CRP In Group Research Articles

The long-term effects of rapamycin-based immunosuppressive protocols on the expression of renal aquaporins 1, 2, 3 and 4 water channels in rats.

To this day, the effect of multi-drug immunosuppressive protocols on renal expression of AQPs is unknown. This study aimed to determine the influence of rapamycin-based multi-drug immunosuppressive regimens on the expression of aquaporins (AQPs) 1, 2, 3, and 4 in the rat kidney. For 6 months, 24 male Wistar rats were administered immunosuppressants, according to the three-drug protocols used in patients after organ transplantation. The rats were divided into four groups: the control group, the TRP group (tacrolimus, rapamycin, prednisone), the CRP group (cyclosporine A, rapamycin, prednisone), and the MRP group (mycophenolate mofetil, rapamycin, prednisone). Selected red cell indices and total calcium were measured in the blood of rats and quantitative analysis of AQP1, AQP2, AQP3 and AQP4 immunoexpression in the kidneys were performed. In the TRP and CRP groups, a mild increase of mean corpuscular hemoglobin concentration, hematocrit and total calcium were observed. Moreover, decreased expression of AQP1-4 was found in all experimental groups, with the highest decrease in the CRP group. The long-term immunosuppressive treatment using multi-drug protocols decreased AQP1-4 expressions in renal tubules, possibly leading to impaired urine-concentrating ability in rat.

Factors associated with radiographic progression in patients with Takayasu's arteritis.

To identify the factors related to radiographic progression in patients with Takayasu's arteritis (TAK). A retrospective cohort study was conducted among patients with TAK who underwent computed tomography angiography (CTA) at least twice in a 2-5-year interval. Radiographic progression was defined as newly developed and/or aggravated (more than 20%) characteristic CTA findings. Correlation analysis was performed using a multivariate Cox regression model. The cohort included 153 TAK patients with a mean CTA interval of 3.53 years, and 24 (15.7%) showed radiographic progression. Those with progression showed higher acute-phase reactant levels (erythrocyte sedimentation rate [ESR], 26.06 vs. 35.72 mm/h, p=0.040; C-reactive protein [CRP], 0.45 vs. 1.13 mg/dL, p<0.001), were younger at the initial CTA (43.70 vs. 31.81 years, p<0.001), and were more likely to be receiving immunosuppressants (14 [10.9%] vs. 7 [29.2%] patients, p=0.038). Multivariate Cox regression analysis revealed age at the initial CTA (hazard ratio [HR]=0.945, confidence interval [CI]=0.898-0.995, p=0.030) and area under the curve (AUC) of CRP levels (HR=2.126, CI=1.046-4.319, p=0.037) as significant factors for radiographic progression. In a subgroup of patients with high CRP levels, 30.4% (14/24) showed progression; only age at the initial CTA was significantly different (37.03 vs. 27.10 years, p=0.012) between those with and without progression. Higher CRP levels and younger age were risk factors of radiographic progression in patients with TAK. In the high CRP group, younger patients are more prone to progression and may need aggressive anti-inflammatory treatment.

C-Reactive Protein Levels Predict Outcomes in Continuous-Flow Left Ventricular Assist Device Patients: An INTERMACS Analysis.

CRP is an established inflammatory biomarker with prognostic value in patients with chronic heart failure, yet its role in continuous-flow left ventricular assist device (LVAD) patients is largely unknown. 5,183 patients from the INTERMACS registry who underwent durable LVAD between 2008 and 2017 and had preimplant CRP levels were included. The sample was stratified into two groups based on preimplant CRP levels: CRP of 0-10 mg/L (low) and >10 mg/L (high). Kaplan-Meier survival estimates were used to assess outcomes at 2 years after LVAD implantation, with log-rank testing used to compare groups. Cox proportional hazard models were used for multivariable adjustment. Patients with high preimplant CRP were younger, more likely to be INTERMACS class I, and had a higher need for temporary mechanical circulatory support before LVAD implant compared to those with lower CRP levels (all P < 0.001). The high CRP group had higher WBC counts and BNP levels (all P < 0.001). After adjustment, higher CRP (>10 mg/L) was associated with greater risk of mortality, RV failure, and stroke postimplant (P < 0.001). In addition, elevated postimplant CRP level at 3 months was associated with increased mortality and stroke on LVAD support (P < 0.001). CRP is a predictor of death and complications on LVAD support. Future studies are necessary to explore the mechanisms underlying this finding and the potential role of antiinflammatory therapies in this population.

A New Posterior Extensor Attachment-Point Reconstruction Technique for Cervical Spondylotic Myelopathy Involving C2 Segment: Clinical Outcome and Safety.

Cervical spondylotic myelopathy (CSM) is a common degenerative disease that mainly occurs in elder patients, leading to different degrees of neurological dysfunction. Spinal cord involvement is mainly distributed at the C3-C7 segments, but it may also involve up to the C2 level. This study aimed to assess the clinical efficacy and safety of open-door laminoplasty using a new extensor attachment-point reconstruction technique for treating CSM involving the C2 segment. Fifty-nine patients with CSM involving the C2 segment and undergoing open-door laminoplasty were included in this retrospective study. Based on the titanium plate used in the operation, patients were divided into two groups, a reconstructed titanium plate fixation (RPF) group (n = 28) and a conventional titanium plate fixation (CPF) group (n = 31). Improvements in neurological function, cervical range of motion (ROM), cervical curvature index (CCI), preservation of posterior cervical muscle mass, and axial symptoms were compared between the two groups. There were no significant differences in operative time and intraoperative blood loss between the groups (p > 0.05). The Japanese Orthopaedic Association (JOA) score significantly increased in both groups postsurgery (p < 0.05); the neurological recovery rate was similar between the two groups (64.1 ± 13.3% vs. 65.9 ± 14.7%, p > 0.05). There was no significant loss of cervical ROM in either group (p > 0.05). The anteroposterior dural sac diameter at the C2 level was significantly enlarged in both groups (p < 0.05). Alternatively, CCI was significantly reduced in the CRP group (p < 0.05) but unchanged in the RPF group (p > 0.05). The cross-sectional area of the posterior cervical muscles was also significantly reduced in the CPF group (p < 0.05) but maintained in the RPF group (p > 0.05). Finally, axial symptoms were more severe in the CPF group than in the RPF group (p < 0.05). Laminoplasty is an effective surgical procedure for CSM involving the C2 segment. The reconstructed titanium plate achieved superior maintenance of cervical curvature and reduced both muscle atrophy and severity of axial symptoms compared with titanium conventional plates.

Baseline Serum C-Reactive Protein Level Predicts Mortality in Cryptococcal Meningitis.

BackgroundC-reactive protein (CRP) is an acute phase protein produced by the liver in response to systemic inflammation. CRP is a helpful surrogate biomarker used for following the progression and resolution of infection. We aimed to determine the association of baseline CRP level and the temporal change in CRP over time with cryptococcal meningitis outcome.MethodsWe reviewed 168 prospectively enrolled HIV-infected Ugandans with confirmed first-episode cryptococcal meningitis. Baseline plasma CRP collected within 5 days of meningitis diagnosis was categorized into quartiles. We compared baseline CRP with 18-week survival using time-to-event analysis.ResultsOf 168 participants, the baseline first quartile of serum CRP was <29.0 mg/L, second quartile 29.0–49.5 mg/L, third quartile 49.6–83.6 mg/L, and fourth quartile >83.6 mg/L. Baseline CD4 count, HIV viral load, and cerebrospinal fluid results did not differ by CRP quartile. Participants with CRP >49.5 mg/L more likely presented with Glasgow Coma Scale (GCS) <15 (P = .03). The 18-week mortality rate was 55% (46/84) in the highest 2 quartile CRP groups (>49.5 mg/L), 41% (17/42) in the mid-range CRP group (29.0–49.5 mg/L), and 14% (6/42) in the low-CRP group (<29.0 mg/L; P < .001). After adjustment for possible confounding factors including GCS <15, CRP remained significantly associated with mortality (adjusted hazard ratio, 1.084 per 10 mg/L; 95% CI, 1.031–1.139; P = .0016).ConclusionsHigher baseline CRP is associated with increased mortality in HIV-infected individuals with first-episode cryptococcal meningitis. CRP could be a surrogate marker for undiagnosed coinfections or may reflect immune dysregulation, leading to worse outcomes in persons with advanced AIDS and concomitant cryptococcal meningitis.

LDL cholesterol reduction by lipid lowering therapy after acute myocardial infarction is not significantly influenced by baseline systemic inflammation

In secondary prevention, the 2019 ESC guidelines recommend achieving LDL cholesterol below 1.4 mmol/l and decreasing over 50% of its baseline value. After myocardial infarction (MI), it has been debated whether MI inflammation could influence lipid profile and thus response to lipid lowering therapy. We investigated whether inflammation in the acute phase MI could influence LLT effect on LDL-c reduction at 1-month follow-up. We retrospectively included consecutive patients admitted for an acute ST-elevation MI (STEMI) between October 2014 and December 2017. Clinical characteristics, lipid profile and CRP were collected at baseline within the first 24 h and lipid profile at 1-month follow-up. We compared in LLT naïve patients the LLT response variability according to baseline median CRP (low-CRP vs. high-CRP group) and the percentages of patients achieving goals and targets according to 2019 guidelines (% achieving an LDL-c < 1.4 mmol/l and % decreasing over 50%). We included 209 STEMI patients. Baseline and 1-month LDL-c was 3.3 ± 0.9 and 1.8 ± 0.6 mmol/L respectively. Baseline median CRP was 4.0 [1.9–9.4] mg/L, and baseline LDL-c was not different according to CRP group. More than 95% of patients were discharged with atorvastatin 80 mg or rosuvastatin 20 mg, but ezetimibe in only 8 patients. In 187 LLT naïve patients, LLT response profile was not different according to baseline median CRP (figure) with a mean LDL-c decrease of 42 ± 20% in low-CRP and 37 ± 25% in high-CRP patients ( P = 0.1). The number of patients achieving a LDL-c reduction over 50% was 35 (38%) and 34 (37%) ( P = 0.1). Only 41(20%) patients achieved a LDL-c < 1.4 mmol/L at 1-month ( Fig. 1 ). After STEMI, 1-month LDL-c reduction by mainly high-dose statin was not significantly modified by early inflammation when baseline LDL measured at admission. LDL-c control at 1-month remains scarce according to the 2019 ESC guidelines.

Impact of gender, C-reactive protein and body mass index on erythropoietin resistance index in maintenance hemodialysis patients

Introduction: Anemia is caused by a variety of mechanisms in chronic kidney disease (CKD), including erythropoietin (EPO) deficiency, resistance to erythropoiesis-stimulating agents (ESAs), impaired iron metabolism and its clinical management remains challenging. Objectives: The aim of the current study was to evaluate the impact of CRP, BMI, gender and duration of hemodialysis. Patients and Methods: A total of 94 maintenance HD patients participated in this study. Laboratory investigation included CBC, renal function test and qualitatively C-reactive protein was performed. Erythropoietin resistance index (ERI) was calculated as weekly EPO dose/ body weight in kg/hemoglobin level. Results: Female gender had significantly higher ERI (11.36 ± 1.52) compared to male HD patients (10.68 ± 1.56) (P ˃ 0.05). Patients with low BMI had significant higher ERI (12.08 ± 1.09) compared to HD patients with overweight (10.62 ± 0.79) and obese (9.62 ± 1.68) (P ˃ 0.05). The highest ERI were found in the positive CPR group (P ˃ 0.05) compared to negative CRP group. There is no significant difference between duration of hemodialysis. Conclusion: Our data exposed that female gender; low BMI and inflammation (positive CRP) contributed to EPO hyporesponsiveness. In addition, there is no significant difference between lengths on hemodialysis.

Calorie restriction and synbiotics effect on quality of life and edema reduction in breast cancer-related lymphedema, a clinical trial

BackgroundLittle evidence exists regarding the clinical value of synbiotics in the management of post-treatment complications of breast cancer especially breast cancer-related lymphedema (BCRL). This study aimed to investigate the effects of synbiotic supplementation along with calorie restriction on quality of life and edema volume in patients with BCRL. MethodsThis randomized, placebo-controlled, clinical trial was conducted on 135 overweight and obese women with BCRL aged 18–65 years old. Participants were randomly allocated to receive a calorie-restricted diet plus 109 CFU synbiotic supplement (CRS group; n = 45) or placebo (CRP group; n = 45), daily for 10 weeks. Also, a control group (n = 45) with no intervention was included in the trial. All of the participants received Complete Decongestive Therapy for lymphedema treatment. The quality of life score, edema volume and body mass index (BMI) were measured at baseline and end of the trial. ResultsA total of 121 subjects completed the trial. CRS group showed a significant decrease in the total quality of life score (P = 0.004), and it’s psychosocial (P = 0.022) and functional (P = 0.002) domain scores, as well as edema volume (P = 0.002) and BMI (P < 0.001) in comparison to the control. However, there were no significant differences in changes in trial outcomes between the CRS and CRP groups. ConclusionSynbiotic supplementation along with a low-calorie diet was effective in quality of life, edema volume, and BMI improvement; mostly due to low-calorie diet. It seems that adding a dietitian consultation on the lymphedema management strategy may provide a better result in lymphedema control.

Duration of antibiotic therapy in critically ill patients: a randomized controlled trial of a clinical and C-reactive protein-based protocol versus an evidence-based best practice strategy without biomarkers

BackgroundThe rational use of antibiotics is one of the main strategies to limit the development of bacterial resistance. We therefore sought to evaluate the effectiveness of a C-reactive protein-based protocol in reducing antibiotic treatment time in critically ill patients.MethodsA randomized, open-label, controlled clinical trial conducted in two intensive care units of a university hospital in Brazil. Critically ill infected adult patients were randomly allocated to (i) intervention to receive antibiotics guided by daily monitoring of CRP levels and (ii) control to receive antibiotics according to the best practices for rational use of antibiotics.ResultsOne hundred thirty patients were included in the CRP (n = 64) and control (n = 66) groups. In the intention-to-treat analysis, the median duration of antibiotic therapy for the index infectious episode was 7.0 (5.0–8.8) days in the CRP and 7.0 (7.0–11.3) days in the control (p = 0.011) groups. A significant difference in the treatment time between the two groups was identified in the curve of cumulative suspension of antibiotics, with less exposure in the CRP group only for the index infection episode (p = 0.007). In the per protocol analysis, involving 59 patients in each group, the median duration of antibiotic treatment was 6.0 (5.0–8.0) days for the CRP and 7.0 (7.0–10.0) days for the control (p = 0.011) groups. There was no between-group difference regarding the total days of antibiotic exposure and antibiotic-free days.ConclusionsDaily monitoring of CRP levels may allow early interruption of antibiotic therapy in a higher proportion of patients, without an effect on total antibiotic consumption. The clinical and microbiological relevance of this finding remains to be demonstrated.Trial registryClinicalTrials.gov Identifier: NCT02987790. Registered 09 December 2016.

MP79-16 LONG-TERM RESULTS OF CYTOREDUCTIVE RADICAL PROSTATECTOMY IN MEN WITH HORMONE-NAIVE, LOW VOLUME METASTATIC PROSTATE CANCER(MHNPCA)

You have accessJournal of UrologyProstate Cancer: Advanced (including Drug Therapy) IV (MP79)1 Apr 2020MP79-16 LONG-TERM RESULTS OF CYTOREDUCTIVE RADICAL PROSTATECTOMY IN MEN WITH HORMONE-NAIVE, LOW VOLUME METASTATIC PROSTATE CANCER(MHNPCA) Patricia John*, David Pfister, Axel Heidenreich, and Florian Hartmann Patricia John*Patricia John* More articles by this author , David PfisterDavid Pfister More articles by this author , Axel HeidenreichAxel Heidenreich More articles by this author , and Florian HartmannFlorian Hartmann More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000971.016AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Androgen deprivation combined with apalutamide, abiraterone or docetexal represents the treatment of choice in mhnPCA. Cytoreductive radical prostatectomy (cRP) has been proposed as part of a multimodality treatment in selected patients with oligometastatic prostate cancer. Recently, our group has demonstrated that the combination of 6 months neoadjuvant ADT followed by cRP exerted a significant benefit in terms of progression-free, local symptom-free survival and time to castration resistance. We report on the long-term outcome of this cohort of men with low volume mhnPCA. METHODS: 32 patients with hnmPCA were retrospectively analysed. All men had low volume skeletal metastases (≤3 lesions on a bone scan), absence of visceral and retroperitoneal lymph node metastases, and a PSA-decrease <1,0 ng/ml following 6 months of ADT. 38 case-matched patients with mhnPCA and ADT monotherapy served as a control group. Perioperative complications were assessed according to Clavien-Dindo, PSA-free, symptom-free, cancer specific and overall survival was analysed and assessed via descriptive statistics. RESULTS: Mean age of the patients was 61 (42–69) years. Mean PSA at time of diagnosis was 135.2 (3.5-150.4) ng/ml, the mean PSA at time of cRP was 0.42 (0.01-9.8) ng/ml. All patients demonstrated a mean of 2.1 (1-3) osseous metastases, intrapelvic lymph node metastases were identified preoperatively in 17.4% of patients. All men underwent cRP and extended pelvic lymphadenectomy. The median follow-up is 75,5 (7–135) months, 27/32 (84.4%) patients are still alive. 16/27 (59.2%) have developed mCRPC. Median overall survival is 78.9 months and the median time to CRPC is 40 (9–65) months. Overall survival, progression-free survival and time to CRPC was significantly superior in the cRP group as compared to ADT alone (p = 0.003). 10 (31.2%) patients developed perioperative complications of whom only 3/32 (9.4%) patients required interventions and were defined as Clavien-Dindo IIIa/b. 28/32 (87.5%) patients are continent (0-1 pads/day). None of the patients developed locally symptomatic relapses after cRP whereas this was the case in 12 (31.6%) pts in the ADT alone group. CONCLUSIONS: Even after long-term follow-up neoadjuvant ADT and cRP result in good oncological and functional outcome with a 6-year overall survival rate of more than 80%. As compared to about 25% symptomatic local relapses following radiation therapy and to 31% relapses following ADT alone, none of the patients developed symptomatic local relapses following cRP. Although data from prospective randomized trials are lacking, cRP should be considered as a valid treatment option in well selected patients with low volume metastatic disease and good response to neoadjuvant ADT. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1221-e1222 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Patricia John* More articles by this author David Pfister More articles by this author Axel Heidenreich More articles by this author Florian Hartmann More articles by this author Expand All Advertisement PDF downloadLoading ...

Gotfried positive reduction promotes the repair of femoral neck fracture potentially via enhancing osteogenesis and angiogenesis

The aim of this study was to investigate the effect of Gotfried positive reduction (GPR) on repair of femoral neck fracture in rabbits and its underlying mechanisms. Male New Zealand white rabbits were employed to establish the model of femoral neck fracture. All the rabbits were randomly divided into four groups: control, open accurate reduction (OR), closed Gotfried negative support reduction (CR-N) and closed Gotfried positive support reduction (CR-P). At the 8th and 12th week after surgery, the anteroposterior and lateral radiographs of their hip joints were taken by X-ray, and local hemodynamics of their hip joints was detected by ultrasound. Histological examination was evaluated by HE staining and bone biological strength test was measured by testing machine, which was performed to study the repair of femoral neck fracture. Osteogenesis and angiogenesis-related proteins were measured by western blot in bone tissues and synovial tissues. The results revealed that the fracture healing intensity and blood supply in CR-P were better than those in CR-N and much more excellent than those in OR. In addition, the content of bone morphogenetic protein2 (BMP2), platelet derived growth factor (PDGF) and ocsteocalcin was higher in CR-P group than in CR-N, while lower in CR-P than OR. Furthermore, the expression of BMP2, COL-2 and angiopoietin (ANGPT) was upregulated in CR-P compared to CR-N and OR. Taken together, our results indicated that GPR was able to promote the repair of femoral neck fracture via enhancing osteogenesis and angiogenesis, which is valuable to us and shows good application prospect in bone tissue repair.

Relation between maternal C–reactive protein in early pregnancy and neonatal complications

Background C-reactive protein (CRP) is an acute-phase reactant and a commonly employed indicator of low-grade systemic inflammation. Elevated CRP levels are accompanied by higher risk of popular diseases. This study aimed to study the correlations of maternal CRP level with fetal growing and the risk of neonatal complications. Participants and methods This prospective observational randomized study was conducted in Al Zahraa University and El Sheikh Zayed hospital throughout the interval from April 2018 to March 2020. It included 150 pregnant women attending for antenatal care in the outpatient clinic. CRP was done twice. The first measure was done at second trimester (13–20 weeks), and the second measure was done after 26 weeks. Positive results were obtained at a CRP concentration above 10 mg/l. The pregnant women were subdivided into two groups: group A, with positive (high) CRP, and group B, with negative (ordinary CRP). Follow-up was done by ultrasound during pregnancy [to detect Intrauterine Growth Restriction (IUGR), low birth weight, and congenital anomalies]. Follow-up during labor was done to detect mode of delivery, IUGR, respiratory distress, and NICU admission. Results Median CRP level at 13–20 weeks was higher than median CRP level at 26–30 weeks. Regarding CRP finding, it was found that ∼60 (40%) women had positive CRP and 90 (60%) women had negative CRP. IUGR was statistically significantly higher among positive CRP group than negative CRP group (5 and 0%, respectively; P=0.031). Respiratory distress was statistically significantly higher among positive CRP group than negative CRP group (6.7 and 0%, respectively) (P=0.01). Admission at neonatal ICU was statistically significantly higher among positive CRP group than negative CRP group (6.7 and 0%, respectively; P=0.031). Conclusion Maternal-grade inflammation in pregnancy, as estimated by CRP counts, was accompanied with fetal growing restriction and higher risks of neonatal complications.

C-reactive protein as a prognostic factor in intensive care admissions for sepsis: A Swedish multicenter study

PurposeC-reactive protein (CRP) is not included in the major intensive care unit (ICU) prognostic tools such as the Simplified Acute Physiology Score (SAPS). We assessed CRP on ICU admission as a SAPS-3 independent risk marker for short-term mortality and length of stay (LOS) in ICU patients with sepsis. Materials and methodsAdult ICU admissions satisfying the Sepsis-3 criteria to four southern Swedish hospitals were retrospectively identified and divided into a low CRP group (<100 mg/L) and a high CRP group (>100 mg/L) based on the admission CRP level. The standardized mortality ratio (SMR) was calculated. ResultsA total of 851 admissions were included. The SMR was higher in the high CRP group (0.85 vs. 0.67, P = .001 in the whole sepsis group and 0.85 vs. 0.59, P = .003 in the culture-positive subgroup). The CRP levels also correlated with ICU and hospital LOS in survivors (P < .001 and P = .002), again independent of SAPS-3. ConclusionAn admission CRP level >100 mg/L is associated with an increased risk of ICU and 30-day mortality as well as prolonged LOS in survivors, irrespective of morbidity measured with SAPS-3. Thus, CRP may be a simple, early marker for prognosis in ICU admissions for sepsis.

1716. Baseline Serum C-Reactive Protein Level Predicts Mortality in Cryptococcal Meningitis

BackgroundC-reactive protein (CRP) is an acute-phase protein produced by the liver in response to systemic inflammation. CRP is a helpful surrogate biomarker widely used in various infections, particularly for following the progression and resolution of infection. We aimed to determine the association between baseline CRP level and cryptococcal meningitis outcome.MethodsWe reviewed 168 prospectively enrolled HIV-infected Ugandans with confirmed first-episode cryptococcal meningitis. Baseline serum samples collected within 5 days from diagnosis had CRP levels measured and categorized into quartiles. We compared baseline serum CRP with 18-week survival using unadjusted time-to-event analysis.ResultsOf 168 participants, the first quartile of baseline serum CRP was 83.6 mg/L. Baseline CD4 count, HIV viral load, and cerebrospinal fluid results did not differ by quartile. Participants with CRP > 49.5 mg/L more likely presented with Glasgow Coma Scale <15 (P = 0.03). The 18-week mortality rate was 54.8% (46/84) in the highest two quartile CRP groups (49.5 mg/L), 40.5% (17/42) in the mid-range CRP group (29–49.5 mg/L), and 14.3% (6/42) in the low CRP group (<29 mg/L) (P < 0.001) (Figure 1).ConclusionHigher baseline serum CRP is associated with increased mortality in HIV-infected individuals with first-episode cryptococcal meningitis. The serum CRP could be a surrogate marker for undiagnosed co-infections or may reflect immune dysregulation leading to worse outcomes in persons with advanced AIDS and concomitant cryptococcal meningitis. Additional studies investigating more specific inflammatory biomarkers and the longitudinal trend in CRP with effective therapy would be informative. Disclosures All authors: No reported disclosures.

Predictive value of high sensitivity C-reactive protein on progression to heart failure occurring after the first myocardial infarction.

Background: High sensitivity C-reactive protein (hsCRP) predicts myocardial dysfunction after acute coronary syndromes. We aimed to study the association of hsCRP estimation at first acute myocardial infarction (AMI) with myocardial dysfunction and heart failure.Methods: This research was carried out at the Department of Physiology and Department of Emergency Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia. In this prospective study, 227 patients were studied. hsCRP levels were estimated when patients came to the emergency department at AMI, 7 days post AMI, and at 12 weeks of follow up after AMI. The outcome was change in myocardial functions, especially heart failure, 12 months after the attack.Results: Based on a cutoff mean value of hsCRP levels at admission (10.05±12.68 mg/L), patients were grouped into high and low C-reactive protein (CRP.) The ejection fraction was significantly lower at follow up in the high CRP group (37.29±12.97) compared to the low CRP group (43.85±11.77, p<0.0198). hsCRP had significant inverse correlation with left ventricular ejection fraction (r=−0.283, p<0.01). About 38.1% patients showed heart failure, with 23.6% in the high CRP group and 14.5% in the low CRP group (OR 2.4, p=0.028). Receiver operating characteristic curve analysis showed that CRP levels at AMI had a specificity of 79% and sensitivity of 83% to predict heart failure.Conclusion: A high hsCRP level measured at first AMI predicts myocardial dysfunction and heart failure. It is suggested that hsCRP plays an important role in the development of heart failure after myocardial infarction.

Microbiome of Deep Dentinal Caries from Reversible Pulpitis to Irreversible Pulpitis

IntroductionThis study examined the identity of the microbiome of deep dentinal caries and its correlation with the inflammation status of caries-induced pulpitis. MethodsSeventy-five cases were diagnosed based on the American Association of Endodontics's diagnostic criteria and divided into 4 groups: normal pulp with deep caries (NP; n = 13), reversible pulpitis with only cold-evoked pain (CRP; n = 17), reversible pulpitis with both cold/heat-evoked pain (CHRP; n = 24), and symptomatic irreversible pulpitis (SIP; n = 21). Samples were sequenced by 16S rDNA. Alpha and beta diversity were determined. Linear discriminant analysis effect size (LEfSe) analysis was used to detect intergroup differences, and receiver operating characteristic (ROC) curves were generated to assess the role of the caries microbiome in caries-induced pulpitis. ResultsThe 16S rDNA sequencing yielded 9100 operational taxonomic units. Lactobacillus had the highest relative abundance at the genus level among the 4 groups. There were significant differences in the distribution of the microbiome among the groups. In an alpha diversity analysis, species richness differed between the CRP group and the other groups. In a beta diversity analysis, the distribution of microorganisms in the SIP group was significantly different from those in the other 3 groups. LEfSe analysis indicated substantial differences in the microbiome among the groups, and the areas under the ROC curves (AUC) were all high (AUC: 0.734–0.952). ConclusionsCharacterization of the caries microbiome has the potential to become an auxiliary method for the diagnosis of pulpitis. This finding may prompt new research on diagnostic strategies for caries-induced pulpitis.

Assessment of Inflammatory Markers in Hemolytic Crisis with Special Reference to Sickle Cell Anemia

As a global health problem sickle cell anemia affects many world populations. It is an autosomal recessive disease, commonly found in tropical countries. It is the most common single genetic mutation in human and abundantly present in large part of the world. The present study was done in the Department of Biochemistry, Chhattisgarh Institute of Medical Sciences, Bilaspur. The work comprised of two different groups consisting 50 sickle cell patients with hyperhemolytic crisis, including 50 age and sex matched control subject. In the present study namely, Homosysteine, IL-6, TNF-a, and CRP as an inflammatory markers measured in normal and sickle cell disease patients. We found significantly increased mean level of all three parameters (IL-6 Group I V/s Group II p <0.001, TNF-α Group I V/s Group II p < 0.001, CRP Group I V/s Group II p <0.001). when compared to control and subject group.

CRP Group’s technology supporting the first Italian high performance electric motorcycle: Development and construction of the Energica Ego motor housing and dashboard

CRP Group’s technology supporting the first Italian high performance electric motorcycle: Development and construction of the Energica Ego motor housing and dashboard

Use of C-reactive protein to tailor antibiotic use: a systematic review and meta-analysis

Background and objectivesC-reactive protein (CRP) has been proposed to guide the use of antibiotics. However, study results are controversial regarding the benefits of such a strategy. We synthesised the evidence...

MP52-09 MULTICENTRIC PROSPECTIVE LOCAL TREATMENT OF METASTATIC PROSTATE CANCER (LOMP) TRIAL: INTERIM ANALYSIS OF CLINICAL OUTCOMES AND PROGNOSTIC FACTORS

You have accessJournal of UrologyProstate Cancer: Advanced (including Drug Therapy) III1 Apr 2018MP52-09 MULTICENTRIC PROSPECTIVE LOCAL TREATMENT OF METASTATIC PROSTATE CANCER (LOMP) TRIAL: INTERIM ANALYSIS OF CLINICAL OUTCOMES AND PROGNOSTIC FACTORS Sarah Buelens, Filip Poelaert, Bert Dhondt, Elise De Bleser, Caroline Verbaeys, Bernard Rappe, Bart Kimpe, Ignace Billiet, Hendrik Plancke, Karen Fransis, Patrick Willemen, Bart De Troyer, Piet Ost, Karel Decaestecker, and Nicolaas Lumen Sarah BuelensSarah Buelens More articles by this author , Filip PoelaertFilip Poelaert More articles by this author , Bert DhondtBert Dhondt More articles by this author , Elise De BleserElise De Bleser More articles by this author , Caroline VerbaeysCaroline Verbaeys More articles by this author , Bernard RappeBernard Rappe More articles by this author , Bart KimpeBart Kimpe More articles by this author , Ignace BillietIgnace Billiet More articles by this author , Hendrik PlanckeHendrik Plancke More articles by this author , Karen FransisKaren Fransis More articles by this author , Patrick WillemenPatrick Willemen More articles by this author , Bart De TroyerBart De Troyer More articles by this author , Piet OstPiet Ost More articles by this author , Karel DecaesteckerKarel Decaestecker More articles by this author , and Nicolaas LumenNicolaas Lumen More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1660AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The multicentric prospective Local treatment of Metastatic Prostate cancer (LoMP) trial investigates the role of cytoreductive radical prostatectomy (cRP) in addition to standard of care (SoC) for patients with newly diagnosed metastatic prostate cancer (mPC). We aim to evaluate clinical outcomes and prognostic factors. METHODS Since 2014, 72 asymptomatic patients were prospectively included (NTC 02138721). cRP was performed in patients with a resectable tumor, fit to undergo surgery (group A, n&[ident]34). Only SoC was administered to patients who were ineligible or unwilling to undergo cRP (group B, n&[ident]38). Kaplan-Meier method was used for castration-resistant prostate cancer-free survival (CRPC-FS), overall survival (OS), cancer specific survival (CSS), local event-free survival under androgen deprivation therapy (LE-FS) and skeletal related event-free survival (SRE-FS). Risk factors were identified using univariate Cox regression models. RESULTS Compared to group B, patients in group A were younger (median 66 vs 76 years, p≤0.001), showed a better health status (ECOG≥2 in 0% vs 16%, p&[ident]0.026), lower initial PSA (median 18 vs 166 g/L, p≤0.001) and less high-volume mPC (21% vs 63%, p≤0.001) with a lower number of bone metastases (2 vs 7, p&[ident]0.005). Tumor grade group (WHO≥4 in 88% vs 82%, p&[ident]0.5) and cT-stage (≥cT3-4 in 68% vs 79%, p&[ident]0.3) showed no significant difference in group A and B.Median follow-up was 11 months (IQR 5-21). One year CRPC-FS (91% vs 61%, p&[ident]0.019), OS (100% vs 80%, p&[ident]0.003) and CSS (100% vs 83%, p&[ident]0.009) were significantly better in group A compared to group B. Idem for one year LE-FS (100% vs 74%, p&[ident]0.001) and SRE-FS (100% vs 86%, p&[ident]0.023).Only SoC (group B; p&[ident]0.020 en p&[ident]0.003) and high-volume mPC (p&[ident]0.005 en p&[ident]0.013) were identified as risk factors for shorter CRPC-FS and OS. For OS, higher age (p≤0.001), ECOG (p≤0.001) and initial PSA (p&[ident]0.005) were extra risk factors. CONCLUSIONS Asymptomatic patients with newly diagnosed mPC eligible to undergo cRP show more favorable characteristics compared to those receiving only SoC. These patients show significantly better oncological outcomes and moreover less risk of developing both early local and skeletal-related events. To what extent these benefits can be attributed to cRP needs to be further explored. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e698 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Sarah Buelens More articles by this author Filip Poelaert More articles by this author Bert Dhondt More articles by this author Elise De Bleser More articles by this author Caroline Verbaeys More articles by this author Bernard Rappe More articles by this author Bart Kimpe More articles by this author Ignace Billiet More articles by this author Hendrik Plancke More articles by this author Karen Fransis More articles by this author Patrick Willemen More articles by this author Bart De Troyer More articles by this author Piet Ost More articles by this author Karel Decaestecker More articles by this author Nicolaas Lumen More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...