ARANCIBIA CASTRO KRUZKERRY
DIAS GUEVARA EDUARDO
LOZANO BURGA YENNY
PEDEMONTE MURILLO ELKI
ROQUE VEGA KARIN
VENCES MIJAHUNCA MIGUEL ANGEL
Is the study of chemical proces
ses in living organisms, governs
all living organisms and living
Much of biochemistry deals with the structures and
functions of cellular components such as proteins,
carbohydrates, lipids, nucleic acids and other
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.
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.
including multiple techniques
•Nuclear magnetic resonance
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.
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.
physical experiences are reported by the
patient . Not be observed
The sings are findings in the patient and
are detected by the doctor. Can be seen
It consists of various maneuvers performed
by the doctor in the patient
• is the method of physical examination is done
• is the process of examining the body using the sense of
touch. Provides information on shape, size, texture,
surface moisture, tenderness and mobility.
• 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.
is to listen, either directly or through instruments like the
stethoscope, normal or pathological sounds produced by
the human body.
They are a setof studies that providevaluableinformatio
n tomedical analysis,and either to confirmor givemore c
ertaintyto the diagnosis of a disease.
Biopsy: procedure in which tissue
samples under a microscope to
procedure, which shows soft and
solid structures of the body.
Ultrasound: uses sound waves to
create images of internal
Diagnosis and Treatment of
Tuberculous Pleural Effusion
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
acid-fast bacilli in the sputum
pleural biopsy specimens.
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
TB pleural effusions can manifest as primary or reacti
is considered the initial event in the pathogenesis
of primary TB pleural effusions.
increased capillary permeability and
impairment of lymphatic clearance of p
roteins and fluid from the pleural space.
The definitive diagnosis of TB
pleural effusions depends:
demonstration of M tuberculosis
pleural biopsy specimens.
demonstration of classical TB
granulomas in the pleura
and elevated adenosine
IFN-_ levels in pleural fluid.
patients with pleur
al TB without conc
sputum negative a
Positive: evidence in the diagnosis
of TB pleural effusions in areas of
Negative: could result from the
anergy secondary to
sequestration of purified protein
in pleural space.
• A TB pleural effusion is
typically clear and straw
• it can be turbid or
• Pleural fluid pH is usually
between 7.30 - 7.40
• in patients with HIV
coinfection, the yield of
pleural fluid microscopy is
• Culture requires a minimum
of 10 to 100 viable bacilli
• 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
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.
Polymerase chain reaction (PCR) is based on amplification of mycobacterial DNA
Advantages of PCR include rapid diagnosis, improved specificity and sensitivity, a
nd no requirement of intact immunity.
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.
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).
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