Long-lasting reflux episodes in gastroesophageal reflux and its complications in children.

BACKGROUND/AIMS: The aim of the study was to test the hypothesis that long-lasting reflux episodes (episodes longer than 5 minutes and longest reflux episode) are more and are longer in patients with complicated gastroesophageal reflux (GER), such as reflux esophagitis, etc. MATERIAL AND METHODS: In a prospective study 120 children (age 2 months to 14 years) were evaluated for the presence of GER and its complications (respiratory disease, reflux esophagitis). Out of them 51 were without GER (control group). With functional GER were 17, respiratory disease and GER had 21, and RE 16. Diagnosis of GER was established by computed 24 hour pH monitoring (C24hpHM) using Digitrapper Mark III, Synectics, Sweden. GER was positive if pH<4 was >5% of investigated time. Number of reflux episodes (NRE), episodes longer than 5 minutes (EL5), the longest reflux episodes (LRE), reflux index (RI) and duration of investigation were considered for the purpuse of this study. RESULTS: There was no significant statistical difference for the duration of procedure between the groups (Kruskal-Wallis test p>0.05). There was significant statistical difference for all parameters between control group and group with RE (Kruskal-Wallis test p<0.05). In RE patients there was significantly higher number of EL5, and longer duration of LRE compared with uncomplicated GER, functional GER, and GER with respiratory disease (Kruskal-Wallis test p<0.05). Between respiratory disese and functional GER there was no significant statistical difference. There was significant statistical difference between mild and severe RE for EL5 and LRE (Kruskal-Wallis test p<0.05). CONCLUSION: We confirmed that long lasting reflux episodes (EL5, LRE) are significantly higher in number and longer duration in children with RE, and together with acid reflux area, and impaired esophageal clearance contribute to development of RE.

Cytotoxic efficacy of bendamustine in human leukemia and breast cancer cell lines.

PURPOSE: The purpose of this study was to characterise bendamustine's cytotoxic and apoptotic activity in a panel of leukemia and breast cancer cell lines in comparison to its clastogenicity in murine bone marrow. METHODS: The cytotoxic effect of bendamustine was measured by the 3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyltetrazolium bromide (MTT)-dye reduction assay. Induction of apoptosis was evidenced by DNA gel electrophoresis, nuclear staining, Western blot poly-(adenosine diphosphate-ribose) polymerase (PARP) cleavage, and flow cytometry. As a measure of hematological toxicity, the formation of chromosomal aberrations was investigated in bone marrow cells isolated from mice treated with low non-toxic doses of bendamustine and lomustine. RESULTS: Bendamustine was preferably active against leukemic cells of lymphoid origin and was found to induce apoptosis in SKW-3 and BV-173 cells as shown by oligonucleosomal DNA and nuclear fragmentation, PARP cleavage, and formation of a sub-G1 fraction. Myeloid and breast carcinoma cell lines were resistant towards bendamustine with the exception of HL-60 cells which exhibit an intermediate sensitivity. Bendamustine was found to have a very low clastogenic effect as compared with equimolar doses of lomustine. CONCLUSION: Taken together, the mode of action of bendamustine includes induction of apoptosis. The specific spectrum of activity and the unexpectedly low clastogenicity support the hypothesis that bendamustine in not a typical alkylating agent but exerts an additional mode of action, possibly as a purine antimetabolite.

Indicaciones pediátricas actuales de la cisaprida: toma de posesión de la European Society for Pediatric Gastroenterology, Hepathology and Nutrition / Current pediatric indications for cisapride: a position paper by a panel convened by the European Society for Pediatric Gastroenterology, Hepatology and Nutrition

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