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Accuracy of citrulline, I-FABP and d-lactate in the diagnosis of acute mesenteric ischemia
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Research data are not shared.Supplementary Information oi available online at: https://www.nature.com/articles/s41598-021-98012-w#Sec14 .Early diagnosis of acute mesenteric ischemia (AMI) remains a clinical challenge, and no biomarker has been consistently validated. We aimed to assess the accuracy of three promising circulating biomarkers for diagnosing AMIâcitrulline, intestinal fatty acid-binding protein (I-FABP), and D-lactate. A cross-sectional diagnostic study enrolled AMI patients admitted to the intestinal stroke center and controls with acute abdominal pain of another origin. We included 129 patientsâ50 AMI and 79 controls. Plasma citrulline concentrations were significantly lower in AMI patients compared to the controls [15.3 ÎŒmol/L (12.0â26.0) vs. 23.3 ÎŒmol/L (18.3â29.8), pâ=â0.001]. However, the area under the receiver operating curves (AUROC) for the diagnosis of AMI by Citrulline was low: 0.68 (95% confidence intervalâ=â0.58â0.78). No statistical difference was found in plasma I-FABP and plasma D-lactate concentrations between the AMI and control groups, with an AUROC of 0.44, and 0.40, respectively. In this large cross-sectional study, citrulline, I-FABP, and D-lactate failed to differentiate patients with AMI from patients with acute abdominal pain of another origin. Further research should focus on the discovery of new biomarkers.Grants from MSD-Avenir and APHP funded the SURVIBIO study; Alexandre Nuzzo received Ph.D. Grants from âFondation de l'Avenirâ and the French Gastroenterology Society (SNFGE)
Atteinte pulmonaire du déficit en alpha-1 antitrypsine. Recommandations pratiques pour le diagnostic et la prise en charge
International audienceContexte: Le dĂ©ficit en alpha 1-antitrypsine (DAAT) est une maladie gĂ©nĂ©tique autosomique rĂ©cessive associĂ©e Ă lâĂ©tat homozygote du variant Z du gĂšne SERPINA1. Les manifestations cliniques sont un dĂ©ficit sĂ©vĂšre en alpha 1-antitrypsine, un emphysĂšme pulmonaire et une fibrose hĂ©patique.MĂ©thodes: Des recommandations de prise en charge du DAAT ont Ă©tĂ© Ă©laborĂ©es Ă lâinitiative du centre coordonnateur de rĂ©fĂ©rence des maladies pulmonaires rares, sous lâĂ©gide de la SociĂ©tĂ© de pneumologie de langue française, par des groupes de coordination, rĂ©daction, et lecture, impliquant des pneumologues de divers modes dâexercice, biologistes, hĂ©patologue, pharmacien hospitalier, conseiller en gĂ©nĂ©tique, radiologues, mĂ©decins gĂ©nĂ©ralistes, cadre de santĂ©, et associations de patients. La mĂ©thode dâĂ©laboration des « Recommandations pour la pratique clinique » de la Haute autoritĂ© de santĂ© a Ă©tĂ© suivie, incluant un vote en ligne selonune Ă©chelle Likert.RĂ©sultats: AprĂšs une analyse bibliographique, 20 recommandations ont Ă©tĂ© proposĂ©es par les groupes de travail, portant sur tous les aspects de la maladie : diagnostic biologique, bilan initial, conseils dâhygiĂšne de vie, information, indications et modalitĂ©s du traitement substitutif, dĂ©pistage.Conclusion: Ces recommandations fondĂ©es sur les preuves sont destinĂ©es Ă guider le diagnostic et la prise en charge pratique du DAAT