Association of serum betatrophin with fibroblast growth factor-21 in women with polycystic ovary syndrome.

PURPOSE: Betatrophin and fibroblast growth factor-21 (FGF-21), which are recently discovered members of hepatokine/adipokine family, have been proposed to be associated with some metabolic disorders in which insulin resistance plays a major role. METHODS: We aimed to investigate serum betatrophin and FGF-21 concentrations in women with polycystic ovary syndrome (PCOS). In this cross-sectional study, we recruited 31 women with PCOS and 34 women as healthy controls. Serum betatrophin level and its relationship with serum FGF-21 level as well as metabolic parameters were examined. RESULTS: Serum betatrophin level was significantly higher in women with PCOS than the control group [1.10 (0.20-4.20) vs 0.70 (0.20-3.50) ng/ml, p = 0.004], whereas FGF-21 did not differ between the groups [74.80 (7.80-435.90) vs 119.30 (10.50-443.40) pg/ml, p = 0.13]. Serum betatrophin correlated positively with LH levels (r = 0.26, p = 0.03). After controlling BMI, there was a significant positive correlation between betatrophin and FGF-21 (r = 0.25, p = 0.04). Multivariate regression analysis revealed that FGF-21 and presence of PCOS were the significant predictors of betatrophin concentrations (R2 = 0.22, F = 2.56, p = 0.03). CONCLUSIONS: Our results indicate that betatrophin levels are increased and associated with LH and FGF-21 levels, but not with insulin resistance, in women with PCOS.

Effect of polaprezinc on experimental corrosive esophageal burns in rats.

Unconsciously caustic ingestion is one of the most common causes of serious esophageal strictures in children. The aim of this study is to determine the efficiency of polaprezinc in preventing stricture formation after corrosive esophageal burns (CEB); this was the first time it has been used to treat experimental CEB in rats. Twenty-four rats were divided into four groups, three of which received CEB by the instillation of 1 mL of 10% NaOH solution into their isolated esophageal segments for three minutes. Group C (control) was uninjured and untreated. Group B (esophageal burn) received CEB but were left untreated. Groups PT1 and PT2 had CEB and received 100 mg/kg/day and 200 mg/kg/day, respectively, of intraperitoneal polaprezinc treatment (PT) for the first two weeks, then oral PT for another two weeks. We assessed the treatment's efficiency of the treatment after the fourth week by evaluating the stenosis index (SI) and the histopathological damage score, determining tissue hydroxyproline content (HP), and measuring the weight of the rats before and after the experiment. Mean SI was statistically lower in the groups PT1 and PT2 when compared with Group B (p = 0.006, 0.004, respectively). HP levels were highest in Group B, but it was insignificant (P> 0.05). In terms of histopathological damage score, treatment groups demonstrated less collagen deposition, mucosal, and submucosal damage than both Group B (p = 0.01) and Group C (p = 0.02). Group PT1 and Group PT2 (P> 0.05) showed similar results, indicating the treatment's effectiveness was independent of dosage. Outside of Group C, weight gain was detected only in Group PT2, though it was statistically insignificant. In Group PT1, weight loss was lower than in Group B. Polaprezinc, with its antifibrotic, antioxidant, anti-inflammatory, wound-healing and antiapoptotic effects, was efficient in reducing stricture formation by decreasing HP levels and histopathologic damage, preventing stenosis, and weight gain in higher dosages in the treatment group.

Candesartan mediates microcirculation in acute necrotizing pancreatitis.

AIM: In the present study we aimed to determine the effect of an AT-II antagonist candesartan on pancreatic microcirculation in an experimental model of acute necrotizing pancreatitis. MATERIALS AND METHODS: There were five study groups with 10 animals in each. Pancreatitis was induced by intravenous infusion of cerulein and coadministration of glycodeoxycholate into biliopancreatic canal. Candesartan is given at 6th and 18th hour to the 24th and 48th hour groups, respectively. At 24th and 48th hours; following anaesthesia laparotomy was performed and laser Doppler flowmetry was performed in the pancreatic tissue of the animals. Following scarification blood samples were obtained for amylase, myeloperoxidase, IL-6 and tumour necrosis factor alpha. Tissue samples from the pancreas were obtained for histopathological analysis, endothelial cell apoptosis (TUNEL assay) and matrix metalloproteinase-9 immunohistochemistry. RESULTS: Pancreatic microcirculation was higher in the candesartan treated groups (p < 0.05). Myeloperoxidase, IL-6 and tumour necrosis factor alpha was found to be lower in the candesartan treated groups (p < 0.05). The pancreatic edema and inflammation were found to be reduced in the candesartan treated groups (p < 0.05). Endothelial apoptosis was found to be reduced by cadesartan treatment but it did not reach statistical significance (p > 0.05). Tissue matrix metalloproteinase -9 levels were found to be reduced with candesartan treatment (p < 0.05). CONCLUSION: Treatment with candesartan in the early phases of acute necrotizing pancreatitis effective on microcirculation of pancreatic tissue (Tab. 3, Fig. 6, Ref. 28).

Effect of ginger extract on liver damage in experimental obstructive jaundice produced by main bile duct ligation.

BACKGROUND: Obstructive jaundice is one of the most important surgical causes of childhood jaundices. The aim of this study is to investigate effects of ginger (Gingiber officinalis) extracts on liver damage in experimental obstructive jaundice produced by main bile duct ligation. MATERIALS AND METHODS: Forty two Wistar-albino rats were randomly allocated into 7 groups (n = 6). Nothing was performed in the control (C) group. Only laparatomy was performed in the sham (Sh) group. The ginger 1 and 2 (G1 and G2) groups received only 100 and 200 mg/kg/day doses of ginger extract for 1 week orally. In study group, common bile duct ligation was done. In treatment 1 and 2 (T1 and T2) groups common bile duct ligation was followed by administration of 100 and 200 mg/kg/day doses of ginger extract for 1 week orally from the third post operative day, respectively. Blood samples and liver were harvested in order to evaluate the serum aspartate aminotransferase (AST), alanine amino transferase (ALT), gama glutamyltransferase (GGT), total bilirubin (bil), superoxide dismutase (SOD), glutathione (GSH), malondialdehyde (MDA) and liver tissue SOD, GSH, MDA levels and liver apoptosis. Results were analyzed by Mann-Whitney U test statistically. RESULTS: Ginger administration did not result in any differences of serum or tissue levels of the studied parameters and liver apoptosis between the groups statistically (except AST levels in group T2). Tissue GSH and serum SOD levels were only mildly increased in groups receiving ginger alone. CONCLUSIONS: There is no evidence for protective, inhibitive and decreasing effects of ginger extract on liver injury in experimental obstructive jaundice with these findings.

Comparison of the effects of pulsatile cardiopulmonary bypass, non-pulsatile cardiopulmonary bypass and off-pump coronary artery bypass grafting on the respiratory system and serum carbonyl.

BACKGROUND: We aimed to investigate the effects of off-pump coronary artery bypass grafting (CABG), pulsatile cardiopulmonary bypass (CPB), and non-pulsatile CPB techniques on oxidative stress and the respiratory system in the current study. MATERIALS AND METHODS: The patients were allocated into three different groups according to perfusion techniques, as follows: off-pump CABG group (n=10); pulsatile CPB (n=11); and non-pulsatile CPB group (n=11). Serum carbonyl level was measured and a pulmonary function test was performed preoperatively and postoperatively. RESULTS: The postoperative increase in the carbonyl level was significantly lower in the off-pump CABG group compared to the other two groups, while there was no significant difference between the pulsatile and non-pulsatile CPB groups with respect to carbonyl levels. Arterial partial pressure of oxygen, forced expiratory volume in one second, and forced vital capacity were significantly higher in the off-pump CABG group compared to other two groups in the postoperative period. CONCLUSION: We found that off-pump CABG had less negative effects on oxidative stress and the respiratory system compared to pulsatile CPB and non-pulsatile CPB techniques. Additionally, there was no significant difference between pulsatile and non-pulsatile CPB.

Comparison of the effects of pulsatile cardiopulmonary bypass, non-pulsatile cardiopulmonary bypass and off-pump coronary artery bypass grafting on the inflammatory response and S-100beta protein.

BACKGROUND: We aimed to investigate the effects of off-pump coronary artery bypass grafting, pulsatile cardiopulmonary bypass, and non-pulsatile cardiopulmonary bypass techniques on the inflammatory response and the central nervous system in the current study. METHODS: A total of 32 patients who were scheduled for elective coronary artery bypass graft surgery were included in the study. The patients were allocated into three different groups according to the perfusion techniques used during the cardiopulmonary bypass procedure as follows: off-pump coronary artery bypass grafting group (n=10); pulsatile cardiopulmonary bypass group (n=11); and non-pulsatile cardiopulmonary bypass group (n=11). Serum interleukin-6, interleukin-8, tumor necrosis factor-alpha and S-100beta levels were measured preoperatively, and at 0, 6, and 24 hours postoperatively. RESULTS: The postoperative increase in the levels of interleukin-6 and interleukin-8 was significantly lower in the off-pump group compared to the other two groups (p<0.05), while there was no significant difference in tumor necrosis factor-alpha levels between the groups. Postoperative S-100ß levels, an indicator of cerebral injury, was significantly lower in the off-pump CABG group compared to the other two groups (p<0.05). CONCLUSION: We found that off-pump coronary artery bypass grafting had less negative effects on inflammatory response and central nervous system compared to pulsatile cardiopulmonary bypass and non-pulsatile cardiopulmonary bypass techniques.

Serum granulocyte colony-stimulating factor levels in gliomas.

PURPOSE: Apart from its known effects on granulopoiesis, granulocyte-colony stimulating factor (G-CSF) is also involved in growth and progression of malignant cells. In this study we report the serum G-CSF levels and their relationship with survival in patients with glial cell tumors. METHODS: Serum G-CSF levels of 17 patients (10 male, 7 female, median age 55 years, range 19-75), with histologically proven glial cell tumors and of 17 sex- and age-matched healthy controls were assayed by enzyme-linked immunosorbent assay (ELISA). RESULTS: All patients were treated with radiotherapy and concomitant temozolomide, followed by temozolomide alone. Eight patients were treated with carboplatin plus cyclophosphamide combination as second-line chemotherapy. The median follow-up was 21 months (4-42). The median OS was 36 months (95% CI, 15.7-56.4). Serum G-CSF levels in glioma patients and healthy controls were 44.14 ± 18.89 pg/ ml and 28.84±15.65 pg/ml, respectively (p=0.027). There was no significant correlation between survival time and serum G-CSF levels (r=0.384; p=0.217). CONCLUSION: Serum G-CSF levels were high in glioma patients compared with healthy controls and they may be involved in tumor progression, but the G-CSF role in prognosis was not clarified. Further studies with larger numbers of patients must be conducted to elucidate the role of G-CSF in glial cell tumors.

Effect of stent placement, balloon or cutting balloon dilatation on stricture formation after caustic esophageal burn in rats.

INTRODUCTION: This study aimed to evaluate the effects of stent placement prior to stricture development following caustic esophageal burn (CEB) in an animal model. The outcomes after stent placement were also compared with those after balloon dilatation and cutting balloon dilatation performed after stricture development. Groups were compared with regard to stricture development and weight loss. MATERIALS AND METHODS: 40 rats were divided into 5 groups. CEB was created as described by Gehanno et al. In Group A (control) no CEB was performed and the esophagus was only rinsed with saline. Group B rats underwent CEB with no subsequent treatment. Group C rats underwent CEB followed by balloon dilatation in the 3 (rd) and 4 (th) week. Group D rats underwent CEB followed by cutting balloon dilatation in the 3 (rd) week. Group E rats underwent CEB with subsequent placement of a silicon stent in the same session. The animals were sacrificed in the 6 (th) week, and the stenosis index (SI), collagen deposition, and hydroxyproline (HP) levels were determined in the esophageal segments and statistically compared. RESULTS: Although weight loss occurred in Group C and Group B rats (238.87±15.95 g vs. 233.83±19.01 g), weight loss in Group C rats was less marked compared to Group B. Similarly, the SI in Group C was lower compared to that of Group B and the difference was statistically significant. Although there was no difference in weight between the rats in Group C and Group B before the procedure (p=0.318), there was statistically significant difference thereafter (p=0.002). The SI of Group D was also lower compared with that of Group B, and the difference was statistically significant. Weight gain in Group E rats was similar to that noted in Group A rats and was higher compared to Group B; this difference was statistically significant. The SI for Group E was lower compared to that of Group B. CONCLUSION: Stenting performed at the time of corrosive injury and cutting balloon dilatation performed after stricture formation had a positive effect with regard to SI and weight gain in an animal model.

Clinical and immunological analysis of 23 adult patients with common variable immunodeficiency.

BACKGROUND: Common variable immunodeficiency (CVID) is characterized by hypogammaglobulinemia, defective antibody production, and recurrent upper and lower airway tract infections. OBJECTIVES: To reveal the clinical heterogeneity of this condition, analyze the high frequency of respiratory and gastrointestinal complications despite satisfactory trough immunoglobulin (Ig) G levels, and determine the main difficulties in management and treatment. METHODS: We performed a retrospective analysis of 23 patients (13 male and 10 female) diagnosed with CVID between 2001 and 2008. RESULTS: The median diagnostic delay for females and males was 15 years (range, 1-32 years) and 8 years (range, 1-31 years), respectively. Restrictive, obstructive, and combined pulmonary function defects were determined in 23%, 27%, and 14% of patients, respectively. The most frequent findings on the thoracic computed tomography scan were bronchiectasis, mediastinal lymphadenopathy, fibrosis, ground-glass patterns, mosaic oligemia, peribronchial cuffing, and parenchymal nodules. Giardiasis and duodenal lymphoid hyperplasia were detected in 52% and 42% of the patients, respectively, and Helicobacter pylori in 42%. Vitamin A levels were normal, although beta-carotene and/or vitamin E levels were decreased in patients presenting malabsorption-related symptoms. Malignancy was documented in 3 patients and decreased bone mineral density in 9 patients (3 had osteoporosis and 3 had osteomalacia). CONCLUSION: CVID is a multisystemic disease that should be managed by a multidisciplinary team. Intravenous immunoglobulin therapy and antibiotics do not seem to have a suppressive effect on granulomatous or inflammatory manifestations. More comprehensive studies based not only on peripheral blood but also on immunohistological analysis are necessary to shed light on the pathogenesis of these life-threatening complications.

Effects of radiation on protein oxidation and lipid peroxidation in the brain tissue.

Radiation produces reactive oxygen species that modify macromolecules such as protein and lipid by oxidation and act in many pathological processes, causing serious damage to the brain. This study sought to evaluate the effects of radiation and the protective effect of N-acetylcysteine (NAC) on the brain tissue of guinea pigs based on the levels of lipid peroxidation and protein oxidation. Thirty-two guinea pigs were divided into groups of eight animals each: control group (group I); radiation group (group II); NAC group (group III), and NAC administered before radiation exposure group; (group IV). Guinea pigs in groups II and IV were exposed to Co(60) radiotherapy using the Source-Axis-Distance = 80 technique. The levels of protein carbonyl content and malondialdehyde (MDA), which is a marker for lipid peroxidation, were investigated by the Evans-Levine and Uchiyama-Mihara methods, respectively. The protein carbonyl and MDA levels of group II were significantly greater than those of group I (P < .01). The protein carbonyl and MDA levels of group IV were lower than those of group II. The difference between the MDA levels of group IV and group II was significant (P < .01); however, the difference in protein carbonyl levels between the two groups was not significant. The results indicated that radiation increased protein oxidation and lipid peroxidation in the brain, and NAC administration before radiation exposure may aid in the treatment by decreasing protein and lipid oxidation.

The WHO global alliance against chronic respiratory diseases in Turkey (GARD Turkey).

In order to prevent and control non-communicable diseases (NCDs), the 61st World Health Assembly has endorsed an NCD action plan (WHA resolution 61.14). A package for essential NCDs including chronic respiratory diseases (CRDs) has also been developed. The Global Alliance against Chronic Respiratory Diseases (GARD) is a new but rapidly developing voluntary alliance that is assisting World Health Organization (WHO) in the task of addressing NCDs at country level. The GARD approach was initiated in 2006. GARD Turkey is the first comprehensive programme developed by a government with all stakeholders of the country. This paper provides a summary of indicators of the prevalence and severity of chronic respiratory diseases in Turkey and the formation of GARD Turkey.

Effects of different suture materials on wound healing and infection in subcutaneous closure techniques.

BACKGROUND: In this study we aimed to investigate the effects of different suture materials on wound healing and infection in subcutaneous closure techniques. MATERIALS AND METHODS: Twenty-nine rats were randomly allocated to 5 groups. All subjects received 2-cm vertical dermal and subdermal incisions on their backs under sterile and proper surgical conditions. The subdermal cuts were then closed with vicryl (polyglycolic acid), biosyn (monofilament glycomer), prolene (polypropylene) and tissue adhesive (2-octylcyanoacrylate). After 10 days, all sutured areas were examined for seroma, haematoma formation and cosmetic outcome. The incisional lines were excised with 1-cm-wide skin strips and tissue hydroxyproline levels were determined. The specimens obtained were evaluated for the presence of giant cells, mononuclear cells, fibrosis and neutrophils. RESULTS: No differences in tissue hydroxyproline levels were found between any of the suture materials used. Fibrotic process and inflammatory cell infiltration were more prominent in the biosyn and prolene groups than in other groups. Foreign body giant cells were observed in the biosyn group. CONCLUSION: Vicryl and tissue adhesive should be preferred in subcutaneous closure techniques.

The importance of nasal provocation test in the diagnosis of natural rubber latex allergy.

BACKGROUND: Most studies regarding natural rubber latex (NRL) allergy have concentrated on the prevalence using skin prick test (SPT) and specific IgE assay. The objective of this study is to examine the target organ (skin, nasal mucosa) responses in patients with positive SPT to NRL using the nasal provocation test (NPT) and glove use test (GUT). METHODS: Four thousand four hundred and twenty patients presented to our polyclinic between July 2003 and January 2007 were evaluated. One thousand six hundred and ninety-nine patients had positive SPT to one or more allergens (NRL and other inhaler allergens). Twenty-nine patients with positive SPT to NRL comprised the NRL sensitive group (group 1). Thirty-five randomized patients with positive SPT to an inhaler allergen other than NRL and negative NRL-specific IgE comprised atopic control group (group 2). Thirty healthy individuals who had no allergic diseases and had negative SPT and NRL-specific IgE comprised the healthy control group (group 3). RESULTS: The lowest NRL allergen concentration leading to NPT positiveness was 0.05 microg/mL. NPT was negative in groups 2 and 3. NPT was found to have a sensitivity of 96%, specificity of 100%, negative predictive value of 98% and positive predictive value of 100%. GUT was found to have a sensitivity of 81%, specificity of 90%, negative predictive value of 75% and positive predictive value of 93%. CONCLUSIONS: Nasal provocation test was successfully used for the first time in the diagnosis of NRL allergy. NPT is a more sensitive method as compared to GUT.

Food allergy due to olive.

We report the case of a 28-year-old man who presented palatal itching and genaralized urticaria following ingestion of olive 3 years after being diagnosed with olive pollinosis. The patient did not have a history of food allergy or urticaria. The results of skin prick tests with aeroallergens including latex were positive for house dust mite and olive pollen. The results of prick tests and prick-to-prick tests for olive fruit were positive, as were those of specific immunoglobulin E tests to olive pollen and fruit. The results of prick tests to peach, pear, kiwi, melon, and nut were negative. Nasal provocation with olive pollen gave positive results. An open oral provocation test with olive oil did not cause symptoms. This case is unique in that the patient developed olive fruit allergy in the presence of olive pollinosis, and he did not experience allergic symptoms to fruits other than olive, thus enabling us to define a new pollen-food (olive-olive) syndrome.

Prevalence of cypress pollen sensitization and its clinical importance in Izmir, Turkey, with cypress allergy assessed by nasal provocation.

BACKGROUND AND OBJECTIVE: Pollens from the Cupressaceae family are considered important allergens in the Mediterranean area, though reports of the prevalence of allergic symptoms have ranged from 1.04% to 35.4%. Our aim was to detect the prevalence of cypress pollen sensitization and determine its clinical importance in patients with seasonal respiratory allergy. METHODS: We used skin prick tests (SPT) and serum specific IgE assays to reveal sensitization to cypress pollen. In patients who showed positive results to cypress pollen, a nasal provocation test (NPT) with pollen extract was used to assess the target organ response. RESULTS: Sixty-five (14.3%) of 455 patients showed positive SPT responses to Cupressus sempervirens extract. Only 1 patient was monosensitized while 64 patients were polysensitized. Among those, 2 pollen cosensitizations were found to be significant (86% were cosensitized to grasses and 72% were cosensitized to olive (P < .001). Serum specific IgE to cypress pollen was measured in 50 of the 65 patients; findings were positive for 37. When these 37 patients underwent NPT with C sempervirens allergen extract, only the single monosensitized patient had a positive NPT. CONCLUSION: A positive SPT to cypress pollen may not reflect the true prevalence of sensitization. We assume that in the absence of a positive NPT, positive SPT results might be related to the presence of cross-reactivity between pollen species.

Comparison of the effects of sodium nitroprusside and L-carnitine in experimental ischemia-reperfusion injury in rats.

AIM: The aim of this study was to evaluate the protective effect of sodium nitroprusside (SNP) as a nitric oxide (NO) donor and L-carnitine intraperitoneal administration to treat experimental ischemia-reperfusion (I/R) in rats. MATERIALS AND METHODS: Rats were divided into four groups, each one consisting of 10 animals. Group 1 was subjected to a sham operation. In group 2, an I/R process was applied to the rats. In group 3, SNP (5 mg/kg) and in group 4, L-carnitine (500 mg/kg) was administered in addition to the I/R process. Ileal tissue samples were obtained for analysis of tissue malonyl dialdehyde (MDA) and for histopathologic examination. RESULTS: By histopathologic examination, the I/R group showed a significant difference from the SNP and L-carnitine groups (P<.05). There was no difference between the sham, the SNP, and the L-carnitine groups (P>.05). SNP used as an NO donor produced a significant decrease in MDA levels. There was a significant difference between the MDA levels of the SNP and the I/R groups (P<.05). Also, the difference between this group and the I/R group was significant (P<.05). CONCLUSION: SNP helped to both prevent and reduce mucosal damage in terms of histological and tissue MDA levels. Since the results of the L-carnitine group and the SNP group were similar, L-carnitine was as effective as exogenous NO.

Changes in serum carbonyl and malondialdehyde levels following colchicine and vitamin E treatment in Behcet's disease.

Behcet's disease (BD) is an inflammatory disorder of an unknown cause, but growing evidence indicates that the oxidative stress is increased in BD, owing to the overproduction of reactive oxygen species (ROS) and decreased efficiency of antioxidant defenses. ROS affect proteins and lipids and cause their oxidation, therefore, contributing to the formation of oxidation products: carbonyl, a marker of protein oxidation, and malondialdehyde (MDA), a marker of lipid peroxidation. The investigation was undertaken to evaluate protein oxidation (carbonyl group) levels and lipid peroxidation (MDA) levels, and the role of colchicine and vitamin E therapy on protein carbonyl group and MDA levels in serum samples of patients with BD. In this study, subjects were classified as control group, colchicine therapy group alone and colchicine and vitamin E therapy group. Protein carbonyl and MDA levels at the beginning of the study were significantly (p < 0.05) higher in both therapy groups compared with those of the control group. We found that the protein carbonyl and MDA levels at the end of the study showed no significant (p > 0.05) differences between the therapy groups and control group. These results provide some evidence for a potential effect of colchicine and vitamin E therapies on increased protein oxidation and lipid peroxidation in BD.

Locally advanced breast carcinoma treated with neoadjuvant chemotherapy: are the changes in serum levels of YKL-40, MMP-2 and MMP-9 correlated with tumor response?

Serum levels of YKL-40, MMP-2 and MMP-9 in 27 patients with locally advanced breast carcinoma received neoadjuvant chemotherapy were measured. All patients underwent neoadjuvant chemotherapy named as FAC protocol (5-Fluorouracil, Doxorubicin and Cyclophosphamide) with 21 days interval. There was 26,7% decrease in mean serum YKL-40 levels (from 146,4 microg/ml to 107,3 microg/ml) in clinically responsive group. This level was almost unchanged in non-responsive group (P>0, 05). There was 42, 1% decrease in mean serum YKL-40 levels (from 173,1 microg/ml to 98, 8 microg/ml) in pathologically responsive group. This decrease was more dramatic in patients with complete pathological response (70, 2%). However, this level was slightly increased in non-responsive group. Changes in serum levels of MMP-2 and MMP-9 were not found to be associated with tumor response. Serum measurement of YKL-40 can be a helpful tool to predict pathological tumor response in breast cancer patients with neoadjuvant chemotherapy but not MMP-2 and MMP-9.

New onset egg allergy in an adult.

We report newly presenting systemic and local allergic reactions to egg in a 55-year-old woman. The patient did not have a history of egg allergy in childhood or occupational exposure to egg proteins; nor did she report any disease that is known to be related to food allergy. A skin prick test with commercial extracts, prick-to-prick test, CAP radioallergosorbent assay, and a double-blind, placebo-controlled food challenge test were used to prove egg allergy. Because egg allergy mainly affects children and symptoms frequently disappear with age, the late onset in this patient is rare.

Prospective comparison of local, spinal, and general types of anaesthesia regarding oxidative stress following Lichtenstein hernia repair.

As a tension-free repair technique, Lichtenstein operation has gained great popularity worldwide during the last decade. Expert centres do this technique using local anaesthesia in nearly 95 % of cases. However, general anaesthesia is used in many hospitals, while regional anaesthesia is preferred in some centres. To date, no study has compared different types of anesthesia in respect of inflammatory response and oxidative stress specifically. The objective of this prospective study was to compare local, spinal and general types of anesthesia regarding their effects on inflammatory response and oxidative stress in Lichtenstein hernia repair. Lichtenstein hernia repair causes only a mild oxidative stress. While total WBC and neutrophil count responses fade away after 24 hours in patients who are operated under local anaesthesia, these changes in spinal and general types of anaesthesia cases stay valid at 24th hour. Spinal anaesthesia is seen to be more advantageous than local and general types of anaesthesia when C-reactive protein as an acute phase marker is considered. Total antioxidant status shows minor alterations in three types of anaesthesia, however, general anaesthesia seems to be the least reliable among them. Overall, local and spinal anaesthesia methods can be accepted as better alternatives in comparison with general anaesthesia in regard to oxidative stress (Tab. 2, Ref. 25). Full Text (Free, PDF) www.bmj.sk.