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Britt Nakstad
Introduction: A key challenge in identifying serious bacterial infection in new born infants is the nonspecific clinical presentation of early-onset neonatal sepsis (EONS). Routinely used C-reactive protein, white blood cell count, and platelets are nonspecific. We assessed the diagnostic utility of single biomarkers or combinations of procalcitonin (PCT), interleukin (IL)-6, IL-8, and hyaluronic acid (HA) in newborn infant with EONS, and in human umbilical cord blood (HUCB) from deliveries with chorioamnionitis...
2018: Infection and Drug Resistance
Silvia Garcia, Janire Echevarri, Eunate Arana-Arri, Mercedes Sota, Javier Benito, Santiago Mintegi
OBJECTIVE: To determine the outcome of children aged 2-14 years with cerebrospinal fluid (CSF) pleocytosis and at very low risk for bacterial meningitis managed as outpatients without antibiotics. METHODS: Multicentre, prospective, observational study conducted at nine Spanish paediatric EDs. Patients were diagnosed with meningitis based on clinical suspicion of meningitis and CSF pleocytosis when evaluated in the ED. Children between 2 and 14 years of age with pleocytosis and very low-risk criteria for bacterial meningitis (well appearing, Bacterial Meningitis Score (BMS)=0, procalcitonin (PCT)<0...
March 21, 2018: Emergency Medicine Journal: EMJ
Gunnar Elke, Frank Bloos, Darius Cameron Wilson, Frank Martin Brunkhorst, Josef Briegel, Konrad Reinhart, Markus Loeffler, Stefan Kluge, Axel Nierhaus, Ulrich Jaschinski, Onnen Moerer, Andreas Weyland, Patrick Meybohm
BACKGROUND: This study assessed the ability of mid-regional proadrenomedullin (MR-proADM) in comparison to conventional biomarkers (procalcitonin (PCT), lactate, C-reactive protein) and clinical scores to identify disease severity in patients with sepsis. METHODS: This is a secondary analysis of a randomised controlled trial in patients with severe sepsis or septic shock across 33 German intensive care units. The association between biomarkers and clinical scores with mortality was assessed by Cox regression analysis, area under the receiver operating characteristic and Kaplan-Meier curves...
March 21, 2018: Critical Care: the Official Journal of the Critical Care Forum
E Estenssoro
No abstract text is available yet for this article.
March 17, 2018: Medicina Intensiva
Swati Sharma, Beena Uppal, Vikas Manchanda, Anuj Sud
No abstract text is available yet for this article.
March 19, 2018: Infectious Diseases
Hannah Maier, Saskia Helm, Sermin Toto, Nicole Moschny, Wolfgang Sperling, Thomas Hillemacher, Kai G Kahl, Ewgeni Jakubovski, Stefan Bleich, Helge Frieling, Alexandra Neyazi
Background: Electroconvulsive therapy (ECT) is one of the most effective treatment options for refractory depressed patients. To date, there are only a few predictors of response. Aim: The aim was to identify predictive biomarkers of remission to ECT on a molecular level. Methods: 11 patients suffering from a major depressive episode-according to the Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)-underwent 10 ECT sessions...
2018: Disease Markers
Florian Lamping, Thomas Jack, Nicole Rübsamen, Michael Sasse, Philipp Beerbaum, Rafael T Mikolajczyk, Martin Boehne, André Karch
BACKGROUND: Since early antimicrobial therapy is mandatory in septic patients, immediate diagnosis and distinction from non-infectious SIRS is essential but hampered by the similarity of symptoms between both entities. We aimed to develop a diagnostic model for differentiation of sepsis and non-infectious SIRS in critically ill children based on routinely available parameters (baseline characteristics, clinical/laboratory parameters, technical/medical support). METHODS: This is a secondary analysis of a randomized controlled trial conducted at a German tertiary-care pediatric intensive care unit (PICU)...
March 15, 2018: BMC Pediatrics
Liqin Gao, Bin Yang, Hairong Zhang, Qishui Ou, Yulan Lin, Mei Zhang, Zhenhuan Zhang, Sunghee Kim, Bing Wu, Zeng Wang, Lengxi Fu, Jingan Lin, Ruiqing Chen, Ruilong Lan, Junying Chen, Wei Chen, Long Chen, Hengshan Zhang, Deping Han, Jingrong Chen, Paul Okunieff, Jianhua Lin, Lurong Zhang
Early diagnosis of sepsis is critical for successful treatment. The clinical value of DcR3 in early diagnosis of sepsis was determined in a dynamic follow-up study. Alterations in plasma levels of DcR3, PCT, CRP, and IL-6 were measured by ELISA and compared among patients with sepsis ( n = 134), SIRS ( n = 60) and normal adults ( n = 50). Correlations and dynamic patterns among the biomarkers, APACHE II scores, clinical outcomes, and pathogens were also examined. Plasma DcR3 was significantly increased in sepsis compared to SIRS and normal adults (median 3...
February 16, 2018: Oncotarget
A Echeverri, J Naranjo-Escobar, I Posso-Osorio, D Aguirre-Valencia, D Zambrano, G L Castaño, J D Martínez, C A Cañas, G J Tobón
Background/Objective Differentiating systemic lupus erythematosus (SLE) activity from infections in febrile patients is difficult because of similar initial clinical presentation. The aim of this study is to evaluate the usefulness of a number of biomarkers for differentiating infections from activity in SLE patients admitted with systemic inflammatory response (SIRS). Methods Patients with SLE and SIRS admitted to the emergency room were included in this study. Measurements of different markers including procalcitonin, neutrophil CD64 expression and presepsin, were performed...
January 1, 2018: Lupus
Imran Siddiqui, Lena Jafri, Qalab Abbas, Ahmed Raheem, Anwar Ul Haque
Objective: To evaluate the clinical and prognostic utility of procalcitonin (PCT), C-reactive protein (CRP), and lactic acid in children admitted to the Pediatric Intensive Care Unit (PICU) of a university teaching hospital. Materials and Methods: Medical records of children (1 month-16 years) tested for serum PCT at the time of admission in the PICU of our hospital from July 1, 2013, to January 15, 2015, were reviewed. Within 24 h of admission, the Pediatric Risk of Mortality Score, blood cultures, white blood cell count, neutrophil counts, serum CRP, plasma lactic acid, and PCT were noted...
February 2018: Indian Journal of Critical Care Medicine
Tuna Demirdal, Pinar Sen, Salih Atakan Nemli
Background and Aims: Several biomarkers are used in the diagnosis of bacteremia. Procalcitonin (PCT) is more specific than other biomarkers in differentiating bacterial and nonbacterial inflammation. It was aimed to evaluate the diagnostic and prognostic value of PCT in bacteremic patients in Intensive Care Unit (ICU). Materials and Methods: A total of 156 patients diagnosed with noninfectious systemic inflammatory response syndrome, sepsis, and severe sepsis/septic shock in ICU between December 2014 and July 2015 were evaluated in this prospective cohort study...
February 2018: Indian Journal of Critical Care Medicine
Alexander R Levine, Midori Tran, Jonathan Shepherd, Edgar Naut
BACKGROUND: Urinary tract infections (UTIs) are one of the most common reasons women seek treatment in the emergency department (ED). The biomarker procalcitonin (PCT) has gained popularity over the last decade to improve the diagnosis of bacterial infections and reduce unnecessary exposure to antibiotics. PCT has been extensively studied in patients with pneumonia and sepsis and may have additional role in UTI. METHODS: A retrospective study of patients who presented to the ED in which a urinalysis test and a PCT level was obtained within the first 24h of presentation...
March 3, 2018: American Journal of Emergency Medicine
Rachael K Ross, Luke Keele, Sherri Kubis, Andrew J Lautz, Adam C Dziorny, Adam R Denson, Kathleen A O'Connor, Marianne R Chilutti, Scott L Weiss, Jeffrey S Gerber
We retrospectively studied the effect of introducing procalcitonin into clinical practice on antibiotic use within a large academic pediatric intensive care unit. In the absence of a standardized algorithm, availability of the procalcitonin assay did not reduce the frequency of antibiotic initiations or the continuation of antibiotics for greater than 72 hours.
February 8, 2018: Journal of the Pediatric Infectious Diseases Society
Luis J Jara, Gabriela Medina, Miguel A Saavedra
PURPOSE OF REVIEW: To provide an update about the interactions between infections and autoimmune diseases (AIDs), from the molecular perspective to the clinical spectrum and the differentiation between infection and disease activity. RECENT FINDINGS: Any kind of infection may modify the innate and adaptive immune response through the following mechanisms: molecular mimicry, superantigens, epitope spreading and B-cell activation. The consequence is the overproduction of antibodies shared with those found in AIDs...
March 9, 2018: Current Opinion in Rheumatology
Duneesha de Fonseka, Nick A Maskell
PURPOSE OF REVIEW: Pleural infection is a common problem associated with significant morbidity and mortality. Systemic or pleural fluid markers for reliably identifying pleural infection are limited. Procalcitonin (PCT) is known to be elevated in bacterial infection and is currently used for diagnosis and decision-making regarding antibiotic duration in respiratory infections. This review investigates if there is a role for serum and pleural fluid PCT (pf-PCT) in diagnosis and management of pleural infection...
March 9, 2018: Current Opinion in Pulmonary Medicine
Gaye Ulubay, Ebru Ayvazoglu Soy, Irem Serifoglu, Fisun Sozen, Gokhan Moray, Mehmet Haberal
OBJECTIVES: Despite improved success with solid-organ transplant procedures, recipients remain at risk for infections, including pneumonia, due to their immunosuppressive regimens. In solid-organ transplant patients, clinical findings of pneumonia can be nonspecific, and diagnosis of pneumonia may be difficult as several conditions (drug lung, hypervolemia, infections, hemorrhage) can led to pulmonary infiltrates, mimicking pneumonia in these patients. The role of mean platelet volume, a predictor of inflammatory disease, with elevated values inversely correlated with inflammatory problems, in the diagnosis of pneumonia has not yet been investigated in solid-organ transplant patients...
March 2018: Experimental and Clinical Transplantation
Kenan Karaca, Enis Ozkaya, Meryem Kurek Eken, Ilgi Uygun, Sule Yıldırım Kopuk, Murat Alpay
Tubo-ovarian abscess (TOA) coexists in 15% of cases with pelvic inflammatory disease. Medical treatment is the first line of approach in women with TOA, however, 25% of cases fail to respond to antibiotics, therefore, these cases need to undergo surgical intervention. We aimed to determine factors leading to failure of medical treatment in women diagnosed with TOA. According to our results among 144 women, 27 cases required surgical intervention for full recovery. None of the demographic, sonographic or laboratory findings, including procalcitonin level, had significant predictive value for the failure of medical treatment in women with TOA...
March 9, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Yago Leira, Pablo Ameijeira, Clara Domínguez, Rogelio Leira, Juan Blanco
BACKGROUND: To evaluate the contribution of chronic periodontitis (CP) to serum procalcitonin (proCT) levels in chronic migraine (CM) patients in a cross-sectional study. METHODS: We included 138 subjects divided into 4 groups based on clinical features of CM and periodontal parameters: systemically and periodontally healthy individuals (n = 37), systemically healthy and CP patients (n = 19), CM and periodontally healthy patients (n = 34), and CM+CP patients (n = 48)...
March 9, 2018: Journal of Periodontology
José Luis Muñoz, María Oliva Alvarez, Vicent Cuquerella, Elena Miranda, Carlos Picó, Raquel Flores, Marta Resalt-Pereira, Pedro Moya, Ana Pérez, Antonio Arroyo
BACKGROUND: C-reactive protein (CRP) and procalcitonin (PCT) have been described as good predictors of anastomotic leak after colorectal surgery, obtaining the highest diagnostic accuracy on the 5th postoperative day. However, if an enhanced recovery after surgery (ERAS) program is performed, early predictors are needed in order to ensure a safe and early discharge. The aim of this study was to investigate the efficacy of CRP, PCT, and white blood cell (WBC) count determined on first postoperative days, in predicting septic complications, especially anastomotic leak, after laparoscopic colorectal surgery performed within an ERAS program...
March 8, 2018: Surgical Endoscopy
Junma Xu, Jie Zhao, Xiaomin Jia, Gang Wang
OBJECTIVE: To explore the role of early continuous renal replacement therapy (CRRT) in bundle treatment of severe pneumonia. METHODS: Seventy severe pneumonia patients admitted to respiratory intensive care unit (RICU) of Second Affiliated Hospital of Xuzhou Medical University from January 2013 to June 2017 were enrolled. The patients were randomly divided into routine treatment group and CRRT treatment group, with 35 patients in each group. All patients were treated with bundle therapy, and those in CRRT treatment group was treated with CRRT daily on the basis of conventional bundle therapy...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
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