Search results

1

C-Reactive Protein as a Marker of Postoperative Septic Complications

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Witczak A., Jurałowicz P., Modzelewski B., Gawlik M.

Polish Journal of Surgery

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2012

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vol. 84

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issue 2

93-98

EN

The aim of the study was to answer the question whether or not determination of C-reactive protein in patients after serious abdominal surgeries can be prognostic of septic complications.Material and methods. 36 patients who underwent elective surgeries were included in the study. The patients were included either in the group where no postoperative SIRS developed or in the group where postoperative SIRS did occur. In the seven-day period after the surgery, in 26 patients SIRS was found, and in 10 - sepsis was suspected (according to the ACCP/SCCM definitions). In patients who underwent abdominal surgeries blood concentration of C-reactive protein was determined prior to the surgery (measurement '0'), and then on postoperative days 1, 2, 3, 5 and 7.Results. The test for two variables (C-reactive protein on postoperative days five and seven) showed statistically significant difference, and for one variable (C-reactive protein on day three) - difference at the limit of significance. Thus, it was found that in the postoperative SIRS group the level of C-reactive protein is higher than in the non-SIRS group.Conclusions. Serial measurements of C-reactive protein are useful in the first week after surgery, as they can be prognostic of postoperative septic complications. Such complications can be anticipated if CRP on postoperative day 5 is higher than 1/2 of the maximum CRP concentration on day 2 or day 3, or CRP > 150 mg/L as of postoperative day 3. Unfortunately, the severity of the disease cannot be projected based on C-reactive protein level.

2

C-Reactive Protein within the Wall of Large Abdominal Aortic Aneurysms; Pathophysiological Implications. A Preliminary Study

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Cnotliwy M., Kolasa A., Kwas A., Kazimierczak A., Wiernicki I.

Polish Journal of Surgery

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2010

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vol. 82

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issue 4

193-198

EN

The aim of the study was to evaluate the presence and distribution of C-reactive protein (CRP) at the site of the abdominal aortic aneurysm (AAA) suck to determine its potential role in AAA ruptureMaterial and methods. Samples of abdominal aortic aneurysms were obtained from 16 patients during elective surgery. These samples were taken from three places at each three levels of the aneurysmal sack: the neck, at the region of maximum diameter and above bifurcation. The cryostat sections were immunostained for CRP visualization using a specific primary mouse monoclonal anti-C-reactive protein antibody. All the specimens were analyzed morphometrically. The data was analized as the ratio of the active surface of the specimen to its total surface in percentage value.Results. No statistically significant differences between CRP concentrations were found that depended on the site of the aneurysmal sack. However, there exists an average linear correlation between CRP concentration, which is defined as the ratio of the active surface of the specimen to its total surface in percentage value, and the thickness of the adjacent thrombus (Pearson's correlation ratio; r=0.42) with statistical significance of (p<0.00001)Conclusions. The detection of C-reactive protein within the aneurismal wall is not solely sufficient to determine its role in the destruction that eventually leads to a large abdominal aortic aneurysm rupture. It is necessary then to prove an association between not only the metabolism of CRP but also the complement system activation and inflammatory cells response.

3

The 30-day mortality predictor role of c-reactive protein/albumin ratio in critically ill COPD patients.

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Özgür Cırık M., Baldemir R., Doğanay G. E., Ünver M., Avcı S.

Critical Care Innovations

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2020

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vol. 3

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issue 4

1-12

EN

INTRODUCTION: Chronic Obstructive Pulmonary Disease (COPD) is a progressive disease that develops due to inflammation in the airways. The aim of this study is to demonstrate the effectiveness of c-reactive protein/albumin ratio (CAR) as a 30-day mortality indicator in COPD patients admitted to ICU. MATERIAL AND METHODS: A total of 235 COPD patients with available data between January 2018 and December 2018 were included in this retrospective cohort study. Demographics, APACHE II, Charlson comorbidity index (CCI), SOFA score, CAR and outcomes were evaluated. RESULTS: 87 (37%) of the cases were female and 148 (63%) were male. Their ages ranged from 26 to 95 years, with an average of 70.9± 11.4. The non-survivors had significantly higher APACHE II, CCI, SOFA score, procalcitonin, creatinine, mechanical ventilation (MV) time, WBC, CRP and CAR compared to the survivors (p˂0.05). Albumin and prealbumin were significantly lower (p˂0.05) in non-survivors. In the univariate model; age, sepsis, inotropic support, APACHE II score, CCI, SOFA, procalcitonin, creatinine, MV time, WBC, CRP, albumin, prealbumin and CAR were observed to be significantly effective (p˂0.05) in predicting 30-day mortality. In the multivariate reduced model; inotropic support, SOFA, WBC and prealbumin value exhibited significant independent (p<0.05) effectiveness in predicting 30- day mortality. Albumin, CRP, CAR, APACHE II, SOFA and CCI value were observed to be significant in predicting mortality (p=0.000). CONCLUSIONS:In the study, the predictive power of APACHE II score, CCI, SOFA score, albumin and prealbumin values alone was found to be significantly higher than that of the CAR.

PL

WSTĘP: Przewlekła obturacyjna choroba płuc (POChP) jest chorobą postępującą, która rozwija się z powodu zapalenie dróg oddechowych. Celem pracy jest wykazanie skuteczności stosunku białka c-reaktywnego do albuminy (CAR) jako 30-dniowy wskaźnik śmiertelności chorych na POChP przyjętych na OIT. MATERIAŁ I METODY: Ogółem 235 pacjentów z POChP z dostępnymi danymi od stycznia 2018 do grudnia 2018 zostało uwzględnionych w retrospektywnym badaniu kohortowym. Oceniono czynniki demograficzne, APACHE II, wskaźnik chorób współistniejących Charlsona (CCI), wynik SOFA, i CAR. WYNIKI: 87 (37%) przypadków stanowiły kobiety, a 148 (63%) mężczyźni. Ich wiek wahał się od 26 do 95 lat, średnio 70,9 ± 11,4. Osoby, które nie przeżyły, miały znacząco wyższy wynik APACHE II, CCI, SOFA, prokalcytoniny, kreatyniny, czas wentylacji mechanicznej (MV), WBC, CRP i CAR w porównaniu z osobami, które przeżyły (p˂0,05). Albumina i prealbumina były istotnie niższe (p˂0,05) u osób, które nie przeżyły. W modelu jednowymiarowym; wiek, posocznica, wsparcie inotropowe, wynik APACHE II, CCI, SOFA, prokalcytonina, kreatynina, czas MV, WBC, CRP, albumina, prealbumina i CAR były istotne (p˂0,05) w przewidywaniu 30-dniowej śmiertelności. W zredukowanym modelu wielowymiarowym; wsparcie inotropowe, SOFA, WBC i prealbuminy wykazały istotną (p <0,05) skuteczność w przewidywaniu 30-dniowej śmiertelności. Zaobserwowano, że albumina, CRP, CAR, APACHE II, SOFA i CCI były istotne w przewidywaniu śmiertelność (p = 0,000). WNIOSKI: W badaniu mocy predykcyjnej punktacji APACHE II, CCI, SOFA, albuminy i prealbuminy wykazano znacznie wyższe wartości niż CAR.

4

Comparison of the Effectiveness of the Treatment Using Standard Methods and Negative Pressure Wound Therapy (NPWT) in Patients Treated with Open Abdomen Technique

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Szmyt K., Krokowicz Ł., Bobkiewicz A., Cybułka B., Ledwosiński W., Gordon M., Alammari A., Banasiewicz T., Drews M.

Polish Journal of Surgery

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2015

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vol. 87

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issue 1

22-30

EN

Open abdomen technique is a surgical treatment in which the fascia and skin are left open in order to reduce the value of the intra-abdominal pressure. According to the World Society of the Abdominal Compartment Syndrome (WSACS) normal values of the intra-abdominal pressure are between 5 and 7 mm Hg. Intra-abdominal hypertension occurs when the pressure value is equal to or exceeds 12 mm Hg. The aim of the study was to compare the results of the open abdomen treatment using standard methods and negative pressure wound therapy. Material and methods. The study was in the form of a retrospective analysis of the documentation of the patients treated with open abdomen technique. The study included 37 patients treated in the Department of General and Endocrine Surgery and Gastroenterological Oncology and in the Department of Anesthesiology and Intensive Care of the Medical Sciences since 2009-2012. Patients were divided into two groups: group 1 (n = 20) was treated with standard surgical procedures (laparostomy, repeated peritoneal cavity lavage) and group 2 (n =17) was treated using negative pressure wound therapy (NPWT). The analysed clinical data included the period of hospitalization and clinical outcome (survival vs death), the occurrence of enteroatmospheric fistulae, cyclical determination of the quantitative C-reactive protein levels. Results. The number of deaths during hospitalization in the group treated with NPWT was lower than in the group treated with standard methods (3 vs 9). The number of fistulae during hospitalization in the group treated with NPWT dropped as compared to the group treated using standard procedures (18% vs 70%). The decrease in the CRP levels was recorded in the group treated with NPWT and its increase - in the group treated with standard methods. Conclusions. The use of NPWT in patients requiring open abdomen treatment is reasonable due to the positive results with respect to survival rates and the decrease in the number of gastrointestinal fistulae. It is necessary to train the physicians in using this type of therapy in the form of workshops and in the clinical setting.

5

Evaluation of inflammatory markers as predictors of hospital stay and unplanned readmission after colorectal surgery

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Krpata D. M., Keller D. S., Samia H., Lawrence J., Obokhare I., Marderstein E., Brady K. M., Delaney C. P.

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vol. 85

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issue 4

198-203

EN

Hospital length of stay (LOS) and readmissions continue to be expensive and unexpected events following colorectal surgery (CRS) whether patients follow enhanced recovery pathways or traditional care. Predictors of these adverse events could facilitate identification and optimization of CRS patients. The aim of the study was to examine the impact of white blood cell count (WBC) and C-reactive protein (CRP) levels as predictors of delayed recovery or hospital readmission following CRS. Material and methods. Patients undergoing laparoscopic or open abdominal colorectal surgery by a single surgeon were managed using standardized enhanced recovery pathways. Those with postoperative day 2 CRP and white blood cell values were evaluated. Outcomes included 30-day hospital readmission rates and postoperative length of hospital stay. Results. CRP values were available for 193 patients (86 Male, mean age 58.6 years). Ninety-nine patients had surgery for colon cancer, 23 for Crohn’s disease, 19 for ulcerative colitis, 31 for diverticulitis and 18 for other reasons. Twenty patients (10.4%) were readmitted to the hospital within 30 days of surgery. POD2 CRP accurately predicted short length of hospital stay (p< 0.01). Average CRP was 6.3 in the LOS of < 3 days or less, and 11.7 in patients with LOS >4 days. The mean CRP of the readmission and non-readmission groups was 11.8 and 9.9, respectively (p=0.29). The average POD 2 WBC of the readmission and non-readmission groups was 10.6 and 9 respectively (p=0.01). Conclusion. A low POD2 CRP level was correlated with a shorter LOS, but it did not predict readmission. Conversely, POD2 WBC, and the difference in WBC from baseline were associated with readmission. These markers may be useful indicators to predict suitability of early discharge in an ERP. Further evaluation in prospective trials is warranted.

6

Interindividual variability of atorvastatin treatment influence on the MPO gene expression in patients after acute myocardial infarction

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Sygitowicz G., Maciejak A., Piniewska-Juraszek J., Pawlak M., Góra M., Burzyńska B., Dłużniewski M., Opolski G., Sitkiewicz D.

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2016

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vol. 63

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issue 1

89-95

EN

Myeloperoxidase (MPO) and C-reactive protein (CRP) may play critical roles in generation of oxidative stress and the development of the systemic inflammatory response. The aim of the study was to determine the effect of atorvastatin therapy on the MPO gene expression and its plasma level in relation to lipids level lowering and an anti-inflammatory response in patients after acute myocardial infarction. The research material was represented by 112 samples. Thirty-eight patients with first AMI receiving atorvastatin therapy (40 mg/day) and followed up for one month were involved in the study. The relative MPO gene expression in peripheral blood mononuclear cells (PBMCs) was examined using RT-qPCR in 38 patients before-, 38 patients after-therapy and in 36 patients as the control group. The plasma concentrations of MPO and serum concentrations of biochemical parameters were determined using commercially available diagnostic tests. After one month of atorvastatin therapy, in 60.5% patients a decrease of MPO gene expression, whereas in 39.5% patients an increase, was observed. The plasma MPO levels behaved in the same way as the MPO gene expression. However, the serum lipids and CRP concentrations were significantly lower after one month of atorvastatin therapy in both groups of patients - with decreased and increased MPO gene expression. Atorvastatin exhibited a different effect on MPO gene expression and its plasma level. Short-term atorvastatin therapy resulted in lipid lowering and anti-inflammatory activity in patients after AMI, independently of its effect on MPO gene expression. The molecular mechanisms of this phenomenon are not yet defined and require further research.

7

Community acquired infections in elderly population

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Kucukardali Y., Oncul O., Kunter E., Turhan V., Solmazgul E., Terekeci H., Sayan O., Oktenli C.

Open Medicine

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2009

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vol. 4

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issue 2

171-178

EN

In geriatric practice, data regarding infections including the epidemiology, morbidity, and mortality are lacking. Our aim was to evaluate the frequency, location, microbiological and laboratory characteristics of infectious diseases in elderly population admitted to a training hospital. The patients were included total of 330 patients, aged over 65 with infection, seen between January 1, 2005 and January 1, 2006. In the result, of patients 136 (41%) had respiratory system infection, 90 (27%) urinary system infection, 39 (12%) gastrointestinal system infection, 34 (10%) bloodstream infections, 17 (5%) soft tissue infection, 8 (2%) central nervous system infections, and 6 (2%) others. Average length of hospitalization was 8.6±7.7 days. Mortality rate from all causes was 57 (17%). The most common infections in elderly patients were respiratory tract and urinary system infections, and there were no fever, leukocytes and high CRP levels in approximately 1/3 of cases. Infectious diseases may occur even in the absence of such infection indicators as fever, raised WBC count and high CRP level in the elderly population.

8

Changes in serum neopterin and C-reactive protein concentrations in female dogs with mammary gland tumours

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Szczubiał M., Dabrowski R., Łopuszyński W., Bochniarz M., Krawczyk M., Szczubiał M., Dabrowski R., Łopuszyński W., Bochniarz M., Krawczyk M.

Polish Journal of Veterinary Sciences

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2018

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vol. 21

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issue 4

9

Regulation of cell function by isoforms of C-reactive protein: A comparative analysis

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Boncler M., Watała C.

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issue 1

17-31

EN

Despite the emerging evidence suggesting a proatherogenic role of C-reactive protein (CRP) in atherosclerosis, the contribution of CRP in pathogenesis of atherosclerosis and atherothrombosis has not been unequivocally defined. The role of CRP in pathophysiology/pathology seems to largely depend on its structure. Two CRP isoforms, the native pentameric and the modified monomeric one, differ substantially in their physiological functions, which is thought to origin from the considerable structural heterogeneity of the CRP molecule. The present review provides an overview of the experimental evidence with relevance to the clinical role(s) of various CRP isoforms. The biological role of the protein, its structure and distribution are discussed with particular emphasis on the diverse properties of the pentameric and monomeric forms of CRP. Some methodological aspects, related to experimental models and techniques of CRP preparation, are also critically reviewed.

10

Serum concentration of visfatin is decreased in patients with chronic heart failure

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Straburzyńska-Migaj E., Pilaczyńska-Szcześniak Ł., Nowak A., Straburzyńska-Lupa A., Śliwicka E., Grajek S.

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2012

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vol. 59

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issue 3

339-343

EN

Background. There is an increasing interest in the role of adipocytokines in cardiovascular pathophysiology. Aim. The aim of the study was to compare visfatin levels, a novel adipokine, in patients with heart failure (HF) due to the left ventricular systolic dysfunction with those in age- and body mass index (BMI) - matched healthy controls in relation to the parameters of glucose metabolism and high sensitivity C-reactive protein (hsCRP) levels. Material/Subjects and Methods. The study population consisted of 28 males with systolic HF referred for cardiopulmonary exercise testing, divided into two subgroups based on their NYHA class (HF patients NYHAI+II, n=17, and HF patients NYHAIII+IV, n=11), and 23 controls. The following indices were measured in a serum samples: visfatin, hsCRP, glucose and lipid metabolism parameters, and the insulin resistance index HOMAIR (homeostasis model assessment insulin resistance) was calculated. Results. Concentrations of visfatin and high-density lipoprotein cholesterol (HDL-cholesterol) in the HF subjects were significantly lower (p≤0.01) than in controls. The Kruskal-Wallis test showed significant differences between three groups (controls and both subgroups of heart failure patients) in mean levels of visfatin, hsCRP, glucose, HOMAIR and HDL-cholesterol. Conclusion. Serum visfatin concentrations in patients with systolic HF, particularly with more advanced NYHA classes, are significantly lower in comparison to healthy controls and are independent of age or anthropometric and metabolic parameters.

11

ADMA and C-reactive protein as mortality predictors in dialysis patients

70%

Ignjatović A., Cvetković T., Pavlović R., Đorđević V., Milošević Z., Đorđević V., Pavlović D., Stojanović I., Živanović S.

Open Medicine

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2013

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vol. 8

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issue 3

346-353

EN

There is a higher mortality between patients with end-stage renal disease than patients in the general population. These circumstances have led to a search for risk factors as predictors of mortality in dialysis patients. Amongst those, inhibitors of the nitric-oxide (NO) synthesis deserve special attention, since patients with end-stage renal disease are also characterized by accelerated atherosclerosis. Asymmetric-dimethylarginine (ADMA) and symmetric-dimethylarginine (SDMA), as well as C-reactive protein (CRP), have also been recognized as predictors of mortality in patients on dialysis. The aim of our study was to compare the prediction power of ADMA, SDMA and CRP for all-cause mortality in patients with end stage renal disease during the fourteen month follow-up. In total 162 patients on hemodialysis were included. ADMA and SDMA were measured by the high-performance liquid chromatography (HPLC); CRP was measured using immunonephelometric assays. During the 14-month period 28 patients (34.1%) died from all-cause mortality. Using univariate analysis, hazard ratios (HR) of the potential independent predictors of mortality in hemodialysis patients were ADMA (HR 1.39 (1.01–1.91) p=0.043) and CRP (HR 1.024 (1.009–1.1.040) p=0.001). Further, multivariate analysis (MVA), however, showed that ADMA is the only predictor of all-cause mortality (HR 1.76 (1.002–3.11) P=0.049), while SDMA failed to predict death in this population. Therefore, our data shows that ADMA is an independent and better marker of all-cause mortality compared with CRP.

12

Effects of training on resting plasma levels of homocysteine and C-reactive protein in competitive male and female wrestlers

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Hübner-Woźniak E., Ochocki P.

Biomedical Human Kinetics

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2009

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vol. 1

42-46

EN

Study aim: To assess the effects of training on resting plasma levels of homocysteine (Hcy), C-reactive protein (CRP), folic acid, and on the activity of creatine kinase (CK) in competitive male and female wrestlers.Material and methods: Polish elite wrestlers, male MW; n = 11) and female (FW; n = 11), as well as corresponding numbers of untrained, control subjects (MC and FC, respectively), participated in the study. Blood for assays was withdrawn from the antecubital vein in the morning, in pre-prandial state. Homocysteine (Hcy), C-reactive protein (CRP), folic acid and creatine kinase (CK) activity were assayed in plasma.Results: Mean concentrations of Hcy and CRP were in the control groups significantly higher and those of folic acid - lower than in the respective groups of wrestlers. Folic acid levels were negatively correlated with Hcy, especially in wrestlers (r = -0.540; p<0.01). Mean CK activity was significantly (p<0.001) higher in male wrestlers than in male controls or female subjects. No significant correlation between CK and CRP was found.Conclusions: Strength-speed training practiced by elite wrestlers, associated with significantly lower values of Hcy and CRP in them compared with the untrained subjects, may reduce the risk of cardiovascular diseases at later age, like in case of endurance training.

Refine search results

C-Reactive Protein as a Marker of Postoperative Septic Complications

C-Reactive Protein within the Wall of Large Abdominal Aortic Aneurysms; Pathophysiological Implications. A Preliminary Study

The 30-day mortality predictor role of c-reactive protein/albumin ratio in critically ill COPD patients.

Comparison of the Effectiveness of the Treatment Using Standard Methods and Negative Pressure Wound Therapy (NPWT) in Patients Treated with Open Abdomen Technique

Evaluation of inflammatory markers as predictors of hospital stay and unplanned readmission after colorectal surgery

Interindividual variability of atorvastatin treatment influence on the MPO gene expression in patients after acute myocardial infarction

Community acquired infections in elderly population

Changes in serum neopterin and C-reactive protein concentrations in female dogs with mammary gland tumours

Regulation of cell function by isoforms of C-reactive protein: A comparative analysis

Serum concentration of visfatin is decreased in patients with chronic heart failure

ADMA and C-reactive protein as mortality predictors in dialysis patients

Effects of training on resting plasma levels of homocysteine and C-reactive protein in competitive male and female wrestlers