Induced sputum: comparison between isotonic and hypertonic saline solution inhalation in patients with asthma.

BACKGROUND: Sputum induction by hypertonic saline solution inhalation is widely used to study airways secretions in patients with asthma. However, hypertonic saline solution is a potent indirect bronchoconstrictor. STUDY OBJECTIVES: We studied the validity of isotonic saline solution (0.9%) inhalation as a means to induce sputum by comparing it to hypertonic saline solution (4.5%) inhalation. PATIENTS: Sixteen patients with moderate-to-severe asthma reporting a clinical history of mucus hypersecretion. METHODS: Subjects underwent sputum induction twice at 1-week intervals. Saline solution (hypertonic or isotonic) was inhaled for three periods of 5 min. The parameters assessed in sputum samples were cell counts, sodium, eosinophil cationic protein (ECP), and albumin concentrations, osmolality, and pro-matrix metalloproteinase (MMP)-9 activity by zymography. RESULTS: The maximal fall in peak expiratory flow during sputum induction was greater after inhalation of hypertonic saline solution than after inhalation of isotonic saline solution (p < 0.01). Each subject produced analyzable sputum on both visits. There were no statistically significant differences in total and differential sputum cell counts, and the reproducibility coefficients were high for eosinophils and neutrophils when comparing the two methods. Likewise, sputum levels of ECP and albumin as well as sputum pro-MMP-9 activity were not different between the two methods, and were highly reproducible as shown by high intraclass coefficients (Ri) of correlation (0.72, 0.74, and 0.77 for ECP, albumin, and pro-MMP-9, respectively). Sputum sodium concentrations and osmolality were higher after inhalation of hypertonic saline solution (p < 0.05). CONCLUSION: In patients with moderate-to-severe asthma reporting a clinical history of mucus hypersecretion, inducing sputum by isotonic or hypertonic saline solution inhalation leads to comparable results in eosinophil and neutrophil cell counts and fluid phase mediators/proteins.     

Evolution of renal replacement therapy in Central and Eastern Europe 7 years after political and economical liberation

Purpose of the study: The conditions of renal replacement therapy (RRT) were very poor in the countries located in Central and Eastern Europe (CEE) when they were members of the so-called 'socialist bloc'. The aim of the present analysis was to document the impact of the socioeconomic changes on dialysis therapy in the CEE countries. Design: This was a special survey with the participation of 12 CEE countries, with data obtained through national registries (with the exception of Russia). Results: during the period 1990-1996 the number of haemodialysis units increased by 56% and the number of centres performing peritoneal dialysis by 296%. The number of patients increased respectively by 78% (haemodialysis) and 306% (peritoneal dialysis). The percentage of patients with diabetic nephropathy and elderly patients rose dramatically during this period. One of the main reasons of such expansion was the rapid development of peritoneal dialysis programmes in the majority of the CEE countries. The introduction of modern haemodialysis machines and a wider choice of different dialysers and concentrates permitted individualization of dialysis procedures. These points and the wider use of erythropoietin had a positive influence on quality of life and treatment outcome. There was also a notable increase in the number of transplant centres, but less so of the number of transplanted patients. Conclusion: Renal replacement therapy experienced a major expansion in the CEE countries. Despite progress achieved, the level of RRT is not yet completely satisfactory in most CEE countries.     

Renal replacement therapy in Bosnia and Herzegovina: report of the Society of Nephrology, Dialysis and Transplantation of Bosnia and Herzegovina.

Introduction Renal replacement therapy (RRT) had been established in Bosniaand Herzegovina before the war in 1992–1995. During thewar, the activity of the dialysis centres could only continuebecause of donations of supply provided by Medicine Du Mondeand the European Union [1]. Since 1997, the expenses of dialysistreatment are again met by the government of Bosnia and Herzegovina. In 1997, the Society of Nephrology, Dialysis and Transplantationof Bosnia Herzegovina was founded and continues to receive organizationaland financial help from Medicine Du Monde. In 1999, the societyfounded the renal registry of Bosnia and Herzegovina. Completedata reporting was achieved in 2001, covering all 20 dialysiscentres in Bosnia Herzegovina, with a return rate of 100%. Inthe following,     

Kinetics of the heterogeneous acid hydrolysis of regenerated cellulose

The kinetics of the early stage of acid catalyzed heterogeneous hydrolysis of different samples of regenerated cellulose at low temperatures (0, 20, and 30°C) was studied. The degradation of macromolecules was followed by determining the decrease of the degree of polymerization by measuring the viscosity of cellulose solutions in cadoxen. Interpretation of the experimental results using equations for first order reactions showed that in the studied experimental range first order kinetics cannot be applied. It was found that the rate constant decreases during the course of the hydrolysis at constant temperature. However, the experimental results could be explained by kinetic equations for heterogeneous processes with a solid and a liquid phase in the heterogeneous system. Kinetic parameters calculated from these equations point out that the process could be described as a diffusion controlled process.