Fluid Protein Research Articles

A Study of Serum to Pleural Fluid Albumin Gradient in Differentiation of Exudative and Transudative Pleural Effusion in Comparison to Light’s Criteria

Pleural effusion is the accumulation of fluid between the parietal and visceral pleura called the pleural cavity. It can occur by itself or can be the result of surrounding parenchymal diseases like infection, malignancy or inflammatory conditions. Pleural effusion is one of the major causes of pulmonary mortality and morbidity. Both the visceral and the parietal pleura play an important role in fluid homeostasis in the pleural space. Pleural effusions develop when there is excess hydrostatic pressure in the pulmonary capillaries, when fluid removal is impaired by compromised lymphatic drainage or when protein and cell rich fluid enters the pleural space through leaky capillary and pleural membranes. Pleural fluid is classified as a transudate or exudate based on modified Light’s criteria, proposed by Light et al., in 1972 which has been the standard differentiation method. It is considered an exudative effusion if at least one of the criteria is met:  Pleural fluid protein/serum protein ratio of more than 0.5  Pleural fluid lactate dehydrogenase (LDH)/serum LDH ratio of more than 0.6  Pleural fluid LDH is more than two-thirds of the upper limits of normal laboratory value for serum LDH. Commonly performed tests on the pleural fluid to determine etiology are a measurement of fluid pH, fluid protein, albumin and LDH, fluid glucose, fluid triglyceride, fluid cell count differential, fluid gram stain and culture and fluid cytology.

Differences in volume, density, electrolyte concentration, and total proteins in the fluid of the paranasal sinuses of freshwater and saltwater drowning victims: a systematic review and meta-analysis.

This study summarized the available evidence on the differences in volume, density, electrolyte concentration, and total proteins in paranasal sinus fluid between freshwater and saltwater drowning victims. A systematic search was conducted in electronic databases and gray literature, resulting in the inclusion of five studies with 234 drowning victims (92 saltwater incidents and 142 freshwater incidents). Meta-analyses using the inverse-of-variance method and a random-effects model were performed, reporting effect sizes as standardized mean differences (SMD) with 95% confidence intervals (CI). The findings showed a significantly higher sinus density in saltwater drowning cases compared to freshwater drowning cases (SMD 0.91, 95% CI 0.50 to 1.32). However, no significant differences were observed in sinus fluid volume. Saltwater drowning victims exhibited higher electrolyte concentrations (sodium: SMD 3.77, 95% CI 3.07 to 4.48; potassium: SMD 0.78, 95% CI 0.07 to 1.49; chloride: SMD 3.48, 95% CI 2.65 to 4.31; magnesium: SMD 4.01, 95% CI 3.00 to 5.03) and lower total protein concentrations (SMD - 1.20, 95% CI - 1.82 to - 0.58) in sinus fluid compared to freshwater drowning victims. This meta-analysis highlights the importance of analyzing the characteristics and composition of sinus fluid in forensic investigations of drowning cases. While no differences were found in sinus fluid volume, saltwater drowning victims exhibited higher sinus density, elevated electrolyte concentrations, and lower total protein concentrations compared to freshwater drowning victims.

A-218 Analytical Performance Evaluation of Lipid Panel Assays on the Atellica CI 1900 Analyzer

Abstract Background The Atellica® CI 1900 Analyzer is an automated, mid-throughput, integrated chemistry and immunoassay analyzer utilizing both Atellica CH and Atellica IM assays. This study was designed to evaluate the analytical performance of the Atellica CH Creatinine (CREA_2)*, Enzymatic Creatinine (ECre_3)*, Urinary/Cerebrospinal Fluid Protein (UCFP)*, and Microalbumin_2 (µALB_2)* assays on the Atellica CI 1900 Analyzer*. Methods The Atellica CI 1900 CH CREA_2, ECre_3, UCFP, and µALB_2 assays use the same reagents and calibrators as the Atellica CH assays. Precision and method comparison (MC) were used as performance indicators for the Atellica CI 1900 Analyzer. Precision studies were performed according to CLSI EP05-A3 using native and contrived human urine samples. One aliquot of each sample pool was tested in duplicate in two runs per day >2 h apart on each analyzer for >20 days. MC studies were performed according to CLSI EP09-A3. Individual native and contrived human urine samples were analyzed using the Atellica CH assays on both the Atellica CH and Atellica CI 1900 Analyzers. Results Representative precision and MC results observed from one reagent lot across indicated sample ranges are listed for each assay in the table below. Over the four assays tested, repeatability and within-lab %CVs were <5.1% and <6.0%, respectively. Slopes determined by the Deming linear regression model were approximately equal to 1. Conclusion Evaluation of the Atellica CH CREA_2, ECre_3, UCFP, and µALB_2 assays using the Atellica CI 1900 Analyzer demonstrated good precision and equivalent performance compared to the same assays on the Atellica CH Analyzer. *The products/features mentioned here are not commercially available in all countries. Their future availability cannot be guaranteed.

A-105 Analytical Performance Evaluation of Four General Chemistry Assays on the Atellica CI 1900 Analyzer Used to Assess Kidney Function

Abstract Background The Atellica® CI 1900 Analyzer is an automated, mid-throughput, integrated chemistry and immunoassay analyzer utilizing both Atellica CH and Atellica IM assays. This study was designed to evaluate the analytical performance of the Atellica CH Creatinine (CREA_2)*, Enzymatic Creatinine (ECre_3)*, Urinary/Cerebrospinal Fluid Protein (UCFP)*, and Microalbumin_2 (µALB_2)* assays on the Atellica CI 1900 Analyzer*. Methods The Atellica CI 1900 CH CREA_2, ECre_3, UCFP, and µALB_2 assays use the same reagents and calibrators as the Atellica CH assays. Precision and method comparison (MC) were used as performance indicators for the Atellica CI 1900 Analyzer. Precision studies were performed according to CLSI EP05-A3 using native and contrived human urine samples. One aliquot of each sample pool was tested in duplicate in two runs per day >2 h apart on each analyzer for >20 days. MC studies were performed according to CLSI EP09-A3. Individual native and contrived human urine samples were analyzed using the Atellica CH assays on both the Atellica CH and Atellica CI 1900 Analyzers. Results Representative precision and MC results observed from one reagent lot across indicated sample ranges are listed for each assay in the table below. Over the four assays tested, repeatability and within-lab %CVs were <5.1% and <6.0%, respectively. Slopes determined by the Deming linear regression model were approximately equal to 1. Conclusion Evaluation of the Atellica CH CREA_2, ECre_3, UCFP, and µALB_2 assays using the Atellica CI 1900 Analyzer demonstrated good precision and equivalent performance compared to the same assays on the Atellica CH Analyzer. *The products/features mentioned here are not commercially available in all countries. Their future availability cannot be guaranteed.

Assessing Factors That May Impact Physician-based Decisions for Placing Indwelling Pleural Catheters.

Malignant pleural effusion is a common finding in patients with advanced cancer and is a frequent cause of dyspnea. Current guidelines indicate thoracentesis for symptomatic patients, while indwelling pleural catheters (IPC) are recommended for patients who develop pleural fluid re-accumulation. IPC maintenance, however, requires a significant level of financial and social support. This study aims to analyze potential influencing factors that may play a role in the decision for placing IPCs in patients with recurrent malignant pleural effusions. This study retrospectively collected baseline sociodemographic and laboratory data in patients who underwent thoracentesis for malignant pleural effusion from August 2016 to October 2021, and selected patients who presented with re-accumulation of pleural fluid within 30 days or had a pulmonary physician's note documenting that IPC is a potential management option. Of these selected patients (IPC candidates), we stratified patients who underwent IPC placement and those who did not, and performed statistical analysis between these 2 groups. One hundred seventy-six patients who underwent thoracentesis were regarded as IPC candidates. Almost all baseline sociodemographic characteristics, including ethnicity ( P =0.637), sex ( P =0.655), and marital status ( P =0.773) were similar between the 2 groups, but significantly higher ECOG scores ( P =0.049) were noted in the IPC group. No statistically significant differences were noted in age, body mass index, platelet, PTT, international normalized ratio, creatinine, white blood cell, red blood cells, fluid protein, or fluid lactate dehydrogenase. Fluid albumin ( P =0.057) and serum neutrophil:lymphocyte ratio ( P =0.003) were significantly higher in patients without IPC placement. This study did not recognize any baseline sociodemographic factors that may contribute to the decision to place IPCs.

Molecular Biomarkers of Neuronal Injury in Epilepsy Shared with Neurodegenerative Diseases

In neurodegenerative diseases, changes in neuronal proteins in the cerebrospinal fluid and blood are viewed as potential biomarkers of the primary pathology in the central nervous system (CNS). Recent reports suggest, however, that level of neuronal proteins in fluids also alters in several types of epilepsy in various age groups, including children. With increasing evidence supporting clinical and sub-clinical seizures in Alzheimer’s disease, Lewy body dementia, Parkinson’s disease, and in other less common neurodegenerative conditions, these findings call into question the specificity of neuronal protein response to neurodegenerative process and urge analysis of the effects of concomitant epilepsy and other comorbidities. In this article, we revisit the evidence for alterations in neuronal proteins in the blood and cerebrospinal fluid associated with epilepsy with and without neurodegenerative diseases. We discuss shared and distinctive characteristics of changes in neuronal markers, review their neurobiological mechanisms, and consider the emerging opportunities and challenges for their future research and diagnostic use.

Spermatozoa and seminal plasma proteomics: Too many molecules, too few markers. The case of bovine and porcine semen

The study of the protein composition of semen (i.e., spermatozoa and seminal plasma) is not new. However, with development of proteomics technologies, our understanding of the roles of cellular and fluid proteins has expanded enormously. Today, several seminal proteins have already been suggested as biomarkers associated with semen traits (e.g., sperm motility and integrity) and fertility. Also, many others were associated with infertility, being identified in humans and domestic animals with poor semen quality (e.g., oligozoospermia) and fertility impairment. These proteins not only might explain the causes of fail in fertilization but also have potential as diagnostic tools, improving traditional semen analyses. However, despite characterization of thousands of seminal proteins, to date, few commercial kits based on protein biomarkers are available. In this article, not only the advances and advantages of semen proteomics will be discussed, but also limitations in its application in a commercial AI centre.

The amniotic fluid proteome predicts imminent preterm delivery in asymptomatic women with a short cervix

Preterm birth, the leading cause of perinatal morbidity and mortality, is associated with increased risk of short- and long-term adverse outcomes. For women identified as at risk for preterm birth attributable to a sonographic short cervix, the determination of imminent delivery is crucial for patient management. The current study aimed to identify amniotic fluid (AF) proteins that could predict imminent delivery in asymptomatic patients with a short cervix. This retrospective cohort study included women enrolled between May 2002 and September 2015 who were diagnosed with a sonographic short cervix (< 25 mm) at 16–32 weeks of gestation. Amniocenteses were performed to exclude intra-amniotic infection; none of the women included had clinical signs of infection or labor at the time of amniocentesis. An aptamer-based multiplex platform was used to profile 1310 AF proteins, and the differential protein abundance between women who delivered within two weeks from amniocentesis, and those who did not, was determined. The analysis included adjustment for quantitative cervical length and control of the false-positive rate at 10%. The area under the receiver operating characteristic curve was calculated to determine whether protein abundance in combination with cervical length improved the prediction of imminent preterm delivery as compared to cervical length alone. Of the 1,310 proteins profiled in AF, 17 were differentially abundant in women destined to deliver within two weeks of amniocentesis independently of the cervical length (adjusted p-value < 0.10). The decreased abundance of SNAP25 and the increased abundance of GPI, PTPN11, OLR1, ENO1, GAPDH, CHI3L1, RETN, CSF3, LCN2, CXCL1, CXCL8, PGLYRP1, LDHB, IL6, MMP8, and PRTN3 were associated with an increased risk of imminent delivery (odds ratio > 1.5 for each). The sensitivity at a 10% false-positive rate for the prediction of imminent delivery by a quantitative cervical length alone was 38%, yet it increased to 79% when combined with the abundance of four AF proteins (CXCL8, SNAP25, PTPN11, and MMP8). Neutrophil-mediated immunity, neutrophil activation, granulocyte activation, myeloid leukocyte activation, and myeloid leukocyte-mediated immunity were biological processes impacted by protein dysregulation in women destined to deliver within two weeks of diagnosis. The combination of AF protein abundance and quantitative cervical length improves prediction of the timing of delivery compared to cervical length alone, among women with a sonographic short cervix.

Guillain — Barré syndrome following asymptomatic COVID-19 in an adolescent: a clinical case

Guillain — Barré syndrome (GBS) is a rare disease that occurs with an approximate incidence of 1.7 cases per 100,000 children in the pediatric population. The gender difference in the prevalence of the disease is characterized by a 20% greater vulnerability of boys than girls. The exact cause of Guillain — Barre syndrome is unknown; however, it can occur after respiratory infection by Haemophilus influenzae, recent or ongoing Campylobacter jejuni infection or poliovirus. Since the beginning of the COVID-19 pandemic, there have been some reported Guillain — Barré diagnoses among adults following SARS-CoV-2 infection. The article describes a clinical case of an adolescent girl who was admitted to the Regional Municipal Non-Profit Facility “Chernivtsi Regional Children’s Clinical Hospital” with signs of flaccid paraplegia of the lower extremities, pelvic dysfunction and paraparesis of the upper extremities after she had suffered a sudden severe pain syndrome. She had previously been diagnosed with asymptomatic SARS-CoV-2. Initial complex investigations were as follows: high white blood cells count, elevated levels of procalcitonin (PCT), C-reactive protein and D-dimer, low SARS-CoV-2 IgM level and positive IgG titer, high levels of protein in spinal fluid. Electroneuromyography findings and nerve conduction test of lower extremities showed decreased M amplitude and H reflex response. The patient received oxygen therapy, hemodynamic support, cardiac support (infusions and inotrope therapy), gradual antibacterial therapy and was administrated with intravenous normal human immunoglobulin. She was also treated with a short course of parenteral glucocorticoids, vasoactive neurometabolites, nootropics, anticholinesterases, non-steroidal anti-inflammatory drugs along with physical therapy and massages. The patient began demonstrating slow but positive improvement in her limb motor functions and sensitivity within one month.

Enteral Feeding/Total Fluid Intake Ratio Is Associated With Risk of Bronchopulmonary Dysplasia in Extremely Preterm Infants.

BackgroundNutrition is an essential factor in preventing and managing bronchopulmonary dysplasia (BPD), a multifactorial chronic respiratory disease in premature infants. This study examined the association between nutritional intakes during the first 2 weeks of life and BPD in extremely preterm infants.MethodsA retrospective single-center cohort study was performed in infants born <28 weeks' gestational age or with a birth weight <1,000 g. Intake of energy and ratio of enteral feeding/ total fluid intake during the first 2 weeks of life and association with outcome of BPD were examined.Results134 infants were included in our study, and 43 infants (32.1%) developed BPD. During the first 2 weeks of life, the average of total caloric intake and the ratio of enteral feeding/ total fluid intake were significantly lower in the BPD group (total caloric intake:91.90 vs. 95.72 kcal/kg/d, p < 0.05, ratio of enteral feeding/total fluid intake: 0.14 vs. 0.18, p < 0.05), while the average of total fluid intake, caloric and protein intake from parenteral nutrition did not differ between the groups. The ratio of enteral feeding/ total fluid intake during the second week were significantly lower in the BPD group (0.21 vs. 0.28, p < 0.05), while this ratio during the first week did not differ between the groups. An increase of 10% in the ratio of enteral feeding/ total fluid intake during the second week of life significantly reduced the risk of BPD (OR 0.444, 95% CI: 0.270–0.731).ConclusionsA higher ratio of enteral feeding/ total fluid intake was associated with a lower risk for BPD. Early and rapidly progressive enteral nutrition should be encouraged in extremely preterm infants in the absence of feeding intolerance.

Increase of Parkin and ATG5 plasmatic levels following perinatal hypoxic-ischemic encephalopathy

Brain injury at birth is an important cause of neurological and behavioral disorders. Hypoxic-ischemic encephalopathy (HIE) is a critical cerebral event occurring acutely or chronically at birth with high mortality and morbidity in newborns. Therapeutic strategies for the prevention of brain damage are still unknown, and the only medical intervention for newborns with moderate-to-severe HIE is therapeutic hypothermia (TH). Although the neurological outcome depends on the severity of the initial insult, emerging evidence suggests that infants with mild HIE who are not treated with TH have an increased risk for neurodevelopmental impairment; in the current clinical setting, there are no specific or validated biomarkers that can be used to both correlate the severity of the hypoxic insult at birth and monitor the trend in the insult over time. The aim of this work was to examine the presence of autophagic and mitophagic proteins in bodily fluids, to increase knowledge of what, early at birth, can inform therapeutic strategies in the first hours of life. This is a prospective multicentric study carried out from April 2019 to April 2020 in eight third-level neonatal intensive care units. All participants have been subjected to the plasma levels quantification of both Parkin (a protein involved in mitophagy) and ATG5 (involved in autophagy). These findings show that Parkin and ATG5 levels are related to hypoxic-ischemic insult and are reliable also at birth. These observations suggest a great potential diagnostic value for Parkin evaluation in the first 6 h of life.

Proteins in human body fluids contain in vivo antigen analog of the melibiose-derived glycation product: MAGE

Melibiose-derived AGE (MAGE) is an advanced glycation end-product formed in vitro in anhydrous conditions on proteins and protein-free amino acids during glycation with melibiose. Our previous studies revealed the presence of MAGE antigen in the human body and tissues of several other species, including muscles, fat, extracellular matrix, and blood. MAGE is also antigenic and induces generation of anti-MAGE antibody. The aim of this paper was to identify the proteins modified by MAGE present in human body fluids, such as serum, plasma, and peritoneal fluids. The protein-bound MAGE formed in vivo has been isolated from human blood using affinity chromatography on the resin with an immobilized anti-MAGE monoclonal antibody. Using mass spectrometry and immunochemistry it has been established that MAGE epitope is present on several human blood proteins including serum albumin, IgG, and IgA. In serum of diabetic patients, mainly the albumin and IgG were modified by MAGE, while in healthy subjects IgG and IgA carried this modification, suggesting the novel AGE can impact protein structure, contribute to auto-immunogenicity, and affect function of immunoglobulins. Some proteins in peritoneal fluid from cancer patients modified with MAGE were also observed and it indicates a potential role of MAGE in cancer.

Clinical Characteristics and Risk Factors for Mortality in Cryptococcal Meningitis: Evidence From a Cohort Study.

IntroductionDespite advances in the diagnosis and management, cryptococcal meningitis (CM) is still associated with high mortality due to insufficient knowledge about clinical characteristics and risk factors for poor outcomes. The aim of the present study is to provide additional evidence for regarding clinical characteristics, diagnosis, and factors associated with increased risk of mortality in CM patients.MethodsIn this cohort study, we included eligible patients consecutively admitted to West China Hospital between January 2009 and December 2018. The clinical characteristics and diagnosis method of cerebrospinal fluid culture and India ink stain were analyzed. Independent risk factors were identified by a multivariable logistic regression.ResultsA total of 186 CM patients were included in the analysis. After a 1-year follow-up, 63 patients had died. Headache is the most common presenting symptom (97.3%), followed by vomiting (72%), fever (71.5%), altered consciousness (45.7%), abnormal vision (32.8%), and seizure (15.1%). Older age, altered consciousness or seizures, lower white blood cell count or total protein in cerebrospinal fluid (CSF), and unidentified CSF cryptococcal antigen (CrAg) are all factors associated with increasing risk of death (P < 0.05). We also found a dose-dependent trend between the number of symptoms and risk of death (trend p < 0.001). Multivariate logistic regression revealed that age (P = 0.004, OR = 1.042, 95% CI 1.013–1.071), seizure (P = 0.025, OR = 3.105, 95% CI 1.152–8.369), altered consciousness (P < 0.001, OR=6.858, 95% CI 3.063–15.38), and unidentified CSF CrAg are the independent prognostic factors. In addition, we observed that diagnosis of 28.5% and 22.5% CM could not be established by a single testing of CSF India ink stain or culture, respectively. Use of multiple testing methods or combination of the two assays increases the detection rate.ConclusionOur data show that older age, seizures, altered consciousness, and an inability to detect CSF CrAg are the independent risk factors of death within 1 year in CM patients. Moreover, we recommend use of multiple testing methods with CSF culture and India ink stain. Combined testing with both assays should be considered for initial CM diagnosis.

A safety evaluation of allogeneic freeze-dried platelet-rich plasma or conditioned serum compared to autologous frozen products equivalents in equine healthy joints

BackgroundHemoderivatives such as autologous conditioned serum (ACS) and platelet-rich plasma (PRP) have been used as potential disease-modifying therapies in musculoskeletal disorders such as osteoarthritis (OA). These therapies are based on the delivery of multiple growth factors and anti-inflammatory cytokines that are known to participate in inflammatory processes. The variability of cytokine content due to the autologous nature of the product, the non-availability for immediate use and need for storage at low temperatures are limitations for its use in the field. An allogeneic freeze-dried conditioned serum (CS) and PRP would provide field clinicians with a more practical approach to use such products in daily practice. Based on in vitro preliminary data, this experimental study aimed to test the in vivo safety of allogeneic freeze-dried CS and PRP in healthy joints, using the horse as a model.ResultsEight horses were randomly assigned and treated with PRP or CS. Horses had three joints injected with ALLO-FD PRP or CS, and three contralateral joints injected with the AUTO version of the same product, by a blinded clinician. Horses were evaluated clinically, and had synovial fluid collected at different time points and evaluated for cell content, PGE2 and protein. Both CS and PRP products triggered a self-limiting and mild inflammatory response in equine healthy joints. This was indicated by the transient increase in nucleated cell count, PGE2 and total protein in synovial fluid. This mild inflammatory response did not result in significant lameness and was not different among the groups.ConclusionsThe allogeneic freeze-dried PRP and CS showed to be overall safe and not dissimilar compared to their autologous frozen version in equine healthy joints. Further studies are necessary to evaluate the modulatory effects of these therapies in a clinical setting.

Reassessing the Value of CSF Protein and Glucose Measurement in Pediatric Infectious Meningitis.

Infectious meningitis (IM) in US children is increasingly rare and new rapid multiplex PCR-based testing is increasingly available. We evaluated the added value of cerebrospinal fluid (CSF) protein and glucose tests to predict IM when compared with information provided by CSF white blood cell count (WBC) and multiplex polymerase chain reaction (PCR). We retrospectively reviewed CSF results from October 2015 to August 2017 in patients 0 to 18 years at a US children's hospital. Noninfectious evaluations were excluded. Test characteristics were calculated for CSF WBC, protein, and glucose in isolation and in parallel for prediction of microbiologically confirmed IM. Chart review was performed to identify consideration of protein and glucose in medical decision-making (MDM). We identified 735 patients including 446 <2 months; 45 (6.1%) had microbiologically-confirmed IM, including 23 (5.2%) age <2 months. Multiplex PCR and/or CSF WBC identified all IM patients. When added to CSF WBC, measurement of glucose made no contribution to sensitivity, specificity, positive predictive value (PPV) or negative predictive value (NPV), and protein had no impact on sensitivity and decreased the specificity, PPV, and NPV compared with CSF WBC alone. Abnormal protein was documented in MDM in 6 (0.8%) patients, all of whom had elevated WBC counts also cited. Glucose was not mentioned in MDM. Multiplex PCR testing and WBC may be sufficient to predict meningitis in children in low incidence settings. Protein and glucose did not contribute significant additional information. More intentional use of protein and glucose testing in patients with suspected IM may achieve higher value care.

Epidemiological evaluation of meningitis in hospitalized patients in shahid Madani Hospital in Khorramabad

Background: Bacterial meningitis is an acute infection of the meninges requiring immediate diagnosis and treatment. Clinical, laboratory, and epidemiological findings of meningitis are of utmost importance for rapid diagnosis and treatment. The present study aimed to evaluate patients with meningitis based on their epidemiological, clinical, and laboratory findings and compare these variables between patients with septic and aseptic meningitis. Materials and Methods: In this retrospective cross-sectional descriptive study, all children with suspected meningitis in Shahid Madani Hospital in Khorramabad in 2014-2015 were examined for spinal fluid culture, age, gender, seasonal distribution, and antibiogram results. Results: Among 63 patients with meningitis, 30 (47.6%) cases had septic meningitis, and 33 (52.4%) subjects had aseptic meningitis. Out of 30 patients with septic meningitis, 4 (13.3%) patients had positive microbial culture. Among patients with septic meningitis, only four bacterial isolates were isolated by the microbial culture method, out of which Streptococcus pneumoniae was the most common bacterium and the prevalence was higher in autumn and winter. The most effective antibiotics were cotrimoxazole and vancomycin with a sensitivity of 100%; nonetheless, there was relatively high resistance to cloxacillin, erythromycin, and clindamycin. The number of white blood cells (WBCs), sugar, and protein in cerebrospinal fluid (CSF) in septic meningitis were compared with aseptic meningitis, and a significant difference was observed between the two groups. There was also a significant difference between gender and septic meningitis, and male patients were more likely to suffer from septic meningitis. Conclusion: The prevalence of aseptic meningitis was higher than that of septic meningitis. Microbial tests are very effective in the correct diagnosis and treatment; however, the level of WBC, glucose, and protein in CSF can also be of great help in diagnosing different types of meningitis, especially septic meningitis.

Value of brain damage biomarkers in cerebrospinal fluid in neonates with hypoxic-ischemic brain injury.

Hypoxic-ischemic encephalopathy is one of the leading causes of death and neurological disability worldwide. A key issue in neonates with hypoxic-ischemic encephalopathy is accurately establishing the occurrence and severity of brain lesions soon after a perinatal hypoxic-ischemic event. This is crucial to help with prognosis; guide clinical decision-making, including the use of other therapies; and improve family counseling. Neurobiochemical markers may offer a quantitative approximation for estimating the severity of brain damage and identifying infants who have a high risk of further neurological disability. In addition, they should help identify those neonates who would benefit most from the implementation of other neuroprotective and neuroreparative interventions. Despite considerable progress in this area, relatively few studies have been aimed at examining the clinical utility of brain-specific proteins in cerebrospinal fluid, an important opening to characterizing pathological phenomena associated with hypoxic-ischemic brain injury.

Сурфактантное состояние синовиальной жидкости у больных ревматоидным гонитом

По сравнению с больными остеоартрозом со вторичным синовитом коленных суставов (контрольная группа) при ревматоидном гоните наблюдается уменьшение содержания в синовиальной жидкости общего белка, нитритов, мочевой и молочной кислоты на фоне повышения уровней глюкозы и С-реактивного протеина, причем на интегральное сурфактантное состояние синовии влияют степень активности и рентгенологическая стадия заболевания, наличие дигитального артериита и поражения эндокарда. Кроме того содержание общего белка и β2-микроглобулина зависит соответственно от индексов тяжести течения и прогрессирования заболевания, а с поверхностно-активными веществами тесно связаны динамическое межфазное натяжение, вязкие, упругие и вязкоэластичные адсорб­ционно-реологические свойства суставного ликвора.

Identification of Interphotoreceptor retinoid-binding protein in the Schisis cavity fluid of a patient with congenital X-linked Retinoschisis

BackgroundThis case report describes the surgical outcome in a patient with congenital X-linked retinoschisis (CXLRS) and the results of proteomic analysis of surgically extracted samples from both vitreous and intraschisis cavities by mass spectrometry.Case presentationA 3-month-old boy presented with extensive retinoschisis involving macula and retinal periphery in both eyes. Genetic analysis confirmed retinoschisin 1 mutation (c.554C > T), and an electroretinogram showed significant reduction of b-wave and decreased cone and rod responses, which led to a diagnosis of CXLRS. By performing pars plana vitrectomy, including inner wall retinectomy, clear visual axes with stable retinal conditions and functional vision in both eyes were obtained during the 4 years of follow-up. Proteomic analysis of surgically retrieved fluid from the intraschisis cavity revealed a higher expression of interphotoreceptor retinoid-binding protein (IRBP) than that from the vitreous humor. However, both samples showed equal levels of albumin, transferrin, and pigment epithelium-derived factor.ConclusionsCellular adhesive imperfection in CXLRS may cause IRBP diffusion from the interphotoreceptor matrix, resulting in the strong expression of IRBP in the intraschisis cavity. An impaired retinoid cycle caused by an absence of IRBP in the retina may potentially underlie the pathology of CXLRS.

Respiratory and cardiovascular effects of ambient particulate matter from dust storm and non-dust storm periods in Kuwait

Epidemiological studies demonstrate a positive association between daily changes in concentrations of ambient airborne particulate matter (PM) and adverse respiratory and cardiovascular health effects. However, physicochemical properties of PM can vary greatly across geographical, atmospheric, and temporal conditions and influence the relative toxicity of airborne PM. The purpose of this study was to investigate the adverse pulmonary and cardiovascular health effects of ambient PM collected from discrete sampling sites in Kuwait during dust storm (DS) and non-dust storm (NDS) conditions. Collected dust samples were characterized for their chemical composition using atomic absorption, GC–MS, and HPLC–MS analyses. Male BALB/cJ mice were exposed to 100 µg of either NDS or dust storm (DS) PM in 50 µl of PBS by oropharyngeal aspiration. Lung function was measured and bronchoalveolar lavage was conducted at 1, 7, and 14 days post-exposure. Ischemia–reperfusion injury was performed 24 h after exposures by obstructing the left main coronary artery approximately 4 mm distal to its origin for 20 min, followed by 2 h. of reperfusion. Exposure to either NDS or DS PM resulted in airway hyperresponsiveness to acetylcholine compared to PBS controls. Total protein and cells in BAL fluid were elevated in both dust groups one day after exposure; however, DS PM induced a greater increase in cell numbers than did NDS PM, particularly in neutrophils, eosinophils, and lymphocytes. Representative lung sections exhibited positive staining for mucus in large airways at 7 days which resolved by 14 days in dust storm-exposed mice but persisted in NDS-exposed animals. Our findings suggest that NDS PM may be more effective in producing an adaptive immune response, while the early inflammation induced by DS PM may better resolve. We also observed a prolonged airway mucus response after exposure to NDS PM, suggesting it may produce more asthma-like features than dust storm PM. PM-induced changes to cardiac ischemia–reperfusion injury were not observed in this study. The lack of cardiovascular response may have been due to the limited exposure and single time point used in this study.