scholarly journals Assessment of Usefulness of CRP, PMN Elastase, PCT and Il- 6 as Prognostic Factors in Patients with Acute Pancreatitis

2020 ◽  
Vol 3 (2) ◽  
pp. 1-4
Author(s):  
B. Jagan Mohan Reddy ◽  
S.P. Girish
Keyword(s):  
Acute Pancreatitis ◽  
Prognostic Factors ◽  
Solid Phase ◽  
Rapid Onset ◽  
Pmn Elastase ◽  
Severe Pancreatitis ◽  
The Mean ◽  
The Difference ◽  
Elastase Level ◽  
Pmn Élastase

Background: Acute pancreatitis is an inflammatory disease of the exocrine pancreas with rapid onset. The present study was conducted to assess the usefulness of CRP, PMN elastase, PCT and IL- 6 as prognostic factors in patients with acute pancreatitis. Subjects and Methods: The present study comprised 53 patients who presented with a diagnosis of Acute Pancreatitis. CRP was estimated by turbidimetric immunoassay using CRP/U2A-000 kit. PMN-Elastase was estimated by solid-phase enzyme immunoassay. Procalcitonin was estimated by the immuno- chromatographic test. IL-6 was estimated by Immuno-enzymatic assay. Results: There were 47 males and 6 females in the present study. The mean SD CRP in patients with mild pancreatitis was 44.35 53.04 and in severe pancreatitis was 174.80 14.55, PCT was seen in 4 in mild pancreatitis patients and 12 in severe pancreatitis patients, PMN- elastase level was 3.89 1087 in mild pancreatitis and 3.99 2.75 inn severe pancreatitis patients, IL-6 level was 129.63 319.08 in mild pancreatitis and 1166.76 818.06 in severe pancreatitis patients. The difference was significant (P< 0.05). CRP had higher (100) specificity as compared to PCT (81), PMN- E (10) and IL- 6 (90), Specificity found to be 88, 81, 97 and 94 respectively, PPV was 84, 74, 67 and 90 respectively, NPV was 100, 87, 62 and 94 respectively, accuracy was 92, 81, 62 and 92 respectively, AUC was 0.97, 0.81, 0.43 and 0.95 respectively. Conclusion: Authors found that CRP is the single best predictor of the severity of acute pancreatitis. IL-6 and PCT also are reliable predictors. PMN-Elastase needs to be assessed in patients with acute pancreatitis presenting early in the course of the illness.

scholarly journals Comparison of Multifactor Vs Independent Marker in Predicting Severity of Acute Pancreatitis

2020 ◽  
Vol 3 (1) ◽  
pp. 136-141
Author(s):  
Vijaykumar C Bada
Keyword(s):  
Acute Pancreatitis ◽  
Organ Failure ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Pmn Elastase ◽  
Severe Pancreatitis ◽  
Poor Predictor ◽  
Score Apache ◽  
Pmn Élastase ◽  
Independent Marker

Background: Acute pancreatitis (AP) is an inflammatory process with a highly variable clinical course. This study was conducted to compare the multifactor vs independent marker in predicting the severity of acute pancreatitis. Subjects and Methods: The present study comprised    of 50 patients of acute pancreatitis. In all patients, reactive protein (CRP), Interleukin-6 (IL-6), PMN-Elastase (PMN-E), Procalcitonin (PCT), RANSON”s score, GLASGOW score, APACHE-II score, APACHE-O score and Balthazar’s CTSI score was recorded. Results: There were 45 males and 5 females in the study. There were 12 (22.64%) obese patients in this study. The age of the patients was a significant indicator    to discriminate or predict patients with mild or severe pancreatitis. With an AUROC of 0.6004, it was found that age was a poor predictor       of the severity of acute pancreatitis. Obesity of the patients was a significant indicator to discriminate or predict patients with mild or severe pancreatitis. With an AUROC of 0.6004, it was found that age is a poor predictor of the severity of acute pancreatitis. Organ failure at admission is more likely to reflect severe cases, it is found to be a poor predictor of severity in acute pancreatitis. The mean CTSI score in the study was 3.57 (SD 2.64), with a median of 2 and ranged from 1 to 10. It was higher in severe pancreatitis and a CTSI score of >=3 was significantly associated with patients with acute pancreatitis by bivariate analysis. Conclusion: The authors found that overall, CRP was the best predictor, followed by IL-6, CTSI score, PCT, Glasgow, Ranson’s and APACHE-II. PMN-Elastase, Age, obesity and organ failure at admission are poor predictors of severity of acute pancreatitis.

PMN-elastase contributes to the severity of experimental acute pancreatitis via direct effects on acinar cells

Pancreatology ◽  
2012 ◽  
Vol 12 (6) ◽  
pp. 543-544
Author(s):  
Ali A. Aghdassi ◽  
Christian Storck ◽  
Matthias Sendler ◽  
Sudarshan Ravi Malla ◽  
Annett Günther ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Acinar Cells ◽  
Direct Effects ◽  
Experimental Acute Pancreatitis ◽  
Pmn Elastase ◽  
Pmn Élastase

scholarly journals Analysis of incapacitation during +Gz induced loss of consciousness

2021 ◽  
Vol 65 ◽  
pp. 91-96
Author(s):  
MD Sharma ◽  
P Biswal ◽  
N Taneja ◽  
A Agarwal
Keyword(s):  
Air Force ◽  
High Performance ◽  
Age Groups ◽  
Rapid Onset ◽  
Loss Of Consciousness ◽  
Video Recordings ◽  
Operational Capabilities ◽  
Significant Difference ◽  
The Mean ◽  
The Difference

Introduction: Occurrence of G induced loss of consciousness (G-LOC) during centrifuge training is a known entity. The Indian Air Force is currently undertaking high G training of its fighter pilots in High Performance Human Centrifuge (HPHC) which has significantly higher operational capabilities. The study aimed to analyse the incapacitation periods and myoclonic jerks associated with G-LOC occurring during HPHC training. Material and Methods: Records of episodes of 161 G-LOC during closed loop Rapid Onset Rates (ROR) runs over a period of 7 years from 2011 to 2017 were analyzed. The video recordings of these G-LOC episodes were assessed in terms of the participant demographics, +Gz onset rates, incapacitation periods, and presence or absence of myoclonic jerks during the G-LOC episodes. Descriptive statistics was applied to analyze the incapacitation periods and the duration of the myoclonic flail movements. Single tailed t-test was used to analyze the difference between the incapacitation periods of the aircrew who suffered myoclonic flail movements and those who did not. One-way ANOVA was carried out to assess the differences in incapacitation periods, if any, between aircrew of different age groups. Significance was set at P < 0.05. Results: Of these 161 episodes of G-LOC, 43.5% were seen in trainee aircrew. The mean Absolute Incapacitation Period (AIP), Relative Incapacitation Period (RIP) and Total Incapacitation Period (TIP) was 6.9 ± 2.3 s, 12.2 ± 4.7 s, and 19.1 ± 5.5 respectively. Age and flying experience did not show any significant effect with any of the incapacitation periods (p>0.05). The TIP correlated better with the RIP than with the AIP (Pearson’s correlation values of 0.9 and 0.52 respectively). Myoclonic flail movements were witnessed in 25.5% of G-LOC episodes with an average duration of 5.3 s and more than 50% occurring at ≥8Gz. The mean duration of RIP was significantly higher (P=0.03) when G-LOC was associated with myoclonic flail movements, whereas, the duration of AIP did not show any significant difference. Conclusion: The shorter incapacitation periods observed in the study compared to that reported in most of the previous studies could be attributed to the faster Gz offset rates of the present HPHC. Episodes of G-LOC having myoclonic movements were found to have higher relative incapacitation periods. Even though these movements were associated with G-LOC occurring at higher Gz levels, the durations were independent of the Gz levels.

scholarly journals Early enteral nutrition in acute pancreatitis - how beneficial is it?

2021 ◽  
Author(s):  
Shruthikamal Venkat ◽  
Rajesh Subramaniam ◽  
Vijai Raveendran
Keyword(s):  
Acute Pancreatitis ◽  
Hospital Stay ◽  
Pain Score ◽  
Tamil Nadu ◽  
Early Enteral Nutrition ◽  
Medical College ◽  
Severe Pancreatitis ◽  
Number Of Patients ◽  
Significant Difference ◽  
The Mean

Background: Acute pancreatitis is an inflammatory disease of pancreas and is one of the leading cause of acute abdomen requiring hospital admission. Nutritional support plays a crucial role in this hypercatabolic state in not only providing calories but also in preventing complications and decreasing recovery time.Methods: This prospective study was done among 120 patients with acute moderate and severe pancreatitis who got admitted in department of general surgery at Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India between 2018 and 2019.Results: 67 (55.8%) patients were in early enteral and 53 (44.2%) were in parenteral/delayed enteral group. Maximum number of patients were in 30-40 years age group. The mean of patient age was 40.33. Mean duration of hospital stay in enteral group was 7.06 and in parenteral/delayed enteral group it was 14.09 (p<0.001). Mean pain score in enteral group was 2.69 and in parenteral group it was 6.51 (p<0.001).Conclusions: There was significant (p<0.001) decrease in hospital stay duration and pain score in early enteral group compared to parenteral/delayed enteral group. Infections related to feeding route was found high in parenteral group. No significant difference found in complications of acute pancreatitis. Hence early enteral feeding is more beneficial in terms of shortened hospital stay, decreased pain score leading to reduction in usage of analgesics and reducing the recovery time and less nutrition related complications in management of acute moderate and severe pancreatitis.

Severity markers in patients with acute pancreatitis

Open Medicine ◽  
2014 ◽  
Vol 9 (4) ◽  
pp. 556-564 ◽  
Author(s):  
Abdullah Kisaoglu ◽  
Bulent Aydinli ◽  
Gurkan Ozturk ◽  
Sabri Atamanalp ◽  
Bunyami Ozogul ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
High Sensitivity ◽  
Scoring Systems ◽  
Serum Levels ◽  
Apache Ii ◽  
Control Group ◽  
Correct Prediction ◽  
Total N ◽  
The Mean ◽  
The Difference

AbstractTo evaluate the effectiveness of serum levels of resistin and CD14 expression in monocytes, and high-sensitivity C-reactive protein (hsCRP) in early stages of acute pancreatitis and correct prediction of the severity of acute pancreatitis (AP) using scoring systems. The study involved 10 (29.41%) male and 24 (70.59%) female patients (total n=34) followed for AP diagnosis at the Department of General Surgery, Ataturk University Medical School between July 2008 and September 2009. In all the patients, Ranson and APACHE II scores, serum resistin, hsCRP, and monocyte CD14 expression levels were determined. The patients were divided into two groups as mild and severe AP groups. A control group was formed and the intergroup comparisons were made. Values ≥ 3 based on the Ranson scoring scale and values ≥ 8 in APACHE II scoring scale were considered to indicate severe AP. Evaluations were based on the values obtained on the 1st and 7th days for serum resistin and hsCRP levels and monocyte CD 14 expression. In 17 (50%) patients, severe AP was determined. No statistically significant differences were found between the mean serum resistin levels of AP groups, while the difference for the same parameter between the mild and severe AP groups and the control group was statistically significant. In the severe AP group, the mean 1st day and 7th day serum hsCRP levels were statistically significantly higher. The CD14 expression in monocytes was similar in all the groups. Serum hsCRP concentrations and Ranson and APACHE II scores and serum resistin and hsCRP concentrations on the 1st day were positively correlated. Serum hsCRP measurement is effective in determining the severity of acute pancreatitis. Serum resistin measurement may be a useful early marker in determining the inflammatory response in AP. However, CD14 expression in monocytes was not found to be a useful marker in the diagnosis and prediction of the disease severity in AP patients.

Pmn-elastase: A very accurate test for the early prognosis evaluation of acute pancreatitis in clinical practice

2003 ◽  
Vol 124 (4) ◽  
pp. A400
Author(s):  
Augusto Villanueva-Rodriguez ◽  
Julio Iglesias-Garcia ◽  
Jose Larino-Noia ◽  
Manuel Barreiro-Deacosta ◽  
Jose Iglesias-Canle ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Clinical Practice ◽  
Pmn Elastase ◽  
Pmn Élastase ◽  
Prognosis Evaluation

scholarly journals Changes in the management of patients with severe acute pancreatitis

2008 ◽  
Vol 45 (3) ◽  
pp. 181-185 ◽  
Author(s):  
Tercio De Campos ◽  
Candice Fonseca Braga ◽  
Laíse Kuryura ◽  
Denise Hebara ◽  
José Cesar Assef ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Apache Ii ◽  
Specific Approach ◽  
Severe Pancreatitis ◽  
Group A ◽  
The Mean ◽  
Fluid Collections ◽  
Group B

BACKGROUND: Severe acute pancreatitis is present in up to 25% of patients with acute pancreatitis, with considerable mortality. Changes in the management of acute pancreatitis in the last 2 decades contributed to reduce the mortality. AIM: To show the evolution in the management of severe acute pancreatitis, comparing two different approaches. METHODS: All patients with severe acute pancreatitis from 1999 to 2005 were included. We compared the results of a retrospective review from 1999 to 2002 (group A) with a prospective protocol, from 2003 to 2005 (group B). In group A severe pancreatitis was defined by the presence of systemic or local complications. In group B the Atlanta criteria were used to define severity. The variables analyzed were: age, gender, etiology, APACHE II, leukocytes, bicarbonate, fluid collections and necrosis on computed tomography, surgical treatment and mortality. RESULTS: Seventy-one patients were classified as severe, 24 in group A and 47 in group B. The mean APACHE II in groups A and B were 10.7 ± 3.5 and 9.3 ± 4.5, respectively. Necrosis was seen in 12 patients (50%) in group A and in 21 patients (44.7%) in group B. Half of the patients in group A and two (4.3%) in group B underwent to pancreatic interventions. Mortality reached 45.8% in group A and 8.5% in group B. CONCLUSION: A specific approach and a prospective protocol can change the results in the treatment of patients with severe acute pancreatitis.

Primary Hyperparathyroidism Masquerading as Acute Pancreatitis

2021 ◽  
Vol 53 (06) ◽  
pp. 377-381
Author(s):  
Saurabh Arora ◽  
Parminder Singh ◽  
Rohit Verma ◽  
Naveen Mittal ◽  
Ajit Sood ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Primary Hyperparathyroidism ◽  
Control Group ◽  
Initial Manifestation ◽  
Female Ratio ◽  
Skeletal Involvement ◽  
Severe Pancreatitis ◽  
Male Preponderance ◽  
The Mean ◽  
High Index Of Suspicion

AbstractAcute pancreatitis as an initial manifestation of primary hyperparathyroidism (PHPT) is a rare occurrence and timely diagnosis of PHPT is crucial in preventing repeat attack of pancreatitis. The study aimed at evaluating the clinico-radiological profile of patients admitted with acute pancreatitis as the index presentation of PHPT and to determine the factors associated with development of severe pancreatitis. This series included retrospective analysis of medical records of 30 patients admitted with acute pancreatitis as initial manifestation of PHPT. Additionally, we analyzed the data of another 30 patients admitted with PHPT but without any evidence of pancreatitis, to serve as control group. The mean age of the subjects was 44.9±13.9 years with male to female ratio of 1.30. The mean serum calcium level was 12.24±2.79 mg/dl and five (16.6%) patients had normocalcemia at time of presentation. Presence of nephrolithiasis was significantly associated with severe pancreatitis. One patient had refractory hypercalcemia associated with renal failure and was successfully managed with denosumab. Patients with PHPT associated with acute pancreatitis had significantly higher calcium levels and lower frequency of skeletal involvement as compared to PHPT patients without pancreatitis. PHPT masquerading as acute pancreatitis is rare and high index of suspicion is required to diagnose this condition especially in the presence of normocalcemia at presentation. Patients with PHPT associated pancreatitis had male preponderance, higher calcium levels, and lower frequency of skeletal involvement as compared to PHPT patients without pancreatitis.

scholarly journals Serum Procalcitonin in the Prediction of Severity and Outcome of Acute Pancreatitis

2021 ◽  
Vol 9 (1) ◽  
pp. 16-21
Author(s):  
Khan Md Nazmus Saqeb
Keyword(s):  
Acute Pancreatitis ◽  
Statistical Analysis ◽  
Severe Disease ◽  
High Sensitivity ◽  
Biochemical Tests ◽  
Single Marker ◽  
Predicting Outcome ◽  
The Mean ◽  
The Difference

Background: Different modalities are available for predicting severity and outcome of acute pancreatitis. A single marker with high sensitivity and specificity is yet to be identified. Aim: This study intends to find out the utility of serum procalcitonin in predicting the severity and outcome of acute pancreatitis. Methods: 117 patients admitted with acute pancreatitis were included.Clinical parameters and biochemical tests were recorded on admission, on day-3 & day-5 of admission. CT scan was performed in all patients. Serum procalcitonin was done on admission. Multifactorial scores were calculated using these data.Every patient was followed for identification of organ failure or other complications. Statistical analysis was done with SPSS. Result: Among 117 patients, 67(57.3%) were male. Biliary, hypertriglyceridemia, alcohol, malignancy and post-ERCP complications were found as aetiology in 25(21.4%), 23(19.7%), 8(6.8%), 3(2.6%),2(1.7%) cases respectively. In 53(45.3%) cases no definite etiology could be found. 83(70.9%) patients had mild,15(12.8%) had moderately severe and 19(16.2%) had severe acute pancreatitis. 23(19.65%) patients developed complication, whereas 94 (80.34%) developed none. The mean serum procalcitonin(pg/ml) of patients with mild, moderately severe and severe disease was 146±165.21, 1297±439.44, 4361±1493.55 respectively. The difference among the groups were statistically significant. Mean serum procalcitonin(pg/ml) in patientswho developed complications was 3744±1827.05 and in those without complication it was 301±559.97.ROC curve evaluating the role of serum procalcitonin in predicting outcome of acute pancreatitis showed AUC of 0.985. A cutoff point of 1131.28pg/ml showed highest sensitivity (95.7%) & specificity (94.7%). Conclusion: Serum procalcitonin can be a new promising marker to predict severity and outcome of acute pancreatitis. Bangladesh Crit Care J March 2021; 9(1): 16-21

scholarly journals Correlation of PMN elastase and PMN elastase-to-neutrophil ratio with disease activity in patients with myositis

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Siyu Wu ◽  
Wanchan Peng ◽  
Yunli Zhang ◽  
Jingjing Guo ◽  
Jinfang Fu ◽  
...  
Keyword(s):  
Autoimmune Diseases ◽  
Disease Activity ◽  
Roc Curve ◽  
Curve Analysis ◽  
Enzyme Linked Immunosorbent Assay ◽  
Serum Samples ◽  
Roc Curve Analysis ◽  
Pmn Elastase ◽  
Elastase Level ◽  
Pmn Élastase

Abstract Background Polymorphonuclear (PMN) elastase plays an important role in a variety of inflammatory disorders. Our aim was to analyse PMN elastase in idiopathic inflammatory myopathies (IIMs) and its association with disease activity. Methods PMN elastase levels were measured using enzyme-linked immunosorbent assay in serum samples obtained from 74 patients with myositis (58 with dermatomyositis [DM] and 16 with polymyositis [PM]) and 22 healthy controls. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the discriminant capacity of PMN elastase level and PMN elastase-to-neutrophil ratio (ENR) in patients with active and remission myositis. The association of serum PMN elastase level and ENR with disease variables was evaluated in patients with IIMs. The disease specificity of PMN elastase level and ENR was further examined in 60 patients with other systemic autoimmune diseases. Results PMN elastase level and ENR were significantly higher in patients with active IIMs, DM, and PM than in patients with remission. ROC curve analysis revealed that PMN elastase level and ENR both outperformed creatine kinase (CK), the currently used laboratory marker, and strongly discriminated patients with active disease and those with remission of IIMs, DM, and PM (area under the ROC curve [AUC] 0.9, 0.9, and 0.88 for PMN elastase; AUC 0.96, 0.96, and 1.0 for ENR; AUC 0.72, 0.70, and 0.80 for CK, respectively). PMN elastase level and ENR were positively correlated with myositis disease activity assessment, CK, lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase, C-reactive protein, and erythrocyte sedimentation rate. PMN elastase level and ENR were higher in the anti-PM-Scl positive myositis group than those in the anti-PM-Scl negative myositis group. Nevertheless, PMN elastase was not a specific disease marker for IIMs when compared with other autoimmune diseases. Conclusions PMN elastase, particularly ENR, were significantly correlated with disease activity and could serve as useful biochemical markers for evaluating the disease activity of patients with IIMs. Thus, they are potentially helpful in monitoring disease progression and guiding treatment.

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