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Id: biblio-887051
Autor: Bahali, Anil Gulsel; Su, Ozlem; Emiroglu, Nazan; Cengiz, Fatma Pelin; Kaya, Mehmet Onur; Onsun, Nahide.
Título: Evaluation of mean platelet volume in localized scleroderma
Fonte: An. bras. dermatol;92(5):635-637, Sept.-Oct. 2017. tab.
Idioma: en.
Resumo: Abstract: Background: Localized scleroderma is a chronic inflammatory skin disease characterized by sclerosis of the dermis and subcutaneous tissue. Platelets play an important role in inflammation. Following activation, platelets rapidly release numerous mediators and cytokines, which contribute to inflammation. Objectives: To evaluate whether there was any relation between localized scleroderma and platelet parameters. Methods: Forty-one patients with localized scleroderma were enrolled in the study. The control group consisted of 30 healthy subjects. Results: The mean platelet volume level in the patient group was 9.9 ± 1.3 fl and in the control group was 7.6 ± 1.1 fl. This difference was statistically significant (p< 0.001). The plateletcrit values are minimally higher in the patient group as compared to the control group. It was statistically significant (p<0.001). There was no significant difference in the platelet counts between the two groups (p= 0.560) In the patient group, there was no significant relation between the mean platelet volume levels and clinical signs of disease (p=0.09). However, plateletcrit values are higher in generalized than localized forms of disease (p=0.01). Study Limitations: The limited number of patients and the retrospective nature of the study were our limitations. Conclusions: This study suggests that platelets might play a role in the pathogenesis of scleroderma. Platelet parameters may be used as markers for evaluating disease severity and inflammatory processes. Thus, there is a need for more detailed and prospective studies.
Descritores: Esclerodermia Localizada/sangue
Volume Plaquetário Médio
-Biomarcadores
Estudos de Casos e Controles
Limites: Seres Humanos
Masculino
Feminino
Criança
Adolescente
Adulto
Meia-Idade
Adulto Jovem
Responsável: BR1.1 - BIREME


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Id: biblio-887043
Autor: Peng, Jing; Sun, Shu-Bin; Yang, Pei-Pei; Fan, Yi-Ming.
Título: Is Ki-67, keratin 16, involucrin, and filaggrin immunostaining sufficient to diagnose inflammatory linear verrucous epidermal nevus? A report of eight cases and a comparison with psoriasis vulgaris
Fonte: An. bras. dermatol;92(5):682-685, Sept.-Oct. 2017. tab, graf.
Idioma: en.
Resumo: Abstract: Inflammatory linear verrucous epidermal nevus and linear psoriasis are sometimes hard to differentiate clinically and pathologically. Although immunohistochemical expression of keratin 10 (K10), K16, Ki-67, and involucrin may be useful for differentiating both entities, these results have been reported in only a few cases. We collected data from 8 patients with inflammatory linear verrucous epidermal nevus, 11 with psoriasis vulgaris, and 8 healthy controls and evaluated immunohistochemical expression of Ki-67, K16, involucrin, and filaggrin among them. Ki-67 and K16 overexpression was similar in inflammatory linear verrucous epidermal nevus and psoriasis vulgaris compared with normal skin. Although staining for involucrin showed discontinuous expression in parakeratotic regions in 4 inflammatory linear verrucous epidermal nevus cases, it was continuous in the other 4 cases and in all psoriasis vulgaris cases. Filaggrin expression was present in hyperkeratotic regions but scarce in parakeratotic areas in both inflammatory linear verrucous epidermal nevus and psoriasis vulgaris. The immunostaining pattern of Ki-67, K16, involucrin, and filaggrin may be insufficient to discriminate inflammatory linear verrucous epidermal nevus from psoriasis vulgaris.
Descritores: Precursores de Proteínas/análise
Psoríase/diagnóstico
Antígeno Ki-67/análise
Queratina-16/análise
Nevo Sebáceo de Jadassohn/diagnóstico
Proteínas de Filamentos Intermediários/análise
-Psoríase/patologia
Imuno-Histoquímica
Biomarcadores/análise
Estudos de Casos e Controles
Diagnóstico Diferencial
Nevo Sebáceo de Jadassohn/patologia
Limites: Seres Humanos
Masculino
Feminino
Pré-Escolar
Criança
Adolescente
Adulto
Meia-Idade
Idoso
Responsável: BR1.1 - BIREME


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Id: biblio-1053172
Autor: Belalcazar, Silvana; Acosta, Erika Jazmín; Medina Murillo, John Jairo; Salcedo Cifuentes, Mercedes.
Título: Conventional biomarkers for cardiovascular risks and their correlation with the Castelli Risk Index-Indices and TG/HDL-C / Biomarcadores convencionales de riesgo cardiovascular y su correlación con los índices de CASTELLI Y TG/CHDL
Fonte: Arch. med;20(1):11-22, 2020-01-18.
Idioma: en.
Resumo: Objective: to evaluate the correlation between a group of conventional biomarkers of cardiovascular risk with the Castelli-I and Castelli-II indices, and TG/HDL-C ratio in patients assigned to a program of cardiovascular risk for users of the clinical laboratory service of an institution that provides health services in the southwest of the Colombia.Materials and Methods: retrospective, descriptive multivariate exploratory study, carried out in 2 126 patients. Some sociodemographic variables were analyzed, as well as glucose and lipid profile. The Castelli-I and Castelli-II indices, and TG/HDL-C ratio were calculated. The correlation among the variables was evaluated through a matrix of correlations, the correlation index and the Bartlett's Test of Sphericity. The analysis ended with a study of main components, which allowed to identify how the variables studied were grouped into components that characterized the population. Results: the average age was 56 ± 11 years; 68.7% were women; 48% hypercholesterolemic and 49% hypertriglyceridemic; 22% with alterations in glucose. Total cholesterol correlated positively with LDL-C and triglycerides negatively with HDL-C. Two components characterized the population, one related to cardiovascular risk and the other to lipid alterations. Conclusions: conventional biomarkers reveal high prevalences in dyslipidemias, in contrast to atherogenic indices. The results highlight the importance of considering the evaluation of these indices in primary care and the need to strengthen the measurement systems of clinical laboratories for the reliability of the data on which decisions are made for the management of these patients..(AU)

Objetivo: evaluar la correlación entre un grupo de biomarcadores convencionales de riesgo cardiovascular con los índices de Castelli-I, Castelli-II y TG/cHDL en pacientes de riesgo cardiovascular usuarios del servicio de laboratorio clínico de una institución prestadora de servicios de salud del suroccidente de Colombia. Materiales y Métodos: estudio retrospectivo, descriptivo multivariado exploratorio, llevado a cabo en 2 126 pacientes. Se analizaron algunas variables sociodemográficas, glucosa y perfil lipídico. Se calcularon los índices de Castelli I/II y el índice de TG/cHDL. La correlación entre las variables se evaluó a través de una matriz de correlaciones, el índice de correlación y el Test de Esfericidad de Bartlet. El análisis finalizó con un estudio de componentes principales que permitió identificar como se agrupaban las variables estudiadas en componentes que caracterizaban a la población. Resultados: la edad promedio fue de 56±11 años, 68,7% fueron mujeres; 48% ipercolesterolemicos y 49% hipertrigliceridemicos; 22% con alteraciones en la glucosa. El colesterol total correlacionó positivamente con cLDL y los triglicéridos negativamente con cHDL. Dos componentes caracterizaron la población, uno relacionado con el riesgo cardiovascular y otro con las alteraciones lipídicas. Conclusiones: los biomarcadores convencionales develan altas prevalencias en las dislipidemias en contraste con los índices aterogénicos. Los resultados resaltan la importancia de considerar la evaluación de estos índices en atención primaria y la necesidad de fortalecer los sistemas de medición de los laboratorios clínicos para la confiabilidad de los datos sobre los cuales se toman decisiones en el manejo de estos pacientes.
Descritores: Biomarcadores
-Doenças Cardiovasculares
Limites: Seres Humanos
Tipo de Publ: Artigo Clássico
Responsável: CO279.1 - Centro de Biblioteca e Información


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Id: biblio-1053178
Autor: Chávez Vivas, Mónica; Lectamo Caicedo, Lisbeth.
Título: Niveles plasmáticos de la interlucina-1 ß (IL-1ß) en pacientes con diagnóstico de sepsis y choque séptico en la unidad de cuidados intensivos de una clínica en la ciudad de Cali (Colombia) / Plasmatic levels of Interleukin-1ß (IL-1ß) in Patients Diagnosed with Sepsis and Septic Shock in the Intensive Care Unit of a Clinic in the City of Cali (Colombia)
Fonte: Arch. med;20(1):23-32, 2020-01-18.
Idioma: es.
Resumo: Objetivo: el objetivo del presente estudio fue evaluar los niveles plasmáticos de IL-1ß como biomarcador de sepsis bacteriana en pacientes de una clínica de la ciudad de Cali. Materiales y métodos: se realizó un estudio prospectivo en 62 pacientes con sepsis y 20 adultos sanos como control, empleando la técnica de ELISA para medir los niveles plasmáticos de las citocinas. Un análisis de regresión logística se utilizó para estimar Odds Ratio (OR), expresado con su 95% intervalos de confianza (IC del 95%) para el resultado de la sepsis en relación a los niveles de IL-1ß. La prueba de Chi-cuadrado y la U de Mann-Whitney se emplearon cuando correspondió, valores de p<0,05, fueron considerados significativos y se empleó el paquete estadístico SPSS. Vs 23.00. Resultados: la edad promedio de los pacientes fue de 53 años y de estancia en la UCI de 7,00 días, 59,7% de ellos eran hombres. El foco pulmonar (43,5%), la hipertensión arterial (41,9%) y bacterias Gram negativas (59,7%) fueron los más prevalentes con una mortalidad del 16,1%. Los altos niveles de IL-1ß se asoció al desarrollo de choque séptico (OR=28,050; IC95%5,512-142,740;p<0,05) y con padecer insuficiencia respiratoria (OR=9,009;IC95%:0,013-0,941; p<0,05). Conclusión: este estudio evidenció niveles plasmáticos significativamente altos de la IL-1ß durante las primeras 48 horas en pacientes con choque séptico. Los altos niveles de esta citosina se relacionaron con mayor riesgo de desarrollo de choque séptico..(AU)

Objective: the objective of the present study was to evaluate plasma levels of IL-1ß were evaluated as a biomarker of bacterial sepsis in patients from a clinic in the city of Cali. Materials and methods: a prospective study was conducted a prospective study in 62 patients with sepsis and 20 healthy adults as control, using the ELISA test to measure plasma levels of cytokines. The analysis of the odds ratio (OR), expressed with its 95% confidence intervals (95% CI) for the outcome of sepsis in relation to the levels of IL-1ß. The Chi-square test and the Mann-Whitney U test will be applied when appropriate, the p values <0.05, and the statistical data of the SPSS statistical package. Vs 23.00. Results: the average age of the patients were 53 years and they were in the ICU of 7.00 days, 59.7% of them were men. The pulmonary focus (43.5%), arterial hypertension (41.9%) and Gram negative bacteria (59.7%) were the most prevalent with a mortality of 16.1%. The high levels of IL-1ß were associated with the development of septic shock (OR = 28,050, 95% CI 5,512-142,740, p<0.05) and with respiratory failure (OR = 9,009, 95% CI: 0.013-0.941, p<0.05. Conclusion: this study evidenced significantly high levels of IL-1ß during the first 48 hours in patients with septic shock. High levels of this cytokine were associated with increased risk of septic shock development..(AU)
Descritores: Choque Séptico
Biomarcadores
Sepse
Tipo de Publ: Artigo Clássico
Responsável: CO279.1 - Centro de Biblioteca e Información


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Id: biblio-949908
Autor: Çerman, Aslı Aksu; Karabay, Ezgi Aktaş; Altunay, Ilknur Kivanc; Cesur, Seher Küçükoğlu.
Título: Vitamin D levels in actinic keratosis: a preliminary study
Fonte: An. bras. dermatol;93(4):535-538, July-Aug. 2018. tab.
Idioma: en.
Resumo: Abstract: Background: Recent studies that investigated the effect of vitamin D on skin cancer risk have exhibited inconsistent results. Objective: The aim of the study was to evaluate vitamin D status in patients with actinic keratosis. Methods: A cross-sectional study was conducted on 31 patients with actinic keratosis and 29 healthy controls. Serum vitamin D levels in the study group were determined by liquid chromatography/tandem mass spectrometry. Results: Serum 25(OH)D levels in patients with actinic keratosis were significantly higher than those of the healthy controls (P=0.04). Prevalence of 25(OH)D deficiency was significantly higher in the healthy controls (75.9%) compared to the patients with actinic keratosis (54.8%), but the difference was not statistically significant (P= 0.09). Study limitations: The cross-sectional design of the study, data on smoking based on patient self-report, and subjects' different dietary habits, which can influence 25(OH)D levels, are the study's limitations. Conclusion: Serum vitamin D level can be used as a marker for ultraviolet B radiation from sun exposure; therefore, it can be used in individuals at risk of actinic keratosis. Oral intake of vitamin D through diet or supplements is proposed instead of prolonged ultraviolet exposure to maintain adequate vitamin D serum levels. Further research is needed to elucidate the role of vitamin D in skin carcinogenesis.
Descritores: Vitamina D/sangue
Ceratose Actínica/sangue
-Biomarcadores/sangue
Estudos de Casos e Controles
Estudos Transversais
Cromatografia Líquida de Alta Pressão
Espectrometria de Massas em Tandem
Limites: Seres Humanos
Masculino
Feminino
Idoso
Responsável: BR1.1 - BIREME


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Id: biblio-1041355
Autor: Simon, Miriam Isabel Souza dos Santos; Paulo, Gabriele Carra Forte; Marostica, José Cauduro.
Título: Body mass index and albumin levels are associated with pulmonary function parameters in pediatric subjects with cystic fibrosis / índice de massa corporal e níveis de albumina estão associados a parâmetros de função pulmonar em pacientes pediátricos com fibrose cística
Fonte: Rev. Paul. Pediatr. (Ed. Port., Online);37(4):414-418, Oct.-Dec. 2019. tab.
Idioma: en.
Resumo: ABSTRACT Objective: To evaluate the association of body mass index (BMI) and albumin with pulmonary function in cystic fibrosis (CF) pediatric subjects. Methods: This is a cross-sectional study with clinically stable CF's subjects. Clinical (pulmonary function) and nutritional evaluation (body mass index and albumin) were performed. Univariate analysis was performed using simple linear correlations. Regression analysis was performed using an exit level of p<0.05. Results: Seventy-eight CF's subjects (mean age 12.8±3.8 years) with mean albumin 4.2±0.4 mg/dL, predicted forced expiratory volume in 1 second (FEV1%) 80.8±22.6 and BMI median percentile 51.2 (1.3-97.7). In the multiple regression models, albumin, age and BMI percentile were associated with pulmonary function. Subjects with lower than 25 BMI percentile had 12.2% lower FEV1%. An albumin increase of 0.1 mg was associated with 2.7% increase in predicted FEV1%, and one year increase in age was associated with reduction in 1.2% of predicted FEV1%. Conclusions: BMI percentile, albumin and age were independently associated with predicted FEV1% in a tertiary referral hospital.

RESUMO Objetivo: Avaliar a associação do Índice de Massa Corporal (IMC) e da albumina com a função pulmonar em pacientes pediátricos com fibrose cística (FC). Métodos: Estudo transversal com pacientes pediátricos com FC clinicamente estáveis. Foram realizadas avaliação clínica (função pulmonar) e nutricional (IMC e albumina). Análise univariada foi realizada usando correlação linear simples. Análise de regressão foi realizada usando o nível de significância de p<0,05. Resultados: Foram incluídos 78 pacientes com FC (média de idade 12,8±3,8 anos) com média de albumina de 4,2±0,4 mg/dL, volume expiratório forçado em um segundo (VEF1%) predito de 80,8±22,6 e mediana do percentual de IMC de 51,2 (1,3-97,7). No modelo de regressão múltipla, albumina, idade e percentual de IMC apresentaram associação com a função pulmonar. Indivíduos com IMC abaixo de 25% apresentaram VEF1% predito 12,2% menor. Um aumento de 0,1 mg de albumina teve associação com aumento de 2,7% no VEF1% predito, e um ano a mais de idade mostrou relação com a redução de 1,2% de VEF1% predito. Conclusão: O percentual de IMC, albumina e idade apresentaram associação independente com o VEF1% predito em um hospital terciário de referência.
Descritores: Índice de Massa Corporal
Fibrose Cística/fisiopatologia
Albuminas/metabolismo
Pulmão/fisiopatologia
-Biomarcadores/metabolismo
Modelos Lineares
Volume Expiratório Forçado
Estudos Transversais
Fibrose Cística/metabolismo
Limites: Seres Humanos
Masculino
Feminino
Pré-Escolar
Criança
Adolescente
Responsável: BR1.1 - BIREME


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Id: biblio-974341
Autor: Kandil, Mona; Khalil, Gihane; El-Attar, Eman; Shehata, Gihan; Hassan, Salwa.
Título: Accuracy of heparin binding protein: as a new marker in prediction of acute bacterial meningitis
Fonte: Braz. j. microbiol;49(supl.1):213-219, 2018. tab, graf.
Idioma: en.
Resumo: ABSTRACT Background: Cerebrospinal fluid bacterial culture is the gold-standard for confirmation of acute bacterial meningitis, but many cases are not culture confirmed. Antibiotics reduce the chance of a microbiological diagnosis. Objective to evaluate efficacy of Heparin-binding protein in diagnosis of bacterial meningitis. Patients: 30 patients diagnosed with acute bacterial meningitis, 30 viral meningitis, and 30 subjects with normal CSF findings. Design: Diagnosis was based on history, clinical criteria, CSF examination, latex agglutination & culture, and sensitivities and response to therapy. HBP was measured using enzyme-linked immunosorbent technique in both serum & CSF. Results: Cerebrospinal fluid HBP levels averaged 0.82 ± 0.3 ng/mL in controls, 3.3 ± 1.7 ng/mL in viral and 174.8 ± 46.7 ng/mL in bacterial meningitis. Mean serum level was 0.84 ± 0.3 ng/mL in the controls, 3.7 ± 1.9 ng/mL in viral, and 192.2 ± 56.6 ng/mL in bacterial meningitis. Both HBP levels were significantly higher in patients with bacterial meningitis. Cut-offs of 56.7 ng/ml and 45.3 ng/ml in cerebrospinal fluid & serum showed 100% overall accuracy. Even in patients who received prior antibiotics, remained elevated. Conclusion: Serum Heparin-binding protein serves as a non-invasive potential marker of acute bacterial meningitis even in partially treated cases.
Descritores: Proteínas Sanguíneas/líquido cefalorraquidiano
Heparina/metabolismo
Proteínas de Transporte/líquido cefalorraquidiano
Proteínas de Transporte/sangue
Meningites Bacterianas/diagnóstico
Peptídeos Catiônicos Antimicrobianos/líquido cefalorraquidiano
Peptídeos Catiônicos Antimicrobianos/sangue
-Biomarcadores/líquido cefalorraquidiano
Biomarcadores/sangue
Estudos Transversais
Meningites Bacterianas/líquido cefalorraquidiano
Meningites Bacterianas/microbiologia
Meningites Bacterianas/sangue
Meia-Idade
Limites: Seres Humanos
Masculino
Feminino
Lactente
Pré-Escolar
Criança
Adolescente
Adulto
Adulto Jovem
Responsável: BR1.1 - BIREME


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Id: biblio-1011109
Autor: Nery, Rodrigo Araldi; Skare, Thelma Larocca.
Título: Serum uric acid and leg ulcers
Fonte: An. bras. dermatol;94(3):369-370, May-June 2019. graf.
Idioma: en.
Descritores: Ácido Úrico/sangue
Cicatrização
Úlcera da Perna/sangue
-Dor/etiologia
Biomarcadores/sangue
Limites: Seres Humanos
Masculino
Feminino
Meia-Idade
Tipo de Publ: Carta
Responsável: BR1.1 - BIREME


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Id: biblio-1011107
Autor: İslamoğlu, Zeynep Gizem Kaya.
Título: Second-to-fourth digit ratio and seborrheic dermatitis in males: a cross-sectional study*
Fonte: An. bras. dermatol;94(3):327-330, May-June 2019. tab.
Idioma: en.
Resumo: Abstract: Background: Seborrheic dermatitis is a common disease characterized by the erythematous plaques with oily-yellow desquamation. Increased sebaceous gland activity by androgenic hormones has played a role in the etiology of the disease. The second-to-fourth digit (2D:4D) ratio is thought to be a marker of prenatal androgen exposure. Objectives: To investigate the association between 2D:4D ratios and seborrheic dermatitis in a male population. Methods: Healthy male controls and patients with seborrheic dermatitis were included in this study. One hundred seborrheic dermatitis patients and 120 healthy controls, aged 17-59, were enrolled. A digital Vernier caliper was used to measure the finger lengths. Seborrheic dermatitis severity was assessed using the Seborrheic Dermatitis Area and Severity Index (SDASI). Results: The 2D:4D ratios of the patients (x = 0.977) were significantly lower than those of the controls (x = 1.050) for right hands (t = 6.948; p = 0.000; > 0.05). No similar relationship was found between the 2D:4D ratio for left hands (t = 0.901; p = 0.368; > 0.05). Seborrheic dermatitis severity was negatively correlated with 2D:4D ratios of right hands (r = -0.391; p = 0.000-0.05). Study limitations: One of the main limitations of this study was the small sample, which got a head of us from acquiring certain findings about the 2D:4D ratio and seborrheic dermatitis. The other limitation is that the patient selection did not reflect the general population, as a single clinic was studied. Conclusion: To the authors' knowledge, this is the first study examining the relationship between 2D:4D ratios and seborrheic dermatitis. The result of this study may indicate a line of investigation and can support the theory of prenatal androgen exposure.
Descritores: Dermatite Seborreica/diagnóstico
Dedos/anatomia & histologia
-Tamanho do Órgão
Efeitos Tardios da Exposição Pré-Natal
Índice de Gravidade de Doença
Gravidez
Biomarcadores
Estudos de Casos e Controles
Antropometria
Mãos/anatomia & histologia
Androgênios/metabolismo
Limites: Seres Humanos
Masculino
Feminino
Adolescente
Adulto
Meia-Idade
Adulto Jovem
Responsável: BR1.1 - BIREME


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Id: biblio-1038290
Autor: Lu, Wei; Chen, Baobing; Wang, Chunfeng; Yang, Xiaohong; Zhou, Changyu.
Título: Serum amyloid A levels in acute and chronic urticaria
Fonte: An. bras. dermatol;94(4):411-415, July-Aug. 2019. tab, graf.
Idioma: en.
Projeto: Zhejiang Provincial Administration of Traditional Chinese Medicine.
Resumo: Abstract: Background: Serum amyloid A is an acute-phase protein. There is no available data regarding serum amyloid A levels in patients with acute and chronic urticaria (CU). Objective: To investigate the association between serum amyloid A and urticaria. Methods: This was a case-control study of 81 patients who visited our Hospital between June and December 2016 with a diagnosis of urticaria. Eighty healthy controls (HC) who visited for routine health examination and physical checkups were recruited. Serum amyloid A and C-reactive protein levels were measured by automated methods. Results: Serum amyloid A and C-reactive protein levels were significantly higher in AU (Serum amyloid A: 207.1 (6.7-439.0) mg/L; C-reactive protein: 16.0 (0.2-90.0) mg/L) and CU (Serum amyloid A: 6.5 (2.5-35.8) mg/L; C-reactive protein: 1.0 (0.1-16.0) mg/L) compared with HC (Serum amyloid A: 5.04 (2.0-9.1) mg/L; C-reactive protein: 1.2 (0.1-5.6) mg/L), and in AU compared with CU (all P<0.05). There were no differences between the CU and HC group. In CU, Serum amyloid A levels in those with moderate/severe urticaria (median, 16.4 (9.7-35.8) mg/L) were higher than in those with mild urticaria (median, 5.7 (2.5-9.5) mg/L) and HC (all P<0.05). Serum amyloid A and C-reactive protein levels exceeded the normal lab range in 90.7% and 72.1% patients with AU compared with 28.9% and 13.2% patients with CU, respectively. Significant positive correlations were found between serum amyloid A and C-reactive protein (r = 0.562, P < 0.001). Study limitations: There was no comparison between active disease and remission. Conclusion: There was an association between serum amyloid A levels and urticaria. Higher serum amyloid A levels were associated with AU and more severe CU. Serum amyloid A may help to identify CU patients earlier.
Descritores: Urticária/sangue
Proteína Amiloide A Sérica/análise
-Valores de Referência
Índice de Gravidade de Doença
Proteína C-Reativa/análise
Biomarcadores/sangue
Estudos de Casos e Controles
Doença Crônica
Estudos Prospectivos
Estatísticas não Paramétricas
Limites: Seres Humanos
Masculino
Feminino
Adolescente
Adulto
Meia-Idade
Idoso
Adulto Jovem
Responsável: BR1.1 - BIREME



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