blood sedimentation

Influenza mainly involves the pulmonary system, but may cause damage to other organs like liver, kidneys, and bone marrow. It is essential to identify changes in the laboratory markers indicating inflammation and hepatic injury; and changes in white blood cell count in patients with flu. This study aimed to evaluate these laboratory markers and compare them in children and adults.

This retrospective study was performed in three university hospitals in Qazvin, Iran. Clinically available laboratory biomarkers including some inflammatory markers (e.g. CRP and ESR) , marker of hepatic injury (AST, ALT, ALP, billirubin, prothrombin time), and white blood cell count of 435 definite inflenza patients with positive influenza RT-PCR in 2018 and 2019 were collected from their medical records. The results were classified based on age (over 14 years of age in adults) and the normal range reported by the performing laboratory. Using SPSS software 25, data were analyzed by chi-square and pearson correlation coefficient test. P<0.05 was considered significant.

Leukocytosis was observed in 22.5% of adults and 1.0% of children, and the difference between the two groups was significant (p<0.001). ESR was increased in 91.6% of children and 86.9% of adults;CRP was elevated in 34.7% of adults while 80.5% of children showed elevation (p<0.001). The duration of hospital stay was significantly correlated with ESR (p<0.001, r= 0.177), and CRP (p= 0.002, r= 0.163).The increase in ALT was detected in 32.1% of adults versus 10.0% of children and AST in 38.6% of adults versus 10.0% of children. This increase in both liver enzymes was greater in adults compared with children (p<0.044 and p<0.013, respectively). 42.4% of adults, showed increased prothrombin time.

Leukocytosis, CRP elevation and increase in liver enzymes during influenza seems to be more pronounced in adults than in children. The results also showed a significant relationship between a hospital stay and the level of ESR and CRP.

Strokes are among the major causes of disabilities worldwide. In recent years, there has been considerable interest in evaluating stroke prognoses.

In this investigation, we studied the association of lymphocyte-monocyte ratio (LMR), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and ESR-CRP ratio (ECR) with 3 months outcomes among those with acute ischemic stroke (AIS).

We carried out the present cross-sectional investigation among AIS patients at an academic hospital in northern Iran (from 2019 to 2021). Within 24 hours after the onset of symptoms, laboratory and clinical data of the patients were obtained. We assessed the results using the modified rankin scale (mRS) 90 days after the initial assessment. Statistical significance for comparing descriptive data was determined as P<0.05.

We entered 341 participants (Mean±SD age: 69.10±13.55 years, 53.1% female) into this investigation. Based on univariate analysis, there were poor correlations between NLR (r=0.361, P<0.001), PLR (r=0.215, P<0.05), CRP (r=0.234, P<0.001), LMR (r=-0.184, P<0.05), and ECR (r=-0.191, P<0.05) and a 3-month mRS. Also, after three months, the NLR, PLR, and CRP values were higher in the patients who died, but the LMR (P<0.001) and ECR (P<0.05) were lower. In multivariate comparison, only ECR was independently higher among the participants who died within 3 months (P<0.05).

In this study, ECR within 24 hours of symptoms onset was related to functional outcomes and mortality at 3-month follow-up. Thus, ECR might provide valuable prognostic information at a relatively low cost.

Osteomyelitis is one of the complications of diabetic foot infection. The present study aimedto evaluate the diagnostic value of erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) in detec-tion of osteomyelitis in patients with diabetic foot.

In this cross-sectional study, serum levels of ESRand CRP were measured for patients with diabetic foot referring to emergency department or endocrinologyclinic and the screening performance characteristics of these markers in detection of osteomyelitis were calcu-lated. The diagnosis of osteomyelitis was based on clinical examination and positive probe-to-bone test, whichwas confirmed by plain x-rays or MRI.

142 diabetic patients with an average age of 61.2±11.8 yearswere evaluated (66.2% male). The area under the ROC curve of ESR in detection of osteomyelitis in diabeticfoot cases was 0.70 (95% CI: 0.62-0.79). The best ESR cut-off point in this regard was 49 mm/hour. Sensitiv-ity, specificity, positive and negative predictive values, and positive and negative likelihood ratios of ESR in 49mm/Hour cut-point were 74.6% (95% CI: 62.9-83.9), 57.7% (95% CI: 45.5-69.2), 63.9% (95% CI: 52.5-73.9), 69.5%(95% CI: 56.0-80.0), 1.8 (95% CI: 1.3-2.4) and 0.4 (95% CI: 0.3-0.7), respectively. The area under the ROC curveof CRP in detection of osteomyelitis was 0.67 (95% CI: 0.58-0.76). The best cut-off point for CRP in this regardwas 35 mg/liter with sensitivity, specificity, positive and negative predictive values, and positive and negativelikelihood ratios of 76% (95% CI: 64.2-85), 54.9% (95% CI: 42.7-66.6), 62.8% (95% CI: 51.6-72.8), 69.6% (95% CI:51.7-80.8), 1.7 (95% CI, 1.3-2.2), and 0.4 (95% CI: 0.3-0.7), respectively.

Based on the findings ofROC curve analysis, ESR and CRP had fair and poor accuracy, respectively, in detecting the diabetic foot caseswith osteomyelitis.

Considering the importance of early diagnosis of diabetic foot ulcers and its complications, this study aimed to evaluate the accuracy of erythrocyte sedimentation rate (ESR), C - reactive protein (CRP), and pro-calcitonin (PCT) in predicting the ulcer class, osteomyelitis, and peripheral arterial disease (PAD). This cross-sectional study was performed on 200 consecutive patients suffering from diabetic foot ulcer who were referred to Infectious Disease Ward. The levels of PCT, ESR, and CRP were measured for all patients and the screening performance characteristics of each marker in predicting the ulcer class, osteomyelitis, and PAD was calculated. The levels of PCT, ESR and CRP were significantly higher in patients with class IV foot ulcer compared to those with class III ulcers (p<0.001). Patients with evidence of osteomyelitis had significantly higher level of PCT, ESR and CRP. The best cutoff points of PCT, ESR and CRP in predicting osteomyelitis were 0.35 ng/ml (86.1% sensitivity, 45.3% specificity), 56.5 mm/hours (95.8% sensitivity, and 50.0% specificity) and 44 mg/ml (90.3% sensitivity, 57.0% specificity), respectively. The presence of PAD was significantly associated with increased levels of the three biomarkers. The best cutoff values for PCT, ESR and CRP in predicting PAD were 0.45 (70.8% sensitivity, 71.7% specificity), 61.5 (83.3% sensitivity, 52.0% specificity) and 49 (83.3% sensitivity, 63.8% specificity), respectively. Based on the findings of the present study, although the accuracy of PCT, ESR, and CRP in predicting the severity of diabetic foot ulcers was fair, increase in the three parameters can predict the occurrence of osteomyelitis and PAD following diabetic food development with good accuracy and acceptable sensitivity.

 The aim of this study was to evaluate if ozone is capable of decreasing biomarkers of inflammation (CRP/ESR) and pain, and to improve function and quality of life in knee osteoarthrtitis (OA) patients.

 A prospective quasi experimental (before-and-after study) research was performed to investigate the effect of Ozone therapy protocol. The intervention included 4 sessions (1 session/week) of an intra-articular infiltration of a medical mixture of Oxygen-Ozone (95% to 5%) at 20 ug/mL concentration. Biochemical evaluation (CRP and ESR), pain VAS, and WOMAC scales were evaluated before and after the treatment.

 Overall, 33 patients were evaluated. Mean age was 68.18 ± 8.43 years. Female patients accounted for 75.7% (n = 25) and male patients corresponded to 24.3% (n = 8). Female: male ratio was 3:1. The most frequent radiological KL grade was 2º (n = 22, 66.7%), followed by 3º (n = 8, 24.2%), and 4º (n = 3, 9.1%). Biomarkers of inflammation decreased significantly. C-reactive protein (CRP) diminished from 0.33 ± 0.32 mg/dL to 0.25 ± 0.23 mg/dL (P = 0.0456). Erythrocyte sedimentation rate (ESR) decreased from 15.06 ± 12.09 mm/h to 11.81 ± 8.32 mm/h (P = 0.01). Before treatment, pain measured by VAS was 7.33 ± 1.31 points and decreased to 2.84 ± 1.76 (P < 0.0001). The WOMAC-pain subscale was 14.84 ± 2.77 points and diminished to 5.96 ± 3.53 (P < 0.0001), WOMAC stiffness subscale was 3.06 ± 1.95 points and ameliorated to 1.15 ± 1.3 (P < 0.0001), WOMAC-function subscale was 41.15 ± 12.58 points and decreased to 22.3 ± 11.64 (P < 0.0001).

 Ozone is capable of both decreasing pain and stiffness and improving function and quality of life in knee OA patients, yet decreases biomarkers of inflammation, such as CRP and ESR.

Erythrocyte sedimentation rate (ESR) remains as one of the most reliable tests in clinical practices. Yet its use is time consuming and requires a large blood sample. The aim of this study was assessing a faster and reliable method of ESR estimation. An ESR estimation method was described and performed on 108 patients using capillary tube (micro ESR) and capillary peripheral blood. Micro ESR results at different intervals were measured and compared with Westergren ESR (conventional ESR) estimation by Pearson and Spearman’s coefficients. A regression equation was derived to predict conventional ESR values based on micro ESR results. The agreement of two measurements was demonstrated using the Bland-Altman plot. Micro ESR results at 20 minutes showed the earliest close correlation with conventional ESR results at one hour (0.99). The presented regression equation was able to closely predict ESR values (r2 = 0.974) and the Bland-Altman plot showed an acceptable agreement between converted and conventional ESR measurements. Using capillary tube and capillary blood sample (micro ESR) appears to be a faster, cheaper, more reliable, and precise tool for ESR measurement in the ED. The results have acceptable correlation with conventional ESR, especially at 20 minutes of measurement.

Selenium deficiency is a common problem in patients with chronic kidney disease (CKD). This micronutrient has anti-inflammatory and anti-oxidant effects. Selenium is also found in high concentrations in the thyroid gland. To determine the effect of selenium supplementation on thyroid function tests and acute phase reactants in hemodialysis patients.Patients and In this double-blinded randomized clinical in 3 months, 64 hemodialysis patients with selenium deficiency were divided into experimental (received selenium supplementation; 32 cases) or control group (received placebo; 32 cases). Erythrocyte sedimentation rate (ESR), ferritin, quantitative C-reactive protein (CRP) and thyroid function tests (TFTs) including thyroid stimulating hormone (TSH), T3 resin uptake (T3RU), and free T4 were measured before and after the intervention and compared between experimental and control groups. At baseline, no significant difference was found between experimental and control groups regarding CRP, ESR and ferritin serum levels. Likewise, after intervention, no significant difference was found between experimental and control groups for CRP (14.77 ± 17.93 vs. 18.29 ± 21.56 mg/L), ESR (32.90 ± 32.62 vs. 33.91 ± 31.15 mm/h) and ferritin (528.6 ± 423.07 vs. 519.52 ± 345.59 ng/mL). At baseline, no significant difference was found between experimental and control groups regarding TFTs. Likewise, after intervention, no significant difference was found between experimental and control groups for TSH (3.7 ± 2.22 vs. 2.84 ± 1.88 µU/mL), free T4 (7.19 ± 1.98 vs. 7.02 ± 1.87 µg/dL) and T3RU (30.04 ± 2.28% vs. 29.2 ± 1.98%). Oral selenium supplementation for three months did not have any significant effect on thyroid function tests or acute phase reactants.