Mean Levels Of CRP Research Articles

NBS superfood: a promising adjunctive therapy in critically ill ICU patients with omicron variant of COVID-19

This clinical trial aimed to assess the impact of Nutrition Bio-shield superfood (NBS) on clinical status among critically ill ICU patients suffering from acute respiratory distress syndrome (ARDS) due to the Omicron variant of COVID-19. A total of 400 patients with confirmed Omicron-related ARDS were randomly assigned to either the intervention group (n = 200) or the control group (n = 200). Patients in the intervention group received 1.5 g of NBS powder daily for 2 weeks in addition to standard antiviral treatment, while the control group received a placebo alongside standard antiviral therapy. Serum samples were collected from all patients in both groups, and various clinical and laboratory parameters, including ESR, CRP, D-Dimer, CPK, WBC count, lymphocyte count, and lymphocyte percentage, were measured using established methodologies. Following a 14-day intervention period, the intervention group exhibited a significant reduction in mean serum levels of CRP (15.39 vs. 48.49; P < 0.001), ESR (14.28 vs. 34.03; P < 0.001), D-Dimer (485.18 vs. 1009.13; P = 0.001), and CPK (68.93 vs. 131.48; P < 0.001) compared to the control group. Conversely, a significant increase was observed in the mean serum levels of lymphocytes (1537.06 vs. 1152.60; P < 0.001) in the intervention group after 14 days of treatment compared to the control group. The remarkable reduction in inflammatory markers and mortality rates observed with NBS supplementation alongside standard antiviral treatment underscores its crucial role in mitigating inflammation and achieving an important milestone in the fight against COVID-19.

Multiplex analysis of inflammatory proteins associated with risk of coronary artery disease in type-1 diabetes patients.

Chronic uncontrolled hyperglycemia, a precursor to chronic low-grade inflammation, is a leading cause of coronary artery disease (CAD) due to plaque buildup in type-1 diabetes (T1D) patients. We evaluated levels of 22 inflammatory markers in cross-sectional serum samples from 1222 subjects to evaluate their potential as risk factors for CAD in T1D patients. Circulating levels of markers of inflammation may be the risk factors for incident CAD. The T1D subjects were divided into two groups: those without CAD (n = 1107) and with CAD (n = 115). Serum levels of proteins were assayed using multiplex immunoassays on a Luminex Platform. Differences between the two groups were made by univariate analysis. Multivariate logistic regression was used to ascertain the potential of proteins as risk factors for CAD. Influence of age, duration of diabetes, sex, hypertension, and dyslipidemia was determined in a stepwise manner. Serum levels of 22 proteins were combined into a composite score using Ridge regression for risk-based stratification. Mean levels of CRP, IGFBP1, IGFBP2, insulin-like growth factors binding protein-6 (IGFBP6), MMP1, SAA, sTNFRI, and sTNFRII were elevated in CAD patients (n = 115) compared to T1D patients without CAD (nCAD, n = 1107). After adjusting for age, duration of diabetes, sex, hypertension, and dyslipidemia, higher levels of sTNFRI (odds ratio [OR] = 2.18, 1.1 × 10-3 ), sTNFRII (OR = 1.52, 1 × 10-2 ), and IGFBP6 (OR = 3.62, 1.8 × 10-3 ) were significantly associated with CAD. The composite score based on Ridge regression, was able to stratify CAD patients into low, medium, and high-risk groups. The results show activation of the TNF pathway in CAD patients. Evaluating these markers in serum can be a potential tool for identifying high-risk T1D patients for intensive anti-inflammatory therapeutic interventions.

MUTATION OCCURRENCE IN PTGS2GENE SEQUENCE IN CERVICITIS DUE TO TOXOPLASMOSIS AND CYTOMEGALOVIRUS INFECTIONS

In this study, venous blood samples were obtained from 100 women with Cytomegalovirus infection whose ages ranged from 18 to 60 years, and 100 healthy women as a control group. The study was conducted at Al-Elwiya teaching hospital in Baghdad city during the period from 1st November 2021 to 15th June 2022. the distrbution of study groups according to age revealed a significant difference (P=0.01) in the cervicitis patient group (34.43±11.89) in comparison with the control group (39.05±13.53). The distrbution of study groups according to the residency showed that residents of rural areas were 51(51.0%) in comparison with the control group and residents of urban areas were 49(49.0%), while the healthy control group was 51(51.0%) with no significant differences (P=0.088). A highly significant differences were bserved between the mean levels of tumor marker Ca125 in patients (25.5±0.71) in comparison with the healthy controls (19.40±0.68), and between mean levels of Ca15.3 (20.80±0.74) and the healthy control group (18.34±0.77). In addition, the mean levels of CRP was (88.06±5.88) versus the controls (6.73±0.12), with a highly significant differences (P&lt;0.001). Also, no significant differences were seen between mean levels of Ca19.9 marker (19.62±0.79) and the control group (19.21±0.71) (P= 0.7). The distribution of polymorphism according to complete blood picture was shown in table (3) .The mean lymphocyte count was 12(60%), while there was a decrease in Hb levels 3(15%), PCV value 4(20%) and Nuetrophil count 2(10%), with no significant differences. there was no mutation occured in the analysis of rs888160762 SNP of PTGS2 gene, but showed a mutation occured in the analysis of rs20417 SNP of PTGS2 gene using Sanger sequencing. The single “C” peak indicates C homozygous alleles, while the presence of “G” and “C” peaks indicates G/C heterozygous alleles

Procalcitonin and C-Reactive protein levels among COVID-19 patients in Sulaymaniyah

COVID-19 is a viral disease that affects multiple body organs. The objective of this study is Investigating the role of PCT and CRP in predicting the outcome of patients with COVID-19. Cross-sectional prospective study including 135 patients with SARS-CoV-2 confirmed by RT-PCR. Serum level of PCT and CRP are measured at admission and on day 10 post-admission. Patients are followed up for one month. The mean level of PCT on day 1 was 0.1±0.28 ng/ml compared with 0.3±1.27 ng/ml on day 10. Respectively, the mean serum level of CRP on day 1 and day 10 was 113.57±89.88mg/L and 44.76±43.29 mg/L. At admission, the mean serum level of PCT and CRP in dead patients was 0.22±0.6 ng/ml and 164.0±105.59 mg/L, respectively compared with 0.07±0.08 ng/ml and 101.42±82.03 mg/L, respectively in the survived group. After 10 days of admission, the median serum level of PCT and CRP in dead patients was 1.5±2.74 ng/ml and 70.9±57.87 mg/L. respectively compared with 0.13±0.23 ng/ml and 37.7±34.87 mg/L, respectively in the survived patients. In conclusion, the serum level of PCT and CRP increases from admission to day 10 post-admission, and they are considered as indicators of severe inflammatory response and could increase mortality risk.

Acute arterial thrombosis in patients admitted with COVID-19 infection: Clinical experience

Background: Acute limb arterial thrombosis (LAT) is defined as a sudden reduction in arterial supply to the extremity to a degree that affects its viability. Patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease 2019 [COVID-19]) have unbalanced coagulation profiles and are prone to thromboembolic events. Prompt diagnosis of LAT and appropriate urgent intervention, whenever possible, can help decrease morbidity and mortality among these patients and increase the chance of limb rescue. Therefore, this was the stimulus for this study, where based on our clinical experience, we aimed to identify the prevalence and analyze the outcomes of acute LAT in patients admitted with COVID-19 in Baghdad, Iraq. Methods: This study included 135 patients admitted with COVID-19, aged 35–70 years. During admission, these patients were referred to the consultation vascular surgeons because of ischemic changes in their limbs. History, demographics, clinical history, and laboratory tests were collected from all the patients. Vascular Doppler ultrasound and CT angiography were performed in some patients (especially those with re-thrombosis) to finalize the diagnosis and to plan for vascular intervention. Appropriate therapeutic anticoagulants were immediately initiated and once the diagnosis of LAT was established, surgical intervention (under local anesthesia), including thrombo-embolectomy and revascularization, was performed. After postoperative management and anticoagulation were completed, post discharge followup was the final step. Results: The mean age of the enrolled patients was 55.3 ± 7.8 (range 35.1–70.9) years, 86 (63.7%) were males. The mean number of days after the initial COVID-19 manifestation was 22 (16–28). The mean serum levels of D-dimer, CRP, and ferritin were high (795.8 ng/mL, 49.1 mg/mL, and 994.7 ng/mL, respectively). The prevalence of associated risk factors including diabetes, hypertension, and ischemic heart diseases was relatively high. Two-thirds of the patients with LAT had involvement of lower limbs and mostly (69.6%) on the left side. The men represented more than half of the patients affected by LAT in their lower limbs. Re-thrombosis was encountered in 29.6% of the patients, mostly women. Of the total 135 patients with LAT, 14 (10.4%) underwent surgical amputation on presentation to surgical wards or afterwards, however; and unfortunately, 13 (9.6%) of the total patients with LAT died. Most of the recorded mortality among the patients with LAT occurred during hospitalization for COVID-19, nine (75%), regardless of their etiologies. Conclusions: COVID-19 is associated with a high risk of thromboembolic events including LAT. Those with blood group A tend to develop more “re-thrombotic events” than other groups. Even with the successful prescription of prophylactic anticoagulants, young and otherwise healthy cases may be prone to LAT. In patients with COVID-19 and owing to their hypercoagulable state, the surgical intervention of LAT might be harder and more challenging than anticipated. Cardiovascular surgeons and physicians should consider the benefits of extended postoperative anticoagulant administration.

The correlation between Interleukin-6 and D-dimer, Serum ferritin, CRP in COVID-19 patients

Background : Severe acute respiratory syndrome coronavirus-2 is the third fatal coronavirus that has emerged in the past two decades, following severe acute respiratory syndrome coronavirus-1 and the Middle East respiratory syndrome coronavirus . Objective: To investigate the correlation between COVID-19 infection and patient’s descriptive data such as gender, age, and to observe the association of IL-6 and D-dimer, CRP, Serum ferritin in COVID-19 patients. Methodology: A study is conducted during the period from 1st October 2021 to 1st March 2022, 110 samples are collected from COVID-19 patients, Who attended to AL-Amal Specialized Hospital for Communicable Diseases at first week of infection. Their age range between 15-90 years old, and compared them with 50 healthy individuals as control group. The diagnosis of each case was established using clinical diagnosis and confirmed by reverse transcriptase polymerase chain reaction (PCR). 7 ml of fresh venous blood samples were collected from COVID-19 infected patients for serological and immunological assay for measuring the levels of IL6, D-dimer, serum ferritin, and C-reactive protein. Results: In the current study, the prevalence of severe COVID-19 infection according to age are increased in older aged patients, the highest one appeared at the (71-90) age group in 100% followed by (51- 70) age group 87.2%, then the low prevalence frequency was recorded at (36-50 ) age group in (37.5%), and the low prevalence 28.6 % at the age group (15-35). From total patients, 79(71.8%) of them were males and 31(28.1%) were females. The mean serum level of ferritin show a significant differences in sera of patient with COVID-19 as compared with control groups (392.4 vs. 131.6 µg/l), as well as, the mean serum level of CRP show a highly significant difference in sera of patient with COVID-19 as compared with control groups (59.26 vs. 7.61 mg/L), also the mean serum level of D-dimer show a highly significant difference in sera of patient with COVID-19 as compared with control groups (1104 vs. 220 ng/ml). The mean serum level of IL-6 show a highly significant difference in sera of patient with COVID-19 as compared with control groups (130 vs. 9.2 pg/ml), also it show a highly significant differences in severe and severe with death cases when compared with control groups, in addition, COVID-19 patients show a significant positive correlation of IL-6 with CRP, Ferritin, and D-dimer by their r values. Conclusions: The prevalence of severe COVID-19 infection according to age are increased in older aged patients, the male show high infected percentage than female. An elevated serum level of IL-6, CRP, D-dimer, and ferritin are associated with a poor outcome in COVID-19 patients.

Mutation Occurrence in Tor2 Gene in Patients with SARS COV-2 in Association with H. Influenza Infection

SARS COV-2is a very dangerous virus that has led to many deaths. H. Influenzais a bacteria that causes many infections inside the human body, such as pneumonia. In this study, a total of (60)blood samples were taken from patients infected with SARS COV-2shared with H. Influenza infection who attended Ibn-Al-Baladi Hospital/Baghdad city during the period from 15th January to 1st December 2021. Venous blood samples were also taken from (60) healthy individuals as a control group. The results showed that the distribution rate of the SARS COV-2 IgG and H. influenza IgG among the male patients was twice44 (73.3%)more than the distribution rate among female patients. The prevalence of SARS COV-2 IgG and H. influenza IgG was shown to be the highest among the age group (&gt;51) years, followed by the age group (21-30) years. The cases of SARS COV-2and H. influenza infections among the studied patients according to residency were shown to be almost equal among rural and urban residents 30,30 (49.2%,50.8%) respectively. Regarding the relationship between SARS COV-2 IgG and H. influenza IgG and CRP levels, the mean level of CRP in the patients was (73.72±17.05) and in the the controls was (8.71±1.12), while the mean level of H. influenza IgG in the patients was (1.05±0.23) and in the control group was (0.3±0.02), whereas the mean level of SARS COV-2 IgG was (7.00±2.15) in the patients andwas (0.35 ±0.19) in the controls with a highly significant differences (HS).The number and percentage of patients with positive SARS COV-2 and H. influenza IgG was 38(95.0%) who had high levels of GOT up to 65 U/L, while 2(50%) of those patients had GOT &gt;65 U/L, while the Negative infections with SARS COV-2 IgG, H. influenza IgG 17(85.0%) had up 65 U/L and 3(15.0 %) had&gt;65 U/L level (P =0.03).In addition, high levels of GPT, Alkaline phosphates, urea and creatinine were recorded among patients groups when compared with the healthy controls.

The Effect of Non-Surgical Periodontal Therapy on Serum Resistin Level in Chronic Periodontitis Patients with or without Type 2 Diabetes Mellitus.

Background: Resistin is a recognized marker for chronic inflammatory conditions that could be directly linked with type 2 diabetes mellitus. This study aimed to assess serum resistin level in type 2 diabetic patients with chronic periodontitis after non-surgical periodontal therapy. Methods: Forty individuals were recruited into three groups, group I consisted of 15 diabetic patients (type-2 diabetes mellitus) with moderate to severe chronic periodontitis, and 15 non-diabetic patients with moderate to severe chronic periodontitis in group II and group III consisted of 10 non-diabetic individuals with healthy periodontium. Non-surgical periodontal therapy with supra and subgingival debridement was performed for groups I and II. Gingival index, plaque index, probing pocket depth, clinical attachment loss, serum resistin and high sensitivity C-Reactive Protein assay were recorded for groups I and II before and after treatment, while HbA1c was recorded for group I. Results: Both groups showed statistically significant improvement in all clinical periodontal parameters from baseline to 3 months with no statistically significant difference when comparing both groups throughout the clinical study. A highly statistically significant decrease in mean serum levels of resistin and CRP after treatment in each group. Additionally, a statistically significant decrease in mean HbA1c level in group I was observed after treatment. Conclusion: Non-surgical periodontal therapy was effective in improving clinical periodontal parameters, serum resistin and C-reactive protein levels after 3 months for both diabetic and non-diabetic groups.

LUNG VESSELS THROMBOSIS IN HOSPITALIZED PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA: ROLE OF ENDOTHELIAL FUNCTION, HEMOSTASIS, FIBRINOLYSIS AND INFLAMMATION ON DIFFERENT PHASES OF TREATMENT

There are limited data on the relationship between the severity of community-acquired pneumonia (CAP), biomarkers of inflammation and coagulation as well. The aim was to evaluate the association between the severity of CAP and risk of thrombosis in patients with moderate and severe CAP. To estimate the role of parameters of systemic inflammation, endothelial dysfunction, hemostasis, coagulation on different phases of treatment. The main group was 75 patients CAP. We divided the main group according severity: subgroup 1 – 41 patients with moderate CAP, subgroup 2 – 34 patients with severe CAP. Blood coagulation test, determination of biomarkers was performed at admission before starting of antibacterial treatment and after clinical stability on 7–10 day after hospitalization. We found that in both subgroup 1 and subgroup 2 the mean levels of CRP and fibrinogen were higher than in control group. Moreover, the mean level of D-dimer was significantly higher and protein C (PC) was significantly lower in both subgroups in comparison with control group. Normalization of PC is coming after 7–10 days of antibacterial treatment, vice versa ET-1, which reflects prolong endothelial dysfunction in patients with severe CAP. Patients with severe CAP have the high risk of thrombosis which can be associated with endothelial dysfunction; definition of such parameters as ET-1 and PC can be useful for establishment of different coagulant disorders in patient with mild and moderate CAP, and their dynamic changes could be the initial point of prescribing or cancelling of anticoagulant treatment.

Circulating Endothelial Progenitor Cells were Increased in Patients with Thin-Cap Fibroatheroma.

We used virtual histology-intravascular ultrasound (VH-IVUS) to evaluate the relationship between circulating endothelial progenitor cells (EPC) and thin-cap fibroatheroma (TCFA). This study included 52 patients with unstable angina who underwent coronary angiography and IVUS examination. Patients were divided into a TCFA group (n = 21) or a non-TCFA group (n = 31) based on VH-IVUS performance. Before angiography, peripheral blood levels of EPC were measured by flow cytometry. TCFA was defined as a necrotic core (NC) ≥ 10% of the plaque area without overlying fibrous tissue in the presence of ≥ 40% plaque burden. Levels of circulating EPCs were 72.45 ± 31.73 (count/105) in the TCFA group and 23.93 ± 11.87 (count/ 105) (p < 0.01). Mean levels of CRP were 0.38 ± 0.21 mg/L in the TCFA group and 0.23 ± 0.17 mg/L (p < 0.01). Levels of EPCs correlated positively with necrotic core volume(r = 0.421, p = 0.005), CRP (r = 0.405, p = 0.011) and negatively with fibrous tissue volume(r = -0.411, p = 0.009). In multivariate logistic regression analysis, level of EPC (OR: 1.815, 95% CI: 1.12 - 2.798, p = 0.016), plaque burden (OR: 1.26, 95% CI: 1.07 - 1.86, p = 0.027), and CRP (OR; 1.14, 95% CI: 0.74 - 1.56, p = 0.029) were independent predictors of TCFA. Circulating EPCs were increased in patients with TCFA, level of EPCs could predict the presence of TCFA.

Risk Factors of Acute Renal Cortical Lesions in Scintigraphy in Children with Urinary Tract Infection

Introduction: Urinary Tract Infection (UTI) is one of the most common pediatric infections. UTI may create cystitis or pyelonephritis by involving bladder or renal parenchyma, respectively. Pyelonephritis, especially in pediatric patients, can lead to scar formation in kidneys and consequent complications such as hypertension, proteinuria, dysfunction and chronic renal insufficiency. The current study aimed to determine risk factors of acute rental cortical lesions in renal scintigraphy in children with UTI.Materials and Methods: Fifty-three patients with significant renal cortical lesions and 53 cases without significant renal cortical lesions were compared based on the intensity of findings of DMSA scintigraphy within the first two weeks of diagnosis. Patients were divided into three groups of 1 month to 2 years, 2 to 4 years and 4 to 10 years.Results: Of 106 patients, 11 males (20.8%) and 42 females (79.2%) had significant acute renal cortical lesions, whereas 15.1% of males and 84.9% of females had no significant acute renal cortical lesions. There was a significant difference in the degree of fever, the average interval between the onset of fever and treatment, mean level of CRP, leukocytosis and ESR in the two studied groups. The presence of Vesicoureteral Reflux (VUR), low initial hemoglobin and low initial BMI as random findings were associated with significant renal cortical lesions. Gender, age, grade of VUR and type of organism in urine culture had no significant association with significant renal cortical lesions.Conclusions: In this study, delaying in treatment, high degree fever, leukocytosis, high initial ESR and CRP, existence of VUR and low initial BMI and hemoglobin levels were associated with an increase in the value of acute renal cortical lesions, so in these cases, DMSA scan is suggested.Keywords: Urinary Tract Infections; DMSA (Dimercaptosuccinic Acid); Renal scars; Pediatrics.

A Study of Some Biochemical Changes in Hydatid Cyst Patients Before And After Surgical removal of hydatid cyst

Hydatid disease is a major public health and economic problem in Iraq causing morbidity and mortality, This study was done to illustrate some biochemical changes, hemoglobin, blood group and CRP in hydatid cyst patients before and after 15 days of surgery.Twenty patients with hydatid liver cyst infection were enrolled in this study consist of (15 male) and (5 female), Those patients were matched with twenty (14 male) and (6 female) apparently healthy subjects as controls, The results of the study were as the following Significantly high serum triglyceride and serum bilirubin levels were observed in patients with hydatid cyst before and after 15 days of surgical removal when compared with healthy controls And significantly high serum bilirubin level in hydatid cyst patients before surgery when compared with patients after 15 days of surgical removal of the cyst.Blood glucose, urea and hemoglobin level for both studied subjects were within normal range as in healthy controls. Group O was more frequently in hydatid cyst patients than non O group (A, B, AB), Elevated CRP in 14% of hydatid cyst patients before surgery when compared with healthy controls, while after 15 days of surgical removal the mean level of CRP was decreased to 4% .In conclusion all studied parameters may be helpful in following up the effectiveness of surgical treatment. Further investigation in this regard with a larger group of patients is recommended to explore the potential of these parameters compared to alternative measures in monitoring hydatidosis infection and surgical removal of hydatid cyst on hydatid cyst patients.

THU0379 Comparison of Bone Mineral Density in Patients with Systemic Sclerosis and Rheumatoid Arthritis

BackgroundSystemic sclerosis (SSc) is a rare connective tissue disease characterized by vascular, immune and fibrotic changes in the skin and internal organs. Rheumatoid arthritis (RA) is a chronic inflammatory disease...

Effects of subcutaneous and intravenous golimumab on inflammatory biomarkers in patients with rheumatoid arthritis: results of a phase 1, randomized, open-label trial

To evaluate the effects of the anti-TNF-α monoclonal antibody golimumab, administered by s.c. injection or i.v. infusion, on markers of inflammation in patients with RA. In this phase 1, open-label study, patients with active RA were randomized to receive s.c. golimumab 100 mg at baseline and every 4 weeks through week 20 (n = 33; group 1) or i.v. golimumab 2 mg/kg at baseline and week 12 (n = 16; group 2). Serum levels of CRP, IL-6, serum amyloid A (SAA), TNF receptor II (TNFRII), MMP-3, hyaluronic acid, haptoglobin, ferritin and haemoglobin and serum/urine hepcidin were measured at various time points. Associations between the biomarkers were assessed with Spearman's correlations. In both groups 1 and 2, decreases in mean serum levels of CRP, IL-6, SAA, TNFRII, MMP-3, haptoglobin, ferritin and hepcidin, and mean urine levels of hepcidin occurred within 1 week and were sustained through week 8. Decreases in concentrations of serum CRP, IL-6, SAA, MMP-3, hepcidin, ferritin and haptoglobin and urine hepcidin were maintained through week 24 in group 1, but began to reverse after week 8 in group 2. Among all patients, decreases in serum hepcidin correlated significantly with decreases in serum CRP and ferritin. Decreases in serum and urine concentrations of markers of inflammation occurred as early as 24 h after treatment with golimumab, and most of these improvements were sustained through week 24 in group 1.

Correlation of CRP and Serum Level of Fibrinogen with Severity of Disease in Chronic Obstructive Pulmonary Disease Patients

Data of a previously published study have shown that chronic obstructive pulmonary disease (COPD) patients have increased serum levels of CRP and fibrinogen. The aim of this work is to investigate if there was any correlation between inflammation factors and severity of COPD. A case control study conducted on 43 COPD patients and 40 healthy controls. COPD were selected according to GOLD criteria. Exclusion criteria were acute exacerbation of disease in the past 4 weeks, usage of oral corticosteroids and presence of any comorbidity which could raise level of inflammatory proteins. Control group were healthy individuals. Serum levels of CRP and fibrinogen were measured. The mean serum level of CRP in COPD patients was significantly higher than that of controls (p = 0.03). No significant difference was found in the mean serum level of fibrinogen between cases and controls. Also, there were no significant correlation between the serum level of CRP or fibrinogen and severity of the disease and arterial 02 saturation. According to our study results, COPD, per se, can increase serum CRP level. Attenuation of systemic inflammation may offer new perspectives in the management of COPD and its comorbidities.

Abstract 2777: DEXA measures of body fat percentage and relation to acute phase proteins among breast cancer survivors

Abstract C-reactive protein (CRP) and serum amyloid A (SAA) are nonspecific acute phase proteins associated with chronic inflammation. Elevated CRP and SAA levels have been positively associated with obesity and the development and progression of a variety of diseases including breast cancer. The purpose of the current analysis was to examine the associations between body fat percentage as measured by dual energy x-ray absorptiometer (DEXA) and CRP and SAA and to determine whether lifestyle factors (weight change from diagnosis, physical activity level, caloric intake, or smoking status) modify these relationships in breast cancer survivors. The analysis utilized cross-sectional data obtained approximately 30 months after diagnosis for 138 Hispanic and Non-Hispanic-White breast cancer survivors participating in the Health, Eating, Activity, and Lifestyle (HEAL) Study. Regression models were used to calculate geometric means and 95% confidence intervals (CIs) for CRP and SAA by obesity status. Circulating levels of CRP and SAA were significantly associated with increased DEXA-measured adiposity. Obese breast cancer survivors (defined as women having body fat ≥35%) had significantly elevated levels of CRP (2.09 mg/L; 95%CI 1.70-2.56 vs. 0.78 mg/L; 95%CI 0.56-1.09) and SAA (6.51mg/L; 95%CI 5.70-7.44 vs. 3.75 mg/L; 95%CI 3.01-4.68) compared to non-obese survivors. Stratifying by tertile of % body fat revealed a statistically significant dose-response relationship. For CRP, geometric mean levels increased from 0.80 (95%CI 0.59, 1.08), to 1.74 (95%CI 1.32-2.29), to 2.71 (95%CI 2.03-3.64) with increasing tertile of % body fat (&amp;lt;36.2%, 36.2-42.8, &amp;gt;42.8). For SAA, geometric mean levels increased from 3.84 (95%CI 3.13, 4.71), to 5.98 (95%CI 4.98-7.18), to 7.32 (95%CI 6.03-8.90) by tertile of % body fat. Although not statistically significant, a trend emerged where obese women who reported recent use of non-steroidal anti-inflammatory drugs (NSAIDs) had lower geometric mean levels of CRP (1.66 vs. 2.38) and SAA (5.33 vs. 7.33) than obese women who did not take NSAIDs (p=.37 and p=.13 respectively). Additionally, women reporting high caloric intake (&amp;gt;2,000 kcal per day) had higher mean CRP levels than women reporting lower caloric intake, independent of % body fat (p=.01). Obesity remained a strong predictor of elevated levels of CRP/SAA in breast cancer survivors, regardless of stratification by other lifestyle factors. Our data suggest that adiposity is strongly associated with systemic inflammatory markers in breast cancer survivors. Our data provide some suggestive evidence that lifestyle choices, including NSAID use or caloric intake, may influence circulating levels of CRP and SAA. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 2777.

Cytokine Tumor Necrosis Factor‐alpha A Promoter Gene Polymorphism at Position −308 G→A and Pediatric Inflammatory Bowel Disease

Our pilot study aimed to determine the effect of tumor necrosis factor-alpha (TNF-alpha) 308 G-->A promoter single-nucleotide polymorphism in pediatric inflammatory bowel disease (IBD), its influence on inflammatory activity and the clinical manifestations. We obtained genomic DNA from 164 subjects, 82 with long-standing IBD aged 8 to 18 years: 46 with Crohn disease (CD) and 36 with ulcerative colitis (UC). Eighty-two healthy children served as the control population. Genotyping was determined by using a restriction enzyme-based assay. TNF-alpha 308 G-->A polymorphism was assessed in terms of inflammatory (C-reactive protein [CRP]) and disease activity. The latter was assessed by the Pediatric Crohn's Disease Activity Index (PCDAI) and the Truelove index for CD and UC, respectively. Significant differences in TNF-alpha 308 A polymorphism were found between the IBD group and controls (P < 0.05) and the UC group and controls (P < 0.001). No differences were noted between TNF-alpha 308 A polymorphism and clinical characteristics in UC. The frequency of the -308 A allele of TNF was not different in CD compared with that in the control group. The frequency of TNF-alpha 308 A genotype was significantly higher in CD patients with predominantly stenosing/penetrating disease compared with patients without complications (P < 0.001) and healthy controls (P < 0.01). In CD patients, those carrying TNF -308 A had a significant increase in CRP (P < 0.05) and the PCDAI (P < 0.05). In CD, CRP levels strongly correlated with the PCDAI (r = 0.6150, P < 0.001). In UC, significant differences among the mean levels of CRP (P < 0.05) and disease activity (P < 0.001) related to TNF-alpha 308 A polymorphism were found. Allele distribution (odds ratio, 12.9; CI, 1.18-140.81, P < 0.001) and CRP serum levels (odds ratio, 1.020; CI, 1.00-1.04, P < 0.001) were independently associated with CD complications. Although not necessarily dictating IBD initiation, the TNF-alpha 308 A polymorphism may play a role in modifying the CD phenotype. The polymorphism may influence disease activity as well as more intense inflammatory activity in both forms of IBD and may modify the progression of chronic digestive tract inflammation.

Clinical analysis of aseptic meningitis caused by echovirus 13

We examined the clinical symptoms and laboratory findings of 21 children with aseptic meningitis caused by echovirus 13 during the summer of 2002. All patients (mean age: 8.3 years) complained of fever and headache. Some had mild vomiting and some had severe vomiting of 4 times or more. In the early stage of the disease, the mean count of WBC was 8,283/microliter, mean level of CRP was 0.8 mg/dl, and there were no abnormalities in levels of GOT, GPT, or LDH. The levels of protein and sugar, in cerebrospinal fluid showed no abnormalities, and mean total cell count was 560/microliter. The mean number of polynuclear cells was 357/microliter, and of mononuclear cells was 203/microliter, showing polynuclear cell predominance. In the recovery period, the tendency to polynuclear cell predominance in the early stage of the disease shifted to mononuclear predominance. One of the 21 patients exhibited multinucleated cell predominance in the cerebrospinal fluid, a high CRP value of 6.2 mg/dl, as well as symptoms of restlessness including numbness of the limbs, hyperpnea, and excitation, needed careful diagnosis as aseptic meningitis. Almost all of the patients were mild cases, and no large differences were seen with the clinical and laboratory findings in previous reports of echovirus aseptic meningitis.