impact and effect of liver insufficiency of HCV infection on patients with chronic obstructive pulmonary diseases

Hepatitis C virus [HCV] infection is associated with a wide series of extra- hepatic manifestations. Pulmonary involvement is one of the extrahepatic manifestations of chronic hepatitis C virus [HCV] infection. The objective of this study was to determine the impact of HCV; infection and the degree of liver dysfunction in patients with chronic obstructive pulmonary disease [COPD]. This study was conducted on COPD patients. They were selected from outpatient chest clinic in the Menoufia University Hospital. They were classified into 2 groups the first group COPD patients [n = 40] without hepatitis C and the second group COPD patients with chronic hepatitis C. Second group [COPD with HCV] classified into 3 subgroups according Child-Pugh classification to determine the degree of liver insufficiency. Group IIA: patients Child-Pugh [A], group IIB: patients Child-Pugh [B] and group IIC: patients Child-Pugh [C]. The following pulmonary function parameters were recorded: Forced Expiratory Volume in the first second [FEV1], Forced Expiratory Volume percent [FEV1/FVC%], Forced Expiratory Flow 25-75% [FEF 25-75%] and Maximal Voluntary Ventilation [MVV]. The study included 80 patients with COPD, 40 patients without chronic HCV infection [group I], and 40 patients with chronic HBV infection [group II].COPD patients with HCV infection have increased deterioration in pulmonary function [FEV1, FEV1/FVC, FEF 25-75% and MVV] than COPD patients without HCV infection. Also there were significant decreases in pulmonary function tests [FEV1, FEV1/FVC, FEF 25-75% and MVV] in group II subgroups IIA, IIB and IIC according to the degree of decompensation. Patients with COPD with HCV infection, have increased deterioration in pulmonary function than patients with COPD without HCV infection and the deterioration increases with hepatitis decompensation

Role of fibulin-3 in the diagnosis of malignant mesothelioma

Early detection of malignant pleural mesothelioma [MPM] is critical to survival, the use of pleural or blood fibuin-3 might allow this early detection. Studying the validity of measuring serum and pleural fibulin-3 in the diagnosis of MPM. Fibulin-3 levels were measured in serum and pleural fluid by enzyme-linked immunosorbant assay [ELISA] in 45 patients with exudative pleural effusion. Patients with non-conclusive cytology or microbiological examination had undergone medical thoracosope for histopathological examination. Twenty five was diagnosed as MPM, 11 cases as pleural metastasis of carcinoma [Mets] and nine cases with benign pleural effusions. Patients with MPM had significantly higher pleural effusion and serum fibulin-3 levels than those with metastatic effusion of carcinoma or benign pleural effusion [p-value < 0.001]. Using a cut-off point of pleural fluid fibulin-3 [150 ng/ml] with AUC of 0.878 [sensitivity 72.3%, specificity 80] and at a cut-off point of serum fibulin-3 [66.5 ng/ml], with AUC of 0.776 [sensitivity 88%, specificity 81.8%], discrimination between MPM and Mets occurred. Also, using a cut-off point of pleural fluid fibulin-3 [127.5 ng/ml] with AUC of 0.909 [sensitivity 88%, specificity 77.8%], and at a cut-off point of serum fibulin-3 [18 ng/ml], with AUC of 0.931 [sensitivity 100%, specificity 77.8%], discrimination between MPM and benign pleural effusion could occur. Fibulin-3 in the serum and pleural fluid is a good biomarker in the diagnosis of MPM and in differentiation between MPM from malignant pleural metastasis other than mesothelioma and also from benign pleural effusions