Increased plasma vaspin concentration in patients with sepsis: an exploratory examination

Introduction

Vaspin (visceral adipose tissue-derived serpin) was first described as an insulin-sensitizing adipose tissue hormone. Recently its anti-inflammatory function has been demonstrated. Since no appropriate data is available yet, we sought to investigate the plasma concentrations of vaspin in sepsis.

Materials and methods

57 patients in intensive care, fulfilling the ACCP/SCCM criteria for sepsis, were prospectively included in our exploratory study. The control group consisted of 48 critically ill patients, receiving intensive care after trauma or major surgery. Patients were matched by age, sex, weight and existence of diabetes before statistical analysis. Blood samples were collected on the day of diagnosis. Vaspin plasma concentrations were measured using a commercially available enzyme-linked immunosorbent assay.

Results

Vaspin concentrations were significantly higher in septic patients compared to the control group (0.3 (0.1-0.4) ng/mL vs. 0.1 (0.0-0.3) ng/mL, respectively; P < 0.001). Vaspin concentration showed weak positive correlation with concentration of C-reactive protein (CRP) (r = 0.31, P = 0.002) as well as with SAPS II (r = 0.34, P = 0.002) and maximum of SOFA (r = 0.39, P < 0.001) scoring systems, as tested for the overall study population.

Conclusion

In the sepsis group, vaspin plasma concentration was about three-fold as high as in the median surgical control group. We demonstrated a weak positive correlation between vaspin and CRP concentration, as well as with two scoring systems commonly used in intensive care settings. Although there seems to be some connection between vaspin and inflammation, its role in human sepsis needs to be evaluated further.Key words: adipocytokine, inflammation, vaspin, CRP, intensive care     

Performance of D-dimer for predicting sepsis mortality in the intensive care unit

IntroductionThe prognostic value of D-dimer (DD) in sepsis remains controversial. This study aimed to investigate the performance of DD for predicting sepsis mortality in the hospital and for identifying its potential correlates.Materials and methodsThe clinical and laboratory data of adult sepsis patients were extracted from the Medical Information Mart for Intensive Care III (MIMIC III, v1.4) database using the structured query language (SQL). The database contains critical illness admitted to the intensive care unit at Beth Israel Deaconess Medical Center between June 2001 and October 2012. The association between DD and mortality was investigated with receiver operating characteristic (ROC) curve, restricted cubic spline and logistic regression analysis. Subgroup analysis was also used for identifying DD correlates.ResultsThe study population consisted of 358 sepsis patients. Those who died during hospital stay (N = 160) had significantly higher DD values than those who survived (N = 198). The area under the ROC curve (AUC) of DD was 0.59 (P < 0.010). In subgroup analysis, white blood cell (WBC) count > 18 x10⁹/L and vasopressor therapy significantly decreased DD diagnostic performance. Categorical DD value was independently associated with hospital mortality after sequential organ failure score (SOFA) and blood lactate adjustment. Restricted cubic spline analysis revealed a U-shape relationship between DD and in-hospital mortality.DiscussionWe conclude that the accuracy of DD for predicting in-hospital sepsis mortality depends on WBC count and vasopressor therapy. Both low and extremely elevated DD values are associated with higher risk of death.     

Platelet mono amine oxidase and plasma dopamine beta hydroxylase activity in patients with Schizophrenia

The activity of monoamine oxidase in platelets and of dopamine beta hydroxylase in plasma was determined in patients with schizophrenia. The activity of both the enzymes was found to be considerably decreased in patients with schizophrenia when compared to the levels noted in healthy subjects.     

Increased serum concentrations of Soluble CD40 Ligand as a prognostic marker in patients with Acute Coronary Syndrome

CD40-CD40L interaction plays a significant role in the pathogenesis of atherosclerosis and coronary artery disease. The clinical predictive value of Soluble CD40 Ligand (sCD40L) was evaluated in patients with Acute Coronary Syndrome (ACS) and Non-Cardiac Chest Pain (NCCP). The levels of serum soluble CD 40 ligand were measured by ELISA in 485 patients admitted to emergency care unit, of which 89 patients were diagnosed as NCCP. The levels of sCD40L were significantly increased in patients with ACS when compared to controls and NCCP. Receiver Operator Characteristic (ROC) Curve analysis showed sCD40L to be a good discriminator between patients with ischemic heart disease and patients without ischemic heart disease. The area under the curve was found to be 0.940 with 95% CI (0.915 to 0.960) (P<0.0001). The cut off value from the ROC curve was 2.99 ng/ml, above which sCD40L was considered to be positive. Combined assessment of sCD40L, Troponin I and CK-MB enhanced the risk prediction and early classification of patients. sCD40L seems to be a promising biomarker for identification and risk stratification for patients with acute coronary syndrome.     

Platelet factor 3 availability time,plasma phenol and phenolic acids in patients with uremia

Platelet factor 3 availability time (PF3 AT), Prothrombin time (PT), Plasma phenol, phenolic acids, blood urea and serum creatinine were estimated in 31 uremic patients. Significant increase (P<0.01) in PF3 AT and plasma phenolic acid was seen in 100 per cent of cases, while the increase in plasma phenol was seen in 90.3% of cases. The increase in PF3 AT was not uniformly proportional to the increase in plasma phenol or phenolic acids in all cases. Increase in PF3 AT was significant in cases of uremia with bleeding diathesis compared to the cases without bleeding diathesis. Increase in PF3 AT after addition of phenol and urea together to normal platelet rich plasma (PRP) in vitro was greater than the increase in PF3 AT after the addition of phenol or urea alone. Significant decrease (P<0.01) in PF3 AT, plasma phenol, plasma phenolic acids, blood urea and serum creatinine was seen in uremic patients after haemodialysis indicating that the retained toxic metabolites which increase PF3 AT are dializable substances.     

Complete blood count alterations in COVID-19 patients: A narrative review

Coronavirus disease 2019 (COVID-19) pandemic represents a scientific and social crisis. One of the main unmet needs for coronavirus disease 2019 is its unpredictable clinical course, which can rapidly change in an irreversible outcome. COVID-19 patients can be classified into mild, moderate, and severe. Several haematological parameters, such as platelets, white blood cell total count, lymphocytes, neutrophils, (together with neutrophil-lymphocyte and platelet-lymphocyte ratio), and haemoglobin were described to be associated with COVID-19 infection and severity. The purpose of these review is to describe the current state of the art about complete blood count alterations during COVID-19 infection, and to summarize the crucial role of some haematological parameters during the course of the disease. Decreased platelet, lymphocyte, haemoglobin, eosinophil, and basophil count, increased neutrophil count and neutrophil-lymphocyte and platelet-lymphocyte ratio have been associated with COVID-19 infection and a worse clinical outcome. Our study adds some novelty about the identification of effective biomarkers of progressive disease, and might be helpful for diagnosis, prevention of complications, and effective therapy.     

PCT as a Prognostic Marker in Cardiac Patients with Neutropenic Sepsis: Two Case Reports

Procalcitonin (PCT) is an innovative and highly specific marker for diagnosis of clinically relevant bacterial infection and sepsis. PCT supports early diagnosis and Clinical decision making. A retrospective study of two classical cases of neutropenic sepsis with elevated PCT levels in cardiac ICU was done. PCT was analyzed using Elecsys Brahms PCT kit. Serum PCT levels <0.5 ng/ml and ANC <1,000/mm³ was taken as cutoff. The first patient had initial high levels of PCT 100 ng/ml, TLC 13,600/mm³ and ANC 12,250/mm³. It was followed by drop with subsequent rise in PCT levels and drop in TLC 1,000/mm³ and ANC 70/mm³. The second patient had normal PCT 0.116 ng/ml, TLC 5,600/mm³ and ANC 4,420/mm³ levels followed with sharp increase in all the values with subsequent drop in TLC 2,000/mm³ and ANC 880 cells/mm³. Both the patients died of neutropenic sepsis with multiorgan failure. The case reports showed the correlation of PCT with TLC and ANC levels in predicting the mortality of patients with neutropenic sepsis in cardiac ICU.     

北方农村地区火墙兼生活热水系统应用实验研究

火墙系统包括炉灶(或火炉)、火墙、烟囱,作为一种建筑传统供暖系统,近年来,依然是新疆大部分农村地区民居采用的主要供暖形式。目前使用的火墙,建造多以经验为指导,性能参差不齐,普遍存在排烟温度高,能耗大,能源利用率低的缺点。本文针对上述缺点,提出了供暖火墙兼生活热水系统,即在原有火墙中加入了生活热水加热铜盘管。在不同室外温度下,满足室内热舒适性条件下,对该系统的能源利用率进行了实验研究并与传统火墙进行了对比。实验结果表明,供暖火墙兼生活热水系统的新式火墙能在保证室内热舒适性的同时又可以用烟气加热生活用水,降低了排烟温度,明显提高能源利用率,具有现实的推广和深入研究的意义。     

Altered pattern of lipids in plasma and erythrocyte membranes of rheumatoid arthritis patients

The present study has investigated the levels of lipids, lipoprotein cholesterol (HDL and LDL cholesterol), thiobarbituric acid reactive substances (TBARS) and vitamin E in plasma and erythrocyte membranes of twenty two clinically diagnosed adult rheumatoid arthritis patients and an equal number of age matched healthy subjects. The levels of lipids and lipoprotein cholesterol were markedly reduced in patients with rheumatoid arthritis as compared to healthy subjects. The altered lipid pattern may be related to decreased lipoprotein cholesterol, fatty acids and impairment in antioxidant defence mechanism.     

经皮冠状动脉介入术后护理进展

文章从经皮冠状动脉治疗(PCI)的相关知识、术后的一般护理、病情观察、拔除鞘管的护理、抗凝治疗护理、并发症的预防、心理护理及康复指导方面对经皮冠状动脉介入术后的护理进展进行了综述。     

Evaluation of serum zinc level and plasma SOD activity in senile cataract patients under oxidative stress

An imbalance in the systemic redox status leading to oxidative stress has been an important factor in development of senile cataracts, which is reflected by an increase in serum TBARS and a decrease in plasma SOD activity. Zinc has been an important cofactor required for structural stability of SOD. In the present study the role of serum zinc level and plasma SOD activity was analyzed in senile cataract patients showing significant oxidative stress. Serum TBARS, plasma SOD and serum zinc level was measured in thirty randomly selected senile cataract patients against properly matched controls. Although, the analysis of means showed a significant increase in serum TBARS and decrease in plasma SOD and serum zinc level in cases, but plasma SOD was found to be just significantly correlated (p=0.05) with the serum zinc only in the cases. The results of partial correlation studies and multiple regression analysis, also, showed only a significant correlation and predictable dependence between serum TBARS and plasma SOD, excluding any role of serum zinc level. The present study concludes that it is chiefly the plasma SOD activity, but not the serum zinc level, that determines the proneness of the patients for development of senile cataract.     

X-linked adreno leukodistrophy: Profiles of very long chain fatty acids in plasma and fibroblasts in eigth Serbian patients

X-linked adrenoleukodistrophy is a severe neurodegenerative disorder with impaired very long chain fatty acid metabolism. The disease associated ABCD1 gene encodes a peroxisomal membrane protein which belongs to the superfamily of ATP-binding cassette transporters. We investigated eight male X-ALD patients diagnosed among 142 suspected patients referred for investigation. Plasma levels of very long chain fatty acids were measured at our laboratory using capillary gas chromatography. Eight cases of childhood X-ALD were diagnosed. This is the first published series of Serbian patients with X-ALD. In addition, diagnosis identifies carriers, which could be benefit for genetic counselling and prenatal diagnosis.     

不同城市化水平下中国粮食主产区耕地集约利用差异及其政策启示——以江西省和江苏省为例

本文提出从利用投入和产出效应2个方面测度耕地集约利用,并构建耕地集约利用评价的3种基本类型:粗放化型、集约化型和过度化型.以处于不同城市化水平下的江西省和江苏省两个粮食主产区为例,剖析两省2001年-2010年耕地(水稻种植)集约利用的差异及其政策启示.结果表明:①近10a来,城市化水平低的江西省单位耕地面积水稻种植总投入、省工性投入和增产性投入与城市化水平高的江苏省的差距明显缩小,其中省工性投入的差距最小,而江西省的水稻单产,尤其是水稻净利润在2010年进一步低于江苏省;②尽管江西省和江苏省耕地利用属于集约化型的年份均最多,但属于过度化型的年份比例偏高,分别为33.33％和22.22％,这说明两省尤其是江西省耕地产出效应没有同步跟进或者需要进一步跟进耕地利用投入;③江苏省应凭借自身优势推行农业现代化,江西省需增加以增产性投入为核心的农业投入和推行以加大种粮补贴、提高粮食收购价格为重点的惠农政策.     

浅谈以药学服务为核心的高职药理学教学改革途径

以药学服务为核心的高职药理学教学方案是以开发和发展药学服务为中心出发,强调了药学服务的重要性,在原有基础上对传统高职药理学教学方案进行改革。高职药理学教学方案的改革过程要以社会需求和学生的就业方向为标准,做到教学过程与工作需求的结合。通过开展情境教学、案例教学、模拟教学等方式,让学生在课堂学习的过程中更加直观地认识和了解职业需求。对动物教学实验和药房教学内容进行优化改革,以第二课堂的形式丰富教师的课堂教学内容,使得以药学服务为核心的高职药理学教学改革方案更加适应当代社会的发展需求,让学生在社会中更具竞争力。     

Hyperinsulinemia and Hypoadiponectinemia are Associated with Increased Risk for Occurrence of Ovarian Cancer in Non-diabetic Women of North Indian Population

Ovarian cancer has been emerged as a most common and lethal gynecological malignancy in India. High serum insulin and low adiponectin have been associated with increased risk of ovarian cancer. But their role in development of ovarian cancer is conflicting and little evidence is available. We aimed to evaluate blood levels of insulin and adiponectin in epithelial ovarian cancer (EOC) patients and their association with the risk to develop EOC. The study included following three groups; Group 1: fifty cases of cytohistopathologically confirmed cases of EOC, Group 2: fifty age matched cases of benign ovarian conditions and Group 3: fifty ages matched healthy controls with no evidence of any benign or malignant ovarian pathology as ruled out by clinical examination and relevant investigations. Cytohistopathologically confirmed and newly diagnosed cases of EOC and benign ovarian cancer were included in this study. The median value of fasting serum insulin was significantly high (15.0 µlU/ml, P = 0.02) and adiponectin were significantly low (5.1 µg/ml, P < 0.001) in ovarian cancer patients compared to benign ovarian tumors and healthy controls group. A significant increase risk of ovarian cancer was found in high tertile (≥ 18.7 µlU/ml) of serum insulin level (OR = 2.7; 95% CI = 1.00–6.67, P = 0.04) and lower tertile (≤ 5.45 µg/ml) of adiponectin level (OR = 3.2; 95% CI = 1.10–9.71, P = 0.03). High serum insulin level and low adiponectin levels were significantly associated with increased risk for development of ovarian cancer.     

皮肤瘙痒症中糖尿病患者的调查研究

皮肤瘙痒症中内因-系统性疾病以糖尿病最为常见,也是常易被忽略的疾病之一。本研究通过对临床上皮肤瘙痒症患者的血糖情况进行调查,发现皮肤瘙痒症中糖尿病或糖耐量异常患者占13.8%,其血糖升高主要以餐后2小时为主,提示临床上应予重视皮肤瘙痒症患者的血糖情况,以免漏诊糖尿病患者。     

Antioxidant status in patients with acute myocardial infarction

Free radicals play an important role in the pathogenesis of tissue damage in many clinical disorders, including atherosclerosis. Antioxidants protect the body from damage caused by free radicals. In this study we investigated oxidative stress, antioxidants and inflammatory molecules in patients with acute myocardial infarction. This study has been carried out on 106 patients with acute myocardial infarction, (89 men and 17 females). The control group consisted of 50 healthy, age-matched subjects (40 men and 10 females). Levels of Glucose, lipid profile, glutathione reduced, glutathione peroxidase, Superoxide dismutase, Glycosylated hemoglobin, fibrinogen, vitamin C, vitamin E, malondialdehyde, ceruloplasmin, adenosine deaminase, lysozyme and sialic acid were measured. Malondialdehyde and ceruloplasmin levels were significantly high and antioxidants such as vitamin C, vitamin E, glutathione reduced, glutathione peroxidase and superoxide dismutase were significantly decreased in diabetic and non-diabetic AMI patients as compared with control (p<0.001). Inflammatory markers showed significant rise in diabetic patients as compared with controls. Our results clearly show increased inflammation and oxidative stress in patients with acute myocardial infarction. Depression of antioxidant system in these patients confirms this conclusion.     

Comparison of digoxin concentration in plastic serum tubes with clot activator and heparinized plasma tubes

Introduction:

Sample type recommended by the manufacturer for the digoxin Abbott assay is either serum collected in glass tubes or plasma (sodium heparin, lithium heparin, citrate, EDTA or oxalate as anticoagulant) collected in plastic tubes. In our hospital samples are collected in plastic tubes. Our hypothesis was that the serum sample collected in plastic serum tube can be used interchangeably with plasma sample for measurement of digoxin concentration. Our aim was verification of plastic serum tubes for determination of digoxin concentration.

Materials and methods:

Concentration of digoxin was determined simultaneously in 26 venous blood plasma (plastic Vacuette, LH Lithium heparin) and serum (plastic Vacuette, Z Serum Clot activator; both Greiner Bio-One GmbH, Kremsmünster, Austria) samples, on Abbott AxSYM analyzer using the original Abbott Digoxin III assay (Abbott, Wiesbaden, Germany). Tube comparability was assessed using the Passing Bablok regression and Bland-Altman plot.

Results:

Serum and plasma digoxin concentrations are comparable. Passing Bablok intercept (0.08 [95% CI = −0.10 to 0.20]) and slope (0.99 [95% CI = 0.92 to 1.11]) showed there is no constant or proportional error.

Conclusion:

Blood samples drawn in plastic serum tubes and plastic plasma tubes can be interchangeably used for determination of digoxin concentration.     

Association of plasma level of thiobarbituric acid reactive substances with extent of hepatocellular injury in preterm infants with cholestatic jaundice

The present study was designed to determine the association between extent of hepatocellular injury and plasma level of thiobarbituric acid reactive substances (TBARS) in pre term infants with cholestasis. Preterm infants (<35 weeks gestation) admitted to the neonatal intensive care unit were enrolled (with their parents informed consent) in either the ‘cholestasis’ group (if their direct bilirubin was >2 mg/dl) (n=25) or in the control group (n=16). Blood samples for measurement of TBARS, direct bilirubin and transaminases were obtained with-in 24 hours of enrollment. The cholestasis and control groups were comparable with respect to gestational age, birth weight and Apgar score. Serum direct bilirubin, SGOT (EC 2.6.1.1) and SGPT (EC 2.6.1.2) levels were significantly high in the cholestasis group. Plasma levels of TBARS in cholestasis group were correlated with SGOT (F=276.92; P<0.0001) and SGPT (F=355.17; P<0.0001) and differed significantly between cholestatic and control infants. Our findings suggest that oxidative stress in preterm infants with cholestasis is associated with hepatocellular injury.