Effective Albumin Concentration Research Articles

Changes in the lipid balance in the gastric mucosa in rats under acute stress

BACKGROUND: Stress gastric ulcers are a type of peptic ulcer that develops in response to severe physiological or psychological stress. The causes of stress ulcers in the gaster have not yet been fully studied. AIM: To evaluate the composition of lipids in the gastric mucosa in rats under acute stress. MATERIALS AND METHODS: All rats included in the study (n=30) were divided into two groups. Group 1 (main group, n=20) included animals that had a model of stress gastric ulcer created by stimulation with electrical impulses for 12 hours. Group 2 (control group, n=10) included animals that had not been manipulated. At the end of the experiment, the effective and total concentration in blood serum of all animals was determined, followed by the calculation of the albumin binding reserve, and the plasma toxicity index. We also visually assessed the degree of damage to the gastric mucosa and determined the composition of lipids. RESULTS: Our study showed that a stressful situation led to the development of endogenous intoxication of group 1 animals. A decrease in the level of phosphatidylcholine by 16.3% and phosphatidylserine by 18.6% in stressed rats demonstrates the destruction of the cell membrane against the background of apoptosis, which macroscopically manifests itself in the form of spot hemorrhages, erosions and ulcers in the gastric mucosa. An increase in monoacylglycerol by 34.4% and diacylglycerol by 53.4% in group 1 animals indicates an increase in membrane permeability and induction of regenerative processes. CONCLUSIONS: In a stressful situation, against the background of a decrease in the total and effective concentration of albumin, endogenous intoxication develops, which contributes to a violation of the lipid balance and damage to cell membranes and the development of acute damage to the gastric mucosa.

Introduction to the concept of effective albumin concentration.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. The purpose of this article is to discuss how the structural and presumably functional integrity of albumin, as described by the concept of effective albumin concentration (eAlb), has potentially important clinical implications beyond the total albumin concentration (tAlb) routinely reported by clinical laboratories. Albumin has several functions beyond its oncotic effects, including molecule binding, substance transport, detoxification actions, and serving as an antioxidant. However, there are conformational changes that occur during or following the manufacture of albumin and during its administration to patients with various disease states, such as decompensated liver disease, that often impair these functions. Such impairments are not reflected in tAlb values reported by clinical laboratories and might explain the disconnect often seen between albumin's proposed beneficial mechanistic functions and its less-than-predicted clinical effectiveness as noted in published studies. The concept of eAlb has been introduced to describe albumin with structural and functional integrity. Limited studies have found associations between eAlb values and patient prognostic indicators, but the techniques used to decide these effective concentrations to date are complicated and require specialized equipment and experienced researchers for proper interpretation. Estimation of eAlb may provide valuable information on the functional ability of albumin beyond the tAlb reported by clinical laboratories, but more research is needed to decide how this information is best used in the clinical setting.

Pay attention to the diagnosis and treatment of "easily neglected" complications in liver cirrhosis

Managing cirrhosis complications is an important measure for improving patients' clinical outcomes. Therefore, in order to provide a complete disease assessment and comprehensive treatment, improve quality of life, and improve the prognosis for patients with cirrhosis, it is necessary to pay attention to complications such as thrombocytopenia and portal vein thrombosis in addition to common or severe complications such as ascites, esophagogastric variceal bleeding, hepatic encephalopathy, and hepatorenal syndrome. The relevant concept that an effective albumin concentration is more helpful in predicting the cirrhosis outcome is gradually being accepted; however, the detection method still needs further standardization and commercialization.

Research progress on detection techniques for effective albumin concentration

Hypoalbuminemia is one of the important clinical features of decompensated cirrhosis. As the disease progresses, not only does the total albumin concentration decrease, but so does the proportion of albumin that remains structurally and functionally intact. The structural and functional integrity of albumin is essential for its normal physiological role in the body. This led to the concept of "effective albumin concentration," which may be much lower than the total albumin concentration routinely measured clinically in patients with advanced cirrhosis. Liquid chromatography-tandem mass spectrometry, and electron paramagnetic resonance (EMR) are emerging technologies for effective albumin concentration detection, showing promising clinical application prospects, but research in patients with cirrhosis is still in the preliminary stage. Therefore, this article will comprehensively summarize the latest research on the aspects of effective albumin detection methods, liquid chromatography-tandem mass spectrometry, and electron paramagnetic resonance, as well as their applications.

Albumin, an interesting and functionally diverse protein, varies from ‘native’ to ‘effective’ (Review)

Albumin, an interesting and functionally diverse protein, varies from ‘native’ to ‘effective’ (Review)

Effect of ionizing radiation (radiation therapy) on the structural and functional state of serum albumin with cervical cancer

The study of the literature on the detoxification properties of an albumin molecule and a prognostic value of determining albumin indicators allows us to conclude that it is undoubtedly important to assess the structural and functional properties of albumin in cancer patients at all stages of the diagnostic and treatment process already at the present time. At the same time, the lack of information makes it necessary and promising to widely introduce the fluorescent method for assessing total and effective albumin concentrations in the clinical and scientific work of oncologists.Therefore, the aim of our work was to study the effect of radiation therapy on the structural and functional state of serum albumin in patients with cervical cancer.In order to study radiation-induced changes in serum albumin when irradiated with therapeutic doses of ionizing radiation, the biological material (blood) of 28 people from the Gomel region was used: 1st group (control) – 13 healthy people; 2nd group – 15 patients diagnosed with cervical cancer who underwent remote gamma therapy (30 Gy). The collection of biological material in the 2nd group was carried out as follows: upon admission to patient treatment; after the 1st session of radiotherapy (2 Gy); after the 3rd session of radiotherapy (6 Gy); after the 5th session of radiotherapy (10 Gy); after the 7th session of radiotherapy (14 Gy); after the 10th session of radiotherapy (20 Gy), and after the 15th session of radiotherapy (30 Gy).According to A. Gryzunov, G. E. Dobretsov’s method, the following indicators were determined: total albumin concentration (TAC) − the number of albumin molecules capable of binding toxic ligands is equal to the albumin concentration determined in any other way; effective albumin concentration (EAC) − the number of albumin binding centers is unoccupied by toxic ligands; the reserve of albumin binding (RAB) − it reflects the degree of structural modification of the protein; the index of toxicity (IT) − it characterizes the filling of albumin centers with toxic ligands.The total albumin concentration is within normal values, both for healthy and cancer patients throughout the course of radiation therapy. The analysis of the indicators characterizing the structural and functional state of serum albumin (EAC, RAB, and IT) in patients with cervical cancer showed that the amount of fully functioning protein statistically significantly decreases when compared with a group of healthy people.When studying the effect of radiation therapy on the structural and functional state of serum albumin in cancer patients, the following was determined: in 57 % of cases, the values of the IT indicator increase after a course of radiotherapy, and in 43 % − decrease;after the 1st session of radiotherapy, further dynamics of IT after treatment is determined: if after 2 Gy the values of the IT indicator increase, then by the end of therapy this indicator will be higher than that when entering treatment, and, conversely, if after 2 Gy the values of the IT indicator decrease, then after the course of radiotherapy this indicator will be less than that when entering treatment;it is possible that the patient’s place of residence is a determining factor in the development of an individual reaction of the serum albumin transport system to the effect of therapeutic doses of ionizing radiation.The determination of albumin indicators characterizing the structural and functional state of serum albumin, in particular, the index of toxicity in patients with cervical cancer should be used as an individual diagnostic and prognostic criterion in the dynamics of observation of patients undergoing radiation therapy.

Determination of binding characteristics as a measure for effective albumin using different methods

Background & aimsTransport functions of albumin are of clinical and pharmacological interest and are determined by albumin's properties like posttranslational modifications or bound ligands. Both are affected in pathological conditions and in therapeutic grade albumin solutions. The term effective albumin concentration was introduced as a measure of functionally intact albumin. Our aim was to evaluate the impact of ligands and modifications with different approaches as a measure of effective albumin. Approach & resultsWe used a spin labelled fatty acid and dansylsarcosine to characterize binding properties of albumin i) prepared from plasma of patients and healthy control donors, ii) measured directly out of plasma, iii) research grade albumin, iv) in vitro modified albumin, and v) therapeutic infusion solutions before and after removal of stabilizers.Bilirubin is the main determinant for binding function in patients' albumin. In in vitro prepared albumin bound fatty acids correlated with impaired binding. Human nonmercaptalbumin1, not human nonmercaptalbumin2, showed reduced binding properties. Binding and transport function of therapeutic albumin was severely impaired and restored by filtration. Glycation of research grade albumin had no effect on the binding of dansylsarcosine and only a minor effect on fatty acid binding. ConclusionsOur results suggest that effective albumin -in terms of binding properties- is primarily determined by bound ligands and only to a minor extent by posttranslational modifications. Characterizing albumin directly from plasma better reflects the physiological situation whereas in the case of therapeutic grade albumin stabilizers should be removed to make its binding properties accessible.

Application of effective albumin concentration in treatment of chronic liver disease

Application of effective albumin concentration in treatment of chronic liver disease

The relationship of hemorheological disorders with the development of endotoxicosis in the rehabilitation period of acute poisoning

The aim of the study. Obtaining new data on the pathogenesis of endotoxicosis (ET) in the rehabilitation period of acute poisoning by assessing the conjugacy of hemorheology (HR) disorders with the development of ET. Material and methods. To obtain new information about the pathogenesis of acute poisoning in the rehabilitation period in 145 patients with severe acute poisoning with psychopharmacological agents (PFAp) due to the addition of pneumonia, neurotoxicants (NTp) with the development of toxic hypoxic encephalopathy and corrosive substances (CSp) with deep and widespread burns of the mucous membranes of the gastrointestinal tract, a pair correlation analysis of the block structure of the obtained correlation matrix was undertaken, establishing the relationship between the two indicators, as well as a canonical correlation analysis revealing the nature of the statistical relationship between groups of indicators, with the calculation of the canonical correlation coefficient. Results. As a result, statistically significant correlations were established between the indicators HR (viscometric, aggregation and indicators hemostasis) and ET (total and effective albumin concentration, the level of medium molecular weight peptides, the content of leukocytes, lymphocytes, neutrophils and circulating immune complexes detected in the blood, and his integral indicators) (-0.32-0.48 for PFAp, 0.29-0.35 for NTp and 0.28-(-0.51) for CSp), as well as statistically significant values canonical correlation coefficients, which indicated the development of ET due to disorders of HR. Limitations. The study was performed on laboratory data obtained during the examination of patients with acute poisoning, and therefore has no restrictions for the further use of this methodological approach in clinical trials. Conclusion. The obtained data can serve to optimize the treatment of ET in this pathology by targeted therapeutic effects on parameters of HR (on viscosity and hemostasis in PFAp and NTp, and in CSp, in addition, on aggregation).

Effective albumin concentration predicts survival with native liver in cirrhotic children

Background and Aim: Liver disease leads to quantitative as well as qualitative reduction in albumin concentrations. Reversible and irreversible oxidized forms of albumin increase with severity of cirrhosis, compromising with the binding and detoxifying functions and leading to decrease in effective albumin concentration(eAlb). Albumin isoforms were studied in cirrhotic children and compared with non-cirrhotic controls and those with decompensation.

The use of whole-body cryotherapy for increasing the stress resistance of female athletes in group types of gymnastics

Background. Representatives of complex coordination sports are most susceptible to psychoemotional stress, since they demonstrate high sports results already at a young age. The tightening of anti-doping control has significantly reduced the possibility of using pharmacological and biologically active drugs to speed up the recovery of athletes. Against this background, in sports medicine, more attention is paid to the use of non-drug methods to improve performance and recovery in athletes. Aim to study the efficiency of the introduction of whole-body cryotherapy in the training process of female athletes of complex coordination sports (for example, group gymnastics) to increase stress resistance and reduce violations of adaptation processes as a result of neuropsychiatric overstrain. Materials and methods. During the academic-training year, 22 gymnasts received six ten-day courses of whole-body cryotherapy in the ICEQUEEN cryosauna. 19 athletes were included in the control group. The studies were conducted 3 times: before the start of the procedures, after the first course of procedures, at the end of the training year. The diagnosis of nocturnal bruxism and the definition of the psychological component of health were carried out. Total and effective albumin concentrations were determined in the blood serum with the calculation of the albumin binding reserve, helper T-lymphocytes and killer T-lymphocytes with the calculation of the immunoregulatory index. Results. After one course, there was an increase in the functional activity of serum albumins, a decrease in the number of episodes of involuntary contractions of the masticatory muscles at night, and an increase in the psychological component of health according to SF-36. After six courses of cryotherapy, the functional activity of serum albumins and the initial values of the immunoregulatory index were preserved by the end of the season, and the psychological component of health according to SF-36 was increased, while these indicators decreased in the control group. There was also a decrease in the number of episodes of involuntary contractions of the masticatory muscles at night with an increase in their number in the control group of female athletes. Conclusions. Considering the obtained results, it is possible to recommend the use of whole-body cryotherapy in gymnasts during the preparatory and recovery periods of the annual training cycle in order to increase stress tolerance and prevent psychoemotional overstrain.

Determination of Effective Albumin in Patients With Decompensated Cirrhosis: Clinical and Prognostic Implications.

Background and AimsCirculating albumin in cirrhosis can be dysfunctional because of accumulating structural damages, leading to the concept of effective albumin concentration (eAlb), referring to the albumin portion presenting structural and functional integrity. We aimed to estimate eAlb in patients with decompensated cirrhosis and analyze its relationships with albumin function and clinical outcomes as compared to total albumin concentration (tAlb).Approach and ResultsWe evaluated 319 patients with cirrhosis hospitalized for acute decompensation (AD) with and without acute‐on‐chronic liver failure (ACLF) and 18 age‐ and sex‐comparable outpatients with compensated cirrhosis. tAlb was quantified by standard assay, whereas eAlb was estimated combining liquid chromatography/electrospray ionization/mass spectrometry and standard methods. Albumin binding and detoxification efficiency were evaluated by electron paramagnetic resonance analysis. Circulating albumin in patients with decompensated cirrhosis displayed multiple structural abnormalities, with reversible oxidation and glycation being the most frequent. As a result, eAlb progressively declined with the worsening of cirrhosis and was superior to tAlb in stratifying patients between compensated cirrhosis, AD, and ACLF, as well as patients with and without complications. Moreover, eAlb, but not tAlb, was closely associated with binding capacities in ACLF. Finally, eAlb at admission predicted the occurrence of ACLF within 30 days and mortality at 90 days better than tAlb.ConclusionsThis large, observational study provides the evidence in patients with decompensated cirrhosis that eAlb can be quantified and differentiated from tAlb routinely measured in clinical practice. As compared to tAlb, eAlb is more closely associated with disease severity and albumin dysfunction and carries a greater prognostic power. These results prompt future research assessing eAlb as a biomarker for predicting prognosis and treatment response.

The New Approach to the Diagnostics and Treatment of Endogenous Intoxication in Patients with Burn Injury

Background: The main causes of mortality in patients with burn injury are the development of systemic inflammatory process, multiple organ failure and septic complications. The aim of the research: Improvement of diagnostic and therapeutic approaches to the detection and elimination of endogenous intoxication in patients with burn injury. Materials and methods: The main study group consisted of 19 patients and the comparison group—of 10 patients with burn injury. 92 blood serum (BS) samples of the patients of the main group were tested, using the method of fluorescence spectroscopy (MFS). The advanced therapeutic tactics were proposed for the patients of both groups. The control group consisted of 40 healthy individuals (donors). BS of these patients was also tested using MFS. Results: Patients with burn injury have endogenous intoxication in their blood. The effective concentration of albumin is reduced in patients with burn injury due to the blockage of albumin binding centers by bacterial metabolism products. Fluorescence spectra (FS) of BS in patients with burn trauma and donors were obtained and investigated. Based on MFS results, an improved treatment regimen using infusion of albumin solution was proposed. Conclusions: An improved technique for the management of patients with burn injury is based on the use of MFS for the diagnostic evaluation of endogenous intoxication in them. The idea of pathological changes in albumin molecules in patients with burn injury is pathogenetically substantiated by the successful use of infusion of albumin solution in these patients on the basis of the MFS.

Markers of Endogenous Intoxication in Late-Pregnancy Cows as Predictors of Pneumonia in Newborn Calves

Endogenous intoxication indices in late-pregnancy cows have been analyzed. The possibility for the use of these indices as predictors of bronchopulmonary pathology in the newborn calves has been identified. Overall, 29 Red-and-White Holstein cows checked on day 239–262 of gestation and 29 newborn calves were examined. Bronchitis occurred in all the calves within the first month of their life. In addition, it developed into pneumonia in seven newborn calves. The markers of endogenous intoxication in cows were analyzed. The total and effective albumin concentrations, the concentration of medium molecular weight peptides (MMWP) in the blood serum, the leucocyte intoxication index (LII) by the Kalf-Kalif formula, the toxicity index (TI), and the intoxication coefficient (IC) were determined. The MMWP level in the cows with calves unaffected by pneumonia comprised 0.408 ± 0.152 c.u. The cows with calves affected by pneumonia showed a higher MMWP content (0.615 ± 0.197 c.u., p 0.547 in conventional units). The diagnostic value of the IC predictor is rated as very good (AUC = 0.812, susceptibility – 71.43%, specificity – 86.36%, and critical value > 22.5 in conventional units). The concentration of medium molecular weight peptides and the intoxication concentration in cows in the period of gestation can allow us to make predictions for bronchopulmonary pathology development with high predictive accuracy in their offspring.

Endogenous intoxication markers of deep-pregnant cows as predictors of pneumonia in newborn calves

The aim of the work was to analyze the indices of endogenous intoxication in deep-pregnant cows and to identify the possibilities of their use as predictors of bronchopulmonary pathology in newborn calves. 29 cows were examined for 239-262 days of gestation and 29 newborn calves of the red-and-white Holstein breed. Bronchitis developed in all calves during the first month of life, and in 7 newborns it was complicated by pneumonia. Markers of endogenous intoxication of cows were analyzed: total and effective albumin concentration, serum MMP content, Kalf-Kalif leukocyte index of intoxication (LII); toxicity index (IT), the ratio of intoxication (CI). The MMP level in cows whose calves did not develop pneumonia was 0.4080.152 units. Cows whose calves developed pneumonia showed a significantly higher content of SMP (0.6150.977 units, p 0.05). Correlation between the concentration of the MMP and the probability of pneumonia (rs=0.536, p0.005) was found. The leukocyte intoxication index of Kalf-Kalif and the toxicity index (IT) in both groups of cows varied significantly; no differences between groups were found. The coefficient of intoxication in cows whose calves developed pneumonia (CI=26.58.4), statistically significantly (p0.05) exceeded CI in cows whose offspring had uncomplicated bronchitis (CI=17.26,8). Correlation between the CI in cows and pneumonia in their offspring (rs = 0.568, p 0.001) was found. The content of the MMP in blood of pregnant cows can serve as a predictor of pneumonia in newborn calves (AUC=0.782, sensitivity 85.71%, specificity 81.82%, critical value 0.547 units). The diagnostic value of the CI predictor is rated as very good (AUC=0.812); sensitivity 71.43%, specificity 86.36%, critical value 22.5. The concentration of SMP in the blood of cows and CI in the period of gestation allows us to predict the development of bronchopulmonary pathology in their offspring with high accuracy.

NEW CLINICALLY RELEVANT BIOCHEMICAL AND FUNCTIONAL MARKERS IN NEONATOLOGY

Objectives - to identify the markers of liver functional maturation, the dynamics of the cyclic nucleotide in blood plasma, the indicators of cerebral hemodynamics in premature infants during the early and late neonatal periods. Material and methods. The study included 330 premature infants of 26th - 37th weeks of gestation, examined in early and late neonatal periods. There were 3 groups profiled according to the type of leading pathology - respiratory distress syndrome (RDS) (group I, included 80 children), newborn jaundice and edema syndrome (group II, included 80 children), intraventricular hemorrhage Grade1 (IVH Grade1) (group III, consisted of 46 children). The groups in the study were matched by 3 comparison groups of 124 healthy preterm infants. Results. The clinical significance of the first assayed quantitative indicators of AFP, serum albumin system, cyclic nucleotides, plasma fibronectin in conditionally healthy children of different gestation periods is discussed. The scientific credence was given to pathogenetic role of deviations of these indicators in the development of RDS (the decrease in cAMP, the increase in cGMP, the decrease in ratio cAMP/cGMP); in jaundice and edema syndromes (the increased AFP, the reduction in effective serum albumin concentration (EAC) and overall serum albumin concentration (OAC)), IVH grade 1 (the reduction of plasma fibronectin, and the blood flow speed in vein of Galen according to neurosonography with with Doppler measurements (NSDG) in the first days of life).

Фармакологические эффекты ремаксола при механической желтухе неопухолевого происхождения

A study of 35 patients, whom operated by obstructive jaundice of neoplastic origin was done. They were divided into 2 groups: І (comparison groups, n = 15) - in the early postoperative period patients were given standard therapy and II (studied groups, n = 20) - Remaxol was included in the scheme of traditional treatment. In the study dynamics were carried out laboratory and biochemical tests: malonic dialdehyde (MDA) and diene conjugates (DC); phosphalipase A2 (PL A2); hypoxia ratio (HR); middleweight molecules (MWM), total (TAC) and effective albumin concentration (EAC), toxicity index (TI), total bilirubin (TB), alanine aminotransferase (ALT), activated partial thromboplastin time (APTT) and fibrinogen. Thromboelastography (USA) was used to assess the state of the hemostasis system. It was established that postoperative patients in the early time had oxidative stress, increased phospholipase activity, endotoxicosis syndrome, hemostatic disorders (hypercoagulation and hypofibrinolysis), which persisted throughout the observation period. The inclusion Remaxol in traditional therapy led to suppression of the intensity of lipid peroxidation (LP), reduction of phospholipase activity, relief of endogenous intoxication and hypoxia, restoration of blood coagulation-lytic status. The most significant effect of the drug was determined in the first 3 days after surgery.

Antimicrobial nano-zinc oxide-2S albumin protein formulation significantly inhibits growth of "Candidatus Liberibacter asiaticus" in planta.

Huanglongbing (HLB, also known as citrus greening) is considered to be the most devastating disease that has significantly damaged the citrus industry globally. HLB is caused by the Candidatus Liberibacter asiaticus (CLas), the fastidious phloem-restricted gram-negative bacterium, vectored by the asian citrus psyllid. To date, there is no effective control available against CLas. To alleviate the effects of HLB on the industry and protect citrus farmers, there is an urgent need to identify or develop inhibitor molecules to suppress or eradicate CLas from infected citrus plant. In this paper, we demonstrate for the first time an in planta efficacy of two antimicrobial compounds against CLas viz. 2S albumin (a plant based protein; ~12.5 kDa), Nano-Zinc Oxide (Nano-ZnO; ~ 4.0 nm diameter) and their combinations. Aqueous formulations of these compounds were trunk-injected to HLB affected Mosambi plants (Citrus sinensis) grafted on 3-year old rough lemon (C. jambhiri) rootstock with known CLas titer maintained inside an insect-free screen house. The effective concentration of 2S albumin (330 ppm) coupled with the Nano-ZnO (330 ppm) at 1:1 ratio was used. The dynamics of CLas pathogen load of treated Mosambi plants was assessed using TaqMan-qPCR assay every 30 days after treatment (DAT) and monitored till 120 days. We observed that 2S albumin-Nano-ZnO formulation performed the best among all the treatments decreasing CLas population by 96.2%, 97.6%, 95.6%, and 97% of the initial bacterial load (per 12.5 ng of genomic DNA) at 30, 60, 90, and 120 DAT, respectively. Our studies demonstrated the potency of 2S albumin-Nano-ZnO formulation as an antimicrobial treatment for suppressing CLas in planta and could potentially be developed as a novel anti CLas therapeutics to mitigate the HLB severity affecting the citrus industry worldwide.

LASER THERAPY FOR MANAGEMENT OF CEREBRAL DYSFUNCTION IN CASES OF ACUTE SEVERE PANCREATITIS

Background.A persistently high mortality rate of patients with pancreatitis is the result of multiple organ failure which is in many aspects associated with developing endogenous intoxication. Pancreatic encephalopathy is one of particular manifestations of this syndrome.Aim of study: to determine severity of cerebral dysfunction in cases of acute destructive pancreatitis, to assess the efficacy of laser therapy for this disease.Material and methods: The research is based on the results of clinical studies, carried out at the Republican Clinical Hospital No.3. Clinical laboratory analysis of 60 patients was conducted. The patients were randomly split into two equal groups: the comparison group (standard therapy) and the basic group (standard therapy and laser therapy). The patients were examined upon admission to hospital and in dynamics (day 1, 3, 5, and 7). The severity of cerebral dysfunction was assessed within controlled terms with the help of RASS and psychometric tests: number connection tests (A and B), “Point in circle”, “Labyrinth”, test of symbols and numbers. The level of endogenous intoxication was evaluated by the amount of hydrophilic (middle molecules) and hydrophobic (common and effective albumin concentration) component.Results. Acute severe pancreatitis led to a marked endogenous intoxication, which manifested itself as an increase in medium molecular weight peptides, decrease in common and effective albumin concentration, growth of toxicity index with regard to normal indices. During all research period the basic group (laser therapy) there was a decrease in medium molecular weight peptides, significant increase in common and effective albumin concentration and a decrease in index toxicity. Psychometric tests revealed a number of deviations from normal indices. At the beginning of the research, a reliable prolongation of time interval during examination tests (the number connection test B, “point in circle”, “Labyrinth”) was noted, and less cells were filled during symbol and number test with regard to normal indices. The subsequent analysis of psychometric tests of patients from the basic group revealed a shortening of time interval during number connection test block B, “Point in circle” and “Labyrinth”. More filled cells during symbol and numbers test were also observed.Conclusion. Results of psychometric tests confirmed latent encephalopathy during endogenous intoxication, associated with acute severe pancreatitis. The laser therapy as a component of complex treatment promotes to decrease severity of endogenous intoxication and manifestation of encephalopathy.

Importance of detoxification capacity of albumin for assessing state of gastric cancer patients and effective treatment planning.

34 Background: The aim of the study was measuring biochemical indices reflecting endotoxicosis syndrome in gastric cancer patients with adenocarcinoma of different grades and signet ring cell carcinoma. Methods: The study included 67 patients with gastric cancer divided into 4 groups depending on the tumor histotype: well- and moderately-differentiated adenocarcinoma (G1-2); poorly-differentiated adenocarcinoma (G3); signet ring cell carcinoma (SRCC); combined gastric tumors; and 12 healthy donors. The content of medium mass molecules (MMM254 and MMM280), total and effective albumin concentrations (TCA and ECA), toxicity index (IT = TCA/ECA-1) and intoxication factor (IF = MMM254/ECA⋅1000) were used to assess the level of endogenous intoxication. The Statistika 6.0 software package was used. Results: IT, reflecting the functional state of the albumin molecule, significantly exceeded the level in donors: by 2.3 times in G1-2, by 3.3 times in G3, by 3.2 times in SRCC (p < 0.01-0.001), by 2.2 times in mixed tumors (p < 0.05). The greatest increase in IT – by 4.6 times – was observed in patients with serosal invasion and tumor spread to the adjacent structures (T4 in the TNM classification). IF, which is an integral indicator of endotoxemia, in all groups of patients was significantly (p < 0.01-0.00001) higher than in donors. The increase was 55.2% in patients with G1-2, 132.7% for G3, 234.6% for T4, 66.8% for SRCC, and 59.6% for mixed tumors. The dynamic observation of patients showed that a sharp increase in the studied parameters was followed by relapses. Conclusions: The increase in IT and IF in all groups of patients indicated an enhancement of endotoxemia in gastric tumors, mainly due to the decreased detoxification capacity of albumin, as high levels of MMM were observed only in some patients. The changes were significantly more expressed in patients with G3, with the maximal changes in all the studied endotoxicosis parameters in T4. The results demonstrated the diagnostic significance of the detoxification ability of albumin for the evaluation of the state of gastric cancer patients and for the adequate treatment planning.