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10.3748/wjg.v22.i41.9172 http://scihub22266oqcxt.onion/10.3748/wjg.v22.i41.9172 C5107598!5107598 !27895404     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=27895404 &cmd=llinks): Failed to open stream: HTTP request failed! 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Presepsin teardown - pitfalls of biomarkers in the diagnosis and prognosis of bacterial infection in cirrhosis |pdf=|usr=}}{{27895404 }} gab.com Text Presepsin teardown - pitfalls of biomarkers in the diagnosis and prognosis of bacterial infection in cirrhosis JO: World J Gastroenterol http://www.kidney.de/pget.php?&tw=1&pmid=27895404 #FOAvip AIM: To evaluate the diagnostic and prognostic value of presepsin in cirrhosis-associated bacterial infections. METHODS: Two hundred and sixteen patients with cirrhosis were enrolled. At admission, the presence of bacterial infections and level of plasma presepsin, serum C-reactive protein (CRP) and procalcitonin (PCT) were evaluated. Patients were followed for three months to assess the possible association between presepsin level and short-term mortality. RESULTS: Present 34.7 of patients had bacterial infection. Presepsin levels were significantly higher in patients with infection than without (median, 1002 pg/mL vs 477 pg/mL, P < 0.001), increasing with the severity of infection [organ failure (OF): Yes vs No, 2358 pg/mL vs 710 pg/mL, P < 0.001]. Diagnostic accuracy of presepsin for severe infections was similar to PCT and superior to CRP (AUC-ROC: 0.85, 0.85 and 0.66, respectively, P = NS for presepsin vs PCT and P < 0.01 for presepsin vs CRP). At the optimal cut-off value of presepsin > 1206 pg/mL sensitivity, specificity, positive predictive values and negative predictive values were as follows: 87.5%, 74.5%, 61.8% and 92.7%. The accuracy of presepsin, however, decreased in advanced stage of the disease or in the presence of renal failure, most probably because of the significantly elevated presepsin levels in non-infected patients. 28-d mortality rate was higher among patients with > 1277 pg/mL compared to those with ? 1277 pg/mL (46.9% vs 11.6%, P < 0.001). In a binary logistic regression analysis, however, only PCT (OR = 1.81, 95%CI: 1.09-3.01, P = 0.022) but neither presepsin nor CRP were independent risk factor for 28-d mortality after adjusting with MELD score and leukocyte count. CONCLUSION: Presepsin is a valuable new biomarker for defining severe infections in cirrhosis, proving same efficacy as PCT. However, it is not a useful marker of short-term mortality. Twit Text FOAVip Presepsin teardown - pitfalls of biomarkers in the diagnosis and prognosis of bacterial infection in cirrhosis ????World J Gastroenterol http://www.kidney.de/pget.php?&tw=1&pmid=27895404 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=27895404 #FOAvip English Wikipedia <ref>{{Cite pmid|27895404 }}</ref> Presepsin teardown - pitfalls of biomarkers in the diagnosis and prognosis of bacterial infection in cirrhosis #MMPMID27895404 Papp M ; Tornai T ; Vitalis Z ; Tornai I ; Tornai D ; Dinya T ; Sumegi A ; Antal-Szalmas P World J Gastroenterol 2016[Nov]; 22 (41 ): 9172-9185 PMID27895404 show ga AIM: To evaluate the diagnostic and prognostic value of presepsin in cirrhosis-associated bacterial infections. METHODS: Two hundred and sixteen patients with cirrhosis were enrolled. At admission, the presence of bacterial infections and level of plasma presepsin, serum C-reactive protein (CRP) and procalcitonin (PCT) were evaluated. Patients were followed for three months to assess the possible association between presepsin level and short-term mortality. RESULTS: Present 34.7 of patients had bacterial infection. Presepsin levels were significantly higher in patients with infection than without (median, 1002 pg/mL vs 477 pg/mL, P < 0.001), increasing with the severity of infection [organ failure (OF): Yes vs No, 2358 pg/mL vs 710 pg/mL, P < 0.001]. Diagnostic accuracy of presepsin for severe infections was similar to PCT and superior to CRP (AUC-ROC: 0.85, 0.85 and 0.66, respectively, P = NS for presepsin vs PCT and P < 0.01 for presepsin vs CRP). At the optimal cut-off value of presepsin > 1206 pg/mL sensitivity, specificity, positive predictive values and negative predictive values were as follows: 87.5%, 74.5%, 61.8% and 92.7%. The accuracy of presepsin, however, decreased in advanced stage of the disease or in the presence of renal failure, most probably because of the significantly elevated presepsin levels in non-infected patients. 28-d mortality rate was higher among patients with > 1277 pg/mL compared to those with ? 1277 pg/mL (46.9% vs 11.6%, P < 0.001). In a binary logistic regression analysis, however, only PCT (OR = 1.81, 95%CI: 1.09-3.01, P = 0.022) but neither presepsin nor CRP were independent risk factor for 28-d mortality after adjusting with MELD score and leukocyte count. CONCLUSION: Presepsin is a valuable new biomarker for defining severe infections in cirrhosis, proving same efficacy as PCT. However, it is not a useful marker of short-term mortality. |Aged [MESH] |Area Under Curve [MESH] |Bacterial Infections/*blood/diagnosis/microbiology/mortality [MESH] |Biomarkers/blood [MESH] |C-Reactive Protein/metabolism [MESH] |Calcitonin/blood [MESH] |Chi-Square Distribution [MESH] |Female [MESH] |Humans [MESH] |Lipopolysaccharide Receptors/*blood [MESH] |Liver Cirrhosis/*blood/diagnosis/microbiology/mortality [MESH] |Logistic Models [MESH] |Male [MESH] |Middle Aged [MESH] |Odds Ratio [MESH] |Peptide Fragments/*blood [MESH] |Predictive Value of Tests [MESH] |Prognosis [MESH] |ROC Curve [MESH] |Reproducibility of Results [MESH] |Retrospective Studies [MESH] |Risk Factors [MESH] |Severity of Illness Index [MESH] |Time Factors [MESH]Presepsin teardown - pitfalls of biomarkers in the diagnosis and progn(epmc).pdf DeepDyve Pubget Overpricing