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

InterConf ◽  
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.

Corticosteroid Treatment of Severe Community-Acquired Pneumonia

2007 ◽  
Vol 41 (7-8) ◽  
pp. 1233-1237 ◽  
Author(s):  
Sean K Gorman ◽  
Richard S Slavik ◽  
Judith Marin
Keyword(s):  
Clinical Outcomes ◽  
Systemic Inflammation ◽  
Corticosteroid Treatment ◽  
Community Acquired Pneumonia ◽  
Adjunctive Treatment ◽  
Controlled Study ◽  
Inflammatory Reactions ◽  
Markers Of Inflammation ◽  
Randomized Controlled Studies ◽  
Severe Community Acquired Pneumonia

Objective: To assess the evidence for adjunctive corticosteroids for severe community-acquired pneumonia (CAP). Data Sources: MEDLINE (1966–February 2007) and EMBASE (1980–February 2007) were searched to identify English- and French-language publications that evaluated the use of corticosteroids for CAP in adults. Major search terms included community-acquired pneumonia, intensive care unit, steroids, glucocorticoids, and adrenal cortex hormones. Study Selection and Data Extraction: Clinical studies that evaluated the use of corticosteroids for CAP in adults were included. Clinical and surrogate markers of pneumonia were evaluated. Data Synthesis: Severe CAP is associated with an increase in pulmonary and circulatory cytokines such as interleukin-6 and tumor necrosis factor-α that may be associated with higher mortality. Corticosteroids suppress inflammatory reactions and prevent migration of inflammatory cells from the circulation to tissues by suppressing the synthesis of chemokines and cytokines. One observational comparative study and 2 randomized, controlled studies examined the effects of corticosteroid therapy at various doses on endpoints of pulmonary and systemic inflammation and clinical outcomes. One small observational pilot study revealed that methylprednisolone blunted some of the pulmonary and systemic markers of inflammation. One small, randomized, placebo-controlled study revealed that hydrocortisone had no significant effects on markers of pulmonary and systemic inflammation or clinical outcomes. Another small, randomized, placebo-controlled preliminary study with methodological limitations revealed improvements in oxygenation, organ dysfunction score, and markers of inflammation favoring hydrocortisone over placebo. Conclusions: Given the lack of proven benefit on clinically meaningful endpoints and adverse events, corticosteroids cannot be recommended for adjunctive treatment of severe CAP.

scholarly journals Molecular Inflammatory Responses Measured in Blood of Patients with Severe Community-Acquired Pneumonia

2003 ◽  
Vol 10 (5) ◽  
pp. 813-820 ◽  
Author(s):  
Silvia Fernández-Serrano ◽  
Jordi Dorca ◽  
Mercè Coromines ◽  
Jordi Carratalà ◽  
Francesc Gudiol ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Inflammatory Responses ◽  
Community Acquired Pneumonia ◽  
Causative Organism ◽  
Time Interval ◽  
Necrosis Factor Alpha ◽  
Arterial Blood ◽  
Tnf Α ◽  
Intensive Care Unit Admittance ◽  
Severe Community Acquired Pneumonia

ABSTRACT In order to analyze the characteristics of the inflammatory response occurring in blood during pneumonia, we studied 38 patients with severe community-acquired pneumonia. Venous and arterial blood samples were collected at study entry and on days 1, 2, 3, 5, and 7 after inclusion. The concentrations of proinflammatory (tumor necrosis factor alpha [TNF-α], interleukin 1β [IL-1β], IL-6, and IL-8) and anti-inflammatory (IL-10) cytokines were determined in order to detect differences related to the origin of the sample, the causative organism, the clinical variables, and the final outcome of the episode. Legionella pneumonia infections showed higher concentrations of TNF-α, IL-6, IL-8, and IL-10. After 24 h, plasma IL-6, IL-8, and IL-10 concentrations in pneumococcal episodes increased, whereas in the same time interval, cytokine concentrations in Legionella episodes markedly decreased. The characteristics of the inflammatory response in bacteremic pneumococcal episodes were different from those in nonbacteremic episodes, as indicated by the higher plasma cytokine concentrations in the former group. Finally, our analysis of cytokine concentrations with regard to the outcome—in terms of the need for intensive care unit admittance and/or mechanical ventilation as well as mortality—suggests that there is a direct relationship between the intensity of the inflammatory response measured in blood and the severity of the episode.

scholarly journals Correlations of complete blood count, liver enzyme and serum uric Acid in Sudanese pre-eclamptic cases

2018 ◽  
Vol 7 (4) ◽  
pp. 1308
Author(s):  
Hind M. Beheiry ◽  
Ibrahim A. Ali ◽  
Mazin S. Abdalla ◽  
Ahmed M. Sharif ◽  
Amal M. Saeed
Keyword(s):  
Uric Acid ◽  
Serum Uric Acid ◽  
Liver Enzymes ◽  
Complete Blood Count ◽  
Maternity Hospital ◽  
Prognostic Indicators ◽  
Cross Sectional ◽  
Significant Difference ◽  
The Mean ◽  
Wbc Count

Background: Pre-eclampsia is a serious disorder of pregnancy with unknown ethological factors that may occur at any stage of second or third trimester of pregnancy. The objectives of the present study were to assess changes in complete blood counts including platelets, liver enzymes and serum uric acid in pre-eclamptic cases compared to second-half normal pregnant and non-pregnant Sudanese women and their correlations to other biomarkers.Methods: This was a cross-sectional, case-control study performed from December 2008 to December 2010; in Omdurman Maternity Hospital, in concomitance with other studies in pre-eclampsia. The sample size included three groups, 72 up pre-eclamptic cases in their recent pregnancies, 96 normal pregnant in their second half of pregnancy and 63 non- pregnant (control) women; a total of 231 subjects. Questionnaire Interviews and clinical examination were done for all participants. Laboratory investigations were done including complete blood picture, liver enzymes and uric acid.  Results: The mean Hb concentration of the pre-eclamptic (11.3g/dl±1.7) was statistically significantly lower than that of the non-pregnant (12.1g/dl±0.2) (P=0.01) but not from that of the normal pregnant (11.4g/dl±0.1) (P=0.882) .There was no statistical significant difference in the mean WBC count between the pre-eclamptic (7.4x103/mm3±0.3) and non-pregnant (7.3x103/mm3±0.3) (P=0.797) and between the pre-eclamptic and normal pregnant (7.7x103/mm3±0.2) (P=0.270). There was a considerable statistical significant decrease in the mean platelets count of the pre-eclamptic (236.4/mm3±8.3) compared to the non-pregnant group (322.0/mm3±10.4) (P=0.0001) s well as to the normal pregnant (275.0/mm3±8.9) (P = 0.003). In the pre-eclamptic cases, serum ALT correlated significantly with TWCC (r=0.26, P=0.03) and serum AST (r=0.65, P=0.000). In the pre-eclamptic cases, serum AST correlated significantly with Hb (r=0.26, P=0.03), serum ALT and serum uric acid (r=0.36, P=0.01).Conclusions: There was a considerable statistical significant decrease in mean platelets count of the pre-eclamptic compared to the non-pregnant group and to the normal pregnant may be explained by hemodilution; whereas further decrease was due to pre-eclampsia. ALT and AST are strong prognostic indicators of pre-eclampsia.

scholarly journals Serum Vitamin D Level and Risk of Community-Acquired Pneumonia: A Case-Control Study

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Guwani Liyanage ◽  
Anusha Kaneshapillai ◽  
Suthesan Kanthasamy
Keyword(s):  
Vitamin D ◽  
Logistic Regression ◽  
Vitamin D Deficiency ◽  
Serum Vitamin ◽  
Community Acquired Pneumonia ◽  
Conclusive Evidence ◽  
Unconditional Logistic Regression ◽  
Serum Vitamin D ◽  
Significant Difference ◽  
Severe Community Acquired Pneumonia

Introduction. Recent research has shown conflicting evidence on the connection between vitamin D deficiency and community-acquired pneumonia (CAP) in children. Thus, we hypothesized that vitamin D deficiency could be a risk factor for CAP. Methods. Hospitalized children between 2 and 60 months with physician-diagnosed, radiologically confirmed severe community-acquired pneumonia (CAP) were enrolled as cases. Age-matched controls were enrolled from immunization and weighing clinics. A blood sample was collected to assess serum 25-(OH)D concentration. Unconditional logistic regression was done to examine the independent association of vitamin D level with community-acquired pneumonia. Results. Seventy-four children (females: 68%) were included. Overall, 27% had vitamin D deficiency (<20 ng/mL) and 37.8% had insufficiency (20–29 ng/mL). The vitamin D level ranged from 8.67 to 46.2 ng/mL. There was no statistically significant difference in 25(OH)D levels in controls and cases ( p = 0.694 ). In unconditional logistic regression, 25(OH)D concentration was not a determinant of CAP (OR: 0.99, CI: 0.937–1.044, p = 0.689 ). This lack of association remained after adjustment for age, gender, income, crowding, and exposure to passive smoke (OR: 0.99, CI: 0.937–1.065, p = 0.973 ). Household income was significantly associated with CAP (OR: 0.11, 95% CI: 0.021–0.567, p = 0.008 ). Conclusion. Two-thirds of the children with CAP had vitamin D deficiency/insufficiency. In comparison with healthy controls, vitamin D level was not a significant determinant of community-acquired pneumonia. It informs that further multisite research is required using more rigorous scientific methods for conclusive evidence on the relationship between vitamin D and CAP.

Neutropenia in Patients with Thalassemia Major.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3763-3763
Author(s):  
Renzo Galanello ◽  
Raffaella Origa
Keyword(s):  
Neutrophil Count ◽  
Chelation Therapy ◽  
Viral Infections ◽  
Complete Blood Count ◽  
Thalassemia Major ◽  
Nucleated Red Blood Cells ◽  
Significant Difference ◽  
Males And Females ◽  
Wbc Count ◽  
Clear Relation

Abstract Monitoring of the neutrophil count has become an important issue in the management of thalassemia patients after the introduction of the new oral chelator deferiprone, as this chelator has been associated with agranulocytosis and milder neutropenias. Although a clear relation between deferiprone and agranulocytosis has been demonstrated, it is unclear whether milder neutropenias are due to deferiprone use or to other factors such as hypersplenism, infections, autoantibodies, or other drugs. In this study we evaluated 7,708 consecutively blood counts and leukocyte differential obtained between August 2003 to June 2004 from 344 patients with thalassemia major, aged 2 to 40 years, treated with deferiprone (N=39), desferrioxamine (N=179), ICL670 (N=45), or a combination of deferiprone and desferrioxamine (N=81). Complete blood count and differential were performed with Coulter LH 750 automated haematology analyzer (Beckman Coulter, Miami, FL), which can detect nucleated red blood cells (NRBC) and correct the white blood cell (WBC) count in the presence of NRBC, platelets clumps, unlysed or fragmented RBC. The capability to correct the WBC count is particularly relevant in the monitoring of the neutrophil counts of patients with excessive NRBC, which could lead to potential errors in the differrential count. Neutropenia was defined as a neutrophils count below 1500 cells/μL, whereas agranulocytosis was defined as a neutrophil count below 500 cells/μL. No episodes of agranulocytosis were observed. Episodes of neutropenia (range 850 – 1490 neutrophils/μL) were observed in 29 (8,4%) patients. Repeated episodes of neutropenia were observed in 7 of the 29 patients. At the time of neutropenia, 23 (79%) of the patients were being chelated with desferrioxamine, 2 (7%) with deferiprone, 3 (10%) with a combination of both chelators, and 1 (3%) with ICL670. Considering the type of chelation, neutropenia was observed in 12,8% of patients being treated with desferrioxamine, 5% in patients treated with deferiprone, 3,7% in patients treated with combination therapy, and 2.2% in patients treated with ICL670. The severity of neutropenia, assessed as absolute neutrophil count, was not different on the basis of the type of chelation (p=0,26). Neutropenia was more frequent in children than in adults (31% vs 7.8%, respectively, p=0.0001). No statistically significant difference in the incidence of neutropenia was found between males and females (10.2% vs 6.5% respectively, p=0.2), anti-HCV positive and negative (7.7% vs 10.3% respectively p=0.43), or splenectomized and non-splenectomized patients (11.1% vs 8.1% respectively, p=0.5). Neutropenia appears to be a common event in patients with thalassemia major, irrespectively of the chelation therapy used. The higher incidence in children may be secondary to a greater frequency of viral infections at this age, which may produce neutropenia with several mechanisms including redistribution, sequestration and destruction of neutrophils.

scholarly journals The relationship between the plasma proinflammatory cytokine levels of depressed/anxious children and their parents

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tomer Mevorach ◽  
Michal Taler ◽  
Shira Dar ◽  
Maya Lebow ◽  
Irit Schorr Sapir ◽  
...  
Keyword(s):  
Immune System ◽  
Anxiety Disorders ◽  
Children And Adolescents ◽  
Healthy Children ◽  
Depression And Anxiety ◽  
Blood Samples ◽  
Immune System Activation ◽  
Tnf Α ◽  
Significant Difference ◽  
Cytokine Levels

AbstractRecent studies suggest immune function dysregulation in depression and anxiety disorders. Elevated pro-inflammatory cytokines may be a marker for immune system dysregulation. No study assessed the correlation between the levels of cytokines in children and adolescents with depression/anxiety disorders and their parents. In this study, 92 children and adolescents (mean age 13.90 ± 2.41 years) with depression and/or anxiety disorders were treated with fluoxetine. Blood samples were collected before initiation of treatment. One hundred and sixty-four of their parents (mean age 50.6 ± 6.2 years) and 25 parents of healthy children (mean age 38.5 ± 6.2 years) also gave blood samples. Plasma levels of three pro-inflammatory cytokine (TNF-α, IL-6, IL-1β) were measured by enzyme linked immunosorbent assays (ELISA) and compared between depressed/anxious children and their parents. We also compared cytokine levels between parents of children with depression/anxiety and control parents. Mothers of depressed children had higher TNF-α levels than mothers of controls. No significant difference was detected in the fathers. A positive correlation was found between the IL-1β levels of the depressed/anxious boys and their mothers. No such correlation was observed in the fathers. Our conclusions are that higher levels of proinflammatory cytokines may indicate immune system activation in mothers in response to the distress associated with having depressed/anxious offspring. The correlation between IL-1β levels in the mothers and their depressed/anxious children may indicate familial vulnerability to depression and anxiety. Our observation highlights the need for a better understanding of sexual dimorphism in inflammatory responses to stress.

scholarly journals Continuous hemadsorption with cytokine adsorber for severe COVID-19: A case series of 15 patients

2021 ◽  
pp. 039139882110237
Author(s):  
Christopher Paisey ◽  
Chinmay Patvardhan ◽  
Michael Mackay ◽  
Alain Vuylsteke ◽  
Sai Kiran Bhagra
Keyword(s):  
Potential Role ◽  
Case Series ◽  
Post Treatment ◽  
Inflammatory Biomarkers ◽  
Adjunctive Treatment ◽  
Cytokine Storm ◽  
Cytokine Release ◽  
Tnf Α ◽  
Significant Difference ◽  
D Dimer

Background: Hyperinflammation and cytokine release has been associated with severe Covid-19. Hemadsorption cartridges may have a potential role in treatment of cytokine storm associated with the development of severe Covid-19. Methods: We retrospectively examined the case records of patients with severe Covid-19 receiving adjunctive hemadsorption (HA) in our ICU. We analyzed inflammatory biomarkers pre- and post- HA. Results: Fifteen patients received HA during the study period. All were intubated, ventilated and required renal replacement therapy. 11/15 were supported on ECMO. Mean ferritin 2652 (±3286) ng/ml, mean CRP 154 (±92) mg/ml, median D-dimer 3071 (±2689) ng/ml, mean troponin 236 (±461) ng/L. We found significant difference in pre-and post- treatment ferritin 3622 ng/ml versus 1682 ng/ml ( p = 0.022), CRP 222 mg/ml versus 103 mg/ml ( p = 0.008, 95% CI 22.4–126.5), lactate 2 mmol/L versus 1.3 mmol/L ( p = 0.017), and procalcitonin 15.3 ng/ml versus 4.2 ng/ml ( p = 0.023). No significant difference in pre- and post- treatment IL-6 14 pg/ml versus 43 pg/ml ( p = 0.32), IL-10 3.4 pg/ml versus 2.6 pg/ml ( p = 0.31), IL1 β 0.37 pg/ml versus 0.77 pg/ml ( p = 0.75), TNF α 12.77 pg/ml versus 12.49 pg/ml ( p = 0.75), VIS 10.04 versus 6.01 ( p = 0.31, 95% CI 5.98–17.16) was seen. Conclusions: The use of HA as adjunctive treatment in a critically unwell group of COVID-19 patients lead to a reduction in ferritin, CRP, procalcitonin and lactate with no significant change in other parameters. The use of HA in the treatment of severe COVID-19 requires further larger randomized studies.

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

2021 ◽  
Vol 0 ◽  
pp. 1-8
Author(s):  
Olutobi Babatope Ojuawo ◽  
Ademola Emmanuel Fawibe ◽  
Olufemi Olumuyiwa Desalu ◽  
Adeniyi Olatunji Aladesanmi ◽  
Ayotade Boluwatife Ojuawo ◽  
...  
Keyword(s):  
Operating Characteristic ◽  
Complete Blood Count ◽  
Tertiary Hospital ◽  
Community Acquired Pneumonia ◽  
Baseline Serum ◽  
Cell Counts ◽  
Atypical Pathogens ◽  
Significant Difference ◽  
Pre Treatment ◽  
Single Center Observational Study

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.

scholarly journals Circulating inflammatory biomarkers and academic performance in adolescents: DADOS study

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242016
Author(s):  
Mireia Adelantado-Renau ◽  
Maria Reyes Beltran-Valls ◽  
Jorge Mota ◽  
Diego Moliner-Urdiales
Keyword(s):  
Academic Performance ◽  
Verbal Ability ◽  
Roc Curves ◽  
Science Research ◽  
Inflammatory Biomarkers ◽  
Grade Point ◽  
Tnf Α ◽  
Academic Grades ◽  
Wbc Count ◽  
Factor Α

Objective The present study aimed (1) to examine the association between circulating inflammatory biomarkers and academic performance in adolescents, and (2) to identify the ability of circulating inflammatory biomarkers to predict low academic performance. Methods A total of 244 adolescents (13.9±0.3 years, 112 girls) from the DADOS study were included in the analysis. Four inflammatory biomarkers were quantified: white blood cell (WBC) count, interleukin-6, tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP). Academic performance was assessed through academic grades and the Spanish version of the Science Research Associates Test of Educational Abilities. Results TNF-α was inversely associated with math, Spanish and grade point average (β ranging from -0.166 to -0.124; all p<0.05), while CRP was inversely associated with verbal ability (β = -0.128; p<0.05). Overall, receiver operating characteristic (ROC) curves analyses showed discriminatory ability of WBC and TNF-α in identifying low academic performance (all p<0.05). Moreover, logistic regression analyses indicated that students with levels of WBC and TNF-α above the ROC cut-offs values showed between 78% to 87% increased likelihood of lower academic performance (p<0.05). Conclusions Our findings suggested that some circulating inflammatory biomarkers were associated with academic performance in adolescents. Further larger longitudinal and interventional studies are needed to clarify the short-term and long-term relationship between inflammation and academic performance in youths.

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