***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To explore the significance of interleukin-6 ( IL-6 ) and IL-8 in the diagnosis of neonatal sepsis . METHODS This was a prospect i ve study conducted between August 2014 and February 2015 . A total of 140 neonates who were suspected infectious were enrolled and classified into a sepsis group ( n=49 ) and a local infection group ( n=91 ) . Sixty-one neonates who were non-infectious served as the control group .  Serum levels of IL-6 and IL-8  were measured before treatment and 3 days after treatment . The value of serum IL-6 and IL-8  for the diagnosis of neonatal sepsis was assessed by receiver operating characteristic ( ROC ) curve analysis . RESULTS Before treatment , serum levels of IL-6 and IL-8 in the sepsis group were higher than those in the local infection and control groups ( P<0.05 ) , and the local infection group had higher serum levels of IL-6 and IL-8 than the control group ( P<0.05 ) . After three days of treatment , the serum IL-6 level in the sepsis group remained higher than that in the local infection and control groups ( P<0.05 ) , and the local infection group had higher serum level of IL-6 than the control group ( P<0.05 ) . There was no significant difference in the serum IL-8 level among the three groups . According to the ROC curve , when the cut-off value of serum IL-6 was 32 pg/mL , the sensitivity , specificity and accuracy of serum IL-6 for the diagnosis of neonatal sepsis were 87.8 % , 79.6 % and 81.6 % respectively ; when the cut-off value of serum IL-8 was 54 pg/mL , the sensitivity , specificity and accuracy of serum IL-6 for the diagnosis of neonatal sepsis were 77.6 % , 63.8 % and 67.2 % respectively . With the combination of serum IL-6 and IL-8 levels , the sensitivity , specificity and accuracy for the diagnosis of neonatal sepsis were 71.4 % , 86.2 % and 82.6 % respectively . CONCLUSIONS IL-6 and IL-8 participate in the inflammatory response and the serum levels of both vary with the severity of infection . The diagnostic value of IL-6 for neonatal sepsis is higher than IL-8 . The combined detection of serum levels IL-6 and IL-8 may increase the accuracy of diagnosis of neonatal sepsis Abstract In a prospect i ve study , plasma interleukin-6 ( IL-6 ) and interleukin-10 ( IL-10 ) levels were measured by enzyme-linked immunosorbent assay in 45 premature neonates ( 25–34 weeks gestational age ) with signs and symptoms of suspected sepsis at 0 , 12 and 24 h ; C-reactive protein ( CRP ) was measured at 0–24 h after enrolment . Six subjects were excluded due to insufficient blood sampling . The remaining 39 neonates were assigned to one of three groups : 25 newborns with sepsis ( blood culture positive ) , seven with pneumonia ( positive results on broncho-alveolar lavage fluid culture and characteristic chest radiography ) and seven with necrotising enterocolitis ( NEC ) ( characteristic intestinal and radiological signs according to the criteria of Bell et al. ) . A group of 20 healthy preterm neonates represented control subjects . On admission , higher levels of IL-6 , IL-10 and CRP were observed in neonates with sepsis : IL-6 ( median 1500 pg/ml , range 487–10000 pg/ml ) , IL-10 ( median 113 pg/ml , range 70–196 pg/ml ) , CRP ( median 22 mg/l , range 4–80 mg/l ) ; pneumonia : IL-6 ( median 1500 pg/ml , range 747–8000 pg/ml , IL-10 ( median 84 pg/ml , range 76–92 pg/ml ) , CRP ( median 10 mg/l , range 8–33 mg/l ) and NEC : IL-6 ( median 6650 pg/ml , range 1595–7950 pg/ml ) , IL-10 ( median 80 pg/ml , range 61–147 pg/ml ) , CRP ( median 3 mg/l , range 2.8–8 mg/l ) as compared to controls ( IL-6 median 208 pg/ml , range 198–349 pg/ml ; IL-10 median 36 pg/ml , range 19–50 pg/ml ; CRP median < 2 mg/l ) ( P < 0.05 ) . In neonates with sepsis , IL-6 levels were significantly correlated with IL-10 levels ( r=0.65 ; P=0.04 ) at the time of the second sample . The highest IL-6 levels were observed at onset , while IL-10 was predominant 12 h later . On admission , IL-10 and CRP levels were significantly higher in non-survivors ( IL-10 median 507 pg/ml , range 422–753 pg/ml ; CRP median 123 mg/l , range 20–219 mg/l ) than in survivors ( IL-10 median 76 pg/ml , range 61–143 pg/ml ; CRP median 8 mg/l range 3–46 mg/l ) , while IL-10 levels were significantly higher ( P < 0.05 ) also 12 h after admission ( non-survivors : IL-10 median 600 pg/ml , range 538–800 pg/ml ; survivors : IL-10 median 74 pg/ml , range 53–161 pg/ml ) . IL-6 and IL-10 levels were significantly correlated with CRP levels on admission ( r=0.45 ; P=0.05 ) . Conclusion Preterm neonates with sepsis , pneumonia or necrotising enterocolitis showed increased interleukin-6 , interleukin-10 and C-reactive protein levels . High interleukin-10 concentration was associated with mortality and could be an early indicator of prognosis Objective ( s ) : Bacterial infection contributes substantially to neonatal morbidity and mortality . Early diagnosis of neonatal sepsis is difficult because clinical signs are non-specific . We have evaluated serum IL-6 , 8 and 10 as potential early diagnostic markers of neonatal infection and their relationship to mortality rate and poor prognosis . Material s and Methods : A total of 84 infants , aged ≥ 72 hr were enrolled in this prospect i ve case-control trial . The case group ( n=41 ) included babies with clinical and laboratory findings compatible with sepsis and /or positive blood or cerebrospinal fluid cultures . The control group ( n=43 ) included healthy infants .  IL-6 , 8 and 10  were measured for all infants . Receiver-operating characteristic ( ROC ) curves were used for the determination of thresholds . Results : Statistically significant differences were observed between control and case groups for serum median level of IL-6 , 8 and 10 ( P<0.001 ) . IL-6 cut-off values of 10.85 Pg/ml for discriminating between cases and controls and 78.2 Pg/ml for predicting mortality are suggested . IL-8 at a cut-off value of 60.05 Pg/ml was valuable for differentiation of definite versus indefinite infection . Conclusion : Evaluating the IL-6 , 8 and 10 simultaneously , could improve the sensitivity and specificity of early diagnosis of the neonatal sepsis . Regarding our results , interleukin 6 had the greatest value for predicting infection and possible mortality , whereas IL-8 was valuable for diagnosing definitive infection Objective Late-onset sepsis is responsible for high morbidity and mortality in newborn infants in the world and in particular in developing countries . In this study , we evaluated whether clinical characteristics , laboratory parameters and measurements of serum interleukin-8 ( IL-8 ) are able to discriminate between late neonatal sepsis and normal baby . Methods This was a prospect i ve ( case-control ) study conducted between March 2007 and April 2008 , at the neonatal intensive care unit , Ghaem Hospital , Mashhad , Iran . The study comprised 93 neonates ≥72 hours of life . The infants were categorized in two groups based on the clinical presentation , and biochemical markers including complete blood count , C-reactive protein ( CRP ) and blood culture : 1 ) Control group including 42 infants with routine screening  and 2 ) Case group consisting of 38 infants with definitive infection ( positive blood and /or cerebrospinal fluid culture ) or clinical sepsis ( clinical and laboratory signs of infection without positive blood or CSF culture ) . Receiver-operating characteristic curves were used for the determination of thresholds for the infection group versus healthy neonate group . Findings Eighty infants were enrolled in this study . IL-8 and CRP decreased in order of definitive infection , clinical sepsis and healthy subjects respectively ( P<0.001 ) . Sensitivity , specificity , positive predictive value , negative predictive value for serum levels were 0.95 , 0.1 , 0.97 , 0.1 for IL-8 and 0.83 , 0.86 , 0.83 , 0.69 for CRP respectively ( cut-off point for IL-8 > 60pg/ml and for CRP>6mg/dl ) . Conclusion IL-8 may be a valid and early predictive marker of neonatal infection . Also , IL-8 is associated with severity of infection AIMS To evaluate the commonly used markers — namely IL-6 , TNFα , IL-1β , C-reactive protein and E-selectin for identification of late onset neonatal sepsis ; to define the optimal cutoff value for each marker in preterm neonates ; to assess whether these markers could assist in early discontinuation of antibiotics in non-infected cases ; and to delineate the profile of these markers during systemic infection and in relation to successful treatment . METHODS Very low birthweight infants in whom clinical sepsis was suspected when they were > 72 hours of age were eligible for study . A full sepsis screen was performed in each episode .  Cytokines , C-reactive protein , and E-selectin  were serially measured on days 0 ( at the time of sepsis evaluation ) , 1 , 2 , 4 and 7 . The optimal cutoff value for each marker was calculated after minimising the number of misclassified episodes over all possible cutoff values for days 0 and 1 . The sensitivity , specificity , positive and negative predictive values for each test and combination of tests for predicting systemic infection were also determined . RESULTS One hundred and one episodes of suspected clinical sepsis were investigated in 68 infants . Forty five episodes were proved to be infections . The optimal cutoff values were IL-6 31 pg/ml , TNFα 17 pg/ml , IL-1β 1 pg/ml , C reactive protein 12 mg/l and E-selectin 174 ng/ml . IL-6 had the highest sensitivity ( 89 % ) and negative predictive value ( 91 % ) for detecting late onset infection on day 0 . However , between 24 and 48 hours of onset , C-reactive protein was the best single marker , with an overall sensitivity and specificity of 84 % and 96 % , respectively . The use of serial and multiple markers in the first 48 hours further enhanced the sensitivity and specificity of these tests . Performing IL-6 and C-reactive protein on day 0 , together with either TNFα on day 1 or C-reactive protein on day 2 , showed the best overall sensitivity ( 98 % ) and specificity ( 91 % ) for the diagnosis of late onset infection . CONCLUSIONS Optimal cutoff values for these markers in detecting late onset systemic infection in very low birthweight infants have been defined . Withholding antibiotic treatment at the onset of infection could be fatal and is not recommended , but the concomitant use of IL-6 and C-reactive protein or TNFα should allow antimicrobial treatment to be discontinued at 48 hours without waiting for microbiological results , provided that the infants are in good clinical condition Objective To determine whether the DNA damage detected using the Comet assay helps in the diagnosis of neonatal sepsis Methods Sepsis was diagnosed , based on clinical findings , laboratory findings and positive culture results , in 24 of the 48 newborns who participated in the study .  Hematological parameters , baseline demographic data and genotoxic evaluation were investigated . Results There were no significant differences in hematological , demographic and genotoxic data between cases and controls . Conclusions The Comet assay proved to be ineffective in the diagnosis of neonatal sepsis OBJECTIVE Early recognition is important for the successful treatment and outcome of neonatal infections . As interleukin-6 ( Il-6 ) plays a critical role in the induction of C-reactive protein ( CRP ) synthesis in the liver , it was hypothesized that this cytokine could be detected earlier in blood than the CRP during the course of bacterial infection . DESIGN In a prospect i ve study of 298 newborns who were admitted to the nursery unit ,  CRP levels , blood cell count with differential , and Il-6 levels  were determined at the time of admission and 24 hours after admission . Seventy-six newborns were excluded from the study because of incomplete or incorrect blood sampling . RESULT 
    Output:
    
ILs 6 , 8 and 10 are among the initial markers of neonatal sepsis diagnosis .
Interleukins can be helpful in the diagnosis of  neonatal sepsis based on the results of this study .
IL6 had the most sensitivity and IL10 had the most specificity for diagnosis of sepsis