Perception of bronchoconstriction in obstructive pulmonary diseases (disease-specific dyspnoea)

The perception of dyspnoea differs between subjects with obstructive pulmonary diseases, partly because the underlying mechanisms for bronchoconstriction are different. We investigated the perception of bronchoconstriction in subjects with bronchiectasis, asthma and chronic bronchitis and possible contributing factors. Forty-seven non-smoking subjects with bronchiectasis, 50 subjects with asthma and 31 with chronic bronchitis were challenged with histamine. The Borg score was assessed before and after each challenge. The perception score corresponding to a fall in the forced expiratory volume in 1 s (FEV(1)) by 20% (PS(20)) was calculated. The mean values of DeltaBorg/DeltaFEV(1) (the Borg score change divided by the change in FEV(1) as a percentage of the baseline FEV(1)) and PS(20) of subjects with bronchiectasis and chronic bronchitis were significantly lower than in subjects with asthma after histamine challenge. The ratio of non-perceivers was higher in bronchiectasis (25.5%) and in chronic bronchitis (32.3%) than in asthma (4.0%). When all subjects were considered, DeltaBorg/DeltaFEV(1) values were significantly related to female sex ( r (2)=11.5%, P =0.0001), but not to age, duration of the disease, PD(20) or baseline FEV(1)%. The present study indicates that perception of histamine-induced bronchoconstriction is lower in patients with bronchiectasis and chronic bronchitis than in asthmatic patients, and that sex partially contributes to this difference.     

A vertebral hydatid cyst infection mimicking tuberculous spondylodiscitis

Hydatid disease involving the vertebral body and paravertebral soft tissues is rare even in rural areas where echinococcosis is endemic. The case of a 34-year-old woman with vertebral hydatid disease mimicking tuberculous spondylodiscitis (Pott's disease) is presented in this report. Spinal hydatid disease should be considered in the differential diagnosis of spondylodiscitis in endemic countries, and tested for with imaging and serology.     

Effects of honey as a scolicidal agent on the hepatobiliary system

AIM： To examine the effects of 10% diluted honey, which has been shown to be scolicidal, on the liver and biliary system and determine whether it could be used as a scolicidal agent in the presence of biliary-cystic communication. METHODS： Thirty Wistar-Albino rats were divided into two groups. Honey with 10% dilution in the study group and 0.9% saline （NaCI） in the control group were injected into the common bile ducts of rats through a 3-mm duodenotomy. The animals were sacrificed 6 mo alter the procedure. Histopathological, biochemical, and radiological examinations were performed for evaluation of side effects. RESULTS： At the end of the sixth month, liver function tests were found to be normal in both groups. The tissue samples of liver and ductus choledochus of the honey group showed no histomorphologic difference from the control group. No stricture on the biliary tree was detected on the retrograde cholangiograms. CONCLUSION： According to these results, we concluded that 10% diluted honey could be used as scolicidal agent safely in the presence of biliary-cystic communication.     

Clinical and radiographic results of balloon kyphoplasty for treatment of vertebral body metastases and multiple myelomas

Kyphoplasty is a minimally invasive procedure that is used to augment vertebral body strength. This technique has been commonly used to treat osteoporotic, vertebral body compression fractures. The technique was also used to augment painful metastatic vertebral fractures. The objective of this study was to review the clinical and radiological results after kyphoplasty in patients with vertebral body compression fractures due to spinal metastasis and multiple myeloma and to determine factors that may affect outcome. Thirty-one patients had 41 vertebral body fractures secondary to spinal metastasis or multiple myeloma. A kyphoplasty procedure was performed on 39 levels. The pain and neurological status were evaluated using the visual analogue scale (VAS) score and the American Spinal Injury Association classification scale scores, respectively. Radiological evaluations were used to measure vertebral body height loss (VBHL) and the segmental kyphosis angle before and after surgery. The major symptoms that patients presented with included pain (25 patients); and neurological deficit (four patients). Two patients presented with no symptoms because the metastases were found during cancer screening. The mean (±standard deviation [SD]) VAS score was 7.2 ± 2.2 before surgery and 1.6 ± 1.3 after surgery. The mean preoperative VBHL was 27.8 ± 11.3% for the thoracic spine and 27.7 ± 12.5% for the lumbar spine. VBHL values were reduced to 22.4 ± 10.0% and 18.4 ± 10.4% for the thoracic and lumbar spine after surgery, respectively. The segmental kyphosis angles decreased from 21.2 ± 11.4° to 17.0 ± 9.8° for the thoracic spine and from 15.3 ± 8.8° to 10.4 ± 7.2° for the lumbar spine after surgery. There was a correlation between the symptom duration and VBH restoration rate. There was no correlation between the amount of injected polymethylmethacrylate and pain relief. We concluded that kyphoplasty is a safe and effective procedure for treating painful vertebral body fractures caused by metastasis and multiple myeloma. It can restore VBH and correct the kyphosis angle. While the increased amount of the injected PMMA led to its leakage, it did not contribute to restoration of the VBH or kyphosis correction. Therefore, one should avoid injection of excessive amounts of PMMA.     

Relationship between toll-like receptor 8 gene polymorphisms and pediatric pulmonary tuberculosis

Objectives: Genetic variants in Toll-like receptors (TLRs) are considered a potential indicator for host susceptibility to and outcome of several infectious diseases including tuberculosis. The aim of this study was to determine whether −129 C/G and Met1Val polymorphisms of TLR8 were associated with pediatric pulmonary tuberculosis in Turkish population. Methods: The −129 C/G and Met1Val polymorphisms were studied in 124 children with pulmonary tuberculosis compared to 150 age-matched healthy control subjects. Results: We did not identify any statistically significant differences between the patients with TB and control groups with regard to the frequency of genotypes GG or G/(−), CG, and CC or C/(−); and alleles G and C at rs3764879 (p > 0.05). We found a strong association with genotype A/(−) at rs3764880 with susceptibility to pulmonary TB in males (OR 2.87, 95%CI 1.38–5.98, p = 0.007). Conclusions: Our results provide evidence, for the first time, of a role for the TLR8 gene in susceptibility to pulmonary TB in male children. Additional research to verify our results are necessary. Tuberculosis in children presents particularly difficult challenges, but research priorities and advances in pediatric tuberculosis could provide wider insights and opportunities for tuberculosis control.