Relationship between infection burden and atherosclerosis and plaque feature objective : To evaluate the relationship between infection burden and coronary … (2005 Jun)
relationship between infection burden and atherosclerosis and plaque feature objective : To evaluate the relationship between infection burden and coronary atherosclerosis and the plaque feature . methods : One hundred and eighty two patients underwent coronary angiography in zhongshan hospital from 2002 2003 . atherosclerosis and vulnerable plaque were determined by intravascular ultrasound ( IVUS ) . seropositivity of cytomegalovirus , helicobacter pylori , chlamydia pneumonia , hepatitis B virus , EB virus , CoxB virus , influenza A virus , influenza B virus and mycobacterium tuberculosis were determined by elisa . The serum hs CRP was detected by Dade behring prospect ( immuno nehelomitery ) . patients were divided into three groups according to the pathogen burden : group A , n or 3 , group B , n 4 5 and group C , n or 6 . results : The pathogen burden was independent of the C reactive protein level . increasing pathogen burden was significantly associated with increasing atherosclerosis risk , the prevalence of atherosclerosis was 44 . 4 , 70 . 6 and 76 . 7 in group A , B and C . The risk associated with elevated pathogen burden was much higher when CRP was also elevated ( 5 . 0 mg / L ) ( 43 . 8 , 70 . 0 , 70 . 8 ) vs ( 45 . 5 , 63 . 7 , 96 . 8 ) . The positively of vulnerable plaque increased significantly when the pathogen …

C reactive protein in the diagnosis of community acquired pneumonia. (2003 Oct)
C reactive protein in the diagnosis of community acquired pneumonia . qualitative determination of C reactive protein ( CRP ) was evaluated as a diagnostic method for community acquired pneumonia . paired serum and pleural fluid samples from child patients were examined with a CRP test , compared to bacterial cultures , counterimmunoelectrophoresis and immunoassay . The CRP test gave excellent parameters of sensitivity , specificity and predictive values for the diagnosis of bacterial pneumonia .

Contribution of C reactive protein to the diagnosis and assessment of severity of community acquired pneumonia. (2004 Apr)
contribution of C reactive protein to the diagnosis and assessment of severity of community acquired pneumonia . study objective : To assess the usefulness of serum C reactive protein ( CRP ) in the diagnosis and treatment approach of patients with community acquired pneumonia ( CAP ) . design : population based case control study . setting : A mixed residential industrial urban area of 74 , 368 adult inhabitants in the maresme region ( barcelona , spain ) . patients : From december 1993 to november 1995 , all subjects who were 14 years of age , were living in the area , and had received a diagnosis of CAP , which had been confirmed by chest radiographs and compatible clinical outcome , were registered . patients from residential care facilities were excluded . serum samples were assayed for CRP in the acute phase of the disease . Data from 201 patients with CAP were compared with 84 healthy control subjects matched by age , sex , and municipality , as well as with 25 patients with initially suspected pneumonia that was not confirmed at follow up . median CRP levels were 110 . 7 , 1 . 9 , and 31 . 9 mg / L , respectively . The thresholds of the test for discriminating among these three groups of subjects were 11 . 0 and 33 . 15 mg / L . results : eighty nine patients ( 44 . 8 ) had an identifiable etiology …

Total white blood cell count , erythrosedimentation rate and C reactive protein for the detection of serious bacterial infections in … (2008 Mar)
total white blood cell count , erythrosedimentation rate and C reactive protein for the detection of serious bacterial infections in 0 to 90 day old infants with fever without a source introduction : total white blood cell count ( WBC ) , erythrosedimentation rate ( ESR ) and C reactive protein ( CRP ) are frequently used by primary care physicians attending infants 90 days old with fever without localizing signs to distinguish those with a serious bacterial infection ( SBI ) . The main objective of this study was to obtain the diagnostic values of these parameters in infants with fever . patients AND methods : We analyzed previously healthy infants aged 0 to 90 days old and fever with no source of infection admitted to the emergency room and / or hospitalized . The main outcome measure was the presence or absence of a SBI ( urinary tract infection , bacteremia , meningitis , pneumonia , enteritis ) and diagnostic values of WBC , ESR and CRP . results : A total of 103 infants met the inclusion criteria . Of these , 22 infants ( 21 . 3 ) had a SBI , the most common being urinary tract infection . absolute neutrophil count ( ANC ) and WBC had an area under the ROC curve ( AUC ) of 0 . 6 ( 95 CI : 0 . 46 0 . 73 ) and 0 . 55 ( 95 CI : 0 . 44 0 . …

Patterns of pulmonary complications associated with sirolimus. (2006 May)
patterns of pulmonary complications associated with sirolimus . sirolimus inhibits human fibroblast cell proliferation in cell cultures from transbronchial biopsies of lung transplant recipients . however , a few cases of interstitial pneumonitis and bronchiolitis obliterans organizing pneumonia have been recently described in solid organ transplant recipients , including a fatality in a heart transplant recipient . We studied the patterns of pulmonary adverse effects associated with sirolimus in 4 renal transplant recipients who developed pulmonary opacities on chest radiograph , which were proved to be noninfectious in origin . Lung biopsy was performed to obtain histological diagnosis ( 3 interstitial pneumonitis , 1 necrotizing vasculitis ) . symptoms were dyspnea ( 4 ) , cough ( 2 ) , hemoptysis ( 1 ) , fever ( 1 ) and eyelid edema ( 1 ) . those with interstitial pneumonitis had bilateral basal opacities on chest X ray , and histopathology showed mild lymphoplasmocytic interstitial inflammation , scattered intraalveolar epitheloid granulomas and a focal pattern of organizing pneumonia . serum C reactive protein ( CRP ) was elevated and bronchoalveolar lavage revealed lymphocytosis ( 77 , 79 . 5 and 31 ) . The fourth patient had an opacity localized in the upper lobe , which progressed to both the lower lobes , and histopathology showed multifocal necroses of lung tissue with lymphoplasmocytic vasculitis and scattered granulomas . In this patient , the serum CRP level was not elevated and bronchoalveolar lavage was normal . pulmonary symptoms and opacities on …

Acute bronchitis in adults. (1994 Jul)
acute bronchitis in adults . clinical findings , microorganisms and use of antibiotics among 72 adult patients with a diagnosis of acute bronchitis , serological investigation established the presence of an aetiologic agent in 29 ( 40 ) . influenza virus was the most common pathogen . seven patients had bacterial infection , caused by pneumococci in four patients and mycoplasma pneumoniae in three . Five of the patients had pneumonia as diagnosed by radiography , and mycoplasmal aetiology was established in one of these . altogether , 11 patients either had bacterial infection or radiographic pneumonia . although the doctors recording of wheezes was strongly associated with prescription of antibiotics ( p 0 . 0001 ) , wheezes were heard only in two of the 11 patients with pneumonia or bacterial infection , compared with 30 of the 61 patients with viral or unspecified bronchitis . The median value of C reactive protein ( CRP ) was 52 mg / l in the 11 patients , significantly higher than 11 mg / l in the 61 other patients ( p 0 . 0001 ) . The corresponding values for erythrocyte sedimentation rate were 45 and 14 mm / h ( p 0 . 0005 ) . The results indicate that certain patients with acute bronchitis should be treated with antibiotics , and that the erythrocyte sedimentation rate and the CRP test may be useful in detecting which patients this applies to .

Endothelin 1 precursor peptides correlate with severity of disease and outcome in patients with community acquired pneumonia. (2008 Apr)
endothelin 1 precursor peptides correlate with severity of disease and outcome in patients with community acquired pneumonia . background : circulating levels of endothelin 1 are increased in sepsis and correlate with severity of disease . A rapid and easy immunoassay has been developed to measure the more stable ET 1 precursor peptides proet 1 . The objective of this study was to assess the diagnostic and prognostic value of proet 1 in a prospective cohort of mainly septic patients with community acquired pneumonia . methods : We evaluated 281 consecutive patients with community acquired pneumonia . serum proet 1 plasma levels were measured using a new sandwich immunoassay . results : proet 1 levels exhibited a gradual increase depending on the clinical severity of pneumonia as assessed by the pneumonia severity index ( PSI ) and the curb65 scores ( p 0 . 001 and p 0 . 01 ) . The diagnostic accuracy to predict bacteraemia of procalcitonin ( AUC 0 . 84 95 0 . 74 0 . 93 ) was superior than C reactive protein ( AUC 0 . 67 95 CI 0 . 56 0 . 78 ) and leukocyte count ( AUC 0 . 66 95 CI 0 . 55 0 . 78 ) and in the range of proet 1 ( AUC of 0 . 77 95 CI 0 . 67 0 . 86 ) . proet 1 levels on admission were increased in patients with adverse medical outcomes including death and need …

Utility of C reactive protein measurements for empyema diagnosis after pneumonectomy. (1994 May)
utility of C reactive protein measurements for empyema diagnosis after pneumonectomy . serum C reactive protein ( CRP ) levels were studied serially during the postoperative period in 151 consecutive patients who underwent pneumonectomy . virtually all patients who had a simple postoperative course ( 115 of 120 ) , as well as 9 patients who had a bronchial infection of the remaining lung , 3 with a pulmonary embolus , and 2 who suffered postoperative bleeding requiring reoperation , demonstrated a similar postoperative evolution in their CRP values : a rapid postoperative rise until a peak or a plateau ( mean peak value , 132 / 25 mg / L ) was reached within 3 to 6 days , followed by a progressive decline to a value of less than 75 mg / L on day 9 , and less than 50 mg / L on day 12 . conversely , all 12 patients who suffered empyema postoperatively , as well as 3 patients with bacterial pneumonia , 1 patient with chylothorax , and 1 patient with inflammatory pericarditis , demonstrated either a markedly persistent elevation in their CRP values or a secondary rise in the levels which exceeded 100 mg / L . because of the high sensitivity ( 100 ) and specificity ( 91 . 4 ) of the CRP levels in detecting postpneumonectomy empyema , we recommend the routine use of this measure . furthermore , a low CRP value after pneumonectomy ( less than 50 …

Serum C reactive protein cannot differentiate bacterial and viral aetiology of community acquired pneumonia in children in primary healthcare settings. (2000 Dec)
serum C reactive protein cannot differentiate bacterial and viral aetiology of community acquired pneumonia in children in primary healthcare settings . whether serum C reactive protein ( CRP ) can be used to distinguish bacterial from viral pneumonia was studied in 193 paediatric patients who were identified in a prospective , population based study . The proportion of patients 5 y of age was 51 , 53 of these and 12 of the older patients were treated in hospital . pneumococcal aetiology of infection was studied in paired sera by antibody and immune complex assays , and chlamydial , mycoplasmal and viral aetiologies by routine antibody assays . CRP concentration was measured by immunoturbidometry . pneumococcal infection ( mixed infections with other agents included ) was present in 57 cases , mycoplasmal and / or chlamydial infection ( pneumococcal infections excluded ) in 43 , and viral infection ( pneumococcal , mycoplasmal and chlamydial infections excluded ) in 29 cases . The mean CRP concentrations ( 95 confidence interval ) in these groups were 26 . 8 mg / l ( 20 . 1 33 . 5 mg / l ) , 31 . 8 mg / l ( 20 . 5 33 . 1 mg / l ) and 26 . 1 mg / l ( 19 . 1 33 . 1 mg / l ) , respectively , and 24 . 9 mg / l ( 18 . 8 31 . 0 mg / l ) in patients …

Assessment of B type natriuretic peptide in patients with pneumonia. (2008 Feb)
assessment of B type natriuretic peptide in patients with pneumonia . The mammalian heart synthesises and secretes B type natriuretic peptide ( BNP ) , which has potent diuretic , natriuretic and vascular smooth muscle relaxing effects as well as complex interactions with the hormonal and nervous systems . recent studies described that BNP was acute phase reactant . In this study , we aimed to evaluate BNP levels in patients with pneumonia . twenty one patients with pneumonia and 21 healthy control subjects were enrolled in this study . their serum levels of BNP were measured in addition to the standard evaluations . leucocyte count 19 . 3 ( 13 . 2 25 . 7 ) 10 ( 6 ) / ml vs . 9 . 55 ( 3 . 7 13 . 9 ) 10 ( 6 ) / ml , p 0 . 001 , erythrocyte sedimentation rate 73 ( 57 81 ) mm / h vs . 35 ( 4 55 ) mm / h , p 0 . 001 , C reactive protein ( CRP ) 127 . 72 ( 27 290 ) mg / l vs . 13 . 19 ( 3 41 ) mg / l , p 0 . 001 and BNP 53 . 1 ( 17 91 ) pg / ml vs . 16 . 24 ( 1 38 ) pg / ml , p 0 . 001 levels significantly decreased after treatment period . initial BNP levels were significantly higher …

An analysis of interleukin 8 , interleukin 6 and C reactive protein serum concentrations to predict fever , gram negative … (1998 Dec)
An analysis of interleukin 8 , interleukin 6 and C reactive protein serum concentrations to predict fever , gram negative bacteremia and complicated infection in neutropenic cancer patients . A prospective study was performed to assess the potential value of interleukin ( IL ) 8 , IL 6 , and C reactive protein ( CRP ) serum levels to predict fever , gram negative bacteremia and complicated infection in neutropenic patients with cancer . serum samples were obtained three times a week during 208 neutropenic episodes following cytotoxic chemotherapy . fever of any cause developed during 104 out of 191 evaluable episodes . serum levels of neither cytokine nor CRP were predictive of fever within more than 24 h before its onset . unlike CRP , both IL 6 and IL 8 serum levels were significantly different between microbiologically documented infections and unexplained fevers . The highest values of IL 6 and IL 8 were observed in episodes of gram negative bacteremia . using receiver operating characteristic curves , the analysis of cytokine levels measured around the onset of fever indicated that IL 8 is potentially useful for predicting gram negative bacteremia , with a high negative predictive value of 90 and a moderate positive predictive value of 50 ( sensitivity , 70 ; specificity , 91 ) . In patients with persistent fever , predictions of further clinical complications , defined as prolonged fever of more than 7 days duration , pneumonia , shock and / or death due …

Circulating interleukin ( IL ) 1 beta , IL 6 and tumor necrosis factor alpha in children with febrile infection … (1999 Mar)
circulating interleukin ( IL ) 1 beta , IL 6 and tumor necrosis factor alpha in children with febrile infection a comparison with C reactive protein . circulating interleukin ( IL ) 1 beta , IL 6 , and tumor necrosis factor ( TNF ) alpha were examined in 42 febrile children with fever lasting more than 4 days . their diagnosis were probable viral syndrome in 22 , urinary tract infection ( UTI ) in 10 , and probable bacterial pneumonia in 10 . None of our study patients had detectable serum IL 1 beta . TNF alpha levels were significantly higher in children with pneumonia than in those with viral syndrome ( p 0 . 01 ) . children with UTI and pneumonia had significantly higher IL 6 and CRP , compared to those with probable viral syndrome ( p 0 . 01 for both IL 6 and CRP ) . When appropriate cutoff values are chosen , IL 6 had greatly improved specificity ( 86 . 4 , 20 pg / ml ) to demonstrate UTI and pneumonia , as compared to that using CRP ( 48 , 40 mg / l ) . after three days antibiotic treatment , IL 6 fell to control levels in children with UTI and pneumonia , while CRP remained elevated . there was no difference in TNF alpha values before and after treatment . Thus , IL 6 , rather than IL 1 beta and TNF alpha , may be …

Diagnostic value of C reactive protein in discriminating fungal from nonfungal pulmonary infiltrates in patients with hematologic malignancies. (2006 Jul)
diagnostic value of C reactive protein in discriminating fungal from nonfungal pulmonary infiltrates in patients with hematologic malignancies . The objective of this study was to assess the utility of C reactive protein ( CRP ) on differential diagnosis of pulmonary infiltrates occurring in 143 febrile patients with hematologic malignancies . serum CRP level , measured on the first day of pneumonia , was significantly higher in patients with fungal lung infiltrates than in those with nonfungal pneumonia ( 22 . 3 mg / dl vs 7 . 3 mg / dl ; p 0 . 0001 ) . predictive factors for fungal pneumonia were CRP level higher than 10 mg / dl , neutropenia longer than 10 days , and active underlying disease .

Procalcitonin versus C reactive protein for predicting pneumonia in adults with lower respiratory tract infection in primary care. (2007 Aug)
procalcitonin versus C reactive protein for predicting pneumonia in adults with lower respiratory tract infection in primary care . background : The role of procalcitonin in diagnosing bacterial infection has mainly been studied in patients with severe infections . there is no study on the value of procalcitonin measurements in adults with lower respiratory tract infection ( LRTI ) treated in primary care . AIM : To evaluate the accuracy of plasma procalcitonin in predicting radiographic pneumonia , bacterial infection , and adverse outcome in a population of adults with LRTI treated in primary care . design OF study : prospective , observational study . setting : forty two general practices and an outpatient clinic at the department of infectious diseases , odense university hospital , denmark . method : A total of 364 patients with LRTI were prospectively enrolled from 42 general practices . patients were examined with chest radiography , microbiological analyses , and measurements of C reactive protein ( CRP ) and procalcitonin . The outcome measure was hospitalisation within 4 weeks of enrollment . results : median procalcitonin was 0 . 05 ng / ml , which was below the functional sensitivity of the assay ( 0 . 06 ng / ml ) . In predicting radiographic pneumonia , bacterial infection , and hospitalisation , the sensitivities of procalcitonin 0 . 06 ng / ml were 0 . 70 , 0 . 51 , and 0 . 67 , and of CRP were or 20 mg …

Procalcitonin as a marker of sepsis. (2002 Jul)
procalcitonin as a marker of sepsis . prompt diagnosis and treatment with appropriate antimicrobial chemotherapy is of paramount importance to reduce morbidity and mortality associated with sepsis . inflammatory markers currently in use , such as C reactive protein ( CRP ) do not reliably differentiate between the systemic inflammatory response and sepsis . procalcitonin ( PCT ) , a precursor of calcitonin , is a 116 amino acid protein that has been proposed as a marker of disease severity in conditions such as septicaemia , meningitis , pneumonia , urinary tract infection ( UTI ) and fungal and parasitic infection . In particular , serial measurements are useful in order to monitor response to therapy . together with good clinical judgement and judicious use of antimicrobial agents , PCT should serve as a valuable adjunct in the diagnosis and management of sepsis .

Usefulness of C reactive protein in monitoring the severe community acquired pneumonia clinical course. (2008 Jan)
usefulness of C reactive protein in monitoring the severe community acquired pneumonia clinical course . background : The aim of the present study was to evaluate the C reactive protein level , the body temperature and the white cell count in patients after prescription of antibiotics in order to describe the clinical resolution of severe community acquired pneumonia . methods : A cohort of 53 consecutive patients with severe community acquired pneumonia was studied . The C reactive protein levels , body temperature and white cell count were monitored daily . results : By day 3 a C reactive protein level 0 . 5 times the initial level was a marker of poor outcome ( sensitivity , 0 . 91 ; specificity , 0 . 59 ) . patients were divided according to their C reactive protein patterns of response to antibiotics , into fast response , slow response , nonresponse , and biphasic response . about 96 of patients with a C reactive protein pattern of fast response and 74 of patients with a slow response pattern survived , whereas those patients with the patterns of nonresponse and of biphasic response had a mortality rate of 100 and 33 , respectively ( P 0 . 001 ) . On day 3 of antibiotic therapy , a decrease in C reactive protein levels by 0 . 31 or more from the previous day s level was a marker of good prognosis ( sensitivity , 0 . 75 ; specificity , …

C reactive protein as a marker of ventilator associated pneumonia resolution : a pilot study. (2005 May)
C reactive protein as a marker of ventilator associated pneumonia resolution : a pilot study . The aim of this study was to evaluate C reactive protein ( CRP ) levels , body temperature and white cell count ( WCC ) after prescription of antibiotics in order to describe the clinical resolution of ventilator associated pneumonia ( VAP ) . A cohort of 47 VAP patients with microbiological confirmation of disease was assessed . CRP levels , body temperature and WCC were monitored daily . On day 4 of the antibiotic therapy , the CRP level of survivors was 0 . 62 times the initial value , whereas , in nonsurvivors , it was 0 . 98 . Body temperature and WCC remained almost unchanged . By day 4 , a CRP of 0 . 6 times the initial level was a marker of poor outcome ( sensitivity 0 . 92 ; specificity 0 . 59 ) . patients were divided according to their CRP patterns of response to antibiotics : fast response , slow response , nonresponse , and biphasic response . All patients with fast and slow response patterns survived , whereas those showing nonresponse and a biphasic response pattern exhibited a mortality of 78 and 75 , respectively . The adequacy of the initial antibiotic therapy had a marked influence on the rate of CRP decrease , as well as on mortality . In conclusion , daily C reactive protein measurements after antibiotic prescription were useful in …

Eight month prospective study of 14 patients with hospital acquired severe acute respiratory syndrome. (2004 Nov)
eight month prospective study of 14 patients with hospital acquired severe acute respiratory syndrome . objective : To define the clinical characteristics and clinical course of hospital acquired severe acute respiratory syndrome ( SARS ) . patients AND methods : This 8 month prospective study of 14 patients with hospital acquired SARS in taipei , taiwan , was conducted from april through december 2003 . results : The most common presenting symptoms in our 14 patients with hospital acquired SARS were fever , dyspnea , dizziness , malaise , diarrhea , dry cough , muscle pain , and chills . lymphopenia and elevated serum levels of lactate dehydrogenase ( LDH ) and C reactive protein ( CRP ) were the most common initial laboratory findings . initial chest radiographs revealed various pattern abnormalities and normal results . Five of the 14 patients required mechanical ventilation . The need for mechanical ventilation was associated with bilateral lung involvement on the initial chest radiograph and higher peak levels of LDH and CRP . clinical severity of disease varied from mild to severe . At 8 months after disease onset , patients with mild or moderate SARS had normal findings or only focal fibrosis on chest high resolution computed tomography . however , bilateral fibrotic changes remained in the 4 patients who had recovered from severe SARS , 1 of whom had mild restrictive ventilatory impairment . One patient with severe SARS died ; she was elderly and had other comorbidities . Five …

Serum acute phase proteins and swine health status. (2003 Nov)
serum acute phase proteins and swine health status . The purpose of this study was to investigate the relationship between swine health status and the concentration of the serum acute phase proteins , haptoglobin ( HP ) , and C reactive protein ( CRP ) . A total of 378 clinically healthy pigs from farms A and B , plus 20 pigs culled from farm A due to poor growth , were used in this experiment . Each pig was examined and blood samples were collected during slaughter . The HP concentration was measured by using an HP hemoglobin binding assay . The CRP concentration was measured by using a CRP enzyme immunoassay . gross and histopathological lesions were examined and recorded at slaughter . representative samples were then collected in order to isolate pathogens . swine enzootic pneumonia , found in 47 . 7 of the pigs , was the most common lesion . other lesions included pleuropneumonia ( 32 . 7 ) , suppurative pneumonia ( 10 . 3 ) , fibrinous pericardititis ( 4 . 3 ) , ascaris migration in the liver ( 33 . 9 ) , and intestinal serositis ( 3 . 0 ) . On farm A , the percentage of pigs with 1 or more lesions was 88 . 2 . For culled pigs from farm A , the mean serum concentrations of HP and CRP were 2 . 23 / 0 . 14 mg / mL and 252 . 93 / …

The aetiology of pneumonia. (1987 Apr)
The aetiology of pneumonia . application of bacterial serology and basic laboratory methods . The aetiology of community acquired pneumonia was studied by use of new bacterial and established viral serological methods besides blood culture in 162 patients . evidence for a specific aetiology was obtained in 79 patients ( 49 . 4 ) . The pneumococcus was the most common aetiological agent , identified in 25 . 6 of cases . other bacteria , haemophilus influenzae , branhamella catarrhalis , neisseria meningitidis and chlamydia spp . were demonstrated in 23 . 5 , mycoplasma pneumonia in 1 . 2 and viruses in 7 . 4 patients . In 58 those with viral pneumonia there was evidence of mixed infection with bacteria . The predictive value of rapid laboratory tests , erythrocyte sedimentation rate , white blood cell count and C reactive protein ( CRP ) , was evaluated in relation to the aetiological diagnosis . They all differentiated viral from bacterial pneumonia , with CRP having the best predictive value . On the basis of these tests , most cases in which our serological tests remained negative would appear to have a bacterial aetiology also .