Hemopericardium and Cardiac Tamponade in a Patient Treated with Dabigatran Etexilate

Dabigatran etexilate is one of the new oral anticoagulants approved to reduce the risk of stroke in patients with atrial fibrillation (AF). A variety of bleeding complications with dabigatran have been reported, but reports of hemopericardium are rare. We described a case of a 66 year-old female patient with non-valvular AF receiving dabigatran etexilate 150 mg twice daily for one year who suffered from hemopericardium. Her laboratory tests performed 1 year prior were normal and her admission tests revealed acute renal failure and elevated international normalized ratio (INR) level (4.79). Urgent pericardiocentesis was followed by improved renal functions and normalized INR. Dabigatran etexilate is a new oral anticoagulant that is increasingly used in daily practice. However, life-threatening complications warrant caution. Elevated INR may be related with overdose but the association of bleeding risk of dabigatran and INR requires further confirmation.

Urine xanthine oxidase and myeloperoxidase activity in pediatric urinary tract infections

To investigate the relationships between urinary tract infection [UTI], and activity of antioxidant enzymes, xanthine oxidase [XO] and myeloperoxidase [MPO] in urine of children with UTI Prospective observational study. Department of Pediatrics, Kahramanrnaras Sutcu Imam University, Faculty of Medicine, Turkey. A total of 115 random children admitted to our hospital for urinary symptoms, 61 girls and 54 boys, aged between 2 and 15 years [average 10 years] were included. Study subjects were divided into four groups: Group 1 consisted of 29 pyuria positive and urine culture negative children; Group 2 included 30 children with pyuria and positive urine culture; Group 3 included 26 pyuria negative and urine culture positive children and Group 4 included 30 with pyuria and negative urine culture. Measurement of urine XO and MPO activity were performed spectrophotometrically. Urine samples Antioxidant enzyme activity levels in urine were examined in children with urinary tract infection. Urinary XO activities in Group 2 were significantly higher compared with other groups [p < 0.001, p = 0.001 and p < 0.001, respectively]. Significantly different MPO activities were found between Group 1 and Group 2 [p = 0.007]. However, no Significant difference was found between Group 3 and 4. Significantly increased MPO and XO enzyme activity was found in children with UTI. Measurement of MPO and XO activity may be useful in children with urinary symptoms to diagnose UTI, before obtaining a positive urine culture

Diffuse cystic bronchiectasis associated with left microtia and external auditory canal atresia: a very rare coincidence

To present a case in which diffuse cystic bronchiectasis was associated with left microtia/external auditory canal atresia. A 10-year-old girl suffering from cough, fever, dyspnea and sputum for 6 months was transferred to our clinic due to the diagnosis of bronchopneumonia. She had recurrent episodes of bronchopneumonia. On examination, left microtia and left external auditory canal atresia were detected. Thorax CT revealed diffuse cystic bronchiectasis on the left lung. Radiological examination showed atresia of the left external auditory canal. We could not find any etiopathological reason causing bronchiectasis. The patient underwent left pneumonectomy and postoperative histopathology was reported as bronchiectasis. This report shows a unique case in which an association of diffuse cystic bronchiectasis and left microtia/external auditory canal atresia was observed. Hence in newborns with microtia and/or external auditory canal atresia, the probability of development of bronchiectasis should be borne in mind and such patients should be followed up more carefully regarding this rare association

Oxidative stress and antioxidant status in neonatal hyperbilirubinemia

To investigate the possible relationships between plasma bilirubin levels and concentrations of nitric oxide [NO], malondialdehyde [MDA], and erythrocyte antioxidant enzyme activities in newborn infants with hyperbilirubinemia. Thirty term [gestational age >/= 37 weeks] newborn infants with indirect hyperbilirubinemia aged less than 10 days were prospectively recruited in the Kahramanmaras Sutcu Imam University Neonatal Unit, Kahramanmaras, Turkey, between January and July 2007. Thirty randomly selected healthy newborns who had similar age and without clinical jaundice comprised the control group. Erythrocyte catalase, superoxide dismutase, glutathione peroxidase [GPx], glucose-6-phosphate dehydrogenase, and plasma MDA and NO concentrations were measured. Both MDA and NO concentrations were higher in the study group than the controls [p=0.000]. The mean activities of erythrocyte antioxidant enzymes were found to be lower in the study group compared with the controls [p=0.000]. Furthermore, plasma bilirubin showed significant negative correlations with antioxidant enzyme activities but positive correlations with MDA and NO. In this sample, infants with significant hyperbilirubinemia had elevated oxidative stress and disturbed antioxidant enzyme activity. Since these states have been shown to cause cellular injury in neonatal patients with indirect hyperbilirubinemia, such patients should be followed-up and undergo therapy to prevent the harmful effects of hyperbilirubinemia. Further studies are needed to investigate possible benefits of antioxidants in hyperbilirubinemia