calca-protein--human and Pericardial-Effusion

The vascular endothelium has been shown to play a pivotal role in the pathophysiology of sepsis through the expression of surface proteins and secretion of soluble mediators. Endocan (endothelial cell-specific molecule-1), a 50-kDa dermatan sulfate proteoglycan, is expressed by endothelial cells in lung and kidney and can be detected at low levels in the serum of healthy subjects. Increased concentrations were described in patients with sepsis, severe sepsis and septic shock compared to healthy individuals, with serum concentrations related to the severity of illness. In the present study, we investigated endocan, procalcitonin and C-reactive protein in postmortem serum from femoral blood in a series of sepsis-related fatalities and control individuals who underwent medicolegal investigations. Endocan was also measured in pericardial fluid. Two study groups were prospectively formed, a sepsis-related fatalities group and a control group. The sepsis-related fatalities group consisted of sixteen forensic autopsy cases with documented clinical diagnosis of sepsis in vivo. The control group consisted of sixteen forensic autopsy cases with various noninfectious causes of death. Postmortem serum endocan concentrations were significantly higher in the sepsis group, with values ranging from 0.519 ng/ml to 6.756 ng/ml. In the control group, endocan levels were undetectable in eleven out of sixteen cases. The results of the data analysis revealed similar endocan concentrations in the pericardial fluid of both studied groups. Endocan can be considered a suitable biological parameter for the detection of sepsis-related deaths in forensic pathology routine.

Topics: Biomarkers; C-Reactive Protein; Calcitonin; Calcitonin Gene-Related Peptide; Diagnosis; Humans; Neoplasm Proteins; Pericardial Effusion; Prospective Studies; Protein Precursors; Proteoglycans; Sensitivity and Specificity; Sepsis; Severity of Illness Index

This study was designed to identify major risk factors of PCTS and elucidate the possibility of early laboratory diagnosis of this syndrome for the choice of optimal therapeutic strategy. Retrospective analysis covered medical records of 500 patients who had experienced open heart surgery. Prospective studies included 60 patients of whom 50 had clinical manifestations of PCTS. Risk of its development depended on the severity of the underlying disease and increased after mechanical revascularization of myocardium. Urgency surgical intervention and greater extent of coronary shunting increased the probability of PCTS. Results of the measurement of serum procalcitonin by a highly sensitive method and of relative content of different protein fractions in serum and pleural/pericardial fluid suggest high informative value of these methods as diagnostic tools for PCTS. Preventive treatment with non-steriodal anti-inflammatory agents decreased the incidence of PCTS by 53%.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Biomarkers; Blood Proteins; Calcitonin; Calcitonin Gene-Related Peptide; Cardiac Surgical Procedures; Early Diagnosis; Female; Humans; Male; Middle Aged; Pericardial Effusion; Pleural Effusion; Postpericardiotomy Syndrome; Prospective Studies; Protein Precursors; Retrospective Studies; Risk Factors

The paper analyzes the diagnostic value of methods for the laboratory diagnosis of postpericardiotomy syndrome (PPS) in patients who have undergone open heart surgery. The prospective study included 63 patients, of whom 53 had the clinical manifestations of PPS. Ultrasensitive assay of serum procalcitonin and the determination of relative albumin levels in pleural and pericardial fluids are noted to be of high diagnostic value.

Topics: Adenosine Deaminase; Blood Proteins; C-Reactive Protein; Calcitonin; Calcitonin Gene-Related Peptide; Humans; L-Lactate Dehydrogenase; Pericardial Effusion; Pleural Effusion; Postpericardiotomy Syndrome; Prospective Studies; Protein Precursors