tooba mohammadi

A significant correlation exists between elevated lactate dehydrogenase (LDH) levels and thrombotic events, yet the prognostic value of this biomarker in patients with pulmonary embolism (PE) remains elusive. Finding new biomarkers can help us achieve better risk stratification and treatment strategies to reduce the mortality of PE patients.

We aimed to determine the possible association between serum LDH and the in-hospital mortality of PE patients.

In this cross-sectional study, 217 patients with PE (diagnosed by computed tomography angiography) and a serum LDH level documented within the first 24 hours of admission were included. Our exclusion criteria were hepatic and renal diseases, pregnancy, hemolytic disorders, left ventricular infarction, recent stroke, positive history of active cancer, acute and chronic infections, and reticuloendothelial-related diseases.

The mean age of patients was 63.04 ± 16.81 years; 23 patients (10.6%) died during hospitalization. Multivariate analysis showed that LDH and white blood cells (WBC) were independent predictors of in-hospital mortality; however, this association was insignificant. Univariate analysis showed that higher levels of LDH, WBC, and red cell distribution width (RDW) had a significant association with in-hospital mortality (P < 0.05). The receiver operating characteristics curve showed that an LDH cut-off value of 515 U/l had a sensitivity of 91.3% and specificity of 45.9% in predicting in-hospital mortality (95% CI = 0.636 – 0.761, P = 0.0003).

LDH can be an excellent prognostic marker for predicting in-hospital death in patients with pulmonary embolism.

Background and Globally, dermatophytes are the most common filamentous group of fungi causing cutaneous mycoses. Dermatophytes were shown to secrete a multitude of enzymes that play a role in their pathogenesis. There is limited data on co-hemolytic (CAMP-like) effect of different bacterial species on dermatophyte species. In this study, we sought to the evaluate exoenzyme activity and co-hemolytic effect of four bacteria on clinical dermatophytes isolated from patients in Shiraz, Iran.
A total of 84 clinical dermatophyte species were isolated from patients suffering dermatophytosis and identified by conventional methods. Hemolytic activity was evaluated with Columbia 5% sheep blood agar. Proteolytic activity was determined by plate clearance assay method, using gelatin 8% agar. CAMP-like factor was evaluated with four bacteria, namely, S. areus, S. saprophyticus, S. pyogenes, and S. agalactiae. Fisher's exact test was run for statistical analysis.
T. mentagrophytes was the most predominant agent (27 [32.1%]) followed by T. verrucosum (20 [23.8%]), T. tonsurans (10 [11.9%]), Microsporum canis (7 [8.3%]), T. rubrum (6 [7.1%]), E. floccosum (6 [7.1%]), M. gypseum (5 [6%]), and T. violaceum (3[3.6%]). The most common clinical area of dermatophytosis was the skin. All the isolates expressed the zone of incomplete alpha hemolysis. All the isolates had CAMP- positive reaction with S. aureus and the other bacteria were CAMP-negative. All the isolates expressed proteolytic activity and no significant differences were noted among diverse genera of dermatophytes and severities of proteolytic activity.
This study indicated that hemolysin and proteolytic enzymes potentially play a role in dermatophyte pathogenesis and S. aureus could be considered as a main bacterium for creation of co-hemolytic effect in association with dermatophyte species.