The Diagnostic Value of the Pleural Fluid C-Reactive Protein in Parapneumonic Effusions

properly cited. Purpose. The aim of this study was to evaluate the sensitivity of pleural C-reactive protein (CRP) biomarker levels in identifying parapneumonic effusions. Methods. A single-center, retrospective review of 244 patients diagnosed with pleural effusions was initiated among patients at the Rabin Medical Center, Petah Tikva, Israel, between January 2011 and December 2013. The patients were categorized into 4 groups according to their type of pleural effusion as follows: heart failure, malignant, postlung transplantation, and parapneumonic effusion. Results. The pleural CRP levels significantly differentiated the four groups ( < 0.001) with the following means: parapneumonic effusion, 5.38 ± 4.85 mg/dL; lung transplant, 2.77 ± 2.66 mg/dL; malignancy, 1.19±1.51 mg/dL; and heart failure, 0.57±0.81 mg/dL. The pleural fluid CRP cut-off value for differentiating among parapneumonic effusions and the other 3 groups was 1.38 mg/dL. The sensitivity, specificity, positive predictive value, and negative predictive value were 84.2%, 71.5%, 37%, and 95%, respectively. A backward logistic regression model selected CRP as the single predictor of parapneumonic effusion (OR = 1.59, 95% CI = 1.37-1.89). Conclusions. Pleural fluid CRP levels can be used to distinguish between parapneumonic effusions and other types of exudative effusions. CRP levels < 0.64 mg/dL are likely to indicate a pleural effusion from congestive heart failure, whereas levels ≥ 1.38 mg/dL are suggestive of an infectious etiology

Continuous and categorical hazard models of cholesterol levels in the total cohort of men (n = 1,479).

Continuous and categorical hazard models of cholesterol levels in the total cohort of men (n = 1,479).</p

Improved Survival With Higher Pre-diagnosis Cardiorespiratory Fitness in Men Who Developed Digestive System Cancers: A Prospective Pilot Study

BACKGROUND/AIM: Digestive system cancers are the leading cause of cancer mortality and have poor survival particularly in men. The study aimed to assess the association between pre-diagnosis cardiorespiratory fitness (CRF) and cancer mortality in a pilot sample of men who developed digestive system cancers. PATIENTS AND METHODS: Pre-diagnosis CRF (treadmill exercise test) was assessed in 342 men (68.9+/-21.8 years) who developed digestive system cancers during 6.7+/-5 years from baseline evaluation. Cox multivariable hazard models were analyzed for total cancer mortality. RESULTS: During 7.2+/-5 years follow-up from baseline, 120 participants died from cancer. Compared to low CRF, moderate and high CRF levels were associated with 57% [0.43, 95%CI=0.24-0.74] and 73% [0.27, 95%CI=0.12-0.59] reduced risks for cancer mortality, respectively (p trend=0.002). Survival time from baseline was longer among those with moderate [13.5 (range=12.1-14.9) years] and high [16.1 (range=14.0-18.2) years] compared to low CRF [7.9 (range=5.7-10.1) years]. CONCLUSION: Higher pre-diagnosis CRF is independently associated with lower risk of cancer mortality and longer survival in men who later developed digestive system cancers

Sensitivity analyses of cholesterol levels and all-cause mortality in men.

Sensitivity analyses of cholesterol levels and all-cause mortality in men.</p

Hazard ratios in categorical analysis of total cholesterol and low-density lipoprotein cholesterol in men.

Hazard ratios in categorical analysis of total cholesterol and low-density lipoprotein cholesterol in men.</p

Data of statistical analysis.

BackgroundDyslipidemia is a well-established cardiovascular disease (CVD) risk factor, although its association with mortality is less clear. This study aimed to assess the association between established dyslipidemia criteria [National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults [Adult Treatment Panel (ATP) III] and all-cause mortality in men.MethodsProspective cohort study of 1,479 men aged 59.7±10.7 years was conducted between 1987 and 2012. At baseline, dyslipidemia markers of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were assessed as an exposure. Cox proportional hazard models were analyzed adjusting for conventional health risk factors using all-cause mortality as an outcome.ResultsMean and standard deviations of TC, LDL-C and HDL-C were 199.5±45.2, 149.4±47.4 and 44.3±12.2 mg/dL, respectively. During 8.9±4.5 years follow-up, 284 participants died. Compared to TC ConclusionIn reference to established dyslipidemia criteria, this study showed that higher TC and LDL-C were independently and paradoxically associated with lower risk of all-cause mortality and longer survival time in men. Along with previous reports, these novel findings support a rigorous reevaluation of evidence on dyslipidemia and health risks. Systematic review and meta-analysis are warranted for evidence-based recommendations on dyslipidemia for primary and secondary prevention of CVD.</div

Baseline demographic and clinical characteristics of the cohort.

Baseline demographic and clinical characteristics of the cohort.</p

Flowchart of study design.

BackgroundDyslipidemia is a well-established cardiovascular disease (CVD) risk factor, although its association with mortality is less clear. This study aimed to assess the association between established dyslipidemia criteria [National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults [Adult Treatment Panel (ATP) III] and all-cause mortality in men.MethodsProspective cohort study of 1,479 men aged 59.7±10.7 years was conducted between 1987 and 2012. At baseline, dyslipidemia markers of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were assessed as an exposure. Cox proportional hazard models were analyzed adjusting for conventional health risk factors using all-cause mortality as an outcome.ResultsMean and standard deviations of TC, LDL-C and HDL-C were 199.5±45.2, 149.4±47.4 and 44.3±12.2 mg/dL, respectively. During 8.9±4.5 years follow-up, 284 participants died. Compared to TC ConclusionIn reference to established dyslipidemia criteria, this study showed that higher TC and LDL-C were independently and paradoxically associated with lower risk of all-cause mortality and longer survival time in men. Along with previous reports, these novel findings support a rigorous reevaluation of evidence on dyslipidemia and health risks. Systematic review and meta-analysis are warranted for evidence-based recommendations on dyslipidemia for primary and secondary prevention of CVD.</div

Survival analysis of total cholesterol and low-density lipoprotein cholesterol in men.

LDL-C; low density lipoprotein-cholesterol, TC; total cholesterol.</p