Clinical and biochemical evaluation of growth hormone/insulin like growth factor I axis in chronic renal failure

This study was conducted to determine the plasma levels of GH, IGF- I tumor necrosis factor-alpha [TNF-alpha], NO, hyaluronan and fibronectin in plasma of 40 patients with chronic renal failure [CRF] of various clinical causes at presentation and after dialysis. Their levels were correlated with degree of renal impairment and the type of underlying pathology. The study also included 15 healthy controls with comparable age. The study revealed insignificant change in GH levels, significant decrease of IGF-I and fibronectin associated with significant increase in TNF-alpha, NO and hyaluronan in patients with CRF compared with healthy controls

Biochemical modifications of low density lipoprotein particles in diabetic patients

Modified forms of low density lipoprotein [LDL] are associated with increased atherogenicity in diabetic patients. Therefore, biochemical characteristics of LDL particles from 17 type I and 26 type II diabetic patients in the form of glycosylation, sialic acid content, thiobarbituric acid reactive substances [TBARS] as well as lipid composition were studied. The study also included 10 healthy control subjects. The study revealed that LDL from diabetic patients contained decreased amount of sialic acid, increased amounts of fructosyl lysine and TBARS compared with controls. The degree of glycosylation and sialic acid content were correlated with status of diabetic control as determined by blood glucose level and total fructosamine. Furthermore, the lipid composition of LDL from diabetic patients was changed, where triglycerides were increased and cholesterol was decreased compared with healthy subjects. Altogether, diabetic patients' LDL were characterized by a lowered lipid/protein ratio. In conclusion, the cholesterol accumulating effect of diabetic patient's blood sera is mainly related to atherogenic low density lipoprotein fraction, which is modified in various ways, by increased non-enzymatic glycosylation, desialylation and alterations in lipid composition. This multiple-modified LDL may contribute to the premature atherosclerosis development in diabetes mellitus

After scherotherapy bacteraemia and bacterial peritonitis

This study included 120 patients with liver cirrhosis divided into 3 groups: Group I [46 patients], who were subjected to repeated esophageal sclerotherapy, group II [20 patients], who received antibiotics before, during and after sclerotherapy, and group III [54 patients], who were not subjected to sclerotherapy. Patients, who received prophylactic chemotherapy during sclerotherapy developed neither fever nor peritonitis, while some of those, who did not receive chemotherapy, developed fever [10 patients, 21.7%] with positive ascitic fluid [6 patients, 13%] and bacteremia [4 patients, 9.1%]. This rate was much less in patients with liver cirrhosis, who were not subjected to sclerotherapy [3 patients, 5.6%]. Therefore, it may be concluded that prophylactic chemotherapy may be recommended before sclerotherapy to minimize the risk of developing bacteremia or peritonitis

Status of a novel arginine carboxypeptidase generated during coagulation in rheumatoid arthritisIts relationship with fibronection, cerulolasmin and clinical status of the patients

A novel arginine carboxypeptidase which is generated from plasma components during coagulation and possibly during some inflammatory reactions was recently reported to be decreased in rheumatoid arthritis. To further clarify this point, serum and plasma arginine carboxypeptidase together with plasma fibronectin and serum ceruloplasmin were determined in 37 patients with rheumatoid arthritis and 16 healthy controls. The study revealed significantly decreased serum enzyme activity levels as well as serum/plasma enzyme ratio compared with control, while both ceruloplasmin and fibronectin levels were increased significantly. Increased consumption of this enzyme for metabolism of inflammatory peptides such as C3a, C5a and bradykinin may be responsible. Significant negative correlation existed between serum enzyme activity as well as serum/plasma enzyme ratio and both fibronectin and ceruloplasmin. The negative correlation with fibronectin could be due to involvement of the enzyme in removal of this molecule, while negative correlation with ceruloplasmin could be due to the anti-inflammatory function of ceruloplasmin as a metal binding protein. No obvious correlation could be observed between indices of clinical severity, a finding suggesting that arginine carboxypeptidase deficiency could be partly due to inherited or acquired inability to generate this enzyme which results in an accelerated onset of the disease

Bone mineral metabolism in type I diabetes mellitus with special reference to osteocalcin

This study included forty-eight insulin-dependent diabetic males in whom other physiological and pathological factors affecting bone metabolism were included. The results were compared with those obtained from ten age and sex matched healthy controls. From the results obtained, it was concluded that some alterations in mineral metabolism was present in IDD patients and it might share in the pathogenesis of diabetic osteopenia. The significantly positive correlation between urinary excretion of Hyp and both Ca++ and P++ excretion could suggest the use of Ca++ and P++ as alternatives to urinary Hyp to assess bones resorption in diabetic patients

Clinical profile in patients with anterior ischaemic optic neuropathy[AION]

Fifty-four patients were studied. They were diagnosed as having AION in its either form. Forty-eight patients had non-arteritic AION. The mean +/- SD age of them was 60.5 +/- 9 years for males and 65 +/- 8.9 years for females. This study revealed that certain patients with systemic hypertension, diabetes mellitus or both as well as patients with previous cerebrovascular or cardiovascular events were at a higher risk of developing the non- arteritic form of the disease. Hypertension was encountered in 44%, diabetes mellitus in 27% and atherosclerosis in 16.6%. The other six patients were diagnosed as having arteritic form of the disease. Giant cell arteritis was incriminated in four patients, while systemic lupus was found in one patient and the last patient was suffering from pulseless disease

Interrelationship between coagulant activity and tissue-type plasminogen activator activity in hypertensive patients

Tissue plasminogen activator [t-PA] activity, von-Willebrand factor, fibrinogen and lipid pattern were determined in plasma of 49 hypertensive patients as well as 18 healthy subjects. Hypertensive patients compared with controls had significantly decreased t-PA, [P < 0.01], high density lipo-protein [HDL] cholesterol [P < 0.05], and HDL/LDL [low density lipoprotein] cholesterol [P < 0.001], while they had significantly increased plasma levels of von-Willebrand factor [P < 0.001], fibrinogen [P < 0.001], total cholesterol [P < 0.001] LDL cholesterol [P < 0.001], as well as triglycerides [P 0.001]. A significant negative correlation was found between t-PA activity and diastolic blood pressure [BP] indicating that hypofibrinolysis is linked to elevated [BP] which is therefore, considered a cardiovascular risk factor. The effect of antihypertensive drugs on t-PA was studied and we found that propranolol has induced a non significant increase in morning activity of t-PA. Such effect could be contributing to the reported alteration in the circadian pattern of myocardial infarction in patients treated with B-blockers