Role of rehabilitation of chronic obstructive pulmonary disease patients in intensive care unit

To study the effects of pulmonary rehabilitation program in COPD patients in ICU. Eighty COPD patients recovering from acute respiratory failure in ICU were subjected to rehabilitation program of four different steps of increasing difficulty. Demonstrated that pulmonary rehabilitation is useful in patients considered too conditioned, while early intervention gave better results. Also, comprehensive program was superior to ambulation program in general. Follow up re-evaluation confirm the beneficial effects of home program. Therefore, early pulmonary rehabilitation program is of great importance for COPD patients in ICU and prevents further complications

Urinary glycosaminoglycans in systemic lupus erythematosus: marker of renal affection and relation to disease activity

To evaluate glycosaminoglycans [GAG], heparan sulphate [HS] and chondroitin sulphate [CS] levels in the urine of systemic lupus erythematosus [SLE] patients. Also, to determine its possible use as a marker for lupus nephritis and its correlation with disease activity. This study was conducted on 30 patients suffering from SLE. They were subdivided according to disease activity and renal affection. Ten apparently healthy subjects were taken as a control group. GAGs were isolated from urine with ion exchange chromatography on DEAE sephacel. Determination of HS and CS levels were done with ELISA. There was a significant increase of GAGs and HS levels in SLE patients than in controls [p<0.05]. There was a highly significant difference [p<0.01] between active and inactive SLE patients as regards CS/HS ratio. GAGs and CS/HS ratio were significantly higher in active patients with lupus nephritis [p< 0.001]. Urinary GAGs may represent an additional, non-invasive diagnostic approach for lupus nephritis. It could be used as a parameter for disease activity and lupus nephritis

Assesment of soluble ICAM-1 and soluble E-selectin in juvenile idiopathic arthritis: clinical and laboratory correlation

To determine serum levels of soluble adhesion molecules [sICAM-1 and sE-selectin] in juvenile idiopathic arthritis patients. Also, to assess any changes in these levels during remission and exacerbation and to correlate them with clinical and laboratory variables. The serum and synovial levels of soluble intercellular adhesion molecule 1 [sICAM-1] and soluble E-selectin were determined using enzyme linked immunosorbent assay [Elisa] in 44 patients with JIA, 14 systemic [JIA-sys], 15 polyarticular [JIA-poly] and 15 oligoarticular [JIA-oligo], who had active disease or were in remission and 20 healthy controls. The erythrocyte sedimentation rate [ESR], C-reactive protein [CRP] and complete blood count [CBC] were recorded. [sICAM-1] and [E-selectin] were significantly higher in both [JIA-sys] and [JIA-poly] than in [JIA-oligo] or healthy controls. There was a significant negative correlation [sICAM-1] and [s-E-selectin] and age. There was no correlation with some sensitive markers of inflammation [ESR] or [CRP]. [sE-selectin] correlated with white blood cells [WBC] and platelet count in the remission stage .There was a significant correlation between synovial adhesion molecules concentration and total synovial leukocytic count. Increased levels of soluble adhesion molecules in both [JIA-sys] and [JIA-pol] may be due to endothelial cell activation and its persistence in spite of clinical remission could be used as markers of aggressive disease

Correlation of plasma osteopontin and interleukin-18 concentrations with systemic lupus erythematosus disease activity

Osteopontin [OPN] is an extracellular matrix protein of pleotropic properties that has been recognized as a potential inflammatory cytokine. Also it has immunological activities including stimulation of T-helper type 1 lymphocyte response and B-cell antibody synthesis. IL-18 has multiple biological activities that are important in generating Th1 responses and inflammatory tissue damage. We measured the plasma concentration of OPN and the plasma IL-18 concentration in 24 SLE patients and 20 sex and age matched control subjects using an enzyme- linked immunosorbent assay. Plasma OPN concentrations and plasma IL-18 concentrations were significantly higher in SLE patients than in the control group [both p<0.001]. The increase in OPN and IL-18 concentrations correlated positively and significantly with SLE activity [r= 0.831, p<0.001] and [r = 0.826, p<0.001] respectively. Also, there was a highly significant positive correlation between OPN and IL-18 [r=0.75, p<0.001]

Possible role of vitamin E in protection against chemotherapy-induced peripheral neuropathy

To evaluate the neuroprotective effect of Vitamin E supplementation in cancer patients receiving chemotherapy. This study was carried out on 24 patients with breast, ovarian and lung cancer. They were divided into two groups: Group [I] including 12 cancer patients on chemotherapy with 600 mg Vitamin E supplementation and Group [II] including 12 cancer patients on chemotherapy without vitamin E supplementation. All patients were subjected to full medical and neurological examination, nerve conduction velocity study [NCV] of sural, ulnar and peroneal nerves. Measurement of neurotoxicity score was done and was classified as no toxicity, mild, moderate and severe toxicity. Only 21 patients completed this study and we found a significant [p<0.05] reduction of ulnar and sural sensory nerve action potentials [SNAP] in group [II] after treatment with chemotherapy in comparison to that before treatment. On the other hand, no significant slowing of NCV or reduction of M response was detected. We also found a significant reduction [p<0.05] of SNAP of ulnar and sural nerves in group [II] in comparison to patients in group [I] after taking chemotherapy. Vitamin E supplementation may have a role in amelioration of peripheral neuropathy induced by chemotherapy