Efficacy of intravenous ondansetron to prevent vomiting episodes in acute gastroenteritis: a randomized, double blind, and controlled trial

Acute gastroenteritis is one of the most common infectious diseases of childhood. Its symptoms are vomiting, diarrhea, and dehydration. In the emergency ward, intravenous rather than oral rehydration is usually preferred because of the high likelihood of emesis. Treatments to reduce emesis are of value in improving the rehydration procedure. Our study is a double-blind randomized trial and proposes the use of ondansetron as an antiemetic drug to treat children with acute gas-troenteritis. Seventy-four in-patients, aged 3 months to 15 years, were enrolled and randomly assigned to an ondansetron or placebo group. Inclusion criteria were the diagnosis of acute gastroenteritis and the absence of other diseases or allergies to drugs. A single bolus (0.15 mg/kg) of ondansetron was injected intravenously; normal 0.9% saline solution was used as a placebo. This treatment induced vomiting cessation in the ondansetron group significantly in comparison to the placebo group. The length of the hospital stay and the oral rehydration fluid volume were similar in the two groups and no adverse effects were noticed. Thus, safety, low cost, and overall benefit of ondansetron treatment suggests that this drug can be administered successfully to children with acute gastroenteritis

Carotenoid intake and asthma prevalence in Thai children

Several antioxidant nutrients have been described to inversely correlate with asthma. In order to quantify the intake of these substances, it is possible to measure skin levels by Raman spectroscopy, a novel non-invasive technique that can also be used in children. This cross-sectional school-based study involved 423 children from a rural area of Thailand. Asthmatic children were diagnosed according to a Health Interview for Asthma Control questionnaire. Skin carotenoid levels were measured with Raman spectroscopy. Demographic data were obtained by directly interviewing children and their parents, whereas anthropometric parameters were measured by trained staff. Intake of carotenoids, vitamin A and C were evaluated by a food frequency questionnaire. Overall incidence of asthma in Thai schoolchildren (aged 3.5–17.8 years) was 17.3%. There was no significant difference in dietary intake of carotenoids and vitamin A and C, and skin carotenoid level between asthmatic and non-asthmatic children. Skin carotenoid level significantly correlated with all carotenoids and vitamin A intake (P<0.05). Carotenoids and vitamin A and C intakes, and skin carotenoid levels were not associated with the risk of asthma in Thai children. Skin carotenoids correlated with all carotenoids and vitamin A intake in mild to moderate degrees. Raman spectroscopy was confirmed to be a useful tool to determine antioxidant skin levels

Zinc deficiency in children with Dengue viral infection

Zinc deficiency is highly prevalent in low-income countries, with dramatic consequences to child health, in particular by impairing the immune system resulting in infection. This cross-sectional study aimed to determine the prevalence of zinc deficiency in Thai children who were admitted to hospital with a diagnosis of the dengue viral infection. Standard cut-off values according to age, sex, time of blood collection, and fasting status were used to define zinc levels. 32 patients were included in the analysis: The mean age was 7.3 years, of whom 56.3% were males. 11 (34.4%) patients were diagnosed with dengue hemorrhagic fever and the remaining had dengue fever. The prevalence of zinc deficiency was 46.7%, with boys having a higher risk of zinc deficiency than girls (OR=7.3: 95%CI: 1.5-36.6). Fever duration and length of hospital stay were longer in children with zinc deficiency compared to those who had normal levels, albeit without a significant difference. The results of this study provide the rationale for larger studies that will better elucidate the relationship between zinc levels and the clinical outcomes of dengue disease

The hsp 16 Gene of the Probiotic Lactobacillus acidophilus Is Differently Regulated by Salt, High Temperature and Acidic Stresses, as Revealed by Reverse Transcription Quantitative PCR (qRT-PCR) Analysis

Small heat shock proteins (sHsps) are ubiquitous conserved chaperone-like proteins involved in cellular proteins protection under stressful conditions. In this study, a reverse transcription quantitative PCR (RT-qPCR) procedure was developed and used to quantify the transcript level of a small heat shock gene (shs) in the probiotic bacterium Lactobacillus acidophilus NCFM, under stress conditions such as heat (45 °C and 53 °C), bile (0.3% w/v), hyperosmosis (1 M and 2.5 M NaCl), and low pH value (pH 4). The shs gene of L. acidophilus NCFM was induced by salt, high temperature and acidic stress, while repression was observed upon bile stress. Analysis of the 5′ noncoding region of the hsp16 gene reveals the presence of an inverted repeat (IR) sequence (TTAGCACTC-N9-GAGTGCTAA) homologue to the controlling IR of chaperone expression (CIRCE) elements found in the upstream regulatory region of Gram-positive heat shock operons, suggesting that the hsp16 gene of L. acidophilus might be transcriptionally controlled by HrcA. In addition, the alignment of several small heat shock proteins identified so far in lactic acid bacteria, reveals that the Hsp16 of L. acidophilus exhibits a strong evolutionary relationship with members of the Lactobacillus acidophilus group

Efficacy of Two Triple Eradication Regimens in Children with Helicobacter pylori Infection

Triple therapy with bismuth subsalicylate, amoxicillin, metronidazole (BAM) or with omeprazole, amoxicillin, clarithromycin (OAC) has been commonly used for the eradication of Helicobacter pylori infection. We compared the efficacy of these triple therapies in children with H. pylori infection. We retrospectively analyzed results in 233 children with H. pylori infection and treated with OAC (n=141) or BAM (n=92). Overall eradication rates of triple therapy with OAC and BAM were 74% and 85%, respectively, which showed no statistical difference. Our study showed that the triple therapy with BAM was more effective for the first-line eradication of H. pylori infection in Korean children, but has no statistical difference with OAC regimen

The potential of probiotics in the prevention and treatment of atherosclerosis

Atherosclerosis, the underlying cause of cardiovascular diseases such as myocardial infarction, cerebrovascular accident and peripheral vascular disease, is the leading cause of global mortality. Current therapies against atherosclerosis, which mostly target the dyslipidemia associated with the disease, have considerable residual risk for cardiovascular disease together with various side effects. In addition, the outcomes from clinical trials on many promising pharmaceutical agents against atherosclerosis (e.g., low‐dose methotrexate, inhibitors against cholesteryl ester transfer protein) have been disappointing. Nutraceuticals such as probiotic bacteria have therefore generated substantial recent interest for the prevention of atherosclerosis and potentially as add‐ons with current pharmaceutical drugs. This review will discuss our current understanding of the anti‐atherogenic actions of probiotics from pre‐clinical and clinical studies together with their potential underlying mechanisms of action

Ethnicity and gender related differences in extended intraesophageal pH monitoring parameters in infants: a retrospective study

BACKGROUND: Gastroesophageal reflux disease (GERD) is believed to be more common in adult males as compared to females. It also has been shown in adults to be more common in Caucasians. We wanted to determine ethnicity and gender related differences for extended pH monitoring parameters in infancy. METHODS: Extended pH monitoring data (EPM) from infants <1 year of age were reviewed. Results were classified in two groups, as control and Gastroesophageal reflux disease (GERD) group based on the reflux index (RI). The GERD group had RI of equal to or more than 5% of total monitoring period. The parameters of RI, total number of episodes of pH < 4, and the number of episodes with pH < 4 lasting more than 5 minutes were compared by genders and by ethnic groups, Caucasians and African American (AA). RESULTS: There were 569 infants, 388 controls, 181 with GERD (320 males, 249 females; 165 Caucasians, 375 AA). No statistical difference in EPM parameters was detected between genders in both groups. However, Caucasian infants had a significantly higher incidence of GERD than AA infants (p = 0.036). On stratifying by gender, Caucasian females had a significantly higher number of reflux episodes >5 minutes as compared to AA females in the control group (p = 0.05). Furthermore, Caucasian females with GERD showed an overall higher trend for all parameters. Caucasian males had a trend for higher mean number of reflux episodes as compared to AA males in the control group (p = 0.09). CONCLUSION: Although gender specific control data do not appear warranted in infants undergoing EPM, ethnic differences related to an overall increased incidence of pathologic GERD in Caucasian infants should be noted

Compressive stenosis of the inferior vena cava due to localized ascites after living-donor liver transplantation.

A 54-year-old woman was admitted to our hospital following the diagnosis of decompensated liver cirrhosis with hepatitis C. She underwent living-donor liver transplantation, performed using the left hepatic lobe with the middle hepatic vein donated by her husband. After the transplantation, the patient suffered from massive ascites with liver dysfunction. Computed tomography demonstrated stenosis of the suprahepatic inferior vena cava (IVC) with focal collection of fluid. A second laparotomy was performed 19 days after the transplantation. When the encapsulated localized ascites on both sides of the IVC was opened, the ascites was flushed away. Subsequently, the grafted liver was easily mobilized and it was placed in the natural position without any tension, and the pressure gradient of the IVC was improved. Herein, we report a very rare case of compression stenosis of the IVC resulting in Budd-Chiari syndrome caused by localized encapsulated ascites

Current management for acute hepatic failure (การรักษาภาวะตับวายเฉียบพลัน)

Acute hepatic failure is one of the rare disease, but is life-threatening. The present review summarizes about the acute hepatic failure in relation to various treatments available depending upon the complications such as cerebral edema, hepatic encephalopathy, renal dysfunction etc. The gold standard treatment for acute hepatic failure is “orthotopic liver transplantation”. Other treatments include uses of dialysis techniques to remove hepatotoxins, antibiotics and drugs for inflammatory mediators depending upon various etiologies. As the present therapies are associated with various drawbacks, some future therapeutic targets such as cannabinoid receptors, gene therapy and aquaporin channels are also discussed which are in preclinical stages