Erdosteine prevents bleomycin-induced pulmonary fibrosis in rats

Oxidative stress plays an important role in the pathogenesis of idiopathic pulmonary fibrosis. Therefore, erdosteine, an antioxidant, is expected to have an inhibitor potential against the disease. Rats were given one dose of bleomycin in pulmonary fibrosis groups and saline in controls. The first dose of oral erdosteine (10 mg/kg/day) was given 2 days before the bleomycin injection to achieve the plateau level in blood and continued until killing. At day 14, fibrotic changes were evaluated, using Aschoft's criteria and lung hydroxyproline content. Bleomycin produced a fivefold increase in fibrosis score that was decreased by 87% by erdosteine (P>0.001) and almost twofold increases in hydroxyproline content which were completely prevented by erdosteine. Myeloperoxidase activities and MDA levels, which were significantly higher in the bleomycin group, were then significantly attenuated by erdosteine. These results revealed that oral erdosteine may prevent the development of acute pulmonary inflammation caused by bleomycin injection via the repression of neutrophil accumulation and lipid peroxidation, resulting in the inhibition of subsequent lung fibrosis.     

Correlation of serum IgE levels with severity of acute pulmonary thromboembolism

We aimed to investigate whether there is a direct correlation of serum IgE concentration with severity of acute pulmonary thromboembolism (PTE). DESIGN: Prospective study. SETTINGS: University medical center. Forty-six patients (27 female, 19 male) who were diagnosed as acute PTE in our clinic between 01 October 2000 and 30 November 2001 comprised the study group. Mean age was 55 (range was 20-82). The study group was divided into three groups according to severity of PTE: Group A, submassive PTE without pulmonary infarction (20 patients); group B, submassive PTE with pulmonary infarction (15 patients); and group C, massive PTE (11 patients). Serum IgE concentrations were measured by ELISA method at 1st, 5th, 15th, 30th, 60th, 90th days, and 120th days, if needed, after the diagnosis. Statistical analysis was made by Post hoc Tukey test. First day serum IgE levels were highest in group B (mean 507.7) followed by group C (mean 324.2), and were lowest in group A (mean 117.2). The differences between group B and group C, between group B and group A, and also between group C and A were all statistically significant (p< 0.5, p< 0.0001, p< 0.015, respectively). 5th day and 15th day results showed statistically significant differences between group B and A, and between group C and A (at 5th day: p<0.0001, p< 0.015 respectively, and at 15th day: p< 0.0001, p< 0.012 respectively). At 30th, 60th, and 90th days of diagnosis serum IgE concentrations were higher in group B than in group A which were statistically significant (p< 0.0001, p< 0.0001, p< 0.019 respectively). Patients with submassive PTE and pulmonary infarction had the highest serum IgE concentrations and the longest duration of high levels of IgE.     

A Turkish medical rescue team against nuclear, biological, and chemical weapons

Medical aid is one of the primary responses given in the deliberate release of weapons of mass destruction for both military and terrorist purposes. From this point of view, a nuclear, biological, and chemical (NBC) Medical Rescue Team was established in the structure of Gulhane Military Medical Academy. The staff in the team is composed of physicians, nurses, and paramedics who are assigned in Medical Intervention Units, Medical Nursing Units, and Decontamination Units, respectively. The main aim of this team is to give a medical response including first aid, airway, breathing, and circulation resuscitation, decontamination, and triage under any NBC attack. For this purpose, the communication and coordination between the team members were standardized. Moreover, the team was equipped with the required protective clothing, masks, antidotes, and other drugs and agents used for victims exposed to NBC weapons. Within this concept, the personnel in the team were trained with respect to first aid and treatment of NBC casualties in both theoretical and practical scenario. All of this background information was used in a practical operation held in Gulhane Military Medical Academy under a chemical attack scenario given.     

The effects of menopause and hormone replacement therapy on quality and quantity of tear, intraocular pressure and ocular blood flow

OBJECTIVE: To evaluate the effects of menopause and hormone replacement therapy (HRT) on the quality and amount of tear, intraocular pressure (IOP) and retrobulbar blood flow velocities. PATIENTS AND METHODS: Twenty women aged between 40 and 50 years, free of ocular and systemic diseases and planning to receive HRT were recruited as the study group. Twenty-four healthy, age-matched but still menstruating women were enrolled as controls. On the first day of study basal and reflex Schirmer test, tear break-up time and IOP measurements (at 08.00, 12.00 and 16.00 h) were performed for all groups. On the second day of the study, the peak systolic velocity (PSV), end diastolic velocity (EDV) and resistivity index (RI) of the ophthalmic (OA), central retinal (CRA), nasal (NSPCA) and temporal short posterior ciliary (TSPCA) arteries were determined by color Doppler imaging. The menopausal group received HRT for 2 months, when all measurements were repeated for the 15 women who had received HRT on a daily basis. RESULTS: The quality and amount of tear decreased (p < 0.01), IOP (p < 0.01) and RI of the CRA, TPCA and NPCA (p < 0.05) increased in postmenopausal women compared with the control group. After 2 months of HRT, the quality and amount of tear had increased (p < 0.001) and the IOP had decreased (p < 0.001). The PSV of the CRA and TSPCA had decreased (p < 0.05), as had the RI in the CRA (p < 0.001), NSPCA and TSPCA (p < 0.05). CONCLUSION: We conclude that age-induced changes on quality and amount of tear, IOP and retrobulbar blood flow are intensified by the menopause and that it may be possible to decrease the menopausal effects on these parameters by HRT.     

24-year-old female with amenorhea: bilateral primary ovarian Burkitt lymphoma

OBJECTIVES: Burkitt's lymphoma (BL) occurs mostly in children. Isolated bilateral ovarian involvement presenting with amenorrhea is extremely rare in young adults. CASE: A 24-year-old female presented with secondary amenorrhea. Bilateral adnexal masses were identified on physical examination and abdominal computed tomography (CT). She underwent total abdominal histerectomy and bilateral salpingoophorectomy. Histopathologic evaluation yielded a diagnosis of BL of ovaries. Combined chemotherapy was administered. After complete remission an autologous bone marrow transplantation (ABMT) was performed. She died 35 days after ABMT. CONCLUSIONS: Although rare, BL should be kept in mind when isolated ovarian tumors are detected in young patients.     

A randomized placebo-controlled trial of mebendazole for halitosis

OBJECTIVE: To test whether mebendazole, an antiparasitic drug, would affect recovery from halitosis. DESIGN: We conducted a randomized, double-blind, placebo-controlled trial between April 1999 and September 2001. SETTING: A referral medical center. PATIENTS: One hundred sixty-two children aged 5 to 16 years whose parents complained about their chronic bad breath. INTERVENTIONS: Children were randomly assigned to receive mebendazole (n = 82) or placebo (n = 80). MAIN OUTCOME MEASURE: Parents whose children had halitosis were evaluated for halitosis at 2 months of treatment by questionnaire. The microbiologist investigated the stool samples of children for parasitosis at the beginning of the trial and also at the end of the trial in children who were treated with mebendazole. RESULTS: Among those children who had evidence of parasites in stool samples at the beginning of the trial, 18 of 28 who were treated with mebendazole recovered from halitosis, compared with 2 of 24 who received placebo (relative risk [RR] for recovery, 7.7; 95% confidence interval [CI], 2.0-29.9). Among those who did not have stool parasites, 14 of 52 improved with mebendazole, compared with 10 of 48 taking placebo (RR, 1.3; 95% CI, 0.6-2.6). Mebendazole intake made a significant difference whether or not the children had parasites (P =.002). CONCLUSIONS: Parasitosis should be considered as a possible cause of halitosis in the pediatric patient population. Mebendazole therapy seems to offer benefit to those children with parasites as a potential cause of their halitosis.     

Utility of dobutamine stress echocardiography in Kawasaki disease: a case report and review of the literature

Dobutamine stress echocardiography (DSE) has become widely accepted in the evaluation of adult patients with coronary heart disease. There are new challenges about the use of DSE in the pediatric age group to document ischemia. DSE can demonstrate ischemia noninvasively in Kawasaki disease (KD) patients who are candidates for coronary angiography. We wanted to assess the feasibility and the physiologic responses of DSE in a KD patient with coronary aneurysm. The patient had no ischemia in DSE, which was confirmed by coronary angiography showing no stenosis. The literature about DSE use in KD is reviewed.     

Tansanastomotic stents for dismembered pyeloplasty in children

 Among pediatric urologists, there is a debate whether to drain the upper system after pyeloplasty in children. In a prospective, randomized clinical study we compared the early and late results of patients operated upon for ureteropelvic junction obstruction (UPJO) with or without a transanastomotic stent. Anderson-Hynes pyeloplasty was performed in 31 children during a 5-year period. In 15 a transanastomotic stent with multiple holes was used; the upper system was not drained in 16. A Penrose drain was placed in the perinephritic area in all patients. Patients were evaluated in regard to the time of removal of the stent and the Penrose drain, duration of urine leakage, and duration of hospital stay in the early postoperative period, and favorable or unfavorable outcome during follow-up. The statistical analysis showed no significant difference in regard to the removal time of the stent and Penrose drain, duration of drainage, duration of hospitalization, and early or late complications between the groups. Although stenting does not increase morbidity, we believe that pyeloplasty can be performed in children without upper-tract drainage. A feeding tube with multiple holes at the tip is recommended. Accepted: 21 March 2001