Mean C-reactive Protein Levels Research Articles

Role of estradiol and C-reactive protein levels on genitourinary syndrome in menopausal women

Menopause leads to decreased estradiol levels affecting tissue health and causing local inflammation in the genital organs and urinary tract. The rise of blood C-reactive protein (CRP) levels in menopausal women may indicate systemic inflammation associated with estradiol decline. The aim of this study was to determine the relationship between serum estradiol and CRP levels on genitourinary syndrome in menopausal women. A cross-sectional study was conducted among menopausal women who had not experienced menstruation for at least 12 consecutive months at Prof. dr. Chairuddin P. Lubis Hospital, Medan, Indonesia, in 2023. Estradiol and CRP levels were measured using enzyme-linked immunosorbent assay (ELISA) and the presence of genitourinary syndrome was assessed using the Menopause-Specific Quality of Life (MENQOL) questionnaire. The mean levels of estradiol and CRP were compared to menopausal women with and without genitourinary syndrome with the Mann-Whitney test. To assess the correlation between estradiol and CRP levels, and between their levels with the presence of genitourinary symptoms, the Spearman correlation test was used. The genitourinary syndrome was reported in 25% of the total included menopausal women. Our data indicated that the mean estradiol levels were not significantly different between menopausal women with and without genitourinary syndrome (9.13±2.47 pg/mL vs 18.96±31.23 pg/mL, p=0.881). The mean serum CRP level of menopausal women with genitourinary syndrome (9.72±6.30 mg/L) was higher than that of women without the syndrome (2.09±1.26 mg/L) with p<0.001. In addition, serum CRP level, not estradiol, was correlated with the symptom score of genitourinary syndrome. This study highlights that to identify and manage genitourinary syndrome, monitoring of CRP levels is essential in menopausal women.

Effect of saline irrigation temperature difference on postoperative acute pain and hypothermia during biportal endoscopic spine surgery.

Recently, enhanced recovery after surgery (ERAS) protocols have attracted attention; they emphasize on avoiding intraoperative hypothermia while performing lumbar fusion surgery. However, none of the studies have reported the protocol for determining the temperature of saline irrigation during biportal endoscopic spine surgery (BESS) procedure. This study evaluated the effectiveness of warm saline irrigation during BESS in acute postoperative pain and inflammatory reactions. Fifty-five patients who underwent BESS procedure were retrospectively analyzed for the incidence of perioperative hypothermia (< 36oC), postoperative inflammatory factors (white blood cells (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), interleukin-6 (IL-6), serum amyloid A (SAA)), and clinical outcomes (back visual analog scale (VAS) score, postoperative shivering). The patients were divided into the warm and cold saline irrigation groups. Hemoglobin, WBC, ESR, creatine kinase, and creatine kinase-muscle brain levels did not significantly differ between the warm and cold saline groups. The mean CRP, IL-6, and SAA levels were significantly higher in the cold saline group than in the warm saline group (p = 0.0058, 0.0028, and 0.0246, respectively); back VAS scores were also higher with a statistically significant difference until two days postoperatively (p < 0.001). During the entire procedure, the body temperature was significantly lower in the cold saline irrigation group, but the hypothermia incidence rate significantly differed 30min after the operation was started. Using warm saline irrigation during BESS is beneficial for early recovery after surgery, as it is associated with reduced postoperative pain and complication rates.

Clinical features of patients with carcinoma soft tissue metastases as surgical indications: a retrospective cohort study

BackgroundSoft-tissue metastasis of carcinoma is rare. In the present study, we investigated the surgical indications and clinical features of patients with soft tissue metastases of carcinoma.MethodsIn this retrospective cohort study, we enrolled 26 patients with soft tissue carcinoma metastasis referred to our department for treatment. Sex, age, location, size, depth, pain due to the tumor, primary origin, serum C-reactive protein (CRP) level, MRI examinations, diagnosis by a previous physician, carcinoma markers from blood, history of carcinoma, other metastases, performance status (PS), and surgical procedures were documented. Associations between variables and surgery were statistically analyzed.ResultsThe primary cancer origin was found to be the lung (n = 10), kidney (n = 7), esophagus (n = 2), stomach (n = 1), breast (n = 1), liver (n = 1), ureter (n = 1), anus (n = 1), and unknown (n = 2). The mean CRP level of all patients was 2.3 mg/dL. Seven tumors (26.9%) were originally suspected to be soft tissue metastases of carcinoma, while 19 tumors (73.1%) were considered soft tissue sarcomas or inflammatory lesions by the previous treating physician. Twenty patients (76.9%) had other metastases. The PS of the 12 patients (46.2%) was zero. Eleven patients (42.3%) underwent surgery for soft tissue metastases. Diagnosis of soft tissue metastasis by a previous physician and good PS (p < 0.05) were significantly associated with surgery.ConclusionOverall, the present results show that surgical indications for soft tissue metastasis of carcinoma include diagnosis by the referring physician or good PS of the patients.

DYNAMIC CHANGES ININFLAMMATORY PROFILES OF THYROID DYSFUNCTION: A COMPARATIVE ANALYSIS OF HYPERTHYROIDISM AND HYPOTHYROIDISM

Introduction and Aim:The thyroid gland, an endocrine organ, produces vital hormones (T3 and T4) regulating metabolism. Thyroid-stimulating hormone (TSH) controls their release, impacting body tissues. C-reactive protein (CRP), an acute-phase protein, serves as a biomarker, crucial in diagnosing and managing various health conditions, particularly thyroid disorders. Elevated CRP levels often accompany thyroid dysfunction, highlighting the link between inflammation and thyroid disease pathogenesis, essential for diagnosis and management strategies. Methods: The research was conducted at the College of Paramedical Sciences, Teerthanker Mahaveer University &amp;Teerthanker Mahaveer Hospital &amp; Research Center, Moradabad in India, using random sampling. Blood sample was collected in the vacutainer and serum was separated for the clinical examination of CRP by turbidimetric immunoassay method. Clinical examinations were estimated in the biochemistry lab at the College of Paramedical Sciences by using a Semiautoanalyser. Results:The CRP levels in both hypothyroid and hyperthyroid groups were found higher as compared to euthyroid individuals, with mean CRP levels of 8.42 mg/dl, 5.67 mg/dl, and 5.05 mg/dl, respectively. A positive correlation between CRP and TSH is observed in hypothyroidism (r = 0.220). While hyperthyroidism exhibits slightly elevated CRP levels compared to healthy controls (5.67 mg/dl vs. 5.05 mg/dl), this difference lacks statistical significance (p&gt;0.05). Notable variances in serum Hs-CRP levels are observed among individuals with hypothyroidism compared to euthyroidism (p&lt;0.05), hyperthyroidism compared to euthyroidism (p&gt;0.05), and hyperthyroidism compared to hypothyroidism (p&lt;0.05), as determined by statistical analysis. Conclusion:A notable elevation in CRP levels among individuals with hypothyroidism and hyperthyroidism compared to those with euthyroidism. Additionally, a positive correlation is observed between CRP and TSH levels, particularly in the hypothyroid group. The disparities in Hs-CRP levels among different thyroid conditions underscore the link between thyroid function and inflammatory status.

E039 Multiple myeloma and neurological complications: prevalence and risk factors

Abstract Background/Aims Multiple myeloma (MM) is a malignant haematological disorder with a highly variable clinical presentation. Few studies have explored the neurological complications (CN) associated with MM. The objectives of this study were to describe the neurological manifestations observed in MM and to determine predictive factors for neurological complications. Methods We collected data from 126 cases of symptomatic multiple myeloma patients followed in our department over a 30-year period (1993 - 2023). We gathered sociodemographic, clinical, and laboratory data. Neurological complications were diagnosed based on clinical findings and magnetic resonance imaging data. Results Our study included 126 patients with an average age of 65.23 ± 11.63 years [36-92], and a male-to-female sex ratio of 3.8. Bone pain was present in 92.1% (116 cases) with an average duration of 4 months. The mean erythrocyte sedimentation rate and C-reactive protein levels were 99.08 mm at H1 [3-190] and 27.74 [0-196], respectively. Hemoglobin levels were less than 10g/dl in 51.2% of cases, with an average of 9.902 ± 2.22 g/dl [5-13.9]. Calcium levels exceeded 2.75 mmol/l in 20% of cases, with an average of 2.49 ± 0.33 mmol/l. The mean creatinine level was 88.28 ± 77.9 μmol/l [36-587], with levels above 177 μmol/l observed in 15 cases (10.4%). The Durie and Salmon prognostic classification categorized our patients as follows: Stage IA (3.2%), Stage IIA (4%), Stage IIB (0.8%), Stage IIIA (72.2%), and Stage IIIB (18.3%). Neurological complications were present in 22.2% of patients (n = 28). Sixteen patients (12.7%) had spinal cord compression, with nine having dorsal involvement, six having conus medullaris involvement, and one having cervical involvement. Radicular pain affected 14 patients, with eight experiencing sciatalgia and four having cruralgia. Two patients (1.8%) had carpal tunnel syndrome. No cerebral involvement was observed in our series. In our study, only creatinine levels were significantly lower in patients who developed neurological complications (64.35 vs. 95.19, p = 0.004). However, the occurrence of neurological complications was independent of age (p = 0.696), duration of evolution (p = 0.669), erythrocyte sedimentation rate (p = 0.541), C-reactive protein (p = 0.963), hemoglobin (p = 0.076), or calcium levels (p = 0.274). No association was found between neurological complications and gender (p = 0.849) or prognostic stage (p = 0.119) Conclusion Neurological manifestations in MM are diverse and often underestimated. The diagnosis of MM should be considered in the presence of spinal or radicular compression, especially when the laboratory findings suggest it. Disclosure M. Dhifallah: None. I. Fenniche: None. A. Feki: None. S. Ben Djemaa: None. M. Kallel: None. H. Fourat: None. R. Akrout: None. S. Baklouti: None.

Association of Inflammatory Markers and Diabetic Retinopathy

Abstract Introduction: Diabetic retinopathy is a micro-angiopathy, the pathogenesis of which is manifold. Chronic inflammation releasing various mediators has been proposed to cause micro-angiopathy in long-term diabetics. These markers can be easily measured in serum and may serve as a risk factor for progression as well as allow newer modalities of management aimed at this pathology. Aims and Methodology: The aim of the study was to determine the association between different inflammatory markers and diabetic retinopathy. A total of 100 eyes in diabetic patients, 20 each with no retinopathy, mild NPDR, moderate NPDR, severe NPDR, and PDR were included. The serum levels of C-reactive protein (CRP) and absolute neutrophil count were recorded and compared across each of these groups. Results: The mean ANC among these groups, respectively, was 5525, 5162, 5374, 5239, and 5313 (per microlitre), and neither were these raised significantly nor was the difference between groups statistically significant. Mean CRP levels were within normal limits in all groups (2.56, 2.87, 4.06, 5.15, 6.97 mg/dl), although there was a steady increase with each grade of retinopathy, and this was found statistically significant. Conclusion: There was no association between absolute neutrophil count and diabetic retinopathy. Serum CRP levels may guide progression of retinopathy and can be monitored to help management protocols.

A Study of how the Serum Levels of Inflammatory Markers Correlate with Hemoglobin Oxygen Saturation Percentage and the Type of Respiratory Support Received by Covid-19 Patients Hospitalized in Intensive Care Units

Aim This study aimed to shed light on how serum levels of interleukin-6 (IL-6), lactate dehydrogenase (LDH), and C-reactive protein (CRP) correlate with hemoglobin oxygen saturation percentage (SpO2) and the type of respiratory support received among COVID-19 patients hospitalized in COVID-19 intensive care units. Background The clinical care of patients who suffer from COVID-19 requires knowledge of laboratory findings and the way these findings are linked with the type of respiratory support. Methods This descriptive-analytical study was conducted using data from the clinical records of 31 patients hospitalized in the intensive care unit at 22nd-Bahman Hospital in Khaf, Eastern Iran, during the first half of 2021. The study utilized a checklist developed by the researcher for data collection. The data were analyzed with Kolmogorov-Smirnov, independent t, one-way analysis of variance, and Tukey's post hoc statistical tests in the SPSS-22 statistical package. The significance level was established at p &lt;0.05. Results The mean CRP, LDH, and serum levels of IL-6 were significantly higher in COVID-19 patients with SpO2 &lt;93 than in patients with SpO2 ≥93 (p &lt;0.05). Patients receiving intubation and non-invasive respiratory support exhibited significantly greater serum levels of IL-6, CRP, and LDH than patients receiving other respiratory support (p &lt;0.05). The mean CRP, serum levels of IL-6, and LDH were significantly lower among survivors than those who died (p &lt;0.01). Conclusion Understanding the relationship between the serum levels of IL-6, CRP, LDH, and SPO2 and the type of respiratory support can help predict the management of acute respiratory patients, but this decision-making method based on serum levels should be further investigated. and to be compared with the current methods of management of treatment of acute respiratory patients.

Estimated C-reactive protein (CRP) velocity for rapidly distinguishing bacterial from other etiologies in children presenting to emergency department with remarkably elevated CRP levels.

The use of a single C-reactive protein (CRP) value to differentiate between bacterial and non-bacterial causes is limited. Estimated CRP velocity (eCRPv) has shown promise in enhancing such discrimination in adults. This study aims to investigate the association between eCRPv and bacterial etiologies among pediatric patients with very elevated CRP levels. We conducted a retrospective analysis of patients under 18years of age who had been admitted to our Pediatric Emergency Department from 2018 to 2020 with a fever and CRP levels ≥ 150mg/L. Bacterial and non-bacterial etiologies were determined from hospital discharge diagnoses, which were monitored independently by three physicians from the research team. The records of 495 suitable patients (51.2% males, median age 3.2years) were retrieved of whom 444 (89.7%) were eventually diagnosed with bacterial infections. The mean CRP levels were significantly higher for bacterial etiologies compared with other causes (209.2 ± 59.8mg/L vs. 185.6 ± 35.8mg/L, respectively, p < .001), while the mean eCRPv values did not differ significantly (p = .15). In a time course analysis, we found that specifically in patients presenting ≥ 72h after symptom onset, only a eCRPv1 level > 1.08mg/L/h was an independent predictor of bacterial infection (aOR = 5.5 [95% CI 1.7-17.8], p = .004). Conclusion: Pediatric patients with very high CRP levels and fever mostly have bacterial infections. eCRPv levels, unlike CRP values alone, can serve as the sole independent predictor of bacterial infection > 72h from symptom onset, warranting further prospective investigations into CRP kinetics in pediatric patients. What is Known: • The use of a single C-reactive protein (CRP) value to differentiate between bacterial and non-bacterial causes is limited. • Estimated CRP velocity (eCRPv) has shown promise in enhancing such discrimination in adults, but data on CRP kinetics in pediatric patients is sparse. What is New: • eCRPv levels, unlike CRP values alone, can serve as the sole independent predictor of bacterial infection > 72h from symptom onset in pediatric patients with remarkably elevated CRP levels.

Diagnostic Values of Blood Indices for Neonatal Sepsis

Background: Sepsis is the leading cause of death in newborns, particularly in underdeveloped countries. Early diagnosis and appropriate treatment are critical in reducing neonatal mortality. Since blood culture results are often unavailable for 48 - 72 hours, other hematologic findings may provide useful information for early diagnosis. Objectives: We examined the relationship between neonatal sepsis and blood indices in order to achieve early diagnosis. Methods: In this hospital-based retrospective multiple-event case-control study, we allocated the neonates into three groups: Culture-positive sepsis, culture-negative sepsis, and neonates without sepsis. We compared the lab data within these three groups. Results: The study included 319 neonates: 209 cases of culture-positive sepsis, 65 cases of culture-negative sepsis, and 45 cases without neonatal sepsis. Pearson's test demonstrated a significant correlation between thrombocytopenia, positive C-reactive protein (CRP), and high cell distribution width with culture-positive sepsis (P = 0.000), indicating a statistical difference between the three groups. The mean CRP and eosinophil levels were higher in the culture-positive group with fungal sepsis. Conclusions: In septic neonates with high CRP levels, particularly in conjunction with eosinophilia, fungal coverage should be considered.

The Effect of the Holy Quran Recitation on Inflammatory Markers in Hemodialysis Patients in Iran: A Randomized Clinical Trial.

Increased inflammation is a common complication in chronic hemodialysis (HD) patients. Addressing the psychological symptoms of patients may help reduce inflammation and its negative impact on the body. Considering the calming effects of listening to the Holy Quran, this may help reduce mental, psychological, and physical problems in Muslim patients. The present study sought to examine the effects of listening to Holy Quran recitation on the level of inflammatory markers in HD patients. This was a randomized controlled trial involving 50 HD patients at Kowsar Hospital in Semnan, Iran, in 2019-2020. The participants were divided into experimental and control groups using simple randomization by sealed envelopes. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and interleukin-6 (IL-6) levels in blood were measured before the intervention. The participants in the experimental group listened by headphones to the Holy Quran being recited three times a week, 20 min each time, for one month. For those in the control group, headphones were placed but on silent mode. At the end of the intervention one month later, inflammatory markers were measured again for participants in both groups. Data were analyzed in SPSS-16 using descriptive and inferential statistics (t test, Wilcoxon, and Mann-Whitney U). Mean IL-6 level decreased by 20.2pg/ml, mean ESR level by 16.8mm/hr, and mean CRP level by 19.9mg/dl in the experimental group, while these values increased in the control group. The between-group differences in the intervention and control groups at follow-up were significant for all three inflammatory markers (p < 0.05). Listening to the Holy Quran being recited is recommended as a complementary therapy for reducing systemic inflammation (as indicated by inflammatory markers) in Muslim HD patients.Trial registration: Iranian Registry of Clinical Trials, Trial No: IRCT20120109008665N9. Registered 4 Nov 2019.

Correlation of C-Reactive Protein and Severity of Peri-Implant Diseases.

Peri-implant disease pathogenesis is similar to periodontal disease pathogenesis resulting in production of pro-inflammatory mediators. These mediators are released during the inflammation phase, among which C-reactive protein (CRP) is one of the acute phase reactants. The aim of the study was to correlate the levels of CRP with the severity of peri-implant diseases. The present observational study was carried out from June 2022 to December 2022 in the Department of Implantology, Saveetha Dental College and Hospitals, Chennai, India. A total of 60 patients with peri-implant health (n = 20), peri-mucositis (n = 20) and peri-implantitis (n = 20) were enrolled. Unstimulated salivary samples were collected and subjected to latex agglutination assay for CRP analysis. CRP levels were then correlated with severity of peri-implant diseases. The mean CRP level in peri-implant health, peri-implant mucositis, peri-implantitis were 0.25 ± 0.36 mg/dl, 3.56 ± 0.85 mg/dl and 5.07 ± 0.74 mg/dl, respectively. Pearson correlation coefficient analysis revealed a strong positive correlation between CRP and peri-implant parameters suggesting that the CRP level increased as the severity of peri-implant disease increased. CRP level increases with severity of peri-implant diseases and there exists a positive correlation between CRP level and peri-implant parameters. Therefore, CRP can be used as a diagnostic marker for peri-implant diseases.

Effects of curcumin supplementation on abdominal surgical wound healing.

To evaluate the effects of curcumin supplementation on abdominal surgical wound healing in rats using clinical, histological, and hematological parameters. Forty Wistar rats were randomly divided into two groups: the curcumin group, and the control group. The curcumin group received, in addition to water and standard feed, curcumin via gavage at the dose of 200 mg/kg for seven days preceding and seven days following surgery. The control group received only water and standard feed. Both groups underwent median laparotomy and left colotomy. On the eighth postoperative day, the groups were euthanized, and the left colon was resected for histological analysis. In the preoperative evaluation, there was a significant decrease in the mean C-reactive protein levels in the curcumin group (0.06) compared to the control group (0.112) (p = 0.0001). In the postoperative wound healing assessment, a significant decrease was observed in inflammatory infiltrate (p = 0.0006) and blood vessel count (p = 0.0002) in the curcumin group compared to the control group. Curcumin supplementation was able to significantly reduce inflammatory parameters in both pre-and post-operative phases of abdominal surgical wounds in rats.

Exploring the diagnostic potential of mean platelet volume and C-reactive protein levels in ischemic stroke patients

Background: Ischemic stroke remains one of the leading causes of morbidity and mortality worldwide. Thus, developing more efficient tools to diagnose the condition promptly is critical. Mean platelet volume (MPV) and C-reactive protein (CRP), markers that reflect thrombotic and inflammatory pathways, respectively, are closely associated with the pathophysiology of ischemic stroke and may serve as biomarkers. Aims and Objectives: This study aimed to assess the diagnostic potential of MPV and CRP when measured in patients with ischemic stroke against these markers’ levels in healthy persons. The association between these two biomarkers, as measured in ischemic stroke cases, was also explored. Materials and Methods: A cross-sectional comparison study recruited 54 patients with acute ischemic stroke and 54 age- and sex-matched healthy persons at Government Medical College, Kozhikode. MPV and CRP were measured 24 h post-stroke. The variable comparisons across the groups were made using SPSS; similarly, correlation tests were run considering all subjects experiencing stroke. Results: Patients with ischemic stroke had higher MPV levels of 9.17 ± 0.48 fL than controls: 8.25 ± 0.45 fL P &lt; 0.001. The CRP levels were similarly higher in the stroke group: 3.087 ± 1.11 mg/L versus 0.437 ± 0.24 mg/L, P &lt; 0.001. MPV and CRP had a significant positive correlation after analyzing patients with ischemic stroke (r = 0.332, P = 0.014). Conclusion: The results show that MPV and CRP are robust biomarkers for diagnosing ischemic stroke early, as they represent the underlying inflammatory and thrombotic processes. Implementing them in routine checks can promote early detection and management, improving patient outcomes. Further, longitudinal research is critical to confirm and refine their predictive value.

Role of Inflammatory Markers in Early Diagnosis of Neonatal Sepsis; C-Reactive Protein or Procalcitonin or Red Cell Distribution Width; A Hospital-Based Study

Objective: To find out the utilization of C-reactive protein (CRP), Procalcitonin (PCT) and red cell distribution width (RDW) in diagnosing neonatal sepsis considering blood culture findings as gold standard. Study Design: Cross-sectional validation study. Place and Duration of Study: Neonatal Intensive Care Unit (NICU) of Dr Ziauddin Medical University, Karachi Pakistan, from Feb to Jul 2022. Methodology: A total of 42 neonates of either gender with the clinical diagnosis of neonatal sepsis were enrolled. Demographical and clinical characteristics of all neonates were noted at the time of enrollment. A blood sample of 5 ml was withdrawn for the evaluation of CRP, PCT and RDS. The association of different inflammatory markers with the outcome (neonatal sepsis) was assessed. Results: In 42 neonates, the mean age was 7.24±9.24 days, and 26 (61.9%) neonates were boys. Respiratory distress, reluctance to feed and hypoglycemia were the most frequent clinical presentations observed (19,45.2%), (14,33.3%) and (8,19.0%) neonates, respectively. Mean CRP levels among blood culture positive and negative neonates were 40.02±57.84mg/dl and 7.57±13.34 mg/dl, respectively, while the difference was statistically significant (p=0.0068). RDW (p=0.6488) and procalcitonin (0.9021) levels were not statistically significant differences among positive and negative neonates of blood culture. Conclusion: The CRP was a significant predictor of neonatal sepsis, while RDW and procalcitonin did not have a significant relationship with early prediction of neonatal sepsis.

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

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

Effectiveness and safety of adalimumab in patients with intestinal Behçet’s disease: a real-world prospective observational study in South Korea

BackgroundIntestinal Behçet’s disease (BD) is characterized by typical gastrointestinal ulcers in patients with BD followed by complications such as bleeding, perforation and fistula. Biologic agents are currently under active investigation to delay the disease course. Various data regarding infliximab are available, but there is relatively lack of data regarding adalimumab.MethodsThis was a multicenter, real-world prospective observational study to evaluate the effectiveness and safety of adalimumab in intestinal BD. The primary endpoint was disease activity at each follow up, including disease activity index for intestinal Behçet’s disease (DAIBD), serum C-reactive protein (CRP) level, and endoscopic findings. The secondary endpoint was the incidence of adverse drug reactions (ADRs).ResultsA total of 58 patients were enrolled and 8 of them were excluded. Adverse events were reported in 72.0% of patients with 122 events. ADRs were reported in 24.0% with 28 events. For adverse events, arthralgia was most commonly reported (13.1%: 16/122) and only one experienced critical adverse event (0.82%, 1/122: death due to stroke). On multivariable regression analysis, a longer disease duration was significantly associated with decreased ADRs [Odds ratio 0.976 (0.953–0.999, 95% CI); p = 0.042]. Clinical response rates as assessed by DAIBD were 90.9% at Week 12 and 89.7% at Week 56, respectively. The mean serum CRP level at baseline was significantly decreased after 12 weeks (3.91 ± 4.93 to 1.26 ± 2.03 mg/dL; p = 0.0002).ConclusionAdalimumab was found to be safe and effective in Korean patients with intestinal BD. A longer disease duration was significantly associated with decreased ADRs.

Organism profile and C-reactive protein (CRP) response are different in periprosthetic joint infection in patients with hepatitis.

Hepatitis B and C are important and relatively common health issues. It is known that many patients who underwent total knee and hip arthroplasty were also diagnosed with hepatitis. These patients are at higher risk of periprosthetic joint infection (PJI). This study aimed to investigate the differences in PJI cases in hepatitis B and C patients. This is a retrospective case-controlled single-center study. A total of 270 patients with hepatitis and non-hepatitis (control group) who underwent one-stage septic exchange to the hip and knee joints were included in the study. All patients' previous surgical histories, infective organisms, C-reactive protein (CRP) values before septic exchange, and demographic data were evaluated. All microbiological and laboratory evaluations were performed separately for knee and hip arthroplasty. The mean CRP levels of Hep B- and C-positive patients, who underwent one-stage septic exchange in the knee joint, were 23.6mg/L. In the control group, this value was 43.1mg/L and a statistically significant difference was found between the groups (p = 0.004). Gram-negative organisms were identified in a larger proportion of patients with hepatitis who developed PJI in both hip and knee joints and underwent one-stage septic exchange (p = 0.041/p = 0.044). PJIs caused by Gram-negative bacteria are encountered more frequently in patients with hepatitis than in the control group. In addition, the CRP rise is less in patients with hepatitis compared to PJI cases in the control group. Patient-specific evaluation is required in cases of PJI in patient groups with co-existing hepatitis.

Assessment of Clinical Profile in Patients Suffering from Non-radiographic Axial Spondyloarthropathy

Objectives Axial Spondyloarthritis is an inflammatory, immune-mediated condition comprising clinically dif- ferentiated ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA). Clinically, as the name suggests, nr-axSpA lacks definitive plain X-ray evidence of structural damage to the sacroiliac (SI) joint. This study was undertaken to assess the patients with newly diagnosed nr-axSpA clinically and compare the same with those with radiographic AS. The laboratory profile of patients suffering from nr-axSpA and their outcomes over three months were also studied. Material and Method This study was conducted in the Department of Medicine over 18 months in a tertiary health care institution, being a prospective observational type done with 43 subjects. Results We observed a major improvement as per ankylosing spondylitis disease activity score (ASDAS) criteria present among 53.49% of subjects, followed by clinically significant improvement among 27.91% of subjects. 18.60% of subjects did not show any improvement. 9.3 % of subjects showed radiological progression. Out of 8 cases that did not show improvement, all presented with lower back pain (LBP) and morning stiffness. 62.5% had peripheral arthritis. 87.5% had Schober’s test positive, flexion, abduction and external rotation (FABER) test (62.50%), and SI joint tenderness was found among 7.5% of subjects. A total of 4 (9.3%) patients showed radiological progression. They all have low back aches and morning stiffness, and three have peripheral arthritis at presentation. We found that patients who showed progression had higher mean erythrocyte sedimentation rate (ESR) and C-Reactive protein (CRP) levels (45 and 36.5, respectively) values and very high disease activity as per ASDAS and bath ankylosing spondylitis disease activity index (BASDAI) criteria. Conclusion There is a great scope and need for research to differentiate the magnetic resonance imaging (MRI) changes in the normal population against the patients with spinal diseases to be able to use MRI with precision in patients with non-radiographic axial spondyloarthropathy (nr-axSpA). As assessed, physiotherapy and Non-steroidal anti-inflammatory drugs (NSAIDS) are currently first-line therapy for patients suffering from nr-axSpA.

Serum Selenium and Inflammation in Individuals with Human Immunodeficiency Virus Infection.

HIV infection has been linked to selenium deficiency and chronic inflammation. Both selenium deficiency and inflammation have been associated with poor health outcomes among individuals with HIV. However, the role of serum selenium levels in inflammation has not been studied among individuals with HIV. We assessed the relationship of serum selenium levels to C-reactive protein (CRP), a marker of inflammation, in individuals with HIV in Kathmandu, Nepal. In this cross-sectional study, we measured the normal serum CRP and selenium levels of 233 individuals with HIV (109 women and 124 men) using the latex agglutination turbidimetric and atomic absorption methods, respectively. We used multiple linear regression analysis in examining the association of serum selenium levels with CRP adjusting for sociodemographic and clinical parameters, including antiretroviral therapy, CD4+ T cell count, chronic diseases, and body mass index. The geometric means of CRP and selenium levels were 1.43 mg/liter and 9.65 μg/dL, respectively. Overall, serum selenium levels were inversely associated with CRP levels (β for one unit change in log selenium; β = -1.01, p = .06). Mean CRP levels significantly decreased with increasing selenium across selenium tertiles (p for trend = .019). The mean serum CRP levels were 40.8% lower in the highest selenium tertile than in the lowest. Our study suggests that high serum selenium levels may reduce serum CRP levels in individuals with HIV, although a longitudinal study is warranted to establish causality.

Трофические язвы нижних конечностей у долгожителей: есть ли особенности?

Aim. To compare various clinical and laboratory parameters in centenarians and old patients with trophic ulcers of the lower extremities. Materials and methods. 100 patients were enrolled in the cross-sectional study; 45 centenarians with trophic ulcers – in the main group, 55 patients with trophic ulcers younger than 90 years – in the control group. The age of study patients varied from 61 to 101 years, averaging 82.9±10.5 years. The majority of study patients were women (70%). Results. 40% of ulcers in centenarians were venous ulcers, 24.4% – arterial, 20% – mixed ulcers. Centenarians had a smaller number of ulcers (p=0.03), a shorter duration of ulcers (p=0.01), a smaller area and less infection, compared with patients younger than 90 years. Atrial fibrillation was registered in 46.7% of centenarians, while in patients younger than 90 years this arrhythmia was observed in 31.4% of cases (p=0.02). 22.2% of centenarians and 43.4% of patients under 90 years of age suffered from diabetes mellitus (p=0.001). 11.1% of centenarians and 18.9% of patients of old age suffered stroke in the past (p&lt;0.001). There were no differences in the incidence of myocardial infarction in history (p=0.92) and chronic heart failure (p=0.97) between groups of patients. Among centenarians, 45.2% of patients had normal body weight, 31% were overweight, 23.8% were obese, while in the group of patients younger than 90 years, obesity was registered in 53.7%, and only 22.2 of patients had a normal body mass index (p=0.001). The body mass index in centenarians reached an average of 27.2±6.0 kg/m2, in elderly and senile patients it was 33.7±11.2 (p&lt;0.0001), and the weight was 67.9±16.3 kg and 92.2±33.2 kg, respectively (p&lt;0.0001). The mean count of leukocytes in centenarians was 6.4±2.3×109/l, in patients younger than 90 years – 7.3±2.8×109/l (p=0.07), and platelets – 233±87×109/l and 291±117×109/l, respectively (p=0.006). The mean level of C-reactive protein in centenarians was 12.4±14.7 mg/l, and in patients younger than 90 years it was 26.5±34.0 mg/l (p=0.04). An inverse correlation was observed between the level of C-reactive protein and the age of patients (r=-0.49; p&lt;0.0001). In the group of centenarians a direct correlation was registered between ESR and C-reactive protein level (r=0.49; p=0.02). Conclusions. The study results indicate a number of features of various clinical and laboratory parameters in centenarians with trophic ulcers of the lower extremities, compared with similar old patients.