ABSTRACT
The purpose of this experimental study was to evaluate the efficacy of hesperidin [HES] in protecting against methotrexate [MTX]-induced intestinal damage using histopathological and immunohistochemical techniques. Seventy-eight male Wistar albino rats were divided into 4 groups that received [a] saline only [control group], n = 19; [b] HES only, n = 19; [c] MTX only, n = 19, and [d] MTX plus HES, n = 21. On the first day of the study, a single dose of MTX [20 mg/kg] was administered intraperitoneally to group 3 and 4 rats. The HES [200 mg/kg] was administered by gavage for 5 days. For the MTX plus HES group, HES [200 mg/kg] was administered by gavage for 5 days after MTX treatment. Rats were sacrificed on the 2nd, 4th and 6th day of the study. Tissue samples from the jejunum were taken for histopathological and immunohistochemical analysis. On the 4th day, crypt injury in the MTX plus HES group [1.00 +/- 0.00] was less than that in the MTX group [2.00 +/- 0.89; p < 0.05]. The small intestinal damage score was lower in the MTX plus HES group [6.33 +/- 0.82] as compared to the MTX group [8.00 +/- 2.37]. Inducible nitric oxide synthase and interleukin-8 levels were lower in the MTX plus HES group [65 and 25%, respectively] as compared to the corresponding values of the MTX group [80 and 52.5%, respectively]. On the 6th day, the Ki-67 proliferation index in the MTX group [45%] was lower than that in the MTX plus HES group [76.67%] and the control group [p < 0.05]. The small intestinal damage score was high in the HES group on the 4th day due to increased cellular infiltration. On the 6th day, the Ki-67 proliferation index rose in parallel with the decrease in cellular infiltration and therefore histopathological scoring. The proliferation-enhancing effect of HES also appeared in healthy rats. HES seemed to have a protective effect against MTX-induced intestinal injury
ABSTRACT
Objective. To evaluate the effectiveness of HFOV in pediatric patients with acute respiratory distress syndrome. Methods. In this retrospective study, we reviewed all 20 pediatric patients, who were consecutively ventilated with HFOV in the pediatric intensive care unit of a tertiary medical center, from January 2006 to February 2007. Results. A total of 20 patients were enrolled. The median age of the subjects was 70 (3-168) months; 10 were male. All patients received conventional ventilation before HFOV. After initiation of HFOV, there was an immediate and sustained increase in PaO2/FiO2 ratio. The PaO2/FiO2 ratio was elevated and OI was decreased significantly after 10-20 minutes and maintained for at least 48 hours (p= 0.03, both). Thirteen of the 20 patients were successfully weaned. No significant change in the mean arterial pressure and heart rate was noted after HFOV. Overall survival rate was 65%. Of 20 patients, 11 patients suffered from extrapulmonary ARDS (ARDSexp) and 9 from pulmonary ARDS (ARDSp). When HFOV was initiated, there was significant increase in PaO2/FiO2 and decrease in OI in ARDSexp compared to ARDSp (p= 0.03, both). Also mortality rate was significantly lower in patients with ARDSexp (9% vs.66%), (p= 0.01). Conclusion. In our study, HFOV was effective in oxygenation and seems to be safe for pediatric ARDS patients. HFOV affected ARDSp and ARDSexp paediatric patients differently. However prospective, randomized controlled trials are needed to identify its benefits over conventional modes of mechanical ventilation.