Učinak mamografskog postupka na serumske razine upalnih i/ili tumorskih biljega

Mammography is one of the gold standard screening tests for breast cancer. The effects of mammography procedure on blood parameters are not known. This study aimed to investigate whether the procedure-associated breast compression affects the widely and simultaneously performed blood measurements of C-reactive protein (CRP), carcinoembryonic antigen (CEA), and cancer antigen (CA) 15-3. According to breast ultrasound examination results, participants were divided into 3 groups as follows: group 1 (participants with breast mass size ≥20.0 mm, n=48); group 2 (participants with breast mass size <20.0 mm, n=17); and group 3 (participants with no breast mass, n=23). In groups 1 and 2, on the day of the mammographic imaging study, serum CRP, CEA, and CA 15-3 levels were measured before and after the imaging study. Participants in group 3 had their blood parameters measured without mammography and/or any breast compression. Post-mammography blood measurements displayed a significant increase in serum CRP levels, and a significant decrease in serum CEA and CA 15-3 levels in group 1 (in comparison with the same day pre-mammography blood sampling levels; p<0.05 all). Although pre-mammography serum CEA levels in group 1 participants were significantly higher than those in group 2 and 3 participants, this significant elevation became nonsignificant at post-mammography measurements (p0.05, respectively). On the day of the mammographic imaging study, the optimal time of blood sampling for testing CRP, CEA and CA 15-3 levels in persons with a breast mass is before, but not after the mammographic imaging procedure. This issue requires additional detailed studies.Mamografija je jedan od ‘zlatnih’ standardnih testova probira za rak dojke. Učinci mamografskog postupka na krvne parametre nisu poznati. Cilj ovog istraživanja bio je ispitati djeluje li kompresija dojke povezana s ovim postupkom na često i istodobno izvođena mjerenja C-reaktivnog proteina (CRP), karcinoembrijskog antigena (CEA) i karcinom antigen (CA) 15-3 u krvi. Ispitanice su podijeljene u 3 skupine prema rezultatima ultrazvučnog pregleda dojki: 1. skupina (ispitanice s masom u dojci ≥20,0 mm, n=48); 2. skupina (ispitanice s masom u dojci <20,0 mm, n=17); 3. skupina (ispitanice bez mase u dojci, n=23). U 1. i 2. skupini serumske razine CRP, CEA i CA 15-3 mjerene su prije i nakon mamografskog postupka. Kod ispitanica 3. skupine krvni parametri mjereni su bez mamografije i/ili bilo kakve kompresije dojke. Mjerenja provedena nakon mamografije pokazala su značajan porast serumskih razina CRP i značajan pad serumskih razina CEA i CA-15-3 u 1. skupini u usporedbi s razinama tih parametara zabilježenim istoga dana prije mamografije (p<0,05 sve). Iako su razine CEA u serumu prije mamografije bile značajno više u 1. skupini u usporedbi s 2. i 3. skupinom, značajnost tog porasta izgubila se kod mjerenja nakon mamografije (p0,05). Dakle, u danu kad je zakazana mamografija optimalno vrijeme za uzorkovanje krvi za mjerenje razina CRP, CEA i CA 15-3 kod osoba s masom u dojci je prije, a ne poslije mamografskog postupka. Ovo pitanje zahtijeva daljnje podrobne studije

Topical Insulin Accelerates Wound Healing in Diabetes by Enhancing the AKT and ERK Pathways: A Double-Blind Placebo-Controlled Clinical Trial

Background: Wound healing is impaired in diabetes mellitus, but the mechanisms involved in this process are virtually unknown. Proteins belonging to the insulin signaling pathway respond to insulin in the skin of rats. Objective: The purpose of this study was to investigate the regulation of the insulin signaling pathway in wound healing and skin repair of normal and diabetic rats, and, in parallel, the effect of a topical insulin cream on wound healing and on the activation of this pathway. Research Design and Methods: We investigated insulin signaling by immunoblotting during wound healing of control and diabetic animals with or without topical insulin. Diabetic patients with ulcers were randomized to receive topical insulin or placebo in a prospective, double-blind and placebo-controlled, randomized clinical trial (NCT 01295177) of wound healing. Results and Conclusions: Expression of IR, IRS-1, IRS-2, SHC, ERK, and AKT are increased in the tissue of healing wounds compared to intact skin, suggesting that the insulin signaling pathway may have an important role in this process. These pathways were attenuated in the wounded skin of diabetic rats, in parallel with an increase in the time of complete wound healing. Upon topical application of insulin cream, the wound healing time of diabetic animals was normalized, followed by a reversal of defective insulin signal transduction. In addition, the treatment also increased expression of other proteins, such as eNOS (also in bone marrow), VEGF, and SDF-1 alpha in wounded skin. In diabetic patients, topical insulin cream markedly improved wound healing, representing an attractive and cost-free method for treating this devastating complication of diabetes.Sao Paulo Research Foundation (FAPESP)Sao Paulo Research Foundation (FAPESP)National Institute of Science and Technology (INCT)National Institute of Science and Technology (INCT)National Council for Scientific and Technological Development (CNPq)National Council for Scientific and Technological Development (CNPq