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Background: Severe progression of coronavirus disease 2019 (COVID-19) causes respiratory failure and critical illness. Recently, COVID-19 has been associated with heparanase (HPSE)-induced endothelial barrier dysfunction and inflammation, so called endothelitis, and therapeutic treatment with heparin or low-molecular-weight heparin (LMWH) targeting HPSE has been postulated. Because, up to this date, clinicians are unable to measure the severity of endothelitis, which can lead to multiorgan failure and concomitant death, we investigated plasma levels of HPSE and heparin-binding protein (HBP) in COVID-19 intensive care patients to render a possible link between endothelitis and these plasma parameters. Therefore, a prospective prolonged cohort study was conducted, including 47 COVID-19 patients from the intensive care unit. Plasma levels of HPSE, and HBP were measured daily by enzyme-linked immunosorbent assay in survivors (n = 35) and nonsurvivors (n = 12) of COVID-19 from admission until discharge or death. All patients were either treated with heparin or LMWH, aiming for an activated partial thromboplastin time of ≥60 seconds or an anti-Xa level of >0.8 IU/mL using enoxaparin, depending on the clinical status of the patient (patients with extracorporeal membrane oxygenation or >0.1 μg/kg/min noradrenaline received heparin, all others enoxaparin). Results: We found significantly higher plasma levels of HPSE and HBP in survivors and nonsurvivors of COVID-19, compared with healthy controls. Still, interestingly, plasma HPSE levels were significantly higher (P < 0.001) in survivors compared with nonsurvivors of COVID-19. In contrast, plasma HBP levels were significantly reduced (P < 0.001) in survivors compared with nonsurvivors of COVID-19. Furthermore, when patients received heparin, they had significantly lower HPSE (P = 2.22e - 16) and significantly higher HBP (P = 0.00013) plasma levels as when they received LMWH. Conclusion: Our results demonstrated that patients, who recover from COVID-19-induced vascular and pulmonary damage and were discharged from the intensive care unit, have significantly higher plasma HPSE level than patients who succumb to COVID-19. Therefore, HPSE is not suitable as marker for disease severity in COVID-19 but maybe as marker for patient's recovery. In addition, patients receiving therapeutic heparin treatment displayed significantly lower heparanse plasma level than upon therapeutic treatment with LMWH.

With the exponential growth of COVID-19 cases, the neurological complications reported during or after the infection became more common. There is limited knowledge regarding the pathophysiological mechanisms that are responsible for these complications. Recent data provides compelling evidence for the neurotropic nature of SARS-CoV-2, based on neurological manifestations reported during the current pandemic, as well as on previous experience with other coronaviruses. We present the case of a patient who developed headaches, motor deficit and dysphasia after respiratory COVID-19. Imaging tests showed heterogeneous central nervous system lesions (multiple subarachnoid hemorrhages and two ischemic strokes). Given the plethora of atypical neurological complications of COVID-19 described in the current literature, establishing a positive diagnosis and deciding on a treatment plan proved to be particularly challenging. We set to discuss some of the possible pathologies, hypothesized to be associated with COVID-19, that could lead to concomitant neurological lesions, similar to those noticed in our patient.

Investigation of the mechanisms promoting the development of irritable bowel syndrome (IBS) in obese patients is one of the most important issues of modern medicine. We examined 97 patients suffering from IBS. The group of comparison included 10 individuals with obesity. The control group included 21 practically healthy individuals. The levels of C-reactive protein (CRP) in the blood serum, tumor necrosis factor-α (TFNα), transforming growth factor-β1 (TGFβ1), interleukin-10 (IL-10), 8-isoprostane (IP), ceruloplasmin (CP) were examined. Endotoxicosis intensity was identified by the content of average molecular peptides in the blood and the Limulus Amebocyte Lysate (LAL) test. In the case of IBS with prevailing diarrhea, especially its comorbid course with obesity, cytokine imbalance was observed, which was manifested by a decreased amount of IL-10 in the blood serum and increased levels of TNFα and TGFβ1. Patients suffering from irritable bowel syndrome with prevailing diarrhea associated with obesity were characterized by high levels of C-reactive protein, fibrinogen and average molecules, increased content of pro-inflammatory cytokines (TFNα and TGFβ1) with a decreased content of IL-10, as well as imbalance of the pro-oxidant and anti-oxidant blood systems (increased content of 8-isoprostane and ceruloplasmin).

Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has been associated with myocardial dysfunction and heart failure in adult patients. We report a case of reversible myocardial injury and heart failure in an infant with SARS-CoV-2 infection., Graphical abstract

In order to evaluate the effects of specific forms of childhood maltreatment (CM) upon adult C-reactive protein (CRP) concentrations, and to further describe the potentially confounding role that recent life stress and depression hold in that relationship, 221 participants from rural Australia (M age = 44yr, SD = 17.8yr) completed self-report questionnaires and provided a blood sample. There were no sex differences in any variables across the 91 males and 130 females, but depression status did confound the association between global CM and CRP. The specific aspect of CM was identified as physical and mental health abuse, and this was significantly associated with CRP level in participants with depressive symptoms and those without. There was no significant confound from recent life stressors. Results hold implications for the diagnosis of CM-related CRP elevation and (potentially) depression.

Typhoid fever is a systemic infectious disease characterized by the patient experiencing fever and abdominal pain due to the spread of Salmonella bacteria. Typhoid fever sufferers cause the immune system to decline which can affect changes in the number of white blood cells and in an infection, an inflammatory process occurs that produces cytokines which are the core stimulators of acute phase protein production, including C-reactive protein (C-reactive protein = CRP). This study was conducted in April 2021 with the aim of knowing the relationship between the number of leukocytes and CRP levels in typhoid fever patients at RA Basoeni Mojokerto Hospital. The design carried out in this study was a laboratory experimental, the sample needed in this study was 30 typhoid fever patients at RA Basoeni Hospital. Examination of the leukocyte count uses an automatic method with a Hematology analyzer, while CRP examination uses a semi-quantitative method. In the Spearman correlation test, it was found that there was no significant relationship between the number of leukocytes and the level of CRP p = 0.460.

C-Reactive Protein (CRP) is associated with diverse outcomes in patients with, or suspected to have, genitourinary malignancies. CRP levels have been shown to be associated with the probability of a prostate cancer diagnosis in patients with elevated PSA, the probability of biochemical recurrence following definitive treatment for localized prostate cancer, and decreased overall survival for patients with advanced disease. In patients with bladder and kidney cancers, CRP levels have been associated with disease progression, stage, and cancer-specific survival. Despite the abundance of correlative studies, the relationship between CRP levels and genitourinary cancer pathogenesis is not clearly understood. Here, we review the evidence for CRP as a biomarker in genitourinary (GU) cancers, with specific focus on potential clinical applications.

Decreases in Fe status have been reported in military women during initial training periods of 8–10 weeks. The present study aimed to characterise Fe status and associations with physical performance in female New Zealand Army recruits during a 16-week basic combat training (BCT) course. Fe status indicators – Hb, serum ferritin (sFer), soluble transferrin receptor (sTfR), transferrin saturation (TS) and erythrocyte distribution width (RDW) – were assessed at the beginning (baseline) and end of BCT in seventy-six volunteers without Fe-deficiency non-anaemia (sFer 10 mg/l at baseline or end. A timed 2·4 km run followed by maximum press-ups were performed at baseline and midpoint (week 8) to assess physical performance. Changes in Fe status were investigated using paired t tests and associations between Fe status and physical performance evaluated using Pearson correlation coefficients. sFer (56·6 (sd 33·7) v. 38·4 (sd 23·8) µg/l) and TS (38·8 (sd 13·9) v. 34·4 (sd 11·5) %) decreased (PP=0·014, respectively), while sTfR (1·21 (sd 0·27) v. 1·39 (sd 0·35) mg/l) and RDW (12·8 (sd 0·6) v. 13·2 (sd 0·7) %) increased (Psd 7·5) v. 142·9 (sd 7·9) g/l) increased (P=0·009) during BCT. At end, sTfR was positively (r 0·29, P=0·012) and TS inversely associated (r –0·32, P=0·005) with midpoint run time. There were no significant correlations between Fe status and press-ups. Storage and functional Fe parameters indicated a decline in Fe status in female recruits during BCT. Correlations between tissue-Fe indicators and run times suggest impaired aerobic fitness. Optimal Fe status appears paramount for enabling success in female recruits during military training.

The presence of metabolic syndrome (MS) significantly increases the risk of developing cardiovascular diseases that lead to chronic heart failure (CHF). The values of NT-proBNP, ST-2, and CRP markers and their mutual correlations were studied in 37 patients with chronic heart failure (CHF) without metabolic syndrome (MS) (group 1) and 37 patients with CHF with MS (group 2). The aim of the study was to determine the features of their changes in patients with CHF complicated by MS, and to rank patients by assigning a rank value to the values of NTproBNP, ST2, and CRP concentrations. The average ST2 level was 51±24 ng/ml in group 1 and 62±27 ng/ml in group 2. The average values of CRP in group 1 were 23.1±5.3 mg/l, in group 2-33.0±4.4 mg/l (p

Pyomyomas are rare lesions that develop from the suppurative degeneration of ischemic leiomyomas. Pyomyomas can lead to sepsis, so early diagnosis is crucial. Due to their rarity and often nonspecific findings on ultrasonography and computed tomography diagnosis is often delayed. We present a case of a woman who presented with abdominal pain and fever. The computed tomography showed a large hypodense uterine lesion with slight peripheral enhancement without gas in the lesion. The diffusion-weighted magnetic resonance imaging showed restricted diffusion, demonstrating the presence of pus and confirming the diagnosis of pyomyoma. Diffusion-weighted imaging should be done in cases of suspected pyomyomas when computed tomography findings are nonspecific.

Background: COVID-19 commonly presents with upper respiratory symptoms; however, studies have shown that SARS-CoV-2 infection affects multiple organ systems. Here, we review the pathophysiology and imaging characteristics of SARS-CoV-2 infection in organ systems throughout the body and explore commonalities. Objective: Familiarity with the underlying pathophysiology and imaging characteristics is essential for the radiologist to recognize these findings in patients with COVID-19 infection. Though pulmonary findings are the most prevalent presentation, COVID-19 may have multiple manifestations and recognition of the extrapulmonary manifestations is especially important because of the potential serious and long-term effects of COVID-19 on multiple organ systems.

C-reactive protein (CRP) is a widely known, hepatically synthesized protein whose blood levels change rapidly and pronouncedly in response to any tissue damaging event associated with an inflammatory response. The synthesis and secretion of CRP is stimulated by interleukin-6, an early pleiotropic cytokine released by macrophages, endothelial, and other cells that are activated when localized normal tissue structures are compromised by trauma or disease. Serum CRP levels can change rapidly and robustly from 10-100-fold within 6-72 h of any tissue damaging event. Elevated blood levels correlate with the onset and extent of both activated inflammation and the acute phase biochemical response to the tissue insult. Because its functional bioactivity as the prototypic acute phase reactant has eluded clear definition for decades, diagnosticians of various conditions and diseases use CRP blood levels as a simple index for ongoing inflammation. In many pathologies, which involves many different tissues, stages of disease, treatments, and responses to treatments, its interpretive diagnostic value requires a deeper understanding of the localized tissue processes and events that contribute signals which regulate protective or pathological host defense bioactivities. This report presents concepts that describe how local tissue activation events can lead to a non-proteolytic, conformational rearrangement of CRP into a unique isoform with distinctive solubility, antigenicity, binding reactivities and bioactivities from that protein widely known and measured in serum. By describing factors that control the expression, tissue localization, half-life and pro-inflammatory amplification activity of this CRP isoform, a unifying explanation for the diagnostic significance of CRP measurement in disease is advanced.

As the results of clinical trials are inconsistent, we conducted this research to assess the effect of purified anthocyanins or anthocyanin-rich extract supplementation on C-reactive protein (CRP) levels. We searched several databases to identify and extract data on characteristics, methods and outcomes of the eligible randomised controlled trials (RCT). A random-effects model, weighted mean difference (WMD) and 95 % CI were applied for data analysis. To investigate the effects of the study quality score or design on our results, we performed the same analysis by excluding the studies of Karlsen et al., with the lowest quality score, and Hassellund et al., with a cross-over design. Meta-analysis showed that anthocyanins had no significant impact on CRP levels (WMD=0·018; 95 % CI –0·44, 0·47; P=0·94). Although the effect of anthocyanins was independent of supplementation duration (slope: 0·01; 95 % CI –0·002, 0·03; P=0·08), their effect depended on the dose of anthocyanins (slope: 0·001; 95 % CI 0·0007, 0·002; Pet al. and Hassellund et al. Finally, anthocyanins had no effect on CRP levels regarding healthy participants, patients and types of anthocyanins. Although changes in CRP concentrations had no association with trial duration, a significant relationship was found between anthocyanin dosage and CRP level. No significant result was observed between the anthocyanin dosage and CRP levels after excluding the mentioned studies. Further well-designed RCT are needed to validate these findings.

C-Reactive Protein (CRP) is one of the acute phase proteins present in normal serum in very little concentrations synthesized in the liver that play a role in inflammation. Obesity is a state of increase in body fat (adipocyte cells) in which adipocytes will try to maintain energy by releasing proinflammatory cytokines one of them interleukin 6 (IL-6), IL-6 release will induce CRP production in the liver. CRP examination on obese students in SMA Muhammadiyah 02 Medan.This research was conducted descriptively by Latex Aglutination method. This research was conducted at the Laboratory of Poltekkes Kemenkes Medan Health Analyst Department in May 2017 after sampling of students in SMA Muhammadiyah 02 Medan. The population of this research is 30 people of total population of 30 samples.Based on the research that has been done, the result of positive CRP examination is 18 percentage samples are 60% and 12 percent negative sample 40%. Based on sex, the result of positive CRP examination were 13 samples of female sex, 44% and 5 positive samples of male were 17%. Suggested on obese students to regularly exercise and live healthy with healthy foods also to avoid disease.

Schnitzler syndrome is an underdiagnosed clinical condition characterized by 2 major criteria: chronic recurrent urticarial eruption and monoclonal IgM gammopathy, as well as at least 2 of the following minor criteria: (1) recurrent fever, (2) high C-reactive protein (CRP) levels, (3) signs of abnormal bone remodeling with or without bone pain, and (4) neutrophilic infiltrates on skin biopsy.1 We report the case of a patient with history of hairy cell leukemia who exhibited atypical clinical presentation of chronic urticaria for 2 years before the final diagnosis of Schnitzler syndrome was established. To the best of our knowledge, this is the first reported case of Schnitzler syndrome associated with hairy cell leukemia.

Objectives: When laboratory Reference Ranges (RR) do not reflect analytical methodology, result interpretation can cause misclassification of patients and inappropriate management. This can be mitigated by determining and implementing method-specific RRs, which was the main objective of this study. Design and methods: Serum was obtained from healthy volunteers (Male + Female, n > 120) attending hospital health-check sessions during June and July 2011. Pseudo-anonymised aliquots were stored (at − 70 °C) prior t° analysis on Abbott ARCHITECT c16000 chemistry and i2000SR immunoassay analysers. Data were stratified by gender where appropriate. Outliers were excluded statistically (Tukey method) to generate non-parametric RRs (2.5th + 97.5th percentiles). RRs were compared to those quoted by Abbott and UK Pathology Harmony (PH) where possible. For 7 selected tests, RRs were verified using a data mining approach. Results: For chemistry tests (n = 23), Upper or Lower Reference Limits (LRL or URL) were > 20% different from Abbott ranges in 25% of tests (11% from PH ranges) but in 38% for immunoassay tests (n = 13). RRs (mmol/L) for sodium (138−144), potassium (3.8–4.9) and chloride (102−110) were considerably narrower than PH ranges (133–146, 3.5–5.0 and 95–108, respectively). The gender difference for ferritin (M: 29–441, F: 8–193 ng/mL) was more pronounced than reported by Abbott (M: 22–275, F: 5–204 ng/mL). Verification studies showed good agreement for chemistry tests (mean [SD] difference = 0.4% [1.2%]) but less so for immunoassay tests (27% [29%]), particularly for TSH (LRL). Conclusion: Where resource permits, we advocate using method-specific RRs in preference to other sources, particularly where method bias and lack of standardisation limits RR transferability and harmonisation. Keywords: Reference Ranges, Method-specific, Harmonisation

BACKGROUND Metabolic Syndrome (MetS) is generally characterised as a clustering of the abnormal levels of blood lipids (low HDL and high triglycerides), impaired fasting glucose, elevated blood pressure, and excess abdominal obesity. The objectives of the study areTo evaluate presence of Subclinical Hypothyroidism in the study population of the patients with metabolic syndrome. To find out relation between Subclinical Hypothyroidism and different parameters of metabolic syndrome. To evaluate whether patients of metabolic syndrome with raised hs-CRP have an increased risk of having hypothyroidism. MATERIALS AND METHODS A total of 50 adult patients who met with inclusion criteria were selected. Patients with metabolic syndrome (MetS) who fulfilled the NCEP-ATP III criteria: 3 out of 5 criteria positive. Patients with liver disorders, renal disorders, congestive cardiac failure, pregnant women, patients on oral contraceptive pills, statins and other medications that alter thyroid functions (e.g. lithium, amiodarone or γ-interferon) were excluded from the study. RESULTS A total of 50 patients of metabolic syndrome were enrolled. Out of which 36 were euthyroid, 3 were overt hypothyroid and 11 were subclinical hypothyroid. Out of 11 patients of subclinical hypothyroidism, 9 were female and 2 were male patients. Out of 28 females, 9 (32%) were SCH while out of 22 males, 2 (9%) were SCH. Out of 50 patients, 3 were overt hypothyroid. All 3 patients had BP >130/85, waist circumference was >88 cm and HDL of 130/85, HDL 150 mg/dL and fasting blood glucose of >100 mg/dL were more associated with male patients. CONCLUSION Subclinical Hypothyroidism was present in 22% of study population and more so in females having metabolic syndrome (32%). Hence, it will be worthwhile to screen female metabolic syndrome patients for thyroid function abnormality. Abnormal blood pressure, triglycerides and HDL cholesterol levels were more associated with subclinical hypothyroidism. In our study, all patients of metabolic syndrome had raised hs-CRP levels. Hence, the role of raised hs-CRP with thyroid dysfunction could not be established.

Chronic low-grade inflammation has been recognised as a key underlying mechanism for several chronic diseases, including cancer and CVD. Nutrition represents a host of key modifiable factors that influence chronic inflammation. Dietary inflammatory scores were developed to assess the inflammatory potential of the diet and have been associated with inflammatory biomarkers in cross-sectional and short-term longitudinal studies. The objective of this study was to investigate the relationship between the dietary inflammatory index (DII), the alternate dietary inflammatory index (ADII) and long-term C-reactive protein (CRP). We also tested age as an effect modifier of this relationship. Participants were selected in the Supplémentation en Vitamines et Minéraux Antioxydants study, which included subjects aged 45–60 years old for men and 35–60 years old for women in 1994. Participants with ≥3 24-h dietary records at baseline and a CRP measurement at the 12-year follow-up evaluation were included in the present study (n 1980). The relationships between the DII and ADII and elevated CRP (>3 mg/l) were investigated using logistic multivariable regression. All analyses were stratified by age (cut-off at median age=50 years old). The overall associations between DII and ADII and long-term CRP were not statistically significant (Ptrend across tertiles=0·16 for DII and 0·10 for ADII). A quantitative interaction was found between ADII score and age (P=0·16 for ADII, 0·36 for DII). In stratified analyses the ADII was significantly prospectively associated with CRP only in younger participants: OR tertile 3 v. tertile 1: 1·79 (95 % CI 1·04, 3·07). Pro-inflammatory diets may have long-term effect on CRP only in younger subjects.

Objectives The use of point-of-care (POC) methods and the measurements of C-reactive protein (CRP) as a diagnostic marker have both increased over the past years. This has led to an increase in POC-methods analysing CRP. High CRP levels are often seen as an indication for the subscription of antibiotics. The quality of POC-systems compared to routine diagnostic measurements for the analysis of CRP is thereby of main importance, since many small practises will use POC-methods. This study compared high-level CRP concentrations (above 100 mg/L) using an i-CHROMATM with 2 routinely used laboratory-based systems (Architect and ABX). Design and Methods: A total of 199 patient samples with a CRP concentration above 100 mg/L were analysed with the i-CHROMATM POC system and the turbidimetric routine methods using the Architect and ABX equipment. Results The results of the i-CHROMATM device showed a significant decrease in the CRP levels compared to those obtained with the Architect and the ABX (i-CHROMATM vs. Architect: y ​= ​0.6792x + 94.701; R2 = 0.4980, i-CHROMATM vs. ABX: y ​= ​0.3674x + 118.05; R2 ​= ​0.3964, Architect vs. ABX: y ​= ​0.7657x + 36.337; R2 = 0.9311). Furthermore, data analysis showed a partition of the i-CHROMATM measurements in two defined clouds, which could not be explained with any of the available sample information. Conclusions This analysis showed the limitations of the i-CHROMATM CRP analyser. In addition, it illustrates the need for strict regulations on the information and output provided by companies regarding the boundaries of novel and existing diagnostic methods., Highlights • The i-CHROMATM device gives lower high-level CRP values when compared to other methods. • Correction for haematocrit does not affect these results. • POC systems should be tested under real life conditions to ensure patient safety.

Studies have shown that the reduction in serum TAG concentrations with long-chain n-3 fatty acid supplementation is highly variable among individuals. The objectives of the present study were to compare the proportions of individuals whose TAG concentrations lowered after high-dose DHA and EPA, and to identify the predictors of response to both modalities. In a double-blind, controlled, crossover study, 154 men and women were randomised to three supplemented phases of 10 weeks each: (1) 2·7 g/d of DHA, (2) 2·7 g/d of EPA and (3) 3 g/d of maize oil, separated by 9-week washouts. As secondary analyses, the mean intra-individual variation in TAG was calculated using the standard deviation from the mean of four off-treatment samples. The response remained within the intra-individual variation (±0·25 mmol/l) in 47 and 57 % of participants after DHA and EPA, respectively. Although there was a greater proportion of participants with a reduction >0·25 mmol/l after DHA than after EPA (45 υ. 32 %; P < 0·001), the mean TAG reduction was comparable between groups (–0·59 (sem 0·04) υ. –0·57 (sem 0·05) mmol/l). Participants with a reduction >0·25 mmol/l after both DHA and EPA had higher non-HDL-cholesterol, TAG and insulin concentrations compared with other responders at baseline (all P < 0·05). In conclusion, supplementation with 2·7 g/d DHA or EPA had no meaningful effect on TAG concentrations in a large proportion of individuals with normal mean TAG concentrations at baseline. Although DHA lowered TAG in a greater proportion of individuals compared with EPA, the magnitude of TAG lowering among them was similar.

The use of minimally invasive tubular retractor microsurgery for treatment of multilevel spinal epidural abscess is described. This technique was used in 3 cases, and excellent results were achieved. The authors conclude that multilevel spinal epidural abscesses can be safely and effectively managed using microsurgery via a minimally invasive tubular retractor system.

Objectives The purposes of this study were to compare the relative fit of two alternative factor models of allostatic load (AL) and physiological systems, and to test factor invariance across age and sex. Methods Data were from the Midlife in the United States II Biomarker Project, a large (n = 1255) multisite study of adults aged 34 to 84 years (56.8% women). Specifically, 23 biomarkers were included, representing seven physiological systems: metabolic lipids, metabolic glucose, blood pressure, parasympathetic nervous system, sympathetic nervous system, hypothalamic-pituitary-adrenal axis, and inflammation. For factor invariance tests, age was categorized into three groups (≤45, 45–60, and >60 years). Results A bifactor model where biomarkers simultaneously load onto a common AL factor and seven unique system-specific factors provided the best fit to the biomarker data (comparative fit index = 0.967, root mean square error of approximation = 0.043, standardized root mean square residual = 0.028). Results from the bifactor model were consistent with invariance across age groups and sex. Conclusions These results support the theory that represents and operationalizes AL as multisystem physiological dysregulation and operationalizing AL as the shared variance across biomarkers. Results also demonstrate that in addition to the variance in biomarkers accounted for by AL, individual physiological systems account for unique variance in system-specific biomarkers. A bifactor model allows researchers greater precision to examine both AL and the unique effects of specific systems.

A Whipple-kór egy krónikus, szisztémás, relapsusokkal kísért, kezelés nélkül halálos kimenetelű bakteriális megbetegedés, amely jelentős diagnosztikus kihívást jelent mind a klinikusok, mind a patológusok számára. A betegség az esetek 80%-ában a középkorú, fehér, kaukázusi férfiakat érinti.Célkitűzés:A szerzők három eset kapcsán mutatnak rá a kórkép diagnosztikájának nehézségeire, valamint irodalmi áttekintést adnak a betegség etiológiájáról, klinikumáról, feltételezett patomechanizmusáról, valamint a kezelés lehetőségeiről.Következtetés:A kórkép kialakulásában immunológiai tényezők játszanak szerepet, azonban még nem tisztázott azok primer vagy szekunder jellege. Elsősorban a bélrendszer betegsége, azonban az extraintestinalis tünetek gyakran évekkel, évtizedekkel megelőzik az intestinalis tünetek megjelenését és a diagnózis felállítását. A betegség igazolásának klasszikus eszköze a vékonybél-biopsziás minták perjódsav-Schiff festése, valamint a kórokozó polimeráz láncreakcióval történő igazolása. A megfelelő antibiotikum kiválasztása és a terápia időtartama empirikus, azonban a kezelésre a legtöbb esetben azonnali válasz következik be. A relapsusok különösen központi idegrendszeri érintettség esetén gyakoriak.

We describe what we believe to be the first documented case of Mycobacterium goodii infection in Europe. It is also the second documented report of a pacemaker pocket surgical site infection caused by M. goodii. Although rarely involved in such infections, rapidly growing mycobacteria should be recognized during conventional bacteriological investigations and further identified by molecular tools to provide adequate therapy. In the present case, antimicrobial therapy with doxycycline without removal of the pacemaker was successful.

Infections account for considerable morbidity and mortality in patients with chronic renal failure undergoing hemodialysis (HD). Diagnosis of infection in HD patients is challenging because the most used laboratory parameters may be increased even in the absence of infection. In this setting, procalcitonin (PCT) could be useful for detection of systemic bacterial infections.We measured high sensitivity C Reactive Protein (hsCRP) and PCT serum levels before and immediately after dialysis in 44 HD patients (22 treated with high- and 22 with low-flux membranes), without history of infections.Patients on HD by high-flux membranes, but not by low-flux membranes, displayed mean PCT values significantly decreased after dialysis (high-flux: 0.50 vs. 0.26 ng/mL, p=0.005; low-flux: 0.41 vs. 0.42 ng/mL, p=0.863). HsCRP levels were unchanged. HsCRP correlated with PCT values both before and after HD only in patients on HD by low-flux membranes (r=0.51 and 0.47 before and after HD respectively; p0.05).Although PCT is considered a sensitive and specific diagnostic and prognostic marker of systemic bacterial infection, we suggest that specific reference ranges might be developed in patient with impaired renal function, also showing that and its clinical usefulness might be limited in patients undergoing HD with high-flux membranes.

Voriconazole (VRC) has not previously been reported to cause angio-oedema. Here, we report a case of angio-oedema associated with VRC therapy. A 37-year-old woman with relapsing invasive vertebral aspergillosis received intravenous VRC and developed angio-oedema 10 days after starting therapy. This condition rapidly diminished after administration of intravenous antihistaminics and did not necessitate cessation of VRC treatment. The treatment was continued for 6 months without recurrence of the symptoms. After 18 months, the patient was in good health. To our knowledge, this is the first report of an angio-oedema associated with VRC.

Summary Procalcitonin (PCT) is a marker of severe bacterial and fungal infections. The value of PCT in immunocompromise patients with HIV infection is not well established. We present the usefulness of PCT in diagnosis of various bacterial or fungal infections among HIV infected individuals. Procalcitonin (PCT) is released from the C-cells of the thyroid gland as a precursor of the hormone calcitonin . PCT has been proposed as a marker of severe bacterial and fungal infections. We analysed the last results of various trials with PCT as a marker of infections in patients with HIV.

Pediatric idiopathic intervertebral disc calcification (PIIVDC) is a rare condition; most cases are reported to be selflimited with conservative management. In this study, we describe a case of PIIVDC presenting with acute incomplete spinal cord injury with Brown-Séquard-plus syndrome that was treated with surgery and demonstrate the subsequent rehabilitation time course.

Introduction: C-reactive protein (CRP) and Bedside Index for Severity in Acute Pancreatitis (BISAP) have been used in early risk assessment of patients with AP. Objectives: We evaluated prognostic accuracy of CRP at 24 hours after hospital admission (CRP24) for in-hospital mortality (IM) in AP individually and with BISAP. Materials and Methods: This retrospective cohort study included 134 patients with AP from a Portuguese hospital in 2009-2010. Prognostic accuracy assessment used area under receiver-operating characteristic curve (AUC), continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Results: Thirteen percent of patients had severe AP, 26% developed pancreatic necrosis, and 7% died during index hospital stay. AUCs for CRP24 and BISAP individually were 0.80 (95% confidence interval (CI) 0.65-0.95) and 0.77 (95% CI 0.59-0.95), respectively. No patients with CRP24

This article reviews the function of cytokines during early pregnancy of mammals including the human species. Investigations concerning conceptus and other secretory proteins, their meaning for maternal recognition and maintenance of pregnancy, fetal and placental growth and differentiation, adhesion, invasion and implantation are discussed, and differences between laboratory rodents, carnivores, artiodactyls, horses and human beings elucidated and summarized. Finally topics that might be of interest for further research are emphasized.

Thrombocytopenia and Platelet Microvesicle Formation Caused by Legionella pneumophila Infection

Monkey-specific C-reactive protein (CRP) assay methods (enzyme-linked immunosorbent assay (ELISA) and turbidimetric immunoassay (TIA)) were developed. The anti-monkey CRP serum was prepared by immunization of rabbits with the immune complex formed between the acute-phase serum from turpentine oil-inoculated monkeys and goat anti-human CRP serum. The specificity of the rabbit anti-monkey CRP serum was confirmed by immunoelectrophoresis and Western blotting. The purity of monkey CRP prepared by chromatography procedures was confirmed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). The serum CRP levels in nine normal monkeys, as measured by sandwich ELISA were ranged from 0.26 to 1.42 microg/ml (mean 0.71+/-0.37). The CRP levels in five acute-phase sera of turpentine oil-inoculated monkeys were 248-451 microg/ml (mean 371.2+/-73.8). This monkey-specific CRP assay method was found more sensitive than the human-specific CRP assay method in detecting monkey CRP by TIA.