calca-protein--human and Heat-Stroke

The aim of this study was to describe the role of intestinal fatty acid-binding protein (iFABP) and allergy-related diamine oxidase (DAO) in patients with heat stroke (HS).. A total of 10 patients with HS in intensive care unit and 10 healthy volunteers were enrolled in this study. The plasma intestinal permeability markers iFABP and DAO were measured since the time of admission. The whole blood endotoxin was also assessed. The associations between iFABP, DAO, and endotoxin level were analyzed. Then, white blood cell count, procalcitonin, and C-reactive protein were examined. In addition, we also determined the levels of proinflammatory cytokines such as IL-1α, IL-6, and TNF-α.. Comparing with the healthy control, the plasma iFABP and DAO level in patients with HS increased significantly (P < .05). The kinetic curve showed that plasma iFABP and DAO level reached peak value at day 3 and day 4 after admission, respectively. The endotoxin level was positively correlated with iFABP and DAO level. We also observed a significantly increased level of procalcitonin and C-reactive protein but not white blood count in patients with HS. After treatment, the iFABP and DAO level decreased significantly (P < .05). A significant increase in level of IL-1α and IL-6 was also found in patients with HS.. The plasma concentrations of DAO and iFABP could reflect a better function of the intestinal mucosa barrier in patients with HS. Plasma iFABP and DAO level decreased significantly after the treatment and, thus, might be a predictor for the severity of HS.

Topics: Adult; Amine Oxidase (Copper-Containing); C-Reactive Protein; Calcitonin; Calcitonin Gene-Related Peptide; Case-Control Studies; Cytokines; Disease Progression; Endotoxins; Fatty Acid-Binding Proteins; Female; Heat Stroke; Humans; Interleukin-1alpha; Interleukin-6; Intestinal Mucosa; Male; Middle Aged; Permeability; Protein Precursors; Sepsis; Severity of Illness Index; Shock; Tumor Necrosis Factor-alpha; Young Adult

The aim of this study was to test if Procalcitonin PCT value at the time of admission is a predictor of mortality and/or a diagnostic marker of concomitant infection in exertional heatstroke.. 68 patients with exertional heatstroke admitted to the multidisciplinary intensive care unit were studied. Serum PCT was detected by means of a specific and ultrasensitive immunoluminometric assay within 2 h of admission. The Acute Physiology and Chronic Health Evaluation (APACHE) II score was evaluated within 24 h of admission.. There was no significant difference in PCT levels between concomitant infection and non-infection patients (p=0.712). Elevated PCT level in exertional heatstroke patients was associated with a more critical pathological state. PCT values in patients with multiple organ dysfunction syndrome (MODS) were significantly higher than those without MODS (p=0.007.). PCT values were also positively correlated with APACHE II scores (r=0.588, p=0.016). PCT values in non-survivors were higher than in survivors at univariate regression analysis (p=0.017). After adjusting for confounders, PCT concentration also remained an independent determinant of mortality (OR 2.98; 95% CI 1.02 to 4.41; p=0.039). Receiver operating characteristic curve for PCT concentration was located above the reference line, which shows an association with mortality. The area under the curve for PCT concentration (0.705; 95% CI 0.547 to 0.862) was statistical significantly (p=0.019). As a predictor of mortality, PCT value was inferior to APACHE II score.. PCT value at the time of admission is an independent predictor of mortality, but maybe not a good indicator of concomitant infection in exertional heatstroke.

Topics: Adult; Area Under Curve; Biomarkers; Body Temperature; Calcitonin; Calcitonin Gene-Related Peptide; China; Heat Stroke; Humans; Male; Physical Exertion; Predictive Value of Tests; Prospective Studies; Protein Precursors; Regression Analysis; Risk Factors; Sensitivity and Specificity; Young Adult

To study the effect of non-exertional heatstroke on serum procalcitonin (PCT) levels.. Cohort study.. The emergency and intensive care departments of two academic tertiary-care hospitals, Paris, France. A total of 53 patients with defined heatstroke attending the emergency department and/or the intensive care unit during the August 2003 heat wave in France.. None.. Serum PCT measurement using a sensitive assay and vital and routine biological variables on arrival of patients presenting with classic heatstroke. Thirty-day mortality was recorded.. Among the 53 patients included, 14 (26%) were admitted to an intensive care unit (ICU). At 30 days, 24 patients (45%) had died. Median PCT value was 0.58 microg/l (95% confidence interval 0.16-1.61) and 31 (58%) patients had PCT above 0.2 microg/l (PCT+). Temperature above or equal to 40 degrees C was the only variable significantly associated with fatal outcome. Median PCT values were 1.4 microg/l (0.16-4.71) and 0.18 microg/l (0.12-1.61) in the group of deceased and surviving patients respectively (p = 0.22). All patients admitted in ICU had elevated PCT values. Patients PCT+ initially presented with a more pronounced systemic inflammatory response. Microbiologically or clinically documented infection was not more frequent in PCT+ group.. High serum PCT levels can be observed in heatstroke without any concomitant documented bacterial infection. The PCT is not a valid mortality predictor in heatstroke but could be an indicator of the severity of illness. Heatstroke could represent a model of a "non-septic" pathway of PCT synthesis.

Topics: Aged; Biomarkers; Calcitonin; Calcitonin Gene-Related Peptide; Cohort Studies; Comorbidity; Emergency Service, Hospital; Extreme Heat; Female; Heat Stroke; Humans; Intensive Care Units; Male; Middle Aged; Paris; Prognosis; Protein Precursors

Procalcitonin, the precursor peptide of calcitonin, has been shown to be a serum marker of the severity and mortality of several systemic inflammatory response syndromes. This study addressed the correlation of serum procalcitonin with the course of classic (nonexertional) heatstroke.. Serum samples were collected prospectively every 6 hrs for 24 hrs.. Heatstroke treatment unit, Makkah, Saudi Arabia.. A total of 25 patients were admitted during the annual Hajj pilgrimage in 1994. Ten patients evaluated in the same treatment center with minor illnesses and without pyrexia served as controls.. Patients were cooled according to an established evaporation method.. Standard critical care parameters including continuous rectal temperature. A rapid immunochemical assay for serum procalcitonin was utilized. The mean serum procalcitonin was elevated 20-fold on admission in patients with heatstroke compared with controls (p < .011). The procalcitonin concentration subsequently increased to a plateau by 6 hrs and remained increased at 24 hrs, compared with the admission level (p < .0001). In this study, 77% of the patients with heatstroke survived. A subgroup analysis demonstrated that the patients who survived had a significantly higher procalcitonin concentration than those patients who died of heatstroke; a procalcitonin concentration of >0.5 ng/mL (>0.15 nmol/L) at 6 hrs predicted survival (p = .02).. Classic heatstroke is associated with increased concentrations of serum procalcitonin, particularly among survivors. Further studies are required to elucidate the source and action(s) of procalcitonin as well as its relationship to cytokine activation.

Topics: Adult; Aged; APACHE; Calcitonin; Calcitonin Gene-Related Peptide; Case-Control Studies; Cryotherapy; Female; Heat Stroke; Humans; Male; Middle Aged; Predictive Value of Tests; Prospective Studies; Protein Precursors; Reproducibility of Results; Survival Analysis; Time Factors