Probiotic-induced apoptosis and its potential relevance to mucosal inflammation of gastrointestinal tract.

In this short review we attempt to establish and/or strengthen connections between probiotics administration and apoptotic pathway in gastrointestinal tract. The disturbance of apoptosis is mainly deliberated in the framework of insufficient removal of immuno-effector cells that may cause autoimmunity. In the context of the inflammatory bowel disease (IBD) and necrotizing enterocolitis (NEC), the commensal bacteria and their products effect on gut and immune cell survival are illustrated. The multitude of mechanisms of probiotics to induce cell death is shortly summarized and some aspects of it are being discussed in greater detail. The mechanism of intestinal cell death induced by probiotic administration and its influence on the immune system and potential benefits of apoptosis induction during probiotic therapy is indicated.

Acoustic rhinometry assessment of the nasal cycle in neonates.

In this study the nasal cycle in newborns was assessed using acoustic rhinometry with miniprobe (RHIN 2100). Enrolled in the study were 67 newborns aged 2 to 4 days. Each subject was assessed for 3 h, examinations taking place every 30 min. At least six measurements, three from each nostril, were taken at each examination. The miniprobe RHIN 2100 (SR Electronics ApS) was used for evaluation of nasal geometry. The minimal cross-sectional area (MCA) and the total volume of the anterior 45 mm (VOL45) were calculated and used for statistical analysis. The mean volume of MCA and VOL45 in the examined group of children was 0.08 cm3 and 1.19 cm3 respectively. Nasal cycle was assessed by constructing the plots of acoustic rhinometry parameters MCA or VOL45 for time and statistically using Pearson's correlation coefficients. Most of the examined infants (70-85%) showed no significant fluctuations in nasal patency.

Sputum induction in young cystic fibrosis patients.

A culture from the lower airway secretions is the optimal sample to guide antibiotic therapy in cystic fibrosis (CF) lung disease. The authors therefore examined whether sputum induction is an efficient, safe and acceptable procedure in CF children without spontaneous expectorations. Nineteen patients were studied. Their mean age (range) was 8.6 yrs (4.3-15.2 yrs). Their mean forced expiratory volume in one second (FEV1) was 88% predicted (46-122%). NaCl solutions from 0.9-6% were inhaled, after baseline lung function tests before and after salbutamol. All patients did produce secretions. Alveolar macrophages were present in 16/19 induced samples. The procedure induced minor but significant bronchoconstriction: the mean change (range) in postsalbutamol FEV1 (% pred) was -7 (-24-16). Percutaneous oxygen saturation remained above 90% in all children. The test had to be discontinued in one child because of cough and wheeze. Acceptability of the procedure evaluated using a visual analogue scale from -7-7 showed a mean value (range) at the final concentration of -1.23 (-6.16-5.88). It is concluded that sputum induction is possible, safe and acceptable in cystic fibrosis children who do not expectorate spontaneously.

[The Doppler cerebroplacental ratios and perinatal outcome in post-term pregnancy]. / Dopplerowskie wskazniki mózgowo-lozyskowe a wynik okoloporodowy w ciazy przeterminowanej.

Our purpose was to determine whether the Doppler cerebroplacental ratios predicts perinatal outcome in postterm pregnancy. The middle cerebral to umbilical artery resistant and pulsatility indices (MCA PI/UA PI and MCA RI/UA RI) were measured in 59 postterm pregnancies. We found significant correlation between MCA PI/UA PI, MCA RI/UA RI, nonstress testing and intrapartum fetal heart rate assessment. There was also an association between MCA PI/UA PI and 1- and 5-minute Apgar score. We conclude that the Doppler cerebroplacental ratios provide useful information about perinatal outcome.

Is the correct use of a dry powder inhaler (Turbohaler) age dependent?

BACKGROUND: The metered-dose inhalers are the most commonly used devices in the treatment of asthma, but dry powder inhalers (eg, Turbohaler) are being increasingly used. Studies evaluating how well children can use a Turbohaler are lacking. OBJECTIVE: We assessed whether the correct use of a Turbohaler could be easily taught to unselected stable asthmatic children. METHODS: One hundred sixty-one asthmatic children aged 5 to 17 years (mean, 9.8 years) consecutively attending the outpatient clinic were included in study. After a demonstration and 10 minutes of training, the inhalation technique was checked in a standardized way (yes/no response). Keeping the device upright, proper preparation of the drug dose and inspiratory flow on inhalation were measured by the Turbohaler trainer. RESULTS: One hundred thirty-three children (83%) performed every step correctly (ie, 96% of children older than 8 years but only 55% of children between 5 and 8 years; P <.001). Of 28 children incorrectly using the Turbuhaler-trainer, 20 generated insufficient inspiratory flow through the device. There was no significant difference in airway obstruction (expressed as percent of predicted forced vital capacity, FEV1, and Tiffeneau index) between correct and incorrect users, but when measured through the pneumotachograph, mean peak inspiratory flow (expressed as percent predicted) was significantly lower in those children incorrectly using the device. Turbohaler use was reevaluated after 4.7 +/- 2.0 months in a subset of 64 patients. Fifty-three of 64 (83%) children again used the device correctly. Only 3 of 13 who used the device incorrectly at the first evaluation used it correctly at the second evaluation. CONCLUSIONS: We conclude that the correct use of the Turbohaler can be easily taught to asthmatic children older than 8 years. Those who use the device correctly after initial instructions continue to do so afterwards.