Early Stratification of Sepsis Using Presepsine in Emergency Department (North-East of Romania Experience)

Abstract

Sepsiis syndrome is a common and have devastating implications on health care systems worldwide. Biomarkers may have an important role to highlight the presence, absence or severity of sepsis. Retrospective study was conducted on a group of 81 patients with suspected sepsis, presented in the Emergency Department - Emergency County Hospital St. Spiridon Iasi during 01.09.2014-30.10.2014. The obtained statistical data�s were interpreted using SPSS software and the ROC curve was calculated. The study aims was to establish the following: determining the validity of presepsin as a biological marker in sepsis diagnosis and prognosis; sepsis stratification. The mean age of patients was 64.52 years. Determination of presepsin sensitivity in sepsis early diagnosis was calculated by generating the ROC curve. Following AUC values were found: AUC = 0.709, with a standard error of 0.065 for predicting sepsis; AUC = 0.866, with a standard error of 0.080 for severe sepsis; AUC = 0.864, with a standard error of 0.053 in the presence of septic shock. The average values of presepsin, related with severity of infection, it was found to be 544.39 � 141.93 pg./mL in case of localized infection; 605.6 � 59.55 pg./ mL in patients with systemic inflammatory response syndrome; 1283.21 � 195.74 pg./ mL in patients diagnosed with sepsis; 4787.8 � 1980.43pg./mL in patients presenting severe sepsis and 3734.88 � 1732.41pg./mL in patients diagnosed with septic shock. Presepsin level, measured by using quantitative dosage methods, may be helpful in staging patients diagnosed with sepsis and may be used as an indication for initiation of intensive therapy to prevent septic shock. Presepsin level can be used as an early marker of severe prognostic in septic patients.

Carpal Tunnel Syndrome: Surgical Landmarks which Increase Safety in Carpal Tunnel Release Procedures

“…This frees the content of carpal tunnel and realize the decompression of median nerve, which is found between the tendons of Palmaris longus and Flexor carpi radialis. The most common cause of failure in the intervention of decompression is incomplete cutting of the ligament or injury of the median nerve [22][23][24][25][26][27]. Persistent symptoms may be due to scar tissue formation and/or adhesions around the median nerve( Fig.1, Fig.2).…”