Osteoprotegerin, sRANKL and sRANKL /OPG ratio in pseudosynovial fluid from patients with aseptic loosening of total hip prosthesis

Background. Total hip replacement is the final solution in advanced osteoarthritis. The survival time of the implant significantly depends on the condition of the bone in which it has been located. Upsetting the balance in the RANK/RANKL/OPG system can lead to the development of bone metabolic disorders leading to bone loss. The aim of this study was to evaluate the osteoprotegerin (OPG) and soluble RANKL (sRANKL) concentrations in the pseudosynovial fluid in women with aseptic loosening of total hip prosthesis.Methods. OPG and sRANKL concentrations were assayed in the pseudosynovial fluid collected from 20 women during the revision total hip arthroplasty (THA) (group R), and in the synovial fluid of 13 women in the end-stage of idiopathic osteoarthritis collected during primary THA (group P). OPG and sRANKL were measured using commercially available ELISA kits.Results. OPG concentration was significantly lower, and sRANKL concentration was significantly higher, in group R than in group P. The sRANKL/OPG ratio in group R was significantly higher than in group P. The average total joint endoprosthesis survival time was 8.6 (SD 3.9) years. The OPG concentration was slightly lower in patients with a time interval shorter than 8.6 years. The sRANKL/OPG ratio was higher in women with a shorter implant survival time.Conclusion. Higher sRANKL/OPG ratio in the pseudosynovial fluid contributes to increased resorption of bone tissue surrounding total hip endoprosthesis, leading to its aseptic loosening

IGF-1, cytokines and biochemical bone turnover markers in synovial fluid and serum of patients with primary and secondary osteoarthritis of the hip

Cilj: Usporediti koncentracije IGF-1, biljega koštane pregradnje (BSAP, CTX) i citokina u bolesnika s uznapredovalim osteoartritisom kuka te procijeniti povezanosti između tih parametara i etiopatogeneze bolesti. Materijali i metode: Uzorci zglobne tekućine i seruma prikupljeni su od 17 bolesnika s primarnim osteoartritisom kuka (POA) i 6 bolesnika s avaskular-nom osteonekrozom kuka (SOA) podvrgnutih operacijskom zahvatu na kuku. Koncentracije IGF-1, IL-6, IL-8, IL-10, CTX te aktivnosti BSAP mjerene su metodom ELISA. Rezultati: IGF-1 u serumu bolesnika s osteoartritisom bio je unutar donjeg raspona referentnih vrijednosti, no u bolesnika s osteonekrozom bio je ispod tog raspona. Međutim, koncentracija CTX u serumu bila je značajno viša u bolesnika sa SOA (0,58±0,19) nego u POA (0,39±0,15; P=0,02). IGF-1 u sinovijal-noj tekućini bolesnika sa SOA bio je niži (P=0,008), a CTX viši nego u slučajeva POA (P<0,001). U bolesnika s primarnim osteoartritisom koncentracije IGF-1, CTX, IL-6 i IL-8 u sinovijalnoj tekućini korelirale su s koncentracijama u serumu. U slučajevima osteonekroze utvrđene su slične i naglašene korelacije samo između CTX i IL-8. IGF-1 je u sinovijalnoj tekućini korelirao s aktivnošću BSAP u bolesnika s POA. Pozitivna korelacija je zapažena između CTX i IL-8 u sinovijalnoj tekućini i serumu. U bolesnika s osteonekrozom IGF-1 je u serumu izravno korelirao s IL-10, dok je negativna povezanost nađena između CTX i IL-10. Zaključci: Koncentracija IGF-1 može biti čimbenikom rizika za predispoziciju za osteoartritis kao i povezana s etiopatogenezom te bolesti. Vrlo niska koncentracija IGF-1 u serumu (PPV>70%) ili sinovijalnoj tekućini može ukazati na nekrozno podrijetlo degenerativne bolesti zglobova. Ovdje izneseni podatci pokazuju da je avaskularna osteonekroza obilježena više kataboličkim stanjem koje se odražava niskim IGF-1 s istodobnim porastom koštane razgradnje i proupalnih pokazatelja.Background: To compare the concentrations of IGF-1, bone turnover markers (BSAP, CTx) and cytokines in patients with advanced hip osteoarthritis and to evaluate associations between these parameters and disease etiopathoge-nesis. Materials and methods: Samples of joint fluid and serum were collected from 17 patients with primary hip osteoarthritis (POA) and 6 patients with avascular osteonecrosis of the hip (SOA) who underwent hip surgery. Concentration of IGF-1, IL-6, IL-8, IL-10, CTx and BSAP activity were measured by ELISA. Results: Patients with osteoarthritis had serum IGF-1 in the lower range of reference values but those with osteonecrosis - below this range. Serum CTx concentration was, however, significantly higher in SOA than in POA cases (0.58±0.19 and 0.39±0.15, respectively, P=0.02). Synovial fluid IGF-1 in SOA patients was lower (P=0.008) and CTx higher than in POA cases (P<0.001). In patients with primary osteoarthritis synovial fluid IGF-1, CTx, IL-6 and IL-8 concentrations correlated with those in the serum. Similar and strong associations, but only for CTx and IL-8, were found in cases with osteonecrosis. IGF-1 in synovial fluid correlated with BSAP activity in POA patients. Positive correlation was observed between CTx and IL-8 in synovial fluid and serum. In patients with osteonecrosis, serum IGF-1 was directly related to IL-10 while negative association was found between CTx and IL-10. Conclusions: IGF-1 level may constitute a risk factor predisposing to osteoarthritis and may be related to disease etiopathogenesis. Very low IGF-1 concentration in serum (PPV>70%) or synovial fluid may indicate necrotic origin of degenerative joint disease. The data reported here show that avascular osteonecrosis is characterized by a more catabolic state, reflected by low IGF-1 with concomitant increase in bone resorption and pro-inflammatory indices

Umbilical cord blood NGAL concentration as an early marker of perinatal asphyxia in neonates

Introduction: Recent reports have revealed increased concentration of neutrophil gelatinase-associated lipocalin (NGAL) in cardiovascular diseases and after episodes of hypoxia. We hypothesized that elevated plasma NGAL levels could be a result of vascular endothelial injury due to perinatal asphyxia. Materials and methods: Ninety-three newborns with a gestational age ≥37 weeks, of which 32 newborns were asphyxiated (study group), and 61 were healthy children (control group), were enrolled in the study. Serum NGAL, lactate and creatinine concentrations, acid-base balance, neutrophil and white blood cell count were measured in the umbilical cord blood. Results: Asphyxiated newborns had a significantly lower pH value (7.0 vs. 7.3;

Late preterm infant

In recent years, a subgroup of more mature preterm infants, born at 36 0/7 to 36 6/7 weeks’ gestation has emerged who we called “late preterm” infants. Most of those infants were born by cesarean section. Late preterm infants require special care. We will expect more complications during the adaptation period like the respiratory distress syndrome, hypothermia, hypoglycaemia, hyperbilirubinemia and complications in the late period. All late preterm infants need to be diligently evaluated, monitored and followed-up.W ostatnich latach wyodrębniono nową grupę bardziej dojrzałych wcześniaków, które rodzą się między 34 0/7 tygodnia ciąży a 36 6/7 tygodnia ciąży, nazwaną „późnymi wcześniakami”. Większość z nich rodzi się przez cięcie cesarskie. Późne wcześniaki są noworodkami specjalnej troski, u których możemy się spodziewać wielu powikłań w okresie wczesnonoworodkowym, takich jak: zespół zaburzeń oddychania, hipotermia, hipoglikemia, hiperbilirubinemia oraz zaburzeń w okresie późniejszym. Dzieci te wymagają skrupulatnej oceny, monitorowania i kontroli

Nadwrażliwość na heparyny – opis przypadków

Wprowadzenie: Heparyny są powszechnie stosowane jako antykoagulanty w praktyce klinicznej. Mogą one wywoływać każdy rodzaj nadwrażliwości, chociaż najczęściej występują reakcje nadwrażliwości opóźnionej. Reakcje nadwrażliwości typu natychmiastowego na heparynę są bardzo rzadkie i jak do tej pory opisano tylko kilkanaście przypadków. W niniejszej pracy opisano przypadki czterech pacjentów, u których wystąpiła nadwrażliwość na preparaty zawierające heparynę. Przedstawiono obraz kliniczny, przeprowadzoną diagnostykę i indywidualne zalecenia w razie konieczności stosowania terapii przeciwzakrzepowej. Ponadto omówiono dalsze postępowanie w przypadku stwierdzenia nadwrażliwości na heparynę

Beneficial Effects of 6-Month Supplementation with Omega-3 Acids on Selected Inflammatory Markers in Patients with Chronic Kidney Disease Stages 1–3

Introduction. Chronic kidney disease (CKD) is accompanied by inflammation. The aim of this study was to evaluate the effect of 6-month supplementation with omega-3 acids on selected markers of inflammation in patients with CKD stages 1–3. Methods. Six-month supplementation with omega-3 acids (2 g/day) was administered to 87 CKD patients and to 27 healthy individuals. At baseline and after follow-up, blood was taken for C-reactive protein (CRP) and monocyte chemotactic protein-1 (MCP-1) concentration and white blood cell (WBC) count. Serum concentration of omega-3 acids—eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and alpha-linolenic acid (ALA)—was determined using gas chromatography. And 24-hour urinary collection was performed to measure MCP-1 excretion. Results. After six-month omega-3 supplementation, ALA concentration increased in CKD patients and in the reference group, while EPA and DHA did not change. At follow-up, a significant decrease in urinary MCP-1 excretion in CKD (p=0.0012) and in the reference group (p=0.001) was found. CRP, serum MCP-1, and WBC did not change significantly. The estimated glomerular filtration rate (eGFR) did not change significantly in the CKD group. Conclusions. The reduction of urinary MCP-1 excretion in the absence of MCP-1 serum concentration may suggest a beneficial effect of omega-3 supplementation on tubular MCP-1 production. Trial Registration. This study was registered in ClinicalTrials.gov (identifier: NCT02147002)