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The Diagnostic and Prognostic Value of Serum Procalcitonin among Ventilator Associated Pneumonia Patients

Open Journal of Respiratory Diseases 2013年第2期3卷 73-78页

作者： Ashraf Abd El Halim Adel Attia Taysser Zytoun hosam eldeen salah Chest Department Faculty of Medicine Zagazig University Zagazig Egypt Clinical Pathology Department Faculty of Medicine Zagazig University Zagazig Egypt Critical Care Department Faculty of Medicine Alexandria University Alexandria Egypt

Ventilator-associated pneumonia (VAP) is a complication in as many as 28% of patients who receive mechanical ventilation. Studies have consistently shown that a delay in diagnosis and treatment increases the mortality risk. The aim of this work was to clarify the role of the serum procalcitonin (PCT) in the diagnosis and the prognosis of ventilator associated pneumonia. Methods: Forty two VAP patients, 20 non VAP-ICU (on mechanical ventilation) admitted patients and 20 healthy control subjects of similar age and sex were included in the study. PCT levels in serum samples were measured in all subjects. Results: There was a highly statistically significant difference (p value 0.001) between VAP patients on one side and non VAP-ICU patients and healthy control subjects on the other side regarding the mean values of PCT. Also, the mean values of PCT were statistically significantly higher (p 0.001) among died VAP group than the survivor VAP group. There was a statistically positive correlation (p = 0.449), CRIP (R = 0.403) and SOFA (R = 0.437)) and initial PCT serum levels. Conclusions: This study found that the increased PCT serum level is an important diagnostic tool for VAP and the PCT serum levels can predict the outcome of VAP patients. We recommend other larger studies to augment our findings.

关键词： Ventilator-Associated Pneumonia (VAP) Procalcitonin (PCT) Acute Physiology and Chronic Health Evaluation II (APACHE II) The Sequential Organ Failure Assessment Score (SOFA) Clinical Pulmonary Infection Score (CPIS)

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Role of Ischemia Modified Albumin in Diagnosis of Pulmonary Embolism

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Open Journal of Respiratory Diseases 2014年第1期4卷 22-26页

作者： Ashraf Abd El Halim Adel Attia Saad Samra Tayseer Zytoun hosam eldeen salah Manal Al-Anazi Chest Department Faculty of Medicine Zagazig University Zagazig Egypt Clinical Pathology Department Faculty of Medicine Zagazig University Zagazig Egypt Critical Care Department Faculty of Medicine Alexandria University Alexandria Egypt Resident Internal Medicine King Fahad Specialist Hospital Dammam KSA

Pulmonary embolism is a common and potentially lethal condition. Clinical signs and symptoms for pulmonary embolism are nonspecific. New and simple tests are therefore needed in order to help in early diagnosis of pulmonary embolism. The aim of this work is to elucidate the role of IMA in the diagnosis of pulmonary embolism. Subjects and Methods: 75 patients with suspected pulmonary embolism and 20 control healthy subjects were included in this study. Measurement of IMA was done in all subjects. Results: The mean values of IMA were statistically significantly higher among the PE patient group (0.43 ± 0.104 ABSU) in comparison with non PE patient group (0.27 ± 0.053 ABSU) and healthy control subjects (0.21 ± 0.080 ABSU). At cut-off value of 0.305 ABSU, IMA had 97.5% sensitivity and 71.42% specificity. The area under the curve was 0.952. The positive predictive value of this cut-off value was 79.59% while the negative predictive value was 96.15%. Conclusions: IMA is a good alternative to D-dimer in the diagnosis and exclusion of PE. Larger studies are needed to augment our results.

关键词： Ischemia Modified Albumin D-Dimer Pulmonary Embolism

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Spontaneous bacterial peritonitis:risk factors and causative organisms

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Asian Pacific Journal of Tropical Medicine 2009年第6期2卷 52-58页

作者： Mahmoud M Al-Bendary Mahmoud Abdel-Aziz Waleed A Al-Sherbeeny Raghda El-Sayed Farag Abdel-Hady El-Gilany Mohammad hosam eldeen Zaghloul Tropical Medicine Unit Community Medicine DepartmentCollege of MedicineMansoura UniversityEgypt Clinical Pathology Department College of MedicineMansoura UniversityEgypt

Objective:To determine the prevalent pathogens responsible for spontaneous bacterial peritonitis(SBP) and their sensitivity pattern,to test the efficiency of different culture techniques in microbial isolation,and to study the diagnostic predictors of such ***:One hundred eight SBP episodes from 92 adult patients were compared to 88 cirrhotic ascites patients cross - matched with age and sex without *** fluid was subjected to cytological,biochemical examination and culture on both conventional and blood culture bottles at the bedside for bacterial identification and antimicrobial susceptibility ***:The prevalence of SBP was 25.02%.Logistic regression analysis revealed that;previous SBP episode,low ascitic fluid protein levels, high serum creatinine and low serum albumin levels were the independent significant predictors of *** forty - five per cent of SBP episodes were detected by conventional culture compared to 73.15%by modified technique with a significant *** - negative bacteria were the cause of SBP in 46(58.23%) culture positive *** coli and Staphylococcus aureus were the most commonly detected organisms. Resistance to different antibiotics was ***:Culture of ascitic fluid in blood culture bottles at bedside increases the sensitivity of SBP *** is a recent increase in Gram - positive pathogen with emergence of multidrug *** recent changes may have an impact on guidelines for management and treatment of SBP in our locality.

关键词： Spontaneous bacterial peritonitis Paracentesis Bedside inoculation Blood bottle culture

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