Reactive Protein Concentrations Research Articles

Differential Effect of Transferrin Lobe Iron Occupancy on a Murine Model of Inflammation

Introduction: Iron status is both affected by and a determinant of the inflammatory response. Several lines of evidence support a role for transferrin as a signaling as well as an iron delivery molecule. We previously demonstrated that mice with transferrin mutations that prevent iron binding to the C-lobe of transferrin (C-blocked) have increased red cell production relative to erythropoietin and increased hepcidin expression relative to iron status compared to mice with transferrin mutations that prevent iron binding to the N-lobe of transferrin (N-blocked). Based on these observations, we hypothesize that two forms of transferrin would differentially modulate the hematopoietic and iron distribution changes that occur with inflammation. We explored this hypothesis by comparing the effects of lipopolysaccharide (LPS) administered either acutely or in repeated doses to wild-type, N-lobe blocked, or C-lobe blocked transferrin mutant mice. Methods: For a model of acute inflammation, 14 day old wild-type (wt), N-blocked and C-blocked Tf mutant mice were treated with 1mg/kg LPS or carrier i.p. and sacrificed 6 hours later. Repeated LPS dosing, seven daily i.p. injections of 0.3 mg/kg LPS or carrier beginning at seven days of age, served as a model of chronic inflammation. Results: While wild-type and C-blocked mice had the expected hypoferremia in response to acute LPS administration, there was no effect on serum iron in the N-blocked mice. These mice moreover demonstrated an unanticipated increase in liver iron concentrations with LPS. All strains manifested expected increases in liver hepcidin expression; however, these were attenuated in the N-blocked mice relative to the C-blocked. Moreover, N-blocked mice have higher serum C reactive protein concentrations compared to C-blocked and wt mice following acute LPS administration. The elevated Hamp1 expression was not sustained in the chronic model. Although serum iron returned to baseline in wt and C-blocked mice, it remained elevated in N-blocked mice. Hemoglobin concentrations were decreased in all strains after repeated endotoxin dosing; however, C-blocked mice demonstrated higher neutrophil to lymphocyte ratios than wt or N-blocked mice, and increased circulating RBC count relative to WBCs. Conclusions: We conclude that the specificity of transferrin lobe iron occupancy is an important modulator of the inflammatory response and speculate that this modulation includes an effect on hematopoietic cell lineage determination.

A-041 Measurement of Plasma 3-Hydroxyisovalerylcarnitine by LC-MS/MS to Predict Marginal Biotin Deficiency in Inflammatory Bowel Disease

Abstract Background Biotin’s role in the immune response have emergently revealed that biotin is related to inflammation and that its deficiency leads to an increase in the level of proinflammatory cytokines. A biotin-deficient diet was recently shown to induce a colitis-like phenotype in mice, alleviated by biotin substitution. Mice with dextran sulphate sodium (DSS)-induced colitis showed biotin deficiency and significantly reduced biotin absorption. Oral biotin substitution reversed DSS colitis and induced remission. Diagnosis of biotin deficiency is rather challenging since based solely on measurement of circulating biotin levels has been shown to be insufficiently sensitive for clinical purposes. Increased urinary excretion of biotin metabolites, is suggested as a sensitive indicator of biotin deficiency. However, 24 h urine collection is time consuming, expensive, and the test relies on correct collection of samples by the patient, thus if this is not done properly the results may be inaccurate. 3HIVc increases in the case of biotin deficiency as a response to the decreased activity of biotin dependent enzyme methyl crotonyl-coenzyme. Analysis of circulating 3HIVc levels by LC-MS/MS has been found to be one of the most sensitive markers of biotin depletion. Methods Study cohort conducted with 100 inflammatory bowel disease (IBD) patients (20–60 years, 40 females) whom diagnosed according to standard clinical, radiological and pathological criteria and 100 healthy controls (20–60 years, 40 females). Of the patients 58/100 had Crohn’s Disease (CD), 42/100 had ulcerative colitis (UC) and 29/100 were in inflammatory state (serum high sensitivity C reactive protein (hsCRP) concentrations >5 mg/L). Standard serum and citrate-plasma samples were withdrawn between 8:00–10:00 h in the clinic after overnight fasting and stored at −20 °C until the analysis. Complete blood count (CBC), high sensitivity C reactive protein (hsCRP), fecal calprotectin (fCal) were determined with standard methods in serum matrix. 3-Hydroxyisovalerylcarntine (3HIVc) levels were determined by a commerical LC-MS/MS Kit in citrate plasma (KM3200, Immundiagnostik AG, Germany). Results Patients with IBD were found to have significantly higher 3HIVc levels than controls (6.1 ± 2.4 ng/mL vs 5.1 ± 2.1 ng/mL respectively, P = 0.004). 3HIVc concentrations were compared according to different disease characteristics within the patient group: circulating 3HIVc levels were found to be similar in patients with CD and UC (5.2 ± 2.1 ng/mL vs 4.9 ± 2.1, P = 0.451). Patients were also found to have similar circulating 3HIVc concentrations irrespective of whether or not inflammatory activity was present (5.1 ± 2.0 ng/mL in inflammatory vs 5.7 ± 2.4 ng/mL in noninflammatory conditions, P = 0.131). Conclusion The clinical findings of this study are in line with the existing preclinical evidence indicating that biotin deficiency is more common in patients with IBD in comparison to healthy controls in a clinical setting. However, surprisingly, the biotin status of patients with IBD was not found to differ according to inflammatory status. Therefore, there is still a room for more comprehensive look into the relationship between IBD related inflammation and biotin deficiency. Moreover, LC-MS/MS analysis of plasma 3HIVc has the potential to help clinicians to define biotin repletion and help to clearify the latter relation.

Inflammatory proteomics profiling for prediction of incident atrial fibrillation

ObjectiveAtrial fibrillation (AF) has emerged as a common condition in older adults. Cardiovascular risk factors only explain about 50% of AF cases. Inflammatory biomarkers may help close this gap as...

Consortium of Indigenous Fecal Bacteria in the Treatment of Metabolic Syndrome.

The features of gut microbiota in metabolic syndrome (MS) and ways to correct it using autoprobiotics, based on indigenous bacteria obtained from fecal samples of the host, remain unexplored. The aim of the study was to investigate the effectiveness of an indigenous consortium (IC) of fecal bacteria in treatment of patients with MS. The study was carried out on 36 patients with MS, manifested with abdominal obesity, eating disorders, dyslipidemia, and hypertension. The control group was formed by 20 healthy volunteers. Samples of IC and gut microbiota content were examined by qPCR and metagenome (16S rRNA) analysis before and after therapy. The decrease in anthropometric parameters of obesity, liver enzyme level correction, reduction in C reactive protein and triglyceride concentrations were revealed after IC usage. The decrease in genera Bifidobacterium, Enterobacter, Paraprevotella, and Prevotella, as well as an increase in Bacteroides fragilis and Oscillospira spp. populations were shown after consumption of IC. A negative correlation between the quantity of B. fragilis and the anthropometric parameters of obesity (r = −0.48) and C reactive protein level (r = −0.36) in serum was established. Thus, IC can be considered as a potential functional personified product for the therapy of MS.

Effect of Ganoderma Lucidum, Astaxanthin, Liv.52HB and STC30 on C - Reactive Protein Concentrations of Animal Model with CCL4 Induced Hepatocellular Carninoma

Cancer is a major cause of death in developed countries and second in developing countries. Primarily, hepatocellular carcinoma (HCC) represents 4% of all types of new cases of cancer diagnosed globally and hence making it the most frequently diagnosed globally. This research studied the effect of some natural products (Ayurvedic) commonly used in the management of hepatitis and HCC on serum C-Reactive Protein (CRP) concentration of animal with CCl4 induced hepatocellular carcinoma with the aid of providing and documenting information on some natural products which have been believed to be effective for the management of HCC using C-reactive protein as a marker. Albino rats of Wistar strain with weight range of 60-120g were used for this study. The animals were divided into seven (7) groups of five (5) rats each. Group 1 was the normal control and was not induced while animals in group 2 to 7 where all induced for HCC using CCl4. Group 2 served as positive control and where not treated while animals in group 3 to 7 received various form naturopathic treatment; Ganoderma lucidium, Astaxarthin, Liv52 HB and STC30 respectively. The treatment lasted for a period of three weeks (21 days). Twelve (12) hours after the last treatment, the animal where sacrifice under chloroform anesthesia and blood samples collected via cardiac puncture. The blood sample were allowed to clot by standing then centrifuged at 4000rpm for 10 minutes to separate the blood cells from serum. The serum was separated and used for C - reactive protein concentration estimation. Result of analysis showed the C-Reactive Protein concentration of all induced groups; groups 2 or positive control (584.20 ± 11.08), group 3 or Ganoderma treated group (491.40 ± 26.80), group 4 or Astaxarthin treated group (378.00 ± 37.25), group 5 or STC30 treated group (260.40 ± 5.75), group 6 or liv.52 HB treated group (491.00 ± 15.63) and group 7 or the mix treatment group (408.80 ± 8.54) where all significantly (P≤0.05) higher that of normal control or group 1 (23.44 ± 2.88) indicating an ongoing inflammation occasion by possible carcinoma. However, the CRP concentration in all treated groups was significantly (p≤0.05) reduced compared with the positive control which was not treated. From our results, STC30 appeared to be more potent in reducing the CRP concentration which is also a pointer to reversal of possible cause of inflammation which triggered elevated CRP. Other products used for treatment also showed varying capability is ameliorating CRP triggers which in this study was Hepatocellular carcinoma. Conclusively, significant reduction in CRP levels following various treatment may indicate that the natural products are capable of reducing inflammation caused by the induced hepatocellular carcinoma.

Association of dietary patterns and components with atherosclerosis risk biomarkers in familial hypercholesterolemia.

Familial hypercholesterolemia (FH) is a relatively common genetic disorder associated with elevated atherosclerotic risk. Dietary interventions can modulate processes associated with cardiovascular risk and potentiate the impact of pharmacological lipid-lowering therapies. This review evaluates recent findings of dietary patterns and their components on risk biomarkers in people with FH. Diets lower in saturated fatty acids (SFA) may reduce low-density lipoprotein-cholesterol (LDL-C); however, their effects seem to be modest. A Mediterranean style diet apparently exerts more robust effects on plasma LDL-C, apolipoprotein B and C reactive protein concentrations than one restricted in SFA. Supplementation of plant sterols and stanols reduces LDL-C especially in children with FH. Caloric restricted diets may reduce weight and improve triglyceride levels in individuals with FH and excess body weight. Despite the strong impact of genetic variants, dietary patterns mostly low in SFA and especially the Mediterranean diet may influence risk biomarkers in FH. However, most available studies are limited by cross-sectional design, small number of study subjects and short-term follow-ups. Robust interventional studies are necessary to test the impact of dietary patterns in people with FH.

Protective properties of sardine and chickpea protein hydrolysates against lipoprotein oxidative damages and some inflammation markers in hypercholesterolemic rats

OBJECTIVE: This study evaluated the effect of sardine (SPH) and chickpea protein hydrolysates (CPH) on oxidant stress and inflammatory profile in cholesterol-fed rats. METHODS: The experiment was undertaken for thirty days on 18 cholesterol-fed Wistar rats (220±10 g) divided into three groups and receiving 1 g/kg of body weight either chickpea protein hydrolysate (CPH), sardine protein hydrolysate (SPH) or casein in water (CG). RESULTS: Compared to CG, SPH and CPH treatment reduced cholesterol, hydroperoxide and malondialdehyde contents in serum, lipoproteins, erythrocytes and aorta. These same treated groups showed also lower serum isoprostane levels. However, serum paraoxonase activity and HDL-antioxidant property were improved only by CPH compared to CG. SOD activity of aorta and erythrocytes was higher in CPH but in SPH group, SOD activity was lower in these tissues and remained unchanged in serum. Furthermore, CPH and SPH stimulated glutathione peroxidase and catalase activities of aorta and erythrocytes. In CPH group, nitric oxide levels of serum, erythrocytes and aorta were increased by respectively 1.4- to 1.8-fold compared to CG and SPH. In addition, among the three groups, CPH exhibited the best anti-inflammatory effect by lowering serum C reactive protein, uric acid and albumin concentrations. CONCLUSIONS: SPH and particularly CPH possess antioxidant and anti-inflammatory properties and could be useful as nutraceuticals for health improving and preventing numerous disorders such as cardiovascular diseases.

High Serum Uric Acid and High-Sensitivity C Reactive Protein Concentrations Predict Three-Year Cardiovascular Mortality in Patients Treated With Continuous Ambulatory Peritoneal Dialysis.

Aims: This study aims to access the predicting value of serum uric acid (UA) and high-sensitivity C reactive protein (hs-CRP) concentration on three-year cardiovascular-related mortality in patients performing continuous ambulatory peritoneal dialysis (CAPD).Methods: A total of267 CAPD patients [150 male (56.2%); mean age 48.93 ± 13.58 years] were included in our study. All patients had measured serum UA and hs-CRP concentration. A high-sensitivity particle-enhanced immunoturbidimetric assay determined serum hs-CRP; serum UA levels were determined using an enzymatic colorimetric assay. All patients were followed for three years to detect cardiovascular-related mortality by cardiologists and stroke specialists.Results: Mean serum UA level was 415.16 ± 84.28 µmol/L, 58.4% of patients had increased serum UA level. Median serum hs-CRP level was 2 (1-4) mg/L, 12.4% of patients had increased serum hs-CRP level. During 36 months of follow-up, 41 patients (15.4%) had cardiovascular-related mortality. The results of Cox proportional hazards regression showed that hypertension, diabetes, high serum UA and hs-CRP were risk factors that related to cardiovascular-related mortality (p<0.05). The receiver operating characteristic (ROC) curve and Kaplan-Meier analysis results showed that UA and hs-CRP level had predictive value for three-year cardiovascular-related mortality in CAPD patients [uric acid: area under the curve (AUC)=0.822; hs-CRP: AUC=0.834, p < 0.001].Conclusion: High serum UA and hs-CRP levels were predictive factors of cardiovascular-related mortality in CAPD patients.

Tocilizumab is safe and tolerable and reduces C-reactive protein concentrations in the plasma and cerebrospinal fluid of ALS patients.

We tested safety, tolerability, and target engagement of tocilizumab in amyotrophic lateral sclerosis (ALS) patients. Twenty-two participants, whose peripheral blood mononuclear cell (PBMC) gene expression profile reflected high messenger ribonucleic acid (mRNA) expression of inflammatory markers, were randomized 2:1 to three tocilizumab or placebo treatments (weeks 0, 4, and 8; 8mg/kg intravenous). Participants were followed every 4wk in a double-blind fashion for 16 wk and assessed for safety, tolerability, plasma inflammatory markers, and clinical measures. Cerebrospinal fluid (CSF) was collected at baseline and after the third treatment. Participants were genotyped for Asp358 Ala polymorphism of the interleukin 6 receptor (IL-6R) gene. Baseline characteristics, safety, and tolerability were similar between treatment groups. One serious adverse event was reported in the placebo group; no deaths occurred. Mean plasma C-reactive protein (CRP) level decreased by 88% in the tocilizumab group and increased by 4% in the placebo group (-3.0-fold relative change, P < .001). CSF CRP reduction (-1.8-fold relative change, P=.01) was associated with IL-6R C allele count. No differences in PBMC gene expression or clinical measures were observed between groups. Tocilizumab treatment was safe and well tolerated. PBMC gene expression profile was inadequate as a predictive or pharmacodynamic biomarker. Treatment reduced CRP levels in plasma and CSF, with CSF effects potentially dependent on IL-6R Asp358 Ala genotype. IL-6 trans-signaling may mediate a distinct central nervous system response in individuals inheriting the IL-6R C allele. These results warrant further study in ALS patients where IL-6R genotype and CRP levels may be useful enrichment biomarkers.

Role of endometriosis in defining cardiovascular risk: a gender medicine approach for women’s health

The relationship between endometriosis and subclinical atherosclerosis represents an emerging topic in women’s health, as women with endometriosis are at higher risk of cardiovascular disease later in life. We investigated metabolic parameters and indirect endothelial markers related to atherosclerosis, in women suffering from stage III/IV of endometriosis compared with women without endometriosis. The study population comprised 643 women: 92 women (14.3%) with stage III/IV of endometriosis and 551 (85.7%) without endometriosis. By analyzing biohumoral parameters we observed a significant increased total cholesterol (p = 0.01), LDL-C (p = 0.01), triglycerides (p = 0.05) and homocysteinaemia (p = 0.04), lower vitamin B6 and folate (p = 0.07 and p = 0.03, respectively) values, and higher high-sensitive C reactive protein (p = 0.05) concentrations in stage III/IV in comparison to those observed in women without endometriosis. After adjustment for traditional cardiovascular risk factors, the poorer lipid profile (total cholesterol, LDL-C), as well as Lipoprotein (a), remained significantly associated with severity of endometriosis (p = 0.01 and p = 0.03, respectively). Our findings highlight the role of endometriosis as a gender-specific cardiovascular risk factor. The clinical relevance of our study lies in identifying women with stage III/IV of endometriosis at higher risk of atherosclerotic disease, who could benefit from an early cardiovascular screening to control future cardiovascular risk.

Effect of Tocilizumab on LDL and HDL Characteristics in Patients with Rheumatoid Arthritis. An Observational Study.

BackgroundIn patients with rheumatoid arthritis (RA), qualitative alterations of low and high-density lipoproteins (LDL and HDL, respectively) might partially explain their increased cardiovascular risk. Tocilizumab has been associated with an increase in lipids, including triglyceride (TG) and cholesterol levels. The aim of this study is to evaluate the effect of tocilizumab on certain LDL and HDL characteristics (oxidized LDL levels, HDL-associated enzymes, chemical composition of both total HDL and HDL3c subpopulation, and their capacity to promote cellular cholesterol efflux) at baseline and 3 months after the start of treatment in patients with RA.MethodsTwenty-eight RA patients (ACR/EULAR 2010 criteria) with indication of treatment with tocilizumab were included in the present study. Clinical assessment [Health assessment questionnaire (HAQ)], disease activity score 28 (DAS28), high-sensitivity C reactive protein (hsCRP) concentration, lipid profile, and lipoprotein (a) [Lp(a)] levels were evaluated in all patients at baseline and after 3 months of treatment with tocilizumab. Lipoprotein characteristics were evaluated through the levels of oxidized LDL (OxLDL), the activity of paraoxonase (PON) 1, the composition of total HDL and small, dense HDL3c subpopulation, and their ability to promote cellular cholesterol efflux.ResultsAfter 3 months of treatment with tocilizumab, HAQ (− 23%, p < 0.05), DAS28 (− 49%, p < 0.001), and hsCRP (− 94%, p < 0.01) levels decreased significantly. Total cholesterol (TC), LDL-C, non-HDL-C, and apo B levels showed a significant increase after treatment (TC: + 7.0%, p < 0.01; LDL-C: + 10%, p < 0.01; non-HDL-C: + 9.9%, p < 0.01; and apo B: + 9.6%, p < 0.05). Decreases in Lp(a) and OxLDL levels were also observed after treatment [Lp(a): − 50%, p < 0.01; and oxLDL: − 5.4%, p < 0.05]. The latter was in accordance with the increment detected in PON activity. No changes were observed in HDL capacity to promote cholesterol efflux (p > 0.05) in the whole group.ConclusionsTreatment with tocilizumab reduced hsCRP levels and displayed positive effects on certain lipoprotein-related parameters, such as a potent decrease inLp(a) and a reduction in OxLDL levels. Moreover, HDL capacity to promote cellular cholesterol efflux was maintained after 3 months of treatment.

Relationship between high-sensitivity C reactive protein and the risk of gallstone disease: results from the Kailuan cohort study

ObjectivesGallstone disease (GSD) can be caused by various health and clinical factors such as obesity, dyslipidaemia and an unhealthy diet, all of which are associated with higher high-sensitivity C reactive...

Laboratory test alterations in patients with COVID-19 and non COVID-19 interstitial pneumonia: a preliminary report.

Coronavirus disease 19 (COVID-19) is the greatest pandemic in modern history. Laboratory test alterations have been described in COVID-19 patients, but differences with other pneumonias have been poorly investigated to date, especially in Caucasian populations. The aim of this study was to investigate differences and prognostic potential of routine blood tests in a series of Italian patients with COVID-19 and non-COVID-19 interstitial pneumonia. Clinical data and routine laboratory tests of a consecutive series of 30 COVID-19 patients and 30 age and sex matched patients with non COVID-19 interstitial pneumonia have been retrospectively collected. Differences in laboratory tests between patients with COVID-19 and non COVID-19 pneumonias have been investigated, as well as differences between COVID-19 survivors and non survivors. COVID-19 patients had lower white blood cells, monocytes, neutrophils, and higher platelet counts. In addition, COVID-19 patients showed higher mean platelet volume, lower C reactive protein concentrations, and higher De Ritis ratio. Combined blood cell indexes of systemic inflammation were significantly lower in COVID-19 patients. In further analysis of the COVID-19 group, the neutrophil count, neutrophil to lymphocyte ratio (NLR), derived NLR, systemic inflammation response index and De Ritis ratio, were significantly higher in non survivors than in survivors, while the number of platelets was significantly lower in non survivors. Our study showed several alterations in blood cell populations and indexes in patients with COVID-19 pneumonia in comparison with patients with non COVID-19 pneumonia. Some of these indexes showed promising prognostic abilities. Further studies are necessary to confirm these results.

FRACTIONAL URIC ACID EXCRETION AND C-REACTIVE PROTEIN CONCENTRATION IN TYPE 2 DIABETES MELLITUS: THE INFLUENCE OF GLYCEMIC CONTROL

This study investigated the influence of glycemic control on fractional uric acid excretion and the concentration of C-reactive protein (CRP) in type 2diabetes mellitus. A total of 120 subjects consisting of 76 confirmed diabetic patients, as cases and 44 apparently healthy volunteers served as control, participated in the study. Venous blood and early morning urine were obtained for estimations of CRP, uric acid and creatinine concentrations. The results showed that serum C-reactive protein concentrations were significantly higher in diabetics than in non-diabetic control (p = 0.000) however, serum uric acid, creatinine and uric acid: creatinine ratio were similar in both groups (p = 0.401, p = 0.248, p = 0.141 respectively). The fractional excretion of uric acid in diabetics was also significantly higher than non-diabetics. Among the diabetics, patients with positive HbA1c (poorly controlled diabetics) had significantly higher concentration of C – reactive protein (p = 0.05) and fasting plasma glucose than those with negative HbA1c (better controlled diabetics). However, fractional excretion of uric acid was not significantly different in the HbA1c positive and the negative patients. Pearson bivariate correlation analysis showed that glycated hemoglobin (HbA1c) related positively and significantly with C – reactive protein among the diabetics (r = 0.333, p = 0.003) but did not show significant relationship with concentrations of uric acid in serum and urine as well as with fractional excretion of uric acid. Binary logistic regression analysis also showed that a unit increment in the odds of positive HbA1c (HbA1c ? 6.5) was significantly associated with 1.7-fold increment in C – reactive protein concentrations (CI = 95%, Odd ratio = 1.7, p = 0.015). However, the concentrations of CRP in diabetic patients were observed to correlate significantly with serum uric acid (r = 0.306, p = 0.048), urine uric acid (r = 0.397, p = 0.000) and serum uric acid:creatinine ratio (r = 0.338, p = 0.012); but there was no significant correlation with fractional excretion of uric acid. It can be concluded that the concentration and excretion of uric acid were not significantly affected by glycemic control, however, adequate control of glucose level was observed to modulate the concentration of C-reactive protein.

Association between C reactive protein and microvascular and macrovascular dysfunction in sub-Saharan Africans with and without diabetes: the RODAM study

IntroductionAlthough inflammation assessed by elevated C reactive protein (CRP) concentration is known to be associated with risk of cardiovascular disease, its association with microvascular and macrovascular dysfunction in diabetes and...

Etiology and bacterial susceptibility to antibiotics in patients with recurrent lower urinary tract infections.

Recurrent urinary tract infections (UTIs) are a frequent health problem and a common reason for treatment resistance. The purpose of the study was to evaluate the etiology of community‑ acquired lower recurrent UTI and bacterial antibiotic susceptibility. A total of 796 microbiological urine cultures from 332 patients (280 women and 52 men) treated in a single nephrology outpatient department in central Poland in years 2016 to 2018 were analyzed. The most frequent species responsible for recurrent lower UTI were identified and the susceptibility of all the microbes to specific antibiotics was assessed. The patients' kidney function and inflammation parameters were evaluated. The median (interquartile range [IQR]) age of the patients was 65 (59-77) years (women, 69 [57-78] years; men, 67 [62-77] years), median (IQR) glomerular filtration rate was 56.6 (40.2-81.3) ml/min/1.73 m2 with median (IQR) C‑ reactive protein concentration of 3.2 (1.5-7.0) mg/l. There were 43 bacterial species identified: 24 gram‑positive and 19 gram-negative. The analyzed urine cultures contained 977 microbial samples (563 gram‑negative bacteria, 408 gram-positive, 6 fungi). The most common bacteria was Escherichia coli (39.6%) which showed 100% susceptibility to carbapenems, 98.9% to amikacin, 96.5% to piperacillin / tazobactam, and 94.3% to gentamicin. With regard to oral antibiotics, its highest susceptibility was to fosfomycin 95.5%, nitrofurantoin 85.5%, and cefuroxime 82.3%. In 39.9% of cases, E. coli was resistant to fluoroquinolones and in 46.6% to trimethoprim / sulfamethoxazole. The most frequently occurring bacteria causing recurrent lower UTI are characterized by significant resistance to the antimicrobial therapy recommended as the first‑ line treatment: fluoroquinolones and trimethoprim / sulfamethoxazole. It seems that the first choice in the treatment of lower UTIs should be: fosfomycin, nitrofurantoin, or cefuroxime.

Factors Related to Cardiac Troponin T Increase after Participation in a 100 Km Ultra-Marathon.

Background: Intensive and prolonged exercise leads to a rise of troponin concentration in blood. The mechanism responsible for troponin release during exercise remains ill-defined. The study aim was to search for risk factors of troponin increase after a prolonged endurance competition. Methods: The study included a group of 18 amateurs, healthy volunteers (median age 41.5 years, interquartile range – IQR 36–53 years, 83% male) who participated in a 100 km running ultra-marathon. Information on demographic characteristics, pre- and post-race heart rate, blood pressure, body composition and glucose, lactate (L), troponin T (hs-TnT) and C reactive protein (hs-CRP) concentration were obtained. Additionally, data on L and glucose levels every 9.2 km and fluid/food intakes during the race were collected. Results: There was a significant hs-TnT increase after the race exceeding upper reference values in 66% of runners (from 5 IQR 3–7 ng/L to 14 IQR 12–26 ng/L, p < 0.0001). None of the baseline parameters predicted a post-race hs-TnT increase. The only factors, correlating with changes of hs-TnT were mean L concentration during the race (rho = 0.52, p = 0.03) and change of hs-CRP concentration (rho = 0.59, p = 0.01). Conclusions: Participation in a 100 km ultra-marathon leads to a modest, but significant hs-TnT increase in the majority of runners. Among analysed parameters only mean lactate concentration during the race and change in hs-CRP correlated with troponin change.

Immunomodulatory Effect of Carica Papaya and Actinidia Delicosa on Methotrexate Induced Immunosuppression in Male Rats

This study was carried out to explore the effects of alcoholic extract of Carica papaya fruit (C. papya) and Actinidia delicosa (Kiwi) fruit on some immunological, proinflammatory and anti-inflammatory biomarkers in methotrexate (MTX) treated rats. Forty adult male rats were weighted (130-160gm) and equally allocated into four groups and treated daily for 8weeks with orally as follow: Group G1: (control group) received tap water, G2: rats in this group were injected (20mg/kg /B.W) of MTX in 5thweek, G3: were orally received daily (400 mg/kg /B.W) of Carica papaya fruit alcoholic extract and injected (20mg/kg /B.W) of MTX in 5thweek , G4: were orally received daily (400mg/kg /B.W) of Actinidia delicosa fruit alcoholic extract and were injected (20mg/kg /B.W) of MTX in 5thweek. At the end of experiment, all animals were sacrificed and blood was drawn from median canthus of eye for measuring Serum immunoglobulin M, Serum immunoglobulin G, TNFα, interleukin-10 and C – reactive protein concentrations. Liver tissue collected in liquid nitrogen for Real Time PCR of IL1β and IL6 mRNA expression levels. Spleen tissue collected for histopathological examination and immunohistochemistry of TNFα expression levels. The results of the current study revealed A significant increase in serum serum IgM, IgG and IL10 as well as significant decrease in serum CRP concentrations and TNFα concentrations , mRNA expression levels of IL1β IL6 and immunohistochemical expression of TNFα were return to normal following extract administration comparing to the immune-suppression effect of MTX. Histopathological examination of spleen proved the protective effect of C.papaya and Kiwi fruit extract against necrosis and degenerative changes caused by MTX injection. Immunohistochemically, the expression level of TNFα in spleen tissue was decreased in Carica papaya fruit and Actinidia delicosa fruit groups when compared to MTX treated group. Conclusion, alcoholic extract of Carica papaya fruit and Actinidia delicosa fruit compete the side effects of MTX correlated with immune suppressive and pro-inflammatory effect.

Association of dietary components with dyslipidemia and low-grade inflammation biomarkers in adults with heterozygous familial hypercholesterolemia from different countries.

The association of components of a low saturated fat (SFA) and of a Mediterranean diet was tested with atherosclerosis biomarkers in 190 familial hypercholesterolemia adults (FH) from Brazil (BR) and Spain (SP). Median blood LDL-C, Apolipoprotein B (apoB), and C reactive protein (hs-CRP) concentrations were higher in BR than in SP: 179.0 vs.161 mg/dL; 141 vs. 103 mg/dL; and 1.6 vs. 0.8 mg/L respectively (all p < 0.001). In BR there was lower median total fat (22.3 vs. 38.3%) and SFA (8.1 vs. 12.5%) but higher cholesterol (283.3 mg vs.188.9 mg) and carbohydrate (57.1 vs. 42.5%) consumption (all p < 0.001). Inverse associations were encountered between fibers, mono, and polyunsaturated fats and their ratios to SFA with LDL-C and ApoB (all p < 0.001). There was a direct association respectively of cholesterol with lipid biomarkers and of carbohydrates and trans-fatty acids with hs-CRP while other fats showed inverse relations with the latter (p < 0.001).

Are reactive C protein and procalcitonin useful for early diagnosis of postoperative intraabdominal infection after pancreaticoduodenectomy for pancreatic cancer?

To evaluate the relationship between C reactive protein and procalcitonin levels and the appearance of post-operative intraabdominal infection, in patients with pancreaticoduodenectomy due to pancreatic cancer. A prospective observational study, including 35 patients, was made. Procalcitonin and C reactive protein were measured before surgery, as well as 24, 48 and 72 h after the surgical procedure. Patients were divided in two groups, with and without intraabdominal infection. Six patients (17.1%) presented post-operative intraabdominal infection. Both, procalcitonin and C reactive protein, increased in all patients after surgery, but there were no significant differences between the two groups. However, the ratio between the C reactive protein concentrations on post-operative day 3 and the concentrations on post-operative day 1 was significantly increased in the group of patients with intraabdominal infection. The predictive positive value and the predictive negative value for this ratio were 60% and 95%, respectively, for a cut-off point of 2.3. The ratio between C reactive protein value on post-operative day 3 and the value on post-operative day 1 is a good predictor of post-operative intraabdominal infection after pancreaticoduodenectomy.