Assessment of IL-31 levels and disease severity in children with atopic dermatitis

Introduction and objectives

Atopic dermatitis is a chronic, relapsing, highly pruritic, inflammatory skin disease characterized by typical localization with increasing prevalence of 10–20% in children. Pruritus is one of the major diagnostic criteria of atopic dermatitis and also the main complaint altering quality-of-life of affected patients, inducing and aggravating inflammation. Although pruritus is the absolute symptom of AD, the etiology has not been fully explained yet and current antihistamine therapies are ineffective.The aim of the study was to assess the correlation between IL-31 level and disease severity in patients with atopic dermatitis through Severity SCORing of Atopic Dermatitis (SCORAD) index and the degree of itching assessed subjectively.

Endothelin-1 and nitric oxide concentrations and their response to exercise in patients with slow coronary flow.

In this study, the endothelin-1 (ET-1) and nitric oxide (NO) concentrations in slow coronary flow (SCF) patients were assessed before and at the peak of the exercise stress test and compared with the values from healthy controls. The study population was 25 patients who underwent coronary angiography and were diagnosed as SCF (11 females (44%), aged 56.7+/-9.8 years), and 20 normal subjects (9 females (45%), aged 54.3+/-9.2 years). Mean TIMI frame count in the patients was 54.1+/-13.4. Blood samples were drawn at rest and immediately at the end of exercise testing. The baseline ET-1 concentrations of the control subjects were lower than those of the patients (7.0+/-4.5 pg/ml vs 11.1+/-5.9 pg/ml p<0.0001) and this difference increased after exercise (6.2+/-4.3 pg/ml vs 20.1 +/-10.4 pg/ml, p<0.0001). Post-exercise ET-1 concentrations were significantly higher than baseline in patients with SCF (p<0.0001) and a reduction in the ET-1 concentrations was observed in control subjects (p<0.05). Baseline NO concentrations of the patients were lower than those of the control subjects (27 +/-5.1 micromol/L vs 31.2+/-4.9 micromol/L, p=0.0001). Although the NO concentrations in both groups were significantly increased after exercise (29.4 +/-5.9 micromol/L vs 33.3+/-5.6 micromol/L, p<0.05 for both), the difference was not significant. A significant negative correlation among post-exercise ET-1 concentrations and maximal heart rate, exercise duration and exercise rate - pressure product, and a significant positive correlation among post-exercise NO concentrations and maximal heart rate and exercise duration were observed in both groups. The results of this study show that endothelial function (assessed by ET-1 and NO concentrations) and its response to exercise were abnormal in SCF patients compared with healthy subjects, and this may play some pathophysiologic role.     

Hypersensitive esophagus: can it be classified as a subgroup of gastroesophageal reflux disease?

BACKGROUND/AIMS: Gastroesophageal reflux disease is one of the most common gastrointestinal diseases of adulthood. Hypersensitive esophagus is a new term which defines patients with reflux symptoms, negative endoscopic findings and normal acid contact time on 24 hour pH analysis, although there is a convincing relationship between symptoms and acid reflux episodes on pH analysis- positive symptom index. In this study, the frequency of hypersensitive esophagus among patients with heartburn was determined and demographic findings, symptoms, manometric and pHmetric findings were compared among hypersensitive esophagus, non-erosive reflux disease, erosive reflux disease and normals. METHODS: Patients admitted to hospital with heartburn and without any cardiac, severe gastric or duodenal pathologies (except minimal antral gastritis) and with no abnormal manometric findings suggestive of esophageal motility disorders were included in the study. All patients were questioned about age, height, weight, educational status and intestinal and extraintestinal reflux related symptoms. Upper endoscopy, esophageal manometry and 24 hour pH monitoring were performed respectively. RESULTS: Of the 44 patients (17 male, 27 female) included in the study, seven (16%) had hypersensitive esophagus, 15 (34%) had non-erosive reflux disease, seven (16%) had erosive reflux disease and 15 (34%) had normal findings. The female ratio in the hypersensitive esophagus and normal groups was higher while the male ratio was higher in erosive reflux disease. There was no significant difference among groups according to age, body mass index and symptoms. There was also no significant difference according to manometric findings. De Meester scores were significantly lower in hypersensitive esophagus and normal groups while symptom index was highest in the hypersensitive esophagus group. Reflux was observed especially in the upright position in all groups. CONCLUSION: The ratio of hypersensitive esophagus, gastroesophageal reflux disease and no pathology in patients with heartburn was 16%, 50% and 34% respectively. It would be appropriate to accept hypersensitive esophagus as a subgroup of reflux disease as it has both symptoms and some manometric and pHmetric changes.     

Does Fasciola hepatica infection modify the response of acute hepatitis C virus infection to IFN-α treatment?

Immunologic response to acute hepatitis C is mainly a Th1 response, whereas fasciolopsiasis is associated with a diverse T-cell response. Interferon-alpha has immunomodulatory effects and enhances Th1 immune response. Fasciola infection could theoretically interfere with the Th1 immune response, even when acquired after an initial response to interferon-alpha treatment for acute hepatitis C virus (HCV) infection. We report here the case of a male patient who acquired Fasciola hepatica infection after an initial response to IFN-alpha therapy with a favorable outcome     

Posterior leukoencephalopathy and nephrotic syndrome: just a coincidence?

Posterior leukoencephalopathy syndrome (PLES) is an acute neurological disorder. The most plausible hypothesis for the pathophysiology of PLES is the loss of autoregulation and consequent vasogenic edema. PLES is mostly attributed to severe or sudden elevations of arterial blood pressure. A number of reports, however, describe patients with PLES without severe hypertension. This report presents two patients with nephrotic syndrome who developed PLES without customarily severe hypertension. Proteinuria, low levels of serum albumin, or generalized increase in capillary permeability in nephrotic syndrome can initiate PLES with moderately high arterial blood pressure levels. PLES is increasingly recognized by neurologists, but it should also be remembered by internists when confronted with patients with nephrotic syndrome who present with neurological symptoms, whether or not they have severe hypertension.     

The effect of mouth prop on endotracheal tube intracuff pressure in children during dental rehabilitation under general anaesthesia

Although the endotracheal tube (ETT) cuff may be associated with tracheal morbidity, cuffed tubes may reduce the aspiration risk in oral procedures. Dentists must use a mouth prop to facilitate oral visualization and to protect the oral soft tissues during dental rehabilitation under general anaesthesia (DRGA). The aim of this study was to evaluate the effect of mouth prop on endotracheal tube intracuff pressure in children during DRGA. Two-hundred and three ASA I-II patients, <18 years of age (mean: 5.3?±?2.4 years) were included in the prospective observational study whose comprehensive dental treatment was performed under general anaesthesia. Following the induction of general anaesthesia, placement of a cuffed endotracheal tube which was an appropriate size for children was fixed. The intracuff pressure was measured intermittently after the intubation (baseline) (T0), immediately after the mouth prop (T1), 30 min after the mouth prop (T2), after taking out the mouth prop (T3) and just before extubation (T4). The mean intracuff pressure was 28.3?±?2.01 cm H₂O at T0. The mean intracuff pressure significantly increased at T1 (30.8?±?2.7) and T2 (29.6?±?3.7) compared to T0 (P?<?0.001). No significant differences were observed between the duration of the procedure and intracuff pressure or postoperative complications (P?>?0.05). Cough, sore throat and nausea were observed in 4, 1 and 5 patients, respectively. Because a mouth prop may increase the intracuff pressure of ETT, strict measurement and readjustment of cuff pressures should be employed when used in children during DRGA.     

Induction of apoptosis in lung adenocarcinoma and glioma cells by some oxadiazole derivatives

Oxadiazoles have received much attention due to their wide range of biological activities including antitumor activity. In this study, we aimed to study apoptotic effects of some 1,3,4-oxadiazole derivatives on human lung adenocarcinoma (A549) and rat glioma (C6) cell lines. The cytotoxicity of the compounds on both cell lines was determined, and the effects of these compounds on DNA synthesis were measured. Compounds 2 and 6 which exhibited significant cytotoxic activity in MTT assay were chosen for flow cytometric analyses to determine apoptotic percent of cells. These compounds also exhibited better DNA synthesis inhibition activity on cancer cells. Compound 6 carrying 2,4-dichlorophenyl substituent exhibited the highest apoptotic effect on A549 cells via the induction of Caspase 3 activity. It was suggested that compounds 2 and 6 can be identified as the most promising anticancer agents against A549 and C6 cancer cell lines.