A pilot randomized controlled trial of coblation tonsillectomy versus dissection tonsillectomy with bipolar diathermy haemostasis.

OBJECTIVES: To compare postoperative recovery in children between 4 and 12 years undergoing tonsillectomy, using either coblation tonsillectomy or dissection tonsillectomy with bipolar diathermy haemostasis. DESIGN: A prospective, single blind, randomised controlled trial. SETTING: ENT clinic, University Teaching Hospital. PARTICIPANTS: Forty paediatric patients, aged between 4 and 12 years and between 16 and 60 kg in weight with standard indication for tonsillectomy. METHODS: Patients were randomly allocated to either coblation tonsillectomy or dissection tonsillectomy groups. Patients, parents, and nurses were blinded for operation method. Parents were asked to fill out a postoperative diary from 1 to 10 days. MAIN OUTCOME MEASURES: Primary outcomes were scored for postoperative pain, nutrition, activity, and use of analgetics for each of the 10 postoperative days. Secondary outcomes were estimated from the nurses' postoperative data and 10-day follow-up statistics regarding crossing of the two-score limit. RESULTS: The groups were statistically comparable by age, weight and operation type. There was no significant difference in operation time in two groups. Intra-operative bleeding was significantly less in the coblation group. Statistically significant differences between dissection tonsillectomy and coblation tonsillectomy were found in the day when a score of two of five was passed in pain scores (9.6 versus 6.2), nutrition scores (8.9 versus 6.6), activity score (8.4 versus 6.6) and medicine intake (9.4 versus 6.4), We found parallelism, between regression lines, that indicates better postoperative life quality for the coblation tonsillectomy group and approximately 2 days' shorter recovery time. CONCLUSION: In our pilot study, patients undergoing coblation tonsillectomy reported less pain, quicker return to normal diet, quicker return to normal activity, and less use of analgetics over a 10-day period than patients undergoing dissection tonsillectomy. Our results indicate that the recovery period for coblation tonsillectomy was approximately 2 days shorter and demonstrated less morbidity.     

Diagnostic Value of the Aminopeptidase N,N-Acetyl-β-D-Glucosaminidase and Dipeptidylpeptidase IV in Evaluating Tubular Dysfunction in Patients with Glomerulopathies

Aim. The aim of the present study was to investigate the value of the urine cell glycoprotein 1 (PC-1), aminopeptidase N (APN), N-acetyl-β-D-glucosaminidase (NAGA), and dipeptidylpeptidase IV (DPP IV) in the evaluation of tubular damage in patients with primary glomerulonephritis, diabetic nephropathy, and lupus nephritis. Subjects and Methods. PC-1, APN, NAGA, and DPP IV activities were determined in serum, urine, and lymphocytes of 178 subjects, including 10 patients with membranous nephropathy, 38 with IgA nephropathy, 29 with lupus nephritis, 51 with diabetic nephropathy, and 50 control subjects. Results. Urinary PC-1 excretion in IgA nephropathy group was significantly higher (p < 0.05) than in controls. Urinary NAGA excretion was markedly (p < 0.01) higher in membranous nephropathy group, and APN excretion in diabetic nephropathy group was significantly higher (p < 0.01) than in healthy controls. Urinary APN activity was significantly (p < 0.01) higher in both type 1 and type 2 diabetic patients with microalbuminuria, as well as urinary NAGA and DPP IV activities in type 2 diabetics with microalbuminuria (p < 0.01 and p < 0.05, respectively) compared to controls. Serum PC-1 and APN activities were significantly higher than the control level in membranous nephropathy group, as well as serum PC-1 and DPP IV activities in IgA nephropathy patients (p < 0.05). However, significantly lower serum DPP IV and APN activity was observed in type 2 diabetics with microalbuminuria compared to controls (p < 0.05). Conclusion. Damage of tubules in primary glomerulonephritis, lupus nephritis, and diabetic nephropathy is accompanied by a release of several tubular enzymes, with possible diagnostic and prognostic significance. Increased serum PC-1, APN, and DPP IV activities could be also of diagnostic significance.     

Effects of Parsley (Petroselinum crispum.) and Celery (Apium graveolens.) Extracts on Induction and Sleeping Time in Mice

Abstract

The effects of different extracts of parsley and celery leaves (Et₂O, CHCl₃, EtOAC, n.-BuOH, and H₂O) on ketamine-induced sleeping time have been investigated. The experiments were conducted on BALB/C white laboratory mice divided in five groups. On the first day, each group received ketamine 40 mg/ml s.c. After 5 t_1/2 (next day), mice were treated with 10% extracts (Et₂O, CHCl₃, EtOAC, n.-BuOH, H₂O) of parsley and celery leaves, 1 ml/kg i.p. in two doses, each after 2-h interval. One hour after the last dose, animals received ketamine 40 mg/kg s.c. Just after administration of ketamine, induction time and time of sleeping were measured. Most of the examined extracts of both plants exhibited insignificant changes in induction time. Only the EtOAc extract of celery exhibited significant increase, whereas Et₂O and n.-BuOH extract of parsley induced significant decrease of induction time in treated animals. Furthermore, all examined extracts of both plants exhibited increase of sleeping time in animals treated with ketamine. The Et₂O extract of both celery and parsley exhibited the highest effect. Generally, examined celery extracts caused prolongation of sleeping time in animals compared with those obtained for parsley.     

The Educational Attainment of Children in Care in British Columbia

The purpose of this study was to determine if there was a difference in academic performance between children in care (referred to in British Columbia as children in continuing custody (CCC) and the general population of students in Grades 4, 7, and 10 in the areas of writing, reading, and numeracy. Data for the study consisted of merging information on children in continuing custody with the Foundation Skills Assessment (FSA) scores on all students in the public school system in British Columbia. Academic performance among CCC was found to be significantly lower than in the general population of students. This finding occurs across all grades studied and across all subject categories. Implications of the findings are discussed and a comprehensive strategic model is presented.     

Erratum to: Vascular access registry of Serbia: a 4-year experience

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