The effect of vitamin A on renal damage following acute pyelonephritis in children

Animal studies suggest that administration of vitamin A to rats with experimental urinary tract infection decreases the frequency of renal scars (Kavukçu et al., BJU Int 83(9):1055–1059, 1999). The aim of this study was to determine the effect of vitamin A on the rate of permanent renal damage in children with acute pyelonephritis. Fifty children, median age of 24 months (range 2–144), with first-time pyelonephritis verified by an uptake defect on acute dimercaptosuccinic acid (DMSA) scan were included in the study and randomly allocated to the case or control groups. All were given intravenous ceftriaxone for 10 days followed by oral cephalexin for 3 months. Cases in addition were given a single intramuscular dose of vitamin A, 25,000 U for infants below 1 year of age and 50,000 U for older children. At the repeat DMSA scan after 3 months, five of 25 cases (20%) and 17 of 25 controls (68%) had abnormal findings (p?=?0.001). In conclusion, administration of vitamin A was associated with a significantly lower rate of permanent renal damage.     

Isolation and characterization of a novel γ‐radiation‐resistant bacterium from hot spring in Iran

30 pure colonies with various colors and shapes were isolated from the samples of water and mud which were collected from the Abe‐Siah hot springs in Ramsar, a city in north of Iran, with high‐level of radiation (up to 4 Gy). Colonies were irradiated by 22 KGy radiations and only one of them survived. The survived bacterium with an optimum growth of 30 to 37 °C, pH 6 to 7, and at minimum of 5% NaCl concentration showed promising characteristics. This strain is aerobic, mesophilic, white colony, with catalase‐positive, oxidase‐negative, non motile, spore forming, rod‐shape and finally Gram positive. Strain Bacillus sp. WHO represented a strain of genus Bacillus megaterium according to a phylogenetic analysis of the 16S rDNA and biochemical features. Its radio‐resistancy was compared with E. coli and B. megaterium which were inactivated in 2 KGy and 5.9 KGy respectively. In order to reveal the mechanisms of this extreme radio‐resistancy and WHO DNA repair system we examined its proteomic map, following γ‐irradiation, using two‐dimensional polyacrylamide gel electrophoresis and silver‐staining. The expression levels of majority number of protein spots showed significant changes under radiation stress. (© 2009 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)     

Long-term Follow-up After Anti-reflux Surgery in Patients with Barrett’s Esophagus

Background  

Factors associated with the risk of progression of Barrett’s esophagus remain unclear, and the impact of therapy on this risk remains uncertain. The aim of this study was to assess patients followed long-term after anti-reflux surgery for Barrett’s esophagus.     

Analysis of data from the CDC/FDA Vaccine Adverse Event Reporting System (1990-2009) on Guillain-Barre syndrome after hepatitis vaccination in the USA

We used data from the Vaccine Adverse Event Reporting System, supplemented by additional data provided by the Center for Biologics Evaluation and Research, to identify 189 patients with Guillain–Barré syndrome (GBS) reported after hepatitis vaccination with a mean age of 30.65 years, affecting men and women equally. Among vaccinated patients, 133 (70%) developed GBS within six weeks, 30 (15.9%) after six weeks, and for the remaining 26 (13.7%), the time between GBS occurrence and vaccination was not specified. The reporting rate of post-hepatitis vaccine GBS is approximately 3.4 cases per one million vaccinations, which is in the range expected in the general population. The unbalanced distribution of reports in the first six weeks after vaccination suggests that some cases of GBS may be triggered by vaccination. Nonetheless, the low incidence of hepatitis vaccine-associated GBS, and the dramatic incidence reduction of hepatitis and its complications after vaccination, support the current guidelines for vaccination.     

Ineffective esophageal motility: The impact of change of criteria in Chicago Classification version 4.0 on predicting outcome after magnetic sphincter augmentation

Background

The most recent update of the Chicago Classification (CCv4.0) attempts to provide a more clinically relevant definition for ineffective esophageal motility (IEM). The impact of this new definition on predicting outcome after antireflux surgery is unknown. The aim of this study was to compare utility of IEM diagnosis based on CCv4.0 to CCv3.0 in predicting surgical outcome after magnetic sphincter augmentation (MSA) and to assess any additional parameters that hold value in future definitions.

Methods

Records of 336 patients who underwent MSA at our institution between 2013 and 2020 were reviewed. Preoperative manometry files were re-analyzed using both Chicago Classification version 3.0 (CCv3.0) and CCv4.0 definitions of IEM. The utility of each IEM definition in predicting surgical outcome was then compared. Individual manometric components and impedance data were also assessed.

Key Results

Immediate dysphagia was reported by 186 (55.4%) and persistent dysphagia by 42 (12.5%) patients. CCv3.0 IEM criteria were met by 37 (11%) and CCv4.0 IEM by 18 (5.4%) patients (p = 0.011). CCv3.0 and CCv4.0 IEM were equally poor predictors of immediate (AUC = 0.503 vs. 0.512, p = 0.7482) and persistent (AUC = 0.519 vs. 0.510, p = 0.7544) dysphagia. The predicted dysphagia probability of less than 70% bolus clearance (BC) was 17.4%, higher than CCv4.0 IEM at 16.7%. When BC was incorporated into CCv4.0 IEM criteria, the probability increased significantly to 30.0% (p = 0.0042).

Conclusions & Inferences

The CCv3.0 and CCv4.0 of IEM are poor predictors of dysphagia after MSA. Adding BC to the new definition improves its predictive utility and should be considered in future definitions.