Inhibitory effects of aspirin and indometacin on the growth of Helicobacter pylori in vitro

OBJECTIVE: The interactions between non‐steroidal anti‐inflammatory drugs and Helicobacter pylori have not been sufficiently documented to date. The aim of this study was to investigate the possible effects of aspirin and indometacin on the growth of H. pylori and to determine the effects of aspirin on the susceptibility of H. pylori to some antimicrobials. METHODS: Kinetic studies were performed by inoculating strains of H. pylori in brucella broth with different concentrations of aspirin and indometacin. Growth of bacteria in the broth was assessed spectrophotometrically and by viable colony counts after incubation for 24 and 48 h. Bacterial morphology was determined by Gram stain under light microscopy. The minimal inhibitory concentration (MIC) of aspirin and indometacin was determined by the standard agar dilution method. The MIC of amoxicillin, clarithromycin and metronidazole was measured in the presence and absence of aspirin by the E‐test method. RESULTS: Kinetic studies revealed that aspirin and indometacin inhibited the growth of H. pylori in a dose‐dependent manner. The bactericidal activity of these agents was expressed by cell lysis. Aspirin at 400 µg/mL produced an almost 2‐log decrease in the number of CFU/mL at 48 h. Similar inhibitory effects were obtained when 100 µg/mL indometacin was tested. The MIC at which 90% of H. pylori was inhibited was 512 µg/mL and 128 µg/mL for aspirin and indometacin, respectively. Increased susceptibility of H. pylori to amoxicillin, clarithromycin and metro­nidazole was found in the presence of aspirin. CONCLUSIONS: Aspirin and indometacin could significantly inhibit the growth of H. pylori when incubated in brucella broth in vitro. A subinhibitory concentration of aspirin enhanced the susceptibility of H. pylori to some antimicrobial agents.     

POTENTIAL FALSE-POSITIVE RESULTS WITH ANTIGEN ENHANCEMENT FOR IMMUNOHISTOCHEMISTRY OF THE p53 GENE PRODUCT IN COLORECTAL NEOPLASMS

Aberrant crypt foci (ACF) are putative precursor lesions of colon cancer, recently identified on the methylene blue-stained mucosal surface of human colon. No mutations in K- ras or p53 genes were found by non-radioactive single-strand conformation polymorphism analysis in 14 ACF collected from five patients. Using the more sensitive method of allele-specific polymerase chain reaction (PCR) for K- ras , 8 of 14 ACF were found to contain K- ras mutations, suggesting that mutated cells are present in minute clones in ACF. No dysplasia was observed in any of the ACF containing a mutated clone. The presence of K- ras mutations in ACF suggests that these lesions occur at a very early stage in human colorectal carcinogenesis.     

Metabolic responses in ischemic myocardium after inhalation of carbon monoxide

Background: To clarify the mechanisms of carbon monoxide (CO) tissue-protective effects, we studied energy metabolism in an animal model of acute coronary occlusion and pre-treatment with CO.
Methods: In anesthetized pigs, a coronary snare and microdialysis probes were placed. CO (carboxyhemoglobin 5%) was inhaled for 200 min in test animals, followed by 40 min of coronary occlusion. Microdialysate was analyzed for lactate and glucose, and myocardial tissue samples were analyzed for adenosine tri-phosphate, adenosine di-phosphate, and adenosine mono-phosphate.
Results: Lactate during coronary occlusion was approximately half as high in CO pre-treated animals and glucose levels decreased to a much lesser degree during ischemia. Energy charge was no different between groups.
Conclusions: CO in the low-doses tested in this model results in a more favorable energy metabolic condition in that glycolysis is decreased in spite of maintained energy charge. Further work is warranted to clarify the possible mechanistic role of energy metabolism for CO protection.     

A survey of pediatric caudal extradural anesthesia practice

Background:  Caudal extradural blockade is one of the most commonly performed procedures in pediatric anesthesia. However, there is little information available on variations in clinical practice.
Objectives:  To perform a survey of members of the Association of Paediatric Anaesthetists of Great Britain and Ireland who undertake caudal anesthesia.
Methods:  An 'online' World Wide Web questionnaire collected information on various aspects of clinical practice. The survey ran from April to June 2008.
Results:  There were 366 questionnaires completed. The majority of respondents had >5 years of pediatric experience and performed up to ten caudal extradural procedures a month. The commonest device used was a cannula (69.7%) with 68.6% using a 22G device. There was a trend toward the use of a cannula in those anesthetists with <15 years experience, while those with >15 years experience tended to use a needle. Most anesthetists (91.5%) did not believe that there was a significant risk of implantation of dermoid tissue into the caudal extradural space. The majority used a combination of clinical methods to confirm correct placement. Only 27 respondents used ultrasound. The most popular local anesthetics were bupivacaine (43.4%) and levobupivacaine (41.7%). The most common additives were clonidine (42.3%) and ketamine (37.5%). The caudal catheter technique was used by 43.6%. Most anesthetists (74%) wear gloves for a single shot caudal injection.
Conclusions:  This survey provides a snapshot of current practice and acts a useful reference for the development of enhanced techniques and new equipment in the future.     

Renal Function and Albumin Excretion during Exercise in Children during Remission of the Minimal Change Nephrotic Syndrome

ABSTRACT. Six patients with the minimal change nephrotic syndrome in remission and seven healthy controls were investigated with regard to renal haemodynamics and albumin excretion before, during and after exercise. The glomerular filtration rate and effective renal plasma flow were determined by a standard clearance method, employing continuous infusion of inulin and para-aminohippuric acid. Microalbuminuria was measured by an immunoturbidimetric method. The work load was standardized at 70% of the maximal working capacity and was applied for 20 min. During exercise there was a significant fall in the glomerular filtration rate and effective renal plasma flow and a significant rise in the filtration fraction. The pattern of renal haemodynamic changes did not differ between the groups. Nor was there any statistically significant difference in urinary albumin excretion, although the exercise-induced increase in albumin excretion of the controls did not reach statistical significance. It is concluded that the renal haemodynamics and urinary albumin excretion of children having long remissions of the minimal change nephrotic syndrome are normal at rest as well as during and after a submaximal exercise test.     

RENAL FUNCTION TESTS IN NONACUTE RECURRENT URINARY TRACT INFECTIONS IN CHILDREN

The clinical value of various renal function tests in recurrent urinary tract infections in children has been examined. The study also includes an evaluation of glomerular capacity versus tubular capacity in recurrent urinary tract infections. There was no good correlation between blood urea nitrogen concentration and serum creatinine concentration within the normal limits for these two parameters. When blood urea nitrogen concentration and/or serum creatinine concentration were elevated, a highly significant correlation between the two parameters was found. When relating blood urea nitrogen concentration to the clearance of inulin an elevation of blood urea nitrogen concentration was not found until the filtration rate was below 50 ml/min/1.73 m² b.s. The tubular functions were examined by studies of (a) the concentrating capacity, (b) the diluting capacity, (c) sodium reabsorption and id) renal acid-base regulation. The concentrating capacity was determined by two screening tests, maximal urine osmolality after 19 hours of fluid and food deprivation with or without injection of pitressin tannate, and by free water reabsorption. The administration of exogenous pitressin had no significant effect on maximal urine osmolality. There was a highly significant correlation between free water reabsorption and maximal urine osmolality. A highly significant correlation was also found between free water reabsorption and glomerular filtration rate. Diluting capacity was evaluated by determining minimum urine osmolality and free water clearance. A highly significant correlation between minimum urine osmolality and free water clearance was obtained. There was a good correlation between free water clearance and glomerular filtration rate. When sodium reabsorption is depressed below normal, urine sodium concentration during hydropenia is abnormally low. A normal standard bicarbonate level does not exclude a defect in renal acidifying mechanisms. A defect renal acidifying capacity could be found even in patients with normal filtration rates indicating that renal acidifying capacity might be the first sign of renal damage in children with recurrent urinary tract infections.