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Salivary inflammatory cytokines echo the low inflammatory burden in liver-transplanted children. Clin Oral Investig 2020; 25:2993-2998. [PMID: 33140161 DOI: 10.1007/s00784-020-03619-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 10/01/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVES The aims of this study were to compare the salivary cytokine profile, as a potential replacement for blood tests, in liver-transplanted children to that of a control group of healthy children, and to correlate the values of commonly tested laboratory blood tests to those of published blood values. METHODS Liver-transplanted children, and a control group of healthy children of the same sex and age distribution, were recruited for the study. Saliva was collected at the same appointment for routine blood tests for the liver-transplanted children. Saliva was also collected from a control group of healthy children with similar age and sex distributions. Normal healthy blood values were extracted from the literature, for comparison. Cytokine levels in the saliva were quantified with ELISA. The analysis compared serum and saliva values between liver-transplanted and healthy children. In the serum, the values of albumin, GIT, GPT, GGT, CRP, WBC, neutrophils, and lymphocytes were examined, while the levels of IL-6, CXCL1, IL-1b, and IL-10 were measured in the saliva. RESULTS Thirty liver-transplanted children and 30 healthy children were included in the study. Compared with published data for healthy children, the liver-transplanted group showed similar hepatic serum levels, yet reduced levels of serum inflammatory markers. Compared with the control group, in the transplanted group, the mean value of IL-6 was lower and the mean value of CXCL1 was similar. Interestingly, the anti-inflammatory IL-10 cytokine was lower in the transplanted group, while the pro-inflammatory IL-1β cytokine was higher. CONCLUSION The salivary inflammatory markers examined showed a similar pattern to the serum inflammatory values, though different markers were examined in the serum and saliva. CLINICAL RELEVANCE The current study stresses the potential of oral fluids as an accessible biofluid, for use as a diagnostic substrate for systemic and oral diseases. TRIAL REGISTRATION 0136-16-RMC, Registered on 01 March 2018.
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Higdon MM, Le T, O'Brien KL, Murdoch DR, Prosperi C, Baggett HC, Brooks WA, Feikin DR, Hammitt LL, Howie SRC, Kotloff KL, Levine OS, Scott JAG, Thea DM, Awori JO, Baillie VL, Cascio S, Chuananon S, DeLuca AN, Driscoll AJ, Ebruke BE, Endtz HP, Kaewpan A, Kahn G, Karani A, Karron RA, Moore DP, Park DE, Rahman MZ, Salaudeen R, Seidenberg P, Somwe SW, Sylla M, Tapia MD, Zeger SL, Deloria Knoll M, Madhi SA. Association of C-Reactive Protein With Bacterial and Respiratory Syncytial Virus-Associated Pneumonia Among Children Aged <5 Years in the PERCH Study. Clin Infect Dis 2018; 64:S378-S386. [PMID: 28575375 PMCID: PMC5447856 DOI: 10.1093/cid/cix150] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background. Lack of a gold standard for identifying bacterial and viral etiologies of pneumonia has limited evaluation of C-reactive protein (CRP) for identifying bacterial pneumonia. We evaluated the sensitivity and specificity of CRP for identifying bacterial vs respiratory syncytial virus (RSV) pneumonia in the Pneumonia Etiology Research for Child Health (PERCH) multicenter case-control study. Methods. We measured serum CRP levels in cases with World Health Organization-defined severe or very severe pneumonia and a subset of community controls. We evaluated the sensitivity and specificity of elevated CRP for "confirmed" bacterial pneumonia (positive blood culture or positive lung aspirate or pleural fluid culture or polymerase chain reaction [PCR]) compared to "RSV pneumonia" (nasopharyngeal/oropharyngeal or induced sputum PCR-positive without confirmed/suspected bacterial pneumonia). Receiver operating characteristic (ROC) curves were constructed to assess the performance of elevated CRP in distinguishing these cases. Results. Among 601 human immunodeficiency virus (HIV)-negative tested controls, 3% had CRP ≥40 mg/L. Among 119 HIV-negative cases with confirmed bacterial pneumonia, 77% had CRP ≥40 mg/L compared with 17% of 556 RSV pneumonia cases. The ROC analysis produced an area under the curve of 0.87, indicating very good discrimination; a cut-point of 37.1 mg/L best discriminated confirmed bacterial pneumonia (sensitivity 77%) from RSV pneumonia (specificity 82%). CRP ≥100 mg/L substantially improved specificity over CRP ≥40 mg/L, though at a loss to sensitivity. Conclusions. Elevated CRP was positively associated with confirmed bacterial pneumonia and negatively associated with RSV pneumonia in PERCH. CRP may be useful for distinguishing bacterial from RSV-associated pneumonia, although its role in discriminating against other respiratory viral-associated pneumonia needs further study.
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Affiliation(s)
- Melissa M Higdon
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, and
| | - Tham Le
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, and.,Department of Pharmaceutical Health Services Research, University of Maryland, Baltimore
| | - Katherine L O'Brien
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, and
| | - David R Murdoch
- Department of Pathology, University of Otago, and.,Microbiology Unit, Canterbury Health Laboratories, Christchurch, New Zealand
| | - Christine Prosperi
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, and
| | - Henry C Baggett
- Global Disease Detection Center, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi.,Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - W Abdullah Brooks
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka and Matlab.,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Daniel R Feikin
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, and.,Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Laura L Hammitt
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, and.,Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi
| | - Stephen R C Howie
- Medical Research Council Unit, Basse, The Gambia.,Department of Paediatrics, University of Auckland, and.,Centre for International Health, University of Otago, Dunedin, New Zealand
| | - Karen L Kotloff
- Division of Infectious Disease and Tropical Pediatrics, Department of Pediatrics, Center for Vaccine Development, Institute of Global Health, University of Maryland School of Medicine, Baltimore
| | - Orin S Levine
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, and.,Bill & Melinda Gates Foundation, Seattle, Washington
| | - J Anthony G Scott
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi.,Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, United Kingdom
| | - Donald M Thea
- Center for Global Health and Development, Boston University School of Public Health, Massachusetts
| | - Juliet O Awori
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi
| | - Vicky L Baillie
- Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, and.,Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Stephanie Cascio
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, and
| | | | - Andrea N DeLuca
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, and.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Amanda J Driscoll
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, and
| | | | - Hubert P Endtz
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka and Matlab.,Department of Clinical Microbiology and Infectious Diseases, Erasmus Medical Center, Rotterdam, The Netherlands.,Fondation Mérieux, Lyon, France ; Departments of
| | - Anek Kaewpan
- Global Disease Detection Center, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi
| | - Geoff Kahn
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, and.,Mental Health and
| | - Angela Karani
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi
| | - Ruth A Karron
- International Health, Center for Immunization Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - David P Moore
- Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, and.,Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases Unit, University of the Witwatersrand, Johannesburg, South Africa.,Department of Paediatrics and Child Health, Chris Hani Baragwanath Academic Hospital and University of the Witwatersrand, Johannesburg, South Africa
| | - Daniel E Park
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, and.,Milken Institute School of Public Health, Department of Epidemiology and Biostatistics, George Washington University, District of Columbia
| | | | - Rasheed Salaudeen
- Medical Research Council Unit, Basse, The Gambia.,Medical Microbiology Department, Lagos University Teaching Hospital, Nigeria
| | - Phil Seidenberg
- Center for Global Health and Development, Boston University School of Public Health, Massachusetts.,Department of Emergency Medicine, University of New Mexico, Albuquerque
| | - Somwe Wa Somwe
- Department of Paediatrics and Child Health, School of Medicine, University of Zambia, Lusaka
| | - Mamadou Sylla
- Centre pour le Développement des Vaccins (CVD-Mali), Bamako; and
| | - Milagritos D Tapia
- Division of Infectious Disease and Tropical Pediatrics, Department of Pediatrics, Center for Vaccine Development, Institute of Global Health, University of Maryland School of Medicine, Baltimore
| | - Scott L Zeger
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Maria Deloria Knoll
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, and
| | - Shabir A Madhi
- Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, and.,Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases Unit, University of the Witwatersrand, Johannesburg, South Africa
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Luo X, Tang X, Ma Y, Zhang Y, Fang S. The efficacy of negative pressure wound therapy in treating sacroiliac joint tuberculosis with a chronic sinus tract: a case series. J Orthop Surg Res 2015; 10:120. [PMID: 26243259 PMCID: PMC4525737 DOI: 10.1186/s13018-015-0250-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 06/30/2015] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Tuberculous sacroiliitis with abscess accounts for approximately 50 % of all sacroiliac joint tuberculosis cases. Tuberculous abscesses spread into the sacroiliac joint capsule, subcutaneous tissue, and the skin, and finally becomes a skin sinus. As there are no previous reports about sacroiliac joint tuberculosis with a chronic sinus, we evaluated its clinical characteristics and management by negative pressure wound therapy. METHODS A retrospective analysis of 12 patients with sacroiliac joint tuberculosis with chronic sinuses treated between January 2005 and January 2010 was conducted. Patients were treated with negative pressure wound therapy (NPWT). Treatment was divided into three phases: control phase, standard dressing changes daily for 4 weeks; interphase washout period, dressing changes every 3 days for 1 week; and intervention phase, no dressing changes until minimal sinus tract drainage (<5 ml per 24 h). Outcomes including the sinus healing time and the drainage volume were evaluated. RESULTS The mean follow-up was 37.1 months. Sinus healing was observed at an average of 25.25 ± 7.23 (range, 20-42) days after initial treatment. The mean volume of drainage did not change during the control phase, but decreased from 29.17 ± 16.63 to 0.25 ± 0.87 ml in the intervention phase. The mean daily reduction of wound volume, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) in the intervention phase was greater than in the control phase (P < 0.05). Anti-tubercular therapy was administered an average of 14.00 ± 2.95 (range, 12-18) months. ESR and CRP returned to normal within 3 months after the sinus closure. Bony fusion was observed in 5 (41.7 %) patients, and fibrous ankylosis in the other patients at last follow-up. All patients healed uneventfully. CONCLUSIONS Early diagnosis of sacroiliac joint tuberculosis with a chronic sinus can be difficult. NPWT provides better healing of sacroiliac joint tuberculosis with a chronic sinus than standard dressing changes.
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Affiliation(s)
- Xiaobo Luo
- Department of Orthopedics, General Hospital of Chinese People's Liberation Army (301 Hospital), No. 28 Fuxing Road, Beijing, 100853, China.
- Department of Orthopedics, The 309th Hospital of Chinese People's Liberation Army, Beijing, 100091, China.
| | - Xiangyu Tang
- Department of Orthopedics, General Hospital of Chinese People's Liberation Army (301 Hospital), No. 28 Fuxing Road, Beijing, 100853, China.
- Chinese People's Liberation Army 264 Hospital, Beijing, China.
| | - Yuanzheng Ma
- Department of Orthopedics, The 309th Hospital of Chinese People's Liberation Army, Beijing, 100091, China.
| | - Yonggang Zhang
- Department of Orthopedics, General Hospital of Chinese People's Liberation Army (301 Hospital), No. 28 Fuxing Road, Beijing, 100853, China.
| | - Shuzhi Fang
- Chinese People's Liberation Army 264 Hospital, Beijing, China.
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Bezerra ASDA, D'Ippolito G, Caldana RP, Cecin AO, Szejnfeld J. Avaliação hepática e esplênica por ressonância magnética em pacientes portadores de esquistossomose mansônica crônica. Radiol Bras 2004. [DOI: 10.1590/s0100-39842004000500003] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Avaliar, qualitativa e quantitativamente, as alterações morfológicas hepáticas e esplênicas por ressonância magnética (RM) em pacientes portadores de esquistossomose mansônica crônica, e a reprodutibilidade do método na avaliação hepatoesplênica destes pacientes. MATERIAIS E MÉTODOS: Realizou-se estudo prospectivo em 28 pacientes esquistossomóticos submetidos à RM de abdome superior. Os exames foram realizados em equipamento com alto campo (1,5 T), utilizando-se bobina de corpo e bomba injetora para a administração do contraste endovenoso, e interpretados por dois examinadores independentes, que avaliaram a presença de alterações morfológicas hepáticas e esplênicas. A concordância interobservador e intra-observador foram medidas pelo teste kappa e pelo teste do coeficiente de correlação intraclasses. RESULTADOS: As variáveis qualitativas e quantitativas apresentaram boa concordância interobservador e intra-observador (kapa > 0,65 e r > 0,66, respectivamente). A maior concordância interobservador foi obtida para o diâmetro ântero-posterior do baço (r = 0,98). Os observadores identificaram redução do lobo hepático direito, aumento do lobo hepático esquerdo e caudado associado a esplenomegalia em quase todos os pacientes, e alargamento de fissuras, heterogeneidade do parênquima hepático, irregularidade de contornos, vasos periféricos hepáticos e fibrose periportal em mais de 82% dos pacientes. CONCLUSÃO: As alterações morfológicas hepáticas caracterizam-se pela redução do lobo direito e aumento dos lobos caudado e esquerdo, e as esplênicas, pela presença de esplenomegalia e nódulos sideróticos. A RM apresenta elevada reprodutibilidade na avaliação dessas alterações em pacientes com esquistossomose mansônica crônica.
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