scholarly journals Serum NGAL in Critically Ill Children in ICU from a Single Center in Egypt

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Doaa Mohammed Youssef ◽  
Asmaa Mohammed Esh ◽  
Ebthag Helmy Hassan ◽  
Tahia Mohammed Ahmed
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Critically Ill ◽  
Predictive Value ◽  
Characteristic Curve ◽  
Kidney Injury ◽  
Critically Ill Children ◽  
Control Group ◽  
Mortality And Morbidity ◽  
Neutrophil Gelatinase Associated Lipocalin

Introduction. The mortality and morbidity associated with acute kidney injury (AKI), unfortunately, remain unacceptably high. We aimed to detect the extent of serum neutrophil gelatinase-associated lipocalin (NGAL) to early detect AKI in critically ill children. Subjects and Methods. This is a case control study. It included 75 subjects that include 15 as controls and 60 critically ill children. Patients were further subdivided according to RIFLE criteria into two other categories: patients who developed AKI and patients who did not develop AKI. Serum NGAL assayed on admission and after 3 days. Results. There was significant increase in the level of NGAL among patients group when compared with control group. Also, 21.7% of children admitted to PICU developed AKI from which 8.3% needed dialysis. The receiver operating characteristic curve of NGAL at day 0 revealed AUC of 0.63 with 95% CI of 0.50–0.77. At a cutoff value of 89.5 ng/mL, the sensitivity of NGAL was 84.6%, while specifcity was 59.6%, positive predictive value was 36.7%, negative predictive value was 68.4%, and accuracy was 93.3% in diagnosis of AKI. Conclusion. We found that NGAL acts as a sensitive marker rather than a specific one for AKI. At the same time, it presents as a negative predictive value more valuable than being a positive predictive value in detecting AKI.

scholarly journals Neutrophil Gelatinase Associated Lipocalin Urin sebagai Deteksi Dini Acute Kidney Injury

Sari Pediatri ◽  
2016 ◽  
Vol 16 (3) ◽  
pp. 195
Author(s):  
Siti Aizah Lawang ◽  
Antonius Pudjiadi ◽  
Abdul Latief
Keyword(s):  
Acute Kidney Injury ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Area Under Curve ◽  
Kidney Injury ◽  
Cross Sectional ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Consecutive Sampling ◽  
Neutrophil Gelatinase

Latar belakang. Penelitian terkini fokus pada identifikasi biomarker yang lebih dini untuk acute kidney injury (AKI). Salah satunya adalah neutrophil gelatinase associated lipocalin (NGAL), protein 25 kDa yang merupakan potensial biomarker dini untuk AKI.Tujuan. Melihat neutrophil gelatinase associated lipocalin (NGAL) sebagai biomarker dini untuk acute kidney injury (AKI).Metode. Penelitian kualitatif dengan desain uji diagnostik. Pengambilan sampel secara cross sectional dan consecutive sampling pada 50 orang anak, terdiri atas 28 sepsis dan 22 sepsis berat di ruang rawat intensif anak di RS. Cipto Mangunkusomo Jakarta dan RS. Wahidin Sudirohusodo Makassar.Hasil. Terdapat perbedaan sangat bermakna kadar NGAL urin dan kreatinin berdasarkan beratnya sepsis (p<0,001). Nilai rerata sepsis 132,93 ng/mL dan sepsis berat 2159,98 ng/mL. Terdapat perbedaan bermakna antara beratnya AKI menurut kriteria RIFFLE dengan beratnya sepsis (p=0,013). Tidak terdapat hubungan bermakna antara kadar NGAL urin dengan kriteria RIFFLE (p=0,173). Nilai sensitifitas NGAL urin 100% dan spesifisitas 63,63%, positive predictive value 27,27%, negative predictive value 100% dan area under curve (AuOC) 0,826.Kesimpulan. Neutrophil gelatinase associated lipocalin (NGAL) dapat dipakai sebagai skrining AKI.

Usefulness of the ACTEL Score to Predict Atrial Fibrillation in Patients with Cryptogenic Stroke

Cardiology ◽  
2020 ◽  
Vol 145 (3) ◽  
pp. 168-177 ◽  
Author(s):  
Antonio Muscari ◽  
Pietro Barone ◽  
Luca Faccioli ◽  
Marco Ghinelli ◽  
Marco Pastore Trossello ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Characteristic Curve ◽  
Cryptogenic Stroke ◽  
Left Ventricular ◽  
Control Group ◽  
End Diastolic Volume ◽  
Electrocardiogram Monitoring

Introduction: To assess the probability of undetected atrial fibrillation (AF) in patients with ischemic stroke, we previously compared patients who were first diagnosed with AF with patients with large or small artery disease and obtained the MrWALLETS 8-item scoring system. In the present study, we utilized cryptogenic strokes (CS) as the control group, as AF is normally sought among CS patients. Methods: We retrospectively examined 191 ischemic stroke patients (72.5 ± 12.6 years), 68 with first diagnosed AF and 123 with CS, who had undergone 2 brain CT scans, echocardiography, carotid/vertebral ultrasound, continuous electrocardiogram monitoring and anamnestic/laboratory search for cardiovascular risk factors. Results: In logistic regression, 5 variables were independently associated with AF, forming the “ACTEL” score: Age ≥75 years (OR 2.42, 95% CI 1.18–4.96, p = 0.02; +1 point); hyperCholesterolemia (OR 0.38, 95% CI 0.18–0.78, p = 0.009; –1 point); Tricuspid regurgitation ≥ mild-to-moderate (OR 4.99, 95% CI 1.63–15.27, p = 0.005; +1 point); left ventricular End-diastolic volume <65 mL (OR 7.43, 95% CI 2.44–22.6, p = 0.0004; +1 point); Left atrium ≥4 cm (OR 4.57, 95% CI 1.97–10.62, p = 0.0004; +1 point). The algebraic sum of these points may range from –1 to +4. For AF identification, the area under the receiver operating characteristic curve was 0.80 (95% CI 0.73–0.87). With a cutoff of ≥2, positive predictive value was 80.8%, specificity 92.7% and sensitivity 55.9%. Conclusions: The ACTEL score, a simplified and improved version of the MrWALLETS score, allows the identification of patients with first diagnosed AF, in the context of CSs, with a high positive predictive value.

scholarly journals Evaluation of serum neutrophil gelatinase-associated lipocalin in predicting acute kidney injury in critically ill patients

2017 ◽  
Vol 45 (3) ◽  
pp. 1231-1244 ◽  
Author(s):  
Chen-Chen Hang ◽  
Jun yang ◽  
Shuo Wang ◽  
Chun-Sheng Li ◽  
Zi-Ren Tang
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Acute Decompensated Heart Failure ◽  
Point Of Care ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Kidney Injury ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase

Objective This investigation evaluated the real-time point-of-care testing (RT-POCT) of neutrophil gelatinase-associated lipocalin (NGAL) for detecting acute kidney injury (AKI) and prognosis of critically ill patients. Methods A total of 249 critically ill patients in the emergency department (ED), who were diagnosed with acute decompensated heart failure, sepsis or diabetic ketoacidosis were enrolled in this study. All enrolled patients were followed up for 28 days or to death and the mortalities were recorded. Serum creatinine (sCr) and NGAL were measured. Results 40.6% enrolled patients deteriorated to AKI during the observation period. The NGAL level was significantly higher in the AKI versus non-AKI group. The NGAL levels in the non-survivors group at 7-day and 28-day were significantly higher than in the survivors group. NGAL was detected as an independent risk factor of AKI, and 7-day and 28-day morality. The receiver operating characteristic curve of NGAL was calculated for diagnosing AKI; the area under the curve (AUC) was significantly higher than that of 1-day eGFR. Conclusions NGAL is an independent predictor of AKI, and 7-day and 28-day mortality in critically ill ED patients, and can be an early alert for AKI and useful for determining prognosis.

Predictive Value of Matrix Metalloproteinases and Their Inhibitors for Mortality in Septic Patients: A Cohort Study

2017 ◽  
Vol 35 (1) ◽  
pp. 95-103 ◽  
Author(s):  
Sergio Serrano-Gomez ◽  
Gabriel Burgos-Angulo ◽  
Daniela Camila Niño-Vargas ◽  
María Eugenia Niño ◽  
María Eugenia Cárdenas ◽  
...  
Keyword(s):  
Cohort Study ◽  
Matrix Metalloproteinases ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Characteristic Curve ◽  
Population Sample ◽  
Tissue Inhibitor Of Metalloproteinase ◽  
Predictive Values ◽  
Sensitivity Specificity

Purpose: Over 170 biomarkers are being investigated regarding their prognostic and diagnostic accuracy in sepsis in order to find new tools to reduce morbidity and mortality. Matrix metalloproteinases (MMPs) and their inhibitors have been recently studied as promising new prognostic biomarkers in patients with sepsis. This study is aimed at determining the utility of several cutoff points of these biomarkers to predict mortality in patients with sepsis. Materials and Methods: A multicenter, prospective, analytic cohort study was performed in the metropolitan area of Bucaramanga, Colombia. A total of 289 patients with sepsis and septic shock were included. MMP-9, MMP-2, tissue inhibitor of metalloproteinase 1 (TIMP-1), TIMP-2, TIMP-1/MMP-9 ratio, and TIMP-2/MMP-2 ratio were determined in blood samples. Value ranges were correlated with mortality to estimate sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiving operating characteristic curve. Results: Sensitivity ranged from 33.3% (MMP-9/TIMP-1 ratio) to 60.6% (TIMP-1) and specificity varied from 38.8% (MMP-2/TIMP-2 ratio) to 58.5% (TIMP-1). As for predictive values, positive predictive value range was from 17.5% (MMP-9/TIMP-1 ratio) to 70.4% (MMP-2/TIMP-2 ratio), whereas negative predictive values were between 23.2% (MMP-2/TIMP-2 ratio) and 80.9% (TIMP-1). Finally, area under the curve scores ranged from 0.31 (MMP-9/TIMP-1 ratio) to 0.623 (TIMP-1). Conclusion: Although TIMP-1 showed higher sensitivity, specificity, and negative predictive value, with a representative population sample, we conclude that none of the evaluated biomarkers had significant predictive value for mortality.

Serum interleukin 6 and cancer antigen 125 in the non-invasive diagnosis of endometriosis

2018 ◽  
Vol 10 (2) ◽  
pp. 116-122
Author(s):  
Prasong Tanmahasamut ◽  
Ratthiporn Preukthanathorn ◽  
Chongdee Dangrat
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Interleukin 6 ◽  
Predictive Value ◽  
Control Group ◽  
Diagnostic Study ◽  
Cancer Antigen 125 ◽  
Cancer Antigen ◽  
Non Invasive ◽  
Combined Test

Background: The role of interleukin 6 in endometriosis has been extensively studied but results were inconsistent. The purpose of this study was to determine the performance of serum interleukin 6 and serum cancer antigen 125 for non-invasive diagnosis of endometriosis. Methods: In this prospective diagnostic study, 100 reproductive women who underwent laparoscopy were studies. Patients were divided into endometriosis group (n = 60) and control group (n = 40). Blood samples were taken preoperatively for analysis of serum interleukin 6 and cancer antigen 125 levels. Results: Level of serum interleukin 6 and cancer antigen 125 in endometriosis group were significantly higher than those in control group (1.93 versus <1.50 pg/mL and 41.85 versus 11.86 IU/mL, respectively). A cutoff level of interleukin 6 at 1.52 pg/mL provided sensitivity of 63.3%, specificity of 55%, positive predictive value of 67.9%, and negative predictive value of 50%. The threshold level of cancer antigen 125 at 31 IU/mL had sensitivity of 70%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 69%. The combined test had sensitivity of 86.7%, specificity of 60%, positive predictive value of 76.5%, and negative predictive value of 75%. The area under receiver operating characteristic curve of serum interleukin 6, cancer antigen 125, and combined test were 0.614, 0.945, and 0.945, respectively. Conclusion: Serum interleukin 6 is not suitable to be a candidate of serum marker for the diagnosis of endometriosis. Serum cancer antigen 125 is better than interleukin 6 for detection of endometriosis stage III/IV. Both of them had low performance for diagnostic test in minimal to mild endometriosis. The combined test does not add more benefit than using cancer antigen 125 alone.

CYFRA 21-1 as a novel diagnostic serum biomarker in pancreatic cancer.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 191-191
Author(s):  
Jung Hoon Kim ◽  
Joon Cheol Song ◽  
Jung Hyun Kwon ◽  
Dae Kyun Kim ◽  
Dong Wook Jekarl ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Serum Concentration ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Advanced Disease ◽  
Serum Biomarker ◽  
Control Group ◽  
Intermediate Filament Proteins ◽  
Sensitivity Specificity

191 Background: CYFRA 21-1 is a fragment of cytokeratin 19, a structure protein and part of intermediate filament proteins contributing to stability of epithelial cells. Serum concentration of CYFRA 21-1 is known to be elevated in many types of epithelial malignancies, and especially it has a prognostic and predictive value in patients with non-small cell lung cancer. We assessed serum CYFRA 21-1 and studied its clinical significance in patients with pancreatic cancer. Methods: The sera from 52 patients diagnosed with pancreatic cancer was collected between May 2012 and August 2013 at Incheon St. Mary’s hospital, Catholic University of Korea, School of Medicine and was measured for CYFRA 21-1 and CA 19-9. 48 patients had an advanced disease at presentation, 2 patients had a locally advanced disease, and 2 patients presented with a local disease. Control blood samples were obtained from 31 healthy individuals and 48 patients with nonmalignant hepatic or pancreatobiliary disease. We measured CYFRA 21-1 using two-step sandwich, chemiluminescent microparticle immunoassay, Architect i2000SR (Abbott Laboratories, Ltd., Il, USA). Results: Serum concentration of CYFRA 21-1 was significantly elevated in patients with pancreatic cancer compared with control group. (p=.000) CYFRA 21-1 ( >1.96 ng/ml as determined by the ROC curve) had a sensitivity, specificity, positive predictive value, and negative predictive value of 86.5%, 79.7%, 73.8%, 90% for the diagnosis of pancreatic cancer. Additionally, CA 19-9 ( >35 U/ml determined by our institute’s criteria) had a sensitivity, specificity, positive predictive value, and negative predictive value of 67.3%, 89.9%, 69.1%, 81.6%. The area under curve for CYFRA 21-1 and CA 19-9 was 86.3% and 81.5%, respectively. Conclusions: CYFRA 21-1 has a potential to become a novel serum biomarker for the diagnosis of pancreatic cancer. Serum concentration of CYFRA 21-1 in combination with CA 19-9 can be useful in clinical practice to diagnose pancreatic cancer.

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