New laboratory markers in diagnosis of alzheimer dementia.

OBJECTIVES: The aim of our work was to assess the role of tau protein, beta amyloid and cystatin C in diagnosis of Alzheimer dementia (AD) and other neurodegenerative diseases (NDs). METHODS: The levels of tau protein, beta amyloid and cystatin C were assessed in a set of 79 patients with ND (38 men and 41 women; aged 22-90 years; mean, 61.6 +/- 15.6 years) and in a control group of 79 subjects with a healthy central nervous system (38 men and 41 women; aged 20-91 years; mean, 61.5 +/- 15.1 years). RESULTS: When compared with the subjects in the control group, a statistically significant decrease in tau protein levels was found in patients with ND, an increase in tau protein levels in patients with AD and an increase in cystatin C cerebrospinal fluid/serum index in the ND + AD group. DISCUSSION: Our work only confirmed the previously reported results in part. Although tau protein seems to be a quite reliable marker of AD, the role of beta amyloid in AD diagnosis remains at the least questionable. In the case of cystatin C, our results would seem to confirm the views of certain authors that cystatin C will probably not become a new 'revolutionary' marker contributing to differential diagnostics.

The assessment of beta amyloid, tau protein and cystatin C in the cerebrospinal fluid: laboratory markers of neurodegenerative diseases.

To assess the role of tau protein, beta-amyloid(1-42) and cystatin C in the diagnostics of Alzheimer dementia (AD) and other neurodegenerative diseases (ND) by comparing to the control groups (CG). The levels of tau protein, beta-amyloid(1-42) and cystatin C were assessed in the set of 69 patients (AD + ND, 33 males, 36 females, aged 22-90, mean 60.5 + 16.1 years), and in a control group of 69 subjects without the affection of the central nervous system (CGAD + CGND, 33 males, 36 females, aged 20-91, mean 60.5 + 16.0 years). Statistically significant increased tau protein levels (P = 0.0001) and index tau/beta-amyloid(1-42) levels (P = 0.0002) were shown in the group of AD patients, compared to the group of ND patients. One-way ANOVA analysis with Bonferonni post hoc test did not show any significant differences of the cystatin C values between any of the compared groups. ROC analysis showed at least one tie between the positive actual state group (AD) and the negative actual state group (ND) by CSF cystatin C and at least one tie between the positive actual state group and the negative actual state group by CSF tau protein. Our study confirmed previously reported results only in part. While tau protein seems to be quite a reliable marker of AD, the role of beta-amyloid(1-42) and cystatin C in AD diagnosis remains at least questionable.

[Personal experience with determination of carbohydrate-deficient transferrin]. / Vlastní zkusenosti s vysetrením karbohydrát-deficitního transferinu.

Assessment of carbohydrate-deficient serum transferrin CDT) is considered a very useful indicator of alcohol abuse. There is a number of methods for assessment of CDT. In clinical practice most frequently assessment of the percentage ratio of CDT in transferrin is used. In our hospital we assessed CDT by the method of homogeneous immunoanalysis (Boehringer Mannheim (CDT-BM). Because we obtained a relatively high percentage of false results and because we found in the literature reference to a new method of homogeneous immunoanalysis (The Sanqui BioTech-CD-SB) with a different cut-off, we decided to compare the results of the estimations by the two methods and assess the percentage of false results. We examined a group of 49 patients incl. 16 who admitted alcohol abuse (> 60 g alcohol more than four times per week). As anticipated, we found that the %CDT assessed by the CDT-BM method was significantly higher than the percentage CDT-SB. After classification of the group into sub-groups with regard to alcohol intake the two sub-groups differed significantly only in values of CDT-SB and CDT-BM. In the group of patients with alcohol abuse we found relations between CDT-MB and indicators of hepatic lesions. In CDT-SB we found only an association with AST. This finding could suggest a greater specificity of CDT-SB. We confirmed data in the literature that GMT is independent on CDT and the mean corpuscular volume is independent on CDT in subjects with alcohol abuse. In abstainers who negated alcohol intake we found also when assessing CDT-SB a significant gender differentiation which is described in the literature (the reason is probably the fact that the CDT-SB method analyzes, contrary to CDT-BM, only asialo,-monosialo and disialylic isoforms of transferrin and women have higher levels of monosialylic forms). In our group the examination of %CDT by the new method, the Sanqui Biotech for alcohol abuse, had an almost absolute specificity and sensitivity. Contrary to the older Boehringer-Mannheim method we did not record any false increase in any patient with signs of hepatopathy nor any false negative results). We assume that the described methodical innovation of the analysis could facilitate the differential diagnosis of various diseases in different medical disciplines (internal medicine, neurology, psychiatry, assessment of work capacity).

[Nutritional status in patients with stroke. Diagnosis, therapy and its monitoring]. / Nutricní stav u nemocných s cévní mozkovou príhodou. Diagnostika, lécba a její monitorování.

Stroke (Ischemic) initiates numerous pathophysiological processes and each of them can be dangerous. When evaluating patient's state and choosing therapeutical strategy, a complexity of the followed-up parameters should be taken into account as well as a complexity of a given therapeutical approach. On the basis of literary data and acquired clinical experience, we developed our own algorithm for diagnosis of the nutritional state and it was implemented into a semi-expert computing system SOFT. Using SOFT program, the group of 23 patients with ischemic CMP was examined within 40 hrs after its origin. These patients were found to show a slight protein catabolism and nutritional stress (aminograms, stress index, nutritional percentage of complications, nitrogen balance, CRP, prealbumin). necessity of an early diagnosis of nutritional deficiency and disorders of protein metabolism in STROKE patients is discussed. The paper reports on means of enteral nutrition prepared in the Hospital in Sternberk which appeared to be highly favorable. The aspects of administration of parenteral nutrition are discussed.