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[PMID]: 29390529 [Au] Autor: Wang Y; Li W; Shi L; Zhang F; Zheng S [Ad] Endereço: Department of Periodontology. [Ti] Título: Comparison of clinical parameters, microbiological effects and calprotectin counts in gingival crevicular fluid between Er: YAG laser and conventional periodontal therapies: A split-mouth, single-blinded, randomized controlled trial. [So] Source: Medicine (Baltimore);96(51):e9367, 2017 Dec. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: The erbium-doped yttrium, aluminum, and garnet (Er:YAG) laser is thought to be the most promising laser for periodontal treatment; however, its application is still under consideration. The aim of this study was to compare Er:YAG laser monotherapy with conventional scaling and root planing (SRP) for chronic periodontitis using clinical parameters, the detection rate of periodontal pathogens, and the calprotectin level in gingival crevicular fluid. METHODS: Twenty-seven participants with moderate-to-advanced chronic periodontitis were included. In a split-mouth design, the 2 half-mouths of each participant were randomly assigned to Er:YAG laser or SRP (combination of ultrasonic and manual instruments) treatment. Clinical parameters were recorded at baseline, 6 weeks, and 3 and 6 months after treatment. At the same time points, gingival crevicular fluid was collected to analyze the detection rate of 6 periodontal pathogens by polymerase chain reaction and the levels of calprotectin by enzyme-linked immunosorbent assay. RESULTS: Both treatment groups showed significant reductions in probing depth (PD), bleeding index (BI), and clinical attachment level (CAL) from baseline to 6 months. For sites with 4 mm ≤ PD ≤ 6 mm at baseline, SRP resulted in a greater reduction in PD and CAL than Er:YAG laser treatment, and the difference remained at 6 months post-treatment (P = .01 and P < .01, respectively). For sites with PD ≥7 mm at baseline, the clinical parameters showed similar results between the 2 groups. SRP resulted in a lower detection rate of Porphyromonas gingivalis at 6 months post-treatment. The levels of calprotectin were significantly decreased from baseline to 6 months in both groups, without a significant difference between the groups. CONCLUSION: For mild pockets, conventional SRP may still be the preferred choice. For deep pockets, Er:YAG laser treatment could be an effective alternative. Studies are needed to explore more advanced instruments and new application methods for the Er:YAG laser for periodontal treatment in deep pockets. [Mh] Termos MeSH primário: Periodontite Crônica/terapia Líquido do Sulco Gengival/microbiologia Lasers de Estado Sólido/uso terapêutico Complexo Antígeno L1 Leucocitário/metabolismo Bolsa Periodontal/radioterapia Aplainamento Radicular/métodos [Mh] Termos MeSH secundário: Adulto Periodontite Crônica/diagnóstico Terapia Combinada Ensaio de Imunoadsorção Enzimática Feminino Seguimentos Seres Humanos Masculino Meia-Idade Índice Periodontal Medição de Risco Método Simples-Cego Fatores de Tempo Resultado do Tratamento [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL [Nm] Nome de substância: 0 (Leukocyte L1 Antigen Complex) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180219 [Lr] Data última revisão: 180219 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 180203 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000009367

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[PMID]: 28817809 [Au] Autor: Ohem J; Hradsky O; Zarubova K; Copova I; Bukovska P; Prusa R; Malickova K; Bronsky J [Ad] Endereço: Gastroenterology and Nutrition Unit, Department of Paediatrics, 2nd Faculty of Medicine, Charles, University and Motol University Hospital, Prague, Czech Republic. [Ti] Título: Evaluation of Infliximab Therapy in Children with Crohn's Disease Using Trough Levels Predictors. [So] Source: Dig Dis;36(1):40-48, 2018. [Is] ISSN: 1421-9875 [Cp] País de publicação: Switzerland [La] Idioma: eng [Ab] Resumo: BACKGROUND: In adults, infliximab (IFX) levels correlate with disease activity, and antibodies to IFX (ATIs) predict treatment failure. We aimed to determine the association of IFX levels and ATIs with disease activity in a paediatric population. We prospectively collected blood, stool, and clinical data from 65 patients (age 10.5-15.1 years) with Crohn's disease (CD) before IFX administration, and measured IFX trough levels, ATIs, and faecal calprotectin levels (CPT). Samples were collected during maintenance therapy. We used multivariate analysis to identify the predictors of IFX levels. SUMMARY: Lower levels of IFX were associated with ATIs positivity (OR 0.027, 95% CI 0.009-0.077). Higher C-reactive protein (CRP) level, erythrocyte sedimentation rate, and CPT levels were found in patients with lower IFX levels. The optimal combination of sensitivity (0.5) and specificity (0.74) for disease activity was calculated for IFX levels ≥1.1 µg/mL using CRP level <5 mg/L as a marker of laboratory remission. In a model that used CPT ≤100 µg/g as the definition of remission, the optimal IFX trough level was 3.5 µg/mL. No independent association between remission and ATIs was found in our study population. However, we found an independentz association between IFX levels and serum albumin levels (OR 1.364, 95% CI 1.169-1.593), p < 0.001. Key Messages: The paediatric population was similar to adult populations in terms of the association between IFX and ATIs as well as between IFX and disease activity. [Mh] Termos MeSH primário: Doença de Crohn/tratamento farmacológico Infliximab/uso terapêutico [Mh] Termos MeSH secundário: Adolescente Área Sob a Curva Biomarcadores/metabolismo Sedimentação Sanguínea Proteína C-Reativa/metabolismo Criança Doença de Crohn/sangue Fezes/química Feminino Seres Humanos Inflamação/patologia Infliximab/administração & dosagem Complexo Antígeno L1 Leucocitário/metabolismo Masculino Curva ROC Indução de Remissão Falha de Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE; OBSERVATIONAL STUDY [Nm] Nome de substância: 0 (Biomarkers); 0 (Leukocyte L1 Antigen Complex); 9007-41-4 (C-Reactive Protein); B72HH48FLU (Infliximab) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180216 [Lr] Data última revisão: 180216 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170818 [St] Status: MEDLINE [do] DOI: 10.1159/000477962

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[PMID]: 27773805 [Au] Autor: Camilleri M; Sellin JH; Barrett KE [Ad] Endereço: Clinical Enteric Neuroscience Translational and Epidemiological Research, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota. Electronic address: camilleri.michael@mayo.edu. [Ti] Título: Pathophysiology, Evaluation, and Management of Chronic Watery Diarrhea. [So] Source: Gastroenterology;152(3):515-532.e2, 2017 Feb. [Is] ISSN: 1528-0012 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Chronic watery diarrhea poses a diagnostic and therapeutic challenge and is often a disabling condition for patients. Although acute diarrhea is likely to be caused by infection, the causes of chronic diarrhea (>4 weeks in duration) are more elusive. We review the pathophysiology, diagnosis, and treatment of chronic diarrhea. Drawing on recent insights into the molecular mechanisms of intestinal epithelial transport and barrier function, we discuss how diarrhea can result from a decrease in luminal solute absorption, an increase in secretion, or both, as well as derangements in barrier properties. We also describe the various extraepithelial factors that activate diarrheal mechanisms. Finally, clinical evaluation and tests used in the assessment of patients presenting with chronic diarrhea are reviewed, and an algorithm guiding therapeutic decisions and pharmacotherapy is presented. [Mh] Termos MeSH primário: Diarreia/metabolismo Absorção Intestinal Secreções Intestinais Intestinos/metabolismo [Mh] Termos MeSH secundário: Proteína C-Reativa/metabolismo Cromograninas/metabolismo Doença Crônica Diarreia/diagnóstico Diarreia/fisiopatologia Diarreia/terapia Fezes/química Motilidade Gastrointestinal Seres Humanos Inflamação Intestinos/fisiopatologia Síndrome do Intestino Irritável/metabolismo Lactoferrina/metabolismo Complexo Antígeno L1 Leucocitário/metabolismo Concentração Osmolar Permeabilidade Prostaglandinas/metabolismo Serotonina/metabolismo Substância P/metabolismo [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Nm] Nome de substância: 0 (Chromogranins); 0 (Leukocyte L1 Antigen Complex); 0 (Prostaglandins); 333DO1RDJY (Serotonin); 33507-63-0 (Substance P); 9007-41-4 (C-Reactive Protein); EC 3.4.21.- (Lactoferrin) [Em] Mês de entrada: 1706 [Cu] Atualização por classe: 180201 [Lr] Data última revisão: 180201 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 161025 [St] Status: MEDLINE

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[PMID]: 28467330 [Au] Autor: Maconi G [Ad] Endereço: Gastroenterology Unit, Department of Biomedical and Clinical Sciences, L. Sacco University Hospital, Milan, Italy. giovanni.maconi@unimi.it. [Ti] Título: Diagnosis of symptomatic uncomplicated diverticular disease and the role of Rifaximin in management. [So] Source: Acta Biomed;88(1):25-32, 2017 Apr 28. [Is] ISSN: 0392-4203 [Cp] País de publicação: Italy [La] Idioma: eng [Ab] Resumo:  Patients with diverticulosis who develop persistent abdominal pain, bloating and changes in bowel habits not associated with overt inflammation may have symptomatic uncomplicated diverticular disease (SUDD). The severity and frequency of SUDD symptoms may have an impact on daily activities and severely affect quality of life. Effective management of SUDD should follow a three part strategy: divert, tackle and maintain. Divert to make the correct diagnosis: several symptoms of SUDD are common to other conditions that require different therapeutic approaches. However, several key differences should be used to diagnose SUDD. Pain in SUDD is normally in the iliac fossa, persistent, often lasting more than 24 hrs, and is not relieved by bowel movement, as is often the case with irritable bowel syndrome. Another difference is in the timing: the prevalence of SUDD increases with age, and patients under the age of 40 years are less likely to have diverticula. It is useful to establish whether a patient has diverticulosis, especially if the patient is relatively young; lack of diverticula excludes SUDD. Cross-sectional imaging is indicated; however, recent archival image data or ultrasonography may be useful alternatives. Laboratory tests should be ordered to exclude overt inflammation. Once the diagnosis of SUDD is made, the patient should receive effective therapy to tackle the condition. This should include dietary fibre supplementation and cyclic treatment with rifaximin 400 mg twice daily for 7 days per month. Once symptom control is achieved, it should be maintained by continuing therapy for at least 12 months. [Mh] Termos MeSH primário: Doenças Diverticulares/diagnóstico Doenças Diverticulares/tratamento farmacológico Fármacos Gastrointestinais/uso terapêutico Rifamicinas/uso terapêutico [Mh] Termos MeSH secundário: Dor Abdominal/tratamento farmacológico Biomarcadores/análise Proteína C-Reativa/análise Ensaios Clínicos como Assunto Constipação Intestinal/tratamento farmacológico Diagnóstico por Imagem Diarreia/tratamento farmacológico Fármacos Gastrointestinais/farmacologia Seres Humanos Complexo Antígeno L1 Leucocitário/análise Rifamicinas/farmacologia [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Nm] Nome de substância: 0 (Biomarkers); 0 (Gastrointestinal Agents); 0 (Leukocyte L1 Antigen Complex); 0 (Rifamycins); 9007-41-4 (C-Reactive Protein); L36O5T016N (rifaximin) [Em] Mês de entrada: 1801 [Cu] Atualização por classe: 180125 [Lr] Data última revisão: 180125 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170504 [St] Status: MEDLINE [do] DOI: 10.23750/abm.v88i1.6360

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[PMID]: 29211800 [Au] Autor: Holtman GA; Lisman-van Leeuwen Y; Kollen BJ; Norbruis OF; Escher JC; Walhout LC; Kindermann A; de Rijke YB; van Rheenen PF; Berger MY [Ad] Endereço: Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. [Ti] Título: Diagnostic test strategies in children at increased risk of inflammatory bowel disease in primary care. [So] Source: PLoS One;12(12):e0189111, 2017. [Is] ISSN: 1932-6203 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: In children with symptoms suggestive of inflammatory bowel disease (IBD) who present in primary care, the optimal test strategy for identifying those who require specialist care is unclear. We evaluated the following three test strategies to determine which was optimal for referring children with suspected IBD to specialist care: 1) alarm symptoms alone, 2) alarm symptoms plus c-reactive protein, and 3) alarm symptoms plus fecal calprotectin. METHODS: A prospective cohort study was conducted, including children with chronic gastrointestinal symptoms referred to pediatric gastroenterology. Outcome was defined as IBD confirmed by endoscopy, or IBD ruled out by either endoscopy or unremarkable clinical 12 month follow-up with no indication for endoscopy. Test strategy probabilities were generated by logistic regression analyses and compared by area under the receiver operating characteristic curves (AUC) and decision curves. RESULTS: We included 90 children, of whom 17 (19%) had IBD (n = 65 from primary care physicians, n = 25 from general pediatricians). Adding fecal calprotectin to alarm symptoms increased the AUC significantly from 0.80 (0.67-0.92) to 0.97 (0.93-1.00), but adding c-reactive protein to alarm symptoms did not increase the AUC significantly (p > 0.05). Decision curves confirmed these patterns, showing that alarm symptoms combined with fecal calprotectin produced the diagnostic test strategy with the highest net benefit at reasonable threshold probabilities. CONCLUSION: In primary care, when children are identified as being at high risk for IBD, adding fecal calprotectin testing to alarm symptoms was the optimal strategy for improving risk stratification. [Mh] Termos MeSH primário: Doenças Inflamatórias Intestinais/diagnóstico Atenção Primária à Saúde [Mh] Termos MeSH secundário: Adolescente Proteína C-Reativa/metabolismo Criança Pré-Escolar Feminino Seres Humanos Doenças Inflamatórias Intestinais/metabolismo Complexo Antígeno L1 Leucocitário/metabolismo Masculino Estudos Prospectivos [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Leukocyte L1 Antigen Complex); 9007-41-4 (C-Reactive Protein) [Em] Mês de entrada: 1712 [Cu] Atualização por classe: 171229 [Lr] Data última revisão: 171229 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171207 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0189111

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[PMID]: 29189869 [Au] Autor: Fluxá D; Flores L; Kronberg U; Moreno M; Figueroa C; Ibáñez P; Lubascher J; Simian D; Quera R [Ti] Título: [Acute severe ulcerative colitis treated with accelerated infliximab induction. Case report]. [Ti] Título: Terapia de inducción acelerada con infliximab en paciente con colitis ulcerosa grave refractaria a corticoides. Caso clínico.. [So] Source: Rev Med Chil;145(8):1083-1088, 2017 Aug. [Is] ISSN: 0717-6163 [Cp] País de publicação: Chile [La] Idioma: spa [Ab] Resumo: Acute severe ulcerative colitis (ASUC) is a potentially life-threatening condition that requires early recognition, hospitalization and adequate treatment. Currently, the use of infliximab in ulcerative colitis (UC) is recommended in the case of severe disease refractory to corticosteroids, once that superimposed bacterial or viral infections (such as cytomegalovirus or Clostridium difficile) have been excluded. However, conventional weight-based regimens of infliximab might be insufficient for patients with ASUC. Accelerated infliximab induction regimen may increase its serum concentration levels and efficacy by reducing early colectomy rates in these patients. We report a 34 year old female presenting with an ASUC. She was initially treated with hydrocortisone 300 mg/day and mesalazine enemas 4 g/day with an unfavorable clinical response. At the fifth day of therapy, an accelerated induction therapy with infliximab was started in doses of 10 mg/kg at weeks 0, 1 and 4. After the second dose, there was a favorable response with reduction of abdominal pain, stool frequency and hematochezia. She was discharged with prednisone and azathioprine. After a year of starting infliximab, the patient remains in clinical remission. [Mh] Termos MeSH primário: Colite Ulcerativa/tratamento farmacológico Fármacos Gastrointestinais/uso terapêutico Infliximab/uso terapêutico [Mh] Termos MeSH secundário: Doença Aguda Adulto Biópsia Colite Ulcerativa/diagnóstico por imagem Colite Ulcerativa/patologia Colonoscopia Fezes Feminino Seres Humanos Complexo Antígeno L1 Leucocitário/análise Resultado do Tratamento [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Gastrointestinal Agents); 0 (Leukocyte L1 Antigen Complex); B72HH48FLU (Infliximab) [Em] Mês de entrada: 1712 [Cu] Atualização por classe: 171218 [Lr] Data última revisão: 171218 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171201 [St] Status: MEDLINE

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[PMID]: 28954618 [Au] Autor: Linedale EC; Andrews JM [Ad] Endereço: University of Adelaide, Adelaide, SA Jane.Andrews@sa.gov.au. [Ti] Título: Diagnosis and management of irritable bowel syndrome: a guide for the generalist. [So] Source: Med J Aust;207(7):309-315, 2017 Sep 02. [Is] ISSN: 1326-5377 [Cp] País de publicação: Australia [La] Idioma: eng [Ab] Resumo: Irritable bowel syndrome (IBS) and other functional gastrointestinal disorders (FGIDs) are so prevalent they cannot reasonably have their diagnoses and management based within specialty care. However, delayed diagnosis, lengthy wait times for specialist review, overinvestigation and lack of clear diagnostic communication are common. The intrusive symptoms of IBS and other FGIDs impair patient functioning and reduce quality of life, and come with significant costs to individual patients and the health care system, which could be reduced with timely diagnosis and effective management. IBS, in particular, is no longer a diagnosis of exclusion, and there are now effective dietary and psychological therapies that may be accessed without specialist referral. The faecal calprotectin test is widely available, yet not on the Medical Benefits Schedule, and a normal test result reliably discriminates between people with IBS and patients who warrant specialist referral. [Mh] Termos MeSH primário: Síndrome do Intestino Irritável/diagnóstico Síndrome do Intestino Irritável/terapia [Mh] Termos MeSH secundário: Fezes/química Seres Humanos Complexo Antígeno L1 Leucocitário/análise Qualidade de Vida [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Nm] Nome de substância: 0 (Leukocyte L1 Antigen Complex) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171004 [Lr] Data última revisão: 171004 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170929 [St] Status: MEDLINE

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[PMID]: 28948412 [Au] Autor: Puolanne AM; Kolho KL; Alfthan H; Ristimäki A; Mustonen H; Färkkilä M [Ad] Endereço: Department of Medicine, Clinic of Gastroenterology, Helsinki University Hospital, Haartmaninkatu 4, P.O. Box 340, 00290, Helsinki, Finland. anna-maija.puolanne@hus.fi. [Ti] Título: Rapid Fecal Calprotectin Test and Symptom Index in Monitoring the Disease Activity in Colonic Inflammatory Bowel Disease. [So] Source: Dig Dis Sci;62(11):3123-3130, 2017 Nov. [Is] ISSN: 1573-2568 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Fecal calprotectin is a reliable surrogate marker for inflammatory activity in inflammatory bowel disease (IBD). AIMS: For the noninvasive monitoring of the activity of colonic inflammation, we validated a symptom index suitable for ulcerative colitis and colonic Crohn's disease. By combining the symptom index with a rapid semi-quantitative calprotectin test, we constructed a new activity index based on the highest AUCs, using histological remission as a reference. We also evaluated the correlation of the patient-reported influence of the IBD in the daily life, measured by a VAS, with the inflammation activity. METHODS: The disease activity of 72 patients with IBD of the colon was determined by endoscopic activity scores (SES-CD/UCEIS). The patients provided stool samples for determination of calprotectin and filled in a questionnaire about their symptoms during the last week. RESULTS: The results of the symptom index demonstrated a statistically significant correlation with the rapid calprotectin test, histological inflammation activity, and the VAS. No correlations were found between the VAS and calprotectin or the histological inflammation activity. The sensitivity of the combination index to detect active inflammation was slightly superior to fecal calprotectin alone. CONCLUSION: The new symptom index and the combination index are simple, noninvasive means for distinguishing remission from active inflammation in colonic IBD. With the VAS, we can pick up patients who need psychosocial support because of the disease burden, even if their IBD is in remission. [Mh] Termos MeSH primário: Colite Ulcerativa/diagnóstico Doença de Crohn/diagnóstico Fezes/química Complexo Antígeno L1 Leucocitário/análise [Mh] Termos MeSH secundário: Adolescente Adulto Idoso Área Sob a Curva Biomarcadores/análise Criança Pré-Escolar Colite Ulcerativa/metabolismo Colite Ulcerativa/terapia Colonoscopia Doença de Crohn/metabolismo Doença de Crohn/terapia Feminino Seres Humanos Masculino Meia-Idade Valor Preditivo dos Testes Curva ROC Indução de Remissão Reprodutibilidade dos Testes Índice de Gravidade de Doença Inquéritos e Questionários Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE; VALIDATION STUDIES [Nm] Nome de substância: 0 (Biomarkers); 0 (Leukocyte L1 Antigen Complex) [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171106 [Lr] Data última revisão: 171106 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 170927 [St] Status: MEDLINE [do] DOI: 10.1007/s10620-017-4770-0

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[PMID]: 28934315 [Au] Autor: Toyonaga T; Kobayashi T; Nakano M; Saito E; Umeda S; Okabayashi S; Ozaki R; Hibi T [Ad] Endereço: Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Minato-ku, Tokyo, Japan. [Ti] Título: Usefulness of fecal calprotectin for the early prediction of short-term outcomes of remission-induction treatments in ulcerative colitis in comparison with two-item patient-reported outcome. [So] Source: PLoS One;12(9):e0185131, 2017. [Is] ISSN: 1932-6203 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Fecal calprotectin (FC) is well accepted as a non-invasive biomarker which objectively reflects colonic inflammation in ulcerative colitis (UC). However, its value as a marker of response during the early phase of remission induction treatment has not been well studied. The aim of this study is to evaluate the significance of FC for predicting the short-term outcomes of remission induction treatment in patients with UC. METHODS: A prospective observational study was conducted among 31 patients with active UC. FC was monitored with two-item patient-reported outcome (PRO2), partial Mayo score (PMS), and Lichtiger clinical activity index (CAI) during the first 4 weeks of remission induction treatment. Clinical response was defined as a decrease in CAI of 3 or more points below baseline. Mucosal healing (MH) was defined as Mayo endoscopic subscore 0 or 1. Within-day and within-stool variability of FC were assessed during the first week of treatment. RESULTS: In week 4-clinical responders, PRO2, PMS, and CAI significantly decreased from day 3, however, FC did not show significant reduction until week 2. Among all markers, the decrease in PRO2 at week 4 most accurately predicted MH at week 12. Within-day variability of FC was remarkably wide even at the first week in clinical responders. Within-stool variability was extremely small. CONCLUSIONS: PRO2 predicted the short-term outcomes of remission induction treatment earlier than FC possibly because of the wide within-day variability of FC in active UC. [Mh] Termos MeSH primário: Colite Ulcerativa/tratamento farmacológico Colite Ulcerativa/metabolismo Fezes/química Complexo Antígeno L1 Leucocitário/análise [Mh] Termos MeSH secundário: Adulto Biomarcadores/análise Colite Ulcerativa/patologia Colonoscopia Feminino Seres Humanos Mucosa Intestinal/efeitos dos fármacos Mucosa Intestinal/metabolismo Mucosa Intestinal/patologia Masculino Medidas de Resultados Relatados pelo Paciente Estudos Prospectivos Curva ROC Indução de Remissão Reprodutibilidade dos Testes Índice de Gravidade de Doença Fatores de Tempo Resultado do Tratamento Cicatrização/efeitos dos fármacos Cicatrização/fisiologia [Pt] Tipo de publicação: JOURNAL ARTICLE; OBSERVATIONAL STUDY [Nm] Nome de substância: 0 (Biomarkers); 0 (Leukocyte L1 Antigen Complex) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171024 [Lr] Data última revisão: 171024 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170922 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0185131

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[PMID]: 28866970 [Au] Autor: Jonsson N; Nilsen T; Gille-Johnson P; Bell M; Martling CR; Larsson A; Mårtensson J [Ad] Endereço: Section of Anaesthesia and Intensive Care Medicine, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden. niklas.jonsson@karolinska.se. [Ti] Título: Calprotectin as an early biomarker of bacterial infections in critically ill patients: an exploratory cohort assessment. [So] Source: Crit Care Resusc;19(3):205-213, 2017 Sep. [Is] ISSN: 1441-2772 [Cp] País de publicação: Australia [La] Idioma: eng [Ab] Resumo: BACKGROUND: Calprotectin is the most abundant protein in the cytosolic fraction of neutrophils, and neutrophil degranulation is a major response to bacterial infections. OBJECTIVES: To assess the value of plasma calprotectin as an early marker of bacterial infections in critically ill patients and compare it with the corresponding values for procalcitonin (PCT), C-reactive protein (CRP) and white blood cell count (WBC). METHODS: We measured daily plasma calprotectin levels in 110 intensive care unit patients using a newly developed turbidimetric assay run on clinical chemistry analysers. The likelihood of infection was determined according to the International Sepsis Forum criteria. RESULTS: Overall, 58 patients (52.7%) developed a suspected or confirmed bacterial infection. Plasma calprotectin predicted such infections within 24 hours with an area under the receiver operating characteristics curve (ROC area) of 0.78 (95% CI, 0.68-0.89). The ROC area for calprotectin was significantly greater than the corresponding ROC areas for WBC (P < 0.001) and PCT (P = 0.02) but only marginally better than the ROC area for CRP (0.71; 95% CI, 0.68-0.89). CONCLUSION: Plasma calprotectin appears to be a useful early marker of bacterial infections in critically ill patients, with better predictive characteristics than WBC and PCT. [Mh] Termos MeSH primário: Infecções Bacterianas/metabolismo Calcitonina/metabolismo Estado Terminal Complexo Antígeno L1 Leucocitário/metabolismo [Mh] Termos MeSH secundário: APACHE Adulto Idoso Infecções Bacterianas/diagnóstico Infecções Bacterianas/epidemiologia Biomarcadores/metabolismo Proteína C-Reativa/metabolismo Estudos de Coortes Diagnóstico Precoce Feminino Seres Humanos Unidades de Terapia Intensiva Contagem de Leucócitos Modelos Logísticos Masculino Meia-Idade Análise Multivariada Escores de Disfunção Orgânica Curva ROC Medição de Risco Índice de Gravidade de Doença Suécia [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Biomarkers); 0 (Leukocyte L1 Antigen Complex); 9007-12-9 (Calcitonin); 9007-41-4 (C-Reactive Protein) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171017 [Lr] Data última revisão: 171017 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170905 [St] Status: MEDLINE

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