Blood C-reactive Protein Levels Research Articles

Serum monocyte chemotactic protein 1 and soluble mannose receptor aid predictive diagnosis of pediatric sepsis.

To investigate the value of serum monocyte chemotactic protein 1 (MCP-1) and soluble mannose receptor (sMR) for predictive diagnosis of pediatric sepsis. This study retrospectively analyzed the data of 82 children with acute and severe signs of inflammation. According to the diagnostic criteria of sepsis, these children were divided into a sepsis group (40 cases) and a non-sepsis group (42 cases). In addition, 50 children who received health examinations during the same time period in Cangzhou Central Hospital were selected as a control group. According to the prognosis of the children in the sepsis group, they were further divided into a survival group (33 cases) and a death group (7 cases). The levels of blood indicators, inflammatory markers, liver and kidney function indicators, MCP-1 level, and sMR were collected from the children. The efficacy of using sMR and MCP-1 levels in the predictive diagnosis of sepsis was analyzed by using the area under the ROC curve (AUC). Serum levels of MCP-1 and sMR were (452.32±2.79) μg/ml and (97.23±.15) μg/ml, respectively, in the sepsis group, significantly higher than those in all controls (P<0.001). In the death group, the levels of white blood cells (WBC), C-reactive protein (CRP), procalcitonin (PCT), sMR, and MCP-1 were significantly higher compared to the survival group (P<0.05). The AUC for CRP in predictive diagnosis of sepsis was 0.9075; the AUC for PCT was 0.8759; the AUC for sMR was 0.9244; and the AUC for MCP-1 was 0.9406. Serum sMR and MCP-1 levels can help predict the diagnosis of pediatric sepsis.

Bloodstream Coinfections and Antimicrobial Resistance in Hospitalized COVID-19 Patients: A Single-center Retrospective Study.

Bloodstream infections in patients with COVID-19 are linked to higher mortality rates, whilst data on epidemiology and resistance patterns remains scarce to guide management and prevent antibiotic resistance. This research focuses on the prevalence, clinical features, causative microorganisms, and antimicrobial susceptibility of bacterial and fungal secondary bloodstream co-infections in hospitalized patients with COVID-19. In this retrospective study analysis of 230 patients with COVID-19 from Central Taiwan (June 2021 to June 2022), pathogens were identified via MALDI-TOF MS and Vitek 2 system with Clinical & Laboratory Standards Institute (CLSI) standards. In the cohort, 17.8% experienced bloodstream infections, resulting in a total of 45 isolates from the 41 bloodstream infection patients: predominantly gram-positive bacteria (Staphylococcus and Enterococcus) at 69%, gram-negative at 29% (Escherichia coli and Klebsiella pneumoniae), and fungi at 2%. Infected patients showed significantly elevated levels of white blood count (WBC), C-reactive protein (CRP) and procalcitonin (PCT). Of note, resistance to common antibiotics, such as fluoroquinolones, cephalosporins, and oxacillin was significant, especially in K. pneumoniae, Acinetobacter species, and S. aureus infections. Our study highlights the influence of bacterial infections in hospitalized patients with COVID-19. The bacterial infections were discovered to impact the clinical trajectory of COVID-19, potentially exacerbating or mitigating its symptoms, severity and fatality. These insights are pivotal to addressing clinical challenges in COVID-19 management and underscoring the need for tailored medical interventions. Understanding these co-infections is thus essential for optimizing patient care and improving overall outcomes in the post COVID-19 pandemic era.

Evaluation of the Correlation Between Peripheral Inflammatory Markers and Suicide Risk in Drug-Naive First-Episode Schizophrenia.

Patients with schizophrenia have a higher lifetime prevalence of suicidal behavior (SB) compared to the general population. Therefore, understanding the possible neurobiology of suicide and predicting the risk of suicide in schizophrenia is a solemnly critical issue. 31 drug-naïve first episode schizophrenia (FES) patients with current SB (FES-S), 69 drug-naive patients with first episode schizophrenia without SB (FES-NS), and 69 drug-naïve non-psychotic patients with current SB (NPS) who were diagnosed according to The Diagnostic and Statistical Manual of Mental Disorders - 5 (DSM-5) participated the study. The control group (HC) consisted of 127 individuals matched with the patients. Symptoms at the time of evaluation were assessed using The Positive and Negative Syndrome Scale (PANSS) and Columbia Suicide Severity Rating Scale (CSSRS). Blood samples were collected from all participants to determine White blood cell (WBC), neutrophil, monocyte, albumin, C-reactive protein (CRP), Lymphocyte, and Platelet levels and to measure this protein ratio. The blood levels of WBC, neutrophil, monocyte, albumin, CRP, and Neutrophil/Albumin Ratio (NAR) were higher in all patient groups compared to HC. CRP/Albumin Ratio (CAR) value was observed to be highest in the NPS group. Monocyte/Lymphocyte Ratio (MLR) value was significantly higher in patients with FES compared to HC. There were no significant differences between the FES-S group and the FES-NS and NPS groups. It can be suggested that although inflammation is not a predictor for suicide attempts in schizophrenia, it is associated with the degree of suicide risk in schizophrenia. In addition, the strong relationship between suicide and psychiatric disorders can be the main reason for high peripheral inflammation levels in suicidal patients.

Severe Respiratory Syncytial Virus Infections in Elderly Persons During the COVID-19 Pandemic.

Respiratory syncytial virus (RSV) is a pathogenic respiratory virus that is considered to affect not only children but also adults, especially elderly persons aged ≥65 years. However, in Japan, the annual epidemic situation and severity of RSV infections in these adults have not yet been clarified, especially during the COVID-19 pandemic. The epidemic of RSV, especially the number of adults with RSV infection during the COVID-19 period, was retrospectively analyzed. In addition, the clinical features of patients aged ≥65 years (older group) and those aged ≤64 years (younger group) were compared. A total of 58 patients were found to have RSV infections from April to August 2021. Ten were adults, and five each were detected in June and July, respectively. Of the 10 adult patients, three were in the older group and were more often infected by their grandchildren, and seven were in the younger group. All older patients had underlying diseases, including diabetes mellitus. In addition, the older group showed more severe inflammation, such as increased white blood cell counts and C-reactive protein levels, and received antibiotic therapy, whereas no antibiotics were used for the younger group. Two of the three older patients were admitted to our hospital, but survived. These data suggest that RSV infection in adult patients was related to the increase in pediatric RSV patients and that the infection season had shifted to summer, similar to other countries. Among the adult RSV patients, those aged ≥65 years were more often infected by their grandchildren and received antibiotics because of their more severe inflammatory status than patients aged ≤64 years during the COVID-19 pandemic in Japan.

Effects of rapid weight loss on the body composition and pathophysiological mechanisms involved in obesity.

The Japan Society for the Study of Obesity recommends a weight loss of 3% of body weight over a period of 3-6 months. However, the effects of rapid weight loss on the body composition have not yet been adequately studied. Therefore, we observed the changes in the body composition induced by rapid weight loss and its effects on the pathophysiological mechanisms involved in obesity. The subjects were people with obesity admitted to our institution. The goal was to achieve a 3-5% body weight loss in the subjects by combining a carbohydrate-controlled therapeutic diet of 25-30 kcal/day per kg target body weight, exercise therapy, and pharmacotherapy. The body composition was measured at admission and at discharge by the dual bioelectrical impedance analysis. After 2 weeks, the participants' body weight decreased by 4.2%; the visceral fat area decreased by 16.7%, the subcutaneous fat area by 2.4%, and the lean area by 4.0%. The moderate weight loss, moderate energy restriction and adequate protein intake significantly reduced the visceral fat area while allowing the lean area to be preserved. Improvements were also noted in the peripheral white blood cell count and C-reactive protein level. However, no statistically significant changes in homeostasis model assessment for insulin resistance and the adiponectin level were noted. Regarding clinical parameters, improvements of the systolic and diastolic blood pressures, fasting plasma glucose, triglycerides, low-density lipoprotein cholesterol, and degree of microalbuminuria were observed. Short-term comprehensive treatment produced beneficial body composition changes, and improvements in the pathophysiological mechanisms involved in obesity.

The significance of early-onset malignant arrhythmias in ST-elevation myocardial infarction patients treated with primary percutaneous coronary intervention and their relationship with biomarkers

Background/Aim. Patients who were treated with primary percutaneous coronary intervention (pPCI) and survived ventricular tachycardia (VT) and ventricular fibrillation (VF) in the first 48 hrs after ST-elevation myocardial infarction (STEMI) had, in most investigations, a similar long-term prognosis of the outcome, compared to those patients who did not have VT and VF during the first 48 hrs after STEMI. The aim of the study was to determine the association of myocardial infarction markers: creatine kinase-MB fraction (CK-MB), heart failure marker ? B-type natriuretic peptide (BNP), and systemic inflammation factor ? C-reactive protein (CRP) with early VT and VF onset, in relation to patient mortality during the first six months after STEMI. Methods. The retrospective study included 971 patients with STEMI treated with pPCI for ten years. VF and sustained VT (sVT) were detected outside of the hospital and during the first 48 hrs of hospitalization. Results. During the first 4 8 hrs from admission, 1 08 ( 11.1%) patients had life-threatening arrhythmias, of which 75 (69.4%) had VF, and 33 (30.6%) had sVT and were treated with direct current ? DC shock and intravenous amiodarone. Intrahospital mortality was significantly higher in patients with VF/sVT in the first 48 hrs compared to patients without VF/sVT (14.8% vs. 5.7%, p = 0.001). BNP level had higher accuracy in the prediction of six-month death than the maximum blood level of CRP in patients without VF/sVT after 48 hrs. However, in patients with early-onset malignant arrhythmias, BNP showed a lower level of accuracy in predicting the six-month mortality, a s did the CRP values, which had almost the same level of accuracy. Admission glycemia had a much lower predictive value in both groups of patients compared to BNP and C RP [ 0.705 ( 0.628? 0.781), p &lt; 0.001 and 0.662 (0.521?0.803), p = 0.046, respectively]. In either of the groups, maximum CK-MB levels were not significant in predicting the six-month all-cause mortality. Conclusion. Our study indicates that STEMI patients with early onset of VF and sVT, treated with pPCI, with a high BNP level, have a statistically significantly higher mortality rate compared to patients with a lower BNP level.

The effect of crude extract of Cyathula prostrata leaves on serum c-reactive proteins levels of normal albino Wistar rats after an administration period of 7 days

Food fortification is considered a sustainable public health strategy because it can reach wider populations through existing food delivery systems without requiring major changes in existing consumption patterns (Das et al., 2013.). C-reactive Protein (CRP) is a major acute phase reactant synthesized primarily in the liver hepatocytes. CRP shows the strongest association with cardiovascular events. It is detectable on the surface of about 4% of normal peripheral blood lymphocytes. This research was designed to study the effects of the administration of graded doses (100mg/kg and 200mg/kg) of crude extracts of Cyathulaprotrata leaves on albino Wistar rats after a period of 7 days. The animals were sacrificed after the experimental period and blood collected and prepared for analysis to access the level of blood C-reactive protein. After the study, it was observed that the blood C-reactive protein levels for groups II and III animals were elevated significantly, indicating that there was tissue damage due to toxicity of xenobiotics. This research has led to the conclusion that the consumption of Cyathulaprostrata leaves extract was safe though it generated oxidative stress. Results show that experimental animals of group II, and III indicated elevated C-reactive protein levels (3.21±0.19 and 3.14±1.11 mg/dL respectively) significantly at p&lt;0.5 when compared to experimental animals of group 1 (control, 2.38±1.04 mg/dL) significantly at p&lt;0.05.

Correlation of lymphocyte subsets and inflammatory biomarkers with disease severity in COVID-19 patients.

To determine the correlation of lymphocyte subsets and soluble serum inflammatory biomarkers with disease severity in coronavirus disease-2019 infection. The retrospective study was conducted at the Department of Immunology, Sindh Institute of Urology and Transplantation (SIUI), Karachi, Pakistan from September 1 to November 30, 2021, and comprised data of patients admitted from June to July 2021 who tested positive for coronavirus disease-2019 on the basis of reverse transcription-polymerase chain reaction of nasopharyngeal swab specimens. The patients were categorised into severe group A and non-severe group B. Initial investigations included complete blood count, neutrophil-to-lymphocytes ratio, C-reactive protein, D-Dimers and serum ferritin levels. Lymphocyte subsets included cluster of differentiation-3+, cluster of differentiation-4+/ cluster of differentiation-3+, cluster of differentiation-8+ T lymphocytes, cluster of differentiation-19+B lymphocytes, cluster of differentiation-16+ cluster of differentiation-56+ Natural Killer cells and serum cytokine levels of interleukin-2, interleukin- 4, interleukin-6, interleukin-10, tumour necrosis factor-alpha and interferon gamma. They were correlated with disease severity. Data was analysed using SPSS 20. Of the 54 patients, 33(61.1%) were males and 21(38.9%) were females. There were 29(53.70%) patients in group A with median age 52 years (interquartile range: 43.5-65 years), and 25(46.29%) in group B with median age 50 years (interquartile range: 36.5-59 years) (p=0.241). Disease was significantly more severe in male patients compared to female (p=0.002). In group A, cluster of differentiation-3+ T cells were reduced in 21(72.4%) patients, cluster of differentiation-8+ T cells in 16(55.2%), cluster of differentiation-4+ T cells in 23(79.3%) and cluster of differentiation-19+ B cells in 8(27.6%). In group B, cluster of differentiation-3+ T cells were reduced in 10(40%) subjects, cluster of differentiation-8+ T cells in 7(28%), cluster of differentiation-4+ T cells in 12(48%) and cluster of differentiation-19+ B cells in 4(16%) patients. Serum cytokine levels were not significantly different between the groups (p>0.05). In group A, 7(24.13%) patients died, and in such cases, the neutrophil-to-lymphocytes ratio was significantly higher (p=0.037). Pro-inflammatory markers and cytokine levels increased, while lymphocyte subsets decreased with increasing severity of the disease.

Systematic review of risk factors and outcomes of post-implantation syndrome following endovascular aortic repair

ObjectivePost implantation syndrome (PIS) is an early systemic inflammatory response following endovascular aortic repair (EVAR). The response is variable in patients and the clinical significance of PIS upon outcomes is unknown. This study aims to evaluate the incidence, risk factors, and prognostic implication of PIS. MethodsSystematic literature review and analysis was performed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and Cochrane guidelines of PubMed, Scopus, ClinicalTrials.gov, and the Cochrane Central Register of Controlled Trials. Eligible English-language studies regarding PIS after infrarenal EVAR were included, after removing duplicates. ResultsAfter screening, 31 studies were included. A total of 2847 patients were reviewed, with mean age of 70.7 years, of which 2012 (90.4%) were male, with a pooled mean follow-up of 26.1 months. PIS was reported in 25.3% of cases, with mean aneurysm diameter of 56.4 cm. Polytetrafluoroethylene (PTFE) grafts were utilized in 794 patients (27.9%) with polyester in 1839 (64.6%). White blood cell count, C-reactive protein, interleukin (IL)-6, IL-8, and IL-10 levels were all significantly elevated postoperatively. Thirty-day outcomes included type I endoleak rate of 0.8%, type II endoleak rate of 1.7%, reintervention rate of 0.35%, and mortality rate of 0.25%. Subgroup pooled analysis of patients with PIS (n = 309) vs No-PIS (n = 691) revealed that polyester (n = 642), rather than PTFE (n = 234) grafts, were associated with a higher rate of PIS (94.8% vs 3.7%; P = .0001), White blood cell count was higher in the PIS group both preoperatively (7.61 vs 6.76 × 109/L; P = .04) and postoperatively (15.0 vs 9.8 × 109/L; P = .0007) and IL-6 levels were higher in the PIS group postoperatively (98.6 vs 25.2 pg/mL; P = .02). Aneurysm diameter and amount of chronic or new thrombus within the aneurysm sac was not identified as a risk factor for PIS. Pooled outcomes of patients with PIS vs No-PIS demonstrated a significantly higher rate of 30-day mortality (0.6% vs 0%; P = .03) and major adverse cardiac events (5.8% vs 0.43%; P < .0001) without any differences seen in reintervention or 30-day type I or type II endoleaks. ConclusionsThis systematic review suggests that polyester grafts are strongly associated with PIS compared with PTFE. Interestingly, this report is suggestive of an association between 30-day mortality and major adverse cardiac events and PIS. Given these clinical sequelae, consideration for use of PTFE over polyester grafts to reduce the incidence of PIS may be a simple step to improve overall outcome. Further, exploration of the relationship between inflammatory mediators associated with PIS and mortality and cardiac complications may engender deeper understanding of risks, leading to eventual mitigation of harm for patients experiencing PIS.

Changes in the levels of WBC count, PCT, CRP and ESR in Patients with acute Community-acquired Lower Respiratory tract infections and their diagnostic value.

To investigate the levels of white blood cell count (WBC), procalcitonin (PCT), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) in patients with acute community-acquired lower respiratory tract infections and the value of their combined detection in predicting the occurrence of complications. A retrospective analysis was conducted on the clinical data of 218 patients with acute community-acquired lower respiratory tract infections admitted to Baoding No.1 Central Hospital from January 2021 to December 2021. All patients were divided into two groups according to the presence of complications during treatment: the group with complications (observation group) and the group without complications (control group). The treatment situation of the two groups was compared, and their levels of WBC, PCT, CRP and ESR were quantitatively detected and compared. Patients in the observation group were hospitalized for significantly longer days than those in the control group (P<0.05), and their combined pleural effusion percentage and oxygen uptake rate were higher than those in the control group (P<0.05). The levels of WBC, PCT, CRP and ESR in the observation group were significantly higher than those in the control group at admission, with statistically significant differences (P<0.05). Moreover, the positive rates of WBC, PCT, CRP and ESR in the observation group were higher than those in the control group in the single detection and the combined detection (P<0.05). The combined detection of WBC, PCT, CRP and ESR has substantial predictive value in predicting the occurrence of complications in patients with community-acquired lower respiratory tract infections.

The relationship between blood biochemical parameters and oral health in children with obesity/overweight.

Aim The purpose of this study was to evaluate the effects of obesity and overweight on the oral/dental health and blood biochemistry parameters in children.Methods A total of 87 children (29 boys, 58 girls) aged 1-18 presenting to our paediatric endocrinology outpatient clinic were included in the study. The patient group consisted of children with obesity/overweight and the control group consisted of children with normal weight. Paediatric patients were examined simultaneously by a paediatrician and a paediatric dentist. Oral/dental health examinations of all children included in the study were performed by a specialist paediatric dentist and dmft/DMFT (decayed, missing and filled teeth) values were calculated separately in the mixed dentition period. The Community Periodontal Index of Treatment Needs 23 index and the dental plaque 35 index were evaluated at oral/dental health examinations. Oral and dental health examination findings and blood biochemistry parameters were compared between the two groups.Results While DMFT, dental plaque index, blood c-reactive protein (CRP) and parathyroid hormone (PTH) levels were significantly increased in children with overweight/obesity compared to children with normal weight, there was no difference in terms of daily toothbrushing habits and last dental examination times. Overweight/obesity was found to be associated with the dental plaque and DMFT/dmft index, and elevation in the blood biochemistry parameters CRP and PTH among the children in this study.Conclusion The observation of significant elevation in DMFT and dental plaque indices and numbers of filled deciduous teeth showed that oral/dental health problems and dental decay may emerge more frequently in children with overweight/obesity. Children with overweight should be routinely provided with dental care as part of a multidisciplinary team that includes paediatricians and dentists.

Usage of antimicrobials in patients having intricate clean-contaminated head and neck surgeries.

Objective: The goal of this study is to characterize, the infectious complications and to identify the risk variables most frequently linked, after head and neck surgeries.Methodology: 47 patients who underwent major clean-contaminated head and neck surgery between 2019 and 2022 at the cervicomaxillofacial Surgery Department (Saint-Pierre Hospital) were the subject of a prospective cohort analysis. Two groups of patients were created: group I received a postoperative antibiotic regimen for just 24 hours; group II re-ceived a longer postoperative antibiotic course lasting more than 24 hours. Amoxicillin and clavulanate were given intra-venously 30 to 60 minutes before making the incision as antibacterial precautions. Following surgery, the antibiotic course was maintained. Univariate analysis was used to assess the predictive importance of the antibiotic regimen on postoperative outcomes, including clinical symptoms of infection and biological indicators like the white blood cell count and C-reactive protein levels was evaluated using univariate analysis.Results: 18 patients experienced SSIs. Antibiotics were used to treat each of these grade 2 illnesses. Only a history of hypothyroidism appears to be a predictor of SSI after univariate analysis (P = 0.038). When we compared the patients who received antibiotics for 24 h or more, there was no discernible difference in terms of onset and hospital stay. Addi-tionally, neither group had a different rate of germs that were multidrug resistant.Conclusion: Our findings imply that using postoperative antibiotics for more than 24 hours has no positive effects on SSI.&#x0D; Key words: Cervico-maxillofacial Surgery, clean contaminated surgery, antimicrobials, Surgical Site Infection.

Assessing the associations between plasma C reactive protein, Ab 42/40 ratio, global amyloid and entorhinal tau PET

AbstractBackgroundLower plasma ratio of amyloid beta (Ab42/Ab40) has been associated with brain amyloid, however, the mechanistic link is unclear. Systemic inflammation may contribute to plasma Ab levels and promote or reduce the accumulation of Alzheimer’s disease (AD) neuropathology. C reactive protein (CRP) is an inflammatory marker implicated in amyloidosis. Using a cross sectional analysis, we evaluated the relationship between blood levels of CRP and Ab ratio, global amyloid positron emission tomography (PET), and tau PET in the entorhinal cortex where tau accumulates early. We hypothesized that Ab positivity would modify the relationship between CRP and AD pathology.MethodIn 969 cognitively normal participants (age: 50‐87, 781 Ab‐/188 Ab+) (Table 1) from the Health and Aging Brain Study‐ Health Disparities (HABS‐HD), we acquired 18F‐PI‐2620 tau‐PET, florbetaben amyloid PET scans, and plasma measures of Ab 42/40 and CRP. Subjects were categorized by Ab + or Ab ‐ by a global amyloid PET standardized uptake value ratio (SUVR) cutoff of 1.08. Within Ab groups, we performed multiple regressions to evaluate associations between 1) global amyloid and entorhinal tau‐PET SUVRs and 2) plasma markers of Ab ratio and CRP. We covaried for age, gender, education, APOE4, and scanner and used false discovery rate (FDR) for multiple comparison corrections.ResultIn Ab+ participants, higher amyloid (b = ‐0.31, p = 0.0005) and tau PET (b = ‐0.36, p = 0.004) were significantly associated with low Ab ratio, but not in Ab‐ for amyloid or tau, with significant interactions by Ab positivity for amyloid (b = ‐0.45, p = 2.65×10−6) and tau (b = ‐0.77, p = 0.0002) (Figure 1). In Ab+ participants, higher CRP was associated with higher Ab ratio (b = 0.21, p = 0.04) and a trend toward lower amyloid (b = ‐0.15, p = 0.084) and tau PET (b = ‐0.22, p = 0.084), but not in Ab‐ participants, with a significant interaction by Ab positivity for Ab ratio (b = 0.46, p = 0.011) (Figure 2) and amyloid (b = ‐0.11, p = 0.0006) and tau PET (b = ‐0.17, p = 0.016).ConclusionIn cognitively intact Ab+ but not Ab‐ adults, higher plasma Ab ratio was associated with lower global amyloid and entorhinal tau PET. In Ab+ participants, higher CRP was associated with blood and brain amyloid and tau levels consistent with less AD pathology.

Obesity Is Associated with a Weakened Gingival Inflammatory Cytokine Response.

Background and Objectives: An obesity-related elevated body mass index (BMI) across life is associated with chronic low-grade inflammation and increased levels of C-reactive protein (CRP) in blood. CRP is a marker and promoter of inflammation. The objectives of this study were to examine the effect of obesity on the relationship between peripheral and gingival CRP levels and to examine the effects of gingival CRP levels on gingival fluid inflammatory cytokines in periodontitis-resistant obese individuals. Materials and Methods: Thirty-nine participants in good periodontal health were recruited. Twenty patients were classified as lean and nineteen as obese based on their BMI levels. A thorough periodontal assessment was carried out. Gingival crevicular fluid (GCF) and blood samples were collected. Both GCF and blood samples were analyzed for interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10), interleukin-17A (IL-17A), and CRP. Results: GCF CRP levels were significantly higher in the obese than in the lean individuals. No statistically significant differences were noted between the two groups in either GCF or blood in terms of any of the inflammatory cytokine levels. IL-17A was not detected in the GCF of most subjects in both groups. GCF CRP levels were positively associated with blood CRP levels, and the association tended to be stronger in the obese individuals. GCF CRP showed no associations with GCF IL-10 in both groups. Although GCF CRP levels were positively associated with multiple GCF inflammatory cytokines (e.g., IL-1β, IL-6, IL-8, and TNF-α) in all subjects, the associations tended to be weaker in the obese individuals (e.g., IL-1β, IL-6, and TNF-α). Furthermore, the levels of the GCF inflammatory cytokines IL-6 and TNF-α were decreased in the obese individuals. Conclusions: Obesity unfavorably influences the relationship between blood and GCF CRP levels and promotes increased CRP levels in GCF. Collectively, the findings suggest a weakened inflammatory cytokine response in the gingival tissues of obese individuals.

The association between dietary inflammatory index and C-reactive protein in plasma and semen with semen quality: A cross-sectional study

Background: Infertility affects couples worldwide, with male factors being responsible for half of all cases.&#x0D; Objective: This study aimed to investigate the relationship between dietary inflammatory index (DII) and levels of C-reactive protein (CRP) in plasma and semen with the quality of semen in infertile males.&#x0D; Materials and Methods: In this cross-sectional study, 88 infertile men referring to Besat hospital, Tehran, Iran from December 2021-November 2022 were enrolled. A detailed questionnaire requesting information, and a 168-item semiquantitative food frequency questionnaire, were completed by participants. A food frequency questionnaire was used to calculate the DII. Additionally, semen and blood samples were collected from each participant for semen analysis and CRP-level assessment. Statistical analyses were performed to explore the association between DII and CRP levels with sperm quality. The correlation between DII and serum/semen CRP, besides assessing nutrients in each DII quartile group, was also explored.&#x0D; Results: A significant difference was observed between different DII quartiles considering sperm motility (p = 0.006) and morphology (p = 0.014). Post hoc study revealed a significant difference between the 1st and 2nd quartiles and the 1st and 4th quartiles of DII regarding sperm motility (p = 0.011, and 0.017 respectively) and a significant difference between the 1st and 2nd quartiles of DII considering sperm morphology (p = 0.009). A statistically significant inverse correlation was also observed between DII and sperm motility (p = 0.017). Carbohydrates and β-carotenes were significantly different between the 4 DII quartiles (p = 0.043 and p = 0.026, respectively). Finally, no significant correlation was observed between DII and CRP levels in blood and semen (p &gt; 0.05).&#x0D; Conclusion: The findings suggested a notable correlation between DII and semen quality; however, no significant association were observed between DII and CRP levels in blood and semen.&#x0D; Key words: Infertility, C-reactive protein, CRP, Inflammation, Sperm.

Clinical Characteristics and Diagnostic Prediction of Severe Fever with Thrombocytopenia Syndrome and Rickettsiosis in the Co-Endemic Wakayama Prefecture, Japan.

Background and Objectives: The Wakayama prefecture is endemic for two types of tick-borne rickettsioses: Japanese spotted fever (JFS) and scrub typhus (ST). Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne hemorrhagic viral disease with a high mortality rate and is often difficult to differentiate from such rickettsioses. SFTS cases have recently increased in Wakayama prefecture. For early diagnosis, this study aimed to evaluate the clinical characterization of such tick-borne infections in the co-endemic area. Materials and Methods: The study included 64 febrile patients diagnosed with tick-borne infection in Wakayama prefecture between January 2013 and May 2022. Medical records of 19 patients with SFTS and 45 with rickettsiosis (JSF, n = 26; ST, n = 19) were retrospectively examined. The receiver operating curve (ROC) and area under the curve (AUC) were calculated to evaluate potential factors for differentiating SFTS from rickettsiosis. Results: Adults aged ≥70 years were most vulnerable to tick-borne infections (median, 75.5 years; interquartile range, 68.5-84 years). SFTS and rickettsiosis occurred mostly between summer and autumn. However, no significant between-group differences were found in age, sex, and comorbidities; 17 (89%) patients with SFTS, but none of those with rickettsiosis, experienced gastrointestinal symptoms such as vomiting, abdominal pain, and diarrhea. Meanwhile, 43 (96%) patients with rickettsiosis, but none of those with SFTS, developed a skin rash. The AUCs of white blood cells (0.97) and C-reactive protein (CRP) levels (0.98) were very high. Furthermore, the differential diagnosis of SFTS was significantly associated with the presence of gastrointestinal symptoms (AUC 0.95), the absence of a skin rash (AUC 0.98), leukopenia <3.7 × 109/L (AUC 0.95), and low CRP levels < 1.66 mg/dL (AUC 0.98) (p < 0.001 for each factor). Conclusions: Clinical characteristics and standard laboratory parameters can verify the early diagnosis of SFTS in areas where tick-borne infections are endemic.

Comparative Analysis of Antibiotic Resistance in Acute Cholangitis Patients with Stent Placement and Sphincterotomy Interventions.

In response to rising concerns over multidrug resistance patterns in acute cholangitis patients, this retrospective study was conducted at the Emergency County Hospital Timisoara, Romania, encompassing patients treated between August 2020 and August 2023. The study aimed to investigate the influence of prior interventions, specifically sphincterotomy (with or without stent placement), on the current clinical and microbiological profiles of acute cholangitis patients. By differentiating between patients with a history of sphincterotomy and the endoscopic retrograde cholangiopancreatography (ERCP)-naïve, we assessed the resistance of bacterial strains to antibiotics by the Tokyo Guidelines 2018, using bile cultures from 488 patients. The study identified various multidrug-resistant organisms, with a total multidrug resistance incidence of 19.9%. Significant variations were observed in the distribution of specific microorganisms and resistance patterns across different intervention groups. Patients with previous interventions, particularly those with both sphincterotomy and stent, exhibited elevated white blood cells (WBC) and C-reactive protein (CRP) levels in comparison to their ERCP-naïve counterparts. This group also presented a striking prevalence of two bacteria in their bile cultures at 50.0%, compared to 16.1% in ERCP-naïve individuals. Regarding multidrug resistance, the prior sphincterotomy with stent placement had a prevalence of 50.0%. The presence of ESBL bacteria was also significantly higher in the same group at 28.7%, contrasting with the 8.9% in ERCP-naïve patients. Additionally, the same group had a higher burden of Klebsiella spp. infections, at 37.2%, and Enterococcus spp. at 43.6%. On the antibiotic resistance front, disparities persisted. Piperacillin/Tazobactam resistance was notably more rampant in patients with a previous sphincterotomy and stent, registering at 25.5% against 11.1% in the ERCP-naïve group. This study underscores a substantial discrepancy in multidrug resistance patterns and antibiotic resistance among acute cholangitis patients with previous manipulation of the bile ducts, without expressing significant differences by the type of stent used.

Serum calprotectin as a marker of neonatal sepsis: a hospital-based cross-sectional diagnostic study

Background Despite significant advances in neonatal care, neonatal sepsis remains a major contributor to mortality, morbidity, and protracted hospitalization. The development of early possible diagnostic indicators for newborn sepsis is critical. Since calprotectin participates in major biological processes, it could be a diagnostic marker for infection/inflammation. This study aimed to estimate serum calprotectin in neonates with clinical sepsis. In addition, we compared serum calprotectin with standard sepsis markers and serum procalcitonin to evaluate its diagnostic accuracy. Methods A hospital-based cross-sectional diagnostic study of neonates identified with clinical sepsis using standard criteria was carried out. We compared estimated serum calprotectin levels to serum procalcitonin levels and conventional sepsis markers (leucocyte count, blood culture, immature to total neutrophil ratio, and C- reactive protein). We used SPSS version 25 to analyze the data. To examine diagnostic accuracy and determine a cut-off value for serum calprotectin, we used the receiver operating characteristics (ROC) curve. Results Of the 83 subjects included, 36.5% (30/83) had blood culture positive status, the median value of serum calprotectin being 0.93 ng/ml (0.67 to 1.3). Respiratory, cardiovascular, and gastrointestinal instabilities were present in 67.5% (56/83), 59% (49/83), and 50.1% (42/83) cases, respectively. The median values of serum calprotectin, procalcitonin, TLC, and I/T ratio between neonates withpositive blood culturesand negative culturesdid not differ significantly.. On ROC, calprotectin was not predictive for blood culture positivity (sensitivity: 50%; specificity: 44% at 0.83 ng/ml of serum calprotectin) and C-reactive protein (CRP) levels (sensitivity: 57%; specificity: 67% at serum calprotectin levels of 0.89 ng/ml). However, compared with serum procalcitonin, serum calprotectin at 1.2 ng/ml had sensitivity and specificity of 60% and 73%, respectively. Conclusions Serum calprotectin did not show a distinct advantage over the existing sepsis markers. Serum calprotectin level at 1.2 ng/ml had a sensitivity and specificity of 60% and 73%, respectively, compared to serum procalcitonin in detecting neonatal sepsis.

Differential diagnosis for multiple systemic inflammatory syndrome in children: clinical and laboratory clues

Objectives: We aimed to identify biochemical markers and clinical findings with high sensitivity and specificity that can be used in the differential diagnosis of patients suspected of having Multisystem Inflammatory Syndrome in Children (MISC) in the pediatric emergency department (PED). Moreover, we also examined early warning signs for predicting severe MIS-C patients requiring admission to intensive care unit (ICU). Methods: We conducted a retrospective analysis of patients presenting to the PED with suspected MIS-C. Patient records were assessed for initial complaints, physical examination findings, laboratory and ımaging test results, diagnoses, and follow-up plans. Patients diagnosed with MIS-C were categorized as the MIS-C group, while others were categorized as the non-MIS-C group. Comparisons were made between these two groups. Results: A total of 266 patients were included, with 68 diagnosed with COVID-19-associated MIS-C, including 20 monitored in the pediatric ICU. MIS-C patients had higher mean age, hospitalization, and ICU admission rates compared to non-MIS-C. MIS-C group showed higher prevalence of respiratory symptoms, hematological involvement, and shock. We observed lymphopenia, thrombocytopenia, hyponatremia, and elevated levels of blood C-reactive protein (CRP), procalcitonin, triglycerides, troponin, Brain Natriuretic Peptide (BNP), D-dimer, and fibrinogen in the MIS-C group. ICU patients had higher procalcitonin, aspartate aminotransferase, alanine aminotransferase, triglycerides, troponin, BNP, and ferritin levels, and lower sodium levels. Conclusions: COVID-19-associated MIS-C group had higher rates of respiratory symptoms, hematological involvement, and shock. Lymphopenia, thrombocytopenia, elevated CRP, and D-dimer can guide MIS-C differential diagnosis. Additional tests (procalcitonin, troponin, BNP, triglycerides, ferritin) are recommended for high-suspicion cases. Patients with elevated BNP levels may require ICU admission.

Pistia stratiotes has renoprotective potentials in ischemia reperfusion injury in normal and diabetic rats.

Even though oxidative and inflammatory bursts are a big part of renal reperfusion injury (RI/R), Pistia stratiotes (PS) has been used for a long time to stop these overreactions. People have said that it can drop both blood sugar and cholesterol. Hence, the goal of this study was to show how PS changed kidney reperfusion damage in both diabetic and normal rats. In the study, 30 min of renal ischemia (RI) was followed by 1 h of recovery for each rat. Before the test, PS (100 mg/kg p. o.) was given to the animals for 7 days. Then, using the mixture from the separated kidney tissues, the antioxidant, inflammation, and histopathological effects were determined. When compared to RI/R, diabetic rats given PS had lower blood sugar, aspartate aminotransferase, blood urea nitrogen, and creatinine, myeloperoxidase, C-reactive protein, and tumor necrosis factor-alpha levels in their urine. PS potentially worked in hyperglycemic rats protecting them against RI/R. It is possible that PS's ability to protect the kidneys of the test rats is due to its ability to fight free radicals, lower blood sugar, and stop inflammation.