Comparing Single vs. Combined Cerebrospinal Fluid Parameters for Diagnosing Full-Term Neonatal Bacterial Meningitis

Huang, Heyu; Tan, Jintong; Gong, Xiaohui; Li, Jing; Wang, Liping; Xu, Min; Zhang, Xi; Zhang, Yongjun; Huang, Lisu

doi:10.3389/fneur.2019.00012

Cited by 8 publications

(11 citation statements)

References 27 publications

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“…In general, aerobic exercise protocols reduce exaggerated responses (i.e., hypersensitivities) to these tests. In fact, recent meta-analyses concluded exercise training reduced nociceptive responses to mechanical and thermal tests compared to no exercise controls in animal models of peripheral nerve injury (i.e., SNI and DPN) [ 56 ] and SCI [ 57 ].…”

Section: Preclinical Evidencementioning

confidence: 99%

Exercise and Neuropathic Pain: A General Overview of Preclinical and Clinical Research

Leitzelar

Koltyn

2021

Sports Med - Open

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Neuropathic pain is a disease of the somatosensory system that is characterized by tingling, burning, and/or shooting pain. Medication is often the primary treatment, but it can be costly, thus there is an interest in understanding alternative low-cost treatments such as exercise. The following review includes an overview of the preclinical and clinical literature examining the influence of exercise on neuropathic pain. Preclinical studies support the hypothesis that exercise reduces hyperalgesia and allodynia in animal models of neuropathic pain. In human research, observational studies suggest that those who are more physically active have lower risk of developing neuropathic pain compared to those who are less active. Exercise studies suggest aerobic exercise training (e.g., 16 weeks); a combination of aerobic and resistance exercise training (e.g., 10–12 weeks); or high-intensity interval training (e.g., 15 weeks) reduces aspects of neuropathic pain such as worst pain over the past month, pain over the past 24 h, pain scores, or pain interference. However, not all measures of pain improve following exercise training (e.g., current pain, heat pain threshold). Potential mechanisms and future directions are also discussed to aid in the goal of understanding the role of exercise in the management of neuropathic pain. Future research using standardized methods to further understanding of the dose of exercise needed to manage neuropathic pain is warranted.

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Section: Preclinical Evidencementioning

confidence: 99%

Exercise and Neuropathic Pain: A General Overview of Preclinical and Clinical Research

Leitzelar

Koltyn

2021

Sports Med - Open

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“…has been shown to have better sensitivity and specificity than CSF protein and sugar, chloride and lactate dehydrogenase. 6,7 CSF polymerase chain reaction is shown to have a better diagnostic efficacy than culture, even after the initiation of antibiotics, 8 but is costly and has availability issues. Thus, there is a need felt for a biomarker that can identify these cases early and help in early and accurate diagnosis of meningitis.…”

mentioning

confidence: 99%

Utility of Cerebrospinal Fluid and Serum Procalcitonin for the Diagnosis of Neonatal Meningitis

et al. 2020

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Objective Positive CSF culture is the gold standard for the diagnosis of meningitis but it carries poor sensitivity. CSF procalcitonin (PCT) is shown to have some utility for the diagnosis of meningitis though there are limited studies in neonatal age group. We planned this study to compare CSF, serum, and CSF to serum PCT levels in neonates with confirmed, probable, and nonmeningitis groups to determine its optimal cut-off in CSF and serum for diagnosing meningitis Study Design Sixty-seven neonates who qualified for lumbar puncture were enrolled in the study. Neonates were categorized into confirmed meningitis, i.e., CSF cytochemistry and culture positive (N = 17), probable meningitis, i.e., CSF cytochemistry positive but culture negative (N = 25) and nonmeningitis, i.e., both cytochemistry and culture negative (N = 25). CSF and serum samples were stored at −80°C for PCT assay. Results Significant difference was seen in mean of CSF PCT in neonates with confirmed (0.31 ng/mL), probable (0.22 ng/mL), and nonmeningitis (0.11 ng/mL) groups. Similarly, significant difference was observed in serum PCT levels also, though the ratio of serum to CSF PCT was comparable. At cut-off of 0.2 ng/mL, CSF PCT had sensitivity of 95.2% and specificity of 96% in the diagnosis of meningitis. Conclusion CSF PCT is more specific marker for the diagnosis of neonatal meningitis as compared with serum PCT and CSF to serum PCT ratio. Key Points

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“…Based on previous studies and our pilot study, the estimated sample size was at least 489 for the derivation set. Assuming half of the derivation set, the sample was at least 250 for the external validation set 25,26 …”

Section: Resultsmentioning

confidence: 99%

“…Assuming half of the derivation set, the sample was at least 250 for the external validation set. 25,26…”

Section: Resultsmentioning

confidence: 99%

A sequential guide to identify neonates with low bacterial meningitis risk: a multicenter study

Chen

Yin

Gong

et al. 2021

Ann Clin Transl Neurol

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Objective To derive and validate a predictive algorithm integrating clinical and laboratory parameters to stratify a full‐term neonate's risk level of having bacterial meningitis (BM). Methods A multicentered dataset was categorized into derivation (689 full‐term neonates aged ≤28 days with a lumbar puncture [LP]) and external validation (383 neonates) datasets. A sequential algorithm with risk stratification for neonatal BM was constructed. Results In the derivation dataset, 102 neonates had BM (14.8%). Using stepwise regression analysis, fever, infection source absence, neurological manifestation, C‐reactive protein (CRP), and procalcitonin were selected as optimal predictive sets for neonatal BM and introduced to a sequential algorithm. Based on the algorithm, 96.1% of BM cases (98 of 102) were identified, and 50.7% of the neonates (349 of 689) were classified as low risk. The algorithm’s sensitivity and negative predictive value (NPV) in identifying neonates at low risk of BM were 96.2% (95% CI 91.7%–98.9%) and 98.9% (95% CI 97.6%–99.6%), respectively. In the validation dataset, sensitivity and NPV were 95.9% (95% CI 91.0%–100%) and 98.8% (95% CI 97.7%–100%). Interpretation The sequential algorithm can risk stratify neonates for BM with excellent predictive performance and prove helpful to clinicians in LP‐related decision‐making.

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Comparing Single vs. Combined Cerebrospinal Fluid Parameters for Diagnosing Full-Term Neonatal Bacterial Meningitis

Cited by 8 publications

References 27 publications

Exercise and Neuropathic Pain: A General Overview of Preclinical and Clinical Research

Exercise and Neuropathic Pain: A General Overview of Preclinical and Clinical Research

Utility of Cerebrospinal Fluid and Serum Procalcitonin for the Diagnosis of Neonatal Meningitis

A sequential guide to identify neonates with low bacterial meningitis risk: a multicenter study

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