas Fadil ◽  
Raya Ezat Maroof ◽  
Moayed Abbas Fadil
Keyword(s):  
Sleeve Gastrectomy ◽  
Healthy Person ◽  
Control Group ◽  
C Reactive Protein ◽  
Serum Samples ◽  
Reactive Protein ◽  
Medical City ◽  
Healthy Control ◽  
And Control

Obesity and severe obesity are increasing serious health problems with an epidemic percentage in most countries. In Sleeve gastrectomy, a part of the stomach structure is removed, limiting its capacity by about two to three. A total of thirty blood samples were collected from patients with obesity and the result was compared with healthy person throughout the time from November 2019 to September 2020. Before sleeve gastrectomy and after more than 6 months of sleeve surgery, the sample was collected from the Medical City/Baghdad Teaching Hospital, the withdrawal was again taken at home to have pre and post sleeve gastrectomy, Patient age ranged between [20-46] years for obese patients and healthy control. Then the serum samples were obtained from patients and control group to screen for C-reactive protein by agglutination method. The result of the present study found that the positivity of CRP in pre-operation is higher than that of post-operative with high significance [P<0.005].

scholarly journals A Comparative Study between C-Reactive Protein and Procalcitonin in Iraqi Burn Patients

2017 ◽  
Vol 28 (1) ◽  
pp. 41
Author(s):  
Alia E. Al-Ubadi
Keyword(s):  
Burn Injury ◽  
Total Body Surface Area ◽  
Latex Agglutination ◽  
Burn Patients ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Survivor Group ◽  
Significant Difference ◽  
The Mean ◽  
Total Body

Association between Procalcitonin (PCT) and C-reactive protein (CRP) and burn injury was evaluated in 80 burned patients from Al-Kindy and Imam Ali hospitals in Baghdad-Iraq. Patients were divided into two groups, survivor group 56 (70%) and non-survivor group 24 (30%). PCT was estimated using (Human Procalcitonin ELISA kit) provided by RayBio/USA while CRP was performed using a latex agglutination kit from Chromatest (Spain). Our results declared that the mean of Total Body Surface Area (TBSA %) affected were 63.5% range (36%–95%) in non-survivor patients, while 26.5% range (10%–70%) in survivor patients. There is a significant difference between the two groups (P = 0.00), the higher mean percentage of TBSA has a significant association with mortality. Serum PCT and CRP were measured at the three times of sampling (within the first 48hr following admission, after 5thdays and after 10th days). The mean of PCT serum concentrations in non-survivor group (2638 ± 3013pg/ml) were higher than that of survivor group (588 ± 364pg/ml). Significantly high levels of CRP were found between the survivor and non-survivor groups especially in the 10th day of admission P=0.000, present study show that significant differences is found within the non-survivor group through the three times P= 0.01, while results were near to significant differences within survivor group through the three times (P= 0.05).

scholarly journals Role of acute phase proteins in diagnosis of uremic pancreatitis and destructive pancreatitis in patients receiving renal replacement therapy (programmed hemodialysis)

2021 ◽  
Vol 38 (5) ◽  
pp. 115-122
Author(s):  
Kazim G. Gasanov ◽  
Viktor A. Zurnadzhyants ◽  
Eldar A. Kchibekov ◽  
M. I. Shikhragimov
Keyword(s):  
Renal Replacement Therapy ◽  
Serum Concentration ◽  
Blood Serum ◽  
Replacement Therapy ◽  
Acute Phase Proteins ◽  
Control Group ◽  
Serum Concentrations ◽  
High Concentration ◽  
Surgical Unit

Objective. To determine the blood serum 2-microglobulin and 2-macroglobulin concentration in patients undergoing renal replacement therapy (programmed hemodialysis) for the diagnosis of uremic pancreatitis and / or destructive pancreatitis. Materials and methods. The study involved 52 patients admitted to the Surgical Unit of Astrakhan "RZhD-Medicine" Hospital and City Clinical Hospital № 3. The blood serum 2-microglobulin and 2-macroglobulin concentration was analyzed in patients admitted on an emergency basis with suspicion of uremic pancreatitis and destructive pancreatitis, who receive renal replacement therapy (programmed hemodialysis). The control group included 50 outpatients undergoing renal replacement therapy (programmed hemodialysis). The study did not include patients with suspected pancreatitis who were not receiving renal replacement therapy. The period of the study is 20192021. Results. The concentration of blood serum 2-microglobulin is statistically higher than normal in all patients, who had received renal replacement therapy (programmed hemodialysis) in anamnesis. The most statistically high concentration of 2-microglobulin was revealed while studying patients with uremic pancreatitis (n = 34), and was (30.0 2.75 mg/l) compared with the blood serum concentration in patients with destructive pancreatitis (8 0.51 mg / l). The concentration of 2-macroglobulin was statistically lower in destructive pancreatitis (n = 18) and was 615 161 mg/l compared with uremic pancreatitis (980 216 mg/l). In the control group of outpatients (n = 50) receiving renal replacement therapy (programmed hemodialysis), no statistically significant blood serum concentrations of 2-microglobulin and 2-macroglobulin were found. Conclusions. A clear dependence of the concentration of 2-microglobulin and 2-macroglobulin on the severity of uremic pancreatitis and destructive pancreatitis was established. Statistically high values of 2-microglobulin concentrations were obtained in patients with uremic pancreatitis, and the 2-macroglobulin level was statistically low in destructive pancreatitis.

Prevalence of Psychiatric Disorders in Burn Patients in a Tertiary Care Hospital

2021 ◽  
Vol 15 (11) ◽  
pp. 3389-3391
Author(s):  
Imran Khan ◽  
Taimur Khan ◽  
Shakil Asif ◽  
Syed Azhar Ali Kazmi ◽  
Subhan Ullah ◽  
...  
Keyword(s):  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Total Body Surface Area ◽  
Burn Injuries ◽  
Care Hospital ◽  
Burn Patients ◽  
Total Body

Background and Aim: Burn injuries patients generally suffer from various psychological and mental disorders especially in lower socio-economic groups. It can adversely affect their wellbeing and health. Proper consultation and clinical diagnosis need to be carried out on burns injuries patients from the early critical phase to rehabilitation phase recovery. The current study's aim was to determine the prevalence of psychiatric disorders in burn patients in a tertiary care hospital. Materials and Methods: This cross-sectional study was conducted on 82 attempted burn suicides, adult patients in Khattak Medical Center Peshawar, Khyber Teaching Hospital Peshawar and Divisional Headquarter hospital, Mirpur AJK for duration of six months from June 2020 to December 2020. All the patients admitted with suicides burns were of either gender and had ages above 15 years. The convenience technique was used for sampling. The patients’ demographic details such as psychiatric illness, self-immolation act motivation, burn injury depth, burn total body surface area, inhalation injury, hospitalization duration, and mortality was recorded on pre-designed proforma. Data analysis was carried out with SPSS version 20. Results: The mean age of all 82 patients was 28.9±5.2 with an age range of 14 to 55 years. Of the total, 66 (80.5%) were female while 16 (19.5%) were male. In this study, the most frequent suicidal attempt was made by the marital conflicted patients 50 (61%) followed by love affair failure 8 (9.7%). An overall mean of 53.6±19.6 was observed for total body surface area affected with a range of 15-100%. The hospital duration mean was 8.2±5.9 with a range of 1-38 days. Young, married, and rural area illiterate housewives were the most common self-inflicted/suicide burn injuries. The prime cause of such injuries was getting married. The mortality rate was found at 82.3%. Conclusion: Our study concluded that patient’s well-being and mental health could be severely affected by burn injuries. Prevalent depression was noted among severe burn injuries patients. Depression related to deformity could be prevented with early grafting, wound management, proper splinting, coping ability, intense physiotherapy, and long-term rehabilitation. Keywords: Burn; Depressed mood, Psychiatric morbidity, Posttraumatic stress disorder

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