Intratracheal N-acetylcysteine use in infants with chronic lung disease

To evaluate the effect of intratracheal administration of N-acetylcysteine (Mucomyst) on the clinical status, pulmonary function and gas exchange in premature infants with chronic lung disease, we conducted a randomized, placebo-controlled, crossover trial. Ten mechanically ventilated infants (gestational age 27 +/- 1 week; postnatal age 22 +/- 6 days) with clinical and radiological evidence of chronic lung disease and increased airway secretion were enrolled in the study. Each infant received tracheal administration of 5% N-acetylcysteine for one week and saline placebo every 4 h for another week. N-acetylcysteine was associated with a 59 +/- 26% increase in total airway resistance by the third day of treatment (p less than 0.01). A two-fold increase in airway resistance associated with an increased frequency of bradycardia and cyanosis spells was seen in two of the infants following three days of N-acetylcysteine administration, with a rapid improvement in their condition when subsequently switched to saline. Overall, N-acetylcysteine administration had no effect on the variables measured. We conclude that intratracheal administration of N-acetylcysteine to liquefy airway mucus neither improves the clinical condition nor hastens recovery in premature infants with chronic lung disease and its administration may lead to increased total airway resistance and cyanotic spells. The present data do not support the use of N-acetylcysteine as a mucolytic agent in premature infants with chronic lung disease.     

Acquired local resistance to burns: Prevention of its acquisition by chlorpromazine

Chlorpromazine administered to Sprague-Dawley rats 30 minutes prior to burning dramatically minimized burn oedema by a factor of 7 compared with controls. Reburning of the rats 72 hours later demonstrated acquisition of local (but not systemic) resistance to subsequent burning among the control animals, and prevention of the acquisition of local resistance by the previously treated chlorpromazine group. The pharmacological actions of chlorpromazine are discussed in relation to the above phenomena, and mechanisms for the results obtained are described.     

Differences in lung function among school children in communities in Israel

Differences in lung functions of school-age children who lived near two electrical power plants in the Ashkelon district of Israel were studied. Lung-function tests were performed, and the American Thoracic Society questionnaire was administered in three study periods during the following years: (1) 1990, (2) 1994, and (3) 1997. Measurements of air pollutants (i.e., sulfur dioxide, nitric oxides, ozone) were also taken during the aforementioned study periods. Statistical analysis included an estimation of a series of fixed-effects regression models. A total of 2,455, 1,613, and 4,346 observations were included in the analyses for study years 1990, 1994, and 1997, respectively. The authors controlled for age, sex, height, weight, parents' education and smoking status, and being born out of Israel, and, consequently, substantial differences in lung function across the different communities and study periods were demonstrated in the study area. No robust association with air pollution was demonstrated. The cause of these differences in the respiratory health of children remains unknown.     

Imipramine hydrochloride and desipramine hydrochloride as new reagents for detection of microamounts of blood in urine

Benzidine and o-tolidine, the hazardous carcinogens are still in use for the detection of blood in urine. Development of safer substitutes are of paramount importance. Unfortunately, the alternate available reagents lack specificity, sensitivity and reproducibility. Imipramine hydrochloride (IPH) and desipramine hydrochloride (DPH) are proposed as new reagents for the detection of blood in urine. Both the reagents impact to blood a green-blue to blue color, in the presence of acetic acid and hydrogen peroxide and the development of this color is explored under laboratory conditions. IPH or DPH compares favorably with benzidine and multistix methods. Both the reagents are relatively inexpensive, and have required sensitivity and stability. The proposed reagents offer advantages of relatively low sensitivity to endogenous vegetable peroxidases; hence, the test can be performed on samples taken from patients who are on a normal diet and the results are reproducible. Besides, the reagents, are non-carcinogenic and can replace benzidine and o-tolidine without any extra procedural difficulties as they also exhibit a similar blue color.     

Bilateral hydatid cyst of the fallopian tubes: a case report

We report an exceptional case of bilateral hydatid cysts that developed solely in the fallopian tubes of a young girl. The diagnosis was suggested by the clinical history, the patient's residence in an endemic area, and the ultrasound findings and was confirmed peroperatively. Due to the extensive damage bilateral salpingectomy was required compromising future reproduction potential. We discuss the pathogenesis of pelvic localizations and the ultrasound aspects of pelvic hydatid cysts.     

Fetal thoraco-omphalopagus. Prenatal ultrasonographic diagnosis at 15 weeks

A case of ultrasonographic prenatal diagnosis of conjoined thoraco-omphalopagus twins is reported at the fifteenth week of amenorrhea. Ultrasonography is the only mean of antepartum diagnosis of conjoined twins; Several diagnostic criteria are recalled as well as etiopathogenic and epidemiological considerations of this rare malformation which may concern 1/15.000 to 1/100.000 pregnancies.     

Pseudoaneurysm of the uterine artery: apropos of 1 case

Pseudoaneurism of the uterine artery is uncommon and is usually associated with pregnancy or surgical trauma. Diagnosis is based on both Doppler sonography and arteriography. We report a case of pseudoaneurysm of the uterine artery associated with a leiomyoma without prior surgery or pregnancy. Treatment, which consisted on laparotomy, allowed avoiding rupture and confirmed diagnosis.