Serum Fibrinogen Levels Research Articles

Can fibrinogen level be a criterion in choosing the treatment option in patients with acute cholecystitis?

We aimed to investigate whether there is a relationship between blood fibrinogen levels during hospitalization of patients hospitalized for conservative treatment due to acute cholecystitis (AC) in our clinic. Patients underwent surgery and were discharged with medical treatment. The files of 118 patients who were hospitalized due to the diagnosis of AC and planned for conservative medical treatment in our clinic between January 2018 and February 2020 were recorded, prospectively. The patients were divided into two groups as those who responded to conservative treatment (Group 1), and those who were operated urgently despite conservative treatment (Group 2). Increase in gallbladder wall thickness, presence of pericholecystic fluid and hydrops sac on ultrasound and computed tomography (CT) were considered significant for the diagnosis of acute cholecystitis. Blood fibrinogen levels were measured in all patients during hospitalization. The mean age of 118 patients included in the study was 58.32 (19-96) years. There were 77 patients in Group 1 and 41 patients in Group 2. Serum fibrinogen level was found to be 298.34±111.7 mg/dl in Group 1 and 637±124.5 mg/dl in Group 2, and a statistically significant difference was found (p<0.001). When the cut-off value for the fibrinogen level was taken as 564.50 mg/dl, the sensitivity and specificity of the test were found to be 75.6% and 61%, respectively in showing surgical treatment. As a result of our study, we concluded that when the data obtained are evaluated, it should be kept in mind that despite medical treatment, there is an urgent need for an operation in patients with acute cholecystitis, and in patients with high plasma fibrinogen level (cut-off) at first admission.

Evaluation of the relationship between TAFI level and prognosis in COVID-19 patients.

Serum thrombin-activated fibrinolysis inhibitor (TAFI) levels were measured in coronavirus disease 2019 (COVID-19) patients requiring intensive care, clinical hospitalization, and outpatient follow-up. The relationships between serum TAFI levels and prognosis were determined. Ninety patients who had positive COVID-19 PCR test results were randomly selected and included in the study. Subgroups were formed according to the clinical characteristics of the patients as follows: mild, moderate, and severe. Venous blood samples were taken from all patients, and serum C-reactive protein (CRP), lactate dehydrogenase (LDH), fibrinogen, D-dimer, ferritin, and TAFI levels were measured. The results were evaluated by comparing each group. The one-way ANOVA test to determine differences between subgroups resulted in p-values lower than 0.05 for all biochemical analytes (CRP, LDH, fibrinogen, D-dimer, ferritin, and TAFI). Regarding serum TAFI levels, there were significant differences in the severe group (853.04 ± 338.58 ng/mL) compared to the mild group (548.33 ± 264.17 ng/mL). ROC curve analysis to predict mortality revealed that TAFI levels were able to detect 85% of deaths. In addition, ROC analysis revealed that serum TAFI levels could detect 86% of intubated cases. The disease progression is more severe in patients with high TAFI levels, and high TAFI levels are associated with mortality and intubation rates. Further studies are needed to determine serum TAFI levels as a biomarker of prognosis in COVID-19 patients.

Estimation of Serum Fibrinogen Level in Type 2 Diabetics and Its Association with Major Adverse Cardiovascular Events (Mace)

Estimation of Serum Fibrinogen Level in Type 2 Diabetics and Its Association with Major Adverse Cardiovascular Events (Mace)

Correlation of coagulation states with prognosis of sudden deafness.

Prognosis of sudden deafness remains a challenge in clinics because of inhomogeneity of the disease. Here we report our retrospective study aimed to explore the value of coagulative markers including activated partial thromboplastin time (APTT), prothrombin time (PT), plasma fibrinogen (FIB), and plasma D-dimer in the prognosis of patients. The study included a total of 160 patients, of whom 92 had valid responses, 68 had invalid responses, and 68 had ineffective responses. APTT, PT, and the levels of FIB and D-dimer in serum were compared between the two groups, and their prognostic values were determined in terms of area under the curve (AUC) in receiver operating curve (ROC) analysis, sensitivity, and specificity. The correlations of APTT, PT, and FIB to degree of hearing loss were also assessed. Serum APTT and PT, FIB, and D-dimer levels were lower in patients with sudden deafness who responded poorly to treatments. ROC analysis showed that APTT, PT, FIB, and D-dimer had high AUC, sensitivity, and specificity for nonresponders, particularly when used in combination (AUC = 0.91, sensitivity = 86.76%, and specificity = 82.61%). Patients with a higher degree of hearing loss (>91 dB) also demonstrated significantly lower values of APTT and PT and higher levels of serum FIB and D-dimer than those with a lower degree of hearing loss. Our study demonstrated that APTT, PT, and serum levels of FIB and D-dimer could serve as strong predictors of sudden deafness, potentiating the use of these tests to identify patients who respond poorly to treatments.NEW & NOTEWORTHY Our retrospective study indicated that lower serum APTT and PT levels and higher fibrinogen (FIB) and D-dimer levels are characteristics associated with poor treatment responses among patients with sudden deafness. A combination of these levels had a high accuracy in identifying the nonresponders. APTT, PT, and serum levels of FIB and D-dimer could serve as strong predictors of sudden deafness, potentiating the use of these tests to identify patients who respond poorly to treatments.

Effects of serum fibrinogen correction on outcome of traumatic cranial surgery: A randomized, single-blind, placebo-controlled clinical trial

BackgroundTraumatic brain injury (TBI) is strongly associated with coagulopathy that occurs in 25–35% of patients. This complication is linked to higher mortality and morbidity. Recent lines of evidance have supported administration of fibrinogen concentrate (FC) in patients with severe TBI, while its efficacy remains controversial. In this study we aim to evaluate the effectiveness of serum fibrinogen level correction from 1.5 and 2.0 g/l to more than 2.0 g/l in patients with severe TBI undergoing traumatic cranial surgery. MethodThis randomized, single-blind, placebo-controlled clinical trial included trauma patients who had abbreviated injury scale (AIS) more than 3 in head and below 3 in other organs. FC was administered intravenously to patients with severe TBI undergoing TBI to correct the fibrinogen level above 2 g/l. Patients were randomly assigned to FC and control groups. The amount of intra-operative blood loss, packed cell (PC) transfusion, formation of new intracranial hemorrhage, and hemovac drainage were compared between the two study groups. ResultsForty-seven of 65 participants received the study intervention within 40–112 min of admission. Intra-operative PC transfusion was higher in FC group (80%) compared to control group (55.5%) while the differance was not statistically significant (p > 0.05). Intra-operative blood loss was significantly higher in control group than FC group (P = 0.036). Chance of re-operation and new intracranial hematoma were not significantly different between two study groups. ConclusionEarly delivery of FC, decreases intraoperative bleeding. Although based on our findings it has no other effect on other parameters, further multicenter studies are recommended to investigate the role of early FC administration in management of post traumatic coagulopathy.

Fibrinogen to albumin ratio, a novel serum indicator for evaluating the severity of preeclampsia: A single-center retrospective study.

Preeclampsia (PE) is a disorder that affects approximately 5% to 10% of pregnant women. Timely and accurate identification of PE and assessment of its severity are crucial. Therefore, it is necessary to develop predictive indicators which are easily measured in routine antenatal examinations to enable the early detection of PE and assess its severity. We designed a single-center retrospective study in our daily work to assess whether the serum levels of fibrinogen to albumin ratio (FAR), fibrinogen (Fib), albumin (ALB), prothrombin time, calcium (Ca), activated partial thrombin time, creatinine (Cr), D-dimer(D-D), platelet, white blood cell, neutrophil, and lymphocyte counts could help in assessing PE and evaluating its severity. Our findings showed that the serum levels of FAR, Cr, Fib, and D-D were significantly higher in the severe preeclampsia group (sPE) compared with the control and mild preeclampsia groups, whereas the levels of ALB and Ca were significantly lower in sPE patients. In addition, no differences were found between the control and PE groups in terms of prothrombin time, activated partial thrombin time, platelet, white blood cell, neutrophils, and lymphocytes counts. Furthermore, FAR is a novel and better indicator for evaluating the severity of PE, which has not been reported before. And it is an independent risk factor for the development of sPE. In conclusion, the serum levels of FAR, Cr, D-D and Fib were positively correlated with PE, whereas ALB and Ca were negatively correlated with PE severity, which might be valuable in evaluating the severity of PE. FAR proved to be a feasible diagnostic marker for sPE with sensitivity and specificity comparable to those of ALB and Fib.

Interleukin-28 as a Promising Marker for Predicting Invasive Mechanical Ventilation Requirement and Mortality in COVID-19 Patients.

The study aimed to evaluate serum interleukin-28 levels in COVID-19 patients and correlate the results with disease severity. This study included 90 patients who presented to the COVID-19 outpatient clinics, hospital wards, and intensive care units. Serum interleukin-28, C-reactive protein, lactate dehydrogenase, fibrinogen, d-dimer, and ferritin levels were measured. Patients were divided into 3 groups based on clinical severity to mild, moderate, and severe groups (each group consisted of 30 patients). There were significant differences in serum C-reactive protein, lactate dehydrogenase, fibrinogen, d-dimer, ferritin, and interleukin- 28 levels between all groups. The mean serum interleukin-28 levels of all patients were 383.74 ± 63.58 ng/L. The mean serum interleukin-28 levels were 335.52 ± 42.12 ng/L in the mild group, 366.88 ± 41.27 ng/L in the moderate group, and 453.46 ± 36.78 ng/L in the severe group. There were significant differences in comparisons of all pairs (P < .05). Interleukin-28 may be a promising biomarker for detecting disease severity in COVID-19 patients.

The relationship between COVID-19 and the complement system: mannose-binding lectin.

Mannose-binding lectin (MBL) is one of the important parts of the complement system. In our study, we aimed to determine serum MBL levels and their relationship with intensive care hospitalization. Ninety COVID-19-positive patients from outpatient clinics and clinics were included in this study. The patients were evaluated in three groups as mild, moderate, and severe groups. Each group consisted of 30 patients. A venous blood sample was taken once from each patient. Serum MBL, C-reactive protein (CRP), lactate dehydrogenase (LDH), fibrinogen, D-dimer, and ferritin levels were measured. The mean serum MBL levels of all patients were 695.46±324.42 ng/mL. One-way ANOVA test resulted in significant differences in serum CRP, LDH, fibrinogen, D-dimer, ferritin, and MBL levels between groups (p<0.05 for all comparisons). Post-hoc Tukey analysis showed significant differences in serum MBL levels between mild and severe groups and moderate and severe groups. MBL may be used as a prognostic biomarker in COVID-19 patients. Further studies are needed to determine MBL in treatment strategies.

Glomerular deposition of fibrinogen predicts good prognosis of IgA nephropathy: a single-center cohort study

PurposeIt has been proven that fibrinogen deposition exists in IgA nephropathy (IgAN), but its clinical significance has not been identified. We aim to investigate the clinical implication of fibrinogen deposition in evaluating the activity and prognosis of IgA nephropathy.MethodsIn this cohort, 935 adult IgAN patients were divided into 3 groups according to the intensity of glomerular fibrinogen deposition. Primary outcome refers to a composite event of either a ≥ 50% reduction in eGFR or ESRD (eGFR < 15 ml/min/1.73m2, dialysis, or renal transplantation). Factors associated with fibrinogen deposition and prognosis were identified.ResultsThe results showed that the intensity of fibrinogen deposition was positively correlated with eGFR (P < 0.001), serum albumin (P = 0.041), and hemoglobin levels (P < 0.05), but negatively correlated with age (P = 0.04), serum fibrinogen levels (P < 0.001), serum C4 (P = 0.023), the proportion of patients with hypertension (P = 0.003), and the percentage of glomeruli sclerosis (P < 0.001). The prognostic analyses identified that fibrinogen deposition was an independent predictor for the progression of IgAN (P = 0.033).ConclusionOur study indicated that the deposition of renal fibrinogen can predict the prognosis of IgAN with high reliability.

Low preoperative serum fibrinogen level is associated with postoperative acute kidney injury in patients with in acute aortic dissection

ObjectiveAcute kidney injury (AKI) after cardiac surgery is associated with serious complication and high risk of mortality. The relationship between hemostatic system and the prognosis of patients with acute type A aortic dissection (ATAAD) has not been evaluated. The purpose of this study was to investigate the association between preoperative serum fibrinogen level and risk of postoperative AKI in patients with ATAAD.MethodsA total of 172 consecutive patients undergoing urgent aortic arch surgery for ATAAD between April 2020 and December 2021 were identified from Beijing Anzhen Hospital aortic surgery database. The primary outcome was postoperative AKI as defined by the Kidney Disease Improving Global Outcomes (KDIGO) criteria. The univariate and multivariate logistic regression analysis were done to assess the independent predictors of risk for postoperative AKI. Receiver operating characteristic (ROC) curve was generated to evaluate the predictive probabilities of risk factors for AKI.ResultsIn our study, 51.2% (88/172) patients developed postoperative AKI. Multivariate logistic regression analysis identified low preoperative serum fibrinogen level (OR, 1.492; 95% CI, 1.023 to 2.476; p = 0.021) and increased body mass index (BMI) (OR, 1.153; 95% CI, 1.003 to 1.327; p = 0.046) as independent predictors of postoperative AKI in patients with ATAAD. A mixed effect analysis of variance modeling revealed that obese patients with low preoperative serum fibrinogen level had higher incidence of postoperative AKI (p = 0.04). The ROC curve indicated that low preoperative serum fibrinogen level was a significant predictor of AKI [area under the curve (AUC), 0.771; p < 0.001].ConclusionsLow preoperative serum fibrinogen level and obesity were associated with the risk of postoperative AKI in patients with ATAAD. These data suggested that low preoperative serum fibrinogen level was preferred marker for predicting the postoperative AKI, especially in obese patients with ATAAD.

Efficacy and Prognosis of Adjuvant Argatroban Treatment in Acute Ischemic Stroke Patients with Early Neurological Deterioration.

The therapeutic outcomes for acute ischemic stroke (AIS) with early neurological deterioration (END) are adverse. Argatroban is a novel direct thrombin inhibitor, which is safe in the treatment of AIS, but its efficacy is controversial. This study sought to assess the therapeutic effect of argatroban as an adjunct to aspirin in the treatment of AIS patients with END. Patients' prognosis for the presence of END was also evaluated. Overall, 166 AIS patients with END were included in the study from June 2018 to June 2021 in The Affiliated Zhangjiagang Hospital of Soochow University. Patients were divided in the control group (aspirin alone) and the study group (aspirin combined with argatroban). General data of the patients were collected. Clinical indexes such as the modified Edinburgh-Scandinavian stroke scale (MESSS), and the serum fibrinogen (FIB) and neuropeptide Y (NPY) levels before and after treatment were also collected. Correlations between prognosis and general data, and FIB and NPY levels in AIS patients with END were analyzed by multivariate logistic regression. The performance of FIB and NPY levels in predicting patients' prognosis was further analyzed using receiver operating characteristic (ROC) curves. There was no significant difference in the general data, such as sex, age, course of disease and basic diseases between the 2 groups. After treatment, the MESSS score (13.08 ± 3.24 vs. 16.48 ± 3.32, p < 0.001), serum FIB level (2.72 ± 0.81 vs. 3.52 ± 0.71, p < 0.001), and NPY level (121.28 ± 17.34 vs. 152.09 ± 18.25, p < 0.001) of the study group was significantly lower than that of the control group. A further analysis revealed that the serum FIB (OR, odds ratio = 2.296, 95% confidence interval, CI: 1.437-3.669, p = 0.001) and NPY (OR = 1.020, 95% CI: 1.002-1.039, p = 0.031) levels were independent risk factors of patients' prognosis for the presence of END. Aspirin combined with argatroban significantly improved neurological impairment of AIS patients with END, which is worthy of clinical application.

Determining the relationship between serum acute phase reactants and cervical premalignant lesions: a cohort study.

Acute phase reactants play a role in the progression and prognosis of many malignant and premalignant tumors. This study investigated the diagnostic value of certain reactants as markers for cervical premalignant lesions. Despite advanced screening and vaccination programs, cervical cancer remains a serious health problem worldwide. We aimed to determine the possible relationship between premalignant cervical disease and serum acute phase reactant levels. This study included 124 volunteers who underwent cervical cancer screening. We divided the patients into three groups according to cervical cytology and histopathological findings as follows: no cervical lesion, low-grade neoplasia, or high-grade neoplasia. We included women aged 25-65 years with benign smear or colposcopy results, low- and high-grade squamous intraepithelial lesions. The benign group was based only on cytology findings, whereas the other groups were based on histopathology findings. Demographic data and serum albumin, fibrinogen, ferritin, and procalcitonin levels were evaluated in the three groups. We found significant differences among the three groups in terms of age, albumin level, albumin/fibrinogen ratio, and procalcitonin level. The regression analysis revealed lower serum albumin levels in the low- and high-grade squamous intraepithelial lesion groups compared with the benign group. This is the first study to evaluate the importance of serum inflammatory markers in cervical intraepithelial lesions. Our results indicate that serum albumin level, albumin/fibrinogen ratio, procalcitonin level, and neutrophil values differ among cervical intraepithelial lesions.

Development and Validation of a Nomogram for Predicting Tigecycline-Related Coagulopathy: A Retrospective Cohort Study

Although tigecycline is an effective drug against drug-resistant bacteria, it demonstrated a higher all-cause mortality than comparator antibiotics and a high incidence of coagulation disorders which can be accompanied by severe bleeding. At present, a predictive model for tigecycline-related coagulopathy is not readily available, and the prognostic value of coagulopathy in tigecycline-administered patients has not been elucidated. In this paper, we investigate the association between tigecycline-related coagulopathy and in-hospital mortality to develop a nomogram for the prediction of tigecycline-related coagulopathy. This retrospective cohort study includes 311 adults prescribed with tigecycline from 2018 to 2020. The primary cohort and validation cohort were constructed by dividing the participants in a ratio of 7:3. The endpoint is tigecycline-related coagulopathy, defined as a condition with no abnormality in coagulation prior to tigecycline application but developed the following symptoms upon prescription: activated partial thromboplastin time (APTT) extended by >10 s than the upper limit of normal (ULN), prothrombin time (PT) prolonged for >3 s than the ULN or reduced serum level of fibrinogen to <2.0 g/L. A predictive nomogram based on logistic regression was subsequently constructed. Tigecycline intake for over 7 days, combined other antibiotics, initial PT, initial fibrinogen and estimated glomerular filtration rate (eGFR), are independent prognostic factors of tigecycline-related coagulopathy. The primary and validation cohort each has an area under the receiver operating characteristic curve (AUC) of 0.792 (0.732-0.851) and 0.730 (0.629-0.832) for nomogram, respectively. Furthermore, the fitted calibration curve illustrated adequate fit of the model, while the decision curve analysis demonstrated good clinical value. Survival curves showed a high mortality rate among patients with tigecycline-related coagulopathy. This nomogram exhibited helpful clinical value in predicting tigecycline-related coagulopathy that could reduce the high mortality rate of patients prescribed with tigecycline.

Predictive significance and diagnostic accuracy of plasma fibrinogen levels for coronary stenting outcomes

Objective: The advancement in percutaneous transluminal coronary angioplasty (PTCA) has led to it becoming the predominant mode of revascularization. Post PTCA adverse events in the form of stent thrombosis, recurrent ischemia, unplanned revascularization, recurrent hospitalization etc. result in morbidity as well as mortality. Biomarkers predicting such outcomes can be useful in initiating more aggressive medical therapy and greater modification of risk factors. This study was undertaken to study the predictive significance of periprocedural plasma fibrinogen levels for coronary stenting outcomes. Methods: 80 patients diagnosed as either chronic stable angina (CSA), unstable angina (UA), Non ST Elevation Myocardial Infarction (NSTEMI) or late presentation ST Elevation Myocardial Infarction (STEMI) undergoing planned PTCA were included in study. Patients were evaluated for clinical history, electrocardiogram (ECG), two dimensional echocardiography (2D-echo) and cardiac biomarkers (Creatinine Phosphokinase-MB isomer (CK-MB) and Troponin I). Serum fibrinogen level was measured 24 hours prior to PTCA along with routine pre-operative investigations; and also 24 hours after coronary stenting. Patients were followed for six months. Outcome measure was taken to be freedom from cardiac related adverse events, including rehospitalization, unplanned repeat revascularization, definite stent thrombosis, transient ischemic attack, stroke and all-cause mortality. Results: Fibrinogen level ≥393 mg/dL, 24 hours prior to percutaneous transluminal coronary angioplasty, was associated with higher major adverse cardiac and cerebrovascular events (MACCE) rates (60%) as compared to those with fibrinogen level &amp;lt;393 mg/dL (3.6%). Fibrinogen level ≥427 mg/dL 24 hours after percutaneous transluminal coronary angioplasty, was associated with higher major adverse cardiac and cerebrovascular events rates (65%) as compared to those with fibrinogen level &amp;lt;427 mg/dL (6.7%). Conclusion: The current study demonstrates that higher baseline and post procedural fibrinogen, is an independent predictor of 6 months major adverse cardiac and cerebrovascular events after elective percutaneous coronary intervention. Key words: Coronary stent outcomes, major adverse cardiac and cerebrovascular events, plasma fibrinogen, stent diameter

Impact of fibrinogen levels and modified Glasgow prognostic score on survival of stage III/N2 non-small cell lung cancer patients treated with neoadjuvant therapy and radical resection

PurposeThe prognostic value of pretreatment and preoperative fibrinogen plasma levels and the modified Glasgow prognostic score (mGPS) in stage III/N2 non-small cell lung cancer (NSCLC) patients who receive neoadjuvant treatment followed by radical surgery is yet unclear.MethodsFibrinogen levels and mGPS of 84 patients with initial stage III/N2 NSCLC, who received neoadjuvant therapy followed by complete surgical resection from 2002 to 2014 were retrospectively analyzed and correlated with clinical parameters and overall survival (OS). Data were analyzed using log-rank and Cox regression analysis adjusted for clinical and pathological factors.ResultsMedian serum fibrinogen level after neoadjuvant treatment was 439 mg/dL (IQR 158 mg/dL). Elevated fibrinogen levels (> 400 mg/dL) after neoadjuvant treatment were significantly associated with poorer OS (28.2 months vs. 60.9 months, HR 0.562, p = 0.048). Importantly, a decrease in fibrinogen levels after neoadjuvant treatment (n = 34) was found to be an independent predictor for favorable OS in multivariate analysis (HR 0.994, p = 0.025). Out of 80 patients, 55, 19 and 6 patients had a mGPS of 0, 1 and 2, respectively. Moreover, elevated mGPS after neoadjuvant treatment (mGPS 1–2) showed a non-significant trend for poorer OS compared to mGPS 0 (28.2 vs. 46.5 months, HR 0.587, p = 0.066).ConclusionElevated fibrinogen levels after neoadjuvant therapy prior to surgery in stage III/N2 NSCLC patients are associated with significant disadvantage for OS. A decrease in fibrinogen levels after neoadjuvant therapy was found to be a predictor for superior OS in this retrospective patient cohort.

Frequency of Deranged Coagulation Profile in Patients having Pregnancy Induced Hypertension

Objective: To evaluate the frequency of deranged coagulation profile in patients having pregnancy induced hypertension.&#x0D; Study Design: Descriptive cross sectional Study&#x0D; Place and Duration: Department of Obstetrics and Gynecology, Nishtar Hospital Multan, from 10 July 2016 to 31 December 2017&#x0D; Methodology: A total number of 540 patients were involved in the study. Sample was collected with the help of non-probability consecutive sampling technique. Patients were divided into three groups, pregnancy induced hypertension, preeclampsia and eclampsia. Following variables were calculated and assessed, age, gravidity. Parity, gestational age, diagnosis of eclampsia or preeclampsia, platelet count, prothrombin time, activated partial thromboplastin time, serum fibrinogen and serum albumin. Data thus obtained was subjected to statistical analysis which was performed by a computer software SPSS version 23. Frequency and percentage was calculated for qualitative variables while mean and standard deviation was calculated for quantitative variables. Chi square test was applied to assess the association among different variables and p value less than or equal to 0.05 was taken as significant.&#x0D; Results: Frequency of low platelet count, low serum fibrinogen level, prolonged PT and prolonged aPTT in PIH group was 45.7%, 4.3%, 2.9% and 2.9% respectively. Frequency of low platelet count, low serum fibrinogen level, prolonged PT and prolonged aPTT in preeclampsia group was 39.4%, 8.7%, 5.1% and 4.2% respectively. Frequency of low platelet count, low serum fibrinogen level, prolonged PT and prolonged aPTT in eclampsia was 52.8%, 12%, 7.5% and 5.1% respectively.&#x0D; Conclusion: This study concludes that derangement in clotting profile occurred in certain percentage of patients suffering from preeclampsia and frequency of derangement was significant.

Association of Serum Fibrinogen and Plasma VEGF Levels with Tumor Characteristics and Treatment Response in Operable Breast Carcinoma

A search for factors predicting the behavior of the tumor, its invasiveness, metastasis, response to treatment, and prognosis is the primary focus of breast cancer research. The objective of the present study was to study the association of fibrinogen and vascular endothelial growth factor (VEGF) with various parameters of breast carcinoma. A case control was conducted in which fibrinogen, and VEGF levels were compared between cases and controls and also with various characteristics of breast carcinoma such as T stage, lymph node positivity, grade, lymphovascular invasion, and receptor status. The effect of surgery of breast cancer on fibrinogen and VEGF levels was also studied. The levels of fibrinogen and VEGF were significantly higher in cases when compared to controls (p < 0.001). Increased fibrinogen level was significantly associated with higher grade of the tumor, lymph node metastasis, and lymphovascular invasion. Increased VEGF level was significantly associated with higher grade and lymphovascular invasion of the tumor. After treatment, there was a statistically significant fall in the levels of the above mediators (p < 0.001). Serum fibrinogen and plasma VEGF levels were significantly higher in patients of breast carcinoma and had significant association with invasiveness of the tumor.

Serum Fibrinogen Assay in Prediction of Postpartum Hemorrhage and its Role in Treatment

Background: PPH is postpartum haemorrhage. It is uncommon and severe.1 to 5% of neonates are affected with PPH, the incidence of which varies by age 20 to 30 and socioeconomic level. During pregnancy, fibrinogen levels in plasma increase. Blood loss results in coagulopathy and low fibrinogen concentrations. Premature PPH is associated with severe bleeding and transfusions. FC is produced from human plasma without the need for cross-matching or freezing. Postpartum haemorrhage must coagulate. Problems with coagulation induce PPH. Fluids, blood, and ergotamine are agents that induce uterine contractions. Aim: The aim of the present work was to study the role of serum fibrinogen level as a predictor for postpartum hemorrhage and its role in the treatment. Subjects and Methods: This Prospective observational study was conducted in the obstetrics and gynecology unit of Benha University Hospitals and Tokh Hospital. This study included 50 patients in 3rd trimester (34-37 weeks). The duration of the study ranged from 6-12 months. Results: There was significant difference regarding Logistic regression with odds ratios and 95% confidence intervals (CI) predicting Bleeding severity. Conclusion: The fibrinogen level at PPH diagnosis is a marker of the risk of aggravation and should serve as an alert to clinicians.

Which serum markers predict the success of reimplantation after periprosthetic joint infection?

PurposeIn clinical practice, serum C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels are routinely used to screen for periprosthetic joint infection (PJI), but the effectiveness of predicting the success of reimplantation is variable. This study aimed to evaluate the diagnostic effectiveness of serum CRP, ESR, plasma D-dimer, and fibrinogen values in groups achieving treatment success or failure for PJI.MethodsA total of 119 PJI cases between January 2012 and January 2017 were identified and included in this study. The most recent serum CRP, ESR, plasma D-dimer, and fibrinogen values obtained prior to performing second-stage revision or spacer exchange were collected for analysis. Treatment failure was defined as having been unable to undergo reimplantation due to clinically persistent infection or reinfection after reimplantation.ResultsAll these tests showed significantly lower values in the treatment success group than in the treatment failure group. The optimal cutoff serum CRP, ESR, plasma D-dimer, and fibrinogen levels for predicting the success of reimplantation were 9.4 mg/L, 29 mm/h, 1740 ng/mL, and 365.6 mg/dL, respectively. All tests had the same sensitivity (72.7%) except for ESR (63.6%), while their specificities were 92.6%, 88.0%, 72.3%, and 83.2%, respectively. Plasma fibrinogen had the highest AUC value of 0.831 [95% confidence interval (CI), 0.685 to 0.978], followed by serum CRP (0.829) and ESR (0.795); plasma D-dimer had the lowest AUC value of 0.716 (95% CI, 0.573 to 0.859).ConclusionPlasma CRP and fibrinogen are good tests for predicting reimplantation success after two-stage revision procedures for patients with PJI.

Role of predictable biomarkers in early detection of cardiovascular events in Chronic Kidney Disease III and IV

Abstract This comes about because of a lack of predicted biomarkers in the risk analysis of CVD events in chronic kidney disease (CKD) patients. The present study aimed to determine the clinical utility of independent, predictable biomarkers such as serum creatinine, estimated Glomerular Filtration Rate (eGFR), high sensitive C-Reactive protein (hsCRP), fibrinogen and lipid profile as early predictors of CVD in CKD at stage III/IV. Methods. This is a case-control study that includes a sample size of 100 patients of cases and 100 patients of controls who were recruited from November 2020 to April 2021, from the Nephrology department of the Visakhapatnam tertiary care teaching hospital, and present with chronic kidney disease – stage III/IV. The subjects’ general conditions (age, gender, height, weight, systolic blood pressure, diastolic blood pressure, and smoking history); underlying diseases (coronary heart disease and diabetes mellitus) were recorded. Fasting venous blood samples were collected under aseptic conditions from the study group after taking informed consent. The measurement of serum creatinine was performed by modification of kinetic Jaffe reaction. The Cockcroft-Gault equation was used to calculate eGFR in both cases and controls. CRP testing was done with a Cobas C311 analyzer, using immunoturbidimetric assay. The Fibroquant kit from Tulip was employed to measure fibrinogen levels in blood samples, and enzymatic methods were applied for lipid profile analysis. Results. In this study, higher mean values of hsCRP (34.28 mg/dl), increased serum creatinine levels (2.876 mg/dl), reduced eGFR (28.37 mls/min), high levels of serum fibrinogen (291.6 mg/dl), and cholesterol (214.5 mg/dl), HDL (28.34 mg/dl), TG (162.1 mg/dl), VLDL (32.41 mg/dl) and LDL (153.77 mg/dl) were found to be independent predictors of assessment of CV events in patients with CKD stages III and IV as determined by Chi-square test. Conclusion. A prompt and accurate assessment of cardiovascular risk in CKD patients would enable more aggressive and focused treatment of the individuals who are most in need of preventive interventions to decrease incident rates.