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10.1186/s12916-017-0930-5 http://scihub22266oqcxt.onion/10.1186/s12916-017-0930-5 C5603161!5603161 !28918754     free     free     free Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\28918754 .jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117       BMC+Med 2017 ; 15 (1 ): 172 Nephropedia Template TP {{tp|p=28918754 |t=2017. Macrophage activation-like syndrome: an immunological entity associated with rapid progression to death in sepsis |pdf=|usr=}}{{28918754 }} gab.com Text Macrophage activation-like syndrome: an immunological entity associated with rapid progression to death in sepsis JO: BMC Med http://www.kidney.de/pget.php?&tw=1&pmid=28918754 #FOAvip BACKGROUND: A subanalysis of a randomized clinical trial indicated sepsis survival benefit from interleukin (IL)-1 blockade in patients with features of the macrophage activation-like syndrome (MALS). This study aimed to investigate the frequency of MALS and to develop a biomarker of diagnosis and prognosis. METHODS: Patients with infections and systemic inflammatory response syndrome were assigned to one test cohort (n?=?3417) and a validation cohort (n?=?1704). MALS was diagnosed for patients scoring positive either for the hemophagocytic syndrome score and/or having both hepatobiliary dysfunction and disseminated intravascular coagulation. Logistic regression analysis was used to estimate the predictive value of MALS for 10-day mortality in both cohorts. Ferritin, sCD163, IL-6, IL-10, IL-18, interferon gamma (IFN-?), and tumor necrosis factor alpha (TNF-?) were measured in the blood the first 24 h; ferritin measurements were repeated in 747 patients on day 3. RESULTS: The frequency of MALS was 3.7% and 4.3% in the test and the validation cohort, respectively. In both cohorts, MALS was an independent risk factor for 10-day mortality. A ferritin level above 4420 ng/ml was accompanied by 66.7% and 66% mortality after 28 days, respectively. Ferritin levels above 4420 ng/ml were associated with an increase of IL-6, IL-18, INF-?, and sCD163 and a decreased IL-10/TNF-? ratio, indicating predominance of pro-inflammatory phenomena. Any less than 15% decrease of ferritin on day 3 was associated with more than 90% sensitivity for unfavorable outcome after 10 days. This high mortality risk was also validated in an independent Swedish cohort (n?=?109). CONCLUSIONS: MALS is an independent life-threatening entity in sepsis. Ferritin measurements can provide early diagnosis of MALS and may allow for specific treatment. Twit Text FOAVip Macrophage activation-like syndrome: an immunological entity associated with rapid progression to death in sepsis ????BMC Med http://www.kidney.de/pget.php?&tw=1&pmid=28918754 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=28918754 #FOAvip English Wikipedia <ref>{{Cite pmid|28918754 }}</ref> Macrophage activation-like syndrome: an immunological entity associated with rapid progression to death in sepsis #MMPMID28918754 Kyriazopoulou E ; Leventogiannis K ; Norrby-Teglund A ; Dimopoulos G ; Pantazi A ; Orfanos SE ; Rovina N ; Tsangaris I ; Gkavogianni T ; Botsa E ; Chassiou E ; Kotanidou A ; Kontouli C ; Chaloulis P ; Velissaris D ; Savva A ; Cullberg JS ; Akinosoglou K ; Gogos C ; Armaganidis A ; Giamarellos-Bourboulis EJ BMC Med 2017[Sep]; 15 (1 ): 172 PMID28918754 show ga BACKGROUND: A subanalysis of a randomized clinical trial indicated sepsis survival benefit from interleukin (IL)-1 blockade in patients with features of the macrophage activation-like syndrome (MALS). This study aimed to investigate the frequency of MALS and to develop a biomarker of diagnosis and prognosis. METHODS: Patients with infections and systemic inflammatory response syndrome were assigned to one test cohort (n?=?3417) and a validation cohort (n?=?1704). MALS was diagnosed for patients scoring positive either for the hemophagocytic syndrome score and/or having both hepatobiliary dysfunction and disseminated intravascular coagulation. Logistic regression analysis was used to estimate the predictive value of MALS for 10-day mortality in both cohorts. Ferritin, sCD163, IL-6, IL-10, IL-18, interferon gamma (IFN-?), and tumor necrosis factor alpha (TNF-?) were measured in the blood the first 24 h; ferritin measurements were repeated in 747 patients on day 3. RESULTS: The frequency of MALS was 3.7% and 4.3% in the test and the validation cohort, respectively. In both cohorts, MALS was an independent risk factor for 10-day mortality. A ferritin level above 4420 ng/ml was accompanied by 66.7% and 66% mortality after 28 days, respectively. Ferritin levels above 4420 ng/ml were associated with an increase of IL-6, IL-18, INF-?, and sCD163 and a decreased IL-10/TNF-? ratio, indicating predominance of pro-inflammatory phenomena. Any less than 15% decrease of ferritin on day 3 was associated with more than 90% sensitivity for unfavorable outcome after 10 days. This high mortality risk was also validated in an independent Swedish cohort (n?=?109). CONCLUSIONS: MALS is an independent life-threatening entity in sepsis. Ferritin measurements can provide early diagnosis of MALS and may allow for specific treatment. |Adult [MESH] |Aged [MESH] |Cohort Studies [MESH] |Female [MESH] |Ferritins/*metabolism [MESH] |Humans [MESH] |Interleukin-18/*metabolism [MESH] |Macrophage Activation Syndrome/*complications/pathology [MESH] |Male [MESH] |Middle Aged [MESH] |Prognosis [MESH] |Prospective Studies [MESH] |Reproducibility of Results [MESH] |Sepsis/*etiology/mortality [MESH]Macrophage activation-like syndrome: an immunological entity associate(epmc).pdf DeepDyve Pubget Overpricing