scholarly journals Correlation between NT-proBNP, hsCRP and OXSR1: Clinical relevance in evaluating the prognosis of polytrauma patients

2021 ◽  
Vol 68 (3) ◽  
pp. 406-410
Author(s):  
Costin Dumitru ◽  
◽  
Alexandra Ripszky Totan ◽  
Iulia-Ioana Stănescu-Spînu ◽  
Daniela Miricescu ◽  
...  
Keyword(s):  
Innate Immunity ◽  
Quantitative Analysis ◽  
Biochemical Markers ◽  
Proinflammatory Mediators ◽  
Risk Of Mortality ◽  
Life Threatening ◽  
Polytrauma Patients ◽  
Hs Crp ◽  
Expected Mortality ◽  
Parameters Of Interest

Introduction. Polytrauma patients are expected to have a higher risk of mortality than that obtained by the summation of expected mortality owing to their individual injuries. Subsequent life-threatening posttraumatic complications are associated with overproduction of proinflammatory mediators (e.g. cytokines, chemokines) and the critical imbalance of cell-regulated innate immunity. Material and methods. The present study is aimed to identify a possible relationship between NT-proBNP, hs-CRP and OXSR1 biochemical markers in polytrauma patients, both by bibliographic research and quantitative analysis and statistics of some parameters of interest in lot of 46 patients. Results and discussions. The correlation between hsCRP and the inflammatory response after trauma is well-known and well documented in literature, so the negative correlation between hsCRP and OXSR1 that resulted from our analysis is of great significance resulting in a potentially new biomarker to be further studied and used in determining the possible outcome of polytrauma patients. Conclusion. Although OXSR1 is a new in the field of polytrauma patients, because is negatively correlated with hsCRP and the clinical evolution of the patients we think that OXSR1 is a good biomarker to further in investigate and may be used in determining the clinical progress of the polytrauma patients.

Disseminated Intravascular Coagulation: Clinical Diagnosis and Management

2019 ◽  
pp. 337-344
Author(s):  
Prakash Vishnu ◽  
Sikander Ailawadhi
Keyword(s):  
Innate Immunity ◽  
Severe Sepsis ◽  
Critical Illness ◽  
Clinical Diagnosis ◽  
Disseminated Intravascular Coagulation ◽  
Coagulation Activation ◽  
Intravascular Coagulation ◽  
Risk Of Mortality ◽  
Life Threatening ◽  
Inflammatory System

Disseminated intravascular coagulation (DIC) is a phenomenon with the potential for causing thrombosis and bleeding. DIC, typically occurring in patients with critical illness, can manifest as an acute, life-threatening emergency or as a chronic, subclinical process depending on the influence of morbidity from the underlying cause. The presence of DIC increases the risk of mortality by twofold in patients with trauma and severe sepsis and is an independent predictor of mortality. The pathogenesis of DIC is not only related to abnormal coagulation activation and platelet consumption but also involves multiple mechanisms of the inflammatory system and innate immunity.

scholarly journals Prediction of the risk of mortality in paediatric intensive care unit using PRISM III score

2019 ◽  
Vol 6 (3) ◽  
pp. 1186
Author(s):  
Aashay Abhay Shah ◽  
Dileep Goyal ◽  
Devendra Sareen
Keyword(s):  
Intensive Care Unit ◽  
Paediatric Intensive Care Unit ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Stability Index ◽  
Hospitalized Children ◽  
Care Hospital ◽  
Prism Score ◽  
Risk Of Mortality ◽  
Expected Mortality

Background: is the Pediatric risk of mortality (PRISM) score which has been devised by Pollock et al, to predict the mortality in hospitalized children. PRISM score is a revised form of physiologic stability index of mortality score.Methods: A observational prospective study was conducted at tertiary care hospital, Udaipur Rajasthan over period of March 2017 to September 2018. Total 207 patient were enrolled in study as per inclusion and exclusion criteria.Results: Total 29.92% had PRISM III score of 0 to 5, 25.45% had score of 6-10, 16.53% had score of 11-15, 13.12% had score of 16-20, 7.61% between 21 to 25, 4.72% between 26-30 and 2.62% had score of greater than 30. There was no mortality when the PRISM score of the child was between 0 to 5. The percentage of deaths increased progressively with increasing PRISM score.Conclusions: There was no significance difference in predicted from PRISM score and the actual death. The expected mortality was comparable to actual death, except in children who required mechanical ventilation and vasopressor drugs.

ASCENDING AORTIC ANEURYSM – A CASE REPORT

2020 ◽  
Vol 1 (3) ◽  
pp. 54-55
Author(s):  
Prathap Kumar. J.
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Case Report ◽  
Aortic Aneurysm ◽  
Ascending Aorta ◽  
Leg Pain ◽  
Ultrasound Screening ◽  
Ascending Aortic Aneurysm ◽  
Risk Of Mortality ◽  
Abdominal Aortic ◽  
Life Threatening

An aortic aneurysm is an abnormal dilation of the aorta to greater than 1.5 times its normal size. They usually cause no symptoms except when ruptured. Occasionally, there may be symptoms like abdominal, back, or leg pain. They are most commonly located in the abdominal aorta, but can also be located in the thoracic aorta, rarely in arch of aorta. Abdominal aortic aneurysm is more common in men, a disease that is often asymptomatic and has up to a 90% risk of mortality if the aneurysm ruptures. It can be easily diagnosed by an ultrasound screening, and if the aneurysm is > 5.5 cm, it can be surgically repaired to prevent a life-threatening rupture. Aneurysm of the ascending aorta is rare but can be easily diagnosed by echocardiogram.

Modern complement analysis: indications, methods and outlook1),2)

2012 ◽  
Vol 36 (3) ◽  
Author(s):  
Ruxandra Tudoran ◽  
Michael Kirschfink
Keyword(s):  
Innate Immunity ◽  
Targeted Therapies ◽  
Basic Knowledge ◽  
Complement Components ◽  
Life Threatening ◽  
Excessive Activation

AbstractComplement is one of the key systems of innate immunity and homeostasis. Its excessive activation and also a deficiency of complement components or regulators can lead to life-threatening conditions. This review aims to provide the basic knowledge that clinicians need in order to understand complement-related diseases. Moreover, it shows possible indications and interpretations of a complement analysis and explains the rationale behind complement-targeted therapies.

scholarly journals INCREASED CIRCULATING COPEPTIN LEVELS ARE ASSOCIATED WITH VASO-OCCLUSIVE CRISIS AND RIGHT VENTRICULAR DYSFUNCTION IN SICKLE CELL ANEMIA

2021 ◽  
Author(s):  
Onur Sinan Deveci ◽  
Caglar Ozmen ◽  
Muhammet Bugra Karaaslan ◽  
Aziz Inan Celik ◽  
Hatice Rahimova ◽  
...  
Keyword(s):  
Steady State ◽  
Right Ventricular ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Multiple Logistic Regression Analysis ◽  
Laboratory Data ◽  
Proinflammatory Mediators ◽  
Copeptin Level ◽  
Potential Biomarker ◽  
Hs Crp

Objective Vaso-occlusive crisis (VOC) is a common clinical manifestation of sickle cell anemia (SCA) and is associated with increased proinflammatory mediators. Copeptin is the C-terminal part of the prohormone for pro-vasopressin and seems clinically relevant in various clinical conditions. Right ventricular (RV) dysfunction significantly appears in SCA patients due to pulmonary hypertension. This study aimed to investigate the association of copeptin levels in VOC patients and evaluate RV dysfunction. Materials and Methods A total of 108 patients were enrolled in the study. Twenty-eight SCA patients in steady state (30.2±10.9 years), 25 SCA patients in VOC (36.8±11.8 years), and 55 healthy individuals (31.9±9.4 years) with HbAA genotype were included. Clinical, echocardiographic, and laboratory data were recorded. ELISA was used for the determination of serum levels of copeptin. Results VOC patients had significantly higher copeptin level compared both with controls and SCA subjects in steady-state (22.6±13.0 vs. 11.3±5.7 pmol/l, 22.6±13.0 vs. 12.4±5.8 pmol/l, p=0.009 for both). Additionally, the copeptin level was significantly higher in SCA patients with RV dysfunction than those without RV dysfunction (23.2±12.2 vs. 15.3±9.5 pmol/l, p=0.024). Multiple logistic regression analysis revealed that hs-CRP and copeptin levels were found to be associated with VOC. Conclusion The study showed that copeptin and hs-CRP levels were increased in patients with VOC, and a significant relationship was found between RV dysfunction in VOC patients. As a conclusion copeptin can be used as a potential biomarker in predicting VOC crisis in SCA patients and in early detection of patients with SCA who have the potential to develop RV dysfunction.

scholarly journals AN EASY AFFORDABLE STATISTICAL AND ECONOMIC (EASE) APPROACH TO AVOID UNNECESSARY AND EXPENSIVE EXAMS TO MONITOR PATIENTS WITH SMALL AAA

2021 ◽  
pp. 18
Author(s):  
Keyword(s):  
Clinical Practice ◽  
Abdominal Aorta ◽  
Biochemical Markers ◽  
Operational Research ◽  
Surgical Repair ◽  
Screening Programs ◽  
Research Fields ◽  
Risk Of Mortality ◽  
Abdominal Aortic ◽  
Progressive Growth

Abdominal Aortic Aneurysm (AAA) is a localized enlargement of the abdominal aorta, such that the diameter exceeds 30 mm. AAA is a progressive growth leading to rupture, with high risk of mortality, therefore elective surgical repair is indicated when AAA diamenter is >55 mm. Screening programs, that use morphological imaging, have been developed internationally with the aim of detecting AAA before rupture with important limitations in term of cost and benefit for patients. Furthermore, different biochemical markers have been proposed to monitor AAA progression to overcome the above-mentioned limitations but none of them is used in the clinical practice. In fact, most of the biomarkers proposed are expensive and not feasible in the majority of laboratories. Combining different methodologies coming from Statistics and Operational Research fields, we developed an algorithm able to assess the importance of common biomarkers, requested in the clinical practice to evaluate the health of patient, and therefore no exams are required. Furthermore, we develop an Easy, Affordable Statistics and Economic (EASE) model able to identify if the AAA remain below the cut off for surgical repair. This prediction can provide guidance to how closely the patient’s abdominal aorta should be monitored avoiding additional and expensive exams.

scholarly journals Mycotoxin Zearalenone Attenuates Innate Immune Responses and Suppresses NLRP3 Inflammasome Activation in LPS-Activated Macrophages

Toxins ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 593
Author(s):  
Po-Yen Lee ◽  
Ching-Chih Liu ◽  
Shu-Chi Wang ◽  
Kai-Yin Chen ◽  
Tzu-Chieh Lin ◽  
...  
Keyword(s):  
Innate Immunity ◽  
Adverse Effects ◽  
Signaling Pathways ◽  
Nlrp3 Inflammasome ◽  
Inflammatory Responses ◽  
Mammalian Species ◽  
Inflammasome Activation ◽  
Amino Terminal ◽  
Proinflammatory Mediators ◽  
Nlrp3 Inflammasome Activation

Zearalenone (ZEA) is a mycotoxin that has several adverse effects on most mammalian species. However, the effects of ZEA on macrophage-mediated innate immunity during infection have not been examined. In the present study, bacterial lipopolysaccharides (LPS) were used to induce the activation of macrophages and evaluate the effects of ZEA on the inflammatory responses and inflammation-associated signaling pathways. The experimental results indicated that ZEA suppressed LPS-activated inflammatory responses by macrophages including attenuating the production of proinflammatory mediators (nitric oxide (NO) and prostaglandin E2 (PGE2)), decreased the secretion of proinflammatory cytokines (tumor necrosis factor (TNF)-α, interleukin (IL)-1β and IL-6), inhibited the activation of c-Jun amino-terminal kinase (JNK), p38 and nuclear factor-κB (NF-κB) signaling pathways, and repressed the nucleotide-binding and oligomerization domain (NOD)-, leucine-rich repeat (LRR)- and pyrin domain-containing protein 3 (NLRP3) inflammasome activation. These results indicated that mycotoxin ZEA attenuates macrophage-mediated innate immunity upon LPS stimulation, suggesting that the intake of mycotoxin ZEA-contaminated food might result in decreasing innate immunity, which has a higher risk of adverse effects during infection.

scholarly journals Devils and Angels: Ozonetherapy for microcirculation in covid-19

2020 ◽  
Author(s):  
Giovanni Tommaso Ranaldi ◽  
Emanuele Rocco Villani ◽  
Laura Franza ◽  
Giulia Motola
Keyword(s):  
Lung Inflammation ◽  
Microvascular Complications ◽  
Clinical Manifestations ◽  
Severe Respiratory Failure ◽  
Ozone Therapy ◽  
Risk Of Mortality ◽  
Wide Range ◽  
Life Threatening ◽  
Medical Ozone ◽  
Infusion Technique

COVID-19 is the respiratory disease caused by the new coronavirus SARS-CoV-2 and is characterized by clinical manifestations ranging from mild, flu-like symptoms, to severe respiratory failure and multi-organ failure. Patients with more severe symptoms may require intensive care treatments and have a high risk of mortality. COVID 19 is characterized by an abnormal inflammatory response similar to a cytokine storm, which is associated with endothelial dysfunction and microvascular complications. To date, no specific treatments are available for COVID-19 and its potentially life-threatening complications.Ozone therapy is the administration of a mixture of ozone and oxygen, or Medical Ozone (MO), which produces a series of benefits capable of counteracting a wide range of pathologies, in use for over a century as an unconventional medicine practice.The use of Ozone therapy with the large auto-hemo-infusion technique could help oxygenate the tissues better, decrease lung inflammation and regulate the immune response, help slow down viral growth, regulate lung circulation and avoid or slow down vascular hypertrophy and consequent hyperemia, especially in the early stages

scholarly journals Predicting Outcome in Mechanically Ventilated Pediatric Patients

2019 ◽  
Vol 09 (02) ◽  
pp. 092-098
Author(s):  
Selman Kesici ◽  
Şenay Kenç ◽  
Ayşe Filiz Yetimakman ◽  
Benan Bayrakci
Keyword(s):  
Respiratory Failure ◽  
Mortality Risk ◽  
Pediatric Patients ◽  
Oxygenation Index ◽  
Mortality Rates ◽  
Mechanically Ventilated ◽  
Risk Of Mortality ◽  
Predicting Outcome ◽  
Expected Mortality ◽  
Pediatric Index Of Mortality

AbstractTo apply and determine whether standardized mortality scores are appropriate to predict the risk of mortality in mechanically ventilated pediatric patients, 150 patients were retrospectively evaluated. Pediatric risk of mortality (PRISM) III-24 and pediatric index of mortality (PIM)-2 scores were unable to discriminate survivors and nonsurvivors; the observed mortality rate was lower than expected mortality rates. Oxygenation index (OI) was calculated at 0, 12, 24, and 72 hours of ventilation. OI-12 and OI-72 were found to be higher in nonsurvivors. PRISM III-24 and PIM-2 scores failed to predict mortality risk in mechanically ventilated pediatric patients. OI can be used to predict degree of respiratory failure and mortality risk.

scholarly journals Interhospital variation in mortality among patients with systemic lupus erythematosus and sepsis in the USA

Rheumatology ◽  
2019 ◽  
Vol 58 (10) ◽  
pp. 1794-1801 ◽  
Author(s):  
Maria G Tektonidou ◽  
Abhijit Dasgupta ◽  
Michael M Ward
Keyword(s):  
Lupus Erythematosus ◽  
Population Based ◽  
Demographic Characteristics ◽  
National Inpatient Sample ◽  
Systemic Lupus ◽  
Average Hospital ◽  
Risk Of Mortality ◽  
Major Organ ◽  
The Usa ◽  
Expected Mortality

Abstract Objective To determine whether the risk of mortality in patients with SLE hospitalized with sepsis varies among hospitals in the USA. Methods We used the National Inpatient Sample (2002–2011) to obtain national population-based data on outcomes for adults with SLE admitted with sepsis, and compared it with that for patients without SLE admitted with sepsis at the same hospital. We computed expected mortality based on patient demographic characteristics, comorbidities and major organ dysfunction, and calculated observed/expected (O/E) mortality ratios separately for patients with SLE and without SLE for each hospital. We then computed the ratio of these O/E ratios within hospitals to assess relative SLE mortality. We considered hospitals with a risk ratio (RR) of ⩾2.0 as having high relative SLE mortality. Results Among 424 hospitals that treated a total of 4024 patients with SLE and sepsis, the risk of in-hospital mortality varied from 0% to 60% (median 11.1%). The RR ranged from 0 to 9.75, with a median of 0.84, indicating that O/E mortality was similar in patients with and without SLE at the average hospital. Sixty-one hospitals (14.4%) had a RR of ⩾2.0, indicating higher mortality among patients with SLE. Hospitals that on average treated ⩾3.9 patients with SLE and sepsis annually were less likely to have a RR of ⩾2.0 than hospitals that treated fewer patients (10% vs 17%; P = 0.004). Conclusion Mortality among patients with SLE and sepsis varied widely between hospitals, and was lower at hospitals that treated more of these patients.

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