Effect of glutamine supplementation on diarrhea, interleukin-8 and secretory immunoglobulin A in children with acute diarrhea

OBJECTIVE: Glutamine is an important fuel for rapidly dividing cells such as enterocytes and lymphocytes. Exogenous glutamine supplementation in catabolic states preserves intestinal mucosal structure and function, decreases bacterial translocation, and supports normal immunologic responses. This study was planned to assess the effect of glutamine supplementation on duration and severity of diarrhea and to assess its immunomodulatory effect by measuring serum interleukin-8 (IL-8) and salivary immunoglobulin A (sIgA) in children with acute diarrhea. METHODS: In this placebo-controlled, double-blind and randomized trial, 6- to 24-month-old otherwise healthy children admitted to the Diarrheal Diseases Training and Treatment Center with acute diarrhea received either 0.3 g/kg/day of glutamine (n = 63) or placebo (n = 65) for 7 days. Serum IL-8 and sIgA levels were determined on admission and 7 days later. All cases were followed until the diarrheal episode ended. Anthropometric measurements and history of subsequent infectious diseases were monitored monthly for 3 months after treatment. RESULTS: Mean duration of diarrhea in the glutamine treated group was significantly shorter than that of the placebo group (3.40 +/- 1.96 days, 4.57 +/- 2.48 days, respectively; P = 0.004). No differences in serum IL-8 and sIgA were found between groups on admission or 1 week later. During 3 month follow-up, mean weight gain and incidence of infectious diseases were similar in both groups. CONCLUSION: Duration of diarrhea was shorter in children supplemented with glutamine. The beneficial impact of glutamine supplementation seems to be through effects on gastrointestinal mucosa rather than the host immune response.     

Hypercalcemia associated with a uterine leiomyoma: a case report and review of the literature

BACKGROUND: Humoral hypercalcemia is known to be an important cause of hypercalcemia associated with malignancy. Humoral hypercalcemia due to benign conditions has been rarely reported. CASE: We report on a 45-year-old woman with humoral hypercalcemia secondary to uterine leiomyoma. Following the surgical removal of leiomyoma by hysterectomy, serum calcium, suppressed parathyroid hormone (PTH) and elevated parathyroid hormone-related protein (PTH-rP) levels were normalized. CONCLUSIONS: To our knowledge, this is the second reported case of humoral hypercalcemia associated with uterine leiomyoma. We suggest that for women with hypercalcemia who had suppressed PTH and elevated PTH-rP levels, uterine leiomyoma should be included in the differential diagnosis.     

Penile prosthesis extrusion due to gonococcal infection

Gonococcal infection of a penile prosthesis is a rare presentation of a common disease. Here we report two cases of penile prosthesis extrusion due to gonococcal infection.     

Seroprevalence and some correlates of Helicobacter pylori at adult ages in Gülveren Health District, Ankara, Turkey

The purpose of the study was to detect the frequency and distribution of Helicobacter pylori in the Gülveren Health Centre service area among residents aged between 25 and 64 years and to evaluate the relation of H. pylori infections with general health status, socioeconomic status, and some lifestyle habits. The study included a representative sample of Gülveren Health Centre residents, aged between 25 and 64 years. A stratified random sample of 1672 individuals was selected for study purposes out of 10,569 residents, stratified by age and gender. A standardized questionnaire was completed for all study participants using a face-to-face interview and all participants were invited to the local health centre for a thorough physical examination and blood tests. The overall prevalence of H. pylori was found to be 77.5 % among individuals aged between 25 and 64 years. The frequency of H. pylori was higher among individuals with low socioeconomic status; those who migrated to Ankara after the age of 20 years; members of large families (household size of 4 or above); non-alcohol drinkers; and those who regularly drink tea.     

Irradiation After Surgically Induced Brain Injury in the Rat: Timing in Relation to Severity of Radiation Damage

The aim of this study was to evaluate how timing of irradiation after brain surgery in rats relates to overall extent of brain radiation damage. Extent of injury was determined according to lipid peroxidation (malondialdehyde; MDA) levels in brain tissue. Thirty female rats were randomly assigned to five equal groups (Groups A-E). Four groups underwent trephination and scalpel hemisection of right frontal lobe. Rats in Groups B and D received 25 Gy cranial irradiation in a LINAC system at 10 and 20 days after surgery, respectively. Twenty-four hours later they were killed and their right frontal lobes were removed for lipid peroxidation determination. Groups A and C were not irradiated; these groups were killed and had their frontal lobes removed on day 11 and day 21 post-surgery, respectively. The remaining six animals (Group E, sham surgery) underwent trephination only, and were killed and had their frontal lobes removed 24 h later. There was a significant difference between the mean MDA levels in the control group and Group D, and between the levels in Group B and Group D (P < 0.05 for both). The difference between the mean for Group A and the mean for Group B was even more significant (P < 0.01). The most striking differences were between the control group and Group B, and between Group B and Group C (P < 0.001 for both). The data from this rat model suggest that, in humans, starting radiotherapy early (1-2 weeks) after debulking of a brain tumor may result in significantly higher levels of tissue damage than if the radiation is started 3 weeks or more postoperatively. Further experimental research is needed to project these findings in rats to human subjects.     

Antioxidant enzyme and malondialdehyde values in social phobia before and after citalopram treatment

A growing body of evidence indicates that oxidative stress is involved in the etiopathogenesis of some psychiatric disorders. In our previous study, we have found that social phobia (SP) seems to be associated with elevated antioxidant enzymes and malondialdehyde (MDA) levels, a lipid peroxidation product. In the present investigation, we sought to determine whether the increased radical burden observed in patients with SP would be attenuated with alleviation of symptoms. Thirty-nine patients diagnosed with generalized SP and 39 healthy controls participated in this study. The measurements of MDA, superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase (CAT) were performed before and after a period of 8 weeks of citalopram treatment. In this period, the patients received citalopram but controls did not. The initial dose of citalopram was 20mg, with 20 mg increments occurring every 2 weeks, to a maximum dose of 60 mg, with the mean daily dose of 38.9 +/- 13.3 mg/day. All patients were evaluated by using Liebowitz Social Anxiety Scale (LSAS). The mean MDA, SOD, GSH-Px and CAT levels of the patient group at baseline were significantly higher than those of controls. Antioxidant enzymes and MDA levels decrease significantly through citalopram treatment. Significant and positive correlation was observed between decrease in the total LSAS scores, and SOD or CAT levels. In conclusion, our results suggest that, in patients with SP, subchronic treatment with citalopram may decrease antioxidant enzymes and MDA values and that they are state markers of SP because they return to normal values with treatment.     

Free radicals in patients with post-traumatic stress disorder

There is mounting evidence indicating that reactive free radical species (FRs) are involved in initiation and development of many different forms of human pathologies including psychiatric disorders. In the present study, we aimed to determine whether antioxidant enzyme (glutathione peroxidase, GSH-Px; superoxide dismutase, SOD and catalase, CAT) activities and malondialdehyde (MDA) levels, a product of lipid peroxidation, were associated with post-traumatic stress disorder (PTSD). The study comprised 14 patients who had been diagnosed with PTSD according to DSM-IV criteria and met the admission criteria and 14 healthy controls. The activities of GSH-Px SOD, CAT and MDA were measured in both the patients and controls. In addition, all patients were assessed using the Clinician Administered PTSD Scale (CAPS). The mean GSH-Px, SOD, CAT activities and MDA levels of the patient group did not differ from those of the controls. However, in patients, the GSH-Px and SOD activities were significantly and positively correlated with CAPS scores, while there was a trend toward positive correlations between CAPS scores and MDA or CAT. In conclusion, our results suggest that the production of FRs does not seem to be related to PTSD.     

Neopterin production in posttraumatic stress disorder before and after pharmacotherapy

Post-traumatic stress disorder (PTSD) has been associated with decreased neopterin levels. In the present study, we evaluated whether this low neopterin levels would normalize following pharmacotherapy with sertraline in PTSD. Fourteen patients with PTSD and 14 controls were enrolled in the study. A clinical evaluation and measurements of neopterin levels before and after sertraline treatment were performed. In addition, all patients were assessed with the Clinician Administered PTSD Scale (CAPS). The mean neopterin levels were significantly lower in the patient group than control group at baseline and were negatively correlated with the duration of illness, or severity of illness. Sertraline treatment decreased the symptoms of PTSD; however this was not accompanied by a significant increase in neopterin production. In conclusion, our results reveal that the failure for neopterin to normalize through symptom alleviation suggests that either neopterin may be a trait marker of the illness, or that more sustained treatment is necessary to elevate the neopterin production. Received: 30 September 2002 / Accepted: 12 December 2002 Correspondence to Dr. Murad Atmaca