Azithromycin for chronic eosinophilic rhinosinusitis with nasal polyp: a placebo-controlled trial.

BACKGROUND: Chronic eosinophilic rhinosinusitis with nasal polyps (CRSwNP eosinophilic) is characterised by the formation of benign and bilateral nasal polyps. We aimed to compare the effectiveness of azithromycin as an immunomodulator with the use of a placebo in patients presenting with CRSwNP concomitant with asthma and aspirin intolerance after 3 months of treatment and at a 1-year follow-up. METHODOLOGY: We performed a randomised, double-blind, placebo-controlled trial. Patients received 500 mg azithromycin orally three times/week for 12 weeks. Improvement was evaluated by staging, the Sino-Nasal Outcome Test (SNOT-22), and nasal polyp biopsy. Data collected at pretreatment and 3 months posttreatment were compared. Quality of life was evaluated at the 1-year follow-up. RESULTS: Twenty-seven and 21 patients were treated with azithromycin and a placebo, respectively. The medication was well tolerated overall. Twenty patients (74%) in the azithromycin group and three patients (14%) in the placebo group were not refer- red for surgery at the end of the 3-month treatment. Regarding subjective improvement, there was a median decrease only in the azithromycin group, and the between-group difference was significant. SNOT-22 improvement was maintained in the azithromy- cin group at the 1-year follow-up. CONCLUSIONS: Azithromycin could be considered a therapeutic option for patients presenting with CRSwNP concomitant with asthma and aspirin intolerance.

Effects of alcohol and nicotine consumption on the development of apical periodontitis in rats: a correlative micro-computed tomographic, histological and immunohistochemical study.

AIM: To evaluate the effects of alcohol and nicotine, when used alone or simultaneously, in the development of apical periodontitis induced in rats, using a correlative analytic approach with micro-CT, histological and immunohistochemical analysis. METHODOLOGY: Twenty-eight male Wistar rats were arranged into four groups: Control, Nicotine, Alcohol and Alcohol + Nicotine. The alcohol groups were exposed to self-administration of a 25% alcohol solution, whilst the other groups drunk only filtered water. The nicotine groups received daily intraperitoneal injections of a solution with 0.19 µL of nicotine per mL, whilst the other groups received saline solution. The pulps of the left mandibular first molars were exposed for 28 days to induce periapical lesions. Throughout the experiment, drug administration was maintained, and the animals had their weight and solid and liquid consumption measured. After euthanasia, the mandibles were removed and the area, volume and major diameter of the periapical lesions were measured using micro-computed tomography images. The samples were submitted to histopathological evaluation and immunohistochemistry for RANKL and PTHrP. Statistical analysis was undertaken with a significance level of 5%. Nonparametric data were analysed using the Kruskal-Wallis test followed by Dunn's test, whilst one-way anova followed by Tukey's test was performed for parametric data. RESULTS: The alcohol groups had lower solid and liquid consumption and gained less weight when compared to the nonalcohol groups (P < 0.05). The Alcohol + Nicotine group had lesions with significantly larger volume and area when compared to the other groups (P < 0.05), whilst the Alcohol or Nicotine groups had significantly larger lesions than the control group (P < 0.05). There was no significant difference in the largest diameter of the lesions amongst groups (P > 0.05). The experimental groups had greater inflammatory response scores than the control group (P < 0.05), and the representative samples had more pronounced immunoreaction against RANKL and PTHrP antibodies. CONCLUSIONS: Alcohol and nicotine consumption exacerbated the inflammatory response and the development of periradicular lesions in rats. The association of both substances enhanced their harmful effects.

Impact of maternal diabetes mellitus on the thermoregulation of the offspring.

Maternal diabetes mellitus (DM) can induce metabolic alterations in both newborn and adult offspring. It is believed that inadequate intrauterine conditions can impair thermogenic capacity of the offspring. The objective of the present study was to evaluate the effects of maternal DM on the offspring thermoregulation. DM was induced by streptozotocin injection (60 mg/g) in Wistar EPM-1 female rats. Control animals were injected with an equal volume of citrate buffer solution (pH 4.5). Fifteen days after confirmation of diabetes by glycaemia higher than 250 mg/dl, the rats were mated and the intercourse was confirmed by vaginal smear. Diabetic animals received daily 1 UI of insulin and control animals, an equivalent volume of saline. After delivery, 6 newborn females were randomly assigned to each mother in order to assure equivalent nutritional status during lactation during which body weight of the offspring was recorded daily. At weaning (28th day) the animals were transferred to individual metallic cages kept inside a chamber under a room temperature of 25 degrees C. In the 60th day, half of the offspring was moved to a chamber at 5 degrees C, remaining there until the 90th day. Four experimental groups were thus formed that were the offspring of control or diabetic dams acclimated at 25 degrees C or 5 degrees C. During the whole experimental period body weight and food intake were recorded and during the acclimation period energy balance was determined. When rats were 90 days-old, they were blood sampled and the carcasses prepared for calorimetric determination. At birth, weaning and 90 days of age, animals were killed for quantification of body fat, protein and water. Blood samples were collected and used to determine blood glucose and insulin. Offspring from diabetic dams showed lower body weight than controls throughout the whole experiment. No effect of maternal DM on energy balance of offspring acclimated at 25 degrees C or at 5 degrees C was observed. Nevertheless, as expected, cold induced an increase in energy intake and energy expenditure as well as a reduction in food efficiency, which was characterized by lower body weight and fat gain without change in body protein. Body composition was altered only at birth, when animals from diabetic mothers showed decreased body fat content and increased percentage of water in the carcass. Only at 90 days the rats from diabetic mothers showed higher glycaemia and lower blood insulin levels than controls suggesting delayed effects of maternal DM on the offspring. After weaning, rectal temperature of the animals was measured at 25 degrees C and 5 degrees C during 2 hours at time 0, 30, 60, 90, and 120 minutes. This parameter was determined at weaning and at 45, 60, 75, and 90 days of age. The results showed that the offspring from diabetic mothers not only had a delayed thermogenic capacity as shown by their inability to keep body temperature at 5 degrees C until 90 days. It is, thus, suggested that maternal diabetes mellitus delayed thermoregulation of the offspring.

Mercury concentrations in fish from the Itacaiúnas-Parauapebas river system, Carajás region, Amazon

This paper reports on total Hg concentrations in muscle tissue from 12 fish species collected in the Itacaiúnas and Parauapebas Rivers in the Carajás region,South Pará. It is found that carnivorous species present Hg concentrations higher than herbivorous and omnivorous species. Also, large carnivorus species presented higher Hg concentrations than smaller carnivorus species. Significant positive relationship are found between fish weight and total Hg concentrations for at least two studied in detailed, the carnivorous Paulicea likeni (jaú) and Serrasalmus nattererii (piranha)

Mercury concentrations in fish from the Itacaiúnas-Parauapebas River system, Carajás region, Amazon.

This paper reports on total Hg concentrations in muscle tissue from 12 fish species collected in the Itacaiúnas and Parauapebas Rivers in the Carajás region, South Pará. It is found that carnivorous species present Hg concentrations higher than herbivorous and omnivorous species. Also, large carnivorous species presented higher Hg concentrations than smaller carnivorous species. Significant positive relationships are found between fish weight and total Hg concentrations for at least two species studied in detailed, the carnivorous Paulicea lutkeni (jaú) and Serrasalmus nattererii (piranha).

Effects of streptomycin and neomycin on the adrenal medulla of dogs.

The blocking effects of streptomycin and neomycin upon adrenal neurotransmission were studied in dogs. The pressor responses to splanchnic nerve stimulation (SNS) or 50 micrograms/kg nicotine were both blocked by 100 mg/kg but not by 50 mg/kg of the antibiotics injected systemically through the femoral vein. The effect was reversed by intravenous infusion of calcium chloride. The pressor response to SNS, but not that to nicotine, was blocked by the antibiotics injected into the adrenal gland through the adrenolumbar vein at doses up to 10 mg/kg. This effect was reversed by 50 micrograms/kg calcium chloride. Higher doses of antibiotics blocked the response to both stimuli, with only the response to nicotine being reversed by calcium chloride. These data indicate that streptomycin and neomycin block adrenal neurotransmission by interfering with calcium ions at pre- or pre-plus postsynaptic levels depending on the dose and route of administration.