scholarly journals CAN BASE EXCESS BE USED FOR PREDICT TO NEONATAL SEPSIS IN PRETERM NEWBORNS?

2019 ◽  
Vol 11 (1) ◽  
pp. e2019014 ◽  
Author(s):  
Sema Arayıcı
Keyword(s):  
Early Diagnosis ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Base Excess ◽  
Early Stage ◽  
Clinical Signs ◽  
Clinical Syndrome ◽  
Gas Analysis ◽  
Healthy Controls ◽  
Mortality And Morbidity

Background: Neonatal sepsis remains an important and potentially life-threatening clinical syndrome and a major cause of neonatal mortality and morbidity. The aim of this study to investigate whether values of base excess before the onset of clinical signs and symptoms of sepsis indicate infection in the early diagnosis of neonatal sepsis. Methods: In this study a total of 118 infants were enrolled. The infants were classified into two groups: group 1 (sepsis, n=49) and group 2 (control, n=69). Blood gas analysis investigated for screening of neonatal sepsis. Results: A total of 49 newborns with neonatal sepsis and 69 healthy controls were enrolled. A comparison of markers of sepsis revealed C-reactive protein, interleukin-6 level to be significantly higher and pH, pCO2, HCO3 and base excess values to be significantly lower in newborns with sepsis compared healthy controls (p<0.01). The optimum cut-off value in the diagnosis of neonatal sepsis was found to be -5 mmol/L for base excess. Sensitivity, specificity, positive predictive value and negative predictive value of this base excess cut-off for neonatal sepsis were 75, 91, 86 and 84% respectively. Conclusion: This is the first study to determine the relationship between the decrease value of base excess and early stage of neonatal sepsis. If the value of base excess <-5 mmol/L without an underlying another reason, may need close follow up of infants for neonatal sepsis and it may help early diagnosis.

scholarly journals Role of procalcitonin in early diagnosis of neonatal sepsis

2017 ◽  
Vol 4 (2) ◽  
pp. 383 ◽  
Author(s):  
Fareedul Hasan ◽  
Shamshad A. Khan ◽  
Maharoof M. K. ◽  
Niyaz Muhammed
Keyword(s):  
Blood Culture ◽  
Early Diagnosis ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Clinical Signs ◽  
P Value ◽  
Gastric Aspirate ◽  
College Hospital ◽  
Mortality And Morbidity ◽  
Early Onset Sepsis

Background: Neonatal sepsis is the most common cause for neonatal mortality and morbidity in India, Therefore it is essential that we diagnose early onset sepsis using clinical signs and symptoms and rapid diagnostic techniques and start appropriate treatment without any delay. Various diagnostic tests that differentiate infected and non-infected neonates particularly in the first few days of life can potentially make significant impact on the neonatal care.Methods: This was a hospital based clinical prospective study, done in the NICU department of pediatrics at Yenepoya medical college hospital, from January 2013 to December 2013. Sample size in this study was 50. All consecutive neonates fulfilling the inclusion and exclusion criteria were subjected to investigations like serum Procalcitonin, CRP, Total count, Gastric aspirate, Peripheral smear and Blood culture before starting treatment with antibiotics. Positive blood culture was taken as proven sepsis. The results obtained from our study parameters were statistically compared with cases of proven sepsis. Results: In our study 16(32%) out of 50 neonates had proven sepsis. In comparison to the other  markers of neonatal sepsis Elevated levels of serum Procalcitonin was found to be the most sensitive test with sensitivity of 100%, specificity of 50%, positive predictive value of 48.5%and negative predictive value of 100% and with a very highly significant p value of <0.001.Among the levels of PCT moderately elevated (2-10ng/dl) had sensitivity of 100%, specificity of 84.5%, PPV of 62.5% and NPV of 100% and highly elevated (>10ng/dl) had sensitivity of 100%, specificity of 80%, PPV of 75% and NPV of 100%.Conclusions: The use of procalcitonin in the diagnosis of neonatal sepsis has proved to be very useful compared to other regular sepsis markers. Procalcitonin performs better than CRP in the diagnosis of neonatal infection. Serum Procalcitonin levels >2 ng/dl has got a better sensitivity; PPV and NPV thus help us not only in the early diagnosis and also in the prognosis of the treatment and helps us in guiding in reducing the unwanted usage on antibiotics.

scholarly journals Modified hematological sepsis score in early diagnosis of neonatal sepsis

2017 ◽  
Vol 5 (8) ◽  
pp. 3573
Author(s):  
Vani Krishnamurthy ◽  
Deepti Thandaveshwar ◽  
Srinivasa Murthy Doreswamy
Keyword(s):  
Blood Culture ◽  
Early Diagnosis ◽  
Neonatal Sepsis ◽  
Complete Blood Count ◽  
Early Stage ◽  
Clinical Signs ◽  
Likelihood Ratios ◽  
Diagnostic Ability ◽  
Ability Tests ◽  
Sepsis Score

Background: Diagnosis of neonatal sepsis at an early stage substantially reduces the mortality. The clinician often relies on laboratory parameters to support the clinical suspicion. As blood culture takes time and yield is low, hematological and biochemical parameters often guide to the diagnosis and management. Rodwell’s Hematological sepsis score (HSS) has a reasonable sensitivity but low specificity. Some of the parameters included in that scoring system are repetitive of same pathogenic mechanism. A modified HSS was developed by the authors by removing the repetitive parameters, increasing the weightage for low neutrophil count and adding a new parameter - nucleated RBC. Objective of the study was to compare the diagnostic ability of the modified hematological sepsis score with Rodwell’s hematological sepsis score.Methods: Prospective analytical study conducted in a tertiary level hospital. Neonates admitted to NICU and had complete blood count done were included. Babies with clinical signs of systemic inflammatory response syndrome and evidence of organ dysfunction were considered septic. They were classified as proven sepsis if the blood culture was positive. All the samples were scored for both HSS and modified HSS. The sensitivity, specificity and other diagnostic ability tests were compared between the two scoring systems.Results: Total of 75 neonates were enrolled. 25 of them had sepsis and three had blood culture positive. At a score of 3, the sensitivity and specificity of HSS was 80 and 70% and that of Modified HSS was 84 and 82% respectively.Conclusions: Modified hematological score improves the specificity and likelihood ratios without decreasing the sensitivity in early diagnosis of neonatal sepsis.

scholarly journals Automated Assay of a Four-Protein Biomarker Panel for Improved Detection of Ovarian Cancer

Cancers ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 325
Author(s):  
Christopher Walker ◽  
Tuan-Minh Nguyen ◽  
Shlomit Jessel ◽  
Ayesha B. Alvero ◽  
Dan-Arin Silasi ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Early Detection ◽  
Predictive Value ◽  
Early Stage ◽  
Ca 125 ◽  
Healthy Controls ◽  
Classification Models ◽  
Serum Samples ◽  
Protein Biomarker ◽  
Biomarker Panel

Background: Mortality from ovarian cancer remains high due to the lack of methods for early detection. The difficulty lies in the low prevalence of the disease necessitating a significantly high specificity and positive-predictive value (PPV) to avoid unneeded and invasive intervention. Currently, cancer antigen- 125 (CA-125) is the most commonly used biomarker for the early detection of ovarian cancer. In this study we determine the value of combining macrophage migration inhibitory factor (MIF), osteopontin (OPN), and prolactin (PROL) with CA-125 in the detection of ovarian cancer serum samples from healthy controls. Materials and Methods: A total of 432 serum samples were included in this study. 153 samples were from ovarian cancer patients and 279 samples were from age-matched healthy controls. The four proteins were quantified using a fully automated, multi-analyte immunoassay. The serum samples were divided into training and testing datasets and analyzed using four classification models to calculate accuracy, sensitivity, specificity, PPV, negative predictive value (NPV), and area under the receiver operating characteristic curve (AUC). Results: The four-protein biomarker panel yielded an average accuracy of 91% compared to 85% using CA-125 alone across four classification models (p = 3.224 × 10−9). Further, in our cohort, the four-protein biomarker panel demonstrated a higher sensitivity (median of 76%), specificity (median of 98%), PPV (median of 91.5%), and NPV (median of 92%), compared to CA-125 alone. The performance of the four-protein biomarker remained better than CA-125 alone even in experiments comparing early stage (Stage I and Stage II) ovarian cancer to healthy controls. Conclusions: Combining MIF, OPN, PROL, and CA-125 can better differentiate ovarian cancer from healthy controls compared to CA-125 alone.

scholarly journals Osteoarthritis in pet guinea pigs: an update on diagnosis, treatment and management

2021 ◽  
Vol 26 (6) ◽  
pp. 100-106
Author(s):  
Emma Keeble
Keyword(s):  
Quality Of Life ◽  
Early Diagnosis ◽  
Guinea Pigs ◽  
Advanced Disease ◽  
Early Stage ◽  
Clinical Signs ◽  
Nutritional Supplements ◽  
Lifestyle Changes ◽  
Early Age

This article reviews the current literature on osteoarthritis in pet and laboratory guinea pigs. The associated clinical signs, diagnosis and treatment of osteoarthritis in pet guinea pigs will be discussed, with options for analgesia detailed. This condition is thought to be common in pet guinea pigs, even from an early age in some genetic lines, although osteoarthritis often goes undiagnosed in this species until advanced disease is present, posing a major welfare concern. Increasing awareness of this condition in veterinary practitioners should aid early diagnosis in pets and help improve their quality of life. Prevention may be possible using oral protective nutritional supplements to slow down the progression of this disease at an early stage. Lifestyle changes are also discussed for the management of this condition in pet guinea pigs.

scholarly journals Biochemical and immunological markers for the early diagnosis of neonatal septicaemia

2020 ◽  
Vol 46 (2) ◽  
pp. 83-89
Author(s):  
Ayatun Nesa ◽  
Farjana Yesmin ◽  
M A Muttalib
Keyword(s):  
Tumor Necrosis Factor ◽  
Early Diagnosis ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Tumor Necrosis ◽  
White Cell Count ◽  
Sepsis Group ◽  
Cross Sectional ◽  
Neonatal Septicaemia ◽  
Necrosis Factor

Background: Neonatal sepsis is a life-threatening condition with high mortality and morbidity throughout the world. Objective: This study evaluated the diagnostic role of serum procalcitonin (PCT), interleukin-6 (IL-6), tumor necrosis factor-a (TNF-a) and C-reactive protein (CRP) in the early diagnosis of neonatal sepsis. Methods: This cross-sectional study was conducted among neonates admitted to the special baby care unit (SCABU) of BIRDEM General Hospital, Dhaka, from November 2018 to April 2019. According to selection criteria, 90 clinically suspected cases of neonatal sepsis were selected and categorised into confirmed, probable, and no sepsis groups based on CRP, white cell count, platelet count, and blood culture results. Serum PCT, IL-6, and tumor  necrosis factor (TNF-a) were estimated in all cases by standard laboratory methods. Results: Serum PCT, IL-6, CRP, and TNF-awere significantly higher in confirmed and probable sepsis groups in comparison to no sepsis group. Among the studied biomarkers, serum PCT was found most sensitive (95% sensitivity), and serum IL-6 was found most specific biomarkers (65.7% specificity) than CRP and TNF-a for the diagnosis of neonatal septicaemia. Though the accuracy of both PCT and IL-6 was found equal (70%), but the positive predictive value (PPV) and negative predictive value (NPV) of serum PCT were higher than IL-6. Conclusion: Both serum PCT and IL-6 are more sensitive and specific markers than CRP and TNF-a in the diagnosis of neonatal sepsis. Moreover, serum PCT is more useful than IL-6. Bangladesh Med Res Counc Bull 2020; 46(2): 83-89

scholarly journals PLATELET TO LYMPHOCYTE RATIO IN NEONATES: A PREDICTOR OF EARLY ONSET NEONATAL SEPSIS

2019 ◽  
Vol 11 (1) ◽  
pp. e2019055 ◽  
Author(s):  
Birol Karabulut ◽  
Baran Cengiz Arcagok
Keyword(s):  
Early Diagnosis ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Neonatal Intensive Care ◽  
Systemic Disease ◽  
Critical Role ◽  
Control Group ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Sepsis Diagnosis

Introduction Neonatal sepsis (NS) is a common systemic disease that causes morbidity and mortality in newborns. But there is no ideal biomarker that can be used in the early diagnosis of NS. In recent studies, platelet width to lymphocyte ratio (PLR)  have been reported to play a critical role in the inflammatory process. In this study, we aimed to contribute to the research about whether or not PLR can be used in the early diagnosis of NS. Methods This retrospective cohort study was conducted among the newborns whose born in İzmir Buca Maternity and Pediatric Hospital between March 2015-February 2016. During these twelve months, 611 neonates with EOS were admitted to our neonatal intensive care unit. One hundred and forty-nine neonates with  suspected EOS, 67 neonates with proven EOS and 92 healty neonates were enrolled in the study. Results Platelet width lymphocyte (LPR) values of the groups were calculated 56.5 ± 17.8 vs 62.4± 14.9 vs 15.3 ± 2.1 respectively. PLR values of suspected or proven EOS group was significantly higher than the control group. PLR has AUC 0.89 to 0.93, cutoff value of 39.5 to 57.7, sensitivity of 88.9% to 91.3% and specifity of 94.7% to 97.6%, positive predictive value of 94.3% to 97.4%, and negative predictive value of 88.6% to 91.8% in suspected and proven sepsis diagnosis. Conclusion Based on our results suggest that PLR can be used as a biomarker predictive of EOS.

scholarly journals Diagnostic value of mean platelet volume in neonatal sepsis

2019 ◽  
Vol 59 (6) ◽  
pp. 289-93
Author(s):  
Kristopher May Pamudji ◽  
I Made Kardana
Keyword(s):  
Neonatal Sepsis ◽  
Predictive Value ◽  
Mean Platelet Volume ◽  
Severe Disease ◽  
Diagnostic Testing ◽  
Clinical Signs ◽  
Diagnostic Value ◽  
Platelet Volume ◽  
Good Potential ◽  
Sensitivity Specificity

Background Neonatal sepsis is a severe disease with potentially serious impacts if not treated early. However, the symptoms and clinical signs are not specific. Several studies have been conducted to find early infection markers for detection of neonatal sepsis, but without satisfactory results. Mean platelet volume (MPV) is a new marker of infection that has good potential for diagnosing neonatal sepsis. Objective To assess the diagnostic value of MPV in early detection of neonatal sepsis. Methods This retrospective study with diagnostic testing was done with data collected from medical records of neonates with neonatal sepsis who were admitted to the Neonatology Department in Sanglah Hospital, Denpasar from December 2018 to March 2019. Mean platelet volume cut-off point was determined using a receiver-operating characteristic (ROC) curve. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MPV in neonatal sepsis were determined using a 2x2 table. Results Of 82 subjects, 55 subjects were male (67%). Positive blood culture results were found in 25 subjects (30%). Mean platelet volume with a cut-off point of 7.44 fL had 80% sensitivity, 84.2% specificity, 69% PPV, and 90.6% NPV. Conclusion Mean platelet volume with a cut-off point of 7.44 fL can be used to diagnose neonatal sepsis with a sensitivity of 80% and specificity of 84.2%.

scholarly journals Procalcitonin – A Reliable Marker for Diagnosis of Neonatal Sepsis in Compare to CRP

2018 ◽  
Vol 42 (1) ◽  
pp. 19-25
Author(s):  
Jesmin Akter ◽  
Forrukh Ahammad ◽  
Tahmina Begum
Keyword(s):  
Early Diagnosis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Early Recognition ◽  
Care Hospital ◽  
Suspected Sepsis ◽  
Reliable Marker ◽  
Serum Crp

Background: Early recognition and diagnosis of neonatal sepsis are difficult because of the variable and non-specific clinical presentation of this condition. It is extremely important to make an early diagnosis of neonatal sepsis for prompt institution of antimicrobial therapy. So the objective of the study was to evaluate the efficacy of serum procalcitonin as a reliable marker in diagnosis of neonatal sepsis.Methodology: This cross sectional analytical study was carried out in the Special Care Baby Unit of a tertiary level care hospital in Bangladesh from September 2012 to May 2013. Total 75 newborn with suspected sepsis were included in the study. Specimens of blood were obtained from each neonate prior to commencement of antibiotic for sepsis work up. Serum CRP and procalcitoninlevels were measured. The data from blood cultures were used as the gold standard to evaluate the optimum sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under the Receiver Operative Characteristic (ROC) curves.Results:Among total 75 newborns included in this study, 49.3% (37) newborn were diagnosed as proven sepsis and 50.7% (38) newborn as clinical sepsis.The procalcitonin (PCT) was high in 58.7% (500-<2000 pg/ml) newborn and remarkably high (2000-<10000) in 36% newborn with sepsis. At a cut-off value > 500pg/ml, the sensitivity of PCT in detecting sepsis was 48.6%, its specificity 76.3%, positive predictive value was 66.7%, and negative predictive value was 60.4% whereas the sensitivity of CRP for predicting sepsis was 35.1%, specificity 78.9%, positive predictive value 61.9% and negative predictive value was 55.6%. The area under the ROC curve for procalcitonin(0.653) was significantly higher than CRP (0.571).Conclusion:Serum PCT was superior to serum CRP level in terms of early diagnosis of neonatal sepsis, in detecting the severity of sepsis. PCT is a reliable marker than CRP in the diagnosis of neonatal sepsis.Bangladesh J Child Health 2018; VOL 42 (1) :19-25

scholarly journals PO-0519 Can Base Excess Be Used For Early Diagnosis Of Neonatal Sepsis In Preterm Newborns?

2014 ◽  
Vol 99 (Suppl 2) ◽  
pp. A418.3-A419 ◽  
Author(s):  
S Arayici ◽  
G Kadioglu Simsek ◽  
FE Canpolat ◽  
M Oncel ◽  
N Uras ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Neonatal Sepsis ◽  
Base Excess ◽  
Preterm Newborns

Neutrophil Volume, Conductivity and Scatter Parameters to Diagnose Neonatal Sepsis

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4726-4726
Author(s):  
Istemi Han Celik ◽  
Gamze Demirel ◽  
Dmitry Sukhachev ◽  
Omer Erdeve ◽  
Ugur Dilmen
Keyword(s):  
Neonatal Sepsis ◽  
Conflicts Of Interest ◽  
Systemic Infection ◽  
Clinical Syndrome ◽  
Volume Distribution ◽  
Regression Equations ◽  
Distribution Width ◽  
Clinical Sepsis ◽  
Mortality And Morbidity ◽  
Selection Parameters

Abstract Abstract 4726 INTRODUCTION: Neonatal sepsis remains an important clinical syndrome despite advances in neonatology. Early diagnosis and adequate antibiotic treatment are required because of high rates of mortality and morbidity. Current hematology analysers can determine cell volume (V), conductivity for internal composition of cell (C) and light scatter for cytoplasmic granularity and nuclear structure (S) and standart deviations. This VCS measurements were used to diagnose sepsis particularly in adults and higher levels of V and lower levels of S were seen in septic patients. We investigated these parameters in diagnosis of neonatal sepsis. METHOD: We investigated these parameters in secreening of neonatal sepsis, defined as a systemic infection, validated by a positive blood culture, diagnosed beyond the first day of life. We used LH780 hematological analyzer (Beckman Coulter, Fullerton, CA). We combined these parameters with interleukin-6 (IL-6) and C-reactive protein (CRP), and developed models to diagnose sepsis by Effective Modelling of Moleculer Activity (EMMA). It uses combinatorial algorithm of the selection parameters for regression equation based on modified stepwise procedure. It allows compute a number of “best” regression equations with different combinations of parameters. RESULTS: A total of 237 newborn, 61 proven sepsis, 108 clinical sepsis and 68 control, were enrolled the study. Gram positive and negative bacteria including 12 types of microorganism were isolated from 34 and 27 patients, respectively. Mean neutrophil volume (MNV) and volume distribution width (VDW) were found to be statistically increased both in proven and clinical sepsis groups. We developed models using MNV, VDV, IL-6 and CRP (Table 1). We used these models both for proven sepsis and sepsis (proven and clinical sepsis) groups. Table 2 and 3 summarize the cut-off levels of MNV, VDV, IL-6, CRP and models' performance of proven sepsis and sepsis groups. These models gave more sensitivity and specificity than usage of MNV, VDW, IL-6 and CRP alone. CONCLUSION: We suggest to use combination of MNV and VDW with markers such as CRP and IL-6, and use diagnostic models created by using EMMA including these markers. Disclosures: No relevant conflicts of interest to declare.

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