RESUMO
Hepatitis C virus [HCV] infection is prevalent around the world and is a common cause of chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma. Apoptosis plays a pivotal role in the maintenance of cellular homeostasis through removal of aged cells, damaged cells, and overgrowing new cells. It is believed that continuous liver cell apoptosis contributes to HCV pathogenesis. Failure of apoptosis induced by various stimuli is one of the most important events in tumor progression as well as in resistance to cytotoxic therapy. The target of the present study was to determine the changes in apoptotic machinery accompanying HCV infection through measurements of tumor necrosis factor alpha [TNFalpha], soluble Fas [sFas], and soluble FasL [sFasL]. A six-month prospective study was done on 30 patients with chronic hepatitis C [CHC] virus and thirty normal control subjects. Plasma TNFalpha levels were measured using ELISA Kit. sFas and sFasL in blood serum were measured using a sFas ELISA Kit and sFasL ELISA Kit. The average levels of plasma TNFalpha, serum sFas and serum sFasL show significant increase in CHC patients in comparison with healthy group [P <0.001]. The rate of apoptosis decreased in CHC patients through increasing the levels of TNFakpha sFas and sFasL and this may result in HCV persistence and development of hepatocellular carcinoma. So, the determination of TNFalpha, sFas and sFasL levels could be good tools for evaluation of chronic liver disease
RESUMO
Bacterial sepsis is a feared complication of the newborn. A large proportion of infants admitted to the Neonatal Intensive Care Unit [NICU] for suspected sepsis receive treatment with potent systemic antibiotics while a diagnostic workup is in progress. The gold standard for detecting bacterial sepsis is blood culture. However, the sensitivity of blood culture is suspected to be low. Molecular assays for the detection of bacterial DNA in the blood represent possible new diagnostic tools for early identification of a bacterial cause. The aim of this study was to compare a broad range 16S rDNA PCR done on blood samples without prior enrichment to conventional BACTEC blood culture for detecting bacteria in blood samples from neonates with suspected sepsis. Fifty five neonates with clinically diagnosed sepsis were included in this study. A broad range 16S rDNA polymerase chain reaction [PCR] without preincubation was compared to conventional diagnostic work up for clinical sepsis, including BACTEC PEDS PLUS/F blood culture, for early determination of bacterial sepsis in each infant. Only 20 infants had a positive blood culture. Analysis by 16Sr DNA PCR revealed 21 samples positive for the presence of bacterial DNA. PCR failed to be positive in one sample from blood culture positive infant, and was positive in 2 samples with blood culture negative infants. Compared to blood culture the diagnosis of bacterial proven sepsis by PCR revealed 95.0% sensitivity, 94.3% specificity, 90.5% positive predictive value and 97.1% negative predictive value. PCR combined with blood culture revealed bacteria in 40.0% of the patients diagnosed with sepsis. There is a need for PCR as a method to quickly point out the infants with sepsis. However, uncertainty about a bacterial cause of sepsis was not reduced by the PCR result, reflecting that blood culture is irreplaceable at present, since pure isolates are essential for antimicrobial drug susceptibility testing