The effect of vascular endothelial growth factor overexpression in experimental necrotizing enterocolitis.

PURPOSE: Necrotizing enterocolitis (NEC) is a serious condition, predominantly observed in premature infants. We used an experimental NEC model to investigate the effects of vascular endothelial growth factor (VEGF) cloned into a plasmid. MATERIALS AND METHODS: Twenty-four newborn Wistar albino rats were randomized equally into three groups as follows: control, NEC and NEC+VEGF. NEC was induced by hyperosmolar enteral formula feeding, exposure to hypoxia/reoxygenation and cold stress. In the NEC+VEGF group, VEGF (1 µg) incorporated into plasmid (2 µg) was administered subcutaneously once daily for a total of 3 days starting on the first day of the NEC procedure. All rats were sacrificed on the 4th day of life, and the specimens were harvested for histopathological and biochemical examinations [including tissue oxidative stress (malondialdehyde and nitric oxide), inflammation (myeloperoxidase, interleukin-6 and tumor necrosis factor alpha) and apoptosis (caspase-3 activity) parameters]. RESULTS: In the NEC+VEGF group, tissue malondialdehyde, nitric oxide, interleukin-6, tumor necrosis factor alpha levels and caspase-3 activity were significantly decreased. In addition, the myeloperoxidase level was increased compared to that of the NEC group (p < 0.05). Histopathologically, VEGF overexpression enhanced angiogenesis, alleviated villous atrophy and tissue edema (p < 0.05). CONCLUSION: VEGF overexpression with plasmids seems to be a promising approach in the management of NEC.

Common behavioral problems among children with asthma: is there a role of asthma treatment?

BACKGROUND: An increased prevalence of behavioral problems has been described among children with asthma. OBJECTIVE: To investigate those associations between common behavioral problems and asthma, with an emphasis on the roles of medications used for asthma. METHOD: We studied 409 children who had been followed-up in pediatric allergy clinics and 157 age-matched healthy controls. A diagnostic and statistical manual disorder-referenced symptom inventory was used to assess "attention deficit-hyperactivity disorder" (ADHD), "attention deficit" (AD), "hyperactivity and impulsivity" (HI), and "oppositional defiant disorder" (ODD) behavioral problems. RESULTS: The study group consisted of 409 patients (male: 251, female: 158), with a mean age of 9.0 ± 2.67 years, and the control group consisted of 157 children (male: 75, female: 82), with a mean age of 9.0 ± 2.86 years. Prevalences of AD, hyperactivity, ADHD, and ODD were not significantly different between the study and control groups. Among those patients receiving leukotriene antagonist (LA) drugs adjunctive to inhaled corticosteroids (ICS), duration of treatment was correlated with total scores calculated for hyperactivity (P = .035, r = 0.432), AD (P = .044, r = 0.414), ADHD (P = .042, r = 0.418), and ODD (P = .032, r = 0.439). Among patients with asthma, children with ODD had a significantly longer duration of LA+ICS use (P = .024) compared with those with no ODD. Patients with hyperactivity had a longer duration of ICS+LA use compared with those with no hyperactivity (P = .009). Patients with asthma receiving LA+ICS treatment had a higher risk for oppositional behavior (4.282 times compared with the control group [P = .042, confidence interval (CI): 1.542-15.949]) and 8.3 times compared with patients with asthma not using any drug (P = .021, CI: 1.419-48.543). CONCLUSION: Rather than asthma itself, adjunctive use of ICS+LA therapy appears to be related with symptoms of common behavioral problems, including hyperactivity, AD, ADHD, and ODD and to increase the risk of ODD.