Evaluation of total oxidative and antioxidative status in pediatric patients undergoing laparoscopic surgery.

OBJECTIVE: Reactive oxygen species (ROS) induced by several diseases can trigger oxidative stress. During laparoscopy, increased intraabdominal pressure caused by pneumoperitoneum may lead to splanchnic ischemia followed by reperfusion because of deflation. Because ischemia reperfusion creates oxidative stress, in this study, we aimed to investigate the oxidative-antioxidative status of the pediatric patients with laparoscopic surgery. METHODS: The children underwent laparoscopic procedures under general anesthesia, and they were mechanically ventilated. Blood samples were obtained after induction of anesthesia, at the end of the surgery, and were centrifuged at 3000 revolutions per minute for 10 minutes to separate plasma. The plasma total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) were determined. RESULTS: Plasma TOS and OSI levels were significantly higher at the end of the surgery than after induction of anesthesia (P < .05 and P < .01, respectively). On the other hand, plasma TAS levels were lower in the end of the surgery than after induction of anesthesia (P < .05). CONCLUSIONS: These results suggest that ROS are generated during the laparoscopic procedure, possibly as a result of an ischemia-reperfusion phenomenon induced by the inflation and deflation of the pneumoperitoneum, which causes oxidative stress and consume plasma antioxidants.

Acute renal failure due to bilateral uric acid lithiasis in infants.

Acute renal failure (ARF) is one of the complications of urolithiasis, but the role of medical treatment to relieve urinary obstruction in children with ARF is uncertain. We report on infants with acute obstructive uric acid lithiasis. We describe presentation features as well as diagnosis methods and medical treatment in five infants who were admitted to our institution with ARF due to uric acid lithiasis. The medical treatments for all patients were fluid liberalization, urine alkalinization, and oral allopurinol. Two children underwent urinary diversion. Within 8 h, urine output improved in all patients, and the stones passed spontaneously. All obstructed kidneys were relieved with medical treatment, and no renal sequel remained. So this series has showed a role of medical therapy in acute obstructive uric acid lithiasis.

Preventive effect of pentoxifylline on renal scarring in rat model of pyelonephritis.

OBJECTIVES: To evaluate the efficiency of pentoxifylline (PTX), a methyl xanthine derivative, in preventing renal scar formation after the induction of pyelonephritis in an experimental rat model with delayed antimicrobial therapy. METHODS: An inoculum of 1 x 10(9) colony-forming units/0.1 mL of the K-12 strain of Escherichia coli, which has both type 1 and P pili, was injected directly into both renal parenchyma of Wistar rats (n = 40). Group 1 (control) received isotonic saline instead of bacterial solution (n = 10). Four equal groups were then formed: group 2 was not treated and group 3 was treated only with ciprofloxacin for 5 days, starting 3 days after bacterial inoculation; in group 4, 50 mg/kg of PTX, and in group 5, PTX (50 mg/kg) and ciprofloxacin (15 mg/kg) together were administered intraperitoneally for 5 days, starting 3 days after bacterial inoculation. Six weeks after bacterial inoculation, all the rats were killed, and both kidneys were examined histopathologically for renal scarring. RESULTS: Delayed treatment with antibiotics had no effect on scarring compared with the untreated controls. However, the addition of PTX to the delayed antibiotic therapy significantly inhibited renal scarring compared with the untreated or antibiotic-only groups (P <0.05). CONCLUSIONS: These results suggest that PTX is effective in preventing renal scar formation in pyelonephritis when the initiation of antimicrobial treatment is delayed in this rat model of pyelonephritis.