Interleukin-10 level in occult hepatitis C virus infection in hemodialysis patient

Interleukin 10 is a critical immunoregulatory molecule, produced mainly by macrophage, Th2 and regulatory T cells, is a potent immunosuppressive cytokine with anti-inflammatory activity. Detection of the serum level of IL-10 in OCI in HD patients. 75 HD patients from HD units in Assiut university Hospital, were enrolled in this study, and IL-10 were measured in 8 patients with OCI, 68 HD without OCI and 10 normal subjects as a control. The level of IL-10 was highly significantly increased in HD patient with OCI than in HD patients without OCI [P< 0.001], and in HD patients than normal subject [P<0.001] There is significant increase as regarding ALT [P<0.001], AST [P< 0.001], in occult HCV infection in HD patients. Our data revealed a high serum level of IL-10 in occult HCV infection in HD patients with persistently abnormal elevated levels of liver enzymes than HD patients without OCI

Prevalência de obstipação intestinal em pacientes em diálise crônica / Prevalence of constipation in chronic dialysis patients

Introdução: A obstipação intestinal é queixa comum de pacientes em diálise e pode estar relacionada a fatores alimentares, emocionais, patológicos, físicos e medicamentosos. Objetivo: investigar a prevalência da obstipação de pacientes em hemodiálise (HD) e em diálise peritoneal (DP). Método: Através do prontuário e entrevista com cada paciente, foram coletados dados sobre a obstipação e fatores relacionados. Grupos com e sem obstipação foram comparados. Resultados: Dos 448 pacientes avaliados em HD, 150 (33,5%) apresentaram obstipação crônica. Em DP, dos 109 pacientes avaliados, 29 (26,6%) relataram obstipação. O grupo obstipado em HD era mais sedentário (n=101, 67,3%; p<0,005), com predominância do sexo feminino (n= 89, 59,4%; p<0,0001) e maior prevalência de diabetes (n=50, 33,3%; p<0,0001). Esse grupo também relatou maior uso de laxantes (n=67, 44,7%; p<0,0001) e ingestão pouco freqüente de alimentos ricos em fibras (n= 246, 82,5%; p<0,05). Em DP, não houve diferença entre os grupos. Dos obstipados em DP, 58,6% (n=17) faziam uso de laxantes (p<0,0001). Em relação ao carbonato de cálcio, não houve diferença entre os grupos de obstipados e não-obstipados,em ambas as diálises. Conclusão: a obstipação intestinal em HD é mais prevalente em mulheres, na presença de diabetes, no sedentarismo e naqueles com baixa ingestão de fibras. Já em DP, nenhum desses fatores contribuiu para o problema. O maior uso de laxantes pelos pacientes obstipados, em ambas as diálises, pode ser devido à busca de tratamento ou ao cólon catártico.

Introduction: Constipation is a common complaint of dialysis patients, and may be related to dietary, emotional, pathological, and physical factors. Objective: To investigate the prevalence of constipation in hemodialysis (HD) and peritoneal dialysis (PD) patients. Methods: Through the medical records and interviews, data were collected regarding the presence of constipation and related factors. Groups with and without constipation were compared. Results: From 448 HD patients evaluated, 150 (33.5%) presented chronic constipation. From 109 PD patients studied, 29 (26.6%) reported constipation. The group presenting constipation in HD was sedentary (n=101, 67.3%; p<0005), with a female predominance (n=89, 59.4%; p <0.0001) and a higher prevalence of diabetes (n=50, 33.3%; p<0.0001). This group also reported greater use of laxative medication (n=67, 44.7%, p<0.0001) and less frequent intake of foods rich in fiber (n=246, 82.5%; p<0.05). In PD, there was no difference between groups. In the PD group presenting constipation, 58.6% (n=17) of the patients were taking laxative medication (p<0.0001). Regarding the use of calcium carbonate, there was no difference between the groups, in both types of dialysis. Conclusion: Constipation in HD is more prevalent in women, in the presence of diabetes, sedentary lifestyle and in those with low fiber intake. In PD, none of these factors contributed to the problem. The greater use of laxative medication by constipated patients, in both forms of dialysis may be due to a search for treatment or to cathartic colon.

Helicobacter pylori in dyspeptic hemodialysed patients: endoscopy findings and non-invasive detection

Objective: We aimed to evaluate dyspeptic hemodialysed patients regarding upper endoscopy findings and HP status. Also to determine the accuracy of several tests, including culture, histology, rapid urease test, serology and Hp stool antigen to screen for H. pylori infection in dyspeptic hemodialysed patients and evaluate the success of eradication therapy in patients with ESRD

Patients and methods: 44 patients with ESRD on regular hemodialysis and 40 dyspeptic patients with normal renal function as a control group were included in the study. All patients underwent upper endoscopy with biopsy intake for HP histopathology, culture and rapid urease test [RUT]. HP positive result was based on histopathology and or culture. HpSA, and Hp-lgG were also performed. HP infected patients were scheduled to undergo 7-day triple therapy and the success of eradication therapy was investigated

Results: 20 of ESRD patients [54.5%] and 25 patients of control group [62.5%] were proven to be infected with HP. The endoscopy findings of the gastroduodenal mucosa in dialysis patients were similar to that of controls, as was the incidence of peptic ulcers. Dialysis patients had a significantly lower prevalence of H. pylori infection than control subjects. In the histological study. H. pylori-positive patients had significantly higher inflammation and activity scores than H. pylori-negative patients for both dialysis patients and controls. The culture technique provided sensitivity, specificity, PPV and NPV of 54.9, 100, 100 and 70.6%, respectively. The CLO test provided sensitivity, specificity, PPV and NPV of 98, 90.0, 92.1 and 98.9%, respectively. The histology provided sensitivity, specificity, PPV and NPV of 93.4, 90.6, 90.5 and 94.0 %, respectively. The serological test of IgG antibodies yielded sensitivity, specificity, PPV and NPV of 96.0, 64.0, 78.6 and 95.9%, respectively. For the detection of HPSA using FemtoLAB yielded sensitivity, specificity, PPV and NPV of 86.0 100, 100, and 91.0%, respectively, using Premier Platinum yielded sensitivity, specificity, PPV and NPV of 58.0, 86.0 92.0 and 53.0%, respectively, simple rapid test yielded sensitivity. specificity. PPV and NPV of 61.0% 78%, 74.0% and 67% respectively

Conclusion: Upper GI abnormalities are common among HD patients. Biopsy proven antral gastritis is the most common histological diagnosis among these patients and is highly associated with H. pylori infection. Prevalence of H.pylori infection in HD patients is similar to those with normal renal function undergoing endoscopy for dyspepsia. FemtoLAB HpSA is a noninvasive reliable. inexpensive, and reproducible test for diagnosis and follow up of eradication of HP infection in ESRD patients on regular hemodialysis. Detection and treatment of HP improved dyspeptic symptoms in ESRD patients on hemodialysis

Prognostic value of tissue polypeptide antigen [TPA] plasma levels in patients with malignant salivary gland tumors

Nine subject with various malignant salivary gland tumors were monitored with tissue polypeptide antigen [TPA] pre and post operatively utilizing TA radio-immunoassay kit. The TPA radioimmunoassay proved to be a specific and sensitive method aiding in diagnoses monitoring and a postoperative follow up in malignancies