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Cardio- and neurotoxicity of amphetamines play an important role in worsening morbidity, making the initial evaluation of the patient’s status a potentially lifesaving action. The current study hypothesized that the S-100β serum level could predict the severity of acute amphetamine toxicity and the in-hospital outcome. The current study is a prospective cohort study conducted on 77 patients diagnosed with acute amphetamine exposure and referred to Aseer Poison Control Center, Saudi Arabia. The patients admitted to ICU showed significantly higher serum levels of S-100β in comparison to those not admitted (p 0.430 ug/L, the sensitivity of S-100β serum level as severity predictor was 100%, and the specificity was 74.1%. In conclusion, the current study revealed that the S-100β serum level could be used as an outcome predictor in hospital admission cases due to toxic amphetamine exposure and offers an idea about the cardiac and neuronal involvement. This can help select patients who will benefit most from ICU admission and early management and assess the severity of cases in settings where GC–MS is not available.

This study assessed whether S-100β protein could be measured in urine when detectable in plasma after a mild traumatic brain injury (mTBI). Clinical data, plasma and urine samples were collected for the 46 adult patients prospectively enrolled in the emergency department (ED) of a Level 1 trauma center. S-100β protein concentrations were analysed using ELISA. S-100β protein was detectable in 91% and 71% of plasma and urine samples, but values were not correlated (r = 0.002). Urine sampling would have been a non-invasive procedure, but it does not appear to be useful in the ED during the acute phase after an mTBI.Détection de la protéine S-100β dans le plasma et l’urine à la suite d’un traumatisme cranio-cérébral léger (TCCL). Cette étude a cherché à évaluer dans quelle mesure la teneur en protéine S-100β peut être mesurée dans l’urine après avoir été détectée dans le plasma, et ce, à la suite d’un TCCL. Des données cliniques ainsi que des échantillons de plasma et d’urine ont alors été collectés chez quarante-six patients adultes recrutés de façon prospective dans le service d’urgence d’un centre tertiaire de traumatologie. La teneur en protéine S-100β a été analysée au moyen de la méthode immuno-enzymatique ELISA. La protéine S-100β s’est avérée détectable dans respectivement 91 % et 71 % des échantillons de plasma et d’urine. Cela dit, les valeurs obtenues ne sont pas apparues corrélées (r = 0,002). Le fait de recourir à des échantillons d’urine aurait pu représenter une procédure non-invasive ; cependant, elle ne semble pas utile dans un service d’urgence lors de la phase aigüe consécutive à un TCCL.

Phosphides poisoning is a commonly encountered poisoning in most developing countries and is emerging as a common self-poisoning agent. Over the past 20 years, biochemical markers of brain damage have been increasingly studied as potential tools for prognostic evaluation. S-100β protein is the β-subunit of a calcium binding protein present mainly in glial and Schwann cells. The current study was conducted to evaluate central nervous system affection and the prognostic value of S-100β protein for prediction of mortality after acute phosphides intoxication. Twenty nine patients admitted to Poison Control Unit (Emergency Hospital, Tanta University) suffering from acute phosphide poisoning in nine months period were included in this study. For all patients sociodemographic, clinical and toxicological data were explored. One milliliter venous blood was withdrawn for analysis of S-100β protein level. Primary outcome included mortality. Meanwhile, secondary outcomes included GCS, hypotension and length of hospital stay. There was statistical significant difference between survivor patients and non-survivor patients regarding blood pressure. Meanwhile, no statistical significant difference was noticed between survivors and non-survivors in either GCS, pulse or duration of hospital stay. Toxicological data of the participant patients revealed that (96.6%) of patients were in suicidal attempts by oral route. Zink phosphide was identified in (75.9%) of patients, while, aluminum phosphide was recognized in (24.1%) patients. Serum level of S-100β concentrations was significantly increased in phosphide intoxicated patients compared to the reference value for detection of injury to neural tissue (0.1 µg/L). There was significant negative statistical correlation between serum S-100β concentrations and GCS. Analysis of (ROC) curve of serum S-100β level as a predictor of mortality showed (AUC) = 0.956, P 1.762 ug/l, serum S100β had a sensitivity of 100% and a specificity 95%. (PPV) was 95%, while (NPV) was 100%.

Objective: The serum S-100β protein level is a specific marker of damage to the central nerve system (CNS). We studied its significance in pediatric cardiac surgery as a possible marker of CNS damage.Methods: Subjects were 18 consecutive pediatric patients aged 12 days to 13 years (mean: 2.8 years) undergoing open-heart surgery. We measured the serum S-100β protein level using ELISA (SRL Co. Ltd., Tokyo) immediately after inducing anesthesia and immediately, 12 hours, and 24 hours after weaning from cardiopulmonary bypass (CPB).Results: None had postoperative neurological symptoms. The prebypass serum S-100β protein level showed a significant logarithmic correlation with patient age. All patients showed increased S-100β protein immediately after weaning from CPB, and multiple regression analysis showed that bypass time and cyanosis were significant factors in such as increase. Cyanosis was the only factor in increased S-100β protein levels 12 and 24 hours after weaning from CPB. The peak S-100β protein level showed a significant exponential correlation with bypass time.Conclusion: Serum S-100β protein elevated immediately after weaning from CPB correlated with bypass time but not with neurological symptoms. Physiological changes other than substantial brain damage caused by CPB may increase the serum S-100β protein level. Prebypass data on neonates and infants showed serum S-100β protein increased without brain damage supporting this hypothesis.

Patients undergoing cardiac surgery experience an ab normal whole-body inflammatory response after the initiation of cardiopulmonary bypass (CPB). The inflam matory response to CPB may cause postoperative or gan dysfunction and morbidity, especially in the pedi atric population. The systemic inflammatory response may be initiated during CPB by blood contact with the foreign surface of the pump circuit, ischemia-reperfu sion injury, and endotoxemia. Although significant mortality is rare, most patients undergoing CPB expe rience some degree of organ dysfunction as a result of the inflammatory response.

Resume Notre etude evalue l'apport du dosage serique de la PS100 pour la detection de metastase ganglionnaire au cours du suivi de patients operes d'un melanome malin en complement d'une scintigraphie au Sestamibi et d'une recherche du gene MDR1 afin de detecter un phenomene de chimioresistance. Nous avons etudie 37 patients aux antecedents de melanome malin presentant un examen clinique retrouvant une anomalie au niveau des aires de drainage ganglionnaires du melanome malin precedemment opere. La sensibilite et la specificite du dosage de la PS100 sont respectivement 95,5 % et 86,5 %; de la scintigraphie sont de 95 % et 85 %. Nous avons trouve une hyperexpression du gene MDR1 six fois. En cas de scintigraphie negative l'analyse conjointe du taux de PS100 et du resultat scintigraphique permet de discerner les patients MDR+ metastatiques des patients non melastatiques. Le dosage de la PS100 pourrait etre propose dans le suivi des melanomes malins

Resume Notre etude evalue l'apport du dosage serique de la proteine S-100 pour la detection de metastase ganglionnaire au cours du suivi de patients operes d'un melanome malin en complement d'une scintigraphie au 99m Tc-Sestamibi (MIBI) pour deux groupes de patients. Onze avec suspicion clinique de metastase beneficiant d'un dosage de PS-100 et d'une scintigraphie et 38 ne presentant pas d'anomalie clinique beneficiant d'un dosage de PS-100. La concentration de la proteine S-100 est elevee dans le cas des melanomes malins et liee au stade de la maladie. Le MIBI peut detecter les metastases ganglionnaires de melanome. La scintigraphie, le dosage de proteine S-100 et l'histologie ont ete concordants quatorze fois, cinq fois il y a eu discordance (1 FN de PS100, 1 FP de MIBI, 3 FN de MIBI) dans le 1 er groupe. Dans ce groupe la sensibilite de la scintigraphie est de 70 %, sa specificite de 90 %. Pour la proteine S-100 nous avons eu 90 % de sensibilite et 100 % de specificite. Dans le 2 e groupe le dosage de proteine S-100 a ete negatif 34 fois et positif quatre fois. La sensibilite du dosage est de 100 %, la specificite de 92 % pour ce groupe. Nous concluons a l'interet de l'exploration biologique et scintigraphique pour le suivi des melanomes malins.

We evaluated the protein levels of neuron-specific enolase (NSE) and S-100beta in serum and cerebrospinal fluid (CSF) in an animal model of acute spinal cord injury and ascertained their relevance. Spinal cord injury was induced at the T8 level in rats. Enzyme-linked immunosorbent assay was used to measure the protein levels of NSE and S-100beta in both serum and CSF at different time points (30 min, 2 h, 6 h, 12 h and 24 h after induction of spinal cord injury). There existed a significant correlation between neurological deficits and the severity of spinal cord injury (p0.05). Compared with the control group, the protein levels of NSE and S-100beta in serum and CSF significantly increased from 2 h after injury (p0.05) and reached a maximum at 6 h. Within a certain time window, the protein levels of NSE and S-100beta in serum and CSF were closely related to the severity of injury level (p0.05). The protein levels of NSE and S-100beta in serum and CSF significantly increased after experimental spinal cord injury in a time-dependent manner and thus may be considered specific biomarkers for acute spinal cord injury.

To describe normal serum levels of S-100beta in healthy children and determine whether serum S-100beta levels after traumatic brain injury are associated with outcome.Prospective cohort study.Urban, tertiary care, children's teaching hospital.A total of 136 healthy children and 27 children with traumatic brain injury.Serum S-100beta levels were measured in 136 healthy children. A total of 27 children with traumatic brain injury had S-100beta levels collected within 12 hrs of injury. Other indices of severity of injury measured were admission Glasgow Coma Scale score, and Pediatric Risk of Mortality score at 24 hrs (PRISM 24). Outcome was measured by the Pediatric Cerebral Performance Category (PCPC) score at hospital discharge and 6 months postinjury or at death.S-100beta levels in healthy children had a mean of 0.3 microg/L (90% confidence interval, 0.03-1.47) and inversely correlated with age, (r = -.32, p.001). In children with traumatic brain injury, 6-month postinjury outcome inversely correlated with Glasgow Coma Scale score (r = -.47, p =.01) and correlated with PRISM 24 score (r =.83, p.001) and S-100beta levels (r =.75, p.001). Six months postinjury, comparing good outcome (PCPCor = 3, n = 20) vs. poor outcome (PCPCor = 4, n = 7), median admission Glasgow Coma Scale scores were 8 (range, 3-15) and 3 (range, 3-7, p =.01), median PRISM 24 scores were 7 (range, 0-19) and 30 (range, 18-35, p.001), and median S-100beta levels were 0.85 microg/L (range, 0.08-4.8 microg/L) and 3.6 microg/L (range, 1.4-20 microg/L, p.001), respectively. A serum S-100beta level ofor =2.0 microg/L is associated with poor outcome, with a sensitivity of 86% and a specificity of 95%. The area under the receiver operating curve for S-100beta was 0.94 (+/-0.05).Serum S-100beta levels in healthy children have a moderate inverse correlation with age. After traumatic brain injury in children, the acute assessment of serum S-100beta levels seems to be associated with outcome.

Objective: To assess whether subtle brain damage after carotid endarterectomy could be detected using serum levels of neuron-specific enolase (NSE) or S-100β protein. Design: Prospective noninterventional study. Setting: University hospital. Participants: Twenty-two patients undergoing carotid endarterectomy and 16 patients undergoing repair of abdominal aortic aneurysm. Interventions: Serum levels of NSE and S-100β protein were measured in all patients before surgery and postoperatively at 12, 24, 36, and 48 hours. In patients undergoing carotid endarterectomy, neuropsychologic testing was performed before surgery and postoperatively at discharge from the hospital and after 3 months using a neuropsychologic test battery. Measurements and Main Results: Compared with abdominal aortic surgery patients, the preoperative serum concentration of NSE was significantly higher in carotid artery surgery patients. Postoperatively, the NSE serum level decreased significantly after uncomplicated carotid artery surgery, and the level was then similar to that in the aortic surgery patients. Before operation, the S-100β protein levels were similar in the two groups, but a significant increase was seen in aortic surgery patients postoperatively. Neuropsychologic testing after uncomplicated carotid artery surgery revealed cognitive dysfunction in 2 of 20 (10%) of the patients after 5 days and 3 of 16 (19%) of the patients after 3 months. There was no correlation between the change in cognitive function and the changes in blood levels of either NSE or S-100β protein. Conclusions: Subtle brain damage after carotid artery surgery could not be detected by measuring blood levels of NSE and S-100β protein. The NSE level was significantly higher before carotid artery surgery and decreased postoperatively to the level observed in aortic surgery.

Acute hemorrhagic stroke, a subtype of acute stroke is one of the leading causes of death and disability throughout the world. At present, the diagnosis of acute hemorrhagic stroke is mainly based on Computer Tomography (CT) or Magnetic Resonance Imaging (MRI) but till now no biomarkers are routinely used in acute hemorrhagic stroke management. This article is a critical and descriptive review on the role of S100β protein as a biomarker in acute hemorrhagic stroke. Plasma S-100β level increases significantly in acute hemorrhagic stroke patients when compared to the normal subjects. Beside, the plasma S-100β can be correlated to the volume of hemorrhage in brain measured by plane CT scan. Plasma S-100β is an useful biomarker in acute hemorrhagic stroke and can be used for estimation of volume of hemorrhage in brain in acute hemorrhagic stroke patients. Thus, S-100β can be useful as an alternative to CT scan/MRI in diagnosis and in taking therapeutic decision in acute hemorrhagic stroke management.

The human gene encoding the beta subunit of S-100 protein (S-100 beta) was mapped on chromosome 21. In order to confirm the expression of gene-dosage effect of S-100 beta in patients with Down's syndrome (DS), concentrations of immunoreactive S-100 alpha and S-100 beta proteins were determined in the blood plasma and lymphocytes fraction of the patients and control subjects. Cu/Zn-superoxide dismutase (SOD), a protein that is known to show the gene-dosage effect on the trisomy of chromosome 21, also was immunoassayed in the same blood samples as control proteins. In blood plasma, S-100 beta protein as well as Cu/Zn SOD was enhanced (P less than 0.001) in the patients (160 +/- 70 pg S-100 beta/ml and 87 +/- 83 ng SOD/ml, N = 44) as compared with control individuals (76 +/- 25 pg/ml, and 18 +/- 11 ng/ml, respectively, N = 28). However, concentrations of S-100 alpha in blood plasma of DS patients were similar to those of normal subjects. Concentrations of S-100 beta in lymphocyte fractions of DS patients (24.7 +/- 10.9 ng/mg protein) were also higher (P less than 0.001) than those of control subjects (10.1 +/- 5.8 ng/mg protein). These results indicate that gene-dosage effect of S-100 beta levels are expressed in DS patients.