Serum Procalcitonin Levels Are Elevated in Esophageal Cancer Patients with Postoperative Infectious Complications
ABSTRACT The normal systemic inflammatory response to surgical stimuli often makes early diagnosis of postoperative infections difficult.
We investigated whether serum procalcitonin (PCT) levels may be a useful marker of bacterial infections in patients after invasive surgery.
The subjects were 40 patients who had undergone radical surgery for esophageal carcinoma by a right thoracoabdominal approach. Nine patients were diagnosed to have a postoperative infection during the first 7 days after surgery. Changes in serum PCT levels were compared between the group diagnosed to have postoperative infection (infection group) and the group without infection (noninfection group).
The postoperative serum PCT levels were significantly higher in the infection group than in the noninfection group (ANOVA: p < 0.01). Serum PCT peaked on postoperative day (POD) 5 in the infection group (8.7 +/- 8.2 ng/ml, mean +/- SD) and on POD 1 in the noninfection group (0.5 +/- 0.5 ng/ml). No significant differences were found between the two groups in leukocyte count, serum CRP or cytokine levels. The receiver operating characteristics (ROC) curve was constructed for infection identification. The area under the ROC curve for peak postoperative PCT was 0.968, and at a cutoff value of 2.0 ng/ml, the sensitivity was 89% and the specificity was 93%.
Serum PCT levels may be useful for the early diagnosis of postoperative infectious complications.
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Conference Paper: On-line Learning of Motion Patterns using an Expert Learning Framework[Show abstract] [Hide abstract]
ABSTRACT: Tracking uncertain mobile objects such as humans and vehicles is an important problem in computer vision, robotics, and geo-spatial visualization. As the name suggests, predictor-corrector tracking is performed in two steps -prediction and correction. Prediction steps have typically utilized a-priori motion model most common of which is a uniform motion model. In this work, we apply an expert learning framework for on-line prediction and learning the motion of an uncertain mobile object. We define a number of probabilistic experts, each of which predicts the future position of the object with some uncertainty and then combine the predictions of all the experts to produce an estimate of the object's location. Individual experts predictions are weighted adaptively depending on their performance. We show that this adaptive combination is powerful when there are changes in the pattern of the object's motion. Results of our algorithm are compared with linear extrapolation and the best off-line expert predictions. We have tested our algorithm with synthetic data using uniform and non-uniform patterns as well as real data acquired using GPS equipment in presence of intermittent and highly erroneous data.Computer Vision and Pattern Recognition Workshop, 2004. CVPRW '04. Conference on; 07/2004
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ABSTRACT: The Rosetta waterway is one of the two main branches of the Nile river in Egypt. It is considered the life artery for fishermen who live at the Rosetta district in Egypt. The closure of the Rosetta estuary caused by sedimentation will not only affect their livelihood but also endangers the people live upstream of the mouth due to releasing a probable emergency flood. The present paper focuses on the accretion problem as a second phase of a comprehensive study performed by Delft3D numerical model for the Rosetta promontory. The first phase focused on combating the shoreline erosion problem at the southwestward of the Rosetta (A. S. M. Ahmed, 2004). The causes of the sedimentation problem were understood and the consequences in case of no countermeasure are explained. Based on the knowledge obtained by investigating the motivation of Rosetta sedimentation, three alternatives were simulated. The proper solution was recommended as it produces low environmental impacts.OCEANS '04. MTTS/IEEE TECHNO-OCEAN '04; 12/2004
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ABSTRACT: The efficacy of direct hemoperfusion with polymyxin B-immobilized fiber columns (PMX) has already been demonstrated in clinical studies for the treatment of septic shock. However, serum procalcitonin levels following PMX remain unknown. This prospective, multicenter, nonrandomized clinical study was performed at 12 institutions. Forty-five patients with severe sepsis or septic shock due to colorectal perforation underwent PMX. Patients' outcome as well as circulating levels of endotoxin, procalcitonin and IL-6 were monitored. Before surgery, procalcitonin level, but not endotoxin and IL-6 levels, was elevated according to patients' septic conditions. Procalcitonin was significantly and positively correlated with sequential organ failure assessment score. Circulating levels of procalcitonin peaked 24 h after PMX treatment. Change in serum procalcitonin level was significantly higher in nonsurvivors than survivors. Nine mortalities were observed within 28 days. The best predictor for 28-day mortality was procalcitonin >85.7 ng/ml at 24 h after PMX (area under the receiver operating characteristic curve: 0.808 +/- 0.105). Procalcitonin may be a good indicator of severity of sepsis secondary to colorectal perforation. Furthermore, procalcitonin level at 24 h after PMX appears to predict outcome after PMX. Therefore, procalcitonin may be a useful diagnostic marker to evaluate patients' condition in candidates for PMX treatment.European Surgical Research 12/2008; 42(2):109-17. DOI:10.1159/000187169 · 1.43 Impact Factor