ABSTRACT
BACKGROUND: Pleurodesis with talc has been used for many years. No objective criteria of inflammatory symptoms are known in order to use them to predict the effect of therapy and selection of patients. PURPOSE OF THE STUDY: To objectify the course of local inflammatory changes in the pleural cavity, quantify their dynamics in a clinically used procedure, and to determine specific predictors of inflammation as perspective markers of selection of patients suitable for talcage. MATERIAL AND METHOD: A total of 114 patients were retrospectively divided into Group A (n1 = 98) of patients without relapse and Group B (n2 = 16) of patients with relapse of exudate. The need for repeated thoracic punctures or drainages over the course of a 12-month monitoring period was the criterion of treatment failure. RESULTS: The groups were not different as for the baseline values of sTLR-2 (p0 = 0.638). Group A showed a marked growth during the monitoring period in 2 hours following talcage (p2= 0.002) and in 24 hours (p24 = 0.016). Group B showed higher sCD-163 levels (p0 < 0.001). The initial sTREM-1 values and those after two hours were similar in both groups (p0 = 0.146; p2 < 0.0641). In 24 hours, Group A had markedly higher values (p24 < 0.001). CONCLUSION: The sTLR-2, sCD-163 and sTREM-1 values can be prospectively determined. High sCD-163 values predict unsuitable selection of a candidate for talcage. The degree of inflammatory response can be evaluated using sTLR-2 or sTREM-1. Talcage using an inserted thoracic drain can be repeated at low levels. The cost of ELISA examination is approximately 18 euros (Tab. 1, Fig. 4, Ref. 20).
Subject(s)
Pleural Effusion, Malignant/therapy , Pleurodesis , Talc/therapeutic use , Aged , Antigens, CD/metabolism , Antigens, Differentiation, Myelomonocytic/metabolism , Biomarkers , Female , Humans , Male , Membrane Glycoproteins/metabolism , Middle Aged , Pleural Effusion, Malignant/metabolism , Prognosis , Receptors, Cell Surface/metabolism , Receptors, Immunologic/metabolism , Recurrence , Retrospective Studies , Toll-Like Receptor 2/metabolism , Treatment Failure , Treatment Outcome , Triggering Receptor Expressed on Myeloid Cells-1ABSTRACT
OBJECTIVE: To study the dynamic of changes in the level of parathyroid hormone (PTH), calcitonin (CT), cyclic nucleotides (cAMP, cGMP) and calcium in the blood of rats, while in urine--phosphate, calcium and cyclic nucleotides. DESIGN: Laboratory based experiment. SETTING: Laboratory in the Department of Biochemistry, Faculty of Medicine, University of Nairobi, Nairobi, Kenya and in the Department of Biochemistry, Kharkov State University, Ukrain Republic. RESULTS: Correlation between the changes in the parameters of study was shown. This supports the theory about the relationship between branches of hormonal systems (cyclic nucleotides-calcium), which perform the central role in the regulation of homeostasis. The results show that daily excretion of calcium and phosphate is age dependent in rats during the pathogenesis of hypokinesia: the values are higher in control groups. Changes in calcium in the blood and phosphaturia in the experimental animals of all ages were attributed to changes in the intensive re-absorption process within the bones during the readaptation period of hypokinesia. CONCLUSION: Old rats have a higher ability to adaptation than younger experimental counterparts during hypokinesia.
Subject(s)
Calcium/metabolism , Cyclic AMP/metabolism , Cyclic GMP/metabolism , Disease Models, Animal , Homeostasis/physiology , Hypokinesia/metabolism , Aging/metabolism , Animals , Bone and Bones/metabolism , Calcitonin/metabolism , Creatinine/metabolism , Female , Humans , Male , Parathyroid Hormone/metabolism , Phosphates/metabolism , Rats , Rats, Wistar , Second Messenger Systems/physiology , Time FactorsABSTRACT
OBJECTIVE: To detect fibrinogen degradation products (FDP) in blood as a result of induced hyperfibrinolysis. DESIGN: This in-vitro and in-vivo study compared the relationship between the plasma FDP levels, the rate of their production, the degree of fibrinolysis and the effect of protease inhibitors in primary hyperfibrinolysis conditions. SETTING: Department of Medical Biochemistry, Kharkov General and Emergency Operational and Research Institute, Ukraine in collaboration with the Department of Biochemistry, University of Nairobi, Kenya. SUBJECTS: Blood plasma of humans and rabbits. INTERVENTION: Streptokinase was added to plasma of humans and rabbits to induce in vitro primary hyperfibrinolysis. Studies on the activity of plasmin by protamine degradation was conducted with this streptokinase treated plasma. The effect of natural protease inhibitors of rabbit fibrinolysis were also conducted by adding each inhibitor to the streptokinase treated blood plasma. A further study on FDP levels in experimental rabbits with primary hyperfibrinolysis, was conducted by giving the animals intramuscular injections of pantripin. RESULTS: In vivo studies with rabbits show a correlation between the degree of fibronolysis and the inhibitory effect of natural inhibitors of fibrinolysis. Increased FDP levels were recorded following hyperfibrinolysis. Natural inhibitors of fibrinolysis decrease FDP levels in experimental samples. CONCLUSION: These results suggest the possibility of applying plasmin inhibitors during pathological conditions of hyperfibrinolysis.
Subject(s)
Fibrin Fibrinogen Degradation Products/analysis , Fibrinolysis/drug effects , Fibrinolytic Agents/pharmacology , Streptokinase/pharmacology , Animals , Humans , In Vitro Techniques , Protease Inhibitors/pharmacology , RabbitsABSTRACT
There are four hypotheses which have been advanced to explain the pathophysiology of severe and complicated malaria such as cerebral malaria. However, none of them adequately explains all the features of cerebral malaria in man. One such hypotheses is Disseminated Intravascular Coagulation (DIC). To determine whether this condition occurs in patients with uncomplicated malaria, the authors conducted a study on fibrinogen and its degradation products, euglobulin lysis time and parasite counts in 30 cases of uncomplicated malaria. By spectrophotometric method, plasma fibrinogen in patients with uncomplicated malaria was found to be normal as compared to normal healthy adults. There were no fibrinogen degradation production (FDP) detected in either patients or healthy controls, using latex agglutination tests at a dilution of 1:5. This method for FDP estimation is significant in that a serum agglutination with 1:5 dilution indicates a concentration of FDP in the original serum in excess of 10g/ml, designated as positive results of experiment. High values of euglobulin lysis time (ELT) were noted in patients with low parasitaemia. Analysis of these results showed that disseminated intravascular coagulation did not occur in uncomplicated cases of malaria. In this study on cases of uncomplicated malaria and low parasitaemia the biochemical parameters relating to to DIC have been essentially normal, although DIC is thought to be a primary stage in the development of cerebral malaria. According to Reid, DIC is an important intermediate mechanism in the pathophysiology of severe and complicated malaria such as cerebral malaria.
