C-reactive Protein Levels In Patients Research Articles

Increased C-Reactive Protein in Patients with Post-Stroke Depression: A Meta-analysis of Cohort Study.

Pathophysiological mechanisms and related biological markers for post-stroke depression (PSD) are unknown. Some studies have noted that C-reactive protein (CRP) is activated in the serum of PSD patients. We aim to quantitatively summarize the concentrations of CRP in PSD patients compared to non-PSD patients. Original studies evaluating the association between CRP and PSD were searched in 4 specific databases from the establishment of the databases to March 2023. RevMan 5.20 and Stata 11.0 statistical software were used for meta-analysis. Publication bias was tested by Egger's test. The CRP level were combined by standardized mean difference (SMD) with 95% confidence interval (CI). A total of 43 relevant literatures were retrieved, while 13 cohort studies were collected. The heterogeneity test result of the level of CRP in patients with PSD vs. non-PSD was (Q = 98.38, P < .001, I2 = 88%). The combined value of the estimated effect was [SMD = 0.34, 95% CI (0.12-0.56); P = .003]. Sensitivity analysis indicated that no study had a remarkable influence on the result of the pooled estimate. Egger's test was used to test the bias and the result was (Egger's test, P = .548), suggesting that there was no publication bias, and the results were credible. We found that different depression evaluation criteria (P = .035) and stroke types (P = .024) were considered as influencing factors for potential sources of heterogeneity. In conclusion, compared to those without depressive symptoms, patients with post-stroke depression have higher concentrations of CRP in the blood.

All that Glitters Is not Gold: Type-I Error Controlled Variable Selection from Clinical Trial Data.

Clinical trials are primarily conducted to estimate causal effects, but the data collected can also be invaluable for additional research, such as identifying prognostic measures of disease or biomarkers that predict treatment efficacy. However, these exploratory settings are prone to false discoveries (type-I errors) due to the multiple comparisons they entail. Unfortunately, many methods fail to address this issue, in part because the algorithms used are generally designed to optimize predictions and often only provide the measures used for variable selection, such as machine learning model importance scores, as a byproduct. To address the resulting unclear uncertainty in the selection sets, the knockoff framework offers a model-agnostic, robust approach to variable selection with guaranteed type-I error control. Here, we review the knockoff framework in the setting of clinical data, highlighting main considerations using simulation studies. We also extend the framework by introducing a novel knockoff generation method that addresses two main limitations of previously suggested methods relevant for clinical development settings. With this new method, we empirically obtain tighter bounds on type-I error control and gain an order of magnitude in computational efficiency in mixed data settings. We demonstrate comparable selections to those of the competing method for identifying prognostic biomarkers for C-reactive protein levels in patients with psoriatic arthritis in four clinical trials. Our work increases access to the knockoff framework for variable selection from clinical trial data. Hereby, this paper helps to address the current replicability crisis which can result in unnecessary research efforts, increased patient burden, and avoidable costs.

Utilizing procalcitonin, C-reactive protein, and serum amyloid A in combination for diagnosing sepsis due to urinary tract infection.

In this study, we aimed to evaluate the combined diagnostic value of procalcitonin (PCT), C-reactive protein (CRP), and serum amyloid A (SAA) in sepsis caused by urinary tract infection. A total of 80 patients with urosepsis who were hospitalized were included in the study group, and 80 patients with urinary tract infection without sepsis were included in the control group. We collected the PCT, SAA, and CRP levels of patients following admission. Subsequently, we conducted a comparative analysis to assess the specificity, accuracy, and sensitivity of combined diagnostic approaches in contrast to individual diagnostic methods for blood PCT, SAA, and CRP. The levels of PCT, SAA, and CRP in the study group were significantly higher than those in the control group, and the differences were statistically significant (P < 0.01). Multi-factor logistic regression analysis revealed that the levels of PCT (P = 0.003) and SAA (P = 0.014) were associated with urosepsis. The sensitivity of PCT was 87.133% and the specificity was 93.066%, which were higher than that of SAA and CRP. The specificity of the combined detection of the three was 95.670%, which was higher than that of PCT, SAA, and CRP alone. Correlation analysis revealed that PCT had a significant positive correlation with CRP and SAA (P < 0.01), and a weak correlation with white blood cell count (WBC) and fibrinogen (FIB) (P = 0.03 for WBC, P = 0.04 for FIB). PCT, SAA, and CRP indicators in patients with urosepsis are significantly elevated, and all three are valuable in the diagnosis of urosepsis. PCT alone has good diagnostic efficiency for urosepsis, and a certain correlation with other inflammatory factors. The diagnostic efficacy of the three indicators in combination is better than that of any one of the three, and is worthy of widespread clinical application.

Early Predictors of Fistula Formation Following Head and Neck Reconstruction.

Salivary fistula formation is a common and serious complication following head and neck reconstruction. Because it can cause delayed wound healing and infection and carotid artery rupture in severe cases, hence, early detection and treatment are crucial. This study was designed to identify early predictors of postoperative fistula formation. We conducted a retrospective analysis of patients who underwent head and neck reconstruction between 2015 and 2022. Body temperature, serum white blood cell (WBC) count, and serum C-reactive protein (CRP) levels were assessed until postoperative day (POD) 14 and compared between patients with and without fistula. In this study, 200 patients were included. No significant differences in body temperature and WBC count were observed between the two groups during the entire study period. CRP levels after POD2 were higher in the fistula group than in the without fistula group. From the receiver operating characteristic curves comparing the two groups, the best cutoff level for CRP was 6.27 mg/dL from POD7 to POD8, with 77.1% sensitivity, 69.8% specificity, and 90.1% negative predictive value. CRP is a valuable predictor of fistula formation following head and neck reconstruction. The course of CRP levels in patients with fistulas remains consistently elevated compared to patients without fistulas, and it is particularly useful for the exclusion diagnosis of fistula.

Effect of Nutritional Interventions on Serum C-reactive Protein Levels in Patients with Periodontitis: A Comprehensive Meta-Analysis

Elevated level of serum C-reactive protein, a systemic inflammation biomarker, is associated with periodontitis, a common inflammatory condition. This meta-analysis aimed to determine the effects of nutritional interventions on serum C-reactive protein levels in patients with periodontitis. We searched the Cochrane Library, PubMed, Scopus, and Web of Science databases according to PRISMA guidelines, including articles published until December 2023. The articles were selected according to predetermined inclusion criteria, and data extraction and quality assessment were conducted utilizing the Newcastle-Ottawa Scale and standardized forms. Seven out of 438 identified articles met the inclusion criteria. We found that patients with periodontitis had a statistically significant correlation between nutritional interventions and decreased serum C-reactive protein levels (p &lt; 0.05). The interventions included specified dietary modifications and dietary supplements, including vitamin C and folic acid. Diverse patient demographics and intervention categories were observed across the identified articles. Thus, this meta-analysis confirmed that nutritional interventions can reduce serum C-reactive protein levels in patients with periodontitis; therefore, dietary modification is essential in managing the systemic inflammation associated with periodontal disease.

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.

Diabetes Status, c-Reactive Protein, and Insulin Resistance in Community-Acquired Pneumonia-A Prospective Cohort Study.

C-reactive protein (CRP) is commonly used to guide community-acquired pneumonia (CAP) treatment. A positive association between admission glucose and CRP levels has been observed in patients with CAP. The associations between prediabetes, unknown diabetes, acute-on-chronic hyperglycaemia, and CRP levels, and between admission CRP levels and insulin resistance (IR) in CAP, remain unexplored. This study investigated the associations firstly between chronic, acute, and acute-on-chronic hyperglycaemia and CRP levels, and secondly between admission CRP levels and IR in CAP. In a prospective cohort study of adults with CAP, the associations between chronic, acute, and acute-on-chronic hyperglycaemia (admission glucose minus HbA1c-derived average glucose) and CRP levels until admission day 3 were modelled with repeated-measures linear mixed models. IR was estimated with the homeostasis model assessment of IR (HOMA-IR). The association between admission CRP levels and HOMA-IR was modelled with linear regression. In 540 patients, no association between chronic, acute, or acute-on-chronic hyperglycaemia and CRP levels was found. In 266 patients, every 50 mg/L increase in admission CRP was associated with a 7% (95% CI 1-14%) higher HOMA-IR. In conclusion, our findings imply that hyperglycaemia does not influence CRP levels in patients with CAP, although admission CRP levels were positively associated with IR.

Acute bronchitis - modern possibilities of mucactive therapy

Analysis of the clinical effectiveness and safety of erdosteine use in comparison with standard (real practice) mucoactive therapy in patients with acute bronchitis (АВ) in adults. The observational program included 100 adult patients with АВ, 50 of them (group 1) received erdosteine, the group 2 also included 50 patients who received acetylcysteine, bromhexine and other mucolytics (real clinical practice). The following were assessed: cough severity, average time for resolution of night and daytime cough, satisfaction with treatment, NO concentration in exhaled air, levels of C-reactive protein (CRP) and interleukin-6 (IL-6). The average duration of relief of severe daytime cough requiring continued therapy was: in group 1 - 3.7±0.46 days, night cough - 1.14±0.94 days. In the second group, daytime cough was relieved in 3.8±0.4 days, night cough - 1.08±0.7 days. The duration of mucoactive therapy in group 1 was 5.32±0.82 days, in group 2 this figure was 8.5±1.4 days (p<0.05). The number of АВ patients with a significant reduction in the severity of productive cough (1 point on cough severity scale) on the 6th day from the beginning of treatment in group 1 (erdosteine) amounted to 32 (64%), in group 2 - 27 (54%). Satisfaction with the treatment was higher in the group receiving erdosteine: according to the indicators "very satisfied" and "extremely satisfied" the patients of the group 1 - 42 - were the leaders in comparison with the group 2, where these positions were marked by 28 patients. The level of CRP in patients with АВ in group 1 was 24.7±21.24 mg/l, in group 2 - 16.37±16.5 mg/l, which indicates the viral etiology of the process and no need in the prescription of antimicrobial drugs. For the first time in Russian practice, the following were determined: the level of IL-6, which in the group 1 was 10.3±6.7 pc/ml; in the group 2 - 10.03±3.94 pc/ml; the level of exhaled NO in group 1 was 16.5±5.1 ppb, in group 2 - 14.9±4.6 ppb (the norm is up to 25 ppb). These indicators, against the background of mucoactive therapy, decreased to normal values by 6th day. The findings expand our understanding of АВ in adults. New results have been obtained on the role of CRP, IL-6 and NO in exhaled air during АВ. The use of erdosteine was accompanied by a significant mucoactive effect in the form of a pronounced regression of cough in patients with АВ compared to the comparison group in shorter term.

C-reactive Protein Levels in Patients With Autoimmune Hypothyroidism Before and After Levothyroxine Treatment.

Hypothyroidism is one of the most common endocrine disorders. Most patients with hypothyroidism have autoimmune thyroiditis (Hashimoto's), characterized by elevated concentrations of anti-thyroperoxidase (ATPO) antibodies. Both overt hypothyroidism (OH) and subclinical hypothyroidism (SH) have been associated with cardiovascular risk factors, including markers of inflammation. High-sensitivity C-reactive protein (hs-CRP) is a veridical marker of systemic inflammation. Even a minor increase in hs-CRP is considered a cardiovascular risk; therefore, evidence of a beneficial effect of levothyroxine treatment on hs-CRP could be an argument in favor of therapy for SH. To assess hs-CRP levels in patients with hypothyroidism and evaluate levothyroxine treatment's effect on hs-CRP. This is a cohort study in which patients with hypothyroidism were evaluated before and after treatment with levothyroxine. 37 patients (17 with OH and 20 with SH) and 38 healthy controls were included in the study. hs-CRP was measured at the baseline visit, then after 2 and 4 months of levothyroxine therapy at a dose necessary to achieve euthyroidism as evidenced by a normal level of thyroid-stimulating hormone (TSH). hs-CRP was significantly increased in OH (p < 0.001) and SH (p = 0.001) at baseline as compared to controls. hs-CRP significantly decreased in SH (2.2±1.6 mg/L at baseline visit, 1.4±1.1 mg/L after 2 months of levothyroxine treatment, P = 0.017) and tended to decrease in OH (2.3±1.6 mg/L at baseline visit, 1.6±1.1 mg/L after 4 months of levothyroxine treatment, P = 0.067*). Patients with hypothyroidism have increased hs-CRP levels compared to a healthy control group and, thereby, a moderately increased cardiovascular risk. Achievement of euthyroidism by levothyroxine treatment decreased the levels of hs-CRP in patients with hypothyroidism.

Prognostic model using postoperative normalization of C-reactive protein levels in patients with upper tract urothelial carcinoma treated with radical nephroureterectomy.

To improve the prediction of outcomes in patients who will undergo radical nephroureterectomy (RN U) for upper tract urothelial carcinoma (UTUC), we investigated the preoperative prognostic factors and developed a risk classification model. A total of 144 patients who underwent RNU with history of neither neoadjuvant nor adjuvant chemotherapy between 2008 and 2022 were retrospectively reviewed. Associations between perioperative/clinicopathologic factors and outcomes, including cancer-specific survival (CSS), were assessed. We specifically focused on preoperative serum C-reactive protein (CRP) and its postoperative normalization. Non-normalization of postoperative serum CRP level and pathologic T3 stage were identified as independent predictive factors of shorter CSS in univariate and multivariate analysis (p=0.0150 and 0.0037, hazard ratio: 3.628 and 4.470, respectively). We classified the patients into three groups using these factors and found that five-year CSS was 88%, 42.5%, and 0% in the low-risk group (zero factors), intermediate-risk group (one factor), and high-risk group (two factors), respectively (p<0.0001). Non-normalization of postoperative serum CRP level and pathologic T stage were identified as independent postoperative prognostic factors in patients with UTUC who underwent RNU. These factors can stratify three prognostic groups and may help urologists in clinical decision-making for adjuvant therapy.

Hemoadsorption as Adjuvant Therapy in Acute Respiratory Distress Syndrome (ARDS): A Systematic Review and Meta-Analysis.

Acute respiratory distress syndrome (ARDS) is often a consequence of a dysregulated immune response; therefore, immunomodulation by extracorporeal cytokine removal has been increasingly used as an adjuvant therapy, but convincing data are still missing. The aim of this study was to investigate the effects of adjunctive hemoadsorption (HA) on clinical and laboratory outcomes in patients with ARDS. We performed a systematic literature search in PubMed, Embase, CENTRAL, Scopus, and Web of Science (PROSPERO: CRD42022292176). The population was patients receiving HA therapy for ARDS. The primary outcome was the change in PaO2/FiO2 before and after HA therapy. Secondary outcomes included the before and after values for C-reactive protein (CRP), lactate, interleukin-6 (IL-6), and norepinephrine (NE) doses. We included 26 publications, with 243 patients (198 undergoing HA therapy and 45 controls). There was a significant improvement in PaO2/FiO2 ratio following HA therapy (MD = 68.93 [95%-CI: 28.79 to 109.06] mmHg, p = 0.005) and a reduction in CRP levels (MD = -45.02 [95%-CI: -82.64; -7.39] mg/dL, p = 0.026) and NE dose (MD = -0.24 [95%-CI: -0.44 to -0.04] μg/kg/min, p = 0.028). Based on our findings, HA resulted in a significant improvement in oxygenation and a reduction in NE dose and CRP levels in patients treated with ARDS. Properly designed RCTs are still needed.

Relationship among Dietary Intake of Vitamin E, Lipid Peroxidation Markers, and C-Reactive Protein in Flu-Like Patients Diagnosed with COVID-19

Objective. This research aimed to assess the intake of vitamin E and its relationship with lipid peroxidation markers and C-reactive protein levels in patients with flu symptoms and COVID-19 diagnosis. Methods. A cross-sectional study with 121 patients of both sexes assisted at two basic health units in the city of Teresina, Piauí, with COVID-19 diagnosis confirmed through real-time reverse transcription polymerase chain reaction, was performed between the 3rd and 7th days of flu symptoms. The global nutritional status and the measurement of waist circumference were assessed according to the World Health Organization recommendations. The dietary energy intake, macronutrients, and vitamin E consumption were assessed through the 24 hr food recall method. The malondialdehyde plasmatic concentration (MDA) was measured through the method of thiobarbituric acid-reactive substances. Myeloperoxidase (MPO) was assessed through the oxidation speed of the o-dianisidine substrate in the presence of hydrogen peroxide. C-reactive protein (CRP) levels were measured by a high-sensitivity immunoturbidimetry method. Results. The most common symptoms reported by the participants were sore throat, fever, and cough. Regarding the global nutritional status evaluation, the majority of the sample had overweight. The dietary intake of vitamin E was 100% inadequate and presented a mild correlation (r = 0.197) with MDA, a redox status marker. No correlation was observed among MPO, CRP, and the dietary intake of vitamin E. Conclusion. The dietary intake of vitamin E was related to MDA as the marker of redox status.

Assessing the relationship between organ function test results and COVID-19 severity

A number of recent reports have indicated the association of COVID-19 with multiple organ failure and the need to clarify the relationship between organ testing parameters and disease progression. Therefore, this study aimed to determine the degree of abnormal organ function test parameters and its correlation with COVID-19 severity. A cross-sectional study was conducted among COVID-19 patients admitted at Sanaka hospital, India, from August to September 2020. A total of 100 qRT-PCR-confirmed COVID-19 patients divided into groups with mild or severe cases were enrolled. The data from venous blood samples for liver, renal, cardiac and inflammatory test parameters were included from the Sanaka hospital laboratory database. Biochemical prognostic tests were carried out using a clinical automated ERBA analyzer, cardiac markers were estimated with Enzyme Linked Fluorescent Assay. The Pearson correlation analysis was used to analyze the data. Aspartate/Alanine aminotransferases and alkaline phosphatase activity, creatinine, urea and troponin levels were higher in the confirmed positive cases of COVID-19. Significantly higher levels of troponin, D-dimer and C reactive protein (CRP) were found in patients with severe COVID form compared to a mild one. A strong positive correlation between elevated D-dimer and Ferritin with CRP level was revealed in this group of patients. It was concluded that the positive relationship between serum D-dimer, ferritin levels and CRP level in patients can be considered a stable indicator of disease severity. Keywords: COVID-19, CRP, D-dimer, ferritin, liver function test, renal function test

The level of C-reactive protein in patients with acute pulmonary embolism

Background. Modern risk stratification in patients with pulmonary embolism (PE) does not consider all possible factors that may influence the course and prognosis of the disease. In view of this, it is promising to study inflammatory markers, especially C-reactive protein (CRP), for their prognostic value in PE. The purpose was to study the clinical and prognostic value of increased CRP levels in patients with PE during hospitalization. Material and methods. One hundred and three patients with diagnosis of acute PE confirmed by computed tomographic pulmonary angiography (CTPA) or by autopsy were examined, their СRP level was evaluated during hospitalization. In addition to a general clinical examination, all patients were screened for PE risk factors and risk of premature death according to the ESC 2019 guidelines. La-boratory tests included quantitative determination of CPK-MB, D-dimer and СRP in addition to basic ones. Electrocardiography, echocardiography, and CTPA were performed as part of the instrumental studies. Results. Depending on the СRP median (26 mg/l), patients were divided into two groups. Group 1 (СRP &lt; 26 mg/l) included 52 people, group 2 (СRP &gt; 26 mg/l) — 51 patients. It was found that in group 1, patients with low risk predominated (p = 0.044) and the average pulmonary embolism severity index was significantly lower (p = 0.011). In group 2, the average blood oxygen saturation (SpO2) during hospitalization was significantly lower (p = 0.004), the average parameters of the left ventricle, namely end-diastolic and end-systolic volume, were significantly greater (p = 0.045 and p = 0.043, respectively), and the ejection fraction was significantly lower (p = 0.002). Also, the average levels of leukocytes (p = 0.0003), neutrophils (p = 0.00001), urea (p = 0.008), CPK-MB (p = 0.028) and erythrocyte sedimentation rate (p = 0.012) were significantly higher in group 2. Correlation analysis revealed a reliable inverse connection between CRP levels and initial SpO2 and a direct relationship between CRP level and the size of the right atrium, CPK-MB level, and increased risk of early mortality from PE. Conclusions. Elevated CRP was found in 92 % of patients with acute PE and was associated with a significant decrease in SpO2 (p &lt; 0.004), increased left ventricular size (p &lt; 0.05), and decreased ejection fraction (p &lt; 0.003). Correlation analysis revealed a relationship between CRP level and the risk according to the pulmonary embolism severity index, SpO2, the level of CPK-MB and the size of the left atrium.

정신과에 협진 의뢰된 입원 환자에서의 베르니케뇌병증 예측을 위한 의사 결정 모델 개발

Objectives: To determine predictive factors associated with the onset of Wernicke encephalopathy (WE) and produce a decision tree predicting patients prone to developing WE.&#x0D; Methods: Demographic, clinical, and laboratory data and the consultation notes of 314 inpatient alcohol use disorder consultation cases were collected. Receiver operative characteristic curve analysis was performed to identify the predictors of WE development.&#x0D; Results: Of the patients with alcohol use disorder, 34.08% developed WE, and 43.93% of those were also diagnosed with hepatic encephalopathy. Delirium history was a predictive factor for patients with alcohol use disorder, with the highest statistical significance, and 54.8% of the patients with prior delirium history developed WE. Hemoglobin (Hb) levels &lt;12.1 g/dL and alanine aminotransferase (PT) levels ≥25 IU/L were the next most significant predictive factors. For patients with alcohol use disorder with altered mental status, a Hb level of 14.4 g/dL was a predictive factor with the highest statistical significance, and 73.3% of patients with Hb levels &lt;14.4 g/dL developed WE. Total bilirubin levels ≥1.1 mg/dL and C-reactive protein (CRP) ≥2.6 mg/dL were the next most significant predictive factors.&#x0D; Conclusion: Assessing delirium history, Hb, and PT levels in patients with alcohol use disorder and Hb, total bilirubin, and CRP levels in patients with alcohol use disorder with altered mental status can help to evaluate the risk of developing WE.

Association between pretreatment C-reactive protein level and survival in non-small cell lung cancer patients treated with immune checkpoint inhibitors: A meta-analysis

BackgroundCurrent evidence suggests that C-reactive protein (CRP) levels may affect cancer prognosis. However, the effect of CRP has not been validated in immunotherapy recipients with non-small cell lung cancer (NSCLC). Therefore, we performed a meta-analysis to explore the prognostic value of CRP level in patients with NSCLC treated with immune checkpoint inhibitors. MethodsPubMed, Web of Science, Embase, and Scopus databases were systematically retrieved for eligible publications, and hazard ratios (HRs) with corresponding 95% confidence intervals (95%CIs) were extracted and merged to evaluate the correlation between pretreatment CRP levels and overall survival (OS) and progression-free survival (PFS). Subgroup and sensitivity analyses were conducted to confirm these findings. ResultsThirty-five cohorts consisting of 4698 patients were included in the primary analysis. Pooled results demonstrated that a higher pretreatment CRP level is associated with worse OS and PFS (OS: HR = 1.13, 95 %CI:1.09–1.18; PFS: HR = 1.16, 95 %CI:1.10–1.22). These findings remained robust after further statistical analyses. ConclusionPretreatment CRP level could be a promising biomarker for NSCLC immunotherapy. However, prospective studies are required to validate these findings.

Changes of Serum C-Reactive Protein Level in Patients With Depressive Disorders After Treatment With Agomelatine Combined With Aerobic Exercise and Its Significance.

Depressive disorders constitute a series of debilitating diseases. This study investigated the therapeutic effect of agomelatine (AG) combined with aerobic exercise (AE) on patients with moderate-severe depression (MSD) and the changes of the serum C-reactive protein (CRP) level in patients after treatment as well as its significance. A total of 178 MSD patients were randomly assigned to the AG group (N = 90) and AG + AE group (N = 88). The severity of depressive disorders and anhedonia was assessed using the Hamilton Rating Scale for Depression (HAM-D), Beck Depression Inventory, and Snaith-Hamilton Pleasure Scale scores. The serum CRP level in MSD patients was detected by turbidity assay. Patients were defined as remitters, responders, and nonresponders according to the HAM-D17 score, and the treatment efficacy was analyzed, followed by evaluation of the serum CRP level in patients with different treatment responses. Finally, the adverse reactions of patients during treatment were statistically analyzed. After treatment, the HAM-D, Beck Depression Inventory, and Snaith-Hamilton Pleasure Scale scores and the serum CRP level of the 2 groups were reduced, and changes in the AG + AE group was more significant than that in the AG group. The clinical efficacy of the AG + AE group was better than that of the AG group. After treatment, the serum levels of CRP in remitters and responders were reduced, but not significantly in nonresponders. The incidence of adverse events in the AG + AE group was lower than that in the AG group. AG + AE reduced the serum level of CRP in MSD patients and had good therapeutic effects on MSD patients.

Predictive Value of Modified Glasgow Prognostic Score and Persistent Inflammation among Patients with Non-Small Cell Lung Cancer Treated with Durvalumab Consolidation after Chemoradiotherapy: A Multicenter Retrospective Study.

Durvalumab consolidation after chemoradiotherapy (CRT) is a standard treatment for locally advanced non-small cell lung cancer (NSCLC). However, studies on immunological and nutritional markers to predict progression-free survival (PFS) and overall survival (OS) are inadequate. Systemic inflammation causes cancer cachexia and negatively affects immunotherapy efficacy, which also reflects survival outcomes. We retrospectively investigated 126 patients from seven institutes in Japan. The modified Glasgow Prognostic Score (mGPS) values, before and after CRT, were the essential predictors among the evaluated indices. A systemic inflammation-based prognostic risk classification was created by combining mGPS values before CRT, and C-reactive protein (CRP) levels after CRT, to distinguish tumor-derived inflammation from CRT-induced inflammation. Patients were classified into high-risk (n = 31) and low-risk (n = 95) groups, and the high-risk group had a significantly shorter median PFS of 7.2 months and an OS of 19.6 months compared with the low-risk group. The hazard ratios for PFS and OS were 2.47 (95% confidence interval [CI]: 1.46-4.19, p < 0.001) and 3.62 (95% CI: 1.79-7.33, p < 0.001), respectively. This association was also observed in the subgroup with programmed cell death ligand 1 expression of ≥50%, but not in the <50% subgroup. Furthermore, durvalumab discontinuation was observed more frequently in the high-risk group than in the low-risk group. Combining pre-CRT mGPS values with post-CRT CRP levels in patients with locally advanced NSCLC helps to predict the PFS and OS of durvalumab consolidation after CRT.

Roux-en-Y and One-Anastomosis Gastric Bypass Surgery Are Superior to Sleeve Gastrectomy in Lowering Glucose and Cholesterol Levels Independent of Weight Loss: a Propensity-Score Weighting Analysis.

The superior effects of gastric bypass surgery in preventing cardiovascular diseases compared with sleeve gastrectomy are well-established. However, whether these effects are independent of weight loss is not known. In this retrospective cohort study, we compared the change in cardiometabolic risks of 1073 diabetic patients undergoing Roux-en-Y gastric bypass (RYGB) (n = 265), one-anastomosis gastric bypass (OAGB) (n = 619), and sleeve gastrectomy (SG) (n = 189) with equivalent weight loss from the Min-Shen General Hospital. Propensity score-weighting, multivariate regression, and matching were performed to adjust for baseline differences. After 12 months, OAGB and, to a lesser extent, RYGB exhibited superior effects on glycemic control compared with SG in patients with equivalent weight loss. The effect was significant in patients with mild-to-modest BMI reduction but diminished in patients with severe BMI reduction. RYGB and OAGB had significantly greater effects in lowering total and low-density lipoprotein cholesterol than SG, regardless of weight loss. The results of matching patients with equivalent weight loss yielded similar results. The longer length of bypassed biliopancreatic (BP) limbs was correlated with a greater decrease in glycemic levels, insulin resistance index, lipids, C-reactive protein (CRP) levels, and creatinine levels in patients receiving RYBG. It was correlated with greater decreases in BMI, fasting insulin, insulin resistance index, and C-reactive protein levels in patients receiving OAGB. Diabetic patients receiving OAGB and RYGB had lower glucose and cholesterol levels compared with SG independent of weight loss. Our results suggest diabetic patients with cardiovascular risk factors such as hypercholesterolemia to receive bypass surgery.

Correlation between aortic valve calcification and C-reactive protein levels in patients with aortic valve sclerosis

Correlation between aortic valve calcification and C-reactive protein levels in patients with aortic valve sclerosis