Laboratory Results Of Patients Research Articles

Associations between anti‐melanoma differentiation‐associated gene 5 antibody and demographics, clinical characteristics and laboratory results of patients with dermatomyositis: A systematic meta‐analysis

Anti-melanoma differentiation-associated gene 5 (MDA5) antibody is a specific biomarker in patients with dermatomyositis (DM). Results from several studies that examined the relationship between anti-MDA5 antibody and the demographics, clinical characteristics and laboratory results of DM patients have been conflicting. The purpose of this study was to identify the relationship, if any, of anti-MDA5 antibody with demographics, clinical characteristics and laboratory results of DM patients. PubMed, Web of Science, Embase and the Cochrane Library databases were searched for studies without language restrictions conducted before 16March 2017. Stata version 12.0 software was used to calculate pooled odds ratios or weighted mean differences and corresponding 95% confidence intervals to determine the relationship between anti-MDA5 antibody and patient characteristics. Twenty studies comprising 1500 cases were included in this meta-analysis. Anti-MDA5 antibody was strongly associated with clinically amyopathic DM (CADM) and rapidly progressive interstitial lung disease (RPILD). Anti-MDA5 antibody also increased the risk of developing eight characteristics comprising Gottron's sign or papules, mechanic's hand, V rash, skin ulcers, panniculitis, alopecia, arthritis/arthralgia and pneumomediastinum, but reduced the risk of muscle weakness, classic DM (CDM) and elevated creatine kinase (CK). Our meta-analysis indicated that anti-MDA5 antibody is related to muscle weakness, Gottron's sign or papules, mechanic's hand, V rash, skin ulcers, panniculitis, alopecia, arthritis/arthralgia, pneumomediastinum, RPILD, CDM, CADM and elevated CK in patients with DM.

Malignancies in Korean patients with immunoglobulin G4‐related disease

Several studies have implicated increased risk of malignancy in patients with immunoglobulin G4-related disease (IgG4-RD). Hence, we first evaluated the risk and the type of malignancy in Korean IgG4-RD patients. Clinical and laboratory results of patients fulfilling the comprehensive diagnostic criteria for IgG4-RD were retrospectively collected between January 2006 and November 2015. One hundred and eighteen patients were included, and 35 were classified as having definite, 83 as possible/probable IgG4-RD. We compared baseline clinical and laboratory variables between patients with definite and those with possible/probable IgG4-RD and calculated standardized incidence ratios (SIRs) for malignancies. The median age was 60 years old and 91 patients (77.1%) were male. Malignancies were found in 12 of 118 patients (10.1%), and lymphoma (4, 25.0%) was the most frequent malignancy related to IgG4-RD. Definite IgG4-RD patients had higher serum IgG levels and frequent multiple organ involvement. The overall incidence of malignancy was increased in patients with IgG4-RD compared to the general population (SIR 23.08 [95% CI 11.92-40.31]), and the overall risk of SIRs was highest in non-Hodgkin lymphoma (SIR 400.00 [95% CI 109.00-1024.00]). Our data showed that increased risk of malignancy, especially lymphomas, was observed in Korean IgG4-RD patients.

Clinical manifestations of 10 cases of imported human Zika virus disease in Jiangmen city of China

Objective: To study the clinical manifestations and detection method for imported patients of Zika virus disease. Method: The records of symptoms, signs and laboratory results were collected and analyzed. The specimen of blood, saliva and urine from patients were collected. Results: Two of ten patients had mild fever. The visible cutaneous maculopapular rash of the trunk and extremities was observed in all patients. Seven patients were observed congestive conjunctivitis and only one patient gave an account of itching. No patient had symptoms of myalgia or arthralgia. The laboratory results of patients were normal except two patients had mild leucopenia and another one had thrombocytosis. The Zika virus RNA was detected in urine samples for a longest period. The detection rates of Zika virus RNA from the samples of blood, saliva and urine that collected in seventh day after disease onset were 0, 5, 8 cases, respectively. Conclosion: Epidemiology history, maculopapular rash, congestive conjunctivitis and Zika virus RNA being detected in urine can be considered as the important clinical criterion for making a definite diagnosis as Zika virus disease.

Four-Year Analyses of Renal Graft Biopsies: A Single-Center Pathology Experience.

Kidney transplant is the best treatment for patients with end-stage renal disease. Long-term graft survival depends on the protection of renal allograft function. Renal allograft biopsy is the most important method for examining an allograft function. Biopsy provides critical information, enabling diagnosis and grading of pathologic changes, prediction of response to therapy, and long-term graft prognosis. We reviewed the medical records of patients who underwent renal transplant from living and deceased donors at Baskent University Adana Teaching and Research Hospital between 2010 and 2014 and who had an indication for biopsy. Clinical characteristics and laboratory results of patients were recorded. Patient biopsy samples were examined according to the Banff 2009 classification. Between 2010 and 2014, there were 175 renal transplants performed at our hospital, with 134 recipients (76.6%) having living-donor and 41 recipients (23.4%) having deceased-donor transplants. Fifty-one patients (29.1%) were children, and 124 patients (70.9%) were adults. We found that there were 123 biopsies made from 75 transplant patients over a 4-year period. When examined according to Banff 2009 criteria, the biopsy samples revealed acute T-cell-mediated rejection alone in 14.1% of the samples, acute antibody-mediated rejection in 4%, and a combination of the 2 rejections in 5.7%. Specific infections were detected in 12 patients. The graft nephrectomy rate was 5.1%. This study investigated biopsy results, their relation with patient clinical status and 4-year survival rates, and our pathology experience and found that rejection and infection rates were similar to the literature. Our future studies with a longer follow-up and a larger sample size will likely provide more accurate information about graft survival and biopsy results.

Clinical Findings and Management of Imported Cutaneous Leishmaniasis- Presentation of 8 Cases from Poland with a Review of Current Knowledge about Leishmaniasis

Background: Leishmaniasis is a frequent parasitic disease in the world, caused by protists of Leishmani genus and transmitted by Phlebotomusspp. and Lutzomyia spp. sandflies. It is a relatively unknown and uncommon disease on our continent therefore it remains a diagnostic and therapeutic challenge for European physicians. There are two clinical forms of the disease that can be distinguished: cutaneous and visceral leishmaniasis. Aim of the study was to expand the knowledge about cutaneous leishmaniasis among physicians and to show that patients with leishmaniasis can be found in any country due to globalization. Case presentation: Laboratory results of patients infected with cutaneous leishmaniasis and a clinical course of this disease have been presented. 8 patients infected with cutaneous leishmaniasis were treated in the Department of Tropical and Parasitic Diseases in Gdynia, Medical University of Gdansk in the years 2005-2013. All of them were admitted with symptoms lasting at least several months prior to the admittance. Satisfactory results were obtained with the applied treatment. Conclusions: Cutaneous leishmaniasis is a rare finding in Poland, and diagnosis and treatment of the disease are hampered by poor knowledge about the disease among physicians and laboratory staff, as well as lack of registered antimony-based drugs in Poland. The problem of misdiagnosis and, as a consequence, inappropriate treatment of cutaneous leishmaniasis persists also in other European countries as well as Canada and the United States. According to the literature, almost every case of leishmaniasis in these countries was initially treated inappropriately and time to definite diagnosis usually took several weeks.

Comparison of Strontium Ranelate and Alendronate Sodium Treatment among Post-Menopausal Women

Growing rates of osteoporosis in the whole world is a serious health problem. As the “expected lifetime” is prolonged, population of elderly women with chronic diseases who require long-term treatment increases. This study aimed to compare antiresorptive treatment—that has become a classic treatment in the light of Canadian Guideline for osteoporosis—with the antiresorptive plus osteoblastic activity inducing treatment modality. The clinical and laboratory results of patients treated with a single dose of 2 mg Strontium ranelate sachet (Protelos &reg) or alendronate sodium used weekly 70 mg tablet (Fosamax &reg once a week tablet) for 12-months were compared. Treatment compliance has been questioned. A hundred women in post-menopausal period were included in this study. Patient satisfaction survey among the group of strontium ranelate was unsatisfactory. Among patients using alendronate sodium the ease of use in this sense obtained a rate of 91% satisfaction from patients.

Is It Possible to Predict the Failure of Noninvasive Mechanical Ventilation for Acute Respiratory Failure Due to Pneumonia?

SESSION TITLE: Chest Infections Posters I SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM PURPOSE: Non-invasive mechanical ventilation (NIMV) treatment in patients with acute hypoxemic respiratory failure due to pneumonia are controversial. The aim of this study is to determine the prognosis, failure rate of NIMV and risk factors for intubation in these patients. METHODS: Patients who were treated with NIMV for acute respiratory failure due to pneumonia in our intensive care unit (ICU) were assessed retrospectively. Demographic, clinical characteristics and laboratory results of patients were recorded. RESULTS: Eighty four patients (29 female, age 67 years, APACHE II score 17.5±7.0, median PaO2/FiO2 rate 222) were included in this study. NIMV was started on the first day after admission to ICU. The acute respiratory failure develpoed due to community, hospital acquired, healthcare associated pneumonia and pneumonia in immunocompromised patients (29.8%, 22.6%, 16.7%, 29.8%, respectively). 59.5% of patients were intubated on the second day because of failure of NIMV. In the patients of of whom the NIV failed, the baseline APACHE II score, respiratory rate and EPAP level were higher (p=0.008, p=0.001, p=0.002, respectively) and PaO2/FiO2 rate, hemoglobine, albumin levels were lower (p=0.001, p=0.001, p=0.001, respectively). The mortality rate due to acute respiratory failure was 58.3%. Hemoglobine level of <10 g/dl, existence of ARDS, absence of COPD and administration of vasopressor treatment were found to be independent risk factors for failure of NIMV (OR values were 11.09, 5.61, 6.17, 33.93 respectively) . CONCLUSIONS: NIMV can be applied to the patients who have acute hypoxemic respiratory failure due to pneumonia. However, there is a probability of failure of NIMV due to anemia, development of ARDS and baseline requirement for vasopressor treatment at baseline. CLINICAL IMPLICATIONS: NIMV can be used for the treatment of acute hypoxemic respiratory failure due to pneumonia. On the other hand, some factors such as aneima, existence of ARDS and vasopressor treatment at baseline may cause the failure of NIMV. Therefore, while applying NIMV in this group of patients, they should be monitored carefully. DISCLOSURE: The following authors have nothing to disclose: ALEV GURGUN, Imren Nesil, Pervin Korkmaz Ekren, Funda Elmas Uysal, Feza Bacakoglu No Product/Research Disclosure Information

Optimization of Inflammatory Bowel Disease Cohort Studies in Asia

With the incidence of inflammatory bowel disease (IBD) increasing rapidly in many Asian countries, including Hong Kong, it is important that patient characteristics are better understood. For example, are the phenotypes, behaviors, complications, and even treatment responses found in Asian patients similar to those of their Western counterparts? To formally address these questions, a properly designed local cohort study is needed. Whilst IBD is still relatively uncommon in Asia, the establishment of a local IBD registry will significantly contribute to the answering of these questions. The Hong Kong IBD registry was established to fill the gap in the understanding of IBD patients, and to foster research into IBD in Hong Kong. The Hong Kong IBD registry is a territory-wide registry that includes all public hospitals in Hong Kong. We included all IBD patients who were currently receiving medical care at these hospitals. With the help of the central computer medical record system of the Hospital Authority of Hong Kong, all clinical events, medications usage, endoscopy records, and laboratory results of patients in the registry were captured. Apart from data collection, the registry is also establishing a bio-specimen bank of blood and stool samples of IBD patients for future research. The IBD registry is a very useful platform for population-based studies on IBD in Asia.

How does a biopsy of endoscopically normal terminal ileum contribute to the diagnosis? Which patients should undergo biopsy?

Background Terminal ileum endoscopy and biopsy are the diagnostic tools of diseases attacking the ileum. However, abnormal histological findings can be found in endoscopically normal terminal ileum. Objective This study was performed to evaluate the histopathological results of biopsies from endoscopically normal terminal ileum in order to determine pre-procedure clinical and laboratory factors predicting abnormal histopathological results, if any. Methods A total of 297 patients who underwent colonoscopy and terminal ileum biopsy and had normal terminal ileum or a few aphthous ulcers in the terminal ileum together with completely normal colon mucosa were included in the study. The patients were grouped into two arms as normal cases and cases with aphthous ulcers. Histopathological and pre-procedural laboratory results of patients were analyzed according to their indications. Results The terminal ileum was endoscopically normal in 200 patients, and 97 patients had aphthous ulcers. Chronic ileitis rate was present in 5.5% of those with endoscopically normal terminal ileum and in 39.2% of the patients with aphthous ulcers. In both groups, the highest rate of chronic ileitis was detected in the patients with known inflammatory bowel disease (IBD) (15.4 and 50%, respectively), anemia (9.5 and 43.5%, respectively), and in the patients having chronic diarrhea together with abdominal pain (7.7 and 44.8%, respectively). We found that the sensitivity of mean platelet volume for predicting chronic ileitis was 87% and the specificity was 45% at a cut-off value lower than 9.35 fl. Conclusion In anemia indication or chronic diarrhea together with abdominal pain, the frequency of aphthous ulcers detected by ileoscopy and the frequency of chronic ileitis detected histopathologically despite a normal-appearing ileum were elevated.

Lipid profile frequency and the prevalence of dyslipidaemia from biochemical tests at Saint Louis University Hospital in Senegal.

IntroductionThe aim of this study was to evaluate the frequency of lipid profile requests and the prevalence of dyslipidemia in patients at the biochemistry laboratory of St. Louis University Hospital, as well as their correlation with sex and age.MethodsThis was a retrospective study reviewing 14,116 laboratory results of patients of both sexes, over a period of six months (January-June 2013) regardless of the indication for the request. The lipid parameters included were: Total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides with normal values defined as follows: Total cholesterol (<2g/l), HDL- cholesterol (>0,40g/l), LDL- cholesterol (<1,30g/l) and Triglycerides (<1,50g/l).ResultsThe average age of our study population was 55.15 years with a female predorminance (M/F = 0.60). The age group most represented was that between 55-64 years. The frequency of lipid profile request in our sample was 9.41% (or 1,329). The overall prevalence of isolated hypercholesterolemia, hyperLDLaemia, hypoHDLaemia, hypertriglyceridaemia, and mixed hyperlipidemia were respectively 60.91%, 66.27%, 26.58%, 4.57% and 2.75%. Hypercholesterolemia, hyperLDLaemia, hypertriglyceridaemia and mixed hyperlipidaemia were higher in women with respectively 66.22%, 67.98%, 4.58%, 2.89% than in men (52.01%, 62.81%, 4.44% and 2.40% respectively). On the other hand, the prevalence of hypoHDLaemia was higher in males (32.19%) compared to females (23.76%). Hypercholesterolemia correlated significantly with age and sex.ConclusionOur study showed a relatively low request rate for lipid profile and a high prevalence of dyslipidaemia hence the importance of conducting a major study on the prevalence of dyslipidaemia and associated factors in the Senegalese population.

Acute hyponatremia after cardioplegia by histidine-tryptophane-ketoglutarate – a retrospective study

BackgroundHyponatremia is the most common electrolyte disorder in hospitalized patients and is known to be associated with increased mortality. The administration of antegrade single-shot, up to two liters, histidine-tryptophane-ketoglutarate (HTK) solution for adequate electromechanical cardiac arrest and myocardial preservation during minimally invasive aortic valve replacement (MIAVR) is a standard procedure. We aimed to determine the impact of HTK infusion on electrolyte and acid–base balance.MethodsIn this retrospective analysis we reviewed data on patient characteristics, type of surgery, arterial blood gas analysis during surgery and intra-/postoperative laboratory results of patients receiving surgery for MIAVR at a large tertiary care university hospital.ResultsA total of 25 patients were included in the study. All patients were normonatremic at start of surgery. All patients developed hyponatremia after administration of HTK solution with a significant drop of serum sodium of 15 mmol/L (p < 0.01). Measured osmolality did not change during all times of surgery compared to start of surgery (p = 0.28 – p = 0.79), indicating isotonic hyponatremia. After administration of HTK solution pH fell significantly due to development of metabolic acidosis.ConclusionsAcute hyponatremia during cardioplegia with HTK solution is isotonic and should probably not be corrected without presence of hypotonicity as confirmed by measurement of serum osmolality.

Frequency and Levels of Autoantibodies in Healthy Adult Omanis

A previous pilot study showed a high frequency of anti-smooth muscle autoantibody in Omani blood donors and pregnant women. We conducted this larger-scale study to investigate the frequency and significance of several autoantibodies in healthy individuals from different regions of Oman. Sera obtained from 1537 healthy Omanis (1153 males and 384 females), ranging in age from 18 to 57 years, were tested for the presence of ten different autoantibodies using indirect immunofluorescence, haemagglutination and latex agglutination techniques. Low levels of autoantibodies were detected in 33.5%, whereas a few individuals (1.8%) showed high autoantibody titres. Anti-smooth muscle autoantibodies (ASMA) were the most prevalent (11%). Anti-nuclear autoantibodies (ANA) were the second most prevalent (7.6%). Anti-thyroid microsomal autoantibodies (ATMA) and anti-thyroglobulin autoantibodies (ATA) were present in 6.5% and 4.4% of individuals, respectively. The other autoantibodies were detected much less frequently: anti-parietal cells autoantibodies (APCA) were found in 1.6%, anti-brush border antibodies (ABBA) in 1.3%, anti-reticulin autoantibodies (ARA) in 1%, antimitochondrial antibodies (AMA) in 0.8%, antiglomerular basement membrane antibodies (AGBMA) in 0.7% and rheumatoid factor (RF) in 0.4%. The data indicate that autoantibodies are present in healthy Omani individuals, and therefore caution should be taken when interpreting laboratory results of patients suspected of having autoimmune disease.

Anatomic distribution of venous thrombosis in patients with antiphospholipid antibody: imaging findings.

Antiphospholipid antibodies are immunoglobulins that cross-react with phospholipid within cell membranes. These antibodies have been associated with a hypercoagulable state manifested by early stroke, frequent arterial and venous thromboses, recurrent fetal loss, thrombocytopenia, and livedo reticularis (antiphospholipid syndrome). The purpose of this study was to determine the anatomic distribution of venous thrombosis in patients with antiphospholipid antibodies as seen on imaging examinations. We retrospectively reviewed the laboratory results of patients tested for antiphospholipid antibodies at a tertiary referral center during the period January 1992 to April 1994. This review revealed 228 patients with antiphospholipid antibodies. We excluded patients with systemic lupus erythematosus or any other medical condition associated with a hypercoagulable state and patients over 65 years old. Thirty-one of the remaining 73 patients had undergone imaging studies of the CNS or non-CNS venous system. Radiologic studies (contrast angiography or venography, MR angiography or venography, or Doppler sonography) were examined for the presence of venous thrombosis. Nineteen patients--11 men and eight women, 18-62 years old (average age, 38 years)--with venous thromboses were identified. Twelve patients had non-CNS thrombosis alone, three had CNS thrombosis alone, and four had both CNS and non-CNS thromboses. Locations of non-CNS thromboses included deep veins of the legs (nine occurrences), pulmonary vessels (five), and large veins in the thorax or abdomen (six). Three of these patients had documented thromboses at other sites. Twelve patients had recurrent thrombotic events (six with multiple recurrences), including five with arterial thromboses and two with both venous and arterial thromboses and stroke. Among patients with CNS involvement, five had documented thromboses (four dural sinus, one arterial) and two had arterial distribution strokes demonstrated by CT. Two patients with only non-CNS thromboses had either seizures or migraines. Deep veins of the leg were the most common site of venous thrombosis. The thoracic and abdominal venous system and the dural sinuses--unusual sites of thrombosis in the general population--are other common sites. Antiphospholipid antibodies should be suspected when thromboses are found in these locations in the absence of other known risk factors, or when found in combination with arterial thromboses or CNS ischemic disease in young or middle-aged patients.

Spurious rise in total carbon dioxide and chloride with negative anion gap after cystogram

We report a case of spurious hyperchloraemia, elevated total carbon dioxide and negative anion gap 9 days following a voiding cystourethrogram (VCU) in a patient with bladder exstrophy and obstructive uropathy. We believe that the spurious laboratory results were due to analytical interference of the absorbed iodine with the method of bicarbonate and chloride measurement. The absorbed iodine was retained in the circulation for an extended period because of associated renal impairment. Our patient was also on piperacillin which might have interfered with iodine clearance. Physicians and laboratory pathologists should be aware of this effect when interpreting laboratory results of patients who have undergone a VCU in association with obstructive uropathy and impaired renal function.

The effects of Ramadan fasting on the number of renal colic visits to the emergency department.

Objective:The effects of fluid and diet restriction strictly during the long hours in Ramadan on the number of colic visits and biochemical factors of stone formation are controversial in the literature. The aim of this study was to assess the effects of Ramadan fasting on the number of renal colic visits and laboratory results of patients with renal colic.Methods:This was a prospective observational study, which was conducted with patients who were admitted to our emergency department with renal colic. The study period was divided into two parts: Before Ramadan and Ramadan. All laboratory results of patients and daily air temperature values were recorded. p<0.05 was considered statistically significant for all tests.Results:Total 176 patients (n:89 in before Ramadan, n:87 in Ramadan) with renal colic were enrolled into the study. During Ramadan, 49 (73.1%) of 67 patients were admitted in the first half of the month and 20 patients (26.9%) were admitted in the second half of the month. Only urine density and white blood cell values in Ramadan and non-Ramadan period were significantly different (p=0.004 and p=0.001). Hemoglobin, general crystal, and triple phosphate crystal values in the first and the second half of Ramadan were significantly different (p=0.04, p=0.03, and p=0.03).Conclusion:This study has shown that fasting in Ramadan does not change the number of renal colic visits. In addition, although fasting causes some changes in urinary metabolites, there is not enough evidence that these changes increase urinary calculus formation.