RESUMEN
Background and Objectives: Rapid and early differential diagnosis between tuberculous and nontuberculous pleural effusion [TPE and NTPE] is a critically important clinical problem. The paucibacillary nature of TPE and inefficiency of conventional biochemical and microbiological investigations challenge the application of more comprehensive markers. In this study we evaluated the relevance of applying polymerase chain reaction [PCR], for detection of Mycobacteria Tuberculosis- DNA [TB-DNA], in association with interferon gamma [IFN-gamma] and soluble IL-2 receptor [sIL-2R] levels in pleural fluid for differential diagnosis of TPE
Patients and Methods: Study population included 60 patients with pleural effusion [PE]; 40 patients with TPE [7 patients with confirmed tuberculosis [TB] and 33 patients with probable TB], and 20 patients with non-tubrculous, non-infectious pleural effusion [NTPE] [10 cases due to malignancy and 10 cases due to heart failure]. PE samples were assessed for: biochemical markers [total protein and glucose], lymphocytic count, presence of acid fast bacilli in Ziehl-Neelsen [Z.N.] stained direct smears and by culture on Lowenstein Jensen [L.J.] medium], TB-DNA using conventional PCR, as well as levels of IFN-gamma and sIL-2R using commercial ELISA kits
Results: Biochemical markers, in particular total protein level, confirmed the exudative nature of TPE and malignant PE. The percentage of lymphocytes in PE was significantly higher in patients with confirmed TB [>80%] than all patients in other studied groups. All patients with confirmed TB were positive for TB-DNA PCR and had IFN-gamma and sIL-2R levels more than calculated cut off points. However, probable TB group showed a wide range of variability. None of patients with malignant PE but three of heart failure patients were positive for TB-DNA PCR. All patients with NTPE had IFN-gamma level less than cut off point. On the other hand, all patients with heart failure but 50% of patients with malignancy had sIL-2R level less than cut off point
Conclusion: Clinical data together with simultaneous detection of TB-DNA by PCR and measurement of IFN-gamma and sIL-2R levels as well as lymphocytosis [>80 %] in PE could provide the basis for rapid and efficient diagnosis of pleural TB in different clinical settings
RESUMEN
Heart disease is one of the leading causes of death among diabetic patients. The production of reactive oxygen species [ROS] by the cardiac myocytes was considered the most likely cause for the development of diabetic cardiomyopathy. The aim of the present study was to investigate the cardioprotective effects of insulin and/or vitamin E on streptozotocin [STZ] - induced diabetic animals. This work included 60 adult male albino rats divided into five groups. Group I [control] received phosphate buffered saline. Group II, STZ-induced diabetics. Group III, diabetic rats which received insulin. Group IV diabetic rats which received vitamin E. Group V diabetic rats which received both insulin and vitamin E. Diabetic cardiomyocytes revealed marked fragmentation and degeneration. Myofibrillar lysis and mitochondrial degeneration were detected. Groups II and III did not show remarkable improvement. Group IV showed improvement of some of the degenerative changes. Group V showed marked improvement. Myocytes appeared nearly similar to the controls with regular striations of myofibrils. The mean area percent of collagen content was measured by the image analyzer. Group II showed a very highly significant increase compared to the control Then a significant decrease in groups III, IV and V relative to STZ-group, was detected .It might be concluded that diabetes induced marked histological alterations in the cardiac muscles of albino rats. These structural changes were not corrected by the use of either insulin or vitamin E alone, but were markedly improved by the concomitant use of both insulin and vitamin E