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Informacje o czasopiśmie
Format
Czasopismo
eISSN
2284-5623
Pierwsze wydanie
08 Aug 2013
Częstotliwość wydawania
4 razy w roku
Języki
Angielski

Wyszukiwanie

Tom 29 (2021): Zeszyt 4 (October 2021)

Informacje o czasopiśmie
Format
Czasopismo
eISSN
2284-5623
Pierwsze wydanie
08 Aug 2013
Częstotliwość wydawania
4 razy w roku
Języki
Angielski

Wyszukiwanie

10 Artykułów
Otwarty dostęp

Cell Cycle Regulatory CCND1 G870A Gene Polymorphism and Periodontitis-Induced Oral Cancer: A Risk Analysis

Data publikacji: 22 Oct 2021
Zakres stron: 349 - 363

Abstrakt

Abstract

Strong association has been recently observed between periodontitis/gingivitis and Oral squamous cell carcinoma (OSCC). A high incidence of oral cancer has been reported in the case of chronic periodontitis. Recently Cell cycle regulatory /Senescence genes have been associated with Gingivitis/ Periodontitis susceptibility. Cyclin D1 is one such cell cycle regulatory gene. Several findings have reported that Cyclin D1 (CCND1) G870A Single nucleotide polymorphism is associated with oral cancer (OC) risk, but yielded inconsistent data across different studies. This meta-analysis explores the precise relationship between CCND1 G870A polymorphism and OC risk. PubMed (Medline), EMBASE, & Google Scholar databases were searched for eligible studies and pooled odds ratios (ORs) and 95% confidence intervals (CI) were calculated. Newcastle-Ottawa analysis was done for selected articles quality assessment, bias in publication (if any) was estimated through Funnel plots and Egger’s test. Pooled analysis from eleven eligible studies suggests that CCND1 G870A polymorphism is not significantly associated with OC risk. Sub-group analysis by ethnicity failed to show any association. Sequential single study omission was performed to determine the credibility and resilience of the inferences drawn.

Słowa kluczowe

  • CCND1 gene
  • periodontitis
  • meta-analysis
  • trial sequential analysis
  • oral cancer
Otwarty dostęp

Mutations in the KRAS gene as a predictive biomarker of therapeutic response in patients with colorectal cancer

Data publikacji: 22 Oct 2021
Zakres stron: 365 - 375

Abstrakt

Abstract

Introduction: Despite the important role of general KRAS mutational status in the selection of an adequate therapeutic protocol in patients with colorectal cancer (CRC), studies that focus on its specific mutations and their significance on progression of disease are scarce. This study aimed to determine the significance of specific KRAS mutations in response to standard chemotherapy protocols with oxaliplatin-based (FOLFOX 4, OXFL) in the first-line and irinotecan-based chemotherapy (FOLFIRI, IFL) in the second-line therapy, and to evaluate the correlation between these mutations and clinicopathological characteristics of CRC patients.

Methods: Genomic DNA was extracted from the FFPE tumour tissue sections while the KRAS mutation test was performed by using PCR methods.

Results: Prevalence of KRAS gene mutations in CRC patients was 45%. Mutated KRAS was more frequent in later stages of tumor infiltrations (P =0.0017), on the right side of the colon (P= 0.0044), and in patients who developed metastases in the first 6 months after CRC diagnosis than in patients who developed metastases after 24 months (P=0.0083). In a group of patients with a poor therapeutic response to standard chemotherapy the most frequent mutations in KRAS gene were G12D and G12V (63.88%), while in a group of patients with a good response to therapeutic protocols the most prevalent mutation was G12A (66.66%).

Conclusion: Our results indicate that there was a significant difference in biological behaviour between tumours harboring different mutations in KRAS gene. Overall, mutation G12A could be a novel prognostic biomarker for CRC patients treated with standard chemotherapy.

Słowa kluczowe

  • colorectal cancer
  • biomarker
  • real-time PCR
  • KRAS gene
Otwarty dostęp

Evaluation of the impact of Covid-19 infection on the evolution and prognosis of patients with acute leukaemia

Data publikacji: 22 Oct 2021
Zakres stron: 377 - 385

Abstrakt

Abstract

Introduciton: COVID19 is one of the largest pandemics. Since December 2019 until now the coronavirus has infected over 131 million people. The mortality rate in the general population varies between 1 to 5%, with a potential of over 30% in patients with neoplasms.

Methods: The main objective of the study was to identify some peculiarities of the evolution, complications and treatment of patients with acute leukaemia and COVID-19. The study was retrospective and included 50 patients with acute leukaemia and COVID-19.

Results: Recent administration of chemotherapy was identified in 20 patients with acute myeloblastic leukaemia and 4 patients with acute lymphoblastic leukaemia. The newly diagnosed patients or those undergoing intensive chemotherapy, in particular elderly patients, had a severe form of COVID-19 and an unfavourable evolution, and these clinical situations were identified as predictive factors for adverse outcomes. Patients with acute lymphoblastic leukaemia had a shorter survival curve compared to patients with acute myeloblastic leukaemia. Pneumonia was present especially in patients with acute myeloblastic leukaemia, most patients having over 30% of lung fields affected (55.26%). Patients with an unfavourable outcome had significantly increased median values of C-reactive protein, procalcitonin and interleukin6.

Conclusions: Patients with acute leukaemia, especially acute myeloblastic leukaemia who have been diagnosed with COVID-19 infection require special attention because they may associate complications and adverse outcomes of COVID-19. The results we obtained require evaluation in a larger group of patients and analysis in the follow-up period after COVID-19.

Słowa kluczowe

  • acute leukemia
  • COVID-19
  • chemotherapy
  • aplasia
  • respiratory insuficiency
Otwarty dostęp

COVID-19 associated coagulopathy is correlated with increased age and markers of inflammation response

Data publikacji: 22 Oct 2021
Zakres stron: 387 - 394

Abstrakt

Abstract

Background: The severe manifestations of the coronavirus disease 2019 (COVID-19) are linked to viral hyper-inflammation, cytokine release syndrome and subsequent coagulation disturbances. The most common coagulation abnormality observed in COVID-19 patients is the elevation of the plasma levels of D-dimers. The aim of this study was to evaluate the characteristics of COVID-19-associated inflammatory syndrome and coagulopathy, in correlation with disease severity.

Methods: We performed a cross-sectional study, enrolling all consecutive COVID-19 patients treated in the Adulti 3 Department of the Prof. Dr. Matei Bals National Institute of Infectious Diseases, Bucharest, Romania, between 1st march and 30th September 2020. We recorded clinical and epidemiological characteristics, inflammatory markers, coagulation abnormalities and lymphocyte count. The severity of lung involvement was assessed using native Computed Tomography examination.

Results: We included 106 patients with SARS-COV2 infection, 50 males (47.2%) and 56 females (52.8%), age range 14-91 years. All markers of inflammation were increased in our study in patients with severe disease, as were lactate dehydrogenase, monocyte distribution width, and neutrophil-to-lymphocyte ratio. An elevated level of serum D-dimers was observed in approximately half of our subjects and was associated with disease severity. Our best linear regression model for predicting COVID-19 coagulopathy (manifested as abnormal D-dimer levels) included age, fibrinogen, and lymphocyte count.

Conclusion: Our findings emphasize the association between COVID-19 coagulopathy and the presence of systemic inflammation. A significant proportion of patients with moderate and severe disease had coagulation abnormalities and these were linked with the presence of inflammation and older age..

Słowa kluczowe

  • inflammation
  • coagulopathy
  • COVID-19
  • SARS-CoV2
Otwarty dostęp

Values of serum PCT, suPAR combined with severity scores for evaluating prognosis of septic shock patients

Data publikacji: 22 Oct 2021
Zakres stron: 395 - 402

Abstrakt

Abstract

Background: To explore the values of serum procalcitonin (PCT), soluble urokinase-type plasminogen activator receptor (suPAR) combined with APACHE II and SOFA scores for evaluating the prognosis of septic shock patients.

Materials and Methods: A total of 118 eligible patients admitted from August 2017 to January 2021 were divided into survival and death groups. Serum PCT and suPAR levels were detected. APACHE II and SOFA scores were evaluated. A combination predictor pre1 was constructed. The predictive efficacy of the indicator alone or in combination was compared using receiver operating characteristic curve. Risk factors leading to death were analyzed, and a predictive model was established.

Results: Serum PCT and suPAR levels as well as APACHE II and SOFA scores of death group significantly exceeded those of the survival group (P<0.05). PCT, suPAR, SOFA and APACHE II scores were valuable for predicting death. The area under curve (AUC) constructed by predictor pre1 for predicting death was largest. PCT, suPAR, APACHE II, and SOFA scores were independent risk factors for death. The model had AUC of 0.828, with the sensitivity of 86.54%, specificity of 89.03%, and accuracy of 82.47%. The death risk predicted by the model had a high concurrence with the actual one.

Conclusion: PCT, suPAR, APACHE II, and SOFA scores are closely related to the prognosis of septic shock patients. The combined predictor pre1 is more effective than a single index for predicting prognosis. The combined prediction model of septic shock based on PCT, suPAR, APACHE II, and SOFA scores has higher predictive efficiency.

Słowa kluczowe

  • septic shock
  • procalcitonin
  • soluble urokinase-type plasminogen activator receptor
  • Acute Physiology
  • Age and Chronic Health Evaluation II score
  • Sequential Organ Failure Assessment score
  • prognosis
Otwarty dostęp

VEGF-C and podoplanin, as biomarkers of sepsis. An experimental study

Data publikacji: 22 Oct 2021
Zakres stron: 403 - 412

Abstrakt

Abstract

Background: Sepsis is the leading cause of morbidity and mortality in intensive care units. This study explored the possible role of vascular endothelial growth factor-C (VEGF-C) and podoplanin (PDPN) in sepsis.

Methods: 22 Wistar rats were divided into three groups: two experimental (Group A and B, n=8/8) and a control (Group C, n=6). Sepsis was induced with intraperitoneal injection of ESBL (extended-spectrum beta-lactamases)-producing E-coli live bacteria for group A and with lipopolysaccharide for group B. Sterile saline solution was injected for group C. Blood samples were collected after 24 hours to determine the serum level of VEGF-C, and PDPN expression was examined in liver, kidney, and lung tissues. Bacteremia was assessed for group A.

Results: Higher serum levels of VEGF-C were found in Group A vs C (p=0.05) and group B vs. C (p=0.004), respectively.VEGF-C was also increased in animals with negative- vs. positive blood cultures from group A (p=0.04) and from group B vs. those with positive blood cultures from group A (p=0.03). High intensity of PDPN tissue expression was observed in the pulmonary alveolocytes from Group A and epithelium of the proximal renal tubules in groups B and C, compared to group A.

Conclusions: Circulating VEGF-C can be succesfuly used as a biomarker of sepsis with negative blood cultures and high risk of renal failure, whereas PDPN seems to exert a protective role against lung injuries in live bacteria-induced sepsis.

Słowa kluczowe

  • podoplanin
  • vascular endothelial growth factor
  • sepsis
  • lipopolysaccharide
Otwarty dostęp

Agreement between two diagnostic methods for COVID-19: preliminary data from a Brazilian clinical laboratory

Data publikacji: 22 Oct 2021
Zakres stron: 413 - 420

Abstrakt

Abstract

Objective: To investigate possible differences between laboratory profiles of symptomatic and asymptomatic patients. There are different of them available for COVID-19 diagnoses and surveillance, so this research was to evaluate the positive agreement the diagnostic methods.

Methods: For symptomatic patients swab samples from nasal and oral mucosal were collected between first and second week after symptoms onset, to perform RT-PCR, blood samples were collected 7 days after to perform antibody detection test. For asymptomatic patients, only antibody detection was performed to confirm the infection. We investigated specific humoral immune response for symptomatic and asymptomatic patients and also analyzed the positivity index and kappa agreement between immunochromatographic and ELISA assays.

Results: Most symptomatic patients presented negative RT-PCR with IgM and IgA detection. Symptomatic and asymptomatic patients have presented elevated IgM and IgA immunoglobulins, being this detection higher in symptomatic patients. The positivity index for immunochromatographic was higher than ELISA and there was no kappa agreement between IgM and IgA detection between these two methods.

Conclusion: Symptomatic patients presented higher amounts of IgM and IgA than asymptomatic, suggesting a relation between antibody quantity and severity of disease. We verified no agreement between IgM and IgA detection, and observed higher positivity index for IMMUNO when compared to ELISA. The different kinetics may cause a variation in their detection. Also, many different virus proteins can be used as antigens in these methods, being able of altering their sensibility and specificity.

Słowa kluczowe

  • COVID-19
  • symptomatic
  • diagnostic
  • asymptomatic
Otwarty dostęp

Atellica CH 930 chemistry analyzer versus Cobas 6000 c501 and Architect ci4100 - a multi-analyte method comparison

Data publikacji: 22 Oct 2021
Zakres stron: 421 - 438

Abstrakt

Abstract

Large clinical laboratories often rely on multiple chemistry analyzers. However, when a new analyzer is introduced, the laboratory must establish whether the old and new methods are comparable and can be used interchangeably. In this study, we compared the newly introduced Atellica CH930 chemistry analyzer with the already established Architect ci4100 and Cobas 6000 c501 from our laboratory.

Patient samples were randomly selected from daily routine testing and a total of 22 analytes were investigated. Total error (TEobs) between test (Atellica) and comparative (Architect and Cobas) methods was calculated at relevant medical decision levels (MDL). For demonstrative purposes, the assessment of method comparability was based on three different criteria: allowable total error (TEa) derived from biological variation (BV), CLIA proficiency testing criteria for acceptable analytical performance, and CLIA-calculated Sigma metrics. These sets of analytical performance specifications were also compared, and their strengths and limitations are discussed in this paper.

Performance of Atellica CH930 against Architect ci4100 was acceptable or nearly acceptable at 82%, 95%, and 64% of the 22 investigated MDLs across 9 analytes, according to BV-TEa, CLIA-TEa, and CLIA-calculated Sigma metrics, respectively. Similarly, performance of Atellica CH930 against Cobas 6000 c501 was acceptable or nearly acceptable at 61%, 93%, and 63% of the 54 investigated MDLs across 22 analytes, according to BV-TEa, CLIATEa, and CLIA-calculated Sigma metrics, respectively. However, method comparability should not be evaluated by a “one size fits all” approach as some analytes require different criteria of acceptability, ideally based on medically allowable error and clinical outcome.

Otwarty dostęp

Circulating amino acids as fingerprints of visceral adipose tissue independent of insulin resistance: a targeted metabolomic research in women

Data publikacji: 22 Oct 2021
Zakres stron: 439 - 451

Abstrakt

Abstract

Introduction: Although obesity and its biomarkers have been intensively studied, little is known about the metabolomic signature of visceral adiposity independent of insulin resistance that frequently accompanies increased levels of visceral fat. Our study aimed to investigate specific changes in amino acid (AA) levels as biomarkers of increased visceral adiposity independent of insulin resistance, in healthy subjects.

Methods: Forty-two adult women were included in this cross-sectional study. Serum samples were analyzed by AAs targeted metabolomics according to their visceral fat area (<100 cm2 and ≥100 cm2).

Results: By corrected t-test and supervised partial least-squares discriminant analysis (PLS-DA) we identified 4 AAs that were significantly higher in the group with higher visceral fat: proline (variable importance in the projection [VIP] predicted value: 1.97), tyrosine (VIP: 2.21), cysteine (VIP: 1.19), isoleucine (VIP: 1.04; p-values <0.05). Also, glycine was significantly lower in the group with higher visceral fat (VIP: 1.65; p-value <0.05). All AAs identified were associated with visceral fat independent of homeo-static model assessment for insulin resistance (p-value for regression coefficients <0.05).

Conclusion: Metabolic pathways that might be disrupted in persons with increased visceral fat are phenylalanine, tyrosine, and tryptophan biosynthesis; tyrosine metabolism; glycine, serine, and threonine metabolism; glyoxylate and dicarboxylate metabolism, and cysteine and methionine metabolism.

Słowa kluczowe

  • metabolomics
  • amino acids
  • visceral fat
  • insulin resistance
Otwarty dostęp

Acquired Angioedema Due to C1 inhibitor Deficiency Caused by Non-Hodgkin Lymphoma in a Patient with Myasthenia Gravis

Data publikacji: 22 Oct 2021
Zakres stron: 453 - 456

Abstrakt

Abstract

Acquired angioedema due to C1-inhibitor deficiency is a very rare disorder that usually appears in patients with lymphoproliferative and/or autoimmune diseases. This type of swelling is bradykinin mediated and does not respond to antihistamines, corticosteroids, or epinephrine. The symptoms usually appear in patients older than 40 years with recurrent episodes of angioedema without wheals. The family history is negative. The swelling could affect any tissue, but most frequently is located at the face, lips, tongue, larynx, or extremities. In the gastrointestinal tract, it causes pain, nausea, vomiting, and diarrhea. The upper respiratory airway oedema is a potentially life-threatening condition due to asphyxiation. The oedema attacks may precede the symptoms of the causative disease for months or years. In most cases, the treatment of the underlying disease resolves the angioedema episodes. Here we report a case of C1-INH-AAE caused by non-Hodgkin lymphoma in a patient diagnosed many years before with myasthenia gravis whose angioedema symptoms resolved after the specific treatment of lymphoma.

Słowa kluczowe

  • rare disease
  • bradykinin mediated angioedema
  • lymphoproliferative disease
  • autoimmune disease
  • angioedema attack
10 Artykułów
Otwarty dostęp

Cell Cycle Regulatory CCND1 G870A Gene Polymorphism and Periodontitis-Induced Oral Cancer: A Risk Analysis

Data publikacji: 22 Oct 2021
Zakres stron: 349 - 363

Abstrakt

Abstract

Strong association has been recently observed between periodontitis/gingivitis and Oral squamous cell carcinoma (OSCC). A high incidence of oral cancer has been reported in the case of chronic periodontitis. Recently Cell cycle regulatory /Senescence genes have been associated with Gingivitis/ Periodontitis susceptibility. Cyclin D1 is one such cell cycle regulatory gene. Several findings have reported that Cyclin D1 (CCND1) G870A Single nucleotide polymorphism is associated with oral cancer (OC) risk, but yielded inconsistent data across different studies. This meta-analysis explores the precise relationship between CCND1 G870A polymorphism and OC risk. PubMed (Medline), EMBASE, & Google Scholar databases were searched for eligible studies and pooled odds ratios (ORs) and 95% confidence intervals (CI) were calculated. Newcastle-Ottawa analysis was done for selected articles quality assessment, bias in publication (if any) was estimated through Funnel plots and Egger’s test. Pooled analysis from eleven eligible studies suggests that CCND1 G870A polymorphism is not significantly associated with OC risk. Sub-group analysis by ethnicity failed to show any association. Sequential single study omission was performed to determine the credibility and resilience of the inferences drawn.

Słowa kluczowe

  • CCND1 gene
  • periodontitis
  • meta-analysis
  • trial sequential analysis
  • oral cancer
Otwarty dostęp

Mutations in the KRAS gene as a predictive biomarker of therapeutic response in patients with colorectal cancer

Data publikacji: 22 Oct 2021
Zakres stron: 365 - 375

Abstrakt

Abstract

Introduction: Despite the important role of general KRAS mutational status in the selection of an adequate therapeutic protocol in patients with colorectal cancer (CRC), studies that focus on its specific mutations and their significance on progression of disease are scarce. This study aimed to determine the significance of specific KRAS mutations in response to standard chemotherapy protocols with oxaliplatin-based (FOLFOX 4, OXFL) in the first-line and irinotecan-based chemotherapy (FOLFIRI, IFL) in the second-line therapy, and to evaluate the correlation between these mutations and clinicopathological characteristics of CRC patients.

Methods: Genomic DNA was extracted from the FFPE tumour tissue sections while the KRAS mutation test was performed by using PCR methods.

Results: Prevalence of KRAS gene mutations in CRC patients was 45%. Mutated KRAS was more frequent in later stages of tumor infiltrations (P =0.0017), on the right side of the colon (P= 0.0044), and in patients who developed metastases in the first 6 months after CRC diagnosis than in patients who developed metastases after 24 months (P=0.0083). In a group of patients with a poor therapeutic response to standard chemotherapy the most frequent mutations in KRAS gene were G12D and G12V (63.88%), while in a group of patients with a good response to therapeutic protocols the most prevalent mutation was G12A (66.66%).

Conclusion: Our results indicate that there was a significant difference in biological behaviour between tumours harboring different mutations in KRAS gene. Overall, mutation G12A could be a novel prognostic biomarker for CRC patients treated with standard chemotherapy.

Słowa kluczowe

  • colorectal cancer
  • biomarker
  • real-time PCR
  • KRAS gene
Otwarty dostęp

Evaluation of the impact of Covid-19 infection on the evolution and prognosis of patients with acute leukaemia

Data publikacji: 22 Oct 2021
Zakres stron: 377 - 385

Abstrakt

Abstract

Introduciton: COVID19 is one of the largest pandemics. Since December 2019 until now the coronavirus has infected over 131 million people. The mortality rate in the general population varies between 1 to 5%, with a potential of over 30% in patients with neoplasms.

Methods: The main objective of the study was to identify some peculiarities of the evolution, complications and treatment of patients with acute leukaemia and COVID-19. The study was retrospective and included 50 patients with acute leukaemia and COVID-19.

Results: Recent administration of chemotherapy was identified in 20 patients with acute myeloblastic leukaemia and 4 patients with acute lymphoblastic leukaemia. The newly diagnosed patients or those undergoing intensive chemotherapy, in particular elderly patients, had a severe form of COVID-19 and an unfavourable evolution, and these clinical situations were identified as predictive factors for adverse outcomes. Patients with acute lymphoblastic leukaemia had a shorter survival curve compared to patients with acute myeloblastic leukaemia. Pneumonia was present especially in patients with acute myeloblastic leukaemia, most patients having over 30% of lung fields affected (55.26%). Patients with an unfavourable outcome had significantly increased median values of C-reactive protein, procalcitonin and interleukin6.

Conclusions: Patients with acute leukaemia, especially acute myeloblastic leukaemia who have been diagnosed with COVID-19 infection require special attention because they may associate complications and adverse outcomes of COVID-19. The results we obtained require evaluation in a larger group of patients and analysis in the follow-up period after COVID-19.

Słowa kluczowe

  • acute leukemia
  • COVID-19
  • chemotherapy
  • aplasia
  • respiratory insuficiency
Otwarty dostęp

COVID-19 associated coagulopathy is correlated with increased age and markers of inflammation response

Data publikacji: 22 Oct 2021
Zakres stron: 387 - 394

Abstrakt

Abstract

Background: The severe manifestations of the coronavirus disease 2019 (COVID-19) are linked to viral hyper-inflammation, cytokine release syndrome and subsequent coagulation disturbances. The most common coagulation abnormality observed in COVID-19 patients is the elevation of the plasma levels of D-dimers. The aim of this study was to evaluate the characteristics of COVID-19-associated inflammatory syndrome and coagulopathy, in correlation with disease severity.

Methods: We performed a cross-sectional study, enrolling all consecutive COVID-19 patients treated in the Adulti 3 Department of the Prof. Dr. Matei Bals National Institute of Infectious Diseases, Bucharest, Romania, between 1st march and 30th September 2020. We recorded clinical and epidemiological characteristics, inflammatory markers, coagulation abnormalities and lymphocyte count. The severity of lung involvement was assessed using native Computed Tomography examination.

Results: We included 106 patients with SARS-COV2 infection, 50 males (47.2%) and 56 females (52.8%), age range 14-91 years. All markers of inflammation were increased in our study in patients with severe disease, as were lactate dehydrogenase, monocyte distribution width, and neutrophil-to-lymphocyte ratio. An elevated level of serum D-dimers was observed in approximately half of our subjects and was associated with disease severity. Our best linear regression model for predicting COVID-19 coagulopathy (manifested as abnormal D-dimer levels) included age, fibrinogen, and lymphocyte count.

Conclusion: Our findings emphasize the association between COVID-19 coagulopathy and the presence of systemic inflammation. A significant proportion of patients with moderate and severe disease had coagulation abnormalities and these were linked with the presence of inflammation and older age..

Słowa kluczowe

  • inflammation
  • coagulopathy
  • COVID-19
  • SARS-CoV2
Otwarty dostęp

Values of serum PCT, suPAR combined with severity scores for evaluating prognosis of septic shock patients

Data publikacji: 22 Oct 2021
Zakres stron: 395 - 402

Abstrakt

Abstract

Background: To explore the values of serum procalcitonin (PCT), soluble urokinase-type plasminogen activator receptor (suPAR) combined with APACHE II and SOFA scores for evaluating the prognosis of septic shock patients.

Materials and Methods: A total of 118 eligible patients admitted from August 2017 to January 2021 were divided into survival and death groups. Serum PCT and suPAR levels were detected. APACHE II and SOFA scores were evaluated. A combination predictor pre1 was constructed. The predictive efficacy of the indicator alone or in combination was compared using receiver operating characteristic curve. Risk factors leading to death were analyzed, and a predictive model was established.

Results: Serum PCT and suPAR levels as well as APACHE II and SOFA scores of death group significantly exceeded those of the survival group (P<0.05). PCT, suPAR, SOFA and APACHE II scores were valuable for predicting death. The area under curve (AUC) constructed by predictor pre1 for predicting death was largest. PCT, suPAR, APACHE II, and SOFA scores were independent risk factors for death. The model had AUC of 0.828, with the sensitivity of 86.54%, specificity of 89.03%, and accuracy of 82.47%. The death risk predicted by the model had a high concurrence with the actual one.

Conclusion: PCT, suPAR, APACHE II, and SOFA scores are closely related to the prognosis of septic shock patients. The combined predictor pre1 is more effective than a single index for predicting prognosis. The combined prediction model of septic shock based on PCT, suPAR, APACHE II, and SOFA scores has higher predictive efficiency.

Słowa kluczowe

  • septic shock
  • procalcitonin
  • soluble urokinase-type plasminogen activator receptor
  • Acute Physiology
  • Age and Chronic Health Evaluation II score
  • Sequential Organ Failure Assessment score
  • prognosis
Otwarty dostęp

VEGF-C and podoplanin, as biomarkers of sepsis. An experimental study

Data publikacji: 22 Oct 2021
Zakres stron: 403 - 412

Abstrakt

Abstract

Background: Sepsis is the leading cause of morbidity and mortality in intensive care units. This study explored the possible role of vascular endothelial growth factor-C (VEGF-C) and podoplanin (PDPN) in sepsis.

Methods: 22 Wistar rats were divided into three groups: two experimental (Group A and B, n=8/8) and a control (Group C, n=6). Sepsis was induced with intraperitoneal injection of ESBL (extended-spectrum beta-lactamases)-producing E-coli live bacteria for group A and with lipopolysaccharide for group B. Sterile saline solution was injected for group C. Blood samples were collected after 24 hours to determine the serum level of VEGF-C, and PDPN expression was examined in liver, kidney, and lung tissues. Bacteremia was assessed for group A.

Results: Higher serum levels of VEGF-C were found in Group A vs C (p=0.05) and group B vs. C (p=0.004), respectively.VEGF-C was also increased in animals with negative- vs. positive blood cultures from group A (p=0.04) and from group B vs. those with positive blood cultures from group A (p=0.03). High intensity of PDPN tissue expression was observed in the pulmonary alveolocytes from Group A and epithelium of the proximal renal tubules in groups B and C, compared to group A.

Conclusions: Circulating VEGF-C can be succesfuly used as a biomarker of sepsis with negative blood cultures and high risk of renal failure, whereas PDPN seems to exert a protective role against lung injuries in live bacteria-induced sepsis.

Słowa kluczowe

  • podoplanin
  • vascular endothelial growth factor
  • sepsis
  • lipopolysaccharide
Otwarty dostęp

Agreement between two diagnostic methods for COVID-19: preliminary data from a Brazilian clinical laboratory

Data publikacji: 22 Oct 2021
Zakres stron: 413 - 420

Abstrakt

Abstract

Objective: To investigate possible differences between laboratory profiles of symptomatic and asymptomatic patients. There are different of them available for COVID-19 diagnoses and surveillance, so this research was to evaluate the positive agreement the diagnostic methods.

Methods: For symptomatic patients swab samples from nasal and oral mucosal were collected between first and second week after symptoms onset, to perform RT-PCR, blood samples were collected 7 days after to perform antibody detection test. For asymptomatic patients, only antibody detection was performed to confirm the infection. We investigated specific humoral immune response for symptomatic and asymptomatic patients and also analyzed the positivity index and kappa agreement between immunochromatographic and ELISA assays.

Results: Most symptomatic patients presented negative RT-PCR with IgM and IgA detection. Symptomatic and asymptomatic patients have presented elevated IgM and IgA immunoglobulins, being this detection higher in symptomatic patients. The positivity index for immunochromatographic was higher than ELISA and there was no kappa agreement between IgM and IgA detection between these two methods.

Conclusion: Symptomatic patients presented higher amounts of IgM and IgA than asymptomatic, suggesting a relation between antibody quantity and severity of disease. We verified no agreement between IgM and IgA detection, and observed higher positivity index for IMMUNO when compared to ELISA. The different kinetics may cause a variation in their detection. Also, many different virus proteins can be used as antigens in these methods, being able of altering their sensibility and specificity.

Słowa kluczowe

  • COVID-19
  • symptomatic
  • diagnostic
  • asymptomatic
Otwarty dostęp

Atellica CH 930 chemistry analyzer versus Cobas 6000 c501 and Architect ci4100 - a multi-analyte method comparison

Data publikacji: 22 Oct 2021
Zakres stron: 421 - 438

Abstrakt

Abstract

Large clinical laboratories often rely on multiple chemistry analyzers. However, when a new analyzer is introduced, the laboratory must establish whether the old and new methods are comparable and can be used interchangeably. In this study, we compared the newly introduced Atellica CH930 chemistry analyzer with the already established Architect ci4100 and Cobas 6000 c501 from our laboratory.

Patient samples were randomly selected from daily routine testing and a total of 22 analytes were investigated. Total error (TEobs) between test (Atellica) and comparative (Architect and Cobas) methods was calculated at relevant medical decision levels (MDL). For demonstrative purposes, the assessment of method comparability was based on three different criteria: allowable total error (TEa) derived from biological variation (BV), CLIA proficiency testing criteria for acceptable analytical performance, and CLIA-calculated Sigma metrics. These sets of analytical performance specifications were also compared, and their strengths and limitations are discussed in this paper.

Performance of Atellica CH930 against Architect ci4100 was acceptable or nearly acceptable at 82%, 95%, and 64% of the 22 investigated MDLs across 9 analytes, according to BV-TEa, CLIA-TEa, and CLIA-calculated Sigma metrics, respectively. Similarly, performance of Atellica CH930 against Cobas 6000 c501 was acceptable or nearly acceptable at 61%, 93%, and 63% of the 54 investigated MDLs across 22 analytes, according to BV-TEa, CLIATEa, and CLIA-calculated Sigma metrics, respectively. However, method comparability should not be evaluated by a “one size fits all” approach as some analytes require different criteria of acceptability, ideally based on medically allowable error and clinical outcome.

Otwarty dostęp

Circulating amino acids as fingerprints of visceral adipose tissue independent of insulin resistance: a targeted metabolomic research in women

Data publikacji: 22 Oct 2021
Zakres stron: 439 - 451

Abstrakt

Abstract

Introduction: Although obesity and its biomarkers have been intensively studied, little is known about the metabolomic signature of visceral adiposity independent of insulin resistance that frequently accompanies increased levels of visceral fat. Our study aimed to investigate specific changes in amino acid (AA) levels as biomarkers of increased visceral adiposity independent of insulin resistance, in healthy subjects.

Methods: Forty-two adult women were included in this cross-sectional study. Serum samples were analyzed by AAs targeted metabolomics according to their visceral fat area (<100 cm2 and ≥100 cm2).

Results: By corrected t-test and supervised partial least-squares discriminant analysis (PLS-DA) we identified 4 AAs that were significantly higher in the group with higher visceral fat: proline (variable importance in the projection [VIP] predicted value: 1.97), tyrosine (VIP: 2.21), cysteine (VIP: 1.19), isoleucine (VIP: 1.04; p-values <0.05). Also, glycine was significantly lower in the group with higher visceral fat (VIP: 1.65; p-value <0.05). All AAs identified were associated with visceral fat independent of homeo-static model assessment for insulin resistance (p-value for regression coefficients <0.05).

Conclusion: Metabolic pathways that might be disrupted in persons with increased visceral fat are phenylalanine, tyrosine, and tryptophan biosynthesis; tyrosine metabolism; glycine, serine, and threonine metabolism; glyoxylate and dicarboxylate metabolism, and cysteine and methionine metabolism.

Słowa kluczowe

  • metabolomics
  • amino acids
  • visceral fat
  • insulin resistance
Otwarty dostęp

Acquired Angioedema Due to C1 inhibitor Deficiency Caused by Non-Hodgkin Lymphoma in a Patient with Myasthenia Gravis

Data publikacji: 22 Oct 2021
Zakres stron: 453 - 456

Abstrakt

Abstract

Acquired angioedema due to C1-inhibitor deficiency is a very rare disorder that usually appears in patients with lymphoproliferative and/or autoimmune diseases. This type of swelling is bradykinin mediated and does not respond to antihistamines, corticosteroids, or epinephrine. The symptoms usually appear in patients older than 40 years with recurrent episodes of angioedema without wheals. The family history is negative. The swelling could affect any tissue, but most frequently is located at the face, lips, tongue, larynx, or extremities. In the gastrointestinal tract, it causes pain, nausea, vomiting, and diarrhea. The upper respiratory airway oedema is a potentially life-threatening condition due to asphyxiation. The oedema attacks may precede the symptoms of the causative disease for months or years. In most cases, the treatment of the underlying disease resolves the angioedema episodes. Here we report a case of C1-INH-AAE caused by non-Hodgkin lymphoma in a patient diagnosed many years before with myasthenia gravis whose angioedema symptoms resolved after the specific treatment of lymphoma.

Słowa kluczowe

  • rare disease
  • bradykinin mediated angioedema
  • lymphoproliferative disease
  • autoimmune disease
  • angioedema attack

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