The association of milk and multiple food avoidance with growth parameters in infants and children

BACKGROUND

Recent studies reported that strict avoidance of milk products in cow's milk allergy (CMA) affects growth and bone turnover, causing negative calcium balance and changes in bone metabolism.

OBJECTIVE

To investigate biochemical parameters to predict bone turnover and its relations with height and weight measurements and nutritional intake.

METHODS

Height, weight, and body mass index z scores were plotted for age according to the World Health Organization. A 3-consecutive day food record was analyzed for nutritional values of foods. The blood levels of calcium, phosphorus, alkaline phosphatase, vitamin D, and parathyroid hormone (PTH) were determined.

RESULTS

The study included 69 controls, 66 children with isolated CMA, and 59 children with multiple food allergy (FA). The z scores for weight, height, and body mass index were lower in isolated CMA and multiple FA groups than controls (P < .001, P = .004, and P = .002, respectively). The nutritional intakes of protein, fat, carbohydrates, vitamins B2 and B12, niacin, calcium, and phosphorus were significantly lower in isolated CMA and multiple FA than controls. In infants (≤2 years of age), although blood calcium level was in normal range, it was significantly lower in isolated CMA and multiple FA than in controls (P < .001). In children older than 2 years, PTH level was significantly higher in isolated CMA and multiple FA groups than in controls (P = .003).

CONCLUSION

Our study revealed that children with isolated CMA and multiple FA had a high nutrition gap, growth deceleration, and unbalanced bone metabolism, as illustrated by low blood calcium and elevated PTH levels.

Cohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry

AIMS

The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation.

METHODS AND RESULTS

Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (in-hospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, pre-hospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin.

CONCLUSION

The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality.

[Clinical features and survival analysis in non-M(3) acute myeloid leukemia patients with ASXL1 gene mutation]

Objective: To examine the survival rates and clinical characteristics of people with newly discovered non-M(3) acute myeloid leukemia (AML) who carry the ASXL1 gene mutation. Methods: From January 2016 to April 2021, the clinical information of patients with newly diagnosed non-M(3) AML at Shandong University's Qilu Hospital was retrospectively examined, and their clinical characteristics and survival were compared and analyzed. Gene mutation was detected by next-generation sequencing. Results: ① The study included 256 AML patients who were initially diagnosed and had complete data, including 47 cases of ASXL1 gene mutation-positive (ASXL1(+)) patients and 209 cases of ASXL1 gene mutation-negative (ASXL1(-)) patients. All patients were divided into three groups: elderly (≥60 years old, n=92) , middle-aged (45-59 years old, n=92) , and young (≤44 years old, n=72) . ②WBC, and age were higher in patients with ASXL1 mutations compared to ASXL1(-) patients, while complete response after the first round of treatment (CR(1)) was lower (P<0.05) . In the elderly group, WBC and the proportion of aberrant cells in nuclear cells in ASXL1(+) patients were higher than those in ASXL1(-) patients (P<0.05) . In the young group, the WBC of ASXL1(+) patients was higher than that of ASXL1(-) patients (z=-2.314, P=0.021) . ③IDH2 mutation and ASXL1 mutation was related (P=0.018, r=0.34) . In ASXL1(+) patients, the proportion of peripheral blasts in the high VAF group (VAF>40% ) was higher than that in the low VAF group (VAF<20% ) , and the proportion of aberrant nuclear cells was higher in the duplication and replacement mutation patients than in the deletion mutation patients (P<0.05) . ④The overall survival (OS) and progression-free survival (PFS) of ASXL1(+) patients were shorter than those of ASXL1(-) patients (median, 10 months vs 20 months, 10 months vs 17 months; P<0.05) . The proportion number of aberrant cells in nuclear cells (≥20% ) , complex karyotypes, and TET2 mutation were all independent risk variables that had an impact on the prognosis of ASXL1(+) patients, according to multivariate analysis (P<0.05) . Conclusion: ASXL1-mutated non-M(3) AML patients have higher WBC in peripheral blood, a higher proportion of aberrant cells in nuclear cells, lower CR(1) rate, and shorter OS and PFS. Additionally, a poor prognosis is linked to higher VAF, duplication, and substitution mutations in the ASXL1 gene, as well as the high proportion of aberrant cells in nuclear cells, complex karyotype, and TET2 mutation.

The relationship between dietary elimination and maternal psychopathology in breastfeeding mothers of infants with food allergy

BACKGROUND

There has been no study evaluating the psychopathology in breastfeeding mothers of infants with food allergy (FA).

OBJECTIVE

The aim of the study was to investigate the relationship between dietary elimination and maternal psychopathology, specifically anxiety, depression, and mother-to-infant bonding, in breastfeeding mothers of infants with food allergy.

METHODS

Breastfeeding mothers following an elimination diet due to FA in their children aged 1-to-12 months were compared with the healthy controls. The physician-diagnosed FA group was divided into IgE-, non-IgE-mediated, and infants with some minor symptoms which were not enough to make the diagnosis of FA were classified as Indecisive symptoms for FA group. Mothers completed standardized questionnaires including Symptom Checklist 90R, Beck Depression/Anxiety Inventories (BDI/BAI), Postpartum Bonding Questionnaire (Bonding).

RESULTS

Of 179 mother and infants, 64 were healthy, 89 were FA, 16 were indecisive symptoms for FA. The mean age of the mothers and infants were 31.1 ± 4.7 years and 6.3 ± 3.6 months, respectively. The physician-diagnosed FA groups had higher scores for anxiety (p = .008), anger (p = .042), depression (p < .001), obsession (p = .002), phobia (p = .008), somatization (p = .002), general symptom index (GSI) (p = .001), BDI (p < .001), BAI (p = .008), and Bonding (attachment [p = .001], anger [p = .019], and total [p = .036]) than the healthy ones. The indecisive symptoms for FA group had a similar score pattern to physician-diagnosed FA, except interpersonal sensitivity, BDI, and attachment.

CONCLUSION

Breastfeeding mothers of infants with FA were more anxious, with higher depression scores than controls, and had many psychopathologies which affected bonding. Interventions targeting negativity in caregivers' social relationships are urgently needed.

The prognostic role of baseline 18F-FDG PET/CT SUVmax and SUVmax change in patients with node-positive breast cancer receiving neoadjuvant chemotherapy

OBJECTIVE

This study aimed to determine the prognostic role of baseline maximum standardized uptake value (SUVmax) obtained by pretreatment PET/CT and the change in SUVmax (ΔSUVmax [%]) in patients with axillary lymph node-positive breast cancer receiving neoadjuvant chemotherapy (NAC).

METHODS

One hundred and eighty patients with baseline SUVmax and 121 patients with SUVmax measurement after treatment were evaluated in the study. The baseline SUVmax value of the breast (SUVmaxBI) and axilla (SUVmaxAI) and the change in the SUVmax of the breast (ΔSUVmaxB) and axilla (ΔSUVmaxA) were measured. The optimal cut-off value of SUVmax and ΔSUVmax were determined by ROC curve analysis. Disease-free survival (DFS) and overall survival (OS) were calculated using Kaplan-Meier curves.

RESULTS

ΔSUVmaxB, pCRB, pCRA, and pCR parameters were found to be associated with relapse (p < 0.001, p = 0.033, p = 0.016, and p = 0.013, respectively). ΔSUVmaxB and SUVmaxAI were associated with mortality (p = 0.001 and p = 0.006, respectively). Multiple Cox regression analyses revealed that ΔSUVmaxB value was an independent prognostic factor for relapse and mortality (p = 0.013 and p = 0.010, respectively).

CONCLUSION

The results showed that ΔSUVmaxB was an independent prognostic factor for relapse and mortality in patients with axillary lymph node-positive breast cancer who received NAC.

Parvovirus Infection in a Child Presenting with Erythema Multiforme and Vasculitis after a Yellow Jacket Bee Sting

Parvovirus B19 has a wide spectrum of clinical manifestations. Erythema multiforme and vasculitis are rarely reported with parvovirus B19 infections. Reactions to insect stings can range from local swelling to life-threatening systemic reactions. There have been rare reports of unusual reactions, such as vasculitis, occurring in a temporal relationship with insect stings. We report an 8-year-old patient having Parvovirus B-19-related erythema multiforme and vasculitis after a yellow jacket bee sting.

Aeroallergen sensitisation patterns of children aged 5 years and younger with asthma and/or allergic rhinitis in Istanbul

AIM OF THE STUDY

The purpose of the study was to determine the aeroallergen sensitisation patterns of children aged 5 years and younger with asthma (AS) and/or allergic rhinitis (AR) in Istanbul, Turkey.

METHODS

This cross-sectional observational study was conducted between January and December 2018 in the outpatient clinic of a hospital department of pediatric allergy. Patients, who had regular outpatient controls, full clinical and laboratory records, positive skin prick test results, and were willing to participate in the study, were included.

RESULTS

In total, 148 children aged 5 years or younger who had positive skin prick test results were included in the study. The male/female ratio and the mean age at onset of symptoms were 87/61 and 2.13±1.33 (0.4-4.5) years, respectively. Of the 148 patients, 63 (42.6%) had AS, 11 (7.4%) AR, and 74 (50.0%) had both AS and AR. The age of the patients, age at symptom onset, male/female ratio, number of allergen sensitivities, total IgE levels, total eosinophil levels, and skin prick test results for aeroallergens did not differ between the patients with AS, AR, and AS+AR. House dust mite (HDM) was the most common aeroallergen in patients, while the cockroach was the least common aeroallergen. The severity of asthma and control levels were not found to be associated with aeroallergen sensitisation in children.

CONCLUSION

One out of every four atopic children aged 5 years or younger is sensitised to aeroallergens. The most common sensitisation is to house dust mites. Weed aeroallergen may be related to severity of asthma in children aged 5 years or younger in Istanbul. We speculate that HDM and weed allergens could be used in the diagnostic or treatment strategies for the management of asthmatic children aged 5 years or younger.

Effect of Neonatal Phototherapy on Eosinophil Levels in Nonsevere Hyperbilirubinemia

OBJECTIVE

The purpose of the research was to determine the impact of phototherapy (PT) on eosinophil levels in neonates with nonsevere bilirubin levels (<20 mg/dL) treated with PT.

STUDY DESIGN

This observational pilot study included term neonates with early neonatal hyperbilirubinemia.

RESULTS

Ninety-six term neonates were included in the study. The male-to-female ratio was 1.23. Hyperbilirubinemia was most frequently related to ABO group incompatibility (49%). Fifty-two neonates (54.1%) were born by normal spontaneous delivery. After PT, while total serum bilirubin, hemoglobin, hematocrit, leukocyte, and neutrophil levels were found to be significantly decreased, eosinophil levels were significantly increased (p = 0.01). No significant difference was found regarding lymphocyte and basophil levels after PT. A statistically significant correlation was found between bilirubin and eosinophil levels before PT (r ² = 0.28, p = 0.03). No correlation between eosinophil levels and treatment age, gender, diagnosis of hyperbilirubinemia, and delivery route before PT was found. After PT, eosinophil levels increased, while other blood cell series were found to be decreased. The correlation between the bilirubin levels and eosinophil was found to be negative (r ² = - 0.32, p = 0.02) after PT.

CONCLUSION

PT may increase serum eosinophil levels in term neonates with nonsevere hyperbilirubinemia.

Assessment of regular drug use and inhaler technique skills in asthmatic children

OBJECTIVE

This study aimed to assess the regular use of long-term asthma-control medication and to determine inhaler techniques in asthmatic children.

METHODS

The study was conducted on asthmatic children aged 6-18 years. Information on rescue and controller medications was given and the proper inhalation technique was demonstrated. One month later, patients and parents were asked to answer a questionnaire on drug use and to demonstrate their inhaler techniques.

RESULTS

One hundred children and/or their parents were interviewed for the study. All of the patients identified long-term asthma-control medications while quick-relief asthma medications were identified by 93% of the patients. Of the patients, 34% described the dose of their quick-relief medication correctly. All steps in the inhalation technique were correctly carried out by 60.6% of patients using a metered-dose inhaler (MDI), 80% of patients using a Turbuhaler, and 58% of patients using a capsule-based dry-powder inhaler (DPI). Of the participants, 73% reported regular use of long-term asthma-control medications. While the mean age of the patients regularly using long-term asthma medications was 9.05±2.5 years, that of patients not compliant with the regular treatment was 10.29±3.26 years (p=0.04). The most common reason for irregular drug use was forgetting to take the drug.

CONCLUSION

Adherence to long-term asthma-control medications tends to be better in younger patients. Since the most common cause of irregular drug use is forgetting to take the drug, repeated training is necessary to ensure asthma control and the successful treatment of asthmatic children.

The value of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) parameters in analysis with fetal malnutrition neonates

Objective To assess the association between fetal malnutrition (FM) and the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) in singleton term appropriate for gestational age (AGA) neonates. Methods This cross-sectional observational study was performed with 4340 singleton, term AGA neonates without perinatal disease over a two-year period. Results A total of 4320 neonates were evaluated in this study. Those diagnosed with fetal malnutrition, 284 (6%) neonates, were compared with 150 healthy term AGA neonates. Gestational week, birth weight, birth height, head circumference, maternal age, last pregnancy weight, and status of income of the FM group were found to be lower when compared to the control group (P = 0.011). Low last pregnancy weight (P = 0.017) and low level of income (P = 0.042) were found to be factors that affect the presence of FM. The NLR and PLR were found to be significantly higher in the FM group compared with term AGA healthy controls. In correlation analyses, there was a negative correlation between the NLR and PLR with fetal nutritional status (P = 0.011 and P < 0.001, respectively). When the NLR level was taken as 4.51, the sensitivity and specificity of the test for FM were calculated as 81.2% and 80.8%, respectively [area under the receiver-operating characteristic curve (AUROC): 0.81]; when the PLR level was taken as 155.4, the sensitivity and specificity of the test for FM were calculated as 87.0% and 85.4%, respectively (AUROC: 0.94). Conclusion Cord-blood NLR and PLR negatively correlate with term FM AGA neonates.

The Effect on Survival and Mortality of the Highest SUVmax Value on Metastatic Foci in Postoperative Kidney Tumors

Objective

One-third of patients newly diagnosed with a kidney tumor have metachoronous disease, 25-50% have synchronous metastasis, and approximately 30-40% of patients have metastasis at the time of diagnosis. Metastasis mostly occurs in the lungs, regional lymph nodes, bones, and liver. The present study was aimed to determine the effect on mortality the values of standard uptake value (SUV)max measured with positron emission tomography (PET) in metastases of kidney tumors.

Material and Methods

A retrospective review was conducted of the files of 77 patients newly diagnosed with kidney tumor and disease staging determined with PET in the Nuclear medicine Department of Saglik Bilimleri University Diyarbakir Gazi Yasargil Training and Research Hospital between August 2007 and April 2012. The gender, age, histological types, metastases, SUVmax values, and dates of death of the patients were recorded in the SPSS software.

Results

It was observed that higher SUVmax values indicated a shorter survival time (r = .303) (P = 0.022). Patients with metastasis lived for a shorter period (P < 0.001), particularly those with liver metastasis (r = .515) (P = 0.049). Metastases were most frequently seen in lymph nodes (42.1%); the SUVmax values of lung metastases were higher (P = 0.025) and papillary carcinomas showed higher SUVmax uptake (P = 0.015).

Conclusions

In the present study, it was concluded that the higher the SUVmax value the shorter the survival time. The survival time of patients with metastasis was shorter, and this could be estimated through the measured SUVmax values.

The Value of Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio for Detecting Early-onset Neonatal Sepsis

OBJECTIVE

The purpose of this study was to investigate the relationship between neonate early-onset sepsis (EOS) and the neutrophil to lymphocyte ratio (NLR) and the platelet to lymphocyte ratio (PLR) of term neonates.

MATERIALS AND METHODS

This prospective observational study was conducted with term neonates diagnosed with EOS compared with 44 healthy controls. Exclusion criteria were prematurity, postmaturity, small or large for gestational age according to week of pregnancy, preeclampsia, gestational diabetes mellitus, chorioamnionitis, congenital major anomalies, and cyanotic congenital heart disease.

RESULTS

A total of 122 term neonates were included in the study. Of these, 78 were diagnosed with EOS and 44 were healthy controls. Tachycardia and apnea with bradycardia were the most common clinical signs of the onset of EOS in neonates in the EOS group. This group had significantly higher neutrophil counts, axillary temperatures, NLRs, PLRs, C-reactive proteins, and procalcitonin levels compared with the control group. There was a positive association between neutrophil counts, NLR, and PLR in the EOS group. An NLR of 6.76 was determined as the predictive cutoff value of neonate EOS (sensitivity 97.4%; specificity 100%; area under the receiver-operating characteristic curve 0.99; P=0.001). A PLR of 94.05 was determined as the predictive cutoff value of neonate EOS (sensitivity 97.4; specificity 100%; area under the receiver-operating characteristic curve 0.93; P=0.001).

CONCLUSIONS

NLRs and PLRs were positively correlated with EOS in term neonates, and these ratios can be used as diagnostic adjunct tests for neonate EOS workups.

Clinical Efficacy of Metoclopramide to Treat Pain and Nausea in Renal Colic Patients: A Prospective Randomised, Double-Blind, Controlled Trial

Introduction

This study aimed to evaluate the clinical efficacy of intravenous metoclopramide for the relief of pain and nausea among the emergency department patients with renal colic.

Methods

Patients were randomised into three groups: tenoxicam (20 mg); tenoxicam (10 mg) plus metoclopramide (10 mg); and metoclopramide (10 mg). Changes in pain and nausea were examined at the 10th, 20th and 30th minute after treatment. The development of side effects would be recorded. After the 30th minute, the need for additional pain and nausea relief was evaluated.

Results

Totally 80 patients were enrolled in each group. There was significant mean pain score difference as measured by visual analog scale (VAS) from 0 minute to 10th, 20th and 30th minute post-treatment for all treatment groups (p<0.001). There was no significant difference in mean VAS decrease from 0 minute to the 30th minute: tenoxicam group: 36 mm [95% confidence interval (CI) 28-43 mm] vs. tenoxicam plus metoclopramide: 45 mm (95% CI 38-52 mm) vs. metoclopramide group: 37 mm (95% CI 30-45 mm) (p=0.163). Similarly, no significant differences in mean nausea scores between the three groups were demonstrated at the 10th, 20th and 30th minute after treatment (p=0.236, 0.330 and 0.652 respectively). After the 30th minute, 43 (53%) patients needed additional pain relieving agent in the tenoxicam group compared to 27 (33%) patients in the tenoxicam-metoclopramide group and 33 (41%) patients in the metoclopramide group (p=0.030). No significant adverse drug reaction events were encountered.

Conclusion

Metoclopramide is as effective as tenoxicam to treat pain and nausea for patients with renal colic in the emergency department. (Hong Kong j.emerg.med.2015;22:93-99)

Oxcarbazepine-induced Stevens-Johnson syndrome: a pediatric case report

Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis are two rare but life-threatening diseases characterized by detachment of epidermis, bullous skin lesions and mucous membrane erosions. Anti-epileptic drugs are highly suspected to be the causative agents. Although carbamazepine (CBZ) is the most associated anti-epileptic drug, oxcarbazepine (OXC), which is a monohydrated derivative of CBZ, is proposed to be safer because of the different metabolism of the two drugs. Herein, we report a case of SJS induced by oxcarbazepine. A 6-year-old boy with benign rolandic epilepsy, admitted to our hospital with generalized maculopapular rash after starting oxcarbazepine. The diagnosis of SJS was made with cytotoxic skin lesions and mucous membrane involvement. After discontinuing of the drug and topical corticosteroid initiation, the lesions were improved. We report this case to attract attention to the serious side effect of this anti-epileptic drug.

Lack of Association Between Toll-like Receptor 2 Polymorphisms (R753Q and A-16934T) and Atopic Dermatitis in Children from Thrace Region of Turkey

BACKGROUND

Atopic dermatitis is the most common chronic inflammatory skin disease. A complex interaction of both genetic and environmental factors is thought to contribute to the disease.

AIMS

To evaluate whether single nucleotide polymorphisms in the TLR2 gene c.2258C>T (R753Q) (rs5743708) and TLR2 c.-148+1614T>A (A-16934T) (rs4696480) (NM_0032643) are associated with atopic dermatitis in Turkish children.

STUDY DESIGN

Case-control study.

METHODS

The study was conducted on 70 Turkish children with atopic dermatitis aged 0.5-18 years. The clinical severity of atopic dermatitis was evaluated by the severity scoring of atopic dermatitis index. Serum total IgE levels, specific IgE antibodies to inhalant and food allergens were measured in both atopic dermatitis patients and controls, skin prick tests were done on 70 children with atopic dermatitis. Genotyping for TLR2 (R753Q and A-16934T) single nucleotide polymorphisms was performed in both atopic dermatitis patients and controls.

RESULTS

Cytosine-cytosine and cytosin-thymine genotype frequencies of the TLR2 R753Q single nucleotide polymorphism in the atopic dermatitis group were determined as being 98.6% and 1.4%, cytosine allele frequency for TLR2 R753Q single nucleotide polymorphism was determined as 99.29% and the thymine allele frequency was 0.71%, thymine-thymine, thymine-adenine, and adenine-adenine genotype frequencies of the TLR2 A-16934T single nucleotide polymorphism were 24.3%, 44.3%, and 31.4%. The thymine allele frequency for the TLR2 A-16934T single nucleotide polymorphism in the atopic dermatitis group was 46.43%, and the adenine allele frequency was 53.57%, respectively. There was not statistically significant difference between the groups for all investigated polymorphisms (p>0.05). For all single nucleotide polymorphisms studied, allelic distribution was analogous among atopic dermatitis patients and controls, and no significant statistical difference was observed. No homozygous carriers of the TLR2 R753Q single nucleotide polymorphism were found in the atopic dermatitis and control groups.

CONCLUSION

The TLR2 (R753Q and A-16934T) single nucleotide polymorphisms are not associated with atopic dermatitis in a group of Turkish patients.

Investigation of the relationship between non-alcoholic fatty liver disease and coronary artery disease

AIMS

The purpose of the study was to examine the association between visceral adiposity form of non-alcoholic fatty liver and coronary artery disease severity and also to investigate the relationship between the epicardial adipose tissue thickness and non-alcoholic fatty liver disease with clinical and anthropometric measurements.

MATERIALS AND METHODS

This study included 105 patients (mean age of patients were 57 ± 11, 82 of them male) who were hospitalized for coronary angiography because of chest pain. Nonalcoholic fatty liver disease was investigated by using ultrasonography. Thickness of the epicardial adipose tissue was measured by transthorasic echocardiography to right ventricular free wall adjacent to the parasternal long and short axis images. Gensini score was used for the severity of coronary artery disease.

RESULTS

In patients with non-alcoholic fatty liver disease, right ventricular free wall epicardial adipose tissue thickness average of parasternal long and short axis were thicker than those who do not have non alcholic fatty liver disease (0,90 ± 0,19 cm; 0.58 ± 0.18 cm, p<0.001). Also, in patients with severe coronary artery disease, right ventricular free wall parasternal long and short axis average thickness of epicardial fat tissue was thicker than those of patients without severe coronary stenosis (0.86 ± 0.21 cm; 0,66 ± 0.26 cm, p=0.001). For predictability of coronary artery disease, Receiver Operating Characteristic analysis of the area under the curve was found to be 0.60 (50.2 to 74.7, 95% Confidence Limits).

CONCLUSIONS

Not only the fatty tissue which surrounds the heart effects the coronary arteries but also other visceral organs adiposity effects the coronary arteries atherosclerotic process.

Methyl palmitate attenuates lipopolysaccharide-induced acute lung injury in mice

AIM

The study is aimed to determine the beneficial effects of methyl palmitate (MP) which has antioxidant and anti-inflammatory effects demonstrated on murine model of acute lung injury induced by lipopolysaccharide (LPS).

MATERIALS AND METHODS

Forty male BALB/C mice were randomly allocated into four groups (n=10, each): control group, methyl palmitate group (300 mg/kg), LPS group, and methyl palmitate -treated groups. Methyl palmitate or vehicle was given with an intraperitoneal administration 1 h before an intratracheal instillation of LPS (5 mg/kg). The severity of pulmonary injury was evaluated 6 h after LPS challenge. All experimental procedures complied with the requirements of the Animal Care and Ethics Committee of the Adnan Menderes University.

RESULTS

Methyl palmitate pretreatment significantly attenuated LPS-induced pulmonary histopathologic changes, alveolar hemorrhage, and neutrophil infiltration. Methyl palmitate pretreatment also reduced the concentrations of malondialdehyde in lung tissues.

CONCLUSIONS

This study indicates that methyl palmitate may have a protective effect against LPS-induced acute lung injury, and the potential mechanism of this action may involve the inhibition of NF-κB. activation.

Proceedings of the Canadian society of allergy and clinical immunology annual scientific meeting 2015

A1 Role of fibrocytes in allergic rhinitis

Marie-Ève Côté, Marie-Ève Boulay, Sophie Plante, Jamila Chakir, Louis-Philippe Boulet

A2 Patterns of aeroallergens sensitization in Northern Alberta

Hanan Ahmed, Maria-Beatriz Ospina, Kyriaki Sideri, Harissios Vliagoftis

A3 Addressing acceptable risk for adolescents with Food-Induced Anaphylaxis (FIA)

Sara F. Johnson, Roberta L. Woodgate

A4 Outcomes of matched related and unrelated bone marrow transplantation after reduced-toxicity conditioning for children suffering from Chronic Granulomatous Disease

Guilhem Cros, Pierre Teira, Sonia Cellot, Henrique Bittencourt, Helene Decaluwe, Marie France Vachon, Michel Duval, Elie Haddad

A5 Outcomes of patients with severe combined immunodeficiency (SCID) prior to and after initiation of newborn screening for SCID in Ontario

Vy H.D. Kim, Anne Pham-Huy, Eyal Grunebaum

A6 Detection of regulatory B cells in the airways of subjects with asthma

John-Paul Oliveria, Stephanie Phan, Mark W. Tenn, Damian Tworek, Steven G. Smith, Adrian J. Baatjes, Caitlin D. Obminski, Caroline E. Munoz, Tara X. Scime, Roma Sehmi, Gail M Gauvreau

A7 Characterization of IgE-expressing B cells in the airways and peripheral blood of allergic asthmatic subjects

John-Paul Oliveria, Stephanie Phan, Mark W. Tenn, Brittany M Salter, Steven G Smith, Caitlin D Obminski, Caroline E Munoz, Abbey Schlatman, Tara X Scime, Rick Watson, Roma Sehmi, Gail M Gauvreau

A8 Pregnancy: could it be a risk factor for primary immunodeficient patients

Roya Sherkat, Razieh Khoshnevisan, Saba Sheikhbahaei

A9 Clinical experience with Octagam: a Canadian retrospective chart review

Stephen Betschel, Richard Warrington, Robert Schellenberg

A10 Kounis syndrome secondary to contrast media with inferior ST elevations and bilateral ischemic stroke

Michael N Fein, Jean-Philippe Pelletier

A11 Honey bee venom immunotherapy ineffective in bumble bee-induced anaphylaxis: case report and review of literature

Manstein Kan, Robert Schellenberg

A12 Delayed immune reconstitution occurring after multiple immune complications of hematological stem cell transplantation for a leaky SCID

Roxane Labrosse, Guilhem Cros, Pierre Teira, Henrique Bittencourt, Helene Decaluwe, Michel Duval, Elie Haddad

A13 Comparison of Three Case Reports of Acquired Angioedema: presentation, management and outcome

Raymond Mak, James Loh, Amin Kanani

A14 Sitagliptin-associated angioedema not related to concurrent use of ARB or ACE inhibitor

Dominik A. Nowak, Paul K. Keith

A15 Sneddon-Wilkinson subcorneal pustular dermatosis associated with an IgA monoclonal gammopathy

Daniel Pannozzo, Dominik A. Nowak, Hermenio C. Lima

A16 Omalizumab can be effective in patients with allergic bronchopulmonary aspergillosis

Diana Pham, Hoang Pham, Gonzalo G. Alvarez, Istvan T. Bencze, Krishna B. Sharma, Mark Smith, Shawn Aaron, Jennifer Block, Tara Keays, Judith Leech, David Schneidermen, Jodi Cameron, Jennifer Forgie, Alicia Ring, John W. O’Quinn, Stephanie Santucci, William H. Yang

A17 Efficacious use of omalizumab in the treatment of cystic fibrosis

Diana Pham, Hoang Pham, Ena Gaudet, Shawn Aaron, Stephanie Santucci, William H. Yang

A18 HAE with normal C1-INH with inconsistent response to C1 esterase inhibitor infusion but reliably responsive to icatibant

Hoang Pham, Stephanie Santucci, William H. Yang

A19 Anaphylaxis reaction to lactase enzyme

Mathew R. Voisin, Rozita Borici-Mazi

A20 Risk of solid tumor malignancies in patients with primary immune deficiency

Kateryna Vostretsova, Donald F. Stark

A21 Is it time to adopt the chromogenic assay for measuring C1 esterase inhibitor function in patients with HAE Type 2?

Elizabeth Yeboah, Paul K. Keith

A22 Emergency department visits for anaphylaxis and allergic reactions

Michelle Martin-Rhee, Cheryl Gula, Clare Cheng, Geoff Paltser

A23 START: Susceptibility To food Allergies in a Registry of Twins

Alizée Dery, Ann Clarke, Kari Nadeau, Laurie Harada, Kimberley Weatherall, Celia Greenwood, Denise Daley, Yuka Asai, Moshe Ben-Shoshan

A24 Qualifying the diagnostic approach employed by allergists when managing patients with self-diagnosed non-celiac gluten sensitivity (NCGS)

Lee Horgan, Teresa Pun

A25 Retrospective analysis on the agreement between skin prick test and serum food specific IgE antibody in adults with suspected food allergy

Ling Ling, Maria B. Ospina, Kyriaki Sideri, Harissios Vliagoftis

A26 Staple food hypersensitivity from infancy to adolescence: a report from the BAMSE cohort

Jennifer L.P. Protudjer, Mirja Vetander, Marianne van Hage, Ola Olén, Magnus Wickman, Anna Bergström

A27 Evaluating the impact of supervised epinephrine autoinjector administration during food challenges on perceived parent confidence

Timothy Teoh, Christopher Mill, Tiffany Wong, Ingrid Baerg, Angela Alexander, Kyla J. Hildebrand, John Dean, Boris Kuzeljevic, Edmond S. Chan

A28 Local immunoglobulin production to Aspergillus fumigatus cystic fibrosis

Jonathan Argeny, Mia Gona-Hoepler, Petra Fucik, Edith Nachbaur, Saskia Gruber, Reto Crameri, Andreas Glaser, Zsolt Szépfalusi, Claudio Rhyner, Thomas Eiwegger

A29 Extract consumption with skin prick test (SPT) devices

Greg. Plunkett, Brad Mire

A30 Evaluation of our cases with nonsteroidal anti-inflammatory drug reactions

Mehtap Yazicioglu, Ceren Can, Gokce Ciplak

A31 Reasons for referral and final diagnoses in a tertiary care pediatric allergy clinic

Victoria E. Cook, Kyla J. Hildebrand, Elodie Portales-Casamar, Christopher Mill, Edmond S. Chan

A32 Internist referral practices for inpatients with self-reported penicillin allergies at a tertiary care teaching hospital

Michael N Fein, Emil P Nashi

A33 Assessing the risk of reactions in children with a negative oral challenge after a subsequent use of amoxicillin

Sofianne Gabrielli, Christopher Mill, Marie-Noel Primeau, Christine Lejtenyi, Elena Netchiporouk, Alizee Dery, Greg Shand, Moshe Ben-Shoshan

A34 Validity of self-reported penicillin allergies

Erica Hoe, Joel Liem

A35 Effectiveness of allergy-test directed elimination diets in eosinophilic esophagitis

Jason K. Ko, David J.T. Huang, Jorge A. Mazza

A36 Allergy testing and dietary management in pediatric eosinophilic esophagitis (EoE): A retrospective review of a tertiary Canadian centre’s experience

Mary McHenry, Anthony Otley,Wade Watson

A37 Visualizing the impact of atopic and allergic skin disease

Dominik A. Nowak, John N. Kraft

A38 Cystic fibrosis with and without nasal polyposis in pediatric patients: a cross-sectional comparative study

Mihaela Paina, Ahmed A. Darwish Hassan, Delia Heroux, Lynn Crawford, Gail Gauvreau, Judah Denburg, Linda Pedder, Paul K. Keith

A39 Evaluation of macrolide antibiotic hypersensitivity: the role of oral challenges in children

Bahar Torabi, Marie-Noel Primeau, Christine Lejtenyi, Elaine Medoff, Jennifer Mill, Moshe Ben-Shoshan

A40 Venom allergy testing: is a graded approach necessary?

Jaclyn A. Quirt, Xia Wen, Jonathan Kim, Angel Jimenez Herrero, Harold L. Kim

A41 The role of oral challenges in evaluating cephalosporin hypersensitivity reactions in children

Magdalena J. Grzyb, Marie-Noël Primeau, Christine Lejtenyi, Elaine Medoff, Jennifer Mill, Moshe Ben-Shoshan

A42 Breastfeeding and infant wheeze, atopy and atopic dermatitis: findings from the Canadian Healthy Infant Longitudinal Development Study

Meghan B. Azad, Zihang Lu, Allan B. Becker, Padmaja Subbarao, Piushkumar J. Mandhane, Stuart E. Turvey, Malcolm R. Sears, the CHILD Study Investigators

A43 IL33 DNA methylation in bronchial epithelial cells is associated to asthma

Anne-Marie Boucher-Lafleur, Valérie Gagné-Ouellet, Éric Jacques, Sophie Plante, Jamila Chakir, Catherine Laprise

A44 NRF2 mediates the antioxidant response to organic dust-induced oxidative stress in bronchial epithelial cells

Michael Chen, Toby McGovern, Mikael Adner, James G. Martin

A45 The effects of perinatal distress, immune biomarkers and mother-infant interaction quality on childhood atopic dermatitis (rash) at 18 months

Nela Cosic, Henry Ntanda, Gerald Giesbrecht, Anita Kozyrskyj, Nicole Letourneau

A46 Examining the immunological mechanisms associated with cow’s milk allergy

Bassel Dawod, Jean Marshall

A47 Tryptase levels in children presenting with anaphylaxis to the Montréal Children’s Hospital

Sarah De Schryver, Michelle Halbrich, Ann Clarke, Sebastian La Vieille, Harley Eisman, Reza Alizadehfar, Lawrence Joseph, Judy Morris, Moshe Ben-Shoshan

A48 Secondhand tobacco smoke exposure in infancy and the development of food hypersensitivity from childhood to adolescence

Laura Y. Feldman, Jesse D. Thacher, Inger Kull, Erik Melén, Göran Pershagen, Magnus Wickman, Jennifer L. P. Protudjer, Anna Bergström

A49 Combined exposure to diesel exhaust and allergen enhances allergic inflammation in the bronchial submucosa of atopic subjects

Ali Hosseini, Tillie L. Hackett, Jeremy Hirota, Kelly McNagny, Susan Wilson, Chris Carlsten

A50 Comparison of skin-prick test measurements by an automated system against the manual method

Saiful Huq, Rishma Chooniedass, Brenda Gerwing, Henry Huang, Diana Lefebvre, Allan Becker

A51 The accurate identification and quantification of urinary biomarkers of asthma and COPD through the use of novel DIL- LC-MS/MS methods

Mona M. Khamis, Hanan Awad, Kevin Allen, Darryl J. Adamko, Anas El-Aneed

A52 Systemic immune pathways associated with the mechanism of Cat-Synthetic Peptide Immuno-Regulatory Epitopes, a novel immunotherapy, in whole blood of cat-allergic people

Young Woong Kim, Daniel R. Gliddon, Casey P. Shannon, Amrit Singh, Pascal L. C. Hickey, Anne K. Ellis, Helen Neighbour, Mark Larche, Scott J. Tebbutt

A53 Reducing the health disparities: online support for children with asthma and allergies from low-income families

Erika Ladouceur, Miriam Stewart, Josh Evans, Jeff Masuda, Nicole Letourneau, Teresa To, Malcolm King

A54 Epigenetic association of PSORS1C1 and asthma in the Saguenay-Lac-Saint-Jean asthma study

Miriam Larouche, Liming Liang, Catherine Laprise

A55 IL-33 induces cytokine and chemokine production in human mast cells

Stephanie A. Legere, Ian D. Haidl, Jean-Francois Legaré, Jean S. Marshall

A56 Reference ranges for lung clearance index from infancy to adolescence for Canadian population

Zihang Lu, Malcolm Sears, Theo J. Moraes, Felix Ratjen, Per Gustafsson, Wendy Lou, Padmaja Subbarao

A57 Kingston Allergy Birth Cohort: cohort profile and mother/child characteristics to age 2

Michelle L. North, Elizabeth Lee, Vanessa Omana, Jenny Thiele, Jeff Brook, Anne K. Ellis

A58 Cow’s milk protein specific IgE, IgA and IgG4 as a predictor of outcome in oral immunotherapy

Tanvir Rahman, Duncan Lejtenyi, Sarah De Schryver, Ryan Fiter, Ciriaco Piccirillo, Moshe Ben-Shoshan, Bruce Mazer

A59 Age of peanut introduction and development of reactions and sensitization to peanut

Elinor Simons, Allan B. Becker, Rishma Chooniedass, Kyla Hildebrand, Edmond S. Chan, Stuart Turvey, Padmaja Subbarao, Malcolm Sears

A60 Multi-omic blood biomarker signatures of the late phase asthmatic response

Amrit Singh, Casey P. Shannon, Young Woong Kim, Mari DeMarco, Kim-Anh Le Cao, Gail M. Gauvreau, J. Mark FitzGerald, Louis-Philippe Boulet, Paul M. O’Byrne, Scott J. Tebbutt

A61 Early life gut microbial alterations in children diagnosed with asthma by three years of age

Leah T. Stiemsma, Marie-Claire Arrieta, Jasmine Cheng, Pedro A. Dimitriu, Lisa Thorson, Sophie Yurist, Boris Kuzeljevic, Diana L. Lefebvre, Padmaja Subbarao, Piush Mandhane, Allan Becker, Malcolm R. Sears, Kelly M. McNagny, Tobias Kollmann, the CHILD Study Investigators, William W. Mohn, B. Brett Finlay, Stuart E. Turvey

A62 The relationship between food sensitization and atopic dermatitis at age 1 year in a Canadian birth cohort

Maxwell M. Tran, Diana L. Lefebvre, Chinthanie F. Ramasundarahettige, Allan B. Becker, Wei Hao Dai, Padmaja Subbarao, Piush J. Mandhane, Stuart E. Turvey, Malcolm R. Sears

A63 Allergen inhalation enhances Toll-like receptor-induced thymic stromal lymphopoietin receptor expression by hematopoietic progenitor cells in mild asthmatics

Damian Tworek, Delia Heroux, Seamus N. O’Byrne, Paul M. O’Byrne, Judah A. Denburg

A64 The Allergic Rhinitis Clinical Investigator Collaborative – replicated eosinophilia on repeated cumulative allergen challenges in nasal lavage samples

Laura Walsh, Mena Soliman, Jenny Thiele, Lisa M. Steacy, Daniel E. Adams, Anne K. Ellis

A65 The CHILD Study: optimizing subject retention in pediatric longitudinal cohort research

Linda Warner, Mary Ann Mauro, Robby Mamonluk, Stuart E. Turvey

A66 Differential expression of C3a and C5a in allergic asthma

ChenXi Yang, Amrit Singh, Casey P. Shannon, Young Woong Kim, Ed M. Conway, Scott J. Tebbutt

Comparison of recombinant human erythropoietin and darbepoetin alpha in children

BACKGROUND

The aim was to compare the clinical efficacy of recombinant human erythropoietin (rHuEPO) and darbepoetin alpha (DA) in the treatment of anemia in children with chronic kidney disease (CKD).

METHOD

Thirty-four (13 female, 21 male) CKD patients were enrolled in the study. Mean age was 11.42 ± 4.05 years. Nine patients were on hemodialysis, 18 were on peritoneal dialysis and seven patients were in CKD stage 4.

RESULTS

Seventeen patients received rHuEPO and the remaining 17 patients received DA. Hemoglobin (Hb) was not significantly different between the two groups during monthly follow up and at the end of 6 months (P > 0.05), but there was a significant increase within each group at the end of 6 months (P = 0.01 for rHuEPO; P = 0.02 for DA). Hb was not different between the patients on and not on dialysis in both groups at the end of the study (P > 0.05). The efficacy of the s.c. and i.v. routes was similar within each group (P > 0.05). Systolic hypertension was observed in only one patient in the DA group, no other adverse effect was observed in either groups.

CONCLUSION

DA is a reasonable alternative to rHuEPO in the treatment of anemia in pediatric CKD patients, due to its clinical efficacy, convenience of use, patient compliance and tolerability.

Pretreatment parameters obtained from peripheral blood sample predicts invasiveness of bladder carcinoma

PURPOSE

To predict the invasiveness of urothelial bladder carcinoma using a logistic regression model on preoperative peripheral blood samples.

PATIENTS AND METHODS

Hospital data of patients operated for urothelial carcinoma were reviewed retrospectively. Preoperative blood samples were collected before the first cystoscopic examination. Any kind of infection or inflammation was an exclusion criterion. Patients were grouped as having a non-muscle-invasive or muscle-invasive urothelial carcinoma. The mean age was 69 years and was determined as the cut-off value. According to receiver operating characteristic curves, threshold points were determined for lymphocytes, neutrophil count, neutrophil-to-lymphocyte ratio (NLR), thrombocytes and mean platelet volume. Demographic specialties, parameters obtained from blood samples, tumor size and multiplicity were evaluated and significant parameters were put into a logistic regression model.

RESULTS

The study group consisted of 80 non-muscle-invasive and 102 muscle-invasive patients. Age (≤69 vs. >69), female gender, NLR (2.57), mean platelet volume (7.9/fl) and platelet count (400,000/µl) were significant parameters and put in a model. Using odds ratios, the probability of tumor invasiveness was calculated by a formula.

CONCLUSION

Age, female gender, NLR and platelet count were found to be the predictors of invasiveness of urothelial carcinoma.

Critical appraisal of the PADUA classification and assessment of the R.E.N.A.L. nephrometry score in patients undergoing partial nephrectomy

PURPOSE

We validated the PADUA classification and assessed the R.E.N.A.L. nephrometry score to predict perioperative complications of partial nephrectomy. In addition, we assessed their interobserver variability, and the ability to predict the use of ischemia and ischemia time.

MATERIALS AND METHODS

Data from consecutive cases of partial nephrectomy with or without ischemia from 3 centers were retrospectively collected. Associations between preoperative variables and complications were evaluated in univariate and multivariate analyses. Reproducibility was assessed by determining Fleiss' generalized kappa and intraclass correlation coefficients in a subcohort scored by 3 physicians with different degrees of urological expertise.

RESULTS

A total of 134 partial nephrectomies were included in the study and 31 cases (23%) presented with complications. On univariate analyses complications were associated with age (p = 0.02), tumor size on computerized tomography (p = 0.01), pT stage (p = 0.001), and PADUA (p = 0.001) and R.E.N.A.L. scores (p = 0.02). In 3 multivariate models PADUA score 10 or greater (OR 3.98, p = 0.01), R.E.N.A.L. score 9 or greater (OR 4.21, p = 0.02), tumor size in cm (OR 1.35, p = 0.02) and age (OR 1.04, p = 0.04) were independent predictors of complications. The R.E.N.A.L. nephrometry score predicted the use of ischemia (p = 0.03) and both scores predicted ischemia time (both p <0.001). Kappa was 0.37 to 0.80 for PADUA components and 0.23 to 0.73 for R.E.N.A.L. components. The intraclass correlation coefficient was 0.73 for PADUA and 0.70 for R.E.N.A.L. score.

CONCLUSIONS

The highest categories of PADUA and R.E.N.A.L. scores as well as clinical tumor size predict the risk of perioperative complications of partial nephrectomy. Both scores can indicate ischemia time. Their reproducibility is substantial but the implementation of these systems in clinical practice needs further refinement.

Vascular endothelial dysfunction in cyclosporine-treated rat aortas is not associated with serum total homocysteine levels

OBJECTIVES

Elevation of serum total homocysteine (tHcy) is considered to contribute to endothelial cell dysfunction, which is considered to be the initial event in posttransplant vascular disease. We sought to investigate whether an association existed between serum tHcy levels and vascular endothelial function during cyclosporine (CsA) treatment.

MATERIALS AND METHODS

Endothelium-dependent and -independent relaxation responses (to acetylcholine [ACh] and sodium nitroprusside [SNP]) were determined on thoracic aortae from CsA-treated rats (5 mg kg/d, subcutaneously, for 14 days). A correlation analysis was performed between ACh responses and tHcy levels.

RESULTS

CsA decreased the responses to ACh and the pD(2) values of the concentration-response curves compared with controls (P < .05). Responses to SNP and serum tHcy levels were unchanged among the groups. tHcy negatively correlated with the ACh pD(2) values among control (r = -0.69; P < .05) and vehicle (r = -0.73; P < .05) groups, indicating that the increase in tHcy was associated with decreased sensitivity to ACh. In CsA-treated rats, no association was observed between these parameters. Also, no correlation was noted between CsA concentrations and tHcy levels.

CONCLUSION

These data suggested a possible link between serum tHcy and decreased vascular sensitivity to endothelium-dependent vasorelaxation in control aortae, but CsA-induced vascular endothelial dysfunction was not associated with an effect of the drug on homocysteine metabolism.

First Report of Ascochyta rabiei Causing Ascochyta Blight of Cicer pinnatifidum

In July 2005, small (2 to 5 mm), elongated, dark brown spots on the stems of Cicer pinnatifidum Jaub. & Spach. were observed on plants grown in the rocky hills of the Kahramanmaras Province. To understand this phenomenon, field trips to Kahramanmaras, Adiyaman, and Sanliurfa provinces were conducted in the summer of 2006. C. pinnatifidum plants exhibiting symptoms similar to Ascochyta rabiei (Pass.) Lab. were collected during May and June. The plants had flowers and pods with seeds at the time of collection. Ascochyta blight symptoms on stems were not extensive. None of the plants had leaf symptoms, but one plant had lesions on its pods. Twelve plants exhibiting Ascochyta blight symptoms were taken to the laboratory, and necrotic parts were used for isolation of the fungi on potato dextrose agar (PDA). After 3 to 5 days of culturing on PDA, characteristic beige-to-dark brown colony development of A. rabiei from explants was observed and five isolates from different locations were recovered. The fungal colony growth was slow and limited conidia formed on PDA. The isolates were also cultured on chickpea meal agar (CMA) and Czapek Dox Agar (CDA) media. Abundant conidia formation occurred only on CMA, 10 to 12 days after culturing. Conidia were one-celled similar to that of A. rabiei of chickpea and single-spore isolations were done. C. pinnatifidum and chickpea cv. Gokce (C. arietinum L.) were inoculated with spore suspensions of 5 × 10⁵ spores per ml (2). Ten- to twelve-day-old seedlings were used for inoculation in the experiments. Brown-black lesions at the crown region on C. pinnatifidum seedlings were observed 9 to 10 days after inoculation, and characteristic Ascochyta blight symptoms on stems developed on chickpea cv. Gokce. The fungus was reisolated from the infected seedlings. For molecular characterization, mating type of the isolates was determined by PCR using A. rabiei specific Tail1, Com1, and Sp21 primers (1). A single band of Mat 1.2 specific 500- bp product was amplified by PCR from five of the A. rabiei isolates of C. pinnatifidum. This confirmed that the isolates from C. pinnatifidum are A. rabiei. References: (1) M. P. Barve et al. Fungal Genet. Biol. 39:151, 2003. (2) M. S. A. Khan et al. Plant Pathol. 48:230, 1999.

Renal replacement lipomatosis: multidetector-row computed tomography findings in one case

Replacement lipomatosis of the kidney is the result of severe atrophy of the renal parenchyma often caused by chronic calculus disease with secondary marked benign proliferation of fibrofatty tissue replacing atrophied renal parenchyma. Different radiological modalities have been used to illustrate this entity, with magnetic resonance imaging, ultrasound, intravenous pyelogram, and computed tomography (CT) used most frequently. We report multidedector CT (MDCT) findings of replacement lipomatosis in a 50-year-old woman. We think that it accurately provides a complete one-step diagnostic workup and appropriate pre-surgical planning for patients for whom there is a suspicion of replacement lipomatosis.

Effect of smoking on semen parameters of men attending an infertility clinic

OBJECTIVE

To assess the effects of smoking on total sperm count, progressive sperm motility and sperm morphology among couples attending an infertility clinic.

METHODS

A total of 223 sperm samples (126 smokers and 97 nonsmokers) from men attending an infertility clinic for routine infertility workup were compared on the basis of standard semen analysis.

RESULTS

Cigarette smoking is negatively correlated with progressive motile sperm count (r = -0.1464, p = 0.042), but not with sperm concentration (p = 0.961), total motile sperm count (p = 0.890) and sperm morphology (p = 0.838). Furthermore, packages/ year (cumulative dose of cigarettes) did not correlate with any of the sperm parameters including sperm density (p = 0.976), total (p = 0.559) and progressive (p = 0.406) motile sperm count and sperm morphology (p = 0.449).

CONCLUSIONS

Although the effect of smoking on male infertility remains inconclusive, smoking had an adverse effect on the progressive sperm motility, irrespective of total amount of cigarettes smoked per day.

F-18 FDG PET in detecting renal cell carcinoma

PURPOSE

To assess the role of F-18 FDG imaging with a dual head coincidence mode gamma camera (Co-PET) in the detection of renal cell carcinoma (RCC) in patients with renal masses.

MATERIAL AND METHODS

An F-18 FDG Co-PET study was performed in 19 patients (7 F, 12 M; mean age 58.15 +/- 2.5 years, age range 45-79 years) with suspected primary renal tumors based on conventional imaging techniques, including computed tomography (CT) and ultrasonography (US) before nephrectomy or surgical resection of the mass.

RESULTS

Histologically documented RCC was present in 15 patients. Of the 19 patients with suspected primary renal tumors, F-18 FDG Co-PET was true-positive in 13, false-negative in 2, true-negative in 3, and false-positive in I patient. Two angiomyolipomas and one renal mass due to infarction and hemorrhage showed a true-negative Co-PET result. The patient with false-positive FDG Co-PET study was diagnosed as xantogranulomatous pyelonephritis. Overall sensitivity, specificity, and accuracy of FDG Co-PET for RCC were 86% (13/15), 75% (3/4), and 84% (16/19), respectively. Positive predictive value for RCC was 92% and negative predictive value 60%.

CONCLUSION

These findings suggest that F-18 FDG Co-PET may have a role in the diagnostic evaluation of patients with RCC and primary staging of disease. Positive F-18 FDG study may be predictive of the presence of RCC. However, a negative study does not exclude the RCC.

Endotoxin-induced vascular hyporesponsiveness in rat aorta: in vitro effect of aminoguanidine

The current study was designed to evaluate the endotoxin-induced alterations of the mechanisms involved in Ca(2+)handling within the rat thoracic aorta and further to examine whether in vitro inhibition of inducible nitric oxide synthase (iNOS) by aminoguanidine would account for this effect or not. Endothelium denuded aortic rings from rats injected with lipopolysaccharide (LPS) (5 mg kg(-1), i.p. 18 h prior to functional studies) or saline were mounted in isolated organ baths. Various experimental conditions were studied on paired rings of the same animal which were incubated in the presence or absence of aminoguanidine (100 microM). Phenylephrine contractility in Ca(2+)-containing buffer or in Ca(2+)-free buffer, contractions induced by K(+)depolarization and CaCl(2)in depolarized muscle and by caffeine exposure were significantly decreased in LPS-treated rings and were reversed by aminoguanidine exposure. Aminoguanidine also improved the contractions recorded while switching the Ca(2+)-free buffer to Ca(2+)-containing buffer. We conclude that endotoxin induces a generalized contractile defect in vascular smooth muscle including impairment in the influx of extracellular Ca(2+)and release of Ca(2+)from intracellular stores. An increase in iNOS activation leading to excessive nitric oxide synthesis, possibly non-endothelial in origin, may account for this defect.

Sulfasalazine-induced angioimmunoblastic lymphadenopathy developing in a patient with juvenile chronic arthritis

We describe a patient with juvenile chronic arthritis who developed reactive angioimmunoblastic lymphadenopathy, induced by sulfasalazine. Development of angioimmunoblastic lymphadenopathy although rare, is a very serious side effect of sulfasalazine treatment, and patients treated with this drug should be watched carefully.

Inhibition of myointimal proliferation by octreotide in canine vein interposition grafts

<b>Purpose:</b> The aim of this study was to evaluate the efficacy of octreotide in modulating the progression of intimal hyperplasia in autogenous vein bypass grafts in a canine model. The effect of the drug on the progression of intimal hyperplasia was measured with the Gilman parameter, a measure used extensively as a wound-healing descriptor. <b>Methods:</b> 12 mongrel dogs were randomly and equally divided into two groups. The first group (octreotide group) was administered octreotide 20 µg/kg/day. The control group (group II) received saline solution by subcutaneous injection. Each dog had 8- to 10-cm segments of autogenous jugular vein bypassed to the femoral arteries. Quantitative data on luminel narrowing over time from intimal hyperplasia were compared from calculated Gilman parameters after image analysis of retrieved, histologically processed graft sections. Each vein graft was analyzed by computerized morphometric analysis. <b>Results:</b> The mean Gilman parameter for distal graft segments was 0.47 ± 0.17 mm in the control group and 0.25 ± 0.07 mm in the octreotide group 6 weeks after operation (p < 0.05). Distal graft segments between the control and octreotide groups were statistically significant. In proximal, medial and distal graft segments, the mean Gilman parameters were 0.51 ± 0.16 mm in the control group and 0.37 ± 0.18 mm in the octreotide group, the difference being statistically significant (p < 0.01). <b>Conclusion:</b> Octreotide significantly inhibits myointimal thickening, and these data support the efficacy of octreotide in reducing intimal hyperplasia in arterialized vein grafts during the short postoperative period. Further investigations are required to as certain whether this beneficial effect of octretide persists in the long term.

Papillary fibroelastoma of mitral valve: a rare cause of transient ischemic attack in the young

We report the case of a young Turkish man with a transient ischemic attack secondary to a rare cardiac tumor, papillary fibroelastoma. The tumor was diagnosed by 2-dimensional echocardiography and treated surgically.

Downy mildew (Peronospora parasitica) resistance genes in Arabidopsis vary in functional requirements for NDR1, EDS1, NPR1 and salicylic acid accumulation

To better understand the genetic requirements for R gene-dependent defense activation in Arabidopsis, we tested the effect of several defense response mutants on resistance specified by eight RPP genes (for resistance to Peronospora parasitica) expressed in the Col-0 background. In most cases, resistance was not suppressed by a mutation in the SAR regulatory gene NPR1 or by expression of the NahG transgene. Thus, salicylic acid accumulation and NPR1 function are not necessary for resistance mediated by these RPP genes. In addition, resistance conferred by two of these genes, RPP7 and RPP8, was not significantly suppressed by mutations in either EDS1 or NDR1. RPP7 resistance was also not compromised by mutations in EIN2, JAR1 or COI1 which affect ethylene or jasmonic acid signaling. Double mutants were therefore tested. RPP7 and RPP8 were weakly suppressed in an eds1-2/ndr1-1 background, suggesting that these RPP genes operate additively through EDS1, NDR1 and as-yet-undefined signaling components. RPP7 was not compromised in coi1/npr1 or coi1/NahG backgrounds. These observations suggest that RPP7 initiates resistance through a novel signaling pathway that functions independently of salicylic acid accumulation or jasmonic acid response components.

Fulminant hepatic failure as the initial manifestation of primary hepatocellular carcinoma

A 20-year-old male, with no history of chronic liver disease, presented with fulminant hepatic failure. The cause was not established until post mortem when it was found that he had a primary hepatocellular carcinoma in a non-cirrhotic liver. To our knowledge, this is the third report of hepatocellular carcinoma presenting in this manner. Although rare, primary malignancies of the liver should be considered in the differential diagnosis of fulminant hepatic failure, especially when other more common causes are excluded.

Prevention of intimal hyperplasia by single-dose pre-insertion external radiation in canine-vein interposition grafts

OBJECTIVES

to evaluate the efficacy of single-dose pre-insertion gamma radiation of vein grafts in the prevention of intimal hyperplasia.

METHODS

femoral artery interposition grafts with internal jugular vein were inserted in 12 mongrel dogs. The animals were randomly divided into two groups. Immediately before graft replacement, jugular veins were treated with a single dose of cobalt-60 radiation at 14 Gy or received no radiation (control group). Six weeks after graft insertion, the vein grafts were pressure-perfusion fixed and harvested for the histomorphometric analysis. Quantitative data on anastomotic stenosis were calculated from Gilman parameters after cross-sectional image analysis.

RESULTS

vein grafts treated with radiation demonstrated significantly decreased neointima formation compared with grafts in the control group. The mean Gilman parameter for the control group was 1.09 S.E.M. 0.34 mm and for the radiotherapy group was 0.65 S.E. M. 0.23 mm (p<0.05). All vein grafts in the radiotherapy group had a decreased amount of intimal and cellular infiltration.

CONCLUSION

single-dose external pre-insertion gamma radiation of vein grafts reduced the amount of intimal hyperplasia in this animal model.

Protective effect of oral L-arginine administration on gentamicin-induced renal failure in rats

We investigated the effects of orally supplemented L-arginine, the substrate of nitric oxide (NO) and N(omega)-nitro-L-arginine methyl ester (L-NAME), a nitric oxide-synthase inhibitor in gentamicin-induced renal failure. Rats were given gentamicin (100 mg/kg/day s.c.), gentamicin and L-arginine (2 g/l, drinking water), gentamicin and L-NAME (100 mg/l, drinking water) or gentamicin plus L-arginine and L-NAME. After 8 days, the gentamicin group developed marked renal failure, characterized by a significantly decreased creatinine clearance and increased blood creatinine, fractional excretion of sodium, fractional excretion of lithium, urine gamma glutamyl transferase, systolic blood pressure and daily urine volume when compared to controls. Renal histological analysis confirmed tubular necrosis. L-arginine administration caused normalization of these parameters, whereas L-NAME led to aggravation of the failure. Concomitant administration of L-NAME and L-arginine to gentamicin-treated rats caused no significant changes when compared to the rats receiving gentamicin alone. We conclude that L-arginine supplementation has beneficial effects in gentamicin-induced renal failure in rats and that these effects are reversed by the NO-synthase inhibitor, L-NAME.

Multiple oligodendroglioma: case report

An 18-year-old female patient was hospitalized with headache and disturbance of consciousness. Magnetic resonance imaging (MRI) revealed a tumor in the left parieto-occipital lobe. The tumor was totally removed, and postoperative radiation therapy was administered locally at 50 Gy. Ten months later, she experienced sudden onset of unconsciousness and headache. Computed tomography (CT) and MRI demonstrated multiple mass lesions in the whole brain. Following the systemic chemotherapy, removal of the largest tumor was performed. Histological examination proved all excised tumors to be oligodendroglioma without evidence of malignant change.

The use of polytetrafluoroethylene (Gore-Tex) grafts in reconstruction of the urinary bladder

The safety and histopathologic effects of polytetrafluoroethylene (Gore-Tex) grafts in reconstruction of the urinary bladder were examined. Following partial excision of the bladder Gore-Tex was placed, and the rats were sacrificed at days 7, 14 and 30. Gore-Tex did not cause urine infection, and there was no peritonitis or sepsis in any of the rats. Inflammation around the Gore-Tex diminished after four weeks. Some mononuclear cells and exudate were observed on the inner surface of the Gore-Tex. There was no inflammation or fibrosis in the mucosa and muscular layers of the remaining bladder. In this study the Gore-Tex graft was found to be an infection resistant, urine impermeable material, with no adverse effects on the urinary bladder. Gore-Tex is suggested as a safe material for the reconstruction of the urinary bladder.