Tag Archives: inflammation

The Relationship Between Chronic Inflammation and Glucidic-Lipidic Profile Disorders in Kidney Transplant Recipients

DOI: 10.1515/amma-2015-0121

Introduction: Chronic inflammation has a proven role in atherogenesis, lipid profile parameters being related to cytokine production. In kidney transplant recipients, interleukin 6 (IL-6) is significantly associated with graft-related outcomes and also alterations of cholesterol and triglyceride metabolism. The aim of this study was to investigate the relationship between chronic inflammation and glucidic-lipidic metabolism disorders in a group of patients with kidney transplantation as renal replacement therapy.
Methods: A prospective observational study which enrolled thirtysix non-diabetic kidney transplant recipients was conducted in the Nephrology and Peritoneal Dialysis Department, County Clinic Hospital of Tirgu Mures. The study group was divided as following: recipients with serum IL-6 concentration higher than 3.8 pg/ml (group A) and IL-6 within the normal range (group B).
Results: Allograft recipients with higher serum IL-6 had significant higher erytrocyte sedimentation rate(ESR, p=0.0067). Patients with over-the-range levels of IL-6 had significant higher levels of serum cholesterol and LDL-cholesterol respectively (p=0.0242 and p=0.0081). Serum Apo-B was also significant higher in Group A than Group B. Protein excretion was significant higher in patients from group A (p=0.0013). No statistical significant relationship could be proven between elevated levels of IL-6 and hbA1c, insulin and glycosuria disturbances in the two groups. Also, we found no statistical significant association between resistivity and pulsatility indices (both hilum and intragraft) or carotid intima media thickness.
Conclusion: Serum interleukin 6 is related to lipid profile disorders and less to glucidic metabolism anomalies in non-diabetic kidney transplant recipients.

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Morpho-Pathological Review on the Healing of Synthetic Vascular Grafts

DOI: 10.1515/amma-2015-0098

Objective: Tissue integration of vascular grafts partially depends on the host response to injury, which immediately begins after implantation and restoration of the circulation. In an infected environment, the inflammation changes the incorporation patterns. The aim of the study was to observe the tissue incorporation process, in a normal and an infected environment. Methods: We have created an experimental model by performing subfascial implantation of four types of vascular grafts, in rats (woven Dacron®, knitted Dacron®, silver coated Dacron® and expanded Polytetrafloroethylene – ePTFE) and by infecting some of them with three different bacterial strains. We have retrieved the non-infected grafts at two and four weeks after implantation, whilst the infected ones at one, two and three weeks.
Results: Detailed microscopic appearences were analysed. The control and infected groups were compared. Statistical significance was calculated for various corelations. Conclusions: The morphopathological findings showed that the ePTFE graft’s structure was best preserved. Statistical significance existed between the bacterial strain and the degree of inflammation. The silver coated Dacron® was not shown to be superior to the knitted Dacron®. The poorest incorporation was the one of the woven Dacron®.

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The Detection of Premalignant and Malignant Gastric Lesions by Conventional Endoscopy in a General Population Sample

Background and Aims: The identification of patients with premalignant lesions and endoscopic surveillance could improve the early detection of gastric cancer, with better therapy and prognosis. We performed conventional endoscopy with biopsies to identify the incidence rates of premalignant and malignant gastric lesions and the risk of patients for this pathology.
Methods: A total of 1651 patients were investigated with conventional endoscopy. We took biopsies from 1493 patients. Biopsy specimens were analyzed for gastric inflammation, atrophy, intestinal metaplasia, dysplasia and neoplasia.
Results: We demonstrated that major symptoms had a sensitivity of 95.2%, and a specificity of 54.5% for the detection of gastric neoplasia, with a sensitivity of 61.6% and a specificity of 57.2% for the detection of premalignant lesions. We showed the risk of patients over 45 years, with major or minor symptoms, for premalignant and malignant gastric lesions (p < 0.001; RR = 3.34; 95%CI: 2.41–4.61). We emphasized the importance of histological evaluation by biopsies of entire gastric mucosa in case of polyps, ulcers, gastric atrophy detection or remnant stomach, for the evaluation of premalignant lesions (p < 0.,05). We showed that the prevalence of premalignant lesions increased with age and the presence of Hp infection. We demonstrated the risk of the inflammation in the gastric body for premalignant lesions.
Conclusions: The patient’s symptoms were not predictive of endoscopic and histologic findings. Not only symptoms, but also the age, the presence of Helicobacter pylori infection, the histological detection of the extent and location of gastric inflammation and premalignant lesions define the risk for the dyspeptic patients.

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Considerations Regarding the Antiinflammatory Action of Soy Total Extract Vs. Soy Isoflavonoid Daidzein on Animal Model

Introduction: The aim of this study is to investigate the anti-inflammatory action of daidzein on animal model a less studied isoflavone than genistein on this topic and to compare it’s anti-inflammatory activity with the one of soy total extract.
Material and method: Soybean seeds were grounded and a solvent formed of DMSO-ethanol-water in rapport 5-70-25 v/v/v was prepared. The extraction was made at room temperature using an ultrasonic bath (Falc LCD Series) for 30 minutes, 59 kHz. The solvent was evaporated with a rotary evaporator at 50 ºC. Daidzein was acquired from Extrasynthese (France).Animal studies were conducted on C57BL/6J female mice of 8 weeks. Edema was induced in both ears of each mouse by the topical application of 2 μg TPA dissolved in 20 μL of acetone to both the inner and outer ear surfaces. Thirty minutes after the application of TPA, the inner and outer surface of each ear was treated with 2 mg of soy total extract (group C) and 2 mg of daidzein (group D). Mice were killed after 24 h by cervical dislocation and ears were collected. Ears were weighed and histological analyze were made. For the histological analyze, tissue samples (skin) were fixed in 10% formalin solution and were embedded in paraffin and cut at 4 microns. Finally after deparaffinized the samples were stained with H&E (hematoxylin-eosin) and microscopically analyzed.
Results: The obtained results suggest that both of the samples used for the treatment are active agents against inflammation but with different empowering. Soy total extract is in charge of reducing the massive under epithelial inflammation with numerous granulocytes to a discrete under epithelial inflammatory infiltrate. Daidzein successfully reduced the massive under epithelial inflammation with numerous granulocytes to a discrete under epithelial edema.
Conclusion: Both daidzein and soy total extract present an anti-inflammatory action on animal model but daidzein is a better therapeutic choice since it has a stronger anti-inflammatory action.

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Pancreas Injury in Shock

Background: The causes of acute pancreatitis are well known, and although enzymatic injury is the main factor in its development, pancreatic ischemia due to profound hypoperfusion in cardiogenic or hypovolemic shock patients can be an important etiological factor. The aim of our study was to analyse the histological alterations of the pancreas in patients dying after shock, to study the presence and severity of pancreatic injury.
Material and methods: We studied the morphological alteration of the pancreas, in patients who died after cardiogenic or hypovolemic shock, hospitalized in intensive care units in the County Emergency Hospital Tîrgu Mureș, between 2007–2009.
Results: We examined the structure of the pancreas of 117 patients, 20 showed acute hemorrhagic pancreatic necrosis on autopsy. None of the patients showed typical clinical and laboratory signs for acute pancreatitis. The common findings in these patients were prolonged and severe hypotension, leucocytosis, hyperglycemia and hypocalcemia.
Conclusions: Pancreatitis can occur in patients with shock, due to ischemic injury of the pancreas. It is difficult to diagnose it because clinical signs are altered by the severity of the underlying disease or by analgo-sedation commonly used in intensive care units. We therefore recommend to consider the possible development of acute pancreatitis in patients with shock, in patients with prolonged hypotension, leucocytosis, hypocalcemia, even in the absence of characteristic clinical symptoms and hyperamylasemia.

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