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Biomedical subjects

T Mets

Publications and source records attributed to T Mets.

At least 19 recordsLinked to original sources

Inflammatory status as an important determinant of heat shock protein 70 serum concentrations during aging.

Heat shock proteins (Hsp) form a large family of proteins that are ubiquitously present in all organisms. In the absence of destabilising stimuli, Hsp are expressed at low levels, but their expression can be highly induced by various noxious conditions such as heat, oxygen stress and infection. Hsp have been reported to interfere with inflammatory processes and their induction is well known to decrease with aging. In the present study we have investigated Hsp 70 serum concentrations using an optimised ELISA in elderly patients, recruited from a geriatric University Hospital ward. Our results portray positive correlations between the serum levels of Hsp 70 and various markers of inflammation (monocyte count, serum concentration of TNF-alpha, plasma concentrations of C-reactive protein, and fibrinogen), explaining the difference in Hsp 70 serum concentrations in these subjects with various degrees of inflammation. We conclude that Hsp 70 is involved in inflammatory diseases and that the serum level of Hsp 70 is directly linked to the inflammatory status of the subject. However, the nature of this relationship remains to be elucidated.

Aged↗

Elevated serum heat-shock protein 70 levels in patients with acute infection: use of an optimized enzyme-linked immunosorbent assay.

Heat-shock proteins (Hsps) are highly conserved throughout evolution and evoke great interest both in basic biology and in medicine. They are expressed in small quantities under normal conditions, and their expression can be strongly induced by several stressors. Although their action is basically intracellular, it is now obvious that these proteins can be released into the extracellular environment from viable cells. In this study, the human Hsp 70 serum concentrations were determined using an optimized, cost-effective enzyme-linked immunosorbent assay (ELISA). The average intra-assay variation was 6%, whereas the average interassay variation was 9%. The sensitivity of the assay was 10 ng/ml, and spiking experiments showed recoveries between 101 and 109%. As an application of the technique, we have investigated the serum levels of human Hsp 70 in patients with infection and in healthy subjects. Our data show significantly higher levels of Hsp 70 (P = 0.003) in patients compared to control subjects. Positive correlations were noticed between the serum levels of Hsp 70 and various markers of inflammation (IL-6; r = 0.579, P = 0.009, TNF-alpha; r = 0.552, P = 0.012, IL-10; r = 0.361, P = 0.002). We conclude that Hsp 70 is involved in inflammation of infectious origin. The interindividual variation in the serum concentration of Hsp 70 precludes the use of serum Hsp 70 levels to distinguish patients from healthy subjects.

Acute Disease↗

Age-related decrease in the inducibility of heat-shock protein 70 in human peripheral blood mononuclear cells.

We have investigated the effect of age and of the presence of proinflammatory cytokines on Hsp 70 production in human peripheral blood mononuclear cells, using flow cytometry. Twenty-seven women and 23 men, all apparently healthy, participated in the study. At 37 degrees C, the percentage of Hsp 70-producing monocytes and lymphocytes, as well as the level of Hsp 70 in monocytes, were negatively influenced by age. After exposure of the cells to 42 degrees C, the increase of Hsp 70 production was more pronounced in monocytes than in lymphocytes; both the intensity of Hsp 70 production and the percentage of Hsp 70-producing cells were negatively influenced by the age of the subjects, as well for monocytes as for lymphocytes. There was a negative correlation between the intensity of Hsp 70 production by monocytes exposed to 42 degrees C and the serum levels of tumor necrosis factor-alpha and interleukin-6. In conclusion, in human monocytes and lymphocytes, heat-induced Hsp 70 production is reduced with increasing age and is negatively influenced in monocytes by proinflammatory cytokines.

Adult↗

The prevalence of autoantibodies in an elderly sub-Saharan African population.

In the present prospective, census-based study we have investigated the prevalence of organ-specific and non-organ-specific autoantibodies (AAb) in 152 unselected Cameroonians aged 60 years and older living in the community. AAb were detected in 49% of the participants. Non-organ-specific AAb (47%) predominated over organ-specific AAb (7%). Anti-TPO, anti-Tm, anti-Tg and anti-PC AAb were completely absent. RF was the most frequent AAb, being found in 57 (38%) cases. The prevalences of anti-SMA and RF were significantly higher in women than in men (respectively, P=0.023 and P=0.016). Higher serum concentrations of gammaglobulins were accompanied by a higher prevalence of RF (P < 0.0001) and a lower prevalence of ANA (P=0.036). The overall prevalence of AAb was higher in the filaria-infected (60%) compared to the non-infected (42%) participants (P=0.046). There was no significant influence of the vitamin D status, number of pregnancies, physical activity or medication use on the prevalence of AAb. In this study a heterogeneous pattern for the presence of the various AAb was found. Some AAb, which are commonly encountered in other studies on elderly subjects, were completely absent in this population. This diversified pattern of AAb prevalence therefore argues in favour of exogenous influences in the occurrence of AAb in elderly populations.

Aged↗

Comparative study of the intestinal absorption of three salts of calcium in young and elderly women.

A daily ingestion of 1000 to 1500 mg elemental calcium associated with vitamin D supplement is presently considered to be the adequate and least expensive therapy for senile osteoporosis. There exists only scarce data about calcium absorption with available calcium salts in elderly patients. We have compared the digestive absorption of calcium (Ca) citrate in soluble and solid form and calcium gluconolactate-carbonate in 15 young and 20 elderly, healthy women using the oral calcium loading test. The subjects were divided into two groups. In the first group, the absorption of solid Ca citrate (1000 mg Ca element) was compared to the absorption of Ca gluconolactate-carbonate (1000 mg Ca element) both in young (n = 7) and elderly women (n = 10). In the second group, the absorption of soluble Ca citrate (1000 mg Ca element) was compared to the absorption of Ca gluconolactate-carbonate (1000 mg Ca element) in young (n = 8) and elderly (n = 10) women. In the preload phase, basal calciuria was increased in elderly women (p < 0.01) although basal calcemia was similar in young and elderly women. After oral administration of the calcium salts, an increase in plasma Ca was observed in both groups which was greater for soluble Ca citrate and Ca gluconolactate than for solid Ca citrate. In young women, the increase in plasma calcium was significantly higher with soluble Ca citrate compared to Ca gluconolactate (p < 0.05). In elderly women, the postload calciuria was significantly higher for soluble Ca citrate (p < 0.05) and Ca gluconolactate (p < 0.05) compared to solid Ca citrate. A similar pattern was observed in young women, although it was not significant. In conclusion, an oral load of 1000 mg soluble Ca citrate and Ca gluconolactate-carbonate induces significant biochemical changes suggesting a better digestive absorption compared to Ca citrate in solid form, both in young and elderly women. We did not observe different response, between young and old patients.

Adult↗

Drug-induced orthostatic hypotension in the elderly: avoiding its onset.

The prevalence of orthostatic hypotension in the elderly is reported to be 5 to 33%. This high prevalence contributes to the risk of syncope and falls in old age. Drugs are a major cause of postural hypotension. Changes in pharmacokinetics and pharmacodynamics occur with aging in relation to many drugs, resulting in delayed elimination and increased bioavailability. Therefore, drugs with an antihypertensive action (diuretics, calcium antagonists, beta-blockers, ACE inhibitors, alpha 1-blockers, and centrally acting antihypertensives) have a more pronounced effect in the elderly. Nitrates, antiparkinsonian drugs, antidepressants and antipsychotics all cause hypotension as a known adverse effect. When assessing orthostatic hypotension in the elderly, drug treatment should always be reviewed. Whenever possible, antihypertensive drugs should be discontinued, and the dosages of essential drugs should be reduced.

Adult↗

The 6-minute walk as an appropriate exercise test in elderly patients with chronic heart failure.

BACKGROUND: The value of the 6-minute walk in a population of elderly patients with chronic heart failure (CHF) has not yet been established, as it has been in a younger population. METHODS: In a prospective trial, 2 exercise tests were compared: the 6-minute walk (6 MW) and a treadmill test with progressive increments in workload. 37 patients (mean age 81.3, SD 5.6 years): 11 untrained controls, 16 patients with New York Heart Association (NYHA) class II and 10 patients with NYHA class III participated. The main outcome measures were the distance walked in 6 minutes, the symptomatic VO2max in the progressive treadmill test and the degree of CHF as scored by the NYHA classification and the Boston Study Group (BSG) score. RESULTS: For both the 6 MW and the treadmill test there was a significant difference in distance between NYHA class II and III patients (p < .001), between the controls and NYHA class III patients (p < .001), but not between the controls and NYHA class II patients. The distance walked in the 6 MW was well correlated with the distance walked in the treadmill test (p < .001). Eight participants (22%), however, were unable to perform this treadmill test and 6 participants (17%) covered very low distances compared to the 6 MW. The VO2max was lower in NYHA class III than in class II patients (p = .032). NYHA classification and BSG score correlated reasonably well. CONCLUSION: A treadmill exercise test with VO2max measurement in elderly patients with CHF is difficult to accomplish. On the contrary, the 6 MW gives a good impression of the remaining exercise capacity. It is well correlated with the treadmill test. The 6 MW is well tolerated by elderly patients and differentiates between NYHA classes II and III. Untrained controls could not be differentiated from NYHA class II patients.

Aged↗

Captopril treatment of chronic heart failure in the very old.

BACKGROUND: The safety and efficacy of angiotensin-converting enzyme inhibitors for very old patients with chronic heart failure have been less well documented than for younger patients. METHODS: A prospective, randomized double-blind, placebo-controlled study of captopril, 25 mg twice daily, was designed. Fifty patients (mean age 84.2 +/- 5.2) participated. The degree of chronic heart failure (according to the Boston Study Group rating), the distance walked in 6 minutes, and the occurrence of uncontrolled heart failure and adverse reactions were used as main outcome measures. RESULTS: Significantly more patients receiving placebo developed uncontrolled heart failure than patients receiving captopril (p = .022). In an intention to treat analysis, the first and last evaluations of the degree of chronic heart failure were compared. A significantly different evolution was observed between the two treatment groups (p < .001), with a significant improvement only in the captopril-treated patients (p < .001). The distance walked in 6 minutes improved significantly only in the captopril group (p = .004). The only adverse reaction was rash in two patients receiving captopril. CONCLUSIONS: The study gives further evidence that angiotensin-converting enzyme inhibitor treatment for very old patients with chronic heart failure is useful.

Aged↗

The association of bronchiolitis obliterans organizing pneumonia, systemic lupus erythematosus, and Hunner's cystitis.

An 83-year-old woman with histologically confirmed Hunner's cystitis presented with persistent fever, progressive dyspnea, and pulmonary patchy infiltrates. A transbronchial biopsy specimen revealed bronchiolitis obliterans organizing pneumonia. She progressively had development of renal insufficiency, due to systemic lupus erythematosus, proved by renal biopsy specimen. She recovered under corticosteroid treatment, but irreversible renal failure made long-term hemodialysis necessary.

Aged↗

Hepatitis C virus infection in African patients with liver cirrhosis or primary hepatocellular carcinoma.

We have studied the prevalence of hepatitis C virus (HCV) infection in Rwandan patients with histologically proven liver cirrhosis (LC) or primary hepatocellular carcinoma (HCC). Anti-HCV antibodies were determined by using a second-generation test, with a line immunoassay for structural and non-structural antigens as confirmation. Seventy-nine patients with LC, 26 with HCC, and 54 voluntary blood donors as controls were evaluated. Anti-HCV antibodies were more prevalent in LC patients (48%) and in HCC patients (38%) than in the controls (17%; difference, p = 0.0001 and p = 0.03, respectively). Eighty-four per cent of LC patients and 54% of HCC patients were HBsAg-negative. The prevalence of anti-HCV antibodies was significantly higher for LC and HCC patients who had been in contact with HBV but who had no persistent HBV infection (p < 0.05). We conclude that HCV infection is common in Rwanda and is linked to LC and HCC.

Adult↗

[Kaposi's sarcoma in Rwanda: clinico-pathological and epidemiological aspects].

The clinico-pathological and epidemiological features of 119 cases of Kaposi's sarcoma diagnosed during the years 1979-1986 in the main pathology department of Rwanda are presented. Skin involvement (89%) was predominant with almost 70% of cutaneous lesions localised on the lower limbs; 11% of cases presented with extracutaneous localisations, 77% (10 cases out of 13) in the lymph nodes. Incidence rises progressively with age, and males are more affected than females with a sex ratio (m:f) of 6.4:1. The highest frequencies were observed in the western prefectures which border the province of Kivu in eastern Zaire. Histologically, three types were encountered: a mixed type (84%), a spindle cell-predominant type (12.6%) and an anaplastic type (3.4%). The factor VIII-related antigen was present in all 40 cases tested by the PAP method. Antihuman immunodeficiency virus antibodies were looked for in 18 cases: 10 cases with localised Kaposi's sarcoma, all of whom were seronegative, and 8 cases with aggressive generalised Kaposi's sarcoma, all of whom were seropositive. The results are compared with those of other authors, and the histogenesis and pathogenesis, particularly the relationship with the acquired immunodeficiency syndrome, are discussed.

Acquired Immunodeficiency Syndrome↗

Treatment of bacillary dysentery: a comparison between enoxacin and nalidixic acid.

A prospective randomized study has been conducted in Rwanda to compare the efficacy of enoxacin versus nalidixic acid for the treatment of bacillary dysentery in adults. Seventeen patients received nalidixic acid and 21 received enoxacin. All isolates (37 shigella, 1 campylobacter) were sensitive in vitro to the two drugs. All patients showed a favourable clinical and bacteriological response and the results obtained with both drugs were comparable. Enoxacin seems to be a good alternative to nalidixic acid for bacillary dysentery due to multiresistant shigella.

Adult↗