Persistence of obstructive sleep apnea syndrome in children after adenotonsillectomy

OBJECTIVE: To investigate the relative contribution of various risk factors to the surgical outcome of adenotonsillectomy for obstructive sleep apnea syndrome in children. STUDY DESIGN: Children (n = 110; mean age, 6.4 +/- 3.9 years) underwent two polysomnographic evaluations before and after adenotonsillectomy. In addition, 22 control children were studied. History for allergy and family history of sleep-disordered breathing was taken before each polysomnographic evaluation. RESULTS: Significant changes in sleep stage percentages and sleep fragmentation were found in the postsurgery study compared with the presurgery study; 25% of the children had apnea/hypopnea index (AHI) 1 and <5, and 29% had AHI >/=5 in the postsurgery study. The frequency of subjects with AHI 相似文献   

TST与PPH治疗内痔的临床对比研究

目的比较TST（开环式微创痔吻合器）与PPH（痔上黏膜环切吻合术）治疗内痔的临床效果。方法将647例内痔患者随机分为A组和B组，分别采用TST（A组）和PPH（B组）治疗；术后观察平均住院时间，平均恢复工作时间，平均疗程，术后疼痛、术后出血、术后肛管直肠狭窄等并发症。结果两组患者均痊愈，但在术后疼痛、术后出血、术后肛管直肠狭窄等并发症方面，TST明显优于PPH。结论TST治疗内痔在减少术后并发症方面优于PPH。     

Neonatal Bacille Calmette-Guérin vaccination and tuberculin skin test reactions at 2- and 6-months: Effects on mortality up to 1 year of age

BackgroundIn randomized trials, Bacille Calmette-Guérin (BCG) vaccine has been associated with reduced all-cause mortality. BCG-induced Tuberculin Skin Test (TST) reactions have also been associated with reduced all-cause mortality. We aimed to assess the association between TST responses and subsequent mortality in three birth cohorts and conducted a meta-analysis of existing studies.MethodsObservational study within three Guinea-Bissau BCG trial birth cohorts (conducted 2002–04, 2009–2013 and 2014–18) that encompassed children who were BCG-vaccinated within 28 days with TSTs performed at 2- (n = 1389) and 6-months (n = 2635) of age. We evaluated TST reaction determinants by binomial regression and assessed the association between TSTs > 1 mm (reactors) vs. ≤ 1 mm (non-reactors) and subsequent mortality risk up to age 12 months in Cox-models providing Mortality Rate Ratios (MRRs). We searched PubMed for studies to calculate meta-estimates of the association between TST reactivity by age 2- and 6-months and all-cause mortality.ResultsLarge post-vaccination wheal size was associated with 6-month TST positivity and so was receiving BCG-Denmark or BCG-Japan, compared with BCG-Russia. By age 2 months, 22% (302/1389) of infants were TST reactors with a 2–12-month mortality risk of 1.7% (5/302) vs. 3.3% (36/1087) for non-reactors, the corresponding reactor/non-reactor MRR = 0.49 (0.19–1.26). By age 6 months, 44% (1149/2635) of infants were reactors and the 6–12-month mortality risk was 0.4% (4/1149) vs. 0.6% (9/1486) for non-reactors, the MRR = 0.87 (0.27–2.86). The literature search provided 3 studies. The meta-analysis revealed a uniform pattern of reduced mortality associated with TST reactivity, a TST response by 2 months being associated with an MRR of 0.59 (0.39–0.90); for 6-month TST responses the MRR was 0.65 (0.43–1.00).ConclusionAmong BCG-vaccinated infants, TST reactions were associated with markedly reduced mortality. Improved vaccination technique and using certain BCG strains could lead to a higher TST reaction prevalence, which would enhance BCG’s beneficial non-specific effects.     

TST联合外剥内扎术预防环状混合痔术后肛缘水肿的临床观察(附100例报告)

目的探讨选择性痔上黏膜切扎肛垫保留术(Tissue-Selecting Therapy Stapler,TST)联合外剥内扎术预防环状混合痔术后肛缘水肿的方法及疗效。方法对100例环状混合痔的患者行选择性痔上黏膜切扎肛垫保留术(TST)联合外剥内扎术,术后住院期间肛缘水肿情况进行评价。结果术后住院期间水肿得分情况:0分90例,1分8例,2分2例。住院天数7.5±4.5d。结论 TST联合外剥内扎术可以很好的保护肛垫组织,一定程度上阻断脱垂较严重的痔核的血供,可以良好的预防术后肛缘水肿的发生。     

Tuberculin skin testing in inflammatory bowel disease patients from an endemic area of Brazil

ObjectiveInflammatory bowel disease (IBD) is a chronic disorder involving the gastrointestinal tract. Immunosuppressive drugs are usually prescribed to treat IBD patients, and this treatment can lead to tuberculosis reactivation. This paper aimed to analyze tuberculin skin test (TST) results in IBD patients at a reference center in Brazil.MethodsWe evaluated TST results in IBD patients using a cross-sectional study. We also analyzed the medical records of patients treated at a reference IBD outpatient unit where TST is routinely performed.ResultsWe reviewed 119 medical records of 57 (47.9%) Crohn's disease (CD), 57 (47.9%) ulcerative colitis (UC) and 5 (4.2%) indeterminate colitis (IC) patients. The mean (SD) age was 43.5 (13.7) years old. TST was positive in 24 (20.2%) of the patients. TST was positive in 16/57 (28.1%) UC and 6/57 (10.5%) CD patients (prevalence ratio [PR] 2.7). Forty-one patients (34.5%) were taking immunosuppressive drugs (azathioprine or prednisone) at the time of the TST, and six of these patients (14.6%) had positive test results. Two patients using infliximab had negative TST results. Thirty-five of the 41 patients (85.4%) on immunosuppressive treatment were anergic compared with 73.1% (57/78) of the untreated patients (PR 1.2).ConclusionsPatients with IBD have TST results similar to the general Brazilian population. Within the IBD population, CD patients have a lower frequency of TST positivity than UC patients.     

Electrotherapy in mice: dopaminergic and noradrenergic effects in the Tail Suspension Test

The Tail Suspension Test (TST) is a psychotropic screening test which is used principally to detect antidepressant activity. Electrotherapy (ECT) is used to treat depressions which are resistant to the usual antidepressant drugs and has proved to have a profile in the TST approaching that of antidepressants after treating mice at the rate of 2 shocks per day for 5 days. The results of a single treatment were not statistically different from those of the control group, whereas single daily treatment for 5 days showed a reduction in immobility which did not differ significantly from the control group. The reduction in immobility, induced by 5 days of ECT treatment twice daily, was antagonized by sulpiride and prazosin but not by yohimbine, methysergide, metergoline and DL propranolol. The results suggest that electrotherapy leads to an increase in noradrenergic and dopaminergic activities expressed by a reduction in immobility in the TST.     

Involvement of AMPA receptors in the antidepressant-like effects of lithium in the mouse tail suspension test and forced swim test

In addition to its clinical antimanic effects, lithium also has efficacy in the treatment of depression. However, the mechanism by which lithium exerts its antidepressant effects is unclear. Our objective was to further characterize the effects of peripheral and central administration of lithium in mouse models of antidepressant efficacy as well as to investigate the role of alpha-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA) receptors in these behaviors. We utilized the mouse forced swim test (FST) and tail suspension test (TST), intracerebroventricular (ICV) lithium administration, AMPA receptor inhibitors, and BS3 crosslinking followed by Western blot. Both short- and long-term administration of lithium resulted in robust antidepressant-like effects in the mouse FST and TST. Using ICV administration of lithium, we show that these effects are due to actions of lithium on the brain, rather than to peripheral effects of the drug. Both ICV and rodent chow (0.4% LiCl) administration paradigms resulted in brain lithium concentrations within the human therapeutic range. The antidepressant-like effects of lithium in the FST and TST were blocked by administration of AMPA receptor inhibitors. Additionally, administration of lithium increased the cell surface expression of GluR1 and GluR2 in the mouse hippocampus. Collectively, these data show that lithium exerts centrally mediated antidepressant-like effects in the mouse FST and TST that require AMPA receptor activation. Lithium may exert its antidepressant effects in humans through AMPA receptors, thus further supporting a role of targeting AMPA receptors as a therapeutic approach for the treatment of depression.     

石榴籽油对小鼠抗抑郁作用的影响

目的:探讨石榴籽油对小鼠抗抑郁作用的影响。方法:120只小鼠随机分为3组,每组各40只。每组小鼠随机分为对照组、模型组、石榴籽油高剂量组及石榴籽油低剂量组,每组各10只。石榴籽油高剂量组、石榴籽油低剂量组灌胃剂量分别为0.03 m L·g-1、0.015 m L·g-1,对照组给予盐酸多塞平片,50 mg·kg-1,模型组每日给予等量生理盐水灌胃。给药后分别用于小鼠悬尾绝望实验(TST)、强迫游泳实验(FST)和利血平诱发的小鼠体温降低实验,观察石榴籽油对小鼠游泳不动时间和体温的影响。结果:石榴籽油高剂量组、低剂量组在一定程度可减少小鼠游泳不动时间,与模型组比较,差异具有统计学意义(P0.05);石榴籽油高剂量组、低剂量组可减少小鼠悬尾不动时间,与模型组比较,有显著性差异(P0.05);石榴籽油高剂量组、低剂量组与模型组比较,具有明显拮抗小鼠体温下降的作用,差异具有统计学意义(P0.05)。结论:石榴籽油具有抗抑郁作用。