Average C-reactive Protein Levels Research Articles

ENHANCED RECOVERY PATHWAY AFTER LAPAROSCOPIC HERNIOPLASTY IN PATIENTS WITH VENTRAL HERNIAS: IS IT NECESSARY TO APPLY?

The aim: To study the effectiveness of the enhanced recovery after surgery (ERAS) protocol for laparoscopic hernioplasty (LH) in patients with ventral hernias (VH).
 Materials and methods: 190 patients with VH after laparoscopic prosthetic hernioplasty with intraperitoneal mesh placement (IPOM) were included in the study and divided into two groups. The study group (ERAS group) included 92 (48.4%) patients to whom the ERAS protocol was applied, the control group (preERAS group) – 98 (51.6%) patients. The width of the hernia was more than 10 cm in 25 (13.2%) patients of the ERAS group. For them botulinum toxin type A (BTA) was injected into the muscles of the anterior abdominal wall 4 weeks before the operation. In the postoperative period, the duration of the operation, hospital length of stay, the intensity of the pain syndrome and well-being, the level of C-reactive protein (CRP) and interleukin-6 (IL-6) on the first postoperative day were evaluated.
 Results: After the introduction of BTA in 25 patients of ERAS group, the hernial defect decreased by an average of 4.6±0.62 mm and in all cases became less than 10 cm (р<0.001). The average duration of LH in the study and control groups did not differ statistically (ERAS; 91.2±37.41 min vs preERAS 88.9±30.05 min, p=0.76). In 2 hours after the operation, it was possible to activate all patients of the study group and 78 (79.6%) of the control group, within 4-6 hours – the other 20 (20.4%) patients of the control group. Using the ERAS protocol demonstrated significantly less intensity of pain syndrome according to visual analogue scale (VAS), complaints of nausea (р<0.001), bloating (р=0.017), feelings of hunger, thirst and general weakness (р<0.001). At the same time, there was no statistically significant difference in the presence of defecation (р=0.31). The average level of CRP after surgery was significantly higher in the control group compared to the study group (preERAS; 43.63 ± 13.90 vs ERAS; 16.55 ± 9.97, p<0.001). The level of IL-6 similarly increased more significantly in the control group (pre ERAS; 34.03 ± 18.18 vs ERAS; 11.44 ± 5.30, p<0.001). The length of hospital stay after surgery did not differ statistically between the groups (р=0.21).
 Conclusions: The use of the ERAS protocol during laparoscopic hernioplasty IРOM for patients with VH can reduce the intensity of the pain syndrome in the postoperative period and increase the patient's subjective assessment of their condition. The use of BTA in the preoperative period allows the implementation of the ERAS protocol even when used with large ventral hernias.

ЗАЛЕЖНІСТЬ ПОКАЗНИКІВ ДИСЛІПОПРОТЕЇДЕМІЇ ВІД МАРКЕРА СИСТЕМНОГО ЗАПАЛЕННЯ С-РЕАКТИВНОГО ПРОТЕЇНУ У ПАЦІЄНТІВ З ХОЗЛ

Aim was to study the correlation between dyslipoproteinemia and systemic inflammation marker C-reactive protein in COPD patients. Materials and methods. Retrospective data analysis of 66 cases of COPD patients aged 40-60 years was conducted. C-reactive protein (CRP) was assessed as a marker of systemic inflammation. We also measured the dyslipoproteinemia markers, such as total cholesterol (TC) and low-density lipoprotein cholesterol (LDLC). Using paired linear regression method there was studied an effect of CRP level on some dyslipoproteinemia indices in COPD patients. Results. The average level of CRP was 11.60 ± 5.54 mg/l, demonstrating the presence of a systemic inflammation in study patients. We revealed a linear correlation between CRP and TC (r = 0,7 ± 4,7). There was even stronger correlation between CRP and LDLC ( r = 0,8 ± 3,5). Conclusion. In patients from this retrospective study, a correlation between the levels of CRP and TC/LDLC as the indicators of high risk of atherosclerosis was found. Therefore, it is possible to assume in COPD patients, it is feasible to screen the level of TC and LDLC for prevention/ early diagnosing of atherosclerosis, which in turn is the leading cause of death worlwide. Key words: chronic inflammation, atherosclerosis, COPD, C-reactive protein, dyslipoproteinemia.

Microbiological Profile and Clinical Features of Septic Arthritis of the Shoulder: A 10-Year Cohort Single-Centre Study.

Introduction Septic arthritis (SA) constitutes a pressing orthopedic emergency characterized by acute, non-traumatic joint pain. Timely diagnosis and intervention are imperative to avert complications such as chondrolysis and systemic sepsis. The etiology is predominantly hematogenous, necessitating an integrated approach involving surgical and microbiological modalities. Shoulder aspiration and microbiological analysis play pivotal roles in guiding treatment, especially when positive findings prompt more aggressive therapeutic strategies. This study aims to elucidate the nuanced clinical and epidemiological characteristics of septic arthritis in both native and prosthetic joints within a singular institutional cohort over a decade. Methods This retrospective case series analysis spanned a 10-year period, focusing on non-prosthetic shoulder joints from January 2012 to July 2021. In this timeframe, only 183 aspirations were performed and sent to the microbiology department for analysis, including cultures, microscopy, and antibiotic sensitivity tests for positive cultures. The study delved into the microbiological profile of infections, encompassing gram stain, culture positivity rates, identification of microorganisms, and antibiotic susceptibility patterns. Additionally, the incidence of primary joint infections with resistant strains, particularly methicillin-resistant Staphylococcus aureus(MRSA), was scrutinized. Statistical analysis utilized the SPSS program version 20.0 (IBM Inc., Armonk, New York), with a significance level set at 5%. The project, registered with the trust's clinical audit department (Reg #5372), adhered to the Declaration of Helsinki and good clinical practice guidelines. Data collection involved extracting non-identifiable patient modifiers from the laboratory database bank into Excel spreadsheets. Results The study included 183 patients, with 108 (59%) females and 75 (41%) males. The average age was 76.2±16.5 years. Among them, 138 (75.4%) reported pain, and 15 (8.2%) had a body temperature over 37.8°C. Lab results showed a mean white blood cell count of 11.6±4.5 and an average C-reactive protein level of 121.7±102.1. Leucocytosis (>11,000 WBC) was seen in 82 (44.8%) cases. Elevated C-reactive protein (CRP; >10 mg/dl) was found in 136 (74.3%) patients. Synovial fluid analysis revealed no crystals in 91.3% of cases. Microbial resistance analysis showed 19 strains resistant to co-trimoxazole and 11 to erythromycin. Among co-trimoxazole-resistant strains, 73.7% were Staphylococcus aureus, a statistically significant association (p<0.001). Conclusion The evolving sensitivity patterns of microbes in septic arthritis underscore the necessity to reassess empirical antibiotic therapy. Subsequent joint damage resulting from infection can result in substantial disability.

ASSOCIATION OF RELIGIOUS ATTENDANCE, RELIGIOSITY/SPIRITUALITY, AND C-REACTIVE PROTEIN IN MIDDLE TO OLDER ADULTS IN THE U.S

Abstract Elevated levels of C-reactive Protein (CRP), a biomarker of systemic inflammation, are associated with a higher risk of cognitive decline and dementia. Religious attendance and religiosity/spirituality are associated with better cognitive health, yet the underlying physiological mechanisms are not well understood. We examined the association between religious service attendance, religiosity/spirituality, and CRP levels in a nationally representative sample of U.S. adults aged 50 years and older (n=6,652) from the Health and Retirement Study from 2006 to 2014. The mean age was 70.7(9.32) years, 84.4% were White, 58.4% were female, and mean CRP levels were 3.98 (8.50) ug/mL. Utilizing the generalized estimating equation (GEE), a significant negative association was found between religious service attendance and religiosity/spirituality with average CRP levels, even after controlling for age, sex, education, marital status, race/ethnicity, income, body mass index (BMI), and health conditions (diabetes, cancer, hypertension) [B: -0.39, 95% CI:-0.76,-0.03, p&amp;lt;0.034 and B: -0.04, 95% CI:-0.07,-0.01, p&amp;lt;0.01]. Age, income, and education were negatively associated with CRP levels, while being female, Black/African American, having diabetes, cancer, hypertension, and BMI were positively associated with CRP levels. Findings contribute to our understanding of a possible mechanism by which religious service attendance and religiosity/spirituality influence cognitive health through reduced systemic inflammation. Interventions are needed to sustain religious attendance supporting religiosity/spirituality for adults who find religion/spirituality important, with the potential to reduce the risk of cognitive decline and dementia.

Assessing serum C-reactive protein as a predictor of COVID-19 outcomes: a retrospective cross-sectional study.

The current study aims to conclude the possibility of C-reactive protein (CRP) level serving as a biomarker for early prediction of COVID-19 infections. In this retrospective cross-sectional study, 88 people participated who were infected with COVID-19, aged from 25 to 79 years old. Compare the CRP test range of all samples from patients who visited the hospital between January and April 2022. All participants were confirmed to have COVID-19 through nasopharyngeal swab analysis and real-time polymerase chain reaction real-time polymerase chain reaction testing. Results showed that the majority of infected individuals had elevated CRP levels. A P-value of less than 0.05 indicated a significant difference in CRP levels between alive and dead patients. No significant difference in CRP levels was found between male and female patients. The average CRP level of deceased patients was 137.79mg/l, while the average CRP level of survivors was 14.37mg/l. The median interquartile range of deceased patients was also found to be significantly higher compared to survivors. In conclusion, serum CRP levels potentially predict the severity and development of sickness in patients with COVID-19 infections.

#4858 THE CHANGES OF THE C REACTIVE PROTEIN LEVEL DURING THE CRRT PROCEDURE

Abstract Background and Aims Continuous renal replacement therapy (CRRT) is recommended for critically ill patients (pts). Various infections and sepsis often occur in these pts. In addition to being frequently used as inflammation parameter, C reactive protein (CRP) is considered an important regulator of inflammatory processes and may have an active role in atherosclerosis. Changes in its level can have indirect effects on these processes. The aim of this study was to monitor change of CRP level during the CRRT procedure and to evaluate the potential correlation between this change and other monitored parameters. Method The study was done as the observational, retrospectively prospective study on 154 pts, on whom 343 CRRT procedures (proc) were performed. All pts were treated at the Clinics of the University Clinical Centre of Vojvodina, by the Dialysis Department, during 2021. and 2022. Procedures that lasted longer than 5 hours were included. CRRT modalities were CVVHD and CVVHDF, with the use of different filters (EMiC2, Kit8/CiCa1000, oXiris, ST150), according to the device (MultiFiltrate, PrismaFlex) and anticoagulation used. Demographic, clinical and CRRT proc data were collected from the medical documentation. Blood for laboratory testing was sampled at the beginning and the end of the proc. An increase or decrease of CRP level by more than 5% compared to the initial value was considered significant. The collected data were statistically processed. Results From 154 pts, 86.83% were men, 13.17% women, with average (avg.) age of 56.52 years. From 343 proc, 41.69% were CVVHD, 58.31% CVVHDF, with avg. duration of 1033 min. Average ultrafiltration (UF) was 2670mL, with avg. UF/hour of 161.54mL/h. Average initial CRP level was 176.25mg/l, with avg. level of 174.6mg/l at the end of the proc. In 44.9% proc an increase and in 43.44% proc a decrease in the CRP level was verified. The CRP level did not change significantly during 11.66% proc (40/343). Patients' age (p = 868) and gender (p = 752) did not affect the change in CRP level during CRRT proc. Procedures in which CRP level decreased lasted longer (1084min) than those with CRP level increase (1023min), but the difference is not statistically significant (p = 199). Prescribed CRRT dose (p = 485), nor total UF (p = 164) did not affect change in CRP level during proc. Hourly UF was significantly lower for CRRT proc during which CRP level decreased (148.18mL/h) compared to those with the CRP level increase (172.23mL/h) (p = 000). CRRT modality had a significant impact on changes of CRP level during the proc. In a higher percentage of CVVHD proc (48.32%) a decrease in CRP level was seen compared to CVVHDF proc (36.36%) (p = 035). A significant difference was found in the changes of CRP levels in relation to the filters used (p = 011). The use of the EMiC2 filter most often resulted in a decrease in CRP level (56.25%), compared to the use of other filters. Septic condition was present in 85.91% of proc that ended with a decrease of CRP level and in 66.23% of proc with the CRP level increase (p = 000). In proc with the CRP level decrease, basal levels of PCT and fibrinogen were significantly higher than in those with the CRP level increase (p = 037, p = 000 retrospectively). Initial number of WBC did not differ between two groups (p = 424). Comorbidities such as diabetes (p = 489), malignancy (p = 5) or autoimmune disease (p = 25) did not affect change in CRP level during CRRT proc, nor did surgery precede the proc (p = 782). No association between the changes of CRP level during the CRRT proc and the subsequent pts mortality (p = 289) or recovery of renal function (p = 808) was found. Conclusion During the CRRT procedure, the level of CRP in significantly influenced by the average hourly ultrafiltration, the CRRT modality, the filter used, and the presence of septic condition, with high levels of PCT and fibrinogen.

Do Changes in Hemoglobin and C-Reactive Protein Levels in Patients With Hip Tuberculosis After Two Months of Treatment Predict Tubercle Bacilli Deletion?

Background and objective Tuberculosis (TB) of the hip refers to the hip infection caused bytubercle bacilli. Treatment for hip TB includes anti-TB medications, surgery to remove joint abscesses, and orthopedic surgery. It is necessary to conduct tests to confirm that the tubercle bacilli have been eradicated following the treatments. In this study, we aimed to assess the change in hemoglobin and C-reactive protein (CRP) serum levels in patients with hip TB before and two months after receiving specific treatments. We sought to determine whether they are significant tests for the treatment prognosis of hip TB. Methods We employed a prospective cohort design for this study. It was conducted at National Lung Hospital, Hanoi, and involved 24 hip TB patients with intra-articular abscesses who were treated at the center during the period from October 2016 to October 2021. Blood hemoglobin, CRP serum level, and abscesses on hip MRI were assessed before and two months after treatments. Hemoglobin was examined by spectrophotometry, and CRP serum was measured using the immunoturbidimetric method. Results Before treatments, the average hemoglobin level in the patients was 11.48 ± 1.85 g/dl; the average CRP serum level was 63.53 ± 36.47 mg/l. After two months of treatments, the average hemoglobin level increased significantly to 13.22 ± 1.36 g/dl, while the average CRP level reduced significantly to 12.55 ± 11.34 mg/l. However, five cases displayed abnormal findings. These five individuals continued to have intra-articular abscesses. Conclusion In individuals who reacted well to the therapy, bloodhemoglobin and CRP serum levels improved. Blood hemoglobin and serum CRP assays can be utilized to monitor outcomes in hip TB therapy.

C-Reactive Protein (CRP) Medium and Severe Symptoms Levels of COVID-19

Coronavirus Disease 2019 (COVID-19) is a disease caused by SARS-CoV-2 and has caused a global pandemic. Patients with COVID-19 can experience symptoms such as fever, dry cough, headache, and shortness of breath which can lead to pneumonia. Excessive inflammation is considered a leading cause of critical illness and death in COVID-19 patients. C-Reactive Protein is a sensitive indicator as an early marker of infection and inflammation. This study presents an overview of the difference in the average CRP levels between patients with moderate and severe confirmed COVID-19 symptoms at UKI Hospital for June-September 2021. The study design was cross-sectional with descriptive and analytical data presentation obtained from medical record documents at UKI Hospital. The average CRP level of COVID-19 patients with moderate symptoms is 63,705 mg/L, totaling 139 patients. The average CRP level of COVID-19 patients with severe symptoms is 132,050 mg/L, totaling 57 patients. The results obtained from the Mann-Whitney test between groups of patients with moderate and severe COVID-19 showed a significant difference between CRP levels with moderate and severe symptoms with p &lt;0.05.&#x0D; Keywords: COVID-19, CRP levels, SARS-CoV-2

Complex therapy recovered after infectious diseases

Introduction. At the present time, the incidence of acute respiratory viral infections (ARVI) remains at a high level. Some patients who have undergone ARVI and COVID-19 have been disturbed by astheno-neurotic syndrome and chronic fatigue syndrome for quite a long time.Aim. To study the efficacy and safety dietary supplement treatment in the rehabilitation of patients recovered after acute respiratory viral infections.Materials and methods. We have examined 50 patients diagnosed with acute respiratory viral infections (38 people) and COVID-19 (12 people). Age of patients: from 25 years to 60 years old, average age 35 ± 11.84 years old. All patients were randomized into two study groups: the first group (25 people) received a biologically active food supplement and the second group (25 people) did not receive such complex. Сomplex was prescribed to the participants of the first group in amount of two capsules once a day. The course of therapy was 14 days. Before and after taking, all patients were assessed for shortness of breath on the MRC scale, depression on the Beck scale, chronic fatigue syndrome on the FAS scale, and the level of C-reactive protein (CRP) was assessed as well.Results. In the course of the observation, no significant difference between the groups was recorded in the dynamics of the state of assessment for dyspnea, depression and hemoglobin level. The average level of CRP before taking in the first group was 4.4 mg/l (from 0 to 22 mg/l), in the second – 3.8 mg/l (from 0 to 14 mg/l). When comparing the dynamics in the first group, there was more pronounced decrease in the level of CRP. In the first group, decrease in manifestations of pathological fatigue was revealed, characterized by decrease in FAS scores compared to the control group, where the number of scores, on the contrary, increased.Conclusions. Сomplex has a corrective effect on astheno-neurotic symptoms after suffering from acute respiratory viral infections or post-COVID syndrome.

Comparison of Inflammatory Markers Changes in Patients Who Used Postoperative Prophylactic Antibiotics within 24 Hours after Spine Surgery and 5 Days after Spine Surgery.

C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), and white blood cell (WBC) count are inflammatory markers used to evaluate postoperative infections. Although these markers are non-specific, understanding their normal kinetics after surgery may be helpful in the early detection of postoperative infections. To compliment the recent trend of reducing the duration of antibiotic use, this retrospective study investigated the inflammatory markers of patients who had received antibiotics within 24 hours after surgery according to the Health Insurance Review & Assessment Service guidelines and compared them with those of patients who had received antibiotics for 5 days, which was proven to be non-infectious. We enrolled 74 patients, divided into two groups. Patients underwent posterior lumbar interbody fusion (PLIF) at a single institution between 2019 and 2020. Group A included 37 patients who received antibiotics within 24 hours after the PLIF procedure, and group B comprised 37 patients who had used antibiotics for 5 days. A 1 : 1 nearest-neighbor propensity-matched analysis was used. The clinical variables included age, sex, medical history, body mass index, estimated blood loss, and operation time. Laboratory data included CRP, ESR, and WBC, which were measured preoperatively and on postoperative days (POD) 1, 3, 5, and 7. CRP dynamics tended to decrease after peaking on POD 3, with a similar trend in both groups. The average CRP level in group B was slightly higher than that in group A; however, the difference was not statistically significant. Multiple linear regression analysis revealed operation time, number of fused levels, and estimated blood loss as significant predictors of a greater CRP peak value (r²=0.473, p<0.001) in patients. No trend (a tendency to decrease from the peak value) could be determined for ESR and WBC count on POD 7. Although slight differences were observed in numerical values and kinetics, sequential changes in inflammatory markers according to the duration of antibiotic administration showed similar patterns. Knowledge of CRP kinetics allows the assessment of the degree of difference between the clinical and expected values.

Analysis of C-Reactive Protein (CRP) Levels in Venous and Capillary Blood Samples with Immunoturbidimetric Methods

Inflammation or inflammation occurs due to bacterial infection, detection of inflammatory infection can be done by laboratory tests. An examination that can help diagnose and detect abnormalities in the body. One of the parameters for examining inflammation markers is C-Reactive Protein (CRP). CRP examination usually uses venous blood because venous blood is more often used in laboratory examinations. The purpose of this study was to determine differences in CRP levels in venous and capillary blood. This study uses a posttest only design research. Samples were taken from DIV Technology Medical Laboratory IkesT Muhammadiyah Palembang students with total sampling technique. The research was carried out at the Hematology Laboratory of IKesT Muhammadiyah Palembang on December 21, 2021. Based on the results of research that has been carried out on the analysis of C_Reactive Protein levels in venous blood and capillary blood samples using the immunoturbidemteri method, the results showed that the average CRP level of venous blood was 9.6 and average the average capillary blood CRP level was 8.33. Thus it can be concluded that there is no significant difference in the examination of CRP levels in venous and capillary blood.

C-reactive protein elevation predicts in-hospital deterioration after aneurysmal subarachnoid hemorrhage: a retrospective observational study

BackgroundThere is increasing evidence that inflammation plays a role in the pathogenesis of aneurysmal subarachnoid hemorrhage (aSAH) and in the development of delayed cerebral ischemia (DCI). However, the assessment and interpretation of classically defined inflammatory parameters is difficult in aSAH patients. The objective of this study was to investigate the relationship between easily assessable findings (hyperventilation, fever, white blood cell count (WBC), and C-reactive protein (CRP)) and the occurrence of DCI and unfavorable neurological outcome at discharge in aSAH patients.MethodsRetrospective analysis of prospectively collected data from a single center cohort. We evaluated the potential of clinical signs of inflammation (hyperventilation, fever) and simple inflammatory laboratory parameters CRP and WBC to predict unfavorable outcomes at discharge and DCI in a multivariate analysis. A cutoff value for CRP was calculated by Youden’s J statistic. Outcome was measured using the modified Rankin score at discharge, with an unfavorable outcome defined as modified Rankin scale (mRS) > 3.ResultsWe included 97 consecutive aSAH patients (63 females, 34 males, mean age 58 years) in the analysis. Twenty-one (22%) had major disability or died by the time of hospital discharge. Among inflammatory parameters, CRP over 100 mg/dl on day 2 was an independent predictor for worse neurological outcome at discharge. The average C-reactive protein level in the first 14 days was higher in patients with a worse neurological outcome (96.6, SD 48.3 vs 56.3 mg/dl, SD 28.6) in the first 14 days after aSAH. C-reactive protein on day 2 was an indicator of worse neurological outcome. No inflammatory parameter was an independent predictor of DCI. After multivariate adjustment, DCI, increased age, and more than 1 day of mechanical ventilation were significant predictors of worse neurological outcome.ConclusionsEarly elevated CRP levels were a significant predictor of worse neurological outcome at hospital discharge and may be a useful marker of later deterioration in aSAH.

HUBUNGAN BIOMARKER INFLAMASI C-REAKTIF PROTEIN DENGAN LAJU ENDAP DARAH PADA PASIEN TERKONFIRMASI COVID-19

Abstract: China country. It spreads very quickly, namely through physical contact through the nose, mouth, and eyes, and develops in the lungs (C-Reactive Protein). CRP is an acute phase protein synthesized in the liver for non-specific monitoring of local and systemic disease. The erythrocyte sedimentation rate is the rate at which erythrocytes settle in a vertical tube. Research has been carried out to determine the title of the relationship between C-Reactive Protein Levels and Blood Sedimentation Rates in Covid-19 Confirmed Patients. Samples in this study were 60 samples. Then it was found that there were 45 men with a percentage (58.3 %) and a female sex with a percentage of 25 people (41.7 %), and the average c-reactive protein level 477.63 mg/dl and the sedimentation rate was 3.258,33 mm /hour. Then the results of statistical tests obtained results of 0.001 &lt; 0.05. the conclusion is that there is a relationship between levels of c-reactive protein and levels of erythrocyte sedimentation rate in patients suspected of covid-19 with sufficient correlation criteria.Keywords: Corona virus, CRP levels, LED

Infection Probability Index: Implementation of an Automated Chronic Wound Infection Marker.

The number of people suffering from chronic wounds is increasing due to demographic changes and the global epidemics of obesity and diabetes. Innovative imaging techniques within the field of chronic wound diagnostics are required to improve wound care by predicting and detecting wound infections to accelerate the application of treatments. For this reason, the infection probability index (IPI) is introduced as a novel infection marker based on thermal wound imaging. To improve usability, the IPI was implemented to automate scoring. Visual and thermal image pairs of 60 wounds were acquired to test the implemented algorithms on clinical data. The proposed process consists of (1) determining various parameters of the IPI based on medical hypotheses, (2) acquiring data, (3) extracting camera distortions using camera calibration, and (4) preprocessing and (5) automating segmentation of the wound to calculate (6) the IPI. Wound segmentation is reviewed by user input, whereas the segmented area can be refined manually. Furthermore, in addition to proof of concept, IPIs’ correlation with C-reactive protein (CRP) levels as a clinical infection marker was evaluated. Based on average CRP levels, the patients were clustered into two groups, on the basis of the separation value of an averaged CRP level of 100. We calculated the IPIs of the 60 wound images based on automated wound segmentation. Average runtime was less than a minute. In the group with lower average CRP, a correlation between IPI and CRP was evident.

Features of the pregnancy and delivery course, fetal and newborn status in women with COVID-19

Research objective. To evaluate the features of pregnancy and delivery course, fetal and newborn status in women with confirmed COVID-19.Materials and methods. A retrospective clinical and statistical analysis of 106 pregnancy and delivery case histories and medical records of newborn from women with a gestation period of 22–41 weeks with a confirmed diagnosis of COVID-19 was carried out. Women were treated and delivered on the temporarily converted beds for providing obstetric care to pregnant women, women in labor and postpartum women with suspected and infected COVID-19 and gynecological patients of Municipal Non-Profit Enterprise “Kyiv City Maternity Hospital No. 3” from September 2020 to May 2021.Results. Delivery took place in 48 women. Women with A (II) blood group were significantly predominant – 51 (48.1%) and rhesus-positive factor – 85 (80.2%) (p &lt; 0.05). One third of pregnant women sought medical help on their own – 34 (32.1%). 94 (88.7%) women had a positive PCR test, in 6 (11.3%) cases the diagnosis was confirmed by a rapid test in the admission department; in 6 (11.3%) cases the test results were negative. The leading complaints when pregnant women were hospitalized were fever, cough and fatigue in 85 (80.2%), 90 (84.9%) and 73 (68.9%) pregnant women respectively (p &lt; 0.05). Almost every third woman (39, 36.8%) had a subfebrile temperature – 37.0–37.5 oC. In 15 (14.1%) patients the temperature was 38.0–38.5 oC, in 6 (5.7%) patients over 38.5 oC. At the lung ultrasound the signs of bilateral and polysegmental pneumonia were diagnosed in 44 (53.6%) and 36 (43.9%) cases. Lower and upper lobe pneumonia was diagnosed in 20 (24.4%) pregnant women. Severe lung damage was detected in 29 (35.4%) pregnant women in the form of partial “hepatization” of lung tissue, pleural effusion in the form of black areas of various sizes in the pleural cavity.Conclusions. The main typical SARS CoV-2 complaints in hospitalized pregnant women were fever, cough, fatigue and shortness of breath at rest and during exercise. Such neurological manifestations of SARS CoV-2 as headache, anosmia were noted by almost every third pregnant woman, and parosmia and myalgia were noted by every fourth pregnant woman. The average level of C-reactive protein was above normal in 97.2% of women. Lung ultrasound allowed clearly identifying areas of damage and determining the degree of lung tissue damage.

Comparing Genetic and Socioenvironmental Contributions to Ethnic Differences in C-Reactive Protein.

C-reactive protein (CRP) is a routinely measured blood biomarker for inflammation. Elevated levels of circulating CRP are associated with response to infection, risk for a number of complex common diseases, and psychosocial stress. The objective of this study was to compare the contributions of genetic ancestry, socioenvironmental factors, and inflammation-related health conditions to ethnic differences in C-reactive protein levels. We used multivariable regression to compare CRP blood serum levels between Black and White ethnic groups from the United Kingdom Biobank (UKBB) prospective cohort study. CRP serum levels are significantly associated with ethnicity in an age and sex adjusted model. Study participants who identify as Black have higher average CRP than those who identify as White, CRP increases with age, and females have higher average CRP than males. Ethnicity and sex show a significant interaction effect on CRP. Black females have higher average CRP levels than White females, whereas White males have higher average CRP than Black males. Significant associations between CRP, ethnicity, and genetic ancestry are almost completely attenuated in a fully adjusted model that includes socioenvironmental factors and inflammation-related health conditions. BMI, smoking, and socioeconomic deprivation all have high relative effects on CRP. These results indicate that socioenvironmental factors contribute more to CRP ethnic differences than genetics. Differences in CRP are associated with ethnic disparities for a number of chronic diseases, including type 2 diabetes, essential hypertension, sarcoidosis, and lupus erythematosus. Our results indicate that ethnic differences in CRP are linked to both socioenvironmental factors and numerous ethnic health disparities.

Clinical analysis of lateral cervical approach in the treatment of cervical lymphatic tuberculosis complicated with parapharyngeal space abscess

Objective:To investigate the clinical effect of lateral cervical approach in the treatment of cervical lymphatic tuberculosis complicated with parapharyngeal space abscess. Methods:A total of 10 patients with cervical lymph node tuberculosis complicated with tuberculous abscess in parapharyngeal space were treated. Surgery was performed using a transcervical approach. The operation time and blood loss were recorded. The level of ESR, C-reactive protein（CRP）, VAS score and the rating of Kubota drinking test before and 2 weeks after operation were compared. The incision healing, symptoms of tuberculosis poisoning, and the CT findings of the cervical lesions were compared before operation, 2 weeks after operation and at the last follow-up. Results:The operation time ranged from 65 to 130 min with an average of （99.00±21.45） min. The intraoperative blood loss ranged from 100 to 250 mL with an average of （155.00±43.78） mL. The average pre-and post-operative level of ESR was （67.60±21.94） mm/1h and （30.30±13.76） mm/1h, respectively（U=5.500, P<0.01）; The average pre-and post-operative level of CRP was （69.70±31.13） mg/L and （42.40±19.70） mg/L, respectively（U=22.500, P<0.05）; The average pre-and post-operative VAS score was （5.60±1.26） points and （2.50±1.27） points, respectively（U=4.500, P<0.01）. As for Kubota drinking test, the rating was between 1-2 two weeks postoperatively. After relieving the compression, there was no obvious choking and coughing in drinking water. During the follow-up period （range: 6-24 months）, the surgical wound healed completely, and the symptoms of systemic tuberculosis poisoning disappeared. No obvious residual cavity or effusion was found in the parapharyngeal space by CT examination, nor was any protruding tissue in oropharynx. The edema of soft tissue surrounding the operational area disappeared, and the enlarged lymph nodes were significantly reduced. No sign of liquefaction, necrosis, suppuration or recurrence was observed. Conclusion:Surgery using transcervical approach effective in treating cervical lymph node tuberculosis with parapharyngeal space abscess.

Transpyloric optic navigation of tumor using a laparoscope during totally laparoscopic distal gastrectomy for gastric cancer.

PurposeThe purpose of this study was to describe the technique of intraoperative transpyloric optic navigation (TPON) and determine its efficacy and feasibility during totally laparoscopic distal gastrectomy (TLDG) in patients with gastric cancer.MethodsSeventy-nine patients who underwent laparoscopic gastrectomy with transpyloric optic localization of the tumor from January 2016 through December 2018 were enrolled in this study. After resecting the first portion of the duodenum, the distal part of the stomach was exteriorized through an extended supraumbilical trocar site, and a balloon trocar was introduced from the pylorus to determine the location of tumor and determine its resection margin. The clinicopathologic and surgical outcomes were analyzed.ResultsThe tumor was located in the lower third of the stomach in 39 cases, the middle third in 34 cases, and the upper-third in six cases. Tumor localization was successful in 67 patients. The mean proximal margin was 41.7 ± 26.8 mm. There was no morbidity related to the technique. By the fifth postoperative day, the average white blood cell count was within the normal range and the average level of C-reactive protein showed a decreasing pattern.ConclusionTPON of the tumor during TLDG is an effective and feasible method to determine the tumor location and to obtain an adequate resection margin.

Inflammatory and hemostatic abnormality in atrial fibrillation patients at tertiary care hospital, Mardan

Objective: To determine the levels of C-reactive protein (CRP) and D-dimers in patients presenting with atrial fibrillation. Study design: Descriptive Cross sectional/Observational. Place and duration of study: From Januarty 2019 to June 2020, the study was carried out in the cardiology and pathology departments of Mardan Medical Complex and Bacha Khan Medical College Mardan. Material and Methods: This study included a total of 100 patients with atrial fibrillation, with 50 people serving as the control group. The levels of CRP and D-dimers were determined in all cases. Results: 35% of the individuals in this study had increased CRP levels. The average CRP level was 2.99 +/- 0.652mg, which was substantially higher than in the control group. Similarly, 45% of patients had an increased D-dimer level. Among these individuals, 30% had D-dimer levels between 250 and 500mg, and 50% had levels between 500 and 1000 ng/ml, which were considerably higher than the control group. Conclusion: According to the findings of the study, atrial fibrillation is related with both inflammatory and coagulation abnormalities, as seen by higher CRP and D-dimer levels. Both these indicators are thromboembolic risk factors.

Evaluation of Low-Dose Ketamine on Inflammatory Biomarker Profile Following Off-Pump Coronary Artery Bypass Grafting

AbstractThe role of ketamine in attenuating the postoperative inflammatory response is a subject of recent clinical interest. Despite several studies elucidating the anti-inflammatory potential of ketamine in on-pump coronary artery bypass grafting and noncardiac surgeries, the literature on the role of ketamine in ameliorating systemic inflammatory response syndrome following off-pump coronary artery bypass grafting (OPCAB) is rather scarce. This prospective observational study was designed to compare the postoperative inflammatory milieu with and without the addition of low dose (0.5 mg/kg) of ketamine to the anesthetic regimen in the patients undergoing OPCAB, wherein 60 patients were allocated to group T, receiving ketamine (n = 30) and the group C, not receiving ketamine (n = 30). The estimated biomarkers included C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), troponin T, and creatine kinase-MB (CK-MB) at the following time points: prior to induction (T0), immediate postoperative period (T1), 4 hours postoperatively (T2), 24 hours postoperatively (T3), and 48 hours postoperatively (T4). The major finding of the study was a significant reduction in the postoperative values of CRP and IL-6 at T1, T2, T3, and T4 (p &lt; 0.001) However, postoperative serum levels of TNF-α, CK-MB, and troponin T were comparable in the group T and group C. The average postoperative CRP and IL-6 levels positively correlated with the VISh (the highest postoperative vasopressor inotrope score) with the r values of 0.733 (p &lt; 0.001) and 0.704 (p &lt; 0.001), respectively. The index study substantiates the anti-inflammatory potential of ketamine in preventing immune function alterations attributable to anesthesia and cardiac surgery.