Besides genetic factors, it is known that some trace elements, as Selenium, Copper, and Zinc are essential for thyroid gland fuction and thyroid hormone metabolism. Moreover, there were some metals effect that suggested patterns associated with overt thyroid disease. Hashimoto thyroiditis (HT), chronic autoimune inflamation of thyroid gland with cosequtive hipothyroidism, is common disease in Serbia, and we thought it is worthwile to explore potential effects of essential and toxic metals and metalloides on thyroid function and ability to restore euthyroid status of them. This cross-sectional, case-control, study investigated the status of essential elements (Selenium,Copper,and Zinc) and toxic metals and metalloides (Al, Cr, Mn, Co, As, Cd, Sb, Ba, Be, Pb and Ni) from the blood of 22 female, patients with Hashimoto thyroiditis and overt hypothyroidism, and compared it with those of 55 female healthy persons. We tried to establish the presence of any correlation between previous mentioned elements and thyroid function in hypothyroid patients and healthy participants. The results of our study suggested that the blood concentration of essential trace elements, especially the ratio of Copper, and Selenium may influence directly thyroid function in patients with HT and overt hypothyroidism.Thus, our findings may have implication to life-long substitution therapy in terms of l-thyroxine dose reduction. Furthermore, for the first time, our study shown potential toxic effect of Cadmium on thyroid function in HT patients, which may implicate the dose of l-thyroxine substitution.
Inductively coupled plasma-mass spectrometry ((ICP-MS)) was used to determine three toxic (Ni, As, Cd) and six essential trace elements (Cr, Mn, Co, Cu, Zn, Se) in blood serum of patients with hypothyroidism (Hy group) and healthy people (control group), in order to set the experimental conditions for accurate determination of a unique profile of these elements in hypothyroidism. Method validation was performed with standard reference material of the serum by varying the sample treatment with both standard and collision mode for analysis of elements isotopes. Quadratic curvilinear functions with good performances of models and the lowest detection limits were obtained for Cr,Zn, As,Cd in collision mode, and Mn,Co, Ni,Cu, Se in standard mode. Treatment of serum samples with aqueous solution containing nitric acid, Triton X-100 and n-butanol gave the best results. Chemometric tools were applied for discrimination of patients with hypothyroidism. All nine elements discriminated Hy group of samples with almost the same discriminating power as indicated by their higher values for this group of patients. Statistically significant correlation (p< 0.01) was observed for several elements. Results indicated clear differences in element profile between Hy and control group and it could be used as a unique profile of hypothyroid state.
Tumor necrosis factor (TNF) α has been considered the prototypic cytopathogenic cytokine in multiple sclerosis (MS), but recently this cytokine has been shown to possess significant anti-inflammatory and neuroprotective effects in demyelinating diseases. It has been reported that the TNFα –308 polymorphism influences levels of TNFα production, and that the rare allele, TNF2, is associated with high TNFα production. We investigated the TNFα –308 polymorphism in 143 unrelated Serbian patients with MS and 123 ethnically matched, healthy individuals using the allele-specific restriction fragment length polymorphism polymerase chain reaction technique. The frequency of the TNF2 allele was significantly decreased in MS patients (14%) in comparison with controls (24%; p = 0.044). The TNF2 allele had no influence on disease behavior, since it was not associated with the course and severity of MS in this group of patients. The result suggests that in the Serbian population polymorphism at position –308 of TNFα or at an adjacent locus might have a role in MS susceptibility.
Introduction The important indicators of the quality of work in blood transfusion banks and health care facilities in general is the ratio of the cross-matched red blood cell (RBC) units, and the number of transfused RBC, known as cross-match to transfusion ratio (C:T). The objective of this research was to provide an assessment of the quality of our work in a cross-sectional study, showing C:T ratios for certain areas of surgery or particular surgical indications. Methods We analyzed the data related to the activities of the Department for Pre-Transfusion Testing and Blood Distribution at the Blood Transfusion Institute of Serbia during the September and November of 2017 period. In total, 341 patients were included in the study, for whom 1,067 RBC units were requested. Results In pre-transfusion testing, 562 units were cross-matched and 249 units were transfused. The overall C:T ratio was 2.25. There are variations in C:T by departments. For the departments of abdominal surgery and reanimation, where uncrossmatched RBC units were requested, C:T was < 2. Other departments had C:T > 3 for almost all therapeutic areas. Conclusion Our results show that the C:T ratio ranged 2.02-3.6, indicating the need to reevaluate the protocols based on which the blood is requested according to individual indications, to adequately prepare patients for surgery in order to reduce the risk of possible allogeneic transfusion, and to apply Patient Blood Management protocols, which include the use of alternatives to allogeneic blood transfusion.
Our study clearly demonstrated the high efficacy of IVIG therapy in the treatment of severe forms of myastehnia gravis and Guillain-Barré syndome.
Topic: The Kidd blood group (Jk) was discovered in 1951 and according to International Society for blood transfusion (ISBT) the Kidd (Jk) blood group is registered under the number 009. Antigens of the Kidd system are detected only on RBCs and kidney. Incompatibile transfusion in Jk blood group can provoke sensitization and appearance of anti-Jka or anti-Jkb antibodies. Jk antibodies are common cause of delayed hemolytic transfusion reactions (DHTRs). Although Kidd antibodies can lead to acute reactions, kidney damage and hemoglobinuria are very rare. More important is Kidd-antibody ability for delayed hemolytic reactions. The aim is to underline Jka antibodies laboratory characteristics, their role in delayed posttransfusion reactions and possible complications of blood transfusions. The topic position in scientifi c/professional public: Kidd-antibodies, usually, destroy transfused red cells after a variable period of between 7 and 21 days. DHTR is the result of anti-Jka antibodies tendency to fall rapidly to undetectable levels even after incompatible transfusion. Anti-Jka has been reported as reason for kidney transplant rejection. There were examples of anti-Jka that react only when preservatives such as p-hydroxybenzoic acid (parabens), Na-azide or related compounds, antibiotics are present in the reaction mixture. Also, patient's therapy with antibiotics and monoclonal antibodies could cause false positive RBC antibody. Further action needed for better topic covering in future: Except in life threatening condition, reduction of allogenic blood transfusion is recommended. Increase the number of autologous transfusions in all cases when the patient's clinical condition allows. Antigen-free RBC ie universal RBC would be the best choice for transfusion. It is essential to perform extended erythrocyte phenotyping prior to initiation of monoclonal antibodies therapy. As a minimum blood typing for Rh, K, Jka,Jkb, Fya, Fyb and Ss antigens should be done for every patient who is planned to be treated with monoclonal antibodies.Overcoming this problem is very important for patients who are transfusion-dependent or candidates for monoclonal antibody therapy, or candidates for kidney transplantation.
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