Medecine interne最新文献

200 patients with varied types of liver failure were biochemically and clinically investigated. Beside the usual biochemical analyses (transaminases, glutamyl transpeptidase, triglycerides, bilirubin), some special parameters such as lipid peroxides, glutathione, ceruloplasmin and the total antioxidative capacity of plasma were measured. High levels of lipid peroxides appear especially in severe cases of liver failure such as acute viral hepatitis, coma. The persistence of a high level of peroxides in plasma suggests the presence of severe, irreversible lesions. The increase of peroxides in the plasma is mainly due to the overridden production of antioxidative systems, localized especially in the liver. In severe liver failure, the mechanism of the increased formation of peroxides seems to involve bilirubin, due to induction of liver heme oxygenase. The data presented showed inverse correlations between the increase of peroxides and the decrease of glutathione and ceruloplasmin.

The proteinurias can be due to various causes and mechanisms, with different prognosis and therapy. With respect to their mechanisms of occurrence, they are classified as: of overflow or of glomerular origin, by tubular reabsorption, by increase of tubular secretion and by protein loss from the urinary ways. These causes and mechanisms are described in detail, according to the latest data in the medical literature.

The therapy effectiveness in urinary infections (UI) was investigated in 27 patients by the test of immunofluorescence of the urinary bacteria (IFUB) in relationship with bacteriuria, various other biologic investigations and tests of the immune response. The study revealed a complex involvement of the immune mechanisms in the UI occurrence and persistence, as well as a parallelism between the mechanisms of cellular and humoral immunity in some of the patients. The IFUB test could reveal the eventual germ persistence at the renal parenchyma level even in the absence of significant bacteriuria, thus suggesting the necessity of a long term suppressive therapy in such cases.

A study was carried out in 49 flats in Bucharest inhabited by 265 persons. A quantitative analysis of fungi spores was performed as well as allergologic tests with Penicillium and Aspergillus fungi (A13), Aspergillus niger (M2), Alternaria tenuis (M1), Cladosporium herbarum (M3), Dermatophagoides pteronissinus (allergenic products supplied by the Bencard firm). The infested flats presented a high percentage of Aspergillus niger spores, particularly pathogenic. The main triggering factors for the appearance of the respiratory allergenic syndromes were found to be the conditions of humidity and the inadequate ventilation. Children are more affected by exposure to these conditions of the housing microclimate. Latent sensitization to fungi and to the Dermatophagoides pteronissinus mite in about 1/3 of the children and 1/5 of the adults represents a highly significant percentage of future candidates to bronchial asthma. A first requirement for the success of treatment in such subjects is the change of inhabiting conditions.

The leukocyte migration inhibition test reveals in vitro the presence of lymphocyte sensitivity and, consequently, of cell-mediated immunity, to a given antigen. Applied in a variety of immune and allergic cases it proved to be useful for the positive diagnosis of the disease and/or for the detection of cell-mediated immune deficiency. The results obtained recommend the leukocyte migration inhibition test in the clinical practice.

Activation of the terminal complement pathway leads to formation of the C5b--9 complex. The main effects of C5b--9 generation are tissue injury by cell lysis or by stimulation of proinflammatory mediators. In a study carried out in 42 patients, using polyclonal antibodies against C5b--9 neoantigens and C9 in an ELISA assay, we found significantly higher levels of SC5b--9 complex in plasma from the 18 patients with active systemic lupus erythematosus than those found in 10 healthy controls (p less than 0.005). In the 18 patients presenting rheumatoid arthritis and the 6 with progressive systemic sclerosis the plasma levels of SC5b--9 complex did not differ significantly from those in controls. The SC5b--9 levels found in the synovial fluid samples from the 16 rheumatoid arthritis patients were higher than the corresponding plasma ones. The ratio between synovial fluid and plasma levels was 1.2. Immunoperoxidase staining for C5b--9 was intense in three rheumatoid synovial membranes and absent in two normal synovial membranes obtained during meniscectomy. Increased levels of plasma and synovial fluid SC5b--9 reflect pathologic systemic or local activation of the complement carcase in systemic lupus erythematosus and respectively rheumatoid arthritis. Synovial membrane deposits of C5b--9 are indicative for the lytic and proinflammatory effects of complement activation.

The combined phytochemical and pharmaceutical study of Petiveria alleaceae L. (anamú) has shown the existence in the leaves and stems of the plant of a possible hypoglycemic active principle. Extracts from leaves and stem powder were found to produce a decrease of blood sugar concentration of more than 60% one hour after oral administration in male Balb/C mice weighing 20 g fasted for 48 hours.

The serum level of total interferon (IFN) was measured in 15 male patients with systemic lupus erythematosus (SLE) in the active phase and in remission, before and during corticotherapy. The values found were correlated with the clinical and humoral signs of disease. The IFN titer was high in the active phase of disease and was correlated with fever, extension of skin rash, polyarthritis, myositis, autoimmune hemolysis, cardiac and cerebral involvement as well as with ESR, reacting protein C, CIC, ANF and the percentage of LE cells. Isolated LE nephropathy without rapidly progressive or advanced renal failure was not associated with high IFN titer.

Plasma antithrombin III was measured by an immunological approach (AT III:Ag) using an antiserum developed in our laboratory and by its ability to inhibit thrombin (functional assay) using a chromogenic synthetic substrate in 12 patients with myocardial infarction, 9 patients with angina pectoris and 10 healthy control subjects. In the early stage (3 to 24 hours after the onset of pain) of an acute myocardial infarction AT III:Ag (115.67% +/- 21.23) was found to be significantly (p less than 0.01) higher than functional (free) AT III (92% +/- 10.27). This difference was less obvious 10 days later (AT III:Ag 118% +/- 18.93; functional AT III 104.94 +/- 14.45). There was also no significant difference between AT III:Ag and functional AT III in patients with angina pectoris as well as in controls. Since AT III:Ag represents total plasma AT III while functional AT III represents only free AT III the difference between these two variables could provide informations about the amount of the anticoagulant forming complexes with activated clotting factors. It is therefore considered that the significant increase in the difference between AT III:Ag and functional AT III in the early stage of acute myocardial infarction is likely to suggest an intravascular activation of coagulation.