Hemorrhoidal laser procedure: short- and long-term results from a prospective study

Background

We report the results of 2-year regular use of the hemorrhoidal laser procedure (HeLP) in 97 patients with symptomatic second- to third-grade hemorrhoids with minimal or moderate internal mucosal prolapse.

Methods

Data on duration of the procedure, perioperative complications, postoperative pain, downgrading of hemorrhoids, resolution or persistency, and recurrence of hemorrhoidal disease (HD) were prospectively collected.

Results

No significant intraoperative complications occurred. The median follow-up was 15 months. Postoperative pain was null in most patients. There were no cases of rectal tenesmus or alteration of defecation habits. Symptoms and HD downgrading reached a “plateau” at 3 to 6 months after the HeLP. At this evaluation, frequency of bleeding, pain, itching, and hemorrhoidal acute syndrome decreased by 76% to 79%. HD grade showed a significant reduction. HD recurrence rate was 5% at 2 years.

Conclusions

Our study demonstrates that the HeLP is a safe, effective, and painless technique for the treatment of symptomatic second- to third-grade hemorrhoids with minimal or moderate mucosal prolapse, ideally suitable as ambulatory treatment.     

Malondialdehyde and antioxidant enzymes in children with obstructive adenotonsillar hypertrophy

OBJECTIVE: Free radical induced tissue damage has been implicated in the pathogenesis of several diseases. We aimed to investigate the role of free radicals and scavenging enzymes in children with obstructive adenotonsillar hypertrophy. MATERIALS AND METHODS: The study consisted of 29 children with obstructive adenotonsillar hypertrophy and 51 control subjects with similar age and sex. All the patients and/or their parents had complaints of snoring, mouth breathing, and pausing of breath during sleep for at least 6 months. All patients underwent an adenotonsillectomy operation under general anesthesia with curettage and cold dissection methods. Venous blood was taken preoperatively and 4 weeks postoperatively. After collection of blood samples into citrate (3.5 mg/ml blood) containing glass tubes, erythrocyte sediments were prepared for the analyses. Then malondialdehyde (MDA) level, and superoxide dismutase (SOD), glutathione peroxidase (GSHPx), and catalase (CAT) activities were measured. RESULTS: The levels of MDA and activities of SOD and GSHPx were significantly higher in the pre-tonsillectomy period than in the post-tonsillectomy period. However, CAT activity was not different in pre- and postoperative period. CONCLUSION: Our study supports the notion that oxidant and antioxidant defense mechanisms are altered in children with obstructive adenotonsillar hypertrophy, and this alteration improves after tonsillectomy.     

Differences in the in vitro susceptibility to resveratrol and other chemical compounds among several Philasterides dicentrarchi isolates from turbot

Philasterides dicentrarchi is a histophagous scuticociliate that causes important losses in aquaculture. Several strains that differ in morphological, genetic and serological characteristics and virulence have been isolated from outbreaks of turbot scuticociliatosis. In the present study, seven isolates of the ciliate were exposed in vitro to formalin, hydrogen peroxide and resveratrol (a phytoalexin produced by plants) in order to evaluate the susceptibility of the isolates to the different compounds. The LD50 values for the three compounds tested varied widely among the isolates. The LD100 values were similar among isolates for formalin (25–30 ppm) and resveratrol (60–70 ppm) but were very different for hydrogen peroxide (25–>80 ppm). The results indicate that there are many physiological differences among isolates and even among specimens of the same isolates, which must be taken into account in designing control programmes. The naturally occurring resveratrol may be a good alternative to other compounds for reducing the amounts of viable ciliates in water.     

The influence of adding fats of varying saturation on the glycaemic response of white bread

The aim of this study was to examine the effect of three different fats of varying degrees of saturation on the glycaemic response of white bread. Standard white bread was served alone or with 30 g butter, 24.8 g olive oil or 24.8 g grape-seed oil. On separate occasions, 15 subjects consumed the four test foods and reference food (glucose) in 50 g available carbohydrate amounts. Capillary blood glucose was measured from finger-prick samples in fasted subjects (-5 and 0 min) and at 15, 30, 45, 60, 90 and 120 min after starting to eat. All fats lowered the glycaemic response of bread; however, no significant differences in glycaemic index were recorded between the types of fat used when ingested with bread. The results of the present study suggest that the glycaemic response of bread can be lowered using any type of fat; therefore, the use of unsaturated fat is recommended for its potential lipidaemic advantage.     

Novel low-cost assay for the monitoring of CD4 counts in HIV-infected individuals

Several CD4 lymphocyte enumeration methods have been developed to be used as alternatives to conventional flow cytometry. However, no consensus has been reached on which technique should be widely adopted. We introduce here a novel nonflow cytometric method, called CD4 Select, for enumeration of CD4 lymphocytes. Instead of using a flow cytometer, the method requires only an automatic hematoanalyzer (complete blood count [CBC] machine). The correlations of the percentage of CD4 lymphocytes and absolute CD4 counts with the CD4 Select method and standard flow cytometry were 0.932 and 0.922, respectively. The CD4 Select method yielded percentage of CD4 lymphocytes greater than flow cytometry by a mean of 0.06%, and the limits of agreement at 95% confidence interval (CI) were 9.46% to -9.56% using Bland-Altman analysis. The CD4 select method is cheap, valid, and simple enough to be conducted locally at small facilities. The method yields not only absolute CD4 lymphocytes, but also percentage of CD4 lymphocytes. The use of a hematoanalyzer also gives this method relatively high sample throughput and makes it less labor-intensive than other nonflow cytometric methods.     

Genetic polymorphism of N-acetyltransferase 2 in the susceptibility to laryngeal squamous cell carcinoma

BACKGROUND: The purpose of this study was to investigate whether polymorphism of N-acetyltransferase 2 (NAT2) genotypes are associated with the risk of laryngeal squamous cell carcinoma (SCC). METHODS: The study group consisted of 45 white patients with laryngeal SCC (42 men, with a mean age of 54 years [range, 37-70 years] and three women, with a mean age of 47 years [range, 32-55 years]) and 104 control subjects (68 men and 36 women; mean age, 50 years; range, 28-73 years). All of the patients were primarily treated with surgical intervention. Blood samples (5 mL) were obtained before surgery or from the patients under follow-up to 5 years after surgery (mean follow-up, 27 months; range, 6-48 months). DNA was extracted from the lymphocytes by high pure template preparation kit. NAT2*5A, NAT2*6A, NAT2*7A/B, and NAT2*14A were detected by use of LightCycler-NAT2 mutation detection kit by real-time polymerase chain reaction with Light Cycler instruments. The association between NAT2 polymorphisms and laryngeal SCC was prospectively modeled through multivariate logistic regression analysis. RESULTS: We found that the risk of laryngeal SCC was 7.3-fold higher in individuals with NAT2*5 mutant allele, 3.8-fold higher in subjects with NAT2*6 heterozygote allele, and 38.3-fold higher in NAT2*6 mutant allele. We also found that individuals with NAT2*7 heterozygote allele had a 0.2-fold less risk for the development of laryngeal SCC (p = .018). CONCLUSION: In this population, patients with NAT2*5 mutant and *6 heterozygous and mutant genotypes had a significantly higher risk for development of laryngeal SCC.