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Purpose: The role of hypoalbuminemia and raised C-reactive protein (CRP) levels in predicting critical prognosis has been described extensively in adult literature. However, there are limited studies in pediatrics, particularly neonates. The CRP/albumin (CRP/ALB) ratio is often associated with higher mortality, organ failure and prolonged hospital stay. We hypothesized that the serum CRP/ALB ratio has a prognostic value in predicting surgery and mortality in neonates with necrotizing enterocolitis (NEC).
Methods: Retrospective review of all neonates with clinical and radiological evidence of non-perforated NEC that were treated in a tertiary-level referral hospital between 2009 and 2018. General patient demographics, laboratory parameters and outcomes were recorded. Receiver operating characteristics analysis was performed to evaluated optimal cut-offs and area under the curve (AUC) with 95% confidence intervals (CI).
Results: A total of 191 neonates were identified. Of these, 103 (53.9%) were born at ≤ 28 weeks of gestation and 101 (52.9%) had a birth weight of ≤ 1000 g. Eighty-four (44.0%) patients underwent surgical intervention for NEC. The overall survival rate was 161/191 (84.3%). A CRP/ALB ratio of ≥ 3 on day 2 of NEC diagnosis was associated with a statistically significant higher likelihood for surgery [AUC 0.71 (95% CI 0.63–0.79); p < 0.0001] and mortality [AUC 0.66 (95% CI 0.54–0.77); p = 0.0150], respectively.
Conclusions : A CRP/ALB ratio of ≥ 3 on day 2 is indicative of a critical pathway in neonates with radiologically confirmed, non-perforated NEC. This could be used as an additional criterion to guide parental counselling in NEC for surgical intervention and mortality.
In den vergangenen Jahren wurden zahlreiche Stoffe als Photosensibilisatoren evaluiert, deren photodynamische Aktivität gegenüber den Pioniersubstanzen deutlich verbessert werden konnte. Vielen dieser Moleküle blieb jedoch aufgrund ihrer ungünstigen physikochemischen Eigenschaften oder der auftretenden Toxizität die Marktreife versagt. Nanopartikuläre Trägersysteme sind geeignet, Verträglichkeit und Effektivität der Photodynamischen Therapie zu verbessern sowie die Selektivität bei der Behandlung bestimmter Tumorspezies deutlich zu erhöhen. Um dieses Prinzip auf verschiedene Photosensibilisatoren anwenden zu können, wurden in der vorliegenden Arbeit Nanopartikel aus humanem Serumalbumin (HSA) durch Desolvatation hergestellt und die adsorptive, die inkorporative sowie die kovalente Bindung an das Trägersystem untersucht. ...