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He C, Liang L, Zhang Y, Wang T, Wang R. Prognosis prediction of procalcitonin within 24 h for acute diquat poisoning. BMC Emerg Med 2024; 24:61. [PMID: 38616281 PMCID: PMC11017620 DOI: 10.1186/s12873-024-00975-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/26/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND To explore the predictive value of procalcitonin (PCT) within 24 h after poisoning for prognosis of acute diquat poisoning. METHODS This retrospective study included acute diquat poisoning patients in the Nanyang City Hospital between May 2017 and July 2021. RESULTS Among the 45 patients included, 27 survived. The maximum PCT value within 24 h after poisoning was significantly higher in the non-survival patients [9.65 (2.63, 22.77) vs. 0.15 (0.10, 0.50) µg/mL, P < 0.001] compared to the survival patients. The area under the ROC curve (AUC) indicated that the maximum PCT value within 24 h had a good predictive value (AUC = 0.905, 95% CI: 0.808-1.000) compared to ingested quantity (AUC = 0.879, 95% CI: 0.776-0.981), serum creatinine (AUC = 0.776, 95% CI: 0.640-0.912), or APACHE II score (AUC = 0.778, 95% CI: 0.631-0.925). The predictive value of maximum PCT value within 24 h was comparable with blood lactate (AUC = 0.904, 95%CI: 0.807-1.000). CONCLUSIONS The maximum PCT value within 24 h after poisoning might be a good predictor for the prognosis of patients with acute diquat poisoning.
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Affiliation(s)
- Cheng He
- Emergency Department of Nanyang Traditional Chinese Medicine Hospital, 473003, Nanyang, Henan, China.
| | - Liguo Liang
- Emergency Department of Nanyang Traditional Chinese Medicine Hospital, 473003, Nanyang, Henan, China
| | - Yu Zhang
- Emergency Department of Nanyang Traditional Chinese Medicine Hospital, 473003, Nanyang, Henan, China
| | - Tianyi Wang
- Emergency Department of Nanyang Traditional Chinese Medicine Hospital, 473003, Nanyang, Henan, China
| | - Rongyang Wang
- Emergency Department of Nanyang Traditional Chinese Medicine Hospital, 473003, Nanyang, Henan, China
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Flamant L, Giordano Orsini G, Ramont L, Gornet M, De Ruffi S, Leroux P, Kanagaratnam L, Gennai S. Association between admission biomarkers and clinical outcome in older adults diagnosed with an infection in the emergency department. Acta Clin Belg 2022:1-6. [DOI: 10.1080/17843286.2022.2146929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Lucas Flamant
- Emergency Department, Reims University Hospital, 45 rue Cognacq-Jay, 51100, Reims, France
| | | | - Laurent Ramont
- Biochemistry Department, Reims University Hospital, 45 rue Cognacq-Jay, 51100, Reims, France
- Université de Reims Champagne-Ardenne, CHU Reims, SFR CAP-Santé, Reims, France
| | - Marion Gornet
- Emergency Department, Reims University Hospital, 45 rue Cognacq-Jay, 51100, Reims, France
| | - Sebastien De Ruffi
- Emergency Department, Reims University Hospital, 45 rue Cognacq-Jay, 51100, Reims, France
| | - Pierre Leroux
- Emergency Department, Reims University Hospital, 45 rue Cognacq-Jay, 51100, Reims, France
| | - Lukshe Kanagaratnam
- Clinical Research Unit, Reims University Hospital, 45 rue Cognacq-Jay, 51100, Reims, France
| | - Stéphane Gennai
- Emergency Department, Reims University Hospital, 45 rue Cognacq-Jay, 51100, Reims, France
- Université de Reims Champagne-Ardenne, CHU Reims, INSERM, P3Cell, U 1250, Reims, France
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Aydemir S, Hoşgün D. Evaluation of the factors affecting long-term mortality in geriatric patients followed up in intensive care unit due to hospital-acquired pneumonia. Medicine (Baltimore) 2022; 101:e30645. [PMID: 36197164 PMCID: PMC9509032 DOI: 10.1097/md.0000000000030645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Aging is a normal physiological process involving changes in the respiratory system, thereby causing an increased incidence of pulmonary infections such as hospital-acquired pneumonia (HAP). The primary aim of this study was to investigate the role of acute-phase reactants and inflammation-based biomarkers in predicting 90-day mortality in patients aged over 65 years who were hospitalized in the intensive care unit (ICU) due to HAP. Clinical records of patients aged ≥65 years who were diagnosed as having HAP and were followed up in ICU were retrospectively evaluated. One hundred and fifteen ICU patients (67.8% male, mean age 76.81 ± 7.480 years) were studied. Ninety-day mortality occurred in 43 (37.4%) patients. Red cell distribution (RDW, %), mean platelet volume (MPV, f/L), white blood cell count (WBC, 103/μL), C-reactive protein (CRP, mg/L), and procalcitonin (PCT, ng/mL) median values were 18.2 (13.7-35.6), 7.42 (5.66-11.2), 14.3 (3.21-40), 9.58 (0.12-32), 0.41 (0.05-100) in the group with 90-day mortality. In the Receiver Operator Characteristics Curve analysis, a WBC value 18.2 × 10ˆ3/μL predicted 90-day independent mortality with a sensitivity of 90.70% and specificity of 31.94% (P = .029). The results indicated that serum WBC level can be used for predicting long-term mortality and prognosis in HAP patients aged over 65 years. High WBC value was statistically significant in predicting 90-day independent mortality (P < .05).
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Affiliation(s)
- Semih Aydemir
- Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Department of Intensive Care Unit, Ankara, Turkey
- *Correspondence: Semih Aydemir, Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Department of Intensive Care Unit, 06280, Keçiören/Ankara, Turkey (e-mail: )
| | - Derya Hoşgün
- Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Department of Intensive Care Unit, Ankara, Turkey
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Identification of RAGE and OSM as New Prognosis Biomarkers of Severe Pneumonia. Can Respir J 2022; 2022:3854191. [PMID: 35035643 PMCID: PMC8759921 DOI: 10.1155/2022/3854191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 12/17/2021] [Indexed: 11/17/2022] Open
Abstract
Objective To investigate efficiency of RAGE and OSM as new prognosis biomarkers of severe pneumonia. Methods Eligible patients were classified into hypoxemia and nonhypoxemia groups. Meanwhile, the same cohort was divided into survival and nonsurvival groups after a post-hospital stay of 30 days. We analyzed risk factors for the hypoxia and death among these patients. Results Compared with nonsurvival group, significant increase was noticed in PH, lymphocyte, albumin and platelet level in survival group, while significant decline was noticed in neutrophils, RBC, hemoglobin, hematocrit, creatinine, total bilirubin, CRP, PCT, OSM, RAGE and neutrophils/lymphocyte level. Oxygenation index level was related to APACHE II, LIS, SOFA, NUTRIC score, WBC, neutrophils, lymphocyte, RAGE, and albumin level (p < 0.05). LIS, SOFA, NUTRIC score, lac, lymphocyte, platelet, BUN, total bilirubin, PCT, and OSM levels were associated with mortality rate (p < 0.05). Conclusions RAGE and OSM may serve as a new biomarker for poor prognosis in pneumonia patients.
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Partouche B, Pepin M, de Farcy PM, Kahn JE, Sawczynski B, Lechowski L, Teillet L, Barbot F, Herr M, Davido B. Persistent eosinopenia is associated with in-hospital mortality among older patients: unexpected prognostic value of a revisited biomarker. BMC Geriatr 2021; 21:557. [PMID: 34649512 PMCID: PMC8516088 DOI: 10.1186/s12877-021-02515-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 09/29/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction Infection is one of the major causes of mortality and morbidity in older adults. Available biomarkers are not associated with prognosis in older patients. This study aimed to analyze the value of eosinopenia (eosinophil count< 100/mm3) as a prognosis marker among older patients with suspected or confirmed bacterial infection. Methods A retrospective study was performed from 1 January to 31 December 2018 among patients in a geriatrics ward suffering from a bacterial infection treated with antibiotics. Biomarker data including the eosinophil count, neutrophil count and C-reactive protein (CRP) were collected within 4 days after patient diagnosis. Persistent eosinopenia was defined as a consistent eosinophil count< 100/mm3 between Day 2 and Day 4. The association of biomarkers with 30-day hospital mortality in a multivariate analysis was assessed and their predictive ability using the area under the ROC curve (AUC) was compared. Results Our study included 197 patients with a mean age of 90 ± 6 years. A total of 36 patients (18%) died during their stay in hospital. The patients who died were more likely to have persistent eosinopenia in comparison to survivors (78% versus 34%, p < 0.001). In the multivariate analysis, persistent eosinopenia was associated with in-hospital mortality with an adjusted HR of 8.90 (95%CI 3.46–22.9). The AUC for eosinophil count, CRP and neutrophil count between Day 2 and Day 4 were 0.7650, 0.7130, and 0.698, respectively. Conclusion Persistent eosinopenia within 4 days of diagnosis of bacterial infection appeared to be a predictor of in-hospital mortality in older patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02515-0.
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Affiliation(s)
- Bethsabee Partouche
- Geriatrics Department, Paris-Saclay University, Versailles Saint Quentin en Yvelines University (UVSQ), AP-HP Ambroise Paré Hospital, 92100, Boulogne-Billancourt, France
| | - Marion Pepin
- Geriatrics Department, Paris-Saclay University, Versailles Saint Quentin en Yvelines University (UVSQ), AP-HP Ambroise Paré Hospital, 92100, Boulogne-Billancourt, France.,Paris-Saclay University, UVSQ, Inserm, CESP, Clinical Epidemiology, 92100, Boulogne Billancourt, France
| | - Pauline Mary de Farcy
- Geriatrics Department, Paris-Saclay University, UVSQ, AP-HP, Ste Périne Hospital, 75016, Paris, France
| | - Jean-Emmanuel Kahn
- Internal Medicine Department, Paris-Saclay University, UVSQ, AP-HP, Ambroise Paré Hospital, 92100, Boulogne-Billancourt, France
| | - Bruno Sawczynski
- Medical Information Department (DIM), Paris-Saclay University, AP-HP, Ambroise Paré Hospital, 92100, Boulogne-Billancourt, France
| | - Laurent Lechowski
- Geriatrics Department, Paris-Saclay University, UVSQ, AP-HP, Ste Périne Hospital, 75016, Paris, France
| | - Laurent Teillet
- Geriatrics Department, Paris-Saclay University, Versailles Saint Quentin en Yvelines University (UVSQ), AP-HP Ambroise Paré Hospital, 92100, Boulogne-Billancourt, France
| | - Frederic Barbot
- Paris-Saclay University, AP-HP, Raymond Poincaré Hospital, Clinical Investigation Center, Inserm (CIC 1429), 92380, Garches, France
| | - Marie Herr
- Epidemiology and Public Health Department, Paris-Saclay University, UVSQ, Inserm, CESP, Anti-infective evasion and pharmacoepidemiology; AP-HP, Raymond-Poincaré Hospital, 92380, Garches, France
| | - Benjamin Davido
- Infectious and Tropical Disease Department, Paris-Saclay University, UVSQ, AP-HP, Raymond Poincaré Hospital, 92380, Garches, France.
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Takeda S, Nagata N, Ueda Y, Ikeuchi N, Akagi T, Harada T, Miyazaki H, Ushijima S, Aoyama T, Yoshida Y, Yatsugi H, Wada K, Ishii H, Fujita M, Watanabe K. Study of factors related to recurrence within 30 days after pneumonia treatment for community-onset pneumonia. J Infect Chemother 2021; 27:1683-1688. [PMID: 34483030 DOI: 10.1016/j.jiac.2021.08.002] [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: 04/11/2021] [Revised: 07/30/2021] [Accepted: 08/02/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION It is not uncommon for patients hospitalized with pneumonia to experience an early relapse. Here, we investigated the factors related to pneumonia recurrence in Japan. PURPOSE We aimed to elucidate the factors related to early recurrence after completion of pneumonia treatment. METHODS We examined 696 patients with community-acquired pneumonia (CAP) and nursing and healthcare-associated pneumonia (NHCAP) who were admitted to our hospital between October 2010 and February 2018, excluding those who died during hospitalization. Logistic regression analysis was used to assess the endpoint of recurrence within 30 days after the end of antibiotic treatment. RESULTS NHCAP, chronic lung disease and duration of antibiotic treatment were significant risk factors for recurrence of pneumonia within 30 days after antibiotic discontinuation. Aspiration pneumonia was not be a significant factor in the early recurrence of pneumonia. CONCLUSIONS Long-term use of antimicrobials may be a risk factor in early recurrence of pneumonia.
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Affiliation(s)
- Satoshi Takeda
- Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan.
| | - Nobuhiko Nagata
- Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan
| | - Yusuke Ueda
- Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan
| | - Nobumitsu Ikeuchi
- Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan
| | - Takanori Akagi
- Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan
| | - Taishi Harada
- Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan
| | - Hiroyuki Miyazaki
- Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan
| | - Shinichiro Ushijima
- Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan
| | - Takashi Aoyama
- Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan
| | - Yuji Yoshida
- Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan
| | - Hiroshi Yatsugi
- Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan
| | - Kenji Wada
- Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan
| | - Hiroshi Ishii
- Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan
| | - Masaki Fujita
- Department of Respiratory Medicine, Fukuoka University, Jonan-ku, Fukuoka, Japan
| | - Kentaro Watanabe
- Department of Respiratory Medicine, Fukuoka University, Jonan-ku, Fukuoka, Japan
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Jiang L, Lin SH, Wang J, Chu CK. Prognostic values of procalcitonin and platelet in the patient with urosepsis. Medicine (Baltimore) 2021; 100:e26555. [PMID: 34232197 PMCID: PMC8270606 DOI: 10.1097/md.0000000000026555] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 06/07/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The patient suffering from urinary sepsis is often accompanied by elevated serum procalcitonin (PCT) levels and a decline in the average platelet count (PLT), which could result in a poor prognosis. This study aimed to evaluate the value of PCT and PLT in determining the severity of urinary sepsis. METHODS A total of 120 urosepsis patients enrolled were divided into a survival group and a death group, respectively, according to their status within 14 days after admission. Changes in PCT and PLT levels between the 2 groups were compared at different time points. A receiver operating characteristic (ROC) curve was eventually obtained to predict the prognostic value of PCT and PLT. RESULTS The PCT levels in the survival group declined gradually after admission, and the PLT decreased at first but increased rapidly in subsequence. The PCT level in the death group, however, declined in a flat-slope trend or was hardly noticeable together with the number of PLT reduced significantly. In particular, it is on the 3rd day that PCT tended to positively correlate with acute physiological and chronic health score II (APACHE II) score (r = 0.730, P < .05), but negatively with PLT (r = 0.472, P < .05). The APACHE II score and PLT (r = 0.612, P < .05) were also negatively correlated with each other. As indicated by the ROC curve, the PCT level on the 3rd day after admission was of great value for the clinical mortality prognosis, and the area under the curve was 0.858. Moreover, PLT also has a high predictive value for prognosis. Area under the curve is 0.951. When the PLT was more than 51 × 109 /L, the sensitivity was up to 90%, and the specificity was 90%. CONCLUSION PLT and PCT levels are closely related to the APACHE II score, which could indicate the severity of urosepsis in patients. The contribution of this study was to confirm that dynamic monitoring of the changes in PCT and PLT helps determine the prognosis of urosepsis patients.
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Affiliation(s)
- Ling Jiang
- Department of Clinical Laboratory Center, Rongcheng Hospital Affiliated to Shandong First Medical University, Rongcheng, P.R. China
| | - Shao-Hua Lin
- Department of Respiratory and Critical Care Medicine, Rongcheng Hospital Affiliated to Shandong First Medical University, Rongcheng, P.R. China
| | - Jun Wang
- Department of Urology, Rongcheng Hospital Affiliated to Shandong First Medical University, Rongcheng, P.R. China
| | - Cun-Kun Chu
- Library Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, P.R. China
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Evaluation of severity scoring systems in patients with severe community acquired pneumonia. ACTA ACUST UNITED AC 2021; 59:394-402. [PMID: 34182618 DOI: 10.2478/rjim-2021-0025] [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: 05/04/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the ability of severity scoring systems to predict 30-day mortality in patients with severe community-acquired pneumonia. METHODS The study included 98 patients aged ≥18 years with community acquired pneumonia hospitalized at the Intensive Care Unit of the University Clinic for Infectious Diseases in Skopje, Republic of North Macedonia, during a 3-year period. We recorded demographic, clinical and common biochemical parameters. Five severity scores were calculated at admission: CURB 65 (Confusion, Urea, Respiratory Rate, Blood pressure, Age ≥65 years), SCAP (Severe Community Acquired Pneumonia score), SAPS II (Simplified Acute Physiology Score), SOFA (Sequential Organ Failure Assessment Score) and MPM (Mortality Prediction Model). Primary outcome variable was 30-day in-hospital mortality. RESULTS The mean age of the patients was 59.08 ± 15.76 years, predominantly males (68%). The overall 30-day mortality was 52%. Charlson Comorbidity index was increased in non-survivors (3.72 ± 2.33) and was associated with the outcome. All severity indexes had higher values in patients who died, that showed statistical significance between the analysed groups. The areas under curve (AUC) values of the five scores for 30-day mortality were 0.670, 0.732, 0,726, 0.785 and 0.777, respectively. CONCLUSION Widely used severity scores accurately detected patients with pneumonia that had increased risk for poor outcome, but none of them individually demonstrated any advantage over the others.
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Zhang R, Ma J, Zheng P, Zheng R, Meng X, Wang Y. Ulinastatin plus biapenem for severe pneumonia in the elderly and its influence on pulmonary function and inflammatory cytokines. Am J Transl Res 2021; 13:5027-5034. [PMID: 34150088 PMCID: PMC8205704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 01/22/2021] [Indexed: 06/12/2023]
Abstract
UNLABELLED To estimate the efficacy of ulinastatin (UTI) plus biapenem (BIPM) in the treatment of severe pneumonia in the elderly and its influence on pulmonary function (PF) and inflammatory cytokines. METHODS We included 97 elderly patients with severe pneumonia in the present study. Patients in control group (n=47) were given BIPM, and those in research group (n=50) were treated with BIPM plus UTI. The clinical efficacy, adverse reactions, arterial blood gas (ABG) indices, PF and inflammatory cytokines were recorded. RESULTS Patients in the research group had earlier fever clearance, inflammation absorption and cough disappearance than those in control group, as well as better clinical efficacy. In addition, no significant differences were found in the incidence of adverse reactions between the two groups during treatment. Monitoring changes in ABG indices, PF, and inflammatory cytokines revealed increased levels of PaO2, pH, FEV1, FVC, FEV1/FVC after treatment, but levels of PaCO2, IL-1β, IL-6, TNF-α, and hs-CRP decreased compared to before treatment. Levels of indices that increased after treatment in the research group were higher than those in the control group, whereas the levels of other indices that decreased after treatment were lower. CONCLUSION The combination of UTI and BIPM shortens the time of symptom disappearance, enhances PF, and inhibits inflammation, achieving higher efficacy in the treatment of severe pneumonia in the elderly.
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Affiliation(s)
- Rui Zhang
- Intensive Care Unit, The First Hospital of Kunming Kunming 650224, Yunnan Province, China
| | - Jitao Ma
- Intensive Care Unit, The First Hospital of Kunming Kunming 650224, Yunnan Province, China
| | - Pengxiao Zheng
- Intensive Care Unit, The First Hospital of Kunming Kunming 650224, Yunnan Province, China
| | - Ruirui Zheng
- Intensive Care Unit, The First Hospital of Kunming Kunming 650224, Yunnan Province, China
| | - Xu Meng
- Intensive Care Unit, The First Hospital of Kunming Kunming 650224, Yunnan Province, China
| | - Yinjia Wang
- Intensive Care Unit, The First Hospital of Kunming Kunming 650224, Yunnan Province, China
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Gavrilova AA, Bontsevich RA, Vovk YR, Balabanova AA. Modern approaches to pharmacotherapy of Community-Acquired Pneumonia. RESEARCH RESULTS IN PHARMACOLOGY 2020. [DOI: 10.3897/rrpharmacology.6.52318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: The study presents current views on the pharmacotherapy of community-acquired pneumonia (CAP). This study also describes in general terms the current pharmacoepidemiological situation of the CAP in Russia and abroad, which can both help medical professionals make an informed choice when choosing a pharmacotherapy, and inspire them to follow-up research and observations.
The aim of the study is to conduct an analysis of the available research on the pharmacotherapy of CAP in order to accelerate the accumulation and assimilation of knowledge in the field of this pathology.
Materials and methods: The following databases of medical publications and electronic libraries were used to search for the relevant sources of information: PubMed, Medline, Google Scholar, Crossref, and eLIBRARY.RU.
Results and discussion: The choice of a rational antimicrobial therapy (AMT) for CAP is of high relevance due to the widespread of the pathology. The article highlights modern approaches to the pharmacotherapy of CAP in adults, including a review of promising new drugs, and presents the main problematic issues related to the emergence of antibiotic resistance of pathogens, as well as methods to combat it.
Conclusion: The analyzed and generalized results of the conducted research allow the authors to make a conclusion about the feasibility of a more detailed study and raising the level of awareness of medical professionals in this pathology.
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Matsuo A, Takamori A, Kawaura F, Iwanaga Y, Ono H, Kobayashi-Watanabe N, Kuwahara M, Takagi K, Nagasawa Z, Fujimoto K, Hayashi S. Risk for prolonged hospitalization and mortality in aged community acquired pneumonia patients: a retrospective study in Japan. J Clin Biochem Nutr 2020; 67:302-306. [PMID: 33293772 PMCID: PMC7705084 DOI: 10.3164/jcbn.20-85] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 05/29/2020] [Indexed: 12/18/2022] Open
Abstract
The present study aimed to reveal; i) risk for prolonged hospitalization and mortality in aged community acquired pneumonia patients, and ii) whether swallowing ability was related to re-hospitalization. The present retrospective study included 92 patients older than 75 years hospitalized with community acquired pneumonia in Takagi Hospital between April 2017 and March 2018. The patients were classified into 3 groups; discharged within 17 days (group I): hospitalized more than 18 days (group II): died during the hospitalization (group III). Swallowing ability was evaluated if available. Univariate analysis indicated males and body mass index (BMI) in group I (n = 24) were higher than group II (n = 46). Group III (n = 22) had low serum albumin, low BMI, and severe disease progression compared with group I. Multivariate analysis demonstrated that group II BMI was lower than group I [odds ratio (OR) = 1.18, p = 0.042]. Group III had lower serum albumin level compared with group I (OR = 81.01, p = 0.025). Diabetes mellitus (p = 0.009), but not swallowing disability, was risk for readmission. Malnutrition represented by low albumin enhanced mortality rate in the pneumonia patients, and low BMI and diabetes mellitus might increase the pneumonia risk.
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Affiliation(s)
- Ayako Matsuo
- International University of Health and Welfare Graduate School of Medicine, 137-1 Enokizu, Ookawa-city, Fukuoka 831-8501, Japan.,Divisions of Respirology, Kouhou-kai Takagi Hospital, 141-11 Sakami, Ookawa-city, Fukuoka 831-0016, Japan
| | - Ayako Takamori
- Clinical Research Center, Saga University Hospital, 5-1-1 Nabeshima, Saga 849-8501, Japan
| | - Futoshi Kawaura
- Divisions of Respirology, Kouhou-kai Takagi Hospital, 141-11 Sakami, Ookawa-city, Fukuoka 831-0016, Japan
| | - Yasunari Iwanaga
- Otorhinolarygology, Kouhou-kai Takagi Hospital, 141-11 Sakami, Ookawa-city, Fukuoka 831-0016, Japan
| | - Hitomi Ono
- Divisions of Respirology, Kouhou-kai Takagi Hospital, 141-11 Sakami, Ookawa-city, Fukuoka 831-0016, Japan
| | - Naomi Kobayashi-Watanabe
- Divisions of Respirology, Kouhou-kai Takagi Hospital, 141-11 Sakami, Ookawa-city, Fukuoka 831-0016, Japan
| | - Motohisa Kuwahara
- Divisions of Respirology, Kouhou-kai Takagi Hospital, 141-11 Sakami, Ookawa-city, Fukuoka 831-0016, Japan
| | - Kuniaki Takagi
- International University of Health and Welfare Graduate School of Medicine, 137-1 Enokizu, Ookawa-city, Fukuoka 831-8501, Japan
| | - Zennzou Nagasawa
- International University of Health and Welfare Graduate School of Medicine, 137-1 Enokizu, Ookawa-city, Fukuoka 831-8501, Japan
| | - Kazuma Fujimoto
- International University of Health and Welfare Graduate School of Medicine, 137-1 Enokizu, Ookawa-city, Fukuoka 831-8501, Japan
| | - Shinnichiro Hayashi
- International University of Health and Welfare Graduate School of Medicine, 137-1 Enokizu, Ookawa-city, Fukuoka 831-8501, Japan.,Divisions of Respirology, Kouhou-kai Takagi Hospital, 141-11 Sakami, Ookawa-city, Fukuoka 831-0016, Japan
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12
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Cold-inducible RNA-binding protein might determine the severity and the presences of major/minor criteria for severe community-acquired pneumonia and best predicted mortality. Respir Res 2020; 21:192. [PMID: 32689999 PMCID: PMC7372799 DOI: 10.1186/s12931-020-01457-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 07/14/2020] [Indexed: 12/16/2022] Open
Abstract
Background Severity of community-acquired pneumonia (CAP) depends on microbial pathogenicity, load and virulence, and immune responses. The Infectious Disease Society of America and the American Thoracic Society (IDSA/ATS) minor criteria responsible for clinical triage of patients with CAP are of unequal weight in predicting mortality. It is unclear whether the IDSA/ATS major/minor criteria might be strongly and positively associated with the immune responses. It is warranted to explore this intriguing hypothesis. Methods A prospective cohort study of 404 CAP patients was performed. Cold-inducible RNA-binding protein (CIRP) levels were measured using a sandwich-based enzyme-linked immunosorbent assay. The receiver operating characteristic curves were created and the areas under the curves were calculated to illustrate and compare the accuracy of the indices. Results Severe CAP patients meeting the major criteria had the highest plasma concentrations of CIRP. The more the number of most predictive minor criteria strongly associated to mortality, i.e. arterial oxygen pressure/fraction inspired oxygen ≤ 250 mmHg, confusion, and uremia, present, the higher the CIRP level. Interestingly, the patients with non-severe CAP meeting the most predictive minor criteria demonstrated unexpectedly higher CIRP level compared with the patients with severe CAP not fulfilling the criteria. Procalcitonin (PCT), interleukin-6 (IL-6), C-reactive protein (CRP), sequential organ failure assessment (SOFA) and pneumonia severity index (PSI) scores, and mortality confirmed similar intriguing patterns. CIRP was strongly linked to PCT, IL-6, CRP, minor criteria, SOFA and PSI scores, and mortality (increased odds ratio 3.433). The pattern of sensitivity, specificity, positive predictive value, and Youden’s index of CIRP ≥ 3.50 ng/mL for predicting mortality was the optimal. The area under the receiver operating characteristic curve of CIRP was the highest among the indices. Conclusions CIRP levels were strongly correlated with the IDSA/ATS major/minor criteria. CIRP might determine the severity and the presences of major/minor criteria and best predicted mortality, and a CIRP of ≥ 3.50 ng/mL might be more valuable cut-off value for severe CAP, suggesting that CIRP might be a novel and intriguing biomarker for pneumonia to monitor host response and predict mortality, which might have implications for more accurate clinical triage decisions.
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Spoto S, Legramante JM, Minieri M, Fogolari M, Terrinoni A, Valeriani E, Sebastiano C, Bernardini S, Ciccozzi M, Angeletti PS. How biomarkers can improve pneumonia diagnosis and prognosis: procalcitonin and mid-regional-pro-adrenomedullin. Biomark Med 2020; 14:549-562. [DOI: 10.2217/bmm-2019-0414] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Aim: The diagnostic and prognostic role of procalcitonin (PCT) and mid-regional-pro-adrenomedullin (MR-proADM) were investigated in patients with pneumonia. Material & methods: A total of 168 and 77 patients with pneumonia enrolled in two different hospital settings, an internal medicine unit and an emergency unit were included in the study. PCT and MR-proADM plasma concentrations and pneumonia severity index score were measured. Median values were compared by Mann–Whitney’s test. Receiver operating characteristic analysis and rank correlation were used to define the diagnostic and prognostic accuracy. Results: PCT confirmed the diagnostic role at values 0.08–0.10 ng/ml and MR-proADM the prognostic role for severe pneumonia. Significant correlation (p < 0.0001) between MR-proADM and pneumonia severity index score indicated expression of pneumonia severity. Conclusion: This combination of biomarkers presents a high positive predictive value in pneumonia diagnosis and prognosis.
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Affiliation(s)
- Silvia Spoto
- Internal Medicine Department, University Campus Bio-Medico of Rome, Italy
| | - Jacopo M Legramante
- Emergency Department, Policlinico Tor Vergata, Roma, Italy
- Department of Medical Systems, Università di Tor Vergata, Roma, Italy
| | - Marilena Minieri
- Department of Experimental Medicine & Surgery, Università di Tor Vergata, Roma, Italy
- Department of Laboratory Medicine, Policlinico Tor Vergata, Roma, Italy
| | - Marta Fogolari
- Unit of Clinical Laboratory Science, University Campus Bio-Medico of Rome, Italy
| | - Alessandro Terrinoni
- Department of Experimental Medicine & Surgery, Università di Tor Vergata, Roma, Italy
| | - Emanuele Valeriani
- Department of Internal Medicine ‘SS.ma Annunziata' Hospital, Chieti, Italy
| | | | - Sergio Bernardini
- Department of Experimental Medicine & Surgery, Università di Tor Vergata, Roma, Italy
- Department of Laboratory Medicine, Policlinico Tor Vergata, Roma, Italy
| | - Massimo Ciccozzi
- Unit of Medical Statistics & Molecular Epidemiology, University Campus Bio-Medico of Rome, Italy
| | - Prof S Angeletti
- Unit of Clinical Laboratory Science, University Campus Bio-Medico of Rome, Italy
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