scholarly journals The role of plasma presepsin levels in determining the incidence of septic shock and mortality in patients with sepsis

2021 ◽  
Vol 15 (01) ◽  
pp. 123-130
Author(s):  
Ugur Kahveci ◽  
Seda Ozkan ◽  
Adem Melekoglu ◽  
Eren Usul ◽  
Gulfer Ozturk ◽  
...  
Keyword(s):  
Emergency Department ◽  
Septic Shock ◽  
Vital Signs ◽  
Sepsis Group ◽  
Control Group ◽  
Significant Difference ◽  
Healthy Control ◽  
Demographic Attributes ◽  
Sepsis And Septic Shock

Introduction: The present study aimed to investigate the role of plasma presepsin in the early detection of septic shock and in determining the prognosis and mortality of patients with sepsis. Methodology: The study was conducted in the emergency department between 1 January 2017 and 1 July 2017. A total of 106 patients 18 years of age or older who were diagnosed with sepsis according to the quick sequential organ failure assessment (qSOFA) criteria were included in this prospective study. The patients’ symptoms, vital signs, additional diseases, demographic attributes, laboratory results, Mortality in Emergency Department Sepsis (MEDS) scores, imaging findings and treatments were recorded. Moreover, the patients’ blood samples were collected to measure plasma presepsin, procalcitonin and CRP levels. Results: In total, 55.7% of the patients were female. The median age of the patients was 78 (24–103) years, and their 30-day mortality rate was 67%. The presepsin level was significantly higher in the sepsis group than in the healthy control group (p < 0.001). The presepsin levels did not differ significantly between the sepsis and septic shock groups (p = 0.12). Similarly, the procalcitonin levels did not differ significantly between the sepsis and septic shock groups (p > 0.05). There was no significant difference in the presepsin, procalcitonin and CRP levels between survivor and non-survivor patients (p = 0.74). Conclusions: The plasma presepsin level was found to be ineffective in determining the incidence of septic shock and mortality in patients with sepsis in the emergency department.

Evaluation of red cell distribution width (RDW) as a septic marker in comparison with clinical scores and C-reactive protein

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ali Ahmed Naga ◽  
Mohammed Ismaeil Abdel Fattah ◽  
Walid Hamed Nofal ◽  
Mohammed Abd-elsalam AlMenshawe
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Controlled Study ◽  
Control Group ◽  
Study Group ◽  
Distribution Width ◽  
Clinical Scores ◽  
Group I ◽  
Significant Difference ◽  
Sepsis And Septic Shock

Abstract Background Challenges of diagnosing and treating sepsis only seem more difficult as incidence increases, patients become older and sicker, and pathogenic organisms evolve. New understanding of inflammatory mediators and pathways, immunity, and genetic variability in this disease state suggests that the current definitions of SIRS, sepsis, severe sepsis, and septic shock are oversimplified. Objective The aim of our study is to evaluate the level of RDW, CRP and clinical scores "SOFA and APACHI" as markers in patients with sepsis and their levels on the outcome and resolution of sepsis in ICU. Methodology We conducted a prospective observational controlled study on 90 adult persons of both sex, 45 of them are adult patients and served as the study group (Group I), and the other 45 are healthy adult volunteers and served as the control group (Group II). The study group represented patients admitted to the ICU of Intensive Care Unit at Damanhour Medical National Institute who fulfilled the diagnostic criteria for sepsis, severe sepsis and septic shock on arrival to ICU according to the SCCM/ ESICM/ ACCP/ ATS/SIS International Sepsis Definitions Conference. Results. In the present study we found that CRP measured on admission was not a predictor of mortality, while that measured at day 5 and day 10 predicted mortality, where there was no statistically significant difference in CRP levels between survivors and non-survivors at the day of admission while there were statistically significant differences between survivors and non survivors according to CRP levels at day 5 (p = 0.001*) and at day 10 (p = 0.001*). It was found also that there were statistically significant differences between survivors and non-survivors according to RDW at day 1(p = 0.011*) and at day 5(p = 0.009*), at day 10 was found there was no statistically significant difference between survivors and non-survivors (p = 0.338). Conclusion RDW is a new promising cheap and readily available biomarker that can be able to diagnose patients with sepsis with accuracy comparable to CRP. Also, RDW at admission is able to predict mortality.

scholarly journals THE POSSIBLE ROLE OF RENALASE ENZYME IN CARDIOVASCULAR COMPLICATIONS IN CHRONIC KIDNEY DISEASE PATIENTS

2018 ◽  
Vol 11 (2) ◽  
pp. 313
Author(s):  
Zainab A A Al-shamma
Keyword(s):  
Color Change ◽  
Kidney Diseases ◽  
Serum Levels ◽  
Significant Negative Correlation ◽  
Cardiovascular Complications ◽  
Control Group ◽  
Ckd Stage ◽  
Significant Difference ◽  
Healthy Control

  Objective: The objective of this research was to study the possible role of renalase in the controlling blood pressure (BP) in patients with different stages of chronic kidney diseases (CKD) to decrease the incidents of cardiovascular disease in these patients.Methods: The serum levels of renalase were determined by enzyme-linked immune sorbent assay (ELISA) methods in 68 non-diabetic CKD patients in different stages (2–5). Fifty healthy control subjects were included in this study. Renalase high-sensitive C-reactive protein and Cystatin-C were measured by ELISA which is included first incubating the test serum in an antigen-coated polystyrene plate, then enzyme-labeled anti-immunoglobulin is added and the enzyme then remaining in plate after washing provides a measure of the amount of specific antibody in the serum, and in the final step, a substance is added that the enzyme can convert to some detectable signal, most commonly a color change in a chemical substrate.Results: There were a significant difference between serum levels of renalase, in CKD patients stage 5, and CKD patients 2–3 stage than in their healthy control group (p<0.05), in addition to a significant difference in renalase level between CKD stage, 2–3 and stage 5 (p<0.05). There was a significant positive correlation between serum renalase with systolic BP (p<0.05) in CKD patients stage 5. In addition, there was a significant negative correlation between the serum renalase and estimated glomerular filtration rate (p<0.05) in both groups.Conclusions: The main conclusion of the study was the positive significant correlation with systolic BP in CKD patients (stage 5). In addition, the serum renalase levels were elevated according the CKD stage in patients with CKD in different stages (2–5) and it increased with the deterioration of renal function. 

scholarly journals Evaluation of Clinical Pharmacist's Contribution to Sepsis and Septic Shock Management

2021 ◽  
Author(s):  
Nursel Sürmelioğlu ◽  
Kutay Demirkan ◽  
Emre Karakoç ◽  
Murat Gündüz ◽  
Dilek Özcengiz
Keyword(s):  
Septic Shock ◽  
Clinical Pharmacist ◽  
University Hospital ◽  
Control Group ◽  
Study Group ◽  
Drug Related Problems ◽  
Sepsis Management ◽  
Time To Initiation ◽  
Significant Difference ◽  
Sepsis And Septic Shock

Purpose: This study aimed to identify drug-related problems at treatment in patients with sepsis and septic shock and to evaluate the contribution of the clinical pharmacist. Methods: This study was conducted at intensive care units(ICU) of a university hospital. A study group in which the clinical pharmacist participated in the treatment management of septic patients and a control group in which the clinic did not have a pharmacist was formed. In the treatment of the control group, interventions were made for drug-related problems detected by the clinical pharmacist. Study and control group were compared in terms of length of ICU stay, time to initiation of appropriate antimicrobial drug(s), appropriateness of antimicrobial dosing, and drug treatment costs. Results: Total of 65 patients were included in the study group prospectively in which the intervention of clinical pharmacist provided for the drug treatments and retrospectively 65 patients in the control group without any intervention. In the study group, 670 recommendations were made for 753 problems related to their drug therapy. Between groups, improvement in appropriateness of antimicrobials in terms of dose, time to initiation of appropriate antimicrobial therapy, daily antibiotic costs in all patients and antibiotic costs in patients with impaired renal function statistically significant difference were found. Conclusions: As a result of clinical pharmacist involvement in sepsis management, it has been shown to contribute to the prevention and management of drug interactions, to start antimicrobial therapies more quickly, to select the appropriate drug and dose, especially antimicrobials, and to save the costs of antimicrobial drugs.

The miR-15a affected the development of sepsis and septic shock by suppression BCL-2

2019 ◽  
Author(s):  
Yunzhen Wu ◽  
Yuanli Xie ◽  
Fangfang Jiao ◽  
Xinlei Liu
Keyword(s):  
Septic Shock ◽  
Western Blot ◽  
Troponin I ◽  
Sepsis Group ◽  
Luciferase Reporter ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Rt Pcr ◽  
Gene Assay ◽  
Sepsis And Septic Shock

Abstract Background: This study aimed to investigate the mechanism of microRNA-15a (miR-15a) in the development of sepsis and septic shock. Methods: Sepsis and septic shock rat models were constructed by intraperitoneal injection of E.coli endotoxin (LPS). The real-time polymerase chain reaction (RT-PCR), Enzyme-Linked ImmunoSorbent Assay (ELISA), ematoxylin-eosin (HE) and Masson staining, TdT-mediated dUTP Nick-End Labeling (TUNEL), as well as Western blot analysis were performed to reveal the expression of microRNA-15a and changes in sepsis/septic shock myocardial cells or tissue. The rat sepsis model (sepsis group and septic shock group) was successfully established. Results: The results of HE and Mason staining showed that myocardial tissue damage gradually deepened with the progression of sepsis. Moreover, the serum levels of creatinine kinase-mb (CK-MB) and cardiac troponin I (cTnI) in model groups were significantly increased than those in control group. In addition, the RT-PCR analysis showed that miR-15a was up-regulated in model groups. Furthermore, luciferase reporter gene assay showed that 3'-UTR was the binding site of BCL-2 to miR-15a. Finally, the TUNEL and Western blot showed the cardiomyocyte apoptosis in model group. Conclusions: The overexpression of miR-15a might take part in the progression of LPS-induced sepsis and septic shock via suppressing Bcl-2 expression. Furthermore, myocardial markers such as CK-MB and cTnI might be biomarkers for sepsis progression.

Predictive and Prognostic Value of C-reactive Protein/Albumin and Neutrophil/Lymphocyte Ratio in the Patients Diagnosed with Acute Pancreatitis in Emergency Department

2020 ◽  
pp. 24-32
Author(s):  
Utku Murat Kalafat ◽  
Serkan Dogan ◽  
Busra Bildik ◽  
Melis Dorter ◽  
Doganay Can ◽  
...  
Keyword(s):  
Emergency Department ◽  
Acute Pancreatitis ◽  
Healthy Volunteers ◽  
Vital Signs ◽  
Sudden Onset ◽  
Control Group ◽  
High Morbidity ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Significant Difference

Aims: Acute pancreatitis is a severe inflammation of the pancreas presenting sudden onset with high morbidity and mortality. Simple, accessible, cost-efficient and feasible laboratory tests are still needed to demonstrate the prognosis of the patients. The aim of the present study was to search the efficiency of CRP/Alb ratio as a biochemical marker on mortality and clinical progress in the patients diagnosed with acute pancreatitis in correlation with APACHE-2. Methodology: This prospective case-control study was conducted with the patients diagnosed with acute pancreatitis through Atlanta criteria and healthy volunteers as a control group in the emergency department. Demographic characteristics, vital signs, ultrasound reports, clinical outcomes, neutrophil, lymphocyte, neutrophil/lymphocyte ratio (NLR), CRP, albumin and CRP/Alb ratio, APACHE-2 score within control and patient groups were recorded. Logistic regression analysis was performed to distinguish healthy volunteers from acute pancreatitis cases. Results: There was a statistically significant difference between CRP/Albumin and NLR measurements according to the groups and we found that the measurements of the patient group were significantly higher than the control group. The cut-off point for CRP/Albumin and NLR was found to be respectively 1.08, 4.04 and above. (Respectively; sen: 76.64%, 78.50%; spe: 97.20%, 97.20%; PPV: 96.47%, 96.55%; NPV: 80.62%, 81.89%; the accuracy: 86.92%, 87.85%). APACHE-2 scores ranged from 0 to 16, with a mean of 5.80±3.92. The probability of acute pancreatitis was significantly higher in patients with high CRP/Albumin and NLR. Conclusion: This study showed that CRP/Alb ratio and NLR were positively correlated with APACHE-2 scores that designed for prognosis in patients with acute pancreatitis.

scholarly journals Proadrenomedullin in Sepsis and Septic Shock: A Role in the Emergency Department

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 920
Author(s):  
Andrea Piccioni ◽  
Angela Saviano ◽  
Sara Cicchinelli ◽  
Federico Valletta ◽  
Michele Cosimo Santoro ◽  
...  
Keyword(s):  
Emergency Department ◽  
Septic Shock ◽  
Early Diagnosis ◽  
Literature Review ◽  
Current Knowledge ◽  
Organ Damage ◽  
Emergency Physicians ◽  
Improve Patient Survival ◽  
Sepsis And Septic Shock

Sepsis and septic shock represent a leading cause of mortality in the Emergency Department (ED) and in the Intensive Care Unit (ICU). For these life-threating conditions, different diagnostic and prognostic biomarkers have been studied. Proadrenomedullin (MR-proADM) is a biomarker that can predict organ damage and the risk of imminent death in patients with septic shock, as shown by a large amount of data in the literature. The aim of our narrative review is to evaluate the role of MR-proADM in the context of Emergency Medicine and to summarize the current knowledge of MR-proADM as a serum indicator that is useful in the Emergency Department (ED) to determine an early diagnosis and to predict the long-term mortality of patients with sepsis and septic shock. We performed an electronic literature review to investigate the role of MR-proADM in sepsis and septic shock in the context of ED. We searched papers on PubMed®, Cochrane®, UptoDate®, and Web of Science® that had been published in the last 10 years. Data extracted from this literature review are not conclusive, but they show that MR-proADM may be helpful as a prognostic biomarker to stratify the mortality risk in cases of sepsis and septic shock with different degrees of organ damage, guiding emergency physicians in the diagnosis and the succeeding therapeutic workup. Sepsis and septic shock are conditions of high complexity and have a high risk of mortality. In the ED, early diagnosis is crucial in order to provide an early treatment and to improve patient survival. Diagnosis and prognosis are often the result of a combination of several tests. In our opinion, testing for MR-proADM directly in the ED could contribute to improving the prognostic assessment of patients, facilitating the subsequent clinical management and intensive treatment by the emergency physicians, but more studies are needed to confirm these results.

scholarly journals The role of IL-4 gene polymorphism in HCV-related hepatocellular carcinoma in Egyptian patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mohy-Eldin Abd-Elfattah ◽  
Mary Naguib ◽  
Mohammed Elkheer ◽  
Eman Abdelsameea ◽  
Ali Nada
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Gene Polymorphism ◽  
Group Versus ◽  
Control Group ◽  
Homozygous Genotype ◽  
Significant Difference ◽  
Egyptian Patients ◽  
Healthy Control

Abstract Background Interleukin-4 (IL-4), a pleiotropic anti-inflammatory cytokine, is produced mainly by activated T helper 2 (Th2). Hepatocellular carcinoma (HCC) is a typical inflammation-related cancer. Alterations influencing IL-4 expression may disturb immune response and may be associated with HCC risk. We aimed to verify role of IL4 gene polymorphism (IL-4-589C/T (rs2243250)) in HCV-related hepatocellular carcinoma in Egyptian patients. IL-4-589C/T (rs2243250) polymorphism was examined in 50 patients with HCC on top of HCV, 40 patients with HCV-induced liver cirrhosis, and 30 healthy controls using the polymerase chain reaction- restriction fragment length polymorphism method. Results Overall IL-4 gene polymorphism (IL-4-589C/T (rs2243250)) showed significant difference between hepatocellular carcinoma group versus liver cirrhosis and healthy control groups. TT homozygous genotype was more prevalent in HCC group (24%) versus (5%) in liver cirrhosis and (3.3%) in control. TT homozygous genotype had 10 times more risk of hepatocellular carcinoma versus healthy control group and 6.33 times more risk versus cirrhotic patients group (p value = 0.018 and 0.016 respectively). Conclusion IL-4-589C/T (rs2243250) polymorphism, TT homozygous genetic model, may be a risk factor in HCV-related HCC in Egyptian patients.

Effectiveness Of Toilet Training Education On Mother's Behavior And Toddler Age Toilet Training Ability (18-36 Months)

2020 ◽  
Vol 5 (2) ◽  
pp. 49-55
Author(s):  
Hafiko Andresni ◽  
Zahtamal Zahtamal ◽  
Winda Septiani ◽  
Mitra Mitra ◽  
Lita Lita
Keyword(s):  
Sampling Technique ◽  
T Test ◽  
The Body ◽  
Toilet Training ◽  
Wilcoxon Test ◽  
Control Group ◽  
Maternal Knowledge ◽  
Control Group Design ◽  
Significant Difference

ABSTRACT Toilet training is an effort to train children to be able to control and urinate (BAK) and defecate (BAB). Toilet training is one of the main tasks of children at toddler age. Toilet training is one of the main tasks of children in toddler age which is very important to be done to create independence in children in controlling BAK and BAB and children know the parts of the body and their functions. Data in 2012 shows that ± 60% of parents do not teach toilet training to children from an early age. The aim of the study was to find out the effectiveness of toilet training education on maternal behavior and toilet skills in toddler age training (18-36 months). The study was conducted in July-August 2018. This type of quantitative research used the design of the Quasy pretest and posttest experiment with non-equivalent control group design. Samples were 36 mothers and 36 children with purposive sampling technique. Data analysis used Paired t test, Wilcoxon test, Man-Whitney test an Independent t test. The results showed that toilet training education through lecture methods, modules and maze games was more effective than toilet training education through lecture and leaflet methods on children's knowledge and abilities. Conversely, for the role of mothers in supervision there is no significant difference in effectiveness. Health education is recommended in health promotion programs to increase maternal knowledge, the role of mothers and the ability of toilet training children independently. Keywords: Toilet training, Lecture method, Module, Maze game, Leaflet, Knowledge, Role of mother, Children's ability.

Role of Nutrition Counseling and Lifestyle Modification in Managing Prediabetes

2021 ◽  
pp. 037957212110254
Author(s):  
Harleen Kaur ◽  
Neerja Singla ◽  
Rohini Jain
Keyword(s):  
Hemoglobin A1c ◽  
Lifestyle Modification ◽  
Fasting Blood Glucose ◽  
Nutrition Intervention ◽  
Control Group ◽  
Population Prevalence ◽  
Significant Difference ◽  
And Control ◽  
Experimental Group

Objective: India is the second country after China having the highest population prevalence of diabetes. Several research studies investigating diabetes have been done, but not much work has been done on prediabetes. The purpose of this study was to investigate the effect of nutrition and lifestyle modification on prediabetic females. Methods: A total of 120 prediabetic females from Ludhiana city were divided into 2 matched groups: control group (n = 60) and experimental group (n = 60). Impact of nutrition intervention for dietary and lifestyle modification (for 3 months) was assessed on the anthropometric, dietary, biochemical parameters, and diabetes risk score of the experimental group and control group (no intervention). Results: All the selected 120 subjects completed the study (experimental group = 60; control group = 60). There was significant difference in the changes between the 2 groups throughout the study. The fasting blood glucose and glycated hemoglobin A1c levels of the experimental group subjects reduced significantly ( P ≤ .01). However, no change was observed among the control group subjects. The lipid profile of the experimental group showed a significant improvement ( P ≤ .01). Conclusion: Nutrition counselling of the prediabetics regarding dietary and lifestyle modification is recommended so as to improve their metabolic control, thus preventing them from being diabetics.

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