2.  ARANCIBIA CASTRO KRUZKERRY
 DIAS GUEVARA EDUARDO
 LOZANO BURGA YENNY
 PEDEMONTE MURILLO ELKI
 ROQUE VEGA KARIN
 VENCES MIJAHUNCA MIGUEL ANGEL

3. Is the study of chemical proces
ses in living organisms, governs
all living organisms and living
processes.

4. Much of biochemistry deals with the structures and
functions of cellular components such as proteins,
carbohydrates, lipids, nucleic acids and other
biomolecules.
Today the main focus of pure biochemistry is in understanding
how biological molecules give rise to the processes that occur
within living cells which in turn relates greatly to the study and
understanding of whole organisms.

5. As an experimental science of biochemistry requires numerous
instrumental techniques that enable the development and
expansion, some of them are used daily in any laboratory and
others are very exclusive.
.
•Subcellular fractionation,
including multiple techniques
•Centrifugation
•Chromatography
•Electrophoresis
•radioisotope techniques
•PCR
•Flow cytometry
•Immunoprecipitation
•ELISA
•Electron Microscope
•X-ray Crystallography
•Nuclear magnetic resonance
•Mass Spectrometry

6. The most known is the use of
radioiodine (Iodine-131) in the
treatment of hyperthyroidism and
differentiated thyroid cancer.
Is a technique that uses specific antibodies
to a protein to remove these proteins from
the solution. Examples include protein A,
protein G, Zysorbin, or adding a second
antibody to the solution.

7. In medicine, diagnosis or
clinical propaedeutic is the
procedure by which a
disease is identified or any
condition of health-disease.
The medical diagnosis is
based symptoms, signs and
findings of additional tests
to determine what disease
a person suffers.

8. Symptoms Signs
Physical
Examination
Supplementary
Examinations

9. Example:
physical experiences are reported by the
patient . Not be observed
painFatigue

10. The sings are findings in the patient and
are detected by the doctor. Can be seen
Example:
Fever Edema

11. It consists of various maneuvers performed
by the doctor in the patient
Inspection
percusion
Auscultation
Palpation

12. INSPECTION
• is the method of physical examination is done
by sight.
PALPATION
• is the process of examining the body using the sense of
touch. Provides information on shape, size, texture,
surface moisture, tenderness and mobility.
PERCUSION
• is a method that is tapped certain body parts during a
physical examination with fingers, hands or small
instruments to assess the size, consistency, borders and
presence or absence of fluid in the body's organs.
AUSCULTATION
is to listen, either directly or through instruments like the
stethoscope, normal or pathological sounds produced by
the human body.

13. They are a setof studies that providevaluableinformatio
n tomedical analysis,and either to confirmor givemore c
ertaintyto the diagnosis of a disease.
Biopsy
UltrasoundRadiograph

14. Biopsy: procedure in which tissue
samples under a microscope to
observe.
Radiograph: noninvasive
procedure, which shows soft and
solid structures of the body.
Ultrasound: uses sound waves to
create images of internal
oraganos.

15. Diagnosis and Treatment of
Tuberculous Pleural Effusion
in 2006

16. Tuberculous (TB) pleural effusion occurs in
approximately 5% of patients with Mycobacterium
tuberculosis infection. The HIV pandemic has been
associated with a doubling of the incidence of
extrapulmonary TB .
The definitive diagnosis of TB
pleural effusions depends on
the demonstration of:
The diagnosis can be established in a majori
ty of patients from
the clinical features
pleural fluid examination
including cytology
Biochemistry
Bacteriology
pleural biopsy
acid-fast bacilli in the sputum
pleural fluid
pleural biopsy specimens.

17. A total of nine million new cases and approximately
two million deaths from TB were reported in 2004
Although the African region has the highest
estimated incidence (356 per 100,000 pop
ulation per year)
the majority of patients with TB live in the
most populous countries of the Asian subc
ontinent

18. TB pleural effusions can manifest as primary or reacti
vated disease.
is considered the initial event in the pathogenesis
of primary TB pleural effusions.
•predominantly from:
increased capillary permeability and
•secondarily from:
impairment of lymphatic clearance of p
roteins and fluid from the pleural space.
because of
occlusion of
pleural stomata

19. The definitive diagnosis of TB
pleural effusions depends:
demonstration of M tuberculosis
in:
 sputum
pleural fluid
pleural biopsy specimens.
others:
demonstration of classical TB
granulomas in the pleura
and elevated adenosine
deaminase (ADA)
IFN-_ levels in pleural fluid.

20. patients with pleur
al TB without conc
omitant pulmonary
disease.
Are:
sputum negative a
nd
Therefore:
no contagious.
Positive: evidence in the diagnosis
of TB pleural effusions in areas of
low prevalence.
Negative: could result from the
following:
anergy secondary to
immunosuppression
 recent infection;
sequestration of purified protein
derivative-reactive T-lymphocyte
in pleural space.

21. • A TB pleural effusion is
typically clear and straw
colored
• it can be turbid or
serosanguinous
• Pleural fluid pH is usually
between 7.30 - 7.40
Pleural Fluid
Examination
• in patients with HIV
coinfection, the yield of
pleural fluid microscopy is
20%
• Culture requires a minimum
of 10 to 100 viable bacilli
Pleural Fluid
Smear and
Culture

22. • catalyzes the conversion of adenosine and deoxyadenosine to i
nosine and deoxyinosine with the release of ammonia.
• several studies have explored the usefulness of estimation of AD
A activity in the diagnosis of TB pleural effusions
pleural fluid ADA level 70 IU/L is highly suggesti
ve of TB, while a level 40 IU/L virtually excludes t
he diagnosis.

23. Produced by T-lymphocytes, Several studies have found elevated co
ncentrations of INF in TB pleural effusions, which is related to increa
sed production at the disease site by effector T cells.

24. Polymerase chain reaction (PCR) is based on amplification of mycobacterial DNA
fragments.
Advantages of PCR include rapid diagnosis, improved specificity and sensitivity, a
nd no requirement of intact immunity.

26. The utilization of immunodiagnostics is hindered by its low sensitivity. The Table
lists the details regarding various studies using immunologic markers in the
diagnosis of TB pleural effusions. Further studies are required to address the
clinical utility of these markers.

28. The patients with extensive or bilateral pleural effusions and sputum positivity
are given treatment under category I (treated during intensive phase with four
drugs: isoniazid, rifampin, pyrazinamide, and ethambutol for 2 months followed
by continuation phase of 4 months with isoniazid and rifampin).

29. Corticosteroids through their antiinflammatory action may hasten fluid resorption
and prevent pleural adhesions during healing. Three randomized trials have inves
tigated the possible role of adjunctive oral corticosteroids in TB pleural effusion.
A dose of 0.75 to 1 mg/kg/d was used for a period ranging from 4 to 12 weeks
.

30. for yOur attentiOn!!!