Renoprotective Effect of Taxifolin in Paracetamol-Induced Nephrotoxicity: Emerging Evidence from an Animal Model.

BACKGROUND: Taxifolin (TXF) is a flavonoid found abundantly in citrus/onion. Encouraging results on its renoprotective effect have been reported in a limited number of drug-induced nephrotoxicity animal models. The present study aimed to evaluate for the first time the potential renoprotective effects of TXF in a paracetamol (PAR)-induced nephrotoxicity rat model. METHODS: Rats were divided into three equal groups (n = 6 animals per group). Group 1 (PAR group, PARG) received PAR diluted in normal saline by gavage (1000 mg/kg). Group 2 (TXF group, TXFG) received TXF diluted in normal saline by gavage (50 mg/kg) one hour after PAR administration. Group 3 (control group, CG) received normal saline. Twenty-four hours after PAR administration, all animals were sacrificed using high-dose anesthesia. Blood samples were collected and kidneys were removed. RESULTS: The serum blood urea nitrogen, creatinine levels and serum malondialdehyde levels were significantly increased in the PARG. The serum glutathione peroxidase, glutathione reductase and total glutathione levels were significantly higher in the TXFG. At the same time, the kidneys of the PARG animals demonstrated tubular epithelium swelling, distension and severe vacuolar degeneration. The kidneys of the TXFG animals showed mildly dilated/congested blood vessels. CONCLUSIONS: The TXF renoprotective effects are promising in preventing PAR-induced nephrotoxicity, mainly through antioxidant activity, and warrant further testing in future studies.

Attitudes of physicians concerning vaccines not included in the national immunization schedule.

Çatakli T, Duyan-Çamurdan A, Aksakal-Baran FN, Güven AE, Beyazova U. Attitudes of physicians concerning vaccines not included in the national immunization schedule. Turk J Pediatr 2018; 60: 290-297. The aim of this study was to identify attitudes of family physicians and pediatricians working in sub-provinces of central Ankara concerning rotavirus (RV), human papilloma virus (HPV), meningococcal conjugate vaccine (MenACWY-MCV4) and adolescent and adult pertussis (Tdap) vaccines which are not included in the National Immunization Schedule (NIS). Questionnaires were conducted with 300 family physicians and 230 pediatricians who were selected by random sampling. RV vaccine is the most commonly recommended vaccine by physicians (60.5%). It is the vaccine they want to be added to the NIS the most (48.5%). Tdap vaccine is the least recommended vaccine (24.1%) and the least preferred for inclusion in the NIS (19.6%). Of the physicians recommending the RV vaccine 94.0% believe that `RV-related diarrhea cases exhibit a severe course of illness in children younger than two years old.` Pediatricians recommend RV, meningoccocal and Tdap vaccines more than family physicians (p < 0.05). Of the physicians who do not recommend RV, HPV, and conjugated meningococcal vaccine 87.5%, 96.7% and 27.6% found the vaccines expenive, respectively. Of the physicians who do not recommend Tdap vaccine 90.4% think that `Tdap vaccination is not a health problem of priority for their country.` In conclusion physicians are recommending vaccines which are not included in the NIS. Their common concern for not recommending these vaccines is expensive price.

Life-threatening intracranial bleeding in a newborn with congenital cytomegalovirus infection: late-onset neonatal hemorrhagic disease.

The authors present a case of a 36-day-old infant with intracranial and intramuscular hemorrhage due to vitamin K deficiency bleeding, who received intramuscular vitamin K prophylaxis at birth. In this case, laboratory tests showed anemia, liver dysfunction with cholestasis, and coagulopathy, consistent with vitamin K deficiency abnormality. Serological analyses showed that cytomegalovirus immunoglobulin (Ig)M and IgG avidity were both positive. The infant was treated successfully with intravenous ganciclovir and blood products. This case suggests that it is imperative to meticulously investigate the etiology in neonates with late-onset hemorrhagic disease of the newborn. Cholestatic liver disease caused by congenital cytomegalovirus infection should be in mind in term infants who presented with late-onset hemorrhagic disease.