Significant Difference In C-reactive Protein Levels Research Articles

Relationship Between Intraoperative Macroscopic Anterior Cruciate Ligament Findings, Perioperative Surgical Findings, and Postoperative Clinical Outcome After Cruciate-Retaining Total Knee Arthroplasty.

To assess how intraoperative macroscopical anterior cruciate ligament (ACL) findings affect perioperative procedures, biomarkers, and postoperative anterior-posterior (AP) laxity and range of motion (ROM) after cruciate-retaining (CR) total knee arthroplasty (TKA)and to determine how chronic ACL deficiency may affect postoperative inflammatory biomarker, AP laxity, and ROM. A total of 121 patients with varus knee osteoarthritis without a history of ACL injury who underwent ATTUNE® (DePuy Synthes, Warsaw, IN) CR TKA were analyzed. Intraoperative ACL findings were stratified into intact, damaged, and diminished, according to the tension by probing, synovial coverage, and vascularity. C-reactive protein (CRP) levels were examined at one, seven, and 14 days after surgery. Knee AP laxity measurements using Kneelax 3 (Monitored Rehab Systems, Haarlem, The Netherlands)and postoperative knee ROM were also compared. One-way ANOVA showed significant differences in CRP levels examined one day after surgery observed between the three groups (8.4 (3.8), 9.8 (4.3), and 13.2 (7.7) mg/dL, respectively; P = 0.018), with post hoc analysis showing that CRP levels one day after surgery were significantly greater in the diminished group than in the intact and damaged groups (P = 0.012 and 0.023, respectively). AP laxity in 30° of knee flexion was observed between the three groups (5.4 (2.3), 5.8 (2.5), and 7.1 (2.8) mm, respectively; P = 0.039), with post hoc analysis showing that AP laxity in 30° of knee flexion was significantly greater in the diminished group than in the intact group(P = 0.038). Knee ROM showed no significant differences. Intraoperative ACL diminishment was associated with higher CRP one day after surgery and midrange AP laxity one year after surgery.

Comparative Evaluation of C-Reactive Protein Levels among Peri-Implant Health and Disease Conditions.

Peri-implant disease pathogenesis results in production of pro-inflammatory mediators, among which C-reactive protein (CRP) is one of the acute phase reactants. The aim of the study was to comparative CRP levels among peri-implant health and disease conditions. The present study was carried out in the Department of Implantology, Saveetha Dental College and Hospitals, Chennai, India. A total of 40 patients with peri-implant health (n = 10), peri-mucositis (n = 10), early peri-implantitis (n = 10) and advanced peri-implantitis (n = 10) were enrolled. Unstimulated salivary samples were collected and subjected to latex agglutination assay for CRP analysis. CRP levels were then correlated with peri-implant health and diseases. CRP level in peri-implant health, peri-implant mucositis, early peri-implantitis and advanced peri-implantitis were 0.18 ± 0.04 mg/dL, 2.05 ± 0.61 mg/dL, 4.14 ± 1.82 mg/dL and 6.21 ± 1.35 mg/dL respectively. There was a statistically significant difference in CRP levels between all the tested groups (ANOVA, P = 0.03). Pearson correlation coefficient analysis revealed a strong positive correlation between CRP and peri-implant health status. CRP level was high among patients with peri-implantitis followed by peri-implant mucositis and peri-implant health. Also, CRP level increases with severity of peri-implant diseases and there exists a positive correlation between CRP level and peri-implant health status.

Assessing serum C-reactive protein as a predictor of COVID-19 outcomes: a retrospective cross-sectional study.

The current study aims to conclude the possibility of C-reactive protein (CRP) level serving as a biomarker for early prediction of COVID-19 infections. In this retrospective cross-sectional study, 88 people participated who were infected with COVID-19, aged from 25 to 79 years old. Compare the CRP test range of all samples from patients who visited the hospital between January and April 2022. All participants were confirmed to have COVID-19 through nasopharyngeal swab analysis and real-time polymerase chain reaction real-time polymerase chain reaction testing. Results showed that the majority of infected individuals had elevated CRP levels. A P-value of less than 0.05 indicated a significant difference in CRP levels between alive and dead patients. No significant difference in CRP levels was found between male and female patients. The average CRP level of deceased patients was 137.79mg/l, while the average CRP level of survivors was 14.37mg/l. The median interquartile range of deceased patients was also found to be significantly higher compared to survivors. In conclusion, serum CRP levels potentially predict the severity and development of sickness in patients with COVID-19 infections.

No change in interictal C-reactive protein levels in individuals with episodic and chronic migraine: A case-control study and literature review.

ObjectivesThe levels of some migraine biomarkers differ between episodic migraine (EM) and chronic migraine (CM), but information on C-reactive protein (CRP) levels in EM and CM is conflicting. Thus, this study aimed to evaluate CRP levels in participants with EM and CM in comparison to those in healthy controls.MethodsPlasma CRP levels were evaluated by high-sensitivity CRP tests in female participants with EM (n = 174) and CM (n = 191) and healthy controls (n = 50).ResultsThe results showed no significant difference in CRP levels among the EM, CM, and control groups (median and interquartile range, 0.40 [0.15–0.70] mg/L vs. 0.40 [0.15–1.00] mg/L vs. 0.15 [0.15–0.90] mg/L, p = 0.991). The ratio of individuals with elevated CRP levels (>3.0 mg/L) did not significantly differ among the EM, CM, and control groups (3.4% [6/174] vs. 2.1% [4/191] vs. 0.0% [0/50], p = 0.876). Multivariable regression analyses revealed that CRP levels were not significantly associated with headache frequency per month (β = −0.076, p = 0.238), the severity of anxiety (Generalized Anxiety Disorder-7 score, β = 0.143, p = 0.886), and depression (Patient Health Questionnaire-9 score, β = 0.143, p = 0.886). Further, CRP levels did not significantly differ according to clinical characteristics, fibromyalgia, medication overuse, preventive treatment, and classes of preventive treatment medications. Among participants with a body mass index ≥25 kg/m2, the CRP levels in EM (n = 41) and CM (n = 17) were numerically higher than those in the control (n = 6) (1.30 [0.28–4.25] mg/L vs. 1.10 [0.50–3.15] mg/L vs. 0.40 [0.15–0.83] mg/L, p = 0.249) but did not reach statistical significance.ConclusionsThe interictal CRP level is not likely to be a biomarker for EM or CM.

Relationship between CRP of COVID-19 Patients with Severity and Outcome

Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Serum C-Reactive Protein (CRP) is an important marker that is significantly significant in the severity of COVID-19 patient outcomes. An increase in CRP indicates an increased risk of disease progression. IL-6 levels will also increase to become a strong predictor of the risk of damage to the respiratory system. This study aims to determine the relationship between CRP of COVID-19 patients with severity and outcome. This study is an observational study with a cross-sectional design. The subjects involved in the study were COVID-19 patients at the dr. Soedono Madiun in the period January 2020 - April 2021. The instrument used is secondary data in medical records from RSUD dr. Soedono Madiun. There was no significant difference in CRP levels in 114 patients hospitalized for <12 days and >12 days (p=0.051), then the duration of hospitalization was also not correlated with CRP levels (p=0.70, r =-0.251). In addition, there was a significant difference in CRP levels between patients with severe and non-severe severity (p=0.0013). The patient’s severity was also positively correlated with CRP level (p=0.012, r=0.233). There was a significant difference in CRP levels in patients with recovered and dead outcomes and was positively correlated (p=0.000, r=0.378). CRP levels are related to the severity and outcome of COVID-19 patients. A high CRP indicates severity and risk of death.International Journal of Human and Health Sciences Vol. 06 No. 04 Oct’22 Page: 452-456

Hemodynamic assessment in patients with preterm premature rupture of the membranes (pPROM)

ObjectiveThe aim of this study was to assess the hemodynamic differences in women with pPROM versus physiological pregnancies. Study designThis was a prospective case control study of 15 patients with pPROM and 45 controls. Patients and controls were submitted at enrollment to a non-invasive hemodynamic evaluation with UltraSonic Cardiac Output Monitor (USCOM), and to blood tests to check white blood cells count and C-reactive protein (CRP) levels. We followed pPROM patients until delivery noting fetal/neonatal and maternal unfavorable outcomes (maternal fever, APGAR 1′ and 5′< 7, stillbirth). ResultsPatients with pPROM showed higher values of cardiac output (9.1 ± 2.3 vs 7.1 ± 0.85, p < 0.01), lower systemic vascular resistances (792.1 ± 162 vs 1006.2 ± 110.7, p < 0.01), higher minute distance (32.3 ± 7.8 vs 25 ± 2.8, p < 0.01), lower Potential to Kinetic Energy Ratio (16.5 ± 5.3 vs 22.4 ± 6.8, p < 0.01), higher heart rate (97.5 ± 15.4 vs 82.4 ± 12, p < 0.01) and higher oxygen delivery (1313.2 ± 325.8 vs 1080.7 ± 151.8, p < 0.01) vs. controls. Six out of 15 pPROM patients had an unfavorable outcome. There were no significant differences in CRP levels and WBC count at admission in the two pPROM subgroups, whereas maternal hemodynamics was characterized by lower SVR (718 ± 72 vs 863 ± 123, p = 0.02) in subsequently complicated patients. ConclusionsMaternal hemodynamics is altered in pPROM patients, with a lower Systemic Vascular Resistance and higher Cardiac Output vs. controls. This hyperdynamic circulation appears to anticipates the changes of serum markers of inflammation (CRP, WBC count) and seems to be more pronounced at admission in pPROM patients developing unfavorable outcomes.

Pro-inflammatory markers in patients with obstructive sleep apnea and the effect of Continuous Positive Airway Pressure therapy.

ObjectivesTo evaluate the association of obstructive sleep apnea (OSA) with high-sensitivity C-reactive protein (CRP) and fibrinogen levels and to assess the effect of short-term therapy using continuous positive airway pressure (CPAP).Material and MethodsA prospective, open-label, controlled trial was conducted among clinically referred patients at risk for OSA undergoing diagnostic polysomnography (PSG). After PSG, the patients were divided into 3 groups: OSA treatment group (TG) (n=21), untreated OSA group (UOG) (n=19), and non-OSA healthy control group (HCG) (n=24). CRP and fibrinogen levels were measured at baseline and one month after treatment. Repeated-measures (RM) ANOVA and ANCOVA were used to compare changes in CRP and fibrinogen levels among the three groups by analyzing between-subject and within-subject effects as functions of time and adjusting for significant covariates.ResultsAt baseline, OSA subjects had significantly higher CRP [t(52.37)=-2.46, p=0.02)] and fibrinogen levels [t(57)=-2.00, p=0.05)] than HCG subjects. No significant differences in CRP levels [(F(2,58)=2.29, p=0.11)] or fibrinogen levels [(F(2, 58)=1.28, p=0.29)] emerged between TG and HCG subjects after adjusting for the pretest levels.ConclusionCPAP therapy for one month does not affect CRP and fibrinogen levels among moderate-to-severe OSA patients. However, OSA is associated with elevated levels of these inflammatory biomarkers.

C-reactive protein in view of prognosis in sepsis

IntroductionSepsis is the host reaction to invading microbes. The septic response generally occurs when immune defenses fail to contain an invading microbe and may also be induced by microbial exotoxins. C-reactive protein (CRP) is an acute-phase protein in humans and an important component of the innate immune system. CRP activates complement's classical route, which is one of its key strategies for defending the host.Patients and methodsThis study was conducted on 20 patients with systemic sepsis and admitted to the critical care unit; moreover, 20 healthy participants were studied as a control group.ResultsBoth groups were matched for age and sex, with 55% male and a mean age of 43.5 years in the group with systemic sepsis. Regarding the outcome of patients, 45% were survivors. Regarding the description of patients, 55% were surgical and 45% were nonsurgical types among septic patients. We found a highly significant difference in CRP between the two groups regarding CRP. We found no significant difference in CRP levels between septic shock and nonseptic shock. CRP level was consistently higher in nonsurvivors. CRP levels showed no significant difference on days 1 and 7 in surviving patients, but the levels increased significantly from 1 to 7 days in nonsurvivors. We found no significant difference in the length of stay between patients with high CRP levels and those with low CRP.ConclusionCRP is an acute-phase protein whose concentration increases in association with bacterial infection, inflammation, or tissue necrosis. CRP is most useful in that it shows the greatest and most rapid increase, up to a thousand-fold over the baseline level. A persistent elevation in CRP indicates increased continuation of the pathologic process or a postoperative complication in the case of a surgical patient.

Atorvastatin therapy in COVID-19 adult inpatients: A double-blind, randomized controlled trial.

IntroductionEfficacious therapies are urgently required to tackle the coronavirus disease 2019 (COVID-19). This trial aims to evaluate the effects of atorvastatin in comparison with standard care for adults hospitalized with COVID-19.MethodsWe conducted a randomized controlled clinical trial on adults hospitalized with COVID-19. Patients were randomized into a treatment group receiving atorvastatin + lopinavir/ritonavir or a control group receiving lopinavir/ritonavir alone. The primary outcome of the trial was the duration of hospitalization. The secondary outcomes were the need for interferon or immunoglobulin, receipt of invasive mechanical ventilation, and O2 saturation (O2sat), and level of C-reactive protein (CRP) which were assessed at the onset of admission and on the 6th day of treatment.ResultsForty patients were allocated and enrolled in the study with a 1 to 1 ratio in atorvastatin + lopinavir/ritonavir and lopinavir/ritonavir groups. Clinical and demographic characteristics were similar between the two groups. CRP level was significantly decreased in the lopinavir/ritonavir + atorvastatin group (P < 0.0001, Cohen’s d = 0.865) so that there was a significant difference in CRP level on the 6th day between the two groups (P = 0.01). Nevertheless, there was no significant difference in O2sat on day 6. Although the duration of hospitalization in the lopinavir/ritonavir + atorvastatin group was significantly reduced compared to the control group (P = 0.012), there was no significant difference in the invasive mechanical ventilation reception and the need for interferon and immunoglobulin.ConclusionAtorvastatin + lopinavir/ritonavir may be more effective than lopinavir/ritonavir in treating COVID-19 adult hospitalized patients.

Early prediction of anastomotic leakage after laparoscopic rectal surgery using creactive protein.

At present, anterior resection of the rectum or transabdominal rectal resection is the most common surgical technique for rectal cancer. Laparoscopic techniques are popular, and the efficacy and safety of laparoscopic rectal surgery have been confirmed. However, postoperative anastomotic leakage is a common, severe complication that leads to high mortality. Thus, early diagnosis of anastomotic leakage is important for reducing clinical consequences.The aim of this study was to determine whether C-reactive protein (CRP) is a good predictor of anastomotic leakage in laparoscopic transabdominal rectal resection.Our retrospective study involved a series of 196 rectal cancer patients who underwent laparoscopic transabdominal rectal resection without ileostomy between May 2013 and April 2015 at the Sir Run Run Shaw Hospital, Zhejiang University College of Medicine. The following patient data were collected: demographic data, manifestations of the complication, CRP levels and neutrophil percentage during the first 7 postoperative days.Anastomotic leakage was detected in 11 patients (5.6%). Each group showed significant differences (P < .05) in CRP levels on postoperative days 3 to 7; compared with other groups, the anastomotic leakage group showed significant differences in CRP levels (P < .05) on postoperative day 6. When patients were divided into groups with or without anastomotic leakage, CRP was a reliable predictor on postoperative days 4 to 7 (P < .05, area under the curve > 0.800). The best combination was CRP on postoperative day 6 (area under the curve = 0.932) with a cut-off of 76.6 mg/L, resulting in a sensitivity of 83.3%, a specificity of 94.6% and a negative predictive value of 99%.CRP is a reliable predictor of anastomotic leakage after laparoscopic transabdominal rectal resection surgery. High CRP levels on postoperative days 4 to 7 indicate the need for a more careful patient evaluation.

The effect of different continuous saline irrigation volume under arthroscopy on early postoperative pain and swelling of the knee

To investigate the effect of different saline irrigation volume under arthroscopy on early postoperative pain and swelling of the knee. The clinical data of 539 patients with meniscus injury treated by arthroscopic menisci reformation who met the selection criteria between July 2016 and February 2020 were retrospectively analyzed. They were divided into three groups according to the continuous saline irrigation volume during the operation: 176 patients in the non-irrigation group (group A), 183 patients in the 1 liter-irrigation group (group B), and 180 patients in the 3 liters-irrigation group (group C). There was no significant difference in gender, age, cause of injury, sides of injury, body mass index, disease duration, smoking history, and classification of meniscus injury among 3 groups ( P>0.05). At 6, 12, 24, 48, and 72 hours after operation, the patient's pain level was evaluated by the visual analogue scale (VAS) score, and the knee swelling situation was evaluated by the swelling ratings (the difference between both sides in circumference of the 2 cm upper patella of the knee). Knee skin temperature (the difference of the skin temperature between both sides) and the C-reactive protein (CRP) level in serum were measured at the 1st and 3rd days after operation. Range of motion of the knee was measured at the 1st, 3rd, and 5th days after operation. All incisions healed by first intention without any complication after operation. The VAS scores of each group showed a slow increase trend after operation, and gradually decreased to less than the VAS score of 6 hours at 48 hours after operation. There was no significant difference in VAS scores among the 3 groups at each time point after operation ( P>0.05). The swelling ratings of the knee in each group showed a gradually decrease trend after operation. There was no significant difference in the swelling ratings of the knee among the 3 groups at each time point after operation ( P>0.05). The skin temperature of the knee in each group decreased at the 3rd day after operation than the 1st day, and there was no significant difference in the skin temperature of the knee among the 3 groups at each time point after operation ( P>0.05). There was no significant difference in CRP level within the group and among the 3 groups at each time point after operation ( P>0.05). Range of motion of the knee in each group increased gradually at the 1st, 3rd, and 5th days after operation, and there was no significant difference among the 3 groups at each time point after operation ( P>0.05). The different continuous saline irrigation volume would not affect the early postoperative pain, swelling, and inflammation of the knee during the arthroscopic menisci plasty.

Evaluation of Plasma C-Reactive Protein as a Biomarker in Dogs with Atopic -Dermatitis Receiving Allergen-Specific Immunotherapy: A Pilot Study.

In this pilot study, we wished to determine if C-reactive protein (CRP) levels could be a useful severity or treatment biomarker for canine atopic dermatitis (AD). Nine atopic dogs received allergen immunotherapy for 1 year. Blood was collected before and at four re-evaluation visits. At each time point, the skin lesions were graded with the Canine Atopic Dermatitis Extent and Severity Index (CADESI) 4, and the plasma CRP levels were measured by Enzyme-linked Immunosorbent Assay (ELISA). We found a significant yet minimal correlation between the CRP levels and the CADESI4 scores. The CRP levels were not significantly different between dogs with AD of increasing severity. Finally, there was no correlation between the percentage change in CADESI4 and CRP values during immunotherapy. In conclusion, the lack of significant difference in CRP levels between dogs of increasing AD severity and lack of correlation between percentage changes in skin lesion and CRP values suggest that this protein would not be a clinically-useful biomarker in atopic dogs.

C-Reactive Protein Levels of Sepsis Patients: A Comparison of Three Immunoassay Methods

Quick Sequential Organ Failure Assessment (qSOFA) is a modification of the SOFA score that replaces the Systemic Inflammatory Response Syndrome (SIRS) criteria for sepsis diagnosis. C-reactive protein (CRP) is a marker to help diagnose sepsis. There are not many studies about comparison of CRP level with a variety of instruments and methods, currently. This study aimed to analyze differences in CRP results with particle enhanced turbidimetric immunoassay (PETIA), sandwich immunodetection and reflectometry-immunoassay patients. The study used samples of sepsis patients who were treated in emergency care unit, intensive observation rooms, Intensive Care Unit (ICU) and internal medicine wards of the Dr. Soetomo Hospital Surabaya in May-September 2018. A total of 65 sampels of sepsis patient fulfilled the qSOFA criteria. The CRP examination with the three methods were conducted on all study samples. There were significant differences in CRP levels in the sepsis group using the PETIA and Reflectometry immunoassay methods (p = 0.003), thus both of methods cannot be replace each other. There was no significant difference between CRP levels with PETIA and Sandwich Immunodetection (p=0.172) as well as Reflectometry immunoassay and Sandwich Immunodetection (p=0.251). The selection of instruments and methods for CRP examination is adjusted to laboratory needs and facilities.

Preliminary Results on the Effectiveness of a Nutrition Intervention in Lowering Diabetes Risk in Prediabetic People Living with HIV (PLWH) in MASH Cohort (OR36-06-19)

ObjectivesThe objective of this study is to assess the effectiveness of a 6-month nutrition intervention to improve glycemic parameters and inflammation in prediabetic PLWH on stable ART with undetectable HIV viral load. MethodsA 6-month randomized, controlled nutrition intervention was conducted in prediabetic PLWH. The study participants for the intervention were recruited from the Miami Adult Studies for HIV (MASH) cohort at the FIU-Borinquen Research Clinic. Upon their consent, the participants were randomized into the intervention group or the control group. Participants randomized in the intervention group met once a month for approximately 1 hour where they received medical nutrition therapy, nutrition counseling and nutrition education; participants randomized into the control group received educational material at baseline. Blood was drawn at baseline and at 6-month to measure fasting blood glucose (FBG) and high sensitivity C-reactive protein (hs-CRP). ResultsA total of 38 participants were recruited and randomized into either the intervention group (n = 20) or the control group (n = 18). We found that the FBG for the 6-month follow-up for the intervention group was significantly lower than the baseline FBG values of the same study group (paired t-test; P = 0.031). No significant difference was found in the control group between the baseline and 6-month fasting blood glucose values (P = 0.068). Moreover, no significant difference was found in pre/post C-reactive protein (CRP) levels in the intervention or control group (paired t-test; P = 0.404 and P = 0.117 respectively). There was a significant difference in CRP levels at baseline (P = 0.028) between the study groups but no difference at the 6-month follow up (Mann Whitney U test: P = 0.430). ConclusionsThe results from this intervention support the notion that a nutrition intervention is effective in prediabetic PLWH to lower diabetes risk by significantly lowering fasting blood glucose and may be implemented into larger scale interventions; however, no significant changes was seen in hs-CRP values between the 2 groups. Funding SourcesNational Institute of General Medical Sciences (NIGMS): Research Initiative for Scientific Enhancement (RISE), Biomedical Research Initiative (BRI) Grant, National Institute on Drug Abuse 5U01DA040381-03 and FIU-Dissertation Funding.

SuPAR as a marker of infection in acute kidney injury \u2013 a prospective observational study

BackgroundSoluble urokinase-type plasminogen activator receptor (suPAR) has emerged as a new sepsis biomarker. It is not known whether suPAR has a role in critically ill patients with severe acute kidney injury (AKI).MethodsOur main aims were to describe serial serum suPAR concentrations in patients with severe AKI, to investigate a potential association between suPAR and C-reactive protein (CRP), and to compare suPAR and CRP as diagnostic markers of infection in patients with AKI. Between April 2013 – April 2014, we recruited adult patients (≥18 years) with AKI KDIGO stage 2/3 admitted to a multidisciplinary Intensive Care Unit (ICU) in a University Hospital in UK. Serial serum suPAR and CRP concentrations were measured for 6 days. We compared the characteristics and serial suPAR and CRP concentrations of patients with and without an infection using Chi-squared, Fisher’s exact, t-test and Mann-Whitney tests as appropriate, and calculated the area under the receiver operating characteristics curve (AUC).ResultsData of 55 patients with AKI stage 2/3 were analysed (62% male; mean age 60.5) of whom 43 patients received continuous renal replacement therapy. suPAR was not detectable in effluent fluid.There was no significant correlation between daily suPAR and CRP concentrations. In patients with an infection, suPAR results were significantly higher than in those without an infection across all time points; there was no significant difference in CRP levels between both groups. After exclusion of patients with an infection before or on day of admission to ICU, the AUC of suPAR for predicting an infection later was 0.62 (95% CI 0.43–0.80) compared to 0.50 (95% CI 0.29–0.71) for CRP.ConclusionsIn critically ill patients with AKI stage 2/3, suPAR is a better marker of infection than CRP.Trial registrationThe study was retrospectively registered on the ISRCTN registry on 25 November 2012 (ISRCTN88354940).

Plasma C-reactive protein levels in bipolar depression during cyclooxygenase-2 inhibitor combination treatment

Immune system activation and neuroinflammation appear to play a key role in the pathophysiology and treatment of bipolar depression (BDD). This study is the first to analyze blood levels of the pro-inflammatory biomarker C-reactive protein (CRP) in bipolar disorder patients treated with the cyclooxygenase-2 inhibitor, celecoxib (CBX). In this double-blind study, 47 consenting patients with BDD were randomized to receive either escitalopram (10 mg twice/day) + CBX (200 mg twice/day), or escitalopram (10 mg twice/day) + placebo (twice/day). Plasma CRP levels were measured in both patient groups at baseline, week 4, and week 8, and in a healthy control (HC) group of subjects (N = 35) once. Symptoms were rated using the 17-item Hamilton Depression Scale (HAMD-17). The CBX group had significantly lower HAMD-17 scores vs. placebo at week 4 (P = 0.026) and week 8 (P = 0.002). Therefore, SSRI + CBX is more effective than SSRI + placebo in reversing treatment resistance and augmenting antidepressant response in BDD. Baseline CRP levels were significantly increased amongst BDD patients versus HC subjects, indicating that CRP may be a useful biomarker for BDD (P = 0.044). No significant differences in CRP levels were measured between CBX and placebo groups at baseline (P = 0.156), but by week 8 CRP was significantly decreased in the CBX group vs. placebo (P = 0.003). This indicates reduced inflammation in CBX-treated patients, and that CRP may be a useful biomarker for monitoring treatment response in BDD patients during SSRI + CBX combination treatment. CRP and IL-6 levels were positively correlated in the CBX group, and CRP levels were positively correlated with BMI.

New Biomarkers to Diagnose Ventilator Associated Pneumonia: Pentraxin 3 and Surfactant Protein D.

To detect the most effective biomarker to confirm ventilator associated pneumonia (VAP). Fifty patients with VAP suspicious diagnosis and 30 healthy patients were recruited. Suspicion of VAP was established if patients met the modified CPIS score ≥ 6 points. The confirmation of VAP was defined by the quantitative culture of nonbronchoscopic bronchoalveolar lavage (BAL) >105CFU/ml of pathogenic microorganism. Serum samples for determination of C-reactive protein (CRP), procalcitonin (PCT), pentraxin 3 (PTX3), surfactant protein D (SPD) were collected on suspected VAP. Twenty seven of 50 patients were accepted as confirmed VAP group whose nonbronchoscopic BAL cultures were positive and rest of them were accepted as unconfirmed VAP group. PTX3, PCT and SPD levels were significantly higher in confirmed VAP group, (P = 0.021, P = 0.007, P < 0.001 respectively). There were no significant differences in CRP levels between the two groups (P = 0.062). The most sensitive marker for diagnosing VAP was SPD (P < 0.001). Receiver operating characteristic (ROC) curve for modified clinical pulmonary infection score (CPIS) to confirm VAP was evaluated (AUC 0.741 ± 0.07, P < 0.001) and the optimal cutoff value was >7 with a sensitivity of 51.85% and a specificity of 91.3%. SPD levels were significantly higher in Acinetobacter baumannii and Pseudomonas aeruginosa infected patients than culture negative patients (P < 0.001). The index findings suggest that serum SPD is the most sensitive biomarker in diagnosis of VAP and it can be used as an early and organism specific marker for Acinetobacter baumannii and Pseudomonas aeruginosa.

Effects of microcurrent and cryotherapy on C-reactive protein levels and muscle tone of patients with rotator cuff reconstruction.

[Purpose] The purpose of the present study was to apply early intervention via microcurrent and cryotherapy in patients who underwent rotator cuff reconstruction surgery, and to investigate the effects of such interventions on pain and inflammation levels based on the analysis of C-reactive protein (CRP) levels, and on changes in muscle tone. [Subjects and Methods] The study population consisted of 30 patients who had undergone rotator cuff reconstruction surgery, with 10 patients each assigned to the control, experimental I (E-1), and experimental II (E-II) groups. On the day after surgery, muscle tone, blood CRP level, and pain were measured. For the following two weeks, continues passive motion (CPM), icing, cryotherapy, and microcurrent were applied to the each group. After the respective interventions, CRP levels, pain, and muscle tone near the shoulder area were measured again. [Results] In the post-hoc test of between-group comparison, a statistically significant difference in CRP level was found in the cryotherapy group. A difference in shoulder muscle tone appeared only in the supraspinatus muscle, with post-hoc test results showing that the biggest change occurred in the cryotherapy group. [Conclusion] Cryotherapy may be able to help stabilize inflammation as well as reduce pain and muscle tension when applied in patients following rotator cuff reconstruction.

The Association of Inflammation with Food Intake in Older Hospitalized Patients.

An acute inflammatory process may play a role in inhibiting appetite and food intake particularly in acutely ill older individuals. However, there is a lack of knowledge on the effect of inflammation on food intake in humans. In this study, we sought to investigate the association of C-reactive protein (CRP), as an inflammatory marker, with food intake in acutely ill older hospitalized patients. This cross-sectional study investigated older participants who were consecutively admitted to a geriatric acute care ward. Food intake during previous week was measured according to the Nutritional Risk Screening (NRS-2002) and patients were grouped into two categories as intake ≥75% and <75% of requirements. Disease severity and mobility were measured based on the NRS-2002 and Mini Nutritional Assessment Short Form (MNA-SF), respectively. Serum CRP was analyzed according to standard procedures. Of 177 older participants (mean age 83.1 ± 6.5 y, BMI range of 14.7-43.6 kg/m2; 116 females), 67 (38.0%) had moderate to severe inflammation (CRP>3.0 mg/dl). In addition, 109 (62.0%) patients had intake <75% of requirements during previous week, in which 34 (31.0%) and 54 (50.0%) demonstrated mild and moderate to severe inflammation, respectively. Furthermore, there were significant differences in CRP levels between intake ≥75% and <75% of requirements (P<0.001). In a logistic regression analysis, CRP level (odds ratio; OR, 1.14; P=0.006), disease severity (OR, 2.94; P=0.022), mobility (OR, 0.44; P=0.005) and BMI (OR, 0.89; P=0.003) were the major independent predictors of low food intake. Our findings confirm a close association between food intake and inflammation in older hospitalized patients. In addition, CRP level and disease severity together were the most important independent predictors associated with food intake in these patients.

Correlation of C-Reactive Protein and Cardiac Enzymes with Angiographic Severity of Coronary Artery Disease in Pakistani Patients with Acute Coronary Syndrome.

To determine the correlation of C-reactive protein (CRP) levels with the severity of coronary stenosis on angiography and the association of cardiac enzymes with the degree of stenosis in acute coronary syndrome (ACS) patients. Secondly, to compare association of angiographic severity of vascular stenosis with CRP in patients with ST segment elevation myocardial infarction (STEMI) and non-STEMI / Unstable angina (UA). Prospective, descriptive study. Khan Research Laboratories (KRL) Hospital, from October 2014 to March 2015. CRP was measured on diagnosis of ACS in 70 patients. Cardiac enzymes were measured 6 hours after the onset of chest pain. Angiographic scoring for degree of stenosis and number of culprit vessels was done. Two groups consisting of patients with STEMI (group 1) and with NSTEMI/UA (group 2) were made. No correlation was found between CRP levels and angiographic stenosis in patients with ACS (r=0.162, p>0.05). No association was found between eosinophil count and severity of stenosis (p=0.88). Rise of cardiac enzymes and degree of coronary stenosis showed a positive correlation (p <0.001). There was significant difference in the means of coronary artery stenosis scores between the two groups (Gensini score of groups 1 and 2: 35.9 ±4 and 14 ±8, respectively) p<0.001, but there was no significant difference in CRP levels. CRP is a marker of inflammation in ACS rather than a risk factor for determining the severity of vascular stenosis. Rise in cardiac enzymes still grade high in predicting severity of vascular stenosis than eosinophil count or CRP levels.