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Agnello L.,University of Palermo | Bellia C.,University of Palermo | Di Gangi M.,UOC Malattie Infettive Pediatriche | Lo Sasso B.,University of Palermo | And 6 more authors.
Clinical Biochemistry | Year: 2016

Objectives: Although the importance of serum Procalcitonin (PCT) levels at diagnosis is well established in adult Community-Acquired Pneumonia (CAP), its use remains controversial in pediatric CAP. The aim of our study is to investigate the role of PCT and C-Reactive Protein (CRP) in the assessment of pediatric CAP severity defined by the extent of consolidation on chest X-rays and the presence of pleural effusion. In this particular setting, no clinical severity score is available at present and chest X-ray, although important for diagnosis confirmation, is not recommended as routine test. Design and methods: The study involved 119 children admitted to the Department of Pediatric Infectious Disease for radiographically documented CAP aged 1 year to 14 years, without chronic diseases. Baseline PCT, CRP and routine laboratory tests were performed on admission. Results: The median PCT (μg/L) and CRP (mg/L)were 0.11 (0.05-0.58) and 21.3 (4.2-48.1), respectively. PCT showed a good correlationwith CRP, neutrophils andWBC (r=0.538, P < 0.001; r=0.377, P < 0.001; r=0.285, P0.002, respectively). CRP, but not PCT, was associatedwith lobar consolidation (P=0.007) and pleural effusion (P=0.002). Logistic regression analysis revealed that only CRPwas a predictor of lobar consolidation (OR: 1.078; 95% CI: 1.017-1.143; P = 0.011) and pleural effusion (OR: 1.076; 95% CI: 1.005-1.153; P = 0.036). Conclusion: Our findings revealed that PCT is correlated to the main inflammatory markers in children with CAP. CRP, unlike PCT, is able to predict the extent of chest X-ray infiltration and ultimately the severity of the disease confirming its usefulness in the management of pneumonia. © 2015 The Canadian Society of Clinical Chemists. Source

Giulia B.,University of Palermo | Luisa A.,University of Palermo | Concetta S.,University of Palermo | Bruna L.S.,University of Palermo | And 3 more authors.
Clinica Chimica Acta | Year: 2015

The role of procalcitonin (PCT) as a biomarker for sepsis in adults iswell documented, while its role in infections affecting neonatal children remains controversial. Among these infections, Community-Acquired pneumonia (CAP) has been studied extensively, because it's the second cause of death in children in developing countries, and one of the most frequent causes of hospitalization in industrialized countries. The PubMed database and the Cochrane Library were used to search for the following keywords: CAP, procalcitonin, and children. Thirteen articleswere studied to determine the role of PCT in CAPmanagement, specifically its usefulness for distinguishing pneumococcal infections from viral and unknown infections, for predicting severity and the correct antibiotic treatment. This paper focuses on the studies performed to identify the best inflammatory biomarker for CAP management. Although there is an increase in studies confirming the usefulness of PCT in CAP management in children, further studies are needed to have better understanding of its role for pediatric CAP management. © 2015 Elsevier B.V. Source

Bellia C.,University of Palermo | Agnello L.,University of Palermo | Lo Sasso B.,University of Palermo | Milano S.,University of Palermo | And 11 more authors.
Biochemical Genetics | Year: 2016

Vascular calcification has been recently associated to an increased cardiovascular risk and mortality. In few studies, Fetuin-A showed an association to coronary artery calcification (CAC), although the physiopathological mechanism underlying this association has not been fully established yet. Seventy-four patients with one or more cardiovascular risk factor and asymptomatic for coronary vasculopathy were included in the study. CAC was evaluated by Agatston score. Serum Fetuin-A levels were determined by ELISA. Molecular analysis of AHSG T256S gene variant (rs4918) was performed by PCR–RFLP. Serum Fetuin-A was correlated to serum calcium (r = 0,321; P = 0,018), but not to serum phosphorous. Multivariate linear regression analysis confirmed this association and showed that calcium and AHSG genotype were independent predictors of Fetuin-A (P = 0.037, P = 0.014, respectively). In particular, subjects carrying the SS genotype had lower levels of Fetuin-A and calcium (P = 0.037 and P = 0.038, respectively). When we compare subjects with CAC 0–10 with subjects with CAC > 10, we found that only age and male gender (P < 0.001, P = 0.035, respectively), but not Fetuin-A, were associated to CAC. Fetuin-A is not associated to CAC in subjects with low cardiovascular risk profile and asymptomatic for coronary vasculopathy, suggesting that in this setting Fetuin-A, although correlated to serum levels of calcium, could be not involved in mineral deposition on coronary vessels. © 2016 Springer Science+Business Media New York Source

Bivona G.,University of Palermo | Agnello L.,University of Palermo | Pivetti A.,University of Palermo | Milano S.,Uoc Medicina Of Laboratorio Corelab | And 4 more authors.
Clinica Chimica Acta | Year: 2016

Background: Vitamin D insufficiency/deficiency is considered a major factor triggering and enhancing several autoimmune disorders; hypovitaminosis D has been reported to be common in Systemic Sclerosis (SSc). Previous studies assessing vitamin D insufficiency/deficiency in SSc have been reviewed, and the relation with pathogenesis and clinical features has been examined. Content: Eligibility criteria were: reporting measurement of Vitamin D serum levels in all participants and evaluating adult onset-SSc individuals as patients group. Results: The association between clinical features and low hormone levels is controversial. Manifold data have shown vitamin D insufficiency/deficiency to have a potential role in the pathogenesis of disease, providing inconclusive findings. Summary: Promoting the onset of SSc depends on the interaction between genetics, environment and infections. It remains a sound question whether Vitamin D insufficiency/deficiency is an environment-linked immunological heckler, making infectious agents taking root. © 2016 Elsevier B.V. Source

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