Normal Erythrocyte Sedimentation Rate Values Research Articles

Relationship Between Results of Genexpert RT-PCR and Erythrocyte Sedimentation Rate in Suspected Tuberculosis Patients

Pulmonary tuberculosis (TB) is an infectious disease that attacks the lungs and is caused by the bacterium Mycobacterium tuberculosis. The GeneXpert RT-PCR examination (Xpert MTB / RIF) is a development of a diagnostic tool that can automatically detect the presence of Mycobacterium tuberculosis (MTB) by molecular examination and can be used to detect MTB resistance to rifampicin. Erythrocyte sedimentation rate (ESR) is a test used to determine the rate at which erythrocytes settle in the blood. The purpose of this study was to determine the relationship between GeneXpert RT-PCR results and ESR in suspected tuberculosis patients. This research uses a cross-sectional study. The sample used in this study were 56 new suspected TB patients who had never been treated for ATD and underwent GeneXpert RT-PCR examination. Sampling was carried out by purposive sampling with the TCM Rif Sen group and negative results. A total of 27 patients (96.4%) with Rif Sen's GeneXpert RT-PCR results had high ESR values. 15 patients (53.6%) with negative GeneXpert RT-PCR results had normal ESR values. The results of the Chi Square test (X2) show that p-value = 0.000 OR = 0.032. There is a significant relationship between GeneXpert and ESR values ​​in suspected tuberculosis

MEDICAL AND SOCIAL MONITORING OF INCIDENCE RATE OF ACUTE BRONCHITIS AND PNEUMONIA IN CHILDERN (BASED ON DATA FROM MICROBIOLOGICAL LABORATORY OF THE CITY OF HLUKHIV, SUMY REGION)

The article emphasizes on medical and social monitoring of the incidence of acute bronchitis and pneumonia in children and elucidates the peculiarities of the course of these diseases during the Covid-19 pandemic. It has been established that the main cause of acute respiratory viral infection (ARVI), including pneumonia and bronchitis, and other respiratory diseases, is an impairment of the mechanisms of specific and non-specific protection. In terms of prevalence, bronchitis and pneumonia occupy the first place among broncho-pulmonary diseases in children. Recurrent bronchitis occurs in children of different ages, but most often in the childhood period from 4 to 7 years. The highest number of hospitalized children with acute bronchitis and pneumonia was observed in the city of Hlukhiv and the Hlukhiv district, Sumy region, in 2019; the number of boys significantly exceeded the number of girls. The main cause for the decrease in the incidence and pathogenicity of SARS-CoV-2 infection in children is still remaining unclear. Although this decrease in incidence was attributed to reduced exposure and risk factors during the initial phase of a pandemic, it is now understood that biological factors that interfere with the pathogenesis of infection and the immune response may play a protective role in children compared to the more aggressive clinical manifestations seen in adults. The data obtained demonstrate the patients with acute bronchitis have different numbers of erythrocyte sedimentation rate (ESR). Some patients, 43 out of 64, have normal ESR values, within 4-12 mm / h (p <0.05). With an exacerbation of the process, an increase in ESR is noted in the range of 12-14 mm / h in 21 patients. We have found out acute pneumonia in children is associated with complex changes in blood parameters, and, in particularly, with neutrophilic leukocytosis, increased hemoglobin up to 170 ± 1.4 g / l, an accelerated ESR, a significant increase in platelets. The positive effect of physiotherapy exercises and massage can also improve the parameters of the peripheral blood in the children. Thus, these supportive measures maintain the general mechanisms of homeostasis.

C-Reactive Protein versus Erythrocyte Sedimentation Rate: Implications Among Patients with No Known Inflammatory Conditions.

Measurements of C-reactive protein (CRP) concentration and erythrocyte sedimentation rate (ESR) are frequently ordered jointly in clinical practice. To investigate the factors associated with discordances between CRP concentration and ESR in adults. We conducted a cross-sectional study of 1472 adults with no known inflammatory disorders (44.5% male; median age, 52 years; range, 18-91 years), randomly selected from a municipality in Spain. The participants underwent simultaneous measurements of ESR, serum CRP, and interleukin-6 concentrations. Alcohol consumption, smoking, and physical activity were evaluated by questionnaire. Body mass index (BMI) measurement and metabolic syndrome criteria were available for all participants. Most (n = 1123, 74.9%) of the participants showed normal CRP and ESR values. Sixty-nine (4.6%) participants showed high CRP and ESR values. Seventy-two (4.8%) participants showed a discordant pattern of high ESR and normal CRP values, which was associated with age after adjusting for sex, alcohol consumption, physical activity, BMI, and the presence of metabolic syndrome (odds ratio [OR], 1.052; 95% CI, 1.034-1.071; P < .001). A total of 208 (13.8%) participants showed a discordant pattern of high CRP and normal ESR values, which was associated with BMI after adjusting for covariates (OR, 1.099; 95% CI, 1.064-1.136; P < .001). BMI appeared to be the main determinant of serum CRP concentrations in this population. Serum interleukin-6 concentrations were positively associated with the discordant pattern of high CRP and normal ESR values. In this general adult population with no overt inflammatory disease, the discordant pattern of high ESR and normal CRP was associated with greater age, whereas the pattern of high CRP and normal ESR was associated with higher BMI.

Predictors of risk of fracture in inflammatory bowel diseases: a prospective study using FRAX score.

Despite the well-known risk of osteoporosis and bone fractures among patients with inflammatory bowel diseases, the WHO FRAX tool has been used in a limited number of studies in this specific population. The purpose of this study was to search for predictors of risk of fractures assessed by FRAX score. We prospectively calculated FRAX score for hip and major osteoporotic fractures in inflammatory bowel disease patients consecutively recruited. The mean risk of hip fractures at 10 years, for the 80 recruited patients, resulted 1.4%, while the mean risk of major osteoporotic fractures was 7.8%. The risk of hip fractures was 1.3% among the 30 Crohn's disease patients versus 1.4% (P=0.82) among 50 ulcerative colitis patients. A prolonged use of corticosteroids correlated with a tendency to a greater risk of hip fracture (r=0.38, P=0.08). Patients with normal erythrocyte sedimentation rate (ESR) values had a risk of osteoporotic hip fractures of 0.75%, while those with high ESR values had a risk of 1.86% (P=0.04). Regarding the risk of major bone fractures, patients with normal ESR values had a risk of 5.9%, versus a risk of 18% in those with elevated ESR (P=0.03). The correlation between increase of inflammatory markers and increased risk of osteoporotic fractures and the lack of difference between Crohn's disease and ulcerative colitis suggest a central role of inflammation over malabsorption in this population.

A New Method to Predict Erythrocyte Sedimentation Rate with Natural Geographical Factors and Location by Case-based Reasoning: A Case Study of China

Reference values of erythrocyte sedimentation rate (ESR) are the key to interpret ESR blood test in clinic. The common local reference ESR values are more accuracy in blood test that are established with natural geographical factors by using the multiple linear regression (MLR) model and the artificial neural network (ANN). These knowledge-based methods have limitations since the knowledge domains of ESR and natural geographical factors are limited. This paper presents a new cases-depended model to establish reference ESR values with natural geographical factors and location using case-based reasoning (CBR) since knowledge domain of ESR and geographical factors is weak. Overall 224 local normal ESR values of China that calculated from 13 623 samples were obtained, and the corresponding natural geographical factors and location that include altitude, sunshine hours, relative humidity, temperature, precipitation, annual temperature range and annual average wind speed were obtained from the National Geomatics Center of China. CBR was used to predict the unseen local reference ESR values with cases. The average absolute deviation (AAD), mean square error (MSE), prediction accuracy (PA), and Pearson correlation coefficient (r) between the observed and estimated data of proposed model is 33.07%, 9.02, 66.93% and 0.78, which are better than those of ANN and MLR model. The results show that the proposed model provides higher prediction accuracy than those of the artificial neural network and multiple linear regression models. The predicted values are very close to the observed values. Model results show significant agreement of cases data. Consequently, the model is used to predict the unseen local reference ESR with natural geographical factors and location. In spatial, the highest ESR reference areas are distributed in the southern-western district of China that includes Sichuan, Chongqing, Guangxi and Guizhou provinces, and the reference ESR values are greater than 23 mm/60 min. The higher ESR reference values are distributed in the middle part and northern-eastern of China which include Hubei, Henan, Shaanxi, Shanxi, Jilin and Heilongjiang provinces, and the reference ESR values are greater than 18 mm/60 min. The lowest ESR reference values are distributed in the northern-western of China that includes Tibet and Xinjiang, and the reference ESR values are lower than 5 mm/60 min.

Incorporating geographical factors with artificial neural networks to predict reference values of erythrocyte sedimentation rate.

BackgroundThe measurement of the Erythrocyte Sedimentation Rate (ESR) value is a standard procedure performed during a typical blood test. In order to formulate a unified standard of establishing reference ESR values, this paper presents a novel prediction model in which local normal ESR values and corresponding geographical factors are used to predict reference ESR values using multi-layer feed-forward artificial neural networks (ANN).Methods and findingsLocal normal ESR values were obtained from hospital data, while geographical factors that include altitude, sunshine hours, relative humidity, temperature and precipitation were obtained from the National Geographical Data Information Centre in China.The results show that predicted values are statistically in agreement with measured values. Model results exhibit significant agreement between training data and test data. Consequently, the model is used to predict the unseen local reference ESR values.ConclusionsReference ESR values can be established with geographical factors by using artificial intelligence techniques. ANN is an effective method for simulating and predicting reference ESR values because of its ability to model nonlinear and complex relationships.

Does this patient have temporal arteritis?

Clinicians must be able to confidently diagnose temporal arteritis (TA), since failure to make a correct diagnosis may lead to irreversible visual loss as well as inappropriate evaluation and treatment of headache, fatigue, and other potential presenting symptoms. The diagnostic value of particular signs and symptoms among patients with suspected TA is unknown. To determine the accuracy of historical features, physical examination, and erythrocyte sedimentation rate (ESR) in diagnosis of TA. We performed a MEDLINE search of English-language articles published between January 1966 and July 2000 and a hand search of bibliographies of retrieved articles, previous reviews, monographs, and textbooks. Studies that provided detailed clinical information on patients who had been referred for temporal artery biopsy. Of 114 studies retrieved, 41 met our inclusion criteria; 21 included both biopsy-positive and biopsy-negative patients and formed the core of our review. Both authors independently reviewed each study to determine eligibility, abstracted data using a standardized instrument, and classified study quality using predetermined criteria. The prevalence of TA in the general population is less than 1%. However, in our 21 core studies, 39% of patients referred for temporal artery biopsy had positive results. The only 2 historical features that substantially increased the likelihood of TA among patients referred for biopsy were jaw claudication (positive likelihood ratio [LR], 4.2; 95% confidence interval [CI], 2.8-6.2) and diplopia (positive LR, 3.4; 95% CI, 1.3-8.6). The absence of any temporal artery abnormality was the only clinical factor that modestly reduced the likelihood of disease (negative LR, 0.53; 95% CI, 0.38-0.75). Predictive physical findings included temporal artery beading (positive LR, 4.6; 95% CI, 1.1-18.4), prominence (positive LR, 4.3; 95% CI, 2.1-8.9), and tenderness (positive LR, 2.6; 95% CI, 1.9-3.7). Normal ESR values indicated much less likelihood of disease (negative LR for abnormal ESR, 0.2; 95% CI, 0.08-0.51). A small number of clinical features are helpful in predicting the likelihood of a positive temporal artery biopsy among patients with a clinical suspicion of disease; the most useful finding is a normal ESR, which makes TA unlikely.

Erythrocyte sedimentation rate and C-reactive protein in the evaluation of disease activity and severity in polymyalgia rheumatica: A prospective follow-up study

Objective: To determine the frequency and clinical features of patients with polymyalgia rheumatica (PMR) and normal erythrocyte sedimentation rate (ESR) at diagnosis or during relapse/recurrence. To evaluate the usefulness of C-reactive protein (CRP) and ESR in the assessment of PMR activity. Methods: A prospective follow-up study on 177 consecutive patients meeting the criteria for PMR diagnosed over a 5-year period was conducted in two Italian secondary referral centers of rheumatology. At diagnosis and during follow-up, ESR (Westergren method) and CRP (nephelometry) were measured in all patients. Phenotypic analysis of lymphocyte subpopulations was performed on 78 PMR patients at diagnosis. A two-color technique using the association of specific monoclonal antibodies was applied. A control group consisting of 18 healthy adults older than 60 years was matched for age and sex with the PMR patients. Results: Ten of 177 (6%) patients had normal ESR values at diagnosis (≤30 mm/h). Patients with normal ESR were predominantly men and had lower CRP levels; systemic signs and symptoms were more frequent in patients with higher ESR. The percentages of circulating CD8+ cells were similar in the two groups. CRP values at diagnosis were normal in only 2 of 177 (1%) patients. CRP values were elevated in 9 of 10 patients with normal ESR at diagnosis. Twenty-five episodes of relapse/recurrence with normal ESR occurred in 17 patients. CRP was high in 62% of these episodes. Results of univariate analysis indicated that the 10th percentile for ESR (40 mm/h) and the 70th percentile for CRP (7.8 mg/dL) values at diagnosis were the best cutoff points that discriminate between patients with and without relapse/recurrence. Cox proportional hazards modeling showed that ESR greater than 40 mm/h and CRP greater than 7.8 mg/dL at diagnosis were the two variables that independently increased the risk of relapse/recurrence. However, the relative risk related to ESR was twice than that related to CRP (4.9 vs 2.1). Conclusion: PMR with a normal ESR at diagnosis was infrequent in our study compared with previous studies. ESR was a superior predictor of relapse than CRP. However, CRP was a more sensitive indicator of current disease activity. Semin Arthritis Rheum 30:17-24. Copyright © 2000 by W.B. Saunders Company

Acute phase reactants in the initial phase of giant cell arteritis.

The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), fibrinogen and haptoglobin were followed weekly during the initial phase of corticosteroid treatment in 18 patients with 19 episodes of giant cell arteritis (GCA). Fibrinogen and CRP decreased most rapidly, with normal values in 67% of the patients after two weeks of treatment. After two weeks 56% of the patients had normal ESR values and 76% after five weeks. Haptoglobin normalised most slowly, no patient having a normal value after one week, 29% after two weeks and 75% after six weeks. For routine clinical use, we found the ESR alone sufficient for monitoring the initial steroid treatment.