In-hospital levels of C-reactive protein and IL-6 predict post-operative depressive symptoms among patients undergoing total knee replacement surgery
stress; Psychiatry; inflammation; arthroplasty; Neurosciences & Neurology; Immunology; major depression; symptoms; markers; total hip-replacement; coronary-heart-disease; Acute phase proteins; Acute phase proteins; C-reactive protein; Depressive; Interleukin-6; mood; Post-operative outcomes; serum interleukin-6; Total knee replacement surgery
Behavioral changes observed following immune system activation are similar to many of the hallmark symptoms of major depressive disorder (MDD), including appetite change, lethargy, fatigue, negative mood and anhedonia. Acute phase proteins, such as interleukin-6 (IL-6) and C-reactive protein (CRP) have been implicated in the production of sickness behavior, and research has revealed significant differences in the levels of these acute phase proteins between depressed and non-depressed individuals. The current study examined whether early post-operative IL-6 and CRP levels predicted subsequent depressive symptoms in 110 patients undergoing total knee replacement surgery (TKR). In-hospital levels of IL-6 and CRP predicted depressive symptoms at three-months following surgery, as indicated by significant main effects and a significant interaction term. Specifically, lower levels of in-hospital CRP and higher levels of IL-6 in-hospital predicted more depressive symptoms three-months following surgery. The finding that levels of acute phase proteins soon after surgery predict subsequent depressive symptoms, if replicated, extends prior research on the relationships between IL-6, CRP, and depression. Further, this predictive relationship suggests the possibility of early identification of individuals at risk for the subsequent development of post-operative depression. (C) 2009 Elsevier Inc. All rights reserved.
Cremeans-Smith J K; Soehlen S; Greene K; Alexander T; Delahanty D L
Brain Behavior and Immunity
2009
2009-11
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1016/j.bbi.2009.06.148" target="_blank" rel="noreferrer noopener">10.1016/j.bbi.2009.06.148</a>
Serum procalcitonin in the diagnosis and management of intra-abdominal infections
acute; anti-thymocyte globulin; antibiotic-therapy; antibiotic-therapy; appendicitis; c-reactive protein; critically-ill patients; intensive-care units; international multicenter; liver-transplantation; liver-transplantation; major abdominal-surgery; pancreatitis; peritonitis; Pharmacology & Pharmacy; procalcitonin; sepsis; spontaneous bacterial
The biomarker procalcitonin (PCT) has been used to diagnose and monitor a number of clinically significant infections. Serum levels of PCT are often increased in the presence of bacterial and fungal infections but not viral infections or noninfectious inflammation. Intra-abdominal infections (IAIs) are serious conditions that pose difficult challenges to physicians and the healthcare system. Researchers have evaluated PCT in the management of IAIs, both for diagnosis and for guiding antibiotic therapy. The studies have produced mixed results, leading to controversy on the utility of PCT in IAIs. PCT appears to be most useful in diagnosing postoperative infections and necrotizing pancreatitis. This review aims to summarize these data, explore the pathophysiology of PCT in sepsis from IAIs, discuss the strengths and weaknesses of PCT monitoring in IAIs, and provide guidance for the interpretation of PCT levels.
Watkins R R; Lemonovich T L
Expert Review of Anti-Infective Therapy
2012
2012-02
Journal Article
<a href="http://doi.org/10.1586/eri.11.164" target="_blank" rel="noreferrer noopener">10.1586/eri.11.164</a>
High risk for obstructive sleep apnea hypopnea syndrome predicts new onset atrial fibrillation after cardiac surgery: a retrospective analysis
arrhythmias; Atrial fibrillation; c-reactive protein; Coronary artery bypass graft surgery; cost; Length of; mortality; Neurosciences & Neurology; outcomes; recurrence; Respiratory System; Screening; Sleep apnea; stay
Purpose Obstructive sleep apnea hypopnea syndrome (OSAHS) is highly prevalent in patients undergoing coronary artery bypass surgery (CABG). OSAHS is a risk factor for the development of atrial fibrillation (AF), but the risk of AF in patients who are high risk for OSAHS is unclear. Methods A retrospective study was conducted on consecutive patients undergoing CABG from 2013 to 2015 without AF pre-operatively. Patients were categorized as low risk for OSAHS, high risk for OSAHS, or diagnosed OSAHS based on medical records review. All diagnosed OSAHS patients were on active treatment with positive airway pressure. Outcomes assessed were postoperative AF (POAF), postoperative length of stay, re-intubation, in-hospital mortality, and cost of hospitalization. Results Out of 209 eligible patients, 66.5% were low-risk for OSAHS, 18.7% high-risk for OSAHS, and 14.8% diagnosed/treated for OSAHS. POAF developed in 96 patients (45.9%) with greater frequency in high-risk OSAHS patients (69.2% high risk, 41.9% low risk, 40.3% diagnosed/treated, p = 0.01). In analyses adjusted for age, sex, ethnicity and comorbidities, high risk for OSAHS was associated with 2.9 greater odds (95% CI [1.2, 7.3], p = 0.02) for POAF while diagnosed/treated OSAHS was not associated with elevated risk (OR = 1.4, 95% CI [0.6, 3.6], p = 0.50) compared to patients at low risk for OSAHS. Conclusions High risk for OSAHS is an independent predictor for POAF in patients undergoing CABG. In contrast, patients diagnosed and treated for their OSAHS are not at elevated risk of POAF. These findings support evaluation of a standardized OSAHS screening and treatment program as part of the pre-operative evaluation for elective CABG.
Patel S V; Gill H; Shahi D; Rajabalan A; Patel P; Sonani R; Bhatt P; Rodriguez R D; Bautista M; Deshmukh A; Gonzalez J V; Patel S
Sleep and Breathing
2018
2018-12
Journal Article
<a href="http://doi.org/10.1007/s11325-018-1645-3" target="_blank" rel="noreferrer noopener">10.1007/s11325-018-1645-3</a>
Using Procalcitonin to Differentiate Bacterial from Viral Meningitis.
C-Reactive Protein; Meningitis; Biological Markers – Blood; Bacterial – Diagnosis; Viral – Diagnosis; Calcitonin – Diagnostic Use; Cerebrospinal Fluid – Analysis
Watkins Richard R
Hospital Medicine Alert
2015
2015-11
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