Comparing various agents in rats for preventing gastric damage caused by non-steroid anti-inflammatory drugs [Siçanlarda non-steroid anti-inflamatuar i·laçla oluşan gastrik hasarlanmanin önlenmesinde farkli ajanlarin karşilaştirilmasi]

Objective: Non-steroid anti-inflammatory drugs (NSAIDs) may cause damage in the gastrointestinal system mucosa due to topical harm produced by metabolites as well as a decrease in the hydrophobicity of the stomach mucosa and suppression of prostaglandin synthesis. Protecting the mucosa from these effects means using prophylactic agents. In our study, we aimed to compare the effects of L-glutamine, L-arginine, L-carnitine and ranitidine in preventing these effects among rats whose stomachs were damaged after intake of naproxen and hydrochloric acid (HCl). Material and Methods: The rats included in this study were divided into five groups one of which was the control group and prophylactic agents were administered through the intragastric route to all groups for 10 days (Ranitidine: 50 mg/kg, glutamine: 750 mg/kg, arginine: 300 mg/kg, carnitine: 50 mg/kg). In the second stage 40 mg/kg naproxen sodium followed by 0.5 M HCl (10 cc/kg) were administered to the rats in order to produce damage in the stomach mucosa. After sacrification, stomach materials were examined macroscopically, histologically and histomorphologically. Differences between groups were analyzed using the Mann-Whitney U, Fischer's exact and one-way Anova tests. Statistical significance was set at p? 0.05. Results: Macroscopic examination revealed ulcerous mucosa in 60% and congestion as well as edema in 40% of rats not taking prophylactic agents during the test period. No lesion was present in 22.2% and 20% of the rats taking ranitidine and L-glutamine respectively, a wide-scale ulcer case was not discovered. On the other hand, no statistically significant difference in terms of macroscopic findings were determined between prophylactic agents (p> 0.05). Histological examination did not reveal any lesion in 28% of the rats in the ranitidine group and 4% of the control group (p< 0.05). Furthermore, we could not find any statistical difference between the control and prophylaxis groups in terms of average histomorphological measurements. However, significant differences between ranitidine and arginine groups appeared during histomorphological examinations (p< 0.05). Conclusion: We concluded that histological lesions developed less frequently in rats when they were given prophylactic agents to prevent damage in their stomach mucosa; the least damage in terms of morphological evaluation occurred in the ranitidine group. Further studies on this field, including biochemical mediators are required to accomplish higher rates of treatment in patients who widely depend on the intake of NSAIDs. Copyright © 2005 by Türkiye Klinikleri

Nutritional status in cirrhotics children and evaluation with antropometric measurements [Sirozlu çocuklarda beslenme durumunun antropometrik ölçümlerle degerlendirilmesi]

In this study malnutrition frequency of cirrhotic children and effectiveness of nutritionel support on clinical and laboratory data were studied in 60 cirrhotic children prospectively. Nutritional status was evaluated by biochemical techniques and anthropometric measurements [weight, height, triceps skin fold thickness (TST), mid-arm circumference (MAC), mid-arm muscle circumference (MAMC), surface of middle arm muscle (SMAM)] according to Waterlov criteria. Severity of illness was determined according to Child-Pough classification. Malnutrition was determined in 40 patients (66.6%). The nutritional support was achieved by both natural foods and enteral products, which contained 35% of daily caloric requirement, and then 1st, 2nd, 3rd, 6th, and 12th month anthropometric measurements were performed. Thirteen patients not given nutritional support were included as controls. Beginning anthropometric measurements and Child classification distribution of both groups were similar. According to variant analysis, weight and height, TST, MAC, MAMC and SMAM were significantly different at the 2nd, 3rd, 12th and 6th months, respectively. But in the control group; TTS, MAC and MAM measurements were found significantly different after the six month. Malnutrition frequency in cirrhotic patients, especially chronic type, is high. Nutritional support contributes to the life quality and growth

Infliximab treatment of pediatric refractory Crohn's disease: A case report

PubMed ID: 16830299Infliximab is a monoclonal antibody that targets TNF-? and has been shown to be effective for the management of steroid-dependent or refractory Crohn's disease. It is an effective therapy in adult patients, but experience in children is limited. We report a case of Crohn's disease which was refractory to the conventional treatment. A 14-year-old boy was admitted to the hospital with arthralgia and oral and perianal lesions. On physical examination his body weight was below the 3rd percentile, and height was between the 3rd-10th percentiles. He had elevated erythrocyte sedimentation rate and C-reactive protein and decreased hemoglobin, hematocrit and albumin levels. Barium enema and computerized abdominal tomography revealed a markedly distended small bowel with a narrowed area just above the ileocecal valve and terminal ileum. There was no mucosal pathology in his colonoscopic study. A regimen of prednisolone was begun with a diagnosis of Crohn's disease. In the first month of therapy the patient experienced progressive worsening of his symptoms, and azathioprine was added to the treatment in the second month. As he had exacerbation of his symptoms and worsening laboratory tests, infliximab infusions (5 mg/kg/d) were administered intravenously (at 0, 2 and 6 weeks) at the end of the 8th week. At the 6th week of treatment including two infusions of infliximab at 0 and 2 weeks, clinical and laboratory response occurred. The only side effect of the treatment was pneumonia, which was seen after the 6th week of the therapy. In conclusion, infliximab appears to be an effective and safe therapy for childhood refractory Crohn's disease

Blood levels of leukotrienes (LTC 4, D 4, E 4, B 4) and synthesis of leukotriene B 4 by peripheral leukocytes in children with acute a and B hepatitis

PubMed ID: 10770113Leukotrienes (LTs) are cell-membrane derived lipid inflammatory mediators, synthesized and eliminated by the liver. LTs have effects on liver cells in some pathological conditions. In this study, we measured plasma endogenous and liberated leukotriene (LT) concentration in peripheral blood leukocytes stimulated in vitro by the calcium ionophore (CaA23187) and platelet-activating factor (PAF). Production of LTs was measured in type A (n=37) and type B (n=10) acute hepatitis patients and control subjects (n=10). LTs levels were measured by high performance liquid chromatography (HPLC) and radioimmunoassay (RIA). The concentration of LTB 4 measured in plasma and stimulated peripheral blood leukocyte supernatants of children with hepatitis A infection was found to be statistically elevated and in positive correlation with serum alanine aminotransferase (ALT) levels. In plasma samples of hepatitis B patients, LTC 4 and LTE 4 were measured in significantly elevated concentrations. These results suggest that LTB 4 may be a critical mediator of hepatitis A virus-induced hepatocellular injury

Polymorphisms of the ICAM-1 gene are associated with biliary atresia

PubMed ID: 18401716Inflammation is an important feature of biliary atresia, and recent studies suggest that its occurs in a genetically susceptible host. The intercellular adhesion molecule-1 (ICAM-1) is of paramount importance for the initiation and propagation of various inflammatory conditions. Aim: To determine whether the Glu241Arg polymorphism in the ICAM-1 gene, which impairs inflammatory responses, is associated with biliary atresia. Methods: Between February 2002 and November 2004, 19 patients (mean age 1 ± 0.4 years) diagnosed as biliary atresia were included in the study. Thirty-eight children with chronic liver disease and a group of unrelated healthy controls (n = 123) included in this study. After informed consent, blood was collected and genomic DNA was obtained. Genotyping was performed by amplification-refractory mutation system polymerase chain reaction (ARMSPCR). Associations were assessed by using Fischer's exact test. Results: ICAM G242R A allele frequency was significantly higher in the BA group than in both the CLD and healthy control groups (OR = 4.4, 95 CI% 1.3-15.1, P = 0.03 and OR = 4.8 CI% 1.5-15.6, P = 0.01, respectively). Univariate analysis showed that polymorphism of ICAM G241R polymorphism was significantly related to biliary atresia. There was not significant correlation between PELD score and ICAM-1 genotypes both in BA and CLD groups. Conclusion: These findings provide evidence for the possible role of ICAM-1 241R polymorphism in BA pathogenesis. © 2008 Springer Science+Business Media, LLC

Transient fetal myelosuppressive effect of D-penicillamine when used in pregnancy

PubMed ID: 14676735Normal fertility is sustained by progress in the medical therapy of Wilson's disease; however, pregnancy complications are encountered more frequently. The mother we present is a Wilson s disease patient who had been compliant with D-penicillamine for the preceding 13 years. She was admitted with unplanned pregnancy at the 16th gestational week. The dose of D-penicillamine could be reduced to 600 mg/d related to the underlying disease. Pregnancy ended with premature labor and delivery at the 29-30th weeks. The baby experienced type I respiratory distress and was treated by surfactant and mechanical ventilation. Neutropenia and leucopenia were documented at 6th postnatal hours. The baby showed neutropenia and leucopenia for 5 days and resolving without any further therapy. Intrauterine D-penicillamine was suspected to cause transient neonatal myelosuppression