Clinical utility of serum procalcitonin in adult patients admitted with community-acquired pneumonia in Ilorin, Nigeria

Objectives: The usefulness of biomarkers in community acquired pneumonia (CAP) has been under the research light with limited reports from Africa. This study aimed at evaluating the clinical usefulness of serum procalcitonin (PCT) in patients admitted with CAP in a tertiary hospital in Ilorin, Nigeria. Materials and Methods: This was prospective single center observational study of 102 admitted patients with clinical and radiologic features of CAP. All the patients had serum PCT assay, complete blood count, blood culture, sputum microbiology, and serological evaluation for atypical pathogens. Repeat PCT assay was done following 1 week of antibiotic therapy. The patients were classified into one of two diagnostic groups: Those with microbiologically confirmed bacterial CAP and those without bacterial CAP. Results: Over half (58/102; 56.8%) of the patients had microbiologically confirmed bacterial CAP. The baseline serum PCT concentrations were significantly higher in patients with bacterial CAP when compared to the non-bacterial CAP group (2.55 ± 0.14 vs. 0.94 ± 0.61 ng/ml; P < 0.001). There was also a statistically significant difference between the pre- and post-treatment serum PCT concentrations in the bacterial CAP group (P < 0.001) and the non-bacterial CAP group (P = 0.006). The area under the receiver operating characteristic (AUC) for pre-treatment PCT in diagnosing bacterial CAP was 0.795 (95% confidence level [CI]: 0.709–0.881) with a sensitivity of 67.2% and specificity of 79.5% at an optimal cutoff of 1.5 ng/ml. Overall, the biomarker was independently associated with white cell counts >10 × 109/L (AOR = 6.28; 95% CI: 1.30–30.32, P = 0.02). The baseline mean serum PCT levels were also significantly higher in patients admitted for 7 or more days (P = 0.010). Conclusion: Serum PCT had good diagnostic strength in patients admitted with bacterial CAP in Ilorin. The biomarker can also assist clinicians with predicting the pathogenic group and monitoring clinical progress of CAP.

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Bacterial and viral etiology in hospitalized community acquired pneumonia with molecular methods and clinical evaluation

The Journal of Infection in Developing Countries ◽

10.3855/jidc.3560 ◽

2014 ◽

Vol 8 (04) ◽

pp. 510-518 ◽

Cited By ~ 16

Author(s):

Derya Çağlayan Serin ◽

Hüsnü Pullukçu ◽

Candan Çiçek ◽

Oğuz Reşat Sipahi ◽

Sezai Taşbakan ◽

...

Keyword(s):

Bacterial Infections ◽

Culture Method ◽

Community Acquired Pneumonia ◽

Human Bocavirus ◽

Viral Agent ◽

Viral Etiology ◽

Laboratory Findings ◽

Identification Rate ◽

Atypical Pathogens ◽

Significant Difference

Introduction: Polymerase chain reaction (PCR) method has improved the diagnosis rates for patients with community-acquired pneumonia (CAP). We aimed to evaluate the bacterial and viral etiology of hospitalized CAP cases and compare clinical and laboratory findings of patients with pure bacterial and bacterial and viral (mixed) infections. Methodology: A total of 55 patients hospitalized with CAP were enrolled into the prospective study between February 2010 and December 2010. Clinical and laboratory follow-up were performed on days 0, 7 and 14. Deep tracheal aspiration samples were examined for bacterial and viral pathogens by multiplex PCR, and standard bacteriological culture method. Results: The etiological identification rate in 50 patients for bacteria, viruses and mixed virus–bacteria combination by PCR were 62%, 4%, 32%, respectively and 60% in 55 patients by bacterial culture method. Streptococcus pneumoniae concomitant with Haemophilus influenzae (36%) and rhinovirus (16%) was very common, whereas atypical pathogens (only Mycoplasma pneumoniae) were rare (6%). Rhinovirus was the most common viral agent (20%). Recently identified viruses, human coronavirus HKU1 and human bocavirus were not detected except for human metapneumovirus (one case). There was no significant difference in terms of mean age, immune status, leukocyte count, C-reactive protein (CRP) values, hospitalization duration and CURB-65 score between bacterial and mixed viral-bacterial detections. Advanced age (p < 0.01) and higher CURB-65 score (p = 0.01) were found to be associated with increased mortality. Conclusion: Concomitance of bacterial and viral agents is frequent and resemble with bacterial infections alone. Further studies are needed for the clinical significance of mixed detections.

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COMPERISON OF “OLD” AND “NEW” ACUTE PHASE REACTANTS IN PATIENTS WITH COMMUNITY ACQUIRED PNEUMONIA AND DIABETS MELLITUS 2 TYPE AS INFLAMMATORY CHANGES MARKERS

InterConf ◽

10.51582/interconf.7-8.05.2021.023 ◽

2021 ◽

pp. 208-216

Author(s):

Olena Makharynska ◽

Ievgeniia Tokareva

Keyword(s):

Immune System ◽

Complete Blood Count ◽

Community Acquired Pneumonia ◽

Inflammatory Biomarkers ◽

Acute Phase Reactants ◽

Markers Of Inflammation ◽

Tnf Α ◽

Significant Difference ◽

Severe Community Acquired Pneumonia ◽

Wbc Count

The aim of the study was to evaluate “old” (WBC count) and “new” inflammatory biomarkers in hospitalized patients with non-severe community-acquired pneumonia in patients with\without Diabetes Mellitus 2 type. Materials and methods. At inclusion, clinical and laboratory parameters of pneumonia were recorded and the CRB-65 was evaluated. A total of 131 adult patients hospitalized with non-severe CAP were included in this prospective study. Levels of pro-inflammatory (IL-1β, IL-8, TNF-α), anti-inflammatory (IL-10) cytokines and markers of inflammation (CRP, complete blood count) were determined at the beginning of the disease (day O) and in 48-72 hours. Results. The level of leukocytes in CBC was significantly higher in the main group at the beginning of the disease, as well after 10 ± 2 days from day 0 the number of episodes of leukocytosis > 10 · 109 / l was higher (8.5% vs. 2%, respectively, p <0,05). There was no statistically significant difference between the studied inflammatory biomarkers levels in the both groups of patients with and without concomitant diabetes. There was a tendency to a higher number of cases of "recovery" after CAP in the group with CRP levels during hospitalization ≥ 21.8 pg / ml (22% vs. 48%, p <0.1). Conclusion. It can be assumed that such a low dynamics of inflammatory markers is associated with involutive changes in the immune system due to older age of the patients included in the study and the influence of DM on the immune system reactivity in the CAP with concomitant DM 2 type with immune response suppression can also explain absence of significant difference in inflammatory biomarkers concentration in the groups compered in this study.

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Platelet indices in Philadelphia-negative chronic myeloproliferative neoplasms / Indicii plachetari de volum în neoplasmele mieloproliferative cronice Philadelphia-negative

Revista Romana de Medicina de Laborator ◽

10.1515/rrlm-2015-0012 ◽

2015 ◽

Vol 23 (2) ◽

Cited By ~ 2

Author(s):

Ariela-Ligia Olteanu ◽

Romeo-Gabriel Mihaila ◽

Alina-Camelia Catana ◽

Ofelia Flucus ◽

Cristina Bus ◽

...

Keyword(s):

Healthy Subjects ◽

Complete Blood Count ◽

Myeloproliferative Neoplasms ◽

Jak2 V617f ◽

Impedance Method ◽

Amplification Refractory Mutation System ◽

Platelet Volume ◽

Chronic Myeloproliferative Neoplasms ◽

Cell Counts ◽

Significant Difference

AbstractIntroduction: Philadelphia-negative chronic myeloproliferative neoplasms (Ph-MPN): polycythemia vera (PV), essential thrombocythaemia (ET), and primary myelofibrosis (PMF) are characterized by an increased rate of thrombosis complications partly due to platelets activation. Large platelets are more active, have an enhanced procoagulant function and have a pathogenic role in arterial and venous thrombosis. In our study we tried to establish if platelet volume indices (MPV, PDW, P-LCR) issued from automated complete blood count determination are significantly different in Ph-MPN patients in comparison to healthy subjects. Materials and methods: Blood cell counts including platelet volume indices were assessed for 102 Ph-MPN and 102 healthy subjects using the impedance method on Sysmex XS 1000i and glucose and lipid profile, were assessed on Architect c 8000. Assessement of JAK2V617 positivity was conducted with amplification refractory mutation system polymerase chain reaction (ARMS-PCR), in whole peripheral blood. Results: Platelet volume indices (PVI) measured with the impedance based method, did not show significant differences in Ph-MPN patients in comparison to healthy controls. We noticed a moderate correlation between these indices and the presence of JAK2V617F mutation. PVI were increased in the small subgroup of patients treated with anagrelide and decreased in patients treated with simvastatin, comparatively with untreated patients. Conclusion: In our study we did not find a significant difference between platelet volume indices from Ph-MPN patients and healthy subjects. Further studies are required to demonstrate correlations between platelet volume indices and JAK2 V617F mutation, treatment with anagrelide and statins, respectively

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The Effect of Antiplatelet Drugs on Plasma Betathromboglobulin in Coronary Artery Disease

10.1055/s-0038-1665677 ◽

1979 ◽

Cited By ~ 1

Author(s):

P Han ◽

A Turpie ◽

E Genton ◽

M Gent

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Crossover Trial ◽

Specific Protein ◽

Antiplatelet Drugs ◽

Significant Difference ◽

Pre Treatment ◽

Artery Disease ◽

Therapeutic Doses ◽

Granule Release

Platelets play a role in the development and complications of coronary artery disease (CAD) and a number of abnormalities of platelet function which can be corrected by antiplatelet drugs have been described. Betathromboglobulin (BTG), a platelet-specific protein which is released from α-granules during platelet activation is significantly elevated in patients with angiographically demonstrated CAD (51.0 ± 31.0 ng/ml., n = 50) compared to normal (28.0 ± 8.0 ng/ml., n = 70) p < 0.001. The effect of sulphinpyrazone (800 mg.) or aspirin (1200 mg.)/dipyridamole (200 mg.) on plasma BTG in CAD was studied in a blind prospective crossover trial in 25 patients. Mean BTG concentration pre-treatment was 52.3 ng/ml. and after 1 month’s treatment with placebo, sulphinpyrazone or aspirin/dipyridamole mean plasma BTG concentrations were 53.5, 49.6 and 56.7 ng/ml. respectively. Analysis of variance showed no significant difference between the means (p > 0.1) . This study confirms increased plasma BTG concentrations in patients with CAD and indicates that therapeutic doses of these antiplatelet drugs do not significantly effect the BTG level and thus appear not to prevent α-granule release in CAD.

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STUDIES ON SULFATION FACTOR (SF) ACTIVITY OF HUMAN SERUM

Acta Endocrinologica ◽

10.1530/acta.0.xxxv0381 ◽

1960 ◽

Vol XXXV (III) ◽

pp. 381-396 ◽

Cited By ~ 14

Author(s):

Sven Almqvist

Keyword(s):

Human Serum ◽

Normal Serum ◽

Treatment Level ◽

Response Curves ◽

Normal Children ◽

Significant Difference ◽

Human Sera ◽

Normal Humans ◽

Pre Treatment ◽

Dose Levels

ABSTRACT The sulfation factor (SF) activity of human sera has been estimated using a modification of the method of Daughaday et al. (1959). Each assay was statistically evaluated. The method had a mean precision of 0.14 and, used as an assay of GH of human serum, a sensitivity in three pituitary dwarfs of 0.1 to 0.6 μg of HGH/ml of serum. SF activity was found at all ages between 1 month and 75 years. There was a significantly lower mean SF activity below the age of half a year. Three cases of pituitary dwarfism had significantly low SF activities of sera. There was no significant difference between the SF activities of sera from untreated pituitary dwarfs and the sera from normal children below half a year of age. Dose-response curves with large volumes of sera from pituitary dwarfs and small volumes of sera from normal humans had the same slopes. Four mg of HGH prepared according to the method of Li & Papkoff (1956) resulted in a normal serum SF activity in each of the three dwarfs. A significant (P < 0.01) linear relationship was found between the concentration of SF activity of sera from these subjects and the logarithm of the dose of HGH given with dose levels of 1, 2 and 4 mg daily for three days. The decline of serum SF activity to the pre-treatment level following HGH in one dwarf suggested a half life not different from that indicated by others for growth hormone.

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Isolation of an Anti-fatigue Preparation from Cellulase-treated Maca by Hydroalcoholic Extraction

Current Topics in Nutraceutical Research ◽

10.37290/ctnr2641-452x.17:93-98 ◽

2017 ◽

Vol 17 (1) ◽

pp. 93-98

Author(s):

Zheng Yue ◽

Zhang Wen-Cheng ◽

Wu Ze-Yu ◽

Fu Chuan-Xiang ◽

Gao Han ◽

...

Keyword(s):

Positive Control ◽

Glycogen Storage ◽

Hepatic Glycogen ◽

Time To Exhaustion ◽

High Dose ◽

Hydroalcoholic Extract ◽

Swimming Time ◽

Significant Difference ◽

Pre Treatment ◽

Better Than

The purpose of this study was to evaluate the anti-fatigue activity of maca hydroalcoholic extract (ME), which mainly contains macamides and polysaccharides. ME was prepared by circumfluence extraction with enzymatic pre-treatment. Anti-fatigue activity of ME was investigated in weight-loaded forced swimming mice, with pure macamides and commercially available maca tablet as positive control. Compared with normal group, pure macamides treatment group could prolong the swimming time to exhaustion, but there was no statistically significant difference (P > 0.05); while ME (middle-dose and high-dose groups) could effectively prolong the swimming durations (P < 0.05). Supplementation with pure macamides significantly decreased blood lactic acid (BLA), whereas ME significantly increased hepatic glycogen (HG), decreased BLA, and blood urea nitrogen (BUN) compared with those in normal control (P < 0.05). The results suggested that the anti-fatigue effect of ME was better than that of pure macamides, which can be explained by the increase of glycogen storage and the reduction of metabolites accumulation.

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Comparison of leucocyte profiles between healthy children and those with asymptomatic and symptomatic Plasmodium falciparum infections

Malaria Journal ◽

10.1186/s12936-020-03435-x ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Diana Ahu Prah ◽

Linda Eva Amoah ◽

Matthew P. Gibbins ◽

Yaw Bediako ◽

Aubrey J. Cunnington ◽

...

Keyword(s):

T Cells ◽

Plasmodium Falciparum ◽

Peripheral Blood ◽

Parasite Load ◽

Study Groups ◽

Healthy Children ◽

Peripheral Cell ◽

Peripheral Blood Leucocyte ◽

Cell Counts ◽

Significant Difference

Abstract Background The immune mechanisms that determine whether a Plasmodium falciparum infection would be symptomatic or asymptomatic are not fully understood. Several studies have been carried out to characterize the associations between disease outcomes and leucocyte numbers. However, the majority of these studies have been conducted in adults with acute uncomplicated malaria, despite children being the most vulnerable group. Methods Peripheral blood leucocyte subpopulations were characterized in children with acute uncomplicated (symptomatic; n = 25) or asymptomatic (n = 67) P. falciparum malaria, as well as malaria-free (uninfected) children (n = 16) from Obom, a sub-district of Accra, Ghana. Leucocyte subpopulations were enumerated by flow cytometry and correlated with two measures of parasite load: (a) plasma levels of P. falciparum histidine-rich protein 2 (PfHRP2) as a proxy for parasite biomass and (b) peripheral blood parasite densities determined by microscopy. Results In children with symptomatic P. falciparum infections, the proportions and absolute cell counts of total (CD3 +) T cells, CD4 + T cells, CD8 + T cells, CD19 + B cells and CD11c + dendritic cells (DCs) were significantly lower as compared to asymptomatic P. falciparum-infected and uninfected children. Notably, CD15 + neutrophil proportions and cell counts were significantly increased in symptomatic children. There was no significant difference in the proportions and absolute counts of CD14 + monocytes amongst the three study groups. As expected, measures of parasite load were significantly higher in symptomatic cases. Remarkably, PfHRP2 levels and parasite densities negatively correlated with both the proportions and absolute numbers of peripheral leucocyte subsets: CD3 + T, CD4 + T, CD8 + T, CD19 + B, CD56 + NK, γδ + T and CD11c + cells. In contrast, both PfHRP2 levels and parasite densities positively correlated with the proportions and absolute numbers of CD15 + cells. Conclusions Symptomatic P. falciparum infection is correlated with an increase in the levels of peripheral blood neutrophils, indicating a role for this cell type in disease pathogenesis. Parasite load is a key determinant of peripheral cell numbers during malaria infections.

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Effect of Surgical Setting on Hospital-Reported Outcomes for Elective Lumbar Spinal Procedures: Tertiary Versus Community Hospitals

Global Spine Journal ◽

10.1177/2192568219848666 ◽

2019 ◽

Vol 10 (4) ◽

pp. 375-383 ◽

Cited By ~ 1

Author(s):

Tristan B. Weir ◽

Neil Sardesai ◽

Julio J. Jauregui ◽

Ehsan Jazini ◽

Michael J. Sokolow ◽

...

Keyword(s):

Pay For Performance ◽

Linear Regression Analysis ◽

Degenerative Spondylolisthesis ◽

Hospital Costs ◽

Patient Characteristics ◽

Tertiary Hospital ◽

Community Hospitals ◽

Single Level ◽

Significant Difference ◽

Reported Data

Study Design: Retrospective cohort study. Objective: As hospital compensation becomes increasingly dependent on pay-for-performance and bundled payment compensation models, hospitals seek to reduce costs and increase quality. To our knowledge, no reported data compare these measures between hospital settings for elective lumbar procedures. The study compares hospital-reported outcomes and costs for elective lumbar procedures performed at a tertiary hospital (TH) versus community hospitals (CH) within a single health care system. Methods: Retrospective review of a physician-maintained, prospectively collected database consisting of 1 TH and 4 CH for 3 common lumbar surgeries from 2015 to 2016. Patients undergoing primary elective microdiscectomy for disc herniation, laminectomy for spinal stenosis, and laminectomy with fusion for degenerative spondylolisthesis were included. Patients were excluded for traumatic, infectious, or malignant pathology. Comparing hospital settings, outcomes included length of stay (LOS), rates of 30-day readmissions, potentially preventable complications (PPC), and discharge to rehabilitation facility, and hospital costs. Results: A total of 892 patients (n = 217 microdiscectomies, n = 302 laminectomies, and n = 373 laminectomy fusions) were included. The TH served a younger patient population with fewer comorbid conditions and a higher proportion of African Americans. The TH performed more decompressions ( P < .001) per level fused; the CH performed more interbody fusions ( P = .007). Cost of performing microdiscectomy ( P < .001) and laminectomy ( P = .014) was significantly higher at the TH, but there was no significant difference for laminectomy with fusion. In a multivariable stepwise linear regression analysis, the TH was significantly more expensive for single-level microdiscectomy ( P < .001) and laminectomy with single-level fusion ( P < .001), but trended toward significance for laminectomy without fusion ( P = .052). No difference existed for PPC or readmissions rate. Patients undergoing laminectomy without fusion were discharged to a facility more often at the TH ( P = .019). Conclusions: We provide hospital-reported outcomes between a TH and CH. Significant differences in patient characteristics and surgical practices exist between surgical settings. Despite minimal differences in hospital-reported outcomes, the TH was significantly more expensive.

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Extruded breakfast meal from malted finger millet (Eleusine coracana) and watermelon (Citrullus lanatus) seed flour: in-vivo nutritional qualities study

Bulletin of the National Research Centre ◽

10.1186/s42269-021-00533-x ◽

2021 ◽

Vol 45 (1) ◽

Author(s):

Joseph Oghenewogaga Owheruo ◽

Timilehin David Oluwajuyitan ◽

Beatrice Olawunmi Ifesan ◽

Matthew Kolawole Bolade

Keyword(s):

Finger Millet ◽

Citrullus Lanatus ◽

Breakfast Meal ◽

Formulated Diets ◽

Cell Counts ◽

Formulated Diet ◽

Significant Difference ◽

Nutritional Qualities ◽

Flour Blends

Abstract Background The study aimed at evaluating the in-vivo nutritional qualities of extruded breakfast meal produced from flour blends of malted finger millet and watermelon seed. Results The proximate compositions of the flour blends revealed that there was progressive increase in protein (12.83–15.14) %, with increase in the watermelon substitution. The protein quality evaluation of the extrudate showed that the protein efficiency ratio ranged from 0.64 to 89.75, while the biological values were between (87.82–89.75)%. The relative organs weight of rats fed with extruded breakfast meal showed that, the weights of the kidney and liver of rats fed with extruded breakfast meal were significantly lower compared with rats fed with goldenmorn. The hematological indices showed that the packed cell volume and the red blood cell counts of rats fed with the formulated diets were significantly lower compared with those fed with goldenmorn but significantly higher than rats fed with basal. Meanwhile, the values of the white blood cells count for the formulated diet shows no significant difference compared with rats fed with goldenmorn. Conclusions Evidently, the growth performance of the rats fed with the extruded breakfast meal revealed that the formulated diets promote growth status of the animals with relatively low effect on organs of experimental rat used in this study. Hence, formulated diet may serve as alternative to expensive commercial breakfast meal.

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Prognostic Relevance of Neutrophil to Lymphocyte Ratio (NLR) in Luminal Breast Cancer: A Retrospective Analysis in the Neoadjuvant Setting

Cells ◽

10.3390/cells10071685 ◽

2021 ◽

Vol 10 (7) ◽

pp. 1685

Author(s):

Antonino Grassadonia ◽

Vincenzo Graziano ◽

Laura Iezzi ◽

Patrizia Vici ◽

Maddalena Barba ◽

...

Keyword(s):

Breast Cancer ◽

Disease Free Survival ◽

Post Treatment ◽

Neutrophil To Lymphocyte Ratio ◽

Luminal Breast Cancer ◽

Luminal A ◽

Luminal B ◽

Lymphocyte Ratio ◽

Cell Counts ◽

Pre Treatment

The neutrophil to lymphocyte ratio (NLR) is a promising predictive and prognostic factor in breast cancer. We investigated its ability to predict disease-free survival (DFS) and overall survival (OS) in patients with luminal A- or luminal B-HER2-negative breast cancer who received neoadjuvant chemotherapy (NACT). Pre-treatment complete blood cell counts from 168 consecutive patients with luminal breast cancer were evaluated to assess NLR. The study population was stratified into NLRlow or NLRhigh according to a cut-off value established by receiving operator curve (ROC) analysis. Data on additional pre- and post-treatment clinical-pathological characteristics were also collected. Kaplan–Meier curves, log-rank tests, and Cox proportional hazards models were used for statistical analyses. Patients with pre-treatment NLRlow showed a significantly shorter DFS (HR: 6.97, 95% CI: 1.65–10.55, p = 0.002) and OS (HR: 7.79, 95% CI: 1.25–15.07, p = 0.021) compared to those with NLRhigh. Non-ductal histology, luminal B subtype, and post-treatment Ki67 ≥ 14% were also associated with worse DFS (p = 0.016, p = 0.002, and p = 0.001, respectively). In a multivariate analysis, luminal B subtype, post-treatment Ki67 ≥ 14%, and NLRlow remained independent prognostic factors for DFS, while only post-treatment Ki67 ≥ 14% and NLRlow affected OS. The present study provides evidence that pre-treatment NLRlow helps identify women at higher risk of recurrence and death among patients affected by luminal breast cancer treated with NACT.

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