ЭФФЕКТИВНОСТЬ САНАТОРНО-КУРОРТНОГО ЛЕЧЕНИЯ БОЛЬНЫХ С БРОНХИАЛЬНОЙ АСТМОЙ В ПОСТКОВИДНОМ ПЕРИОДЕ В УСЛОВИЯХ ЮЖНОГО БЕРЕГА КРЫМА

Cardiology Patient Page. C-reactive protein: a simple test to help predict risk of heart attack and stroke.

Post-COVID period is considered to be 12 weeks after the COVID-19 infection. Patients in the post-COVID period may have prolonged or newly developed symptoms. Depending on the prolonged effects of the disease, respiratory and functional parameters may be affected. The aim of the study is to investigate the effect of COVID-19 infection on respiratory and functional parameters in the post-COVID period. A cross-sectional study was conducted to evaluate the functional parameters of patients with COVID-19 in the post-COVID period. Subjects with a history of microbiologically proven COVID-19 infection were evaluated with 6-minute walk test results, Borg, and MRC results at least 12 weeks after COVID-19 infection. The relationship between demographic characteristics, comorbidities, vaccination status, and severity of disease with 6-minute walk test results and dyspnea scales in the post-COVID period was investigated. Two hundred seventeen patients were included in the study. The mean age of the patients was 48.6 ± 14.9 years and 126 (58.1%) of them were female. 142 (65.4%) of the patients were completely vaccinated against COVID-19 and 75 (34.6%) patients were incompletely vaccinated or unvaccinated. 158 (72.8%) patients had mild disease, 51 (23.5%) patients had moderate disease, and eight (3.7%) patients had severe disease. Those with a history of moderate or severe disease had significantly worsened functional parameters in the postCOVID period compared to those with mild COVID-19. The Borg scale and MRC dyspnea scale values were significantly higher in women (p= 0.008, p= 0.002, respectively). Functional parameters of those who were completely vaccinated against COVID-19 and those who were incompletely or unvaccinated individuals in the post-COVID period were similar. The functional parameters of people with moderate or severe COVID-19 disease were found to be significantly impaired in the post-COVID period. While the effect of smoking and vaccination status on functional parameters in the post-COVID period could not be demonstrated, disease severity and accompanying comorbidity were found to be effective.

Our aim was to study associations between serum fibrinogen and C-reactive protein (CRP) levels and respiratory parameters on polysomnography (PSG) in patients with snoring as their main complaint and compromised upper airway anatomy. In this retrospective study, consecutive patients (43 female and 132 male; age range 11-82years, respiratory distress index-RDI range 0.1-94.4/h) with snoring as their main complaint and compromised upper airway anatomy who underwent PSG were assessed. Spearman's Rho coefficients between RDI, AI (apnea index), hypopnea index (HI), average and lowest SpO2 (in %) and CRP- and fibrinogen serum levels were calculated. Comparisons between groups were made using Wilcoxon-W test. Patients with CRP>5mg/dl (22% of the cohort) had significantly increased RDI, AI, average and lowest SpO2 than patients with CRP<5mg/dl. Increased correlation coefficients were observed for average SpO2 (-0.386), RDI (0.355), lowest SpO2 (-0.323) and AI (0.309). Patients with fibrinogen >350mg/dl (in 33%) had significantly increased RDI, HI, AI, average and lowest SpO2 than patients with fibrinogen <350mg/dl. Increased correlation coefficients were found for average (-0.340) and lowest (-0.268) SpO2, RDI (0.236) and AI (0.229). Even patients with RDI<15/h had increased serum CRP-(in 11%) and/or fibrinogen-(in 19%) levels. Simultaneous elevation of both CRP and fibrinogen levels occurred only in patients with RDI>5/h. Systemic inflammation is strongly associated with average and lowest SpO2, RDI and AI (and with HI) in snorers with compromised upper airway anatomy and is present even in patients with primary snoring and mild obstructive sleep apnea.

Objective To analyze the curative effects of budesonide combined with salbutamol aerosol inhalation on the improvement of transforming growth factor-β (TGF-β), C-reactive protein (CRP) level and lung function in patients with bronchial asthma. Methods Seventy patients with bronchial asthma treated in Luoyang Third People’s Hospital from January 2016 to August 2018 were selected and divided into two groups according to treatment methods, with 35 cases in each group. All patients underwent routine treatment of bronchial asthma. In addition, patients in control group received budesonide inhalation therapy. And patients in observation group were treated by budesonide combined with salbutamol aerosol inhalation therapy. The improvements of related indicators and lung function were compared between the two groups. Results Before treatment, TGF-β and CRP levels were higher in control group and observation group, and there was no significant difference between the two groups (P>0.05). However, after treatment, the levels of TGF-β and CRP of the two groups were significantly decreased, while the changes in observation group was more remarkable than that in control group (P<0.05). After effective treatment, the relevant indicators of lung function, including forced expiratory volume in one second, peak expiratory flow and forced vital capacity, in observation group were higher than those in control group, and the difference was statistically significant (P<0.05). Conclusions For patients with bronchial asthma, budesonide combined with salbutamol aerosol inhalation can significantly improve airway inflammation, TGF-β and CRP levels, thereby enhancing lung function. Therefore, it is suitable for clinical application in bronchial asthma. Key words: Bronchial asthma; Budesonide; Salbutamol aerosol inhalation; Lung function; Transforming growth factor-β; C-reactive protein

Air pollution and biomarkers of systemic inflammation and tissue repair in COPD patients.

Glucagon-Like Peptide-1 Is a Marker of Systemic Inflammation in Patients Treated with High-Dose Chemotherapy and Autologous Stem Cell Transplantation.

Background/Objectives: Apical periodontitis is a prevalent dental condition associated with systemic inflammation. C-reactive protein (CRP) is a sensitive biomarker of inflammatory status. While previous studies have examined CRP changes after endodontic treatment, limited evidence exists on short-term systemic effects following clinically indicated endodontic therapy in healthy individuals. This prospective observational cohort study aimed to evaluate the impact of endodontic treatment or retreatment on serum CRP levels in patients with symptomatic and asymptomatic apical periodontitis and assess demographic influences. No control group was included. Methods: A prospective observational cohort study was conducted in a private endodontic clinic in Jeddah, Saudi Arabia (2021-2023). Three hundred ASA I patients were enrolled and categorized into symptomatic apical periodontitis (SAP) and asymptomatic apical periodontitis (AAP) groups. Blood samples were collected before treatment and two weeks post-treatment. CRP levels were measured using a high-sensitivity assay. Statistical analyses included paired t-tests, Mann-Whitney U tests, and multiple regression. Laboratory personnel were blinded to patient grouping. Results: CRP levels significantly decreased after treatment in both groups (SAP: 6.99 to 2.01 mg/L; AAP: 5.40 to 1.64 mg/L; p < 0.001). Reduction was greater in SAP (mean difference = 4.98 mg/L) than AAP (3.76 mg/L; p < 0.001). Paired t-test showed a very large effect size (Cohen's d = 3.51). Age and sex were not significant predictors of CRP changes (R2 < 0.02). Conclusions: Endodontic treatment or retreatment significantly reduces systemic inflammation in patients with apical periodontitis. These findings reinforce the oral-systemic health link and highlight the clinical relevance of managing apical infections. Longer-term studies and inclusion of additional biomarkers are recommended.

Lipoprotein(a) in various conditions: To keep a sense of proportions

Objective To analyze the correlation between serum C-reactive protein (CRP) and total serum immunoglobulin E (IgE) level and severity of asthma in children with acute attack. Methods Sixty children with acute asthma attack in Shanxi Children’s Hospital from January 2016 to January 2018 were randomly selected as observation group. In the same period, 30 healthy children were selected as control group. The levels of serum CRP and total IgE in the two groups were measured by turbidimetric inhibition immuno assay and rate nephelometry, respectively. The correlation between serum CRP and total IgE levels and severity of asthma in children with acute exacerbation was analyzed. Results The CRP level in observation group was significantly higher than that in control group [(9.52±2.02)mg/L vs.(1.04±0.75)mg/L], and the difference was statistically significant (P<0.05). The IgE level in observation group was significantly higher than that in control group [(387.1±75.2)IU/ml vs.(81.3±23.3)IU/ml, P<0.05]. Spearman correlation analysis showed that there was a negative correlation between serum CPR level and forced expiratory volume in first second predicted (FEV1%) in observation group (P<0.05), IgE level was negatively correlated with FEV1% (P<0.05). Conclusions Clinical detection of serum CRP and IgE levels in children with acute asthma is helpful for early diagnosis of asthma and its severity. Key words: Serum C-reactive protein; Total serum immunoglobulin E; Asthma; Acute attack; Severity

A role for CCR5+CD4 T cells in cutaneous psoriasis and for CD103+ CCR4+ CD8 Teff cells in the associated systemic inflammation

BackgroundThis study was to determine how C-reactive protein (CRP) responds after total knee replacement (TKR), including both unilateral and simultaneous bilateral TKR in Indian population and if it follows Anglo-Saxon trend. Published literature from North America and Europe shows CRP value peaks on the 2nd post-operative day and drops to normal by 6–8 weeks. We started the study with null hypothesis.Material and methodsThis is a prospective study, with 50 patients (all females, 25 received unilateral operations and 25 bilateral ones) included. CRP levels were measured, on the 2nd day, 8, 12 and 16 weeks after operation.ResultsIn both groups, CRP level rose the 2nd post-operative day. The rise in CRP level was significantly higher in the simultaneous bilateral TKR group than in the unilateral TKR group. In unilateral cases, CRP on the 2nd postoperative day ranged from 65 to 110 mg/l with average level of 80 mg/ml. In bilateral TKR cases, CRP level on the 2nd postoperative day was between 110 and 180 mg/l with a mean of 140 mg/ml. The CRP level returned to normal in about 40% of unilateral TKR patients 8 weeks after operation, while in 92% (23 out of 25) of bilateral simultaneous TKR patients it stayed at a high level 8 weeks post-op and did not come back to normal. At 12 weeks CRP decreased to normal in all 100% of unilateral TKR patients and 32% of bilateral TKR patients. At 16 weeks, CRP was normal in all bilateral TKR patients.Conclusion60% of our unilateral TKR patients and 92% of our simultaneous bilateral TKR patients did not achieve a normal CRP 8 weeks after operation. These findings are significant as CRP is commonly used as a very sensitive indicator of postoperative joint infection. Hence we conclude that in the Indian TKR patients the CRP values take longer time to return to normal than in their Anglo-Saxon counterparts. Published results regarding the normal levels of CRP in unilateral TKR should not be extrapolated to simultaneous bilateral TKR patients.

Aim. The research aims to identify the features of the structural and functional state of the myocardium and manifestations of systemic inflammation in patients with acute ST-elevation myocardial infarction in the presence of such risk factors as arterial hypertension and COVID-19. Material and Methods. The study included 68 patients with STEMI aged 45 to 83 years (mean age 63,80±9,30 years) who underwent primary percutaneous coronary intervention with stenting of the infarcted coronary artery within 24 hours of the onset of clinical manifestations. The proportion of men was 71,43 (60,36-81,33) %, women - 28,57 (18,67-39,64) %. Hypertension was present in 46 patients, and a history of COVID-19 in 26 (67,64 (56,14- 78,17) % and 38,24 (27,12-50,01) %; 17 patients had both risk factors, their proportion in the total sample was 25,00 (15,51-35,90) %. All patients underwent conventional examinations in accordance with local clinical protocols. In addition, the blood levels of natriuretic peptide (NT-proBNP) and C-reactive protein were determined, and an ultrasound examination of the heart was performed at the inpatient stage of treatment and after 6 weeks of follow-up. The results were evaluated using descriptive statistical analysis (arithmetic mean and its standard deviation; median and percentile, proportions and their 95 % confidence intervals calculated using the Wald and Fisher methods), unpaired Student's t-test, and Pearson correlation analysis. Results and Discussion. Most patients with hypertension on admission to the hospital for STEMI have pathological myocardial remodeling, which in 32,61 (19,97-46,69) % of cases is represented by concentric hypertrophy, and in 26,09 (14,56-39,59) % - by concentric left ventricular remodeling. At the time of hospitalization, these patients had a significantly reduced left ventricular ejection fraction (50,00±9,40 %; p&lt;0,001) and higher than the reference values of NT-proBNP (0,50 (0,30;3,30) ng/ml) and C-reactive protein (8,98 (2,30;18,60) IU/ml), p&lt;0,05. During 6 weeks of observation, the left ventricular ejection fraction increased to 55,30±6,80 % (p=0,003), the level of C-reactive protein reached normal values (2,25 (2,30;3,20) IU/mL, p&lt;0,001), but the blood level of NT-proBNP (0,50 (0,40;1,30) ng/mL, p=0,19) remained practically unchanged, indicating the persistence of heart failure in these patients. The correlation between NT-proBNP and ejection fraction in the presence of hypertension is inverse and weak (r=-0,29; p=0,06). In patients with COVID-19, normal left ventricular geometry at hospitalization was noted in only 23,08 (9,24-40,84) % of cases; concentric hypertrophy (42,31 (24,34-61,40) % of cases) and concentric remodeling (34,62 (17,90-53,58) % of patients) prevailed, as in patients with hypertension. In the dynamics of observation, the left ventricular ejection fraction in this category of patients, which was significantly reduced at the time of admission to the hospital (48,50±9,00 %, p&lt;0,001), and also slightly lower than in patients with arterial hypertension (p=0,43), increased to 51,00±9,80 % (p=0,20); C-reactive protein values were normalized, decreasing from 8,20 (5,30;14,30) tо 2,25 (1,30;2,60) IU/mL (p=0,006); the blood content of NT-proBNP, which at hospitalization significantly exceeded the norm and the corresponding values in patients with hypertension (p=0,039), statistically significantly decreased (from 061 (0,30;1,30) to 0,55 (0,40;0.80) ng/ml, p=0,021), indicating a more significant recovery of myocardial function in the presence of COVID-19 compared with such a risk factor as hypertension. The use of sodium-dependent glucose cotransporter type 2 inhibitors (dapagliflozin or empagliflozin) as part of complex treatment contributed to better results in left ventricular geometry and NT-proBNP and C-reactive protein values compared with patients who did not take these drugs, but no significant differences were obtained between these categories of patients. Conclusions. Pathologic myocardial remodeling (with predominance of concentric hypertrophy and concentric remodeling of the left ventricle), inherent in patients with hypertension, worsens (according to the dynamics of NT-proBNP in the blood) the course of the early postinfarction period in the presence of STEMI, contributing to the preservation of heart failure. In patients with COVID-19, at the time of STEMI, concentric hypertrophy (in almost half of patients) and concentric remodeling (in almost a third of patients) of the left ventricle are recorded, accompanied by a significant decrease in left ventricular ejection fraction and significantly higher NT-proBNP values compared with patients with hypertension (p=0,50 and p=0,039, respectively). COVID-19 should be considered, along with arterial hypertension, an important risk factor for adverse STEMI.

Objective To study the changes of C-reactive protein （CRP） and peripheral white blood cell（WBC） levels in children with febrile convulsions. Methods Children with fever were divid- ed into two groups（ 108 children with febrile convulsions and 98 children without febrile convulsions）. The levels of CRP and WBC were detected and statistically analyzed. Results The CRP levels were ele- vated in 30 children with febrile convulsions, whose WBC counts were（ 13.6 ±4. 5） × 10^9/L; The CRP levels were normal in 78 children with febrile convulsions, whose WBC counts were（ 12.2 ±4.6） ×10^9/L. The CRP levels were elevated in 52 children without febrile convulsions, whose WBC counts were （9. 8±4.3） × 10^9/L; The CRP levels were normal in 46 children without febrile convulsions, whose WBC counts were（7.6 ±3.2） × 10^9/L. Whether the levels of CRP increased or not, the WBC counts in children with febrile convulsions were obviously higher than those in children without febrile convulsions, there were significant differences （P 〈 0.05 ）. Among the 78 children with febrile convulsions whose CRP levels were normal, 52 eases（66.7% ） had elevated WBC counts. While among the 46 children without febrile convulsions whose CRP levels were normal, 10 cases（21.7% ） had elevated WBC counts. There were significant differences （P 〈 0. 05）. Conclusions The peripheral white blood cell（WBC） levels are not paralleled with the levels of CRP in children with febrile convulsions, and the WBC counts often are higher than those in children without febrile convulsions. Key words: Febrile convulsions ; White blood cell ; C-reactive protein ; Children

Value of C-reactive protein levels and IL-6 in predicting events levels in women at increased cardiovascular risk

Chronic inflammation, even at subclinical levels, is associated with adverse long-term outcome. In this prospective, observational study, 66 critically ill patients surviving to hospital discharge were included. C-reactive protein (CRP) levels were determined at hospital discharge, 1, 2, and 6 weeks after hospital discharge. All the patients were repeatedly screened for adverse events resulting in rehospitalization or death for 1.5 years. After hospital discharge, over two-thirds of the patients exhibited elevated CRP levels (>2.0 mg/L). During the first week, CRP decreased compared with hospital discharge (P < 0.001) but did not change after week 1 (P = 0.67). Age (P = 0.24), surgical status (P = 0.95), or sepsis (P = 0.77) did not influence the CRP course. The latter differed between patients with (n = 15) and without (n = 51) adverse events (P = 0.003). CRP levels of patients without adverse events persistently decreased after hospital discharge (P = 0.03), whereas those of patients with adverse events did not (P = 0.86) but rebounded early. Plasma CRP levels in critically ill patients decreased during the first week after hospital discharge but remained unchanged during the subsequent 5 weeks. Over two-thirds of the patients exhibited elevated CRP levels compatible with chronic sub-clinical inflammation. Persistently elevated CRP levels after hospital discharge are associated with higher risk of rehospitalization.