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Kim JM, Kim JW, Kang HJ, Choi W, Lee JY, Kim SW, Shin IS, Ahn Y, Jeong MH. Identification of depression in patients with acute coronary syndrome using multiple serum biomarkers. Gen Hosp Psychiatry 2024; 88:1-9. [PMID: 38428184 DOI: 10.1016/j.genhosppsych.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 02/21/2024] [Accepted: 02/21/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Biomarkers for depression in patients with acute coronary syndrome (ACS) have not been identified. METHODS This study evaluated multiple serum biomarkers for depressive disorders after ACS. Thirteen serum biomarkers associated with seven functional systems, along with sociodemographic/clinical characteristics, were evaluated in 969 patients within 2 weeks after ACS onset (acute phase). In total, 711 patients were evaluated for depressive disorder using DSM-IV criteria 1 year later (chronic phase). Logistic regression was used for the analysis. RESULTS Depressive disorders were observed in 378 patients (39.0%) in the acute phase of ACS and 183 patients (25.7%) in the chronic phase. The weighted scores of five serum biomarkers (high-sensitivity C-reactive protein, interleukin-6, homocysteine, troponin I, and creatine kinase-MB) were significantly associated with depressive disorder diagnosis in the acute phase, and the weighted scores of three other biomarkers (tumor necrosis factor-alpha, interleukin-1 beta, and homocysteine) were significantly associated with depressive disorders in the chronic phase, in a dose-dependent manner after adjusting for relevant covariates (all P-values <0.001). CONCLUSIONS The combination of several serum biomarkers exhibited robust associations with depressive disorders in both the acute and chronic phases of ACS.
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Affiliation(s)
- Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.
| | - Ju-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Hee-Ju Kang
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Wonsuk Choi
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Republic of Korea
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Il-Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Youngkeun Ahn
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Myung Ho Jeong
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea
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Wu YC, Fu YJ, Xia HJ, Zhu J, Huang Y, Jiang ZN. Ileocecal involvement in intestinal Behçet's disease and Crohn's disease: comparison of clinicopathological and immunophenotypic features. J Dig Dis 2023; 24:594-602. [PMID: 37864553 DOI: 10.1111/1751-2980.13236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 10/04/2023] [Accepted: 10/18/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVES Intestinal Behçet's disease (BD) predominantly affects the ileocecal region and is currently diagnosed based on endoscopic features and clinical manifestations. It is difficult to distinguish between intestinal BD and Crohn's disease (CD) due to similar patient populations, gastrointestinal involvement, extraintestinal manifestations, and long-term recurrent course. In this study we aimed to compare the clinicopathological and immunophenotypic features of intestinal BD to CD. METHODS The medical and pathological records of 29 cases of intestinal BD and 120 cases of CD diagnosed at Sir Run Run Shaw Hospital were retrospectively analyzed. Immunohistochemistry for CD3, CD20, FOXP3, myeloperoxidase, and quantitative analysis of the infiltrating inflammatory cells was conducted. RESULTS Intestinal BD with ileocecal ulcer had a higher incidence of abdominal pain and a higher erythrocyte sedimentation rate than CD, while chronic diarrhea was more common in CD. Excessive neutrophils in the mucosal lamina propria, neutrophilic exudate on the ulcer surface, and prominent lymphocytic infiltration in ulcer tissues were statistically more frequent in intestinal BD than in CD. The numbers of FOXP3+ T cells, CD3+ T cells, and CD20+ B cells in biopsy tissue from intestinal BD were significantly higher than CD, but the ratio of FOXP3+ T cells to CD3+ T cells was not statistically different. CONCLUSION Besides the typical clinical and endoscopic findings, diagnostic biopsies from the ileocecal region in intestinal BD show some histological and immunophenotypic features that are different from CD, which may be useful in distinguishing these two entities.
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Affiliation(s)
- Yan Chuang Wu
- Department of Pathology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Yu Juan Fu
- Department of Pathology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Hai Jiao Xia
- Department of Gastroenterology, Children's Hospital of Fudan University, Shanghai, China
| | - Jia Zhu
- Department of Pathology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Ying Huang
- Department of Gastroenterology, Children's Hospital of Fudan University, Shanghai, China
| | - Zhi Nong Jiang
- Department of Pathology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
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Kim JM, Kang HJ, Kim JW, Choi W, Lee JY, Kim SW, Shin IS. Age-specific associations between inflammatory markers and remission of depression during antidepressant use. Psychiatry Res 2023; 324:115198. [PMID: 37058794 DOI: 10.1016/j.psychres.2023.115198] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 04/04/2023] [Accepted: 04/09/2023] [Indexed: 04/16/2023]
Abstract
The roles of inflammatory markers in predicting the response to antidepressants are controversial. The levels of inflammatory markers increase with age. Here, we compared the associations of inflammatory markers with remission during 12-week pharmacotherapy according to patient age. Higher high-sensitivity C-reactive protein (hsCRP) levels were associated with non-remission in younger, but not older, patients. However, higher interleukin (IL)-1β and IL-6 levels were associated with non-remission in all patients, regardless of age. Differential associations were observed between inflammatory markers and remission, according to patient age. Patient age should be considered when predicting the response to antidepressants based on serum hsCRP level.
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Affiliation(s)
- Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.
| | - Hee-Ju Kang
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Ju-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Wonsuk Choi
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Il-Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
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Saiki O, Uda H. Ratio of serum amyloid A to C-reactive protein is constant in the same patients but differs greatly between patients with inflammatory diseases. Scand J Immunol 2021; 95:e13121. [PMID: 34796986 DOI: 10.1111/sji.13121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 11/13/2021] [Accepted: 11/17/2021] [Indexed: 11/28/2022]
Abstract
C-reactive protein (CRP) is commonly monitored to track the activity of inflammation and has become the gold standard in the management of all inflammatory diseases. Indeed, serum amyloid A (SAA) have seemed to correlate moderately with CRP, but the discrepancy of CRP and SAA levels has often been reported, especially in rheumatoid arthritis. Then, we examined CRP reflects a real magnitude of inflammation in patients with rheumatic and infectious inflammatory diseases. A total of 414 patients with infectious and non-infectious inflammatory diseases were enrolled. At initial visit, each patient underwent a clinical assessment and had also laboratory tests such as SAA and CRP. In each patient, we carried out a longitudinal analysis of CRP and SAA levels. We determined the inter-individual correlation between SAA and CRP and also clarified intra-individual changes of SAA/CRP ratio. SAA and CRP levels changed approximately linearly over time within individuals irrespective of rheumatic and infectious inflammatory diseases. However, SAA/CRP ratios differed dramatically between patients (from 0.117 to 50.8, median 5.71). In patients with high SAA/CRP ratio (>8.44), SAA is a better predictor of inflammation than CRP. In contrast, CRP is a better predictor in patients with low ratio (<3.52). Our results suggest that the SAA/CRP ratio differed greatly between individuals but was constant in intra-individuals. Low CRP levels could be accompanied by SAA levels predicting any degree of inflammation, implying that CRP is not reflecting a real magnitude of inflammation. To evaluate the real magnitude of inflammation, to access the SAA/CRP ratio in advance is essential.
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Affiliation(s)
- Osamu Saiki
- Department of Rheumatology, Higashiosaka City Medical Center, Higashiosaka City, Japan
| | - Hiroshi Uda
- Department of Rheumatology, Higashiosaka City Medical Center, Higashiosaka City, Japan
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Hetta HF, Mohamed AAA, Zahran AM, A Mahran S, MY Sayed M, GA Saleh M, Abdelazeem K, Batiha GES, Al-Rejaie S, Waheed Y, Muhammad K, M Hassanien M. Possible Role of Regulatory B Cells in Different Behçet's Disease Phenotypes and Therapies: First Report from Egypt. J Inflamm Res 2021; 14:737-744. [PMID: 33727848 PMCID: PMC7955029 DOI: 10.2147/jir.s279912] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 01/28/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND AIM The data about the role of regulatory B cells (Breg) in Behcet Disease (BD) are scarce. We aimed to evaluate the frequency of total B lymphocytes and Breg cells in different BD phenotypes and therapies attempting to unravel their function. METHODS This cross-sectional study included 35 BD patients and 39 healthy controls (HCs). The demographic data of the study subjects were collected including age and gender. Current medications including disease-modifying anti-rheumatic drugs (DMARDs) were recorded. All patients underwent testing for baseline laboratory investigations including full blood count, liver and kidney function tests, erythrocyte sedimentation rate (ESR) by Westergren blot and C-reactive protein (CRP). Measurement of the total B lymphocytes and their subtypes B regulatory lymphocytes by flow cytometric assay. Assessment of BD activity was done using the revised Behçet's Disease Current Activity Form (BDCAF) 2006 and Behçet's Syndrome Activity Score (BSAS) 1111111111. All participants were assessed for the presence of erectile dysfunction using the International Index of Erectile Function (IIEF-5 score), and for depression using the Beck Depression Inventory. RESULTS A dramatic drop in the number of B cells, total and regulatory, was observed in the patients compared to the HCs. Regulatory cells (Bregs) tend to be upregulated with genital ulcers or vascular disease. Bregs but not B lymphocytes were associated with BSAS and ESR. Neither the total B lymphocytes nor the Bregs correlated with CRP or the sexual function or depression scores. Of all the used medications, low-dose aspirin was seen with markedly high Bregs proportions. CONCLUSION This study supports the role of B cells in BD pathogenesis and strongly suggests a possible role for Bregs in the resolution of different BD manifestations.
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Affiliation(s)
- Helal F Hetta
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Correspondence: Helal F Hetta Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, 71515, Egypt Email
| | - Alaa A A Mohamed
- Rheumatology and Rehabilitation Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Asmaa M Zahran
- Clinical Pathology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Safaa A Mahran
- Rheumatology and Rehabilitation Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Marwa MY Sayed
- Department of Cardiology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Mohamed GA Saleh
- Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, 71515, Egypt
| | - Khaled Abdelazeem
- Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, 71515, Egypt
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicines, Damanhour University, Damanhur, 22511, Egypt
| | - Salim Al-Rejaie
- Department of Pharmacology & Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Yasir Waheed
- Foundation University Medical College, Foundation University Islamabad, Islamabad, 44000, Pakistan
| | - Khalid Muhammad
- Department of Biology, College of Science, United Arab Emirates University, Al Ain, 15551, United Arab Emirates
| | - Manal M Hassanien
- Rheumatology and Rehabilitation Department, Faculty of Medicine, Assiut University, Assiut, Egypt
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Clinical Features and Risk Factors of Active Tuberculosis in Patients with Behçet's Disease. J Immunol Res 2020; 2020:2528676. [PMID: 33299897 PMCID: PMC7707958 DOI: 10.1155/2020/2528676] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/20/2020] [Accepted: 10/27/2020] [Indexed: 12/17/2022] Open
Abstract
To investigate the clinical features and potential risk factors of active tuberculosis (ATB) in Behçet's disease (BD), we conducted a case-control study on hospitalized BD patients in our institute from 2010 to 2019. BD patients with ATB were enrolled as the case group. The control group was selected by random number sampling from the remaining BD patients, including those with latent tuberculosis infection, previous tuberculosis, or without tuberculosis. Finally, we reviewed 386 BD patients and identified 21 (5.4%) ATB cases, including four (19.0%) microbiologically confirmed and 17 (81.0%) clinically diagnosed. We found that BD patients with ATB were more prone to have systemic symptoms (fever, night sweating, and unexplained weight loss) and/or symptoms related to the infection site. Multivariate logistic regression analysis revealed that erythrocyte sedimentation rate (ESR) > 60 mm/h (OR = 13.710, 95% CI (1.101, 170.702)), increased IgG (OR = 1.226, 95% CI (1.001, 1.502)), and positive T-SPOT.TB (OR = 7.793, 95% CI (1.312, 48.464), for 24-200 SFC/106PBMC; OR = 17.705 95% CI (2.503, 125.260), for >200 SFC/106PBMC) were potential risk factors for ATB in BD patients. Our study suggested that when BD patients have systemic symptoms with significantly elevated TB-SPOT, the diagnosis of ATB should be considered.
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Ambreen G, Siddiq A, Hussain K, Hussain AS, Naz Z. Repeatedly heated mix vegetable oils-induced atherosclerosis and effects of Murraya koenigii. BMC Complement Med Ther 2020; 20:222. [PMID: 32664977 PMCID: PMC7362559 DOI: 10.1186/s12906-020-03012-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 07/02/2020] [Indexed: 01/15/2023] Open
Abstract
Background Statins are considered as standard drugs to control cholesterol levels, but their use is also associated with renal hypertrophy, hemorrhagic stroke, hepatomegaly, and myopathy. Murraya koenigii is an herb that is used in traditional cuisine and as a medicine in South Asia. Here we assessed the antidyslipidemic and antiatherosclerotic effects of this spice in repeated heated mix vegetable oils (RHMVO)-induced atherosclerotic models. Methods Aqueous extract of M. koenigii leaves (Mk LE) was prepared and its phytoconstituents were determined. Rabbits were divided into 5 groups (n = 10). Except for the control group, all the other four groups were treated with RHMVO for 16 weeks (dose = 2 ml/kg/day) to induce dyslipidemia and atherosclerosis. These groups were further treated for 10 weeks either with 300 and 500 mg/kg/day Mk LE, lovastatin, RHMVO, or left untreated. Body and organ weights were measured along with oxidative stress and tissue damage parameters. Lipid profile and hepatic function markers were studied. Atheroma measurement and histopathological examination were also performed in control and treated groups. Results Mk LE significantly (p < 0.05) attenuated RHMVO-induced dyslipidemia and atheroma formation. Furthermore, fat accumulation and lipid peroxidation in hepatic tissues were reduced by Mk LE in a dose-dependent manner. Our results indicated that the antidyslipidemic effects of Mk LE in 500 mg/kg/day dose were comparable to lovastatin. Additionally, oxidative stress markers were reduced much more significantly in Mk LE-500 than in the statin group (p < 0.05). Conclusions This study recommends Mk LE as a potent antioxidant and lipid-lowering natural medicine that can attenuate the RHMVO-induced atherosclerotic in optimal doses and duration. Therefore, Mk LE can be accessible, cheap, and free of adverse effects alternate to statins.
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Affiliation(s)
- Gul Ambreen
- Department of Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences, University of Karachi, Karachi, Pakistan. .,Department of Pharmacy, Aga Khan University Hospital, Stadium Road (Main Pharmacy), P.O Box 3500, Karachi, 74800, Pakistan.
| | - Afshan Siddiq
- Department of Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences, University of Karachi, Karachi, Pakistan
| | - Kashif Hussain
- Department of Pharmacy, Aga Khan University Hospital, Stadium Road (Main Pharmacy), P.O Box 3500, Karachi, 74800, Pakistan
| | - Abdul Saboor Hussain
- Department of Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences, University of Karachi, Karachi, Pakistan
| | - Zara Naz
- Institute of Pharmaceutical Sciences, Peoples University of Medical and Health Sciences, Nawabshah, Sindh, Pakistan
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Wang YS, Ye J, Yang X, Zhang GP, Cao YH, Zhang R, Dai W, Zhang Q. Association of retinol binding protein-4, cystatin C, homocysteine and high-sensitivity C-reactive protein levels in patients with newly diagnosed type 2 diabetes mellitus. Arch Med Sci 2019; 15:1203-1216. [PMID: 31572465 PMCID: PMC6764307 DOI: 10.5114/aoms.2018.79565] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Accepted: 09/30/2018] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION To investigate the serum retinol binding protein (RBP)-4, cystatin C (Cys C), homocysteine (HCY) and high-sensitivity C-reactive protein (hs-CRP) levels in newly diagnosed type 2 diabetes mellitus (NT2DM) patients, prediabetes mellitus (PDM) subjects and normal controls, as well as their correlation with clinical and laboratory indexes, such as blood pressure and lipoprotein. MATERIAL AND METHODS A total of 242 subjects, including 141 NT2DM patients, 48 PDM subjects and 53 healthy controls, were recruited in the present study. Serum RBP-4, Cys C and hs-CRP concentrations were measured by enzyme-linked immunosorbent assay (ELISA). HCY concentration was determined by the chemical luminescence method. RESULTS There were significant differences in Cys C and hs-CRP among NT2DM patients, PDM subjects and normal controls. In comparison to controls, there were significantly elevated Cys C and hs-CRP levels in PDM (both p < 0.001), and a significantly increased Cys C level in NT2DM (p < 0.001); however, there were no significant differences in Cys C and hs-CRP levels between NT2DM and PDM, and no significant differences of hs-CRP levels between NT2DM and normal controls. No significant differences of RBP-4 and HCY levels among NT2DM, PDM and normal control groups were observed. CONCLUSIONS Aberrant Cys C expression and its clinical associations in NT2DM suggest their important role in this disease.
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Affiliation(s)
- Yun-Sheng Wang
- Department of Endocrinology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Department of Endocrinology, the Second Hospital of Hefei City, Hefei, Anhui, China
| | - Jun Ye
- Department of Endocrinology, the Second Hospital of Hefei City, Hefei, Anhui, China
| | - Xiao Yang
- Department of Ultrasonography, the Second Hospital of Hefei City, Hefei, Anhui, China
| | - Gui-Ping Zhang
- Department of Ultrasonography, the Second Hospital of Hefei City, Hefei, Anhui, China
| | - Yong-Hong Cao
- Department of Endocrinology, the Second Hospital of Hefei City, Hefei, Anhui, China
| | - Rong Zhang
- Department of Endocrinology, the Second Hospital of Hefei City, Hefei, Anhui, China
| | - Wu Dai
- Department of Endocrinology, the Second Hospital of Hefei City, Hefei, Anhui, China
| | - Qiu Zhang
- Department of Endocrinology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
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Xue G, Zhong Y, Hua L, Zhong M, Liu X, Chen X, Gao D, Zhou N. Aberrant alteration of follicular T helper cells in ulcerative colitis patients and its correlations with interleukin-21 and B cell subsets. Medicine (Baltimore) 2019; 98:e14757. [PMID: 30855475 PMCID: PMC6417626 DOI: 10.1097/md.0000000000014757] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Patients with ulcerative colitis (UC) are at increased risk of developing colitis-associated colon cancer. Accumulating evidence suggests that follicular T helper (TFH) cells play a crucial role in the pathogenic process of autoimmune diseases. However, little is known about the role of TFH cells in the development of UC. To investigate the role of TFH cells in the development of UC, the number of TFH cells, the level of interleukin-21 (IL-21), the numbers of B cell subsets, and clinical parameters were detected in peripheral blood from 31 UC patients and 29 healthy controls. TFH cells and the level of IL-21 were significantly higher in UC patients than in the healthy controls. A positive correlation between TFH and IL-21 cells was found in UC patients. Moreover, aberrant frequencies of different subsets of B cells were observed in UC patients, and a positive correlation was found between CD38CD19 B cells and TFH cells and between CD86CD19 B cells and TFH cells. A high number of TFH cells were positively associated with Mayo score, serum C-reaction protein (CRP) and serum IgG in UC patients. Our data indicate that TFH cells and IL-21 are involved in the pathogenesis of UC.
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Affiliation(s)
- Guohui Xue
- Department of Clinical Laboratory, Jiujiang No. 1 People's Hospital, Jiujiang
| | - Yao Zhong
- Department of Clinical Laboratory, The Second People's Hospital of Kunming, Kunming
| | - Lin Hua
- Department of Clinical Laboratory, Jiujiang No. 1 People's Hospital, Jiujiang
| | - Meijun Zhong
- Department of General Practice, The Second Affiliated Hospital of Nanchang University
| | - Xiaofeng Liu
- Department of Clinical Laboratory, Jiujiang No. 1 People's Hospital, Jiujiang
| | - Xueli Chen
- Department of Clinical Laboratory, Jiujiang No. 1 People's Hospital, Jiujiang
| | - Dian Gao
- Department of Pathogen Biology and Immunology, Medical College of Nanchang University, Nanchang, China
| | - Nanjin Zhou
- Jiangxi Academy of Medical Science, Nanchang
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Suwannawong D, Seresirikachorn K, Aeumjaturapat S, Chusakul S, Kanjanaumporn J, Chitsuthipakorn W, Ruksakul W, Snidvongs K. Predicting bacteria causing acute bacterial rhinosinusitis by clinical features. Braz J Otorhinolaryngol 2019; 86:281-286. [PMID: 30685351 PMCID: PMC9422375 DOI: 10.1016/j.bjorl.2018.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 10/27/2018] [Accepted: 12/05/2018] [Indexed: 11/26/2022] Open
Abstract
Introduction Clinicians rely on clinical presentations to select therapeutic agents for acute bacterial rhinosinusitis. Streptococcus pneumoniae and Haemophilus influenzae are common in acute bacterial rhinosinusitis. Drug resistant Streptococcus pneumoniae and Haemophilus influenzae require different antibiotics. Objective This study aimed to evaluate the associations between clinical features of acute bacterial rhinosinusitis and pathogenic bacteria. Methods Sixty-four patients with acute bacterial rhinosinusitis were enrolled. Clinical features including nasal obstruction, discolored discharge, facial pain, smell disturbance, fever and laboratory findings of patients with acute bacterial rhinosinusitis were collected. The bacterial cultures of endoscopic middle meatal swabs were used as a reference. Results Serum C-reactive protein level elevation correlated with the bacterial species (p = 0.03), by which was increased in 80.0% of Haemophilus influenzae rhinosinusitis and 57.1% of Streptococcus pneumoniae rhinosinusitis. The elevated C-reactive protein was the significant predictor for Haemophilus influenzae rhinosinusitis with the Odds Ratio of 18.06 (95% CI 2.36–138.20). The sensitivity of serum C-reactive protein level elevation for diagnosing Haemophilus influenzae rhinosinusitis was 0.80 (95% CI 0.49–0.94). Conclusion Elevation of serum C-reactive protein level was associated with and predicted acute bacterial rhinosinusitis caused by Haemophilus influenzae.
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Affiliation(s)
- Dussawan Suwannawong
- Chulalongkorn University, Faculty of Medicine, Department of Otolaryngology, Bangkok, Thailand; King Chulalongkorn Memorial Hospital, Endoscopic Nasal and Sinus Surgery Excellence Center, Bangkok, Thailand
| | - Kachorn Seresirikachorn
- Chulalongkorn University, Faculty of Medicine, Department of Otolaryngology, Bangkok, Thailand; King Chulalongkorn Memorial Hospital, Endoscopic Nasal and Sinus Surgery Excellence Center, Bangkok, Thailand
| | - Songklot Aeumjaturapat
- Chulalongkorn University, Faculty of Medicine, Department of Otolaryngology, Bangkok, Thailand; King Chulalongkorn Memorial Hospital, Endoscopic Nasal and Sinus Surgery Excellence Center, Bangkok, Thailand
| | - Supinda Chusakul
- Chulalongkorn University, Faculty of Medicine, Department of Otolaryngology, Bangkok, Thailand; King Chulalongkorn Memorial Hospital, Endoscopic Nasal and Sinus Surgery Excellence Center, Bangkok, Thailand
| | - Jesada Kanjanaumporn
- Chulalongkorn University, Faculty of Medicine, Department of Otolaryngology, Bangkok, Thailand; King Chulalongkorn Memorial Hospital, Endoscopic Nasal and Sinus Surgery Excellence Center, Bangkok, Thailand
| | | | - Winyu Ruksakul
- Nakhon Pathom Hospital, Department of Otolaryngology, Nakhon Pathom, Thailand
| | - Kornkiat Snidvongs
- Chulalongkorn University, Faculty of Medicine, Department of Otolaryngology, Bangkok, Thailand; King Chulalongkorn Memorial Hospital, Endoscopic Nasal and Sinus Surgery Excellence Center, Bangkok, Thailand.
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The Role of Adipose Derived Mesenchymal Stem Cells (MSCs) to Control Autoimmune Disease. JOURNAL OF BIOMIMETICS BIOMATERIALS AND BIOMEDICAL ENGINEERING 2018. [DOI: 10.4028/www.scientific.net/jbbbe.39.89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
There are 80 types of autoimmune diseases (ADs) with some of the same symptoms, but causes are still unclear. The major treatment of ADs is immunosuppressive drugs but these are not effective and associated with substantial toxicities. Stem cell has demonstrated remarkable effectiveness in halting destructive immune response and restoring the body to level of normal function by providing cellular level repair of damage, increasing blood flow, and reducing inflammation. Adipose tissue is one of the most potent and concentrated source of mesenchymal stem cells (MSCs) as an anti-inflammatory and tissue protecting agent which is promote healing and minimal invasive. This study conducted in 20 patients with ADs (11 women and 9 men) in various age between 22 to 70 years old. Patients treated with autologous adipose-derived MSCs implantation through catheterization. The laboratory analysis result of patients before and after MSCs application in 6 months were measured, include haemoglobin (Hb), leukocytes, erythrocyte sedimentation rate (ESR), protein and blood levels in urine, high sensitivity c-reactive protein (hsCRP), C3 and C4 complement, anti-nuclear antibodies (ANA) and anti-double stranded DNA (anti-dsDNA). MSCs are able to improve the performance of hemoglobin which statistically significant increased (p=0.002). MSCs are able to reduce the inflammatory as shown in the number of leukocytes (p=0.015) and ESR (p=0.031) which statistically significant decreased. MSCs can repair the renal function as shown in no presences of protein and blood in patient’s urine. MSCs are also able to augment the immune response as shown in hsCRP which statistically significant decreased (p<0.001), while C3 and C4 complements statistically significant increased (p<0.001). ANA and anti-dsDNA showed a negative result which means MSCs therapy may give a good response to heal the ADs.
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Wu S, Zhou Y, Hua HY, Zhang Y, Zhu WY, Wang ZQ, Li J, Gao HQ, Wu XH, Lu TX, Hua D. Inflammation marker ESR is effective in predicting outcome of diffuse large B-cell lymphoma. BMC Cancer 2018; 18:997. [PMID: 30340560 PMCID: PMC6194702 DOI: 10.1186/s12885-018-4914-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 10/08/2018] [Indexed: 12/17/2022] Open
Abstract
Background Systemic inflammation has been implicated in cancer development and progression. This study examined the best cutoff value of erythrocyte sedimentation rate (ESR) in diffuse large B-cell lymphoma (DLBCL) patients. Methods The relationship between ESR and clinical characteristics was analyzed in 182 DLBCL patients from 2006 to 2017. The log-rank test, univariate analysis, and Cox regression analysis were applied to evaluate the relationship between ESR and survival. An ESR of more than 37.5 mm/hour was found to be the optimal threshold value for predicting prognosis. Results ESR was associated with more frequent advanced Ann Arbor stage, poorer performance status, elevated lactate dehydrogenase level, the presence of B symptoms, high-risk International Prognostic Index (IPI 3–5), more extranodal involvement (ENI ≥2), non-germinal-center B-cell (non-GCB) subtypes, and more frequent Myc protein positivity. Shorter overall survival (OS) and progression-free survival (PFS) were found for patients with higher ESRs. Multivariate analysis demonstrated that ESR level is an independent prognostic factor of both OS and PFS. In addition, dynamic changes in ESR are valuable in assessing curative effect and predicting disease recurrence. Conclusion High ESR in DLBCL patients indicated unfavorable prognosis that may require alternative treatment regimens. Electronic supplementary material The online version of this article (10.1186/s12885-018-4914-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shuang Wu
- Department of Hematology, The Third Affiliated Hospital of Nantong University, The Third People's Hospital of Wuxi, Wuxi, 214000, Jiangsu, People's Republic of China
| | - Ye Zhou
- Department of Hematology, The Third Affiliated Hospital of Nantong University, The Third People's Hospital of Wuxi, Wuxi, 214000, Jiangsu, People's Republic of China
| | - Hai-Ying Hua
- Department of Hematology, The Third Affiliated Hospital of Nantong University, The Third People's Hospital of Wuxi, Wuxi, 214000, Jiangsu, People's Republic of China
| | - Yan Zhang
- Department of Hematology, The Third Affiliated Hospital of Nantong University, The Third People's Hospital of Wuxi, Wuxi, 214000, Jiangsu, People's Republic of China
| | - Wen-Yan Zhu
- Department of Hematology, The Third Affiliated Hospital of Nantong University, The Third People's Hospital of Wuxi, Wuxi, 214000, Jiangsu, People's Republic of China
| | - Zhi-Qing Wang
- Department of Hematology, The Third Affiliated Hospital of Nantong University, The Third People's Hospital of Wuxi, Wuxi, 214000, Jiangsu, People's Republic of China
| | - Jin Li
- Department of Hematology, The Third Affiliated Hospital of Nantong University, The Third People's Hospital of Wuxi, Wuxi, 214000, Jiangsu, People's Republic of China
| | - Hua-Qiang Gao
- Department of Hematology, The Third Affiliated Hospital of Nantong University, The Third People's Hospital of Wuxi, Wuxi, 214000, Jiangsu, People's Republic of China
| | - Xiao-Hong Wu
- Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi, 214000, Jiangsu, People's Republic of China
| | - Ting-Xun Lu
- Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi, 214000, Jiangsu, People's Republic of China.
| | - Dong Hua
- Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi, 214000, Jiangsu, People's Republic of China.
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Femtosecond-Pulsed Laser Written and Etched Fiber Bragg Gratings for Fiber-Optical Biosensing. SENSORS 2018; 18:s18092844. [PMID: 30154380 PMCID: PMC6165360 DOI: 10.3390/s18092844] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 08/20/2018] [Accepted: 08/25/2018] [Indexed: 02/07/2023]
Abstract
We present the development of a label-free, highly sensitive fiber-optical biosensor for online detection and quantification of biomolecules. Here, the advantages of etched fiber Bragg gratings (eFBG) were used, since they induce a narrowband Bragg wavelength peak in the reflection operation mode. The gratings were fabricated point-by-point via a nonlinear absorption process of a highly focused femtosecond-pulsed laser, without the need of prior coating removal or specific fiber doping. The sensitivity of the Bragg wavelength peak to the surrounding refractive index (SRI), as needed for biochemical sensing, was realized by fiber cladding removal using hydrofluoric acid etching. For evaluation of biosensing capabilities, eFBG fibers were biofunctionalized with a single-stranded DNA aptamer specific for binding the C-reactive protein (CRP). Thus, the CRP-sensitive eFBG fiber-optical biosensor showed a very low limit of detection of 0.82 pg/L, with a dynamic range of CRP detection from approximately 0.8 pg/L to 1.2 µg/L. The biosensor showed a high specificity to CRP even in the presence of interfering substances. These results suggest that the proposed biosensor is capable for quantification of CRP from trace amounts of clinical samples. In addition, the adaption of this eFBG fiber-optical biosensor for detection of other relevant analytes can be easily realized.
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Small Bowel Lesions Mimicking Crohn's Disease. Curr Gastroenterol Rep 2018; 20:43. [PMID: 30079433 DOI: 10.1007/s11894-018-0651-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE OF REVIEW Not all injuries of the terminal ileum are Crohn's disease. It is the purpose of this review to consider the differential diagnosis of other acute and chronic ileal lesions. RECENT FINDINGS The recognition of a granulomatous disease of the terminal ileum, distinct from tuberculosis, dates back over 85 years and perhaps much farther, but over the past decades, many other clinical pathologic entities have been described that are neither tuberculosis nor Crohn's eponymous regional enteritis. In recent years, the catalog of lesions mimicking Crohn's disease of the small bowel and proposals for differential diagnosis and treatment have expanded to include newly reported appendiceal pathology, primary cancers and lymphomas of the intestine, unexpected metastases from distant organs, unusual infections, vasculitides and other ischemic conditions, Behçet's disease, endometriosis, and drug reactions. A diagnosis of Crohn's disease should not be a reflex action in the face of small bowel structural or inflammatory lesions without consideration of pathology in adjacent organs, primary and metastatic lesions of the small intestine, infections, vascular diseases, infiltrative diseases, drug injury, or other "idiopathic" conditions.
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Huang L, Huang Z, Tai Y, Wang P, Hu B, Tang C. The small bowel diseases detected by capsule endoscopy in patients with chronic abdominal pain: A retrospective study. Medicine (Baltimore) 2018; 97:e0025. [PMID: 29465542 PMCID: PMC5842003 DOI: 10.1097/md.0000000000010025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Chronic abdominal pain (CAP) remains a particular challenge because of its complicated causes, especially when the disorders involve the small bowel, where it is quite difficult to intubate the flexible endoscopes. This study was to investigate the small bowel diseases detected by capsule endoscopy (CE) in CAP patients to evaluate the role of CE on CAP, and analyzed the relationship among the clinical characteristics of CAP patients and the positive rates of CE findings to search for the indications of CE for CAP patients.This retrospective study included 341 patients with CAP defined as recurrent abdominal pain for no <3 months. Each patient underwent CE after a negative diagnostic work-up. All CE images were reviewed by 3 gastroenterologists independently. The positive findings were defined as abnormal findings in the small bowel that might have been the causes of CAP. The final diagnosis was confirmed by CE findings, clinical features, histopathology, and a response to the treatment during the follow-up for at least 3 months after CE.The overall positive rate of CE findings was 28.15% (96/341). The positive rate in CAP-A (CAP with associated symptoms) group was significantly higher than that in CAP-O (CAP only) group (33.16% vs 21.38%, P = .017). Multivariate logistic regression analysis revealed that weight loss (odds ratio [OR] = 2.827, 95% confidence interval (CI) = 1.938-4.926), hypoalbuminemia (OR = 6.142, 95%IC = 4.129-8.274), elevated erythrocyte sedimentation rate (ESR) (OR = 4.025, 95%IC = 3.178-6.892), or increased C-reactive protein (CRP) (OR = 7.539, 95%CI = 5.365-11.723) were significantly associated with high positive rates. On follow-up, final diagnosis was confirmed in 56 of 69 (81.16%) patients with positive CE findings. About half of these patients (46.38%, 32/69) were diagnosed as inflammatory diseases, including Crohn disease (12), tuberculosis (5), NSAID enteropathy (4), etc. Tumors were proved in 21.74% (15/69) patients, including malignant in 7 cases and benign in 8 cases. Parasitosis was found in 9 (13.04%) patients.This study suggests that CE may be helpful for CAP patients to detect the small bowel diseases, half of which were comprised of inflammatory diseases. Besides, weight loss, hypoalbuminemia, elevated ESR, or increased CRP may be regarded as the indications of CE for CAP patients.
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Tsai MZ, Hsiung CT, Chen Y, Huang CS, Hsu HY, Hsieh PY. Real-time CRP detection from whole blood using micropost-embedded microfluidic chip incorporated with label-free biosensor. Analyst 2018; 143:503-510. [DOI: 10.1039/c7an01374d] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
We demonstrate the detection of C-creative protein (CRP) from whole blood samples without sample pretreatment by using a lab-on-a-chip system consisting of a microfluidic chip and a label-free biosensor.
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Affiliation(s)
- Meng-Zhe Tsai
- Department of Mechanical Engineering
- National Chiao Tung University
- Hsinchu
- Taiwan 30010
| | - Chan-Te Hsiung
- Department of Mechanical Engineering
- National Chiao Tung University
- Hsinchu
- Taiwan 30010
| | - Yang Chen
- Department of Mechanical Engineering
- National Chiao Tung University
- Hsinchu
- Taiwan 30010
| | - Cheng-Sheng Huang
- Department of Mechanical Engineering
- National Chiao Tung University
- Hsinchu
- Taiwan 30010
| | - Hsin-Yun Hsu
- Department of Applied Chemistry
- National Chiao Tung University
- Hsinchu
- Taiwan 30010
| | - Pei-Ying Hsieh
- Department of Applied Chemistry
- National Chiao Tung University
- Hsinchu
- Taiwan 30010
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Alsaad KM, Alautaish HHN, Alamery MAY. Congenital arthrogryposis-hydranencephaly syndrome caused by Akabane virus in newborn calves of Basrah Governorate, Iraq. Vet World 2017; 10:1143-1148. [PMID: 29062207 PMCID: PMC5639116 DOI: 10.14202/vetworld.2017.1143-1148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 08/30/2017] [Indexed: 12/19/2022] Open
Abstract
Aim: The study was conducted in Basrah, Iraq, to diagnose congenital arthrogryposis-hydranencephaly syndrome caused by Akabane virus (AKAV) in calves. Materials and Methods: Affected animals (42 calves) are about 2-27 days old from both sexes show signs of arthrogryposis and hydranencephaly. Eight clinically healthy newborn calves were considered as controls. Diagnosis of AKAV was confirmed using a competition enzyme-linked immunosorbent assay test. Results: Results show that all affected calves were found seropositive. Furthermore, a significant increase in total leukocyte count in diseased calves due to a significant increase in the absolute lymphocyte number indicated in affected calves than in controls. Moreover, a significant increase in sedimentation rate of erythrocytes was also encountered in diseased calves than in controls. In addition, a significant increase in haptoglobin level and fibrinogen was also detected. Conclusion: Diagnosis of AKAV infection of Basrah Governorate, Iraq, will provide useful epidemiological information for cattle and other domesticated animals. Therefore, abortion could be prevented and controlled.
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Affiliation(s)
- K M Alsaad
- Department of Internal and Preventive Medicine, College of Veterinary Medicine, University of Basrah, Basrah, Iraq
| | - H H N Alautaish
- Department of Internal and Preventive Medicine, College of Veterinary Medicine, University of Basrah, Basrah, Iraq
| | - M A Y Alamery
- Department of Internal and Preventive Medicine, College of Veterinary Medicine, University of Basrah, Basrah, Iraq
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Zubiate P, Zamarreño C, Sánchez P, Matias I, Arregui F. High sensitive and selective C-reactive protein detection by means of lossy mode resonance based optical fiber devices. Biosens Bioelectron 2017; 93:176-181. [DOI: 10.1016/j.bios.2016.09.020] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 09/04/2016] [Accepted: 09/06/2016] [Indexed: 10/21/2022]
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The outcomes and risk factors of early reoperation after initial intestinal resective surgery in patients with intestinal Behçet's disease. Int J Colorectal Dis 2017; 32:591-594. [PMID: 28028614 DOI: 10.1007/s00384-016-2743-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2016] [Indexed: 02/04/2023]
Abstract
PURPOSE Patients with intestinal Behçet's disease who underwent intestinal resective surgery often require reoperation. However, there have been no studies on the risk factors and outcomes of early reoperation in these patients. METHODS We retrospectively evaluated 41 patients with intestinal Behçet's disease who received repeated intestinal resective surgeries between 2006 and 2016. We analyzed two different patient groups-those who required early reoperation within 6 months and those who underwent reoperation >6 months after the initial surgery-and determined the risk factors for early reoperation. RESULTS Eleven patients (26.8%) underwent reoperation within 6 months and 30 patients (73.2%) after 6 months. Emergency surgery at the initial operation and higher initial perioperative erythrocyte sedimentation rate and C-reactive protein levels were significantly associated with early reoperation in the univariate analysis. After the multivariate analysis, initial emergency operation (P = 0.020; hazard ratio [HR], 42.625; 95% confidence interval [CI], 1.817-1000.088) and high erythrocyte sedimentation rate (P = 0.039; HR, 1.049; 95% CI, 1.002-1.097) were determined to be the independent factors for early reoperation. CONCLUSIONS Emergency surgery and high perioperative erythrocyte sedimentation rate levels were the prognostic factors for early reoperation (within 6 months) in patients with intestinal Behçet's disease after initial bowel resective surgery.
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Meta-Analytic Bayesian Model For Differentiating Intestinal Tuberculosis from Crohn's Disease. Am J Gastroenterol 2017; 112:415-427. [PMID: 28045023 PMCID: PMC5551982 DOI: 10.1038/ajg.2016.529] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 09/01/2016] [Indexed: 01/30/2023]
Abstract
OBJECTIVES Distinguishing intestinal tuberculosis (ITB) from Crohn's disease (CD) is difficult, although studies have reported clinical, endoscopic, imaging, and laboratory findings that help to differentiate these two diseases. We aimed to produce estimates of the predictive power of these findings and construct a comprehensive model to predict the probability of ITB vs. CD. METHODS A systematic literature search for studies differentiating ITB from CD was conducted in MEDLINE, PUBMED, and EMBASE from inception until September 2015. Fifty-five distinct meta-analyses were performed to estimate the odds ratio of each predictive finding. Estimates with a significant difference between CD and ITB and low to moderate heterogeneity (I2<50%) were incorporated into a Bayesian prediction model incorporating the local pretest probability. RESULTS Thirty-eight studies comprising 2,117 CD and 1,589 ITB patients were included in the analyses. Findings in the model that significantly favored CD included male gender, hematochezia, perianal disease, intestinal obstruction, and extraintestinal manifestations; endoscopic findings of longitudinal ulcers, cobblestone appearance, luminal stricture, mucosal bridge, and rectal involvement; pathological findings of focally enhanced colitis; and computed tomographic enterography (CTE) findings of asymmetrical wall thickening, intestinal wall stratification, comb sign, and fibrofatty proliferation. Findings that significantly favored ITB included fever, night sweats, lung involvement, and ascites; endoscopic findings of transverse ulcers, patulous ileocecal valve, and cecal involvement; pathological findings of confluent or submucosal granulomas, lymphocyte cuffing, and ulcers lined by histiocytes; a CTE finding of short segmental involvement; and a positive interferon-γ release assay. The model was validated by gender, clinical manifestations, endoscopic, and pathological findings in 49 patients (27 CD, 22 ITB). The sensitivity, specificity, and accuracy for diagnosis of ITB were 90.9%, 92.6%, and 91.8%, respectively. CONCLUSIONS A Bayesian model based on the meta-analytic results is presented to estimate the probability of ITB and CD calibrated to local prevalence. This model can be applied to patients using a publicly available web application.
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Zhou Y, Huang Y. Inflammatory bowel disease in Chinese children: A retrospective analysis of 49 cases. Exp Ther Med 2016; 12:3363-3368. [PMID: 27882164 DOI: 10.3892/etm.2016.3756] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 08/25/2016] [Indexed: 12/13/2022] Open
Abstract
To present study reports the clinical characteristics, diagnosis and management of pediatric patients with inflammatory bowel disease (IBD) in China. Clinical records of 49 pediatric patients with IBD at Fudan University Children's Hospital (Shanghai, China) between July 2001 and May 2012 were reviewed. Of 49 patients (30 males and 19 females), 8 patients had ulcerative colitis (UC) and 41 patients had Crohn's disease (CD). The mean age was 10.4 years in patients with UC and 10.1 years in patients with CD. The percentages of patients with UC with abdominal pain, diarrhea or rectal bleeding were 62.5, 100 and 87.5%, respectively, and that of CD patients were 75.6, 61 and 39%, respectively. Patients with UC were underweight (37.5%), and had oral ulcers (12.5%) and arthritis (12.5%), and patients with CD were underweight (34.1%), and had oral ulcers (26.8%), anal fistulas (22%) and arthritis (19.5%). Patients with CD had a higher proportion of immunoglobulin G, C-reactive protein and erythrocyte sedimentation rate compared with patients with UC. Histologic lesions of patients with UC were primarily located in the sigmoid colon (75%), transverse colon (50%) or pan-colon (50%), and in patients with CD they were located in the distal ileum (51.2%), ileocecum (58.5%) or upper gastrointestinal tract (41.5%). All patients underwent colonoscopies and 13 underwent double-balloon enteroscopies. Standard treatment for IBD, including corticosteroids, 5-aminosalicylate, and immunosuppressants (6-mercaptopurine and azathioprine), were administered to all patients. In addition 3 patients were treated with infliximab and 10 patients were treated with thalidomide. Comprehensive assessment of clinical, laboratory, endoscopic, and pathohistological data will benefit the timely diagnosis of IBD.
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Affiliation(s)
- Ying Zhou
- Department of Gastroenterology, Children's Hospital of Fudan University, Shanghai 201102, P.R. China
| | - Ying Huang
- Department of Gastroenterology, Children's Hospital of Fudan University, Shanghai 201102, P.R. China
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Liu S, Ding J, Wang M, Zhou W, Feng M, Guan W. Clinical features of Crohn disease concomitant with ankylosing spondylitis: A preliminary single-center study. Medicine (Baltimore) 2016; 95:e4267. [PMID: 27428240 PMCID: PMC4956834 DOI: 10.1097/md.0000000000004267] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Extraintestinal manifestations (EIMs) cause increased morbidity and decreased quality of life in Crohn disease (CD). Ankylosing spondylitis (AS) belongs to EIMs. Very little is known on the clinical features of CD concomitant with AS. This study is to investigate the clinical features of CD patients with AS.We retrospectively collected all CD patients with AS in our hospital, and established a comparison group (CD without AS) with age, sex, and duration of Crohn disease matched. Clinical information was retrieved for comparison.Eight CD + AS patients were identified from 195 CD patients. Sixteen CD patients were randomly selected into comparison group. All CD + AS patients were male, HLA-B27 (+), and rheumatoid factor (-) with an average age of 40.8 ± 4.52 years. Significant correlation between disease activity of CD and AS was revealed (r = 0.857, P = 0.011). Significant correlation between disease activity of CD and functional limitation associated with AS was identified (r = 0.881, P < 0.01). C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and globulin were positively correlated to Crohn disease activity index (CDAI), Bath AS disease activity index, and Bath AS functional index(BASFI) scores (r = 0.73-0.93, P < 0.05). Albumin was negatively associated with CDAI and BASFI (r = -0.73 to -0.91, P < 0.05). The ratio of albumin to globulin (Alb/Glo) was significantly related to all 3 scores (r = -0.81 to -0.91, P < 0.05).Male predominance with a 4.12% concomitant incidence of AS is observed in CD patients. Disease activity of CD correlates with disease activity of AS and functional limitation caused by AS. CRP, ESR, and Alb/Glo may serve as biomarkers for disease activity and functional limitation in CD patients concomitant with AS, although future studies are expected.
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Affiliation(s)
| | | | | | - Wanqing Zhou
- Department of Laboratory Medicine,Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | | | - Wenxian Guan
- Department of General Surgery
- Correspondence: Wenxian Guan, Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China (e-mail: )
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Saylam Kurtipek G, Kesli R, Tuncez Akyurek F, Akyurek F, Ataseven A, Terzi Y. Plasma-soluble urokinase plasminogen activator receptor (suPAR) levels in Behçet's disease and correlation with disease activity. Int J Rheum Dis 2016; 21:866-870. [DOI: 10.1111/1756-185x.12873] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Recep Kesli
- Department of Microbiology; Afyon Kocatepe University; Faculty of Medicine; Afyonkarahisar Turkey
| | | | - Fikret Akyurek
- Department of Biochemistry; Selçuk University; Faculty of Medicine; Konya Turkey
| | - Arzu Ataseven
- Department of Dermatology; Konya Training and Research Hospital; Konya Turkey
| | - Yuksel Terzi
- Department of Biostatistics; 19 May University; Samsun Turkey
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Cintolo M, Costantino G, Pallio S, Fries W. Mucosal healing in inflammatory bowel disease: Maintain or de-escalate therapy. World J Gastrointest Pathophysiol 2016; 7:1-16. [PMID: 26909224 PMCID: PMC4753175 DOI: 10.4291/wjgp.v7.i1.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 11/16/2015] [Accepted: 12/08/2015] [Indexed: 02/06/2023] Open
Abstract
In the past decade, thanks to the introduction of biologic therapies, a new therapeutic goal, mucosal healing (MH), has been introduced. MH is the expression of an arrest of disease progression, resulting in minor hospitalizations, surgeries, and prolonged clinical remission. MH may be achieved with several therapeutic strategies reaching success rates up to 80% for both, ulcerative colitis (UC) and Crohn’s disease (CD). Various scoring systems for UC and for the transmural CD, have been proposed to standardize the definition of MH. Several attempts have been undertaken to de-escalate therapy once MH is achieved, thus, reducing the risk of adverse events. In this review, we analysed the available studies regarding the achievement of MH and the subsequent treatment de-escalation according to disease type and administered therapy, together with non-invasive markers proposed as predictors for relapse. The available data are not encouraging since de-escalation after the achievement of MH is followed by a high number of clinical relapses reaching up to 50% within one year. Unclear is also another question, in case of combination therapies, which drug is more appropriate to stop, in order to guarantee a durable remission. Predictors of unfavourable outcome such as disease extension, perianal disease, or early onset disease appear to be inadequate to foresee behaviour of disease. Further studies are warranted to investigate the role of histologic healing for the further course of disease.
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Shi L, Tan G, Zhang K. Relationship of the Serum CRP Level With the Efficacy of Metformin in the Treatment of Type 2 Diabetes Mellitus: A Meta-Analysis. J Clin Lab Anal 2016; 30:13-22. [PMID: 25277876 PMCID: PMC6807049 DOI: 10.1002/jcla.21803] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 08/11/2014] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Metformin, an anti-diabetes drug, is always used as a first-line agent for the management of T2DM. This meta-analysis was conducted to investigate whether CRP was sensitive in predicting the efficacy of metformin in the treatment of T2DM. METHODS Potential relevant studies were identified covering the following databases: MEDLINE, Science Citation Index database, the Cochrane Library Database, PubMed, EMBASE, CINAHL, Current Contents Index, the Chinese Biomedical Database, the Chinese Journal Full-Text Database, and the Weipu Journal Database. Data from eligible studies were extracted and included into the meta-analysis using a random effects model. Statistical analyses were calculated using the version 12.0 STATA software. RESULTS A total of 33 articles including 1,433 subjects were collected for analysis. Pooled SMD of those studies revealed that serum levels of CRP and hs-CRP significantly decreased in patients with T2DM after receiving the metformin treatment. Subgroup analysis by country yielded significant different estimates in the serum levels of CRP between the baseline and after metformin treatment in the China, Israel and India subgroups; but only detected only in the China subgroup considering serum levels of hs-CRP. Follow-up time-stratified analyses indicated that serum levels of CRP were markedly reduced in the metformin-treated group in all subgroups. While differences in serum hs-CRP levels were not observed in two subgroups. CONCLUSION Decreased serum levels of CRP and hs-CRP may contribute to a more sensitive prediction in providing a more accurate efficacy reference in the metformin drug in T2DM patients.
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Affiliation(s)
- Lei Shi
- Department of PharmacyLiaochengP.R. China
| | | | - Kun Zhang
- Department of PharmacyLiaocheng Third People's HospitalLiaochengP.R. China
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Gho SM, Shin J, Kim MO, Kim DH. Simultaneous quantitative mapping of conductivity and susceptibility using a double-echo ultrashort echo time sequence: Example using a hematoma evolution study. Magn Reson Med 2015; 76:214-21. [DOI: 10.1002/mrm.25869] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 06/23/2015] [Accepted: 07/14/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Sung-Min Gho
- Department of Electrical and Electronic Engineering; Institute of BioMed-IT, Energy-IT and Smart-IT Technology, Yonsei University; Seoul Republic of Korea
| | - Jaewook Shin
- Department of Electrical and Electronic Engineering; Yonsei University; Seoul Republic of Korea
| | - Min-Oh Kim
- Department of Electrical and Electronic Engineering; Yonsei University; Seoul Republic of Korea
| | - Dong-Hyun Kim
- Department of Electrical and Electronic Engineering; Yonsei University; Seoul Republic of Korea
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Ren J, Liu S, Wang G, Gu G, Ren H, Hong Z, Li J. Laparoscopy improves clinical outcome of gastrointestinal fistula caused by Crohn's disease. J Surg Res 2015; 200:110-6. [PMID: 26286894 DOI: 10.1016/j.jss.2015.07.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Revised: 07/11/2015] [Accepted: 07/21/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND Benefits of laparoscopic surgery in the management of gastrointestinal fistula caused by Crohn disease need to be fully elucidated. We conducted this retrospective study to investigate the safety and feasibility and emphasize the advantages of laparoscopy compared with that of laparotomy for patients with gastrointestinal fistula caused by Crohn disease. MATERIALS AND METHODS A total of 1213 patients with gastrointestinal fistula in our center were screened, and 318 qualified patients were enrolled and divided into laparoscopy (n = 122) and laparotomy (n = 196) groups. Postoperative complications, length of hospital stay, systemic stress responses to surgery, postoperative mortality, and economic burden were collected and compared. RESULTS A total of 125 laparoscopic interventions were performed with a conversion rate of 20.0%. Fifteen versus 84 postoperative complications were obtained in laparoscopy and laparotomy groups, respectively (P = 0.0033). Total hospitalization was 22.7 d and 38.0 d in laparoscopy and laparotomy groups, respectively (P < 0.0001). Postoperative hospitalization was 10.9 d and 24.8 d in two groups, respectively (P < 0.0001). Elevation curve of serum C-reactive protein and procalcitonin in response to laparoscopy was significantly lower than that to laparotomy. Reduced postoperative mortality (P = 0.0292) and postoperative cost (P = 0.0292) were observed in laparoscopy instead of laparotomy group. CONCLUSIONS Laparoscopic approach is safe and feasible and could improve clinical outcome in gastrointestinal fistula patients with Crohn disease.
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Affiliation(s)
- Jianan Ren
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
| | - Song Liu
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Gefei Wang
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Guosheng Gu
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Huajian Ren
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Zhiwu Hong
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jieshou Li
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
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Kim SW, Lee SJ, Ryu YJ, Lee JH, Chang JH, Shim SS, Kim Y. Prognosis and Predictors of Rebleeding After Bronchial Artery Embolization in Patients with Active or Inactive Pulmonary Tuberculosis. Lung 2015; 193:575-81. [PMID: 25862253 DOI: 10.1007/s00408-015-9728-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 04/06/2015] [Indexed: 01/09/2023]
Abstract
INTRODUCTION The aim of this study was to characterize the prognosis and identify factors that contribute to rebleeding after bronchial artery embolization (BAE) in patients with active or inactive pulmonary tuberculosis (PTB). METHODS Following a retrospective review, 190 patients had hemoptysis requiring BAE due to PTB in one hospital between 2006 and 2013. RESULTS The median age at the time of diagnosis of PTB was 37 years and 54 years at the time of first episode of hemoptysis. Among 47 patients (24.7 %) who experienced rebleeding after BAE during the median follow-up period of 13.9 months [interquartile range (IQR) 2.3-36.0 months], bleeding recurred in 12 patients (6.3 %) within 1 month and in 15 patients (7.9 %) after 1 year. The median non-recurrence time was 8.6 months (IQR 1.2-27.6 months). Independent predictors of rebleeding after BAE were tuberculous-destroyed lung [hazard ratio (HR) 3.0; 95 % confidence interval (CI) 1.5-6.2; p = 0.003], the use of anticoagulant agents and/or antiplatelet agents (HR 2.6; 95 % CI 1.1-5.8; p = 0.022), underlying chronic liver disease (HR 2.7; 95 % CI 1.1-4-6.9; p = 0.033), elevated pre-BAE C-reactive protein (CRP) (mg/dL) (HR 2.4; 95 % CI 1.0-5.5; p = 0.048), and the existence of fungal ball (HR 2.1; 95 % CI 1.0-4.3; p = 0.050). CONCLUSIONS The risk of rebleeding after BAE in active or inactive PTB was high, particularly in patients with tuberculous-destroyed lung, chronic liver disease, the use of anticoagulant agents and/or antiplatelet agents, elevated pre-BAE CRP, and the existence of fungal ball.
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Affiliation(s)
- Seo Woo Kim
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Ewha Womans University School of Medicine, Anyangcheon-Ro 1071, Yangcheon-gu, Seoul, 158-710, South Korea
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Platelet indices and inflammatory markers as diagnostic predictors for ascitic fluid infection. Eur J Gastroenterol Hepatol 2014; 26:1342-7. [PMID: 25222550 DOI: 10.1097/meg.0000000000000202] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND AIM Ascitic fluid infection (AFI) is a common complication in patients with cirrhosis and ascites. Mean platelet volume (MPV) and platelet distribution width (PDW) may be considered as simple and inexpensive indicators of inflammation in some diseases. We aimed to investigate whether platelet size alterations and platelet indices would be useful in predicting AFI in cirrhotic patients. PATIENTS AND METHODS Of 210 patients, only 150 patients with ascites because of cirrhosis and 70 control participants were enrolled in this study. After ascitic fluid analysis, patients were divided into two groups: 84 patients had AFI and 66 patients did not have AFI. MPV, PDW, and inflammatory marker values were determined for all patients. The ability of platelet indices values to predict AFI in cirrhotic patients was analyzed using receiver operating characteristic curve analysis. RESULTS A significant increase in MPV levels was observed in cirrhotic patients with AFI compared with cirrhotic patients without AFI and healthy controls (P<0.001). A significant increase in MPV, PDW, C-reactive protein, and white blood cell levels was observed in the AFI group compared with the other group (P<0.001, P=0.002, P<0.001, and P=0.001, respectively). The receiver operating characteristic curve for sensitivity and specificity of MPV was assessed. At a cutoff value of 8.77, MPV had 95.9% sensitivity and 91.7% specificity for detecting AFI (area under the curve: 0.964). CONCLUSION Platelet indices and C-reactive protein are increased in cirrhotic patients with AFI. MPV measurement can be considered an accurate diagnostic test in predicting AFI, possibly because of a continuous systemic inflammatory response.
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Chitra P, Bakthavatsalam B, Palvannan T. Osteonecrosis with renal damage in HIV patients undergoing HAART. Biomed Pharmacother 2014; 68:881-5. [PMID: 25194446 DOI: 10.1016/j.biopha.2014.07.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 07/20/2014] [Indexed: 10/25/2022] Open
Abstract
Rheumatoid arthritis in HIV patients undergoing HAART is associated with increased risk of side effect. Elevation of uric acid (UA) is important in tissue damage, deposition of crystal in joints leads to the development of rheumatoid arthritis in the HAART complaint group. This study was carried out to investigate the relationship of uric acid, RA factor, ANA, ESR, cystatin C, urea and creatinine in the HAART complaint group. Moreover; the ratio of uric acid/cystatin C, uric acid/urea and uric acid/creatinine were also studied. To analyze the progression of HIV, the immunological parameters were correlated with uric acid. Our result showed a statistically high significant increase in uric acid, RA factor, ANA, ESR, cystatin C, urea and creatinine in the HAART complaint group when compared to HAART non-complaint group, early stage and control. The ratio of uric acid/cystatin C, uric acid/urea, uric acid/creatinine were significantly increased in the HAART complaint group. Statistically significant positive correlation was observed between uric acid and cystatin C, urea, creatinine, absolute CD4 and CD8 count. The increased level of uric acid, RA factor, ANA, ESR, cystatin C and increased ratio of uric acid/cystatin C in the HAART complaint group might conclude the mechanism underlying the increased risk for rheumatoid arthritis in the HAART complaint group which may relate to the combined effects of low-grade inflammation and renal dysfunction.
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Affiliation(s)
- Pachiappan Chitra
- Department of Biochemistry, Penang International Dental college, Vinayaka, Mission University, Salem 636 011, TamilNadu, India
| | | | - Thayumanavan Palvannan
- Laboratory of Bioprocess and Engineering, Department of Biochemistry, Periyar University, Salem 636 011, TamilNadu, India.
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