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| 1 | Measurement of calprotectin in ascitic fluid to identify elevated polymorphonuclear cell count显示文摘AIM: To evaluate the diagnostic capability of calprotectin in ascitic fluid for detecting a polymorphonuclear (PMN) cell count > 250/μL ascites. METHODS: In this prospective observational study, a total of 130 ascites samples were analysed from 71 consecutive patients referred for paracentesis. Total and differential leukocyte cell counts were determined manually with a Neubauer chamber and gentianviolet stain. Calprotectin was measured in 1 mL ascetic fluid by enzyme-linked immunosorbent assay (ELISA) and a point-of-care (POC) lateral flow assay with the Quantum Blue Reader (Bühlmann Laboratories). All measurements were carried out in a central laboratory by senior personnel blinded to patient history. A PMN count > 250/μL was the primary endpoint of the study. The diagnostic value of ascitic calprotectin measurement was assessed by comparing to the final diagnosis of each patient that had been adjudicated by investigators blinded to calprotectin values. RESULTS: The PMN count was > 250/μL in 19 samples (14.6%) from 15 patients (21.1%) and varied widely among the study population (range 10-19 800/mL and 1-17 820/mL, respectively). Spontaneous bacterial peritonitis (SBP) was the final diagnosis in four patients (5.6%). All patients with PMN ≤ 250/μL had negative bacterial culture. PMN count was elevated in five patients with peritoneal carcinomatosis, three with lymphoma, one with neuroendocrine carcinoma, and two with secondary peritonitis due to abdominal perforation. PMN cell counts correlated with ascitic calprotectin values (Spearman's rho; r = 0.457 for ELISA, r = 0.473 for POC). A considerable range of ascitic calprotectin concentrations was detected by ELISA [median 0.43 μg/mL, interquartile range (IQR) 0.23-1.23 (range 0.10-14.93)] and POC [median 0.38 μg/mL, IQR 0.38-0.56 (range 0.38-13.31)]. Ascitic calprotectin levels were higher in samples with PMN > 250/μL, by both ELISA [median (IQR) 2.48 μg/mL (1.61-3.65) vs 0.10 μg/mL (0.10-0.36), P < 0.001] and POC [2.78 μg/mL (2.05-5.37) vs 0.38 μg/mL (0.38-0.41), P < 0.001]. The area under the receiver operating characteristics curve for identifying an elevated PMN count was 0.977 (95%CI: 0.933 to 0.995) for ELISA and 0.982 (95%CI: 0.942 to 0.997) for POC (P = 0.246 vs ELISA). Using the optimal cut-off value for ELISA (0.63 μg/mL), ascitic calprotectin had 94.8% sensitivity, 89.2% specificity, positive and negative likelihood ratios of 8.76 and 0.06 respectively, positive and negative predictive values of 60.0% and 99.0% respectively, and 90.0% overall accuracy. Using the optimal cut-off value for POC (0.51 μg/mL), the respective values were 100.0%, 84.7%, 6.53, 0.00, 52.8%, 100% and 87.7%. Correlation between ELISA and POC was excellent (r = 0.873, P < 0.001). The mean ± SD of the difference was -0.11 ± 0.48 μg/mL with limits of agreement of + 0.8 μg/mL (95%CI: 0.69 to 0.98) and -1.1 μg/mL (95%CI: -1.19 to -0.91). CONCLUSION: Ascitic calprotectin reliably predicts PMN count > 250/μL, which may prove useful in the diagnosis of SBP, especially with a readily available bedside testing device. | Emanuel Burri Felix Schulte Jürgen Muser Rémy Meier Christoph Beglinger | 2013 | World Journal of Gastroenterology2013，19，13： | 10 |
| 2 | Management of ventricular tachycardia storm in patients with structural heart disease显示文摘Electrical storm(ES) is a medical emergency characterized by repetitive episodes of sustained ventriculararrhythmias(VAs) in a limited amount of time(at least 3 within a 24-h period) leading to repeated appropriate implantable cardioverter defibrillator therapies. The occurrence of ES represents a major turning point in the natural history of patients with structural heart disease being associated with poor short-and longterm survival particularly in those with compromised left ventricular ejection fraction(LVEF) that can develop hemodynamic decompensation and multi-organ failure. Management of ES is challenging with limited available evidence coming from small retrospective series and a substantial lack of randomized-controlled trials. In general, a multidisciplinary approach including medical therapies such as anti-arrhythmic drugs, sedation, as well as interventional approaches like catheter ablation, may be required. Accurate patient risk stratification at admission for ES is pivotal and should take into account hemodynamic tolerability of VAs as well as comorbidities like low LVEF, advanced NYHA class and chronic pulmonary disease. In high risk patients, prophylactic mechanical circulatory support with left ventricular assistance devices or extracorporeal membrane oxygenation should be considered as bridge to ablation and recovery. In the present manuscript we review the available strategies for management of ES and the evidence supporting them. | Daniele Muser Pasquale Santangeli Jackson J Liang | 2017 | World Journal of Cardiology2017，9，6： | 3 |
| 3 | Assessment of Pelvis and Upper Leg Injury Risk in Car-pedestrian Collisions: Comparison of Accident Statistics, Impactor Tests and a Human Body Finite Element Model显示文摘 | Snedeker J G Muser M H Walz F H | 2003 | Stapp Car Crash J2003，47，： | 1 |
| 4 | Assessment ofpelvis and upper leg injury risk in car-pedestrian collisions:comparison of accident statistics,impactor tests and a humanbody finite element model显示文摘 | SNEDEKER J G MUSER M H WALZ F H | 2003 | Stapp Car Crash J2003，47，： | 1 |
| 5 | Low-density lipoprotein size and subclasses are markers of clinically apparent and non-apparent atherosclerosis in type 2 diabetes显示文摘 | Berneis K Jeanneret C Muser J | | 0，，： | 1 |
| 6 | Role of endothelin-1 in renal regu- lation of acid-base equilibrium in acidotic humans 显示文摘 | Pallini A Huher HN Muser J | 2012 | Am J Physiol Renal Physio12012，303，7： | 1 |
| 7 | Partial Neutralization of the acidogenic western diet with potassium citrate increases bone mass in postmenopausal women with osteopenia 显示文摘 | Jehle S Zanetti A Muser J | 2006 | J Am Soc Nephrol2006，17，11： | 1 |
| 8 | Partial neutralization of the acidogenic Western diet with potassium citrate increases bone mass in postmenopausal women with osteopenia 显示文摘 | Jehle S Zanetti A Muser J | 2006 | Journal of American Society of Nephrology2006，17，11： | 1 |
| 9 | Induction of Candida al- bicans drug resistance genes by hybrid zinc cluster tran- scription factors 显示文摘 | Schneider S Morschhc Muser J | 2015 | Antimicrob Agents Cher2015，59，1： | 1 |
| 10 | Neutralization of Westem diet inhibits bone resorption independently of K intake and reduces cortisol secretion in humans显示文摘 | Maurer M RiesenW Muser J | 2003 | Am J Physiol Renal Physiol2003，284，1： | 1 |
| 11 | Outcomes after asystole events occurring during wearable defibrillator-cardioverter use显示文摘AIM To examine whether wearable cardioverter defibrillator(WCD) alarms for asystole improve patient outcomes and survival.METHODS All asystole episodes recorded by the WCD in 2013 were retrospectively analyzed from a database of device and medical record documentation and customer call reports. Events were classified as asystole episodes if initial presenting arrhythmia was asystole(< 10 beats/minor ≥ 5 s pause). Survival was defined as recovery at the scene or arrival to a medical facility alive, or not requiring immediate medical attention. Episodes occurring in hospitals, nursing homes, or ambulances were considered to be under medical care. Serious asystole episodes were defined as resulting in unconsciousness, hospital transfer, or death.RESULTS Of the total 51933 patients having worn the WCD in 2013, there were 257 patients(0.5%) who had asystole episodes and comprised the study cohort. Among the 257 patients(74% male, median age 69 years), there were 264 asystole episodes. Overall patient survival was 42%. Most asystoles were considered 'serious'(n = 201 in 201 patients, 76%), with a 26% survival rate. All 56 patients with 'non-serious' asystole episodes survived. Being under medical care was associated with worse survival of serious asystoles. Among acute survivors, 20% later died during WCD use(a median 4 days post asystole episode). Of the 86 living patients at the end of WCD use period, 48(56%) received ICD/pacemaker and 17(20%) improved their condition.CONCLUSION Survival rates after asystole in patients with WCD are higher than historically reported survival rates. Those under medical care at time of asystole exhibited lower survival. | Jackson J Liang Nicole R Bianco Daniele Muser Andres Enriquez Pasquale Santangeli Benjamin A D'Souza | 2018 | World Journal of Cardiology2018，10，4： | 0 |
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