Protective effects of etanercept and methylprednisolone on pancreatic damage in cerulein-induced acute pancreatitis

To examine the pharmacological effect of etanercept and methylprednisolone [MP] on acute pancreatitis [AP] induced by cerulein in an experimental rat model. The present study was carried out in the Experimental Research Center, Ondokuz Mayis University, Samsun, Turkey between December 2008 and October 2009. Forty adult Sprague-Dawley rats were divided into 5 groups [n=8]:1- sham, 2 - cerulein induced pancreatitis [over 20 hours], 3 - etanercept [5mg/kg, intraperitoneal], 4- MP [10mg/ kg, intramuscular], 5- etanercept plus MP. The rats in groups 3,4 and 5 were cerulean-induced pancreatitis at 20 hours, as well. After the treatment, the pancreas and blood were taken for histopathological and biochemical analysis. All cerulein-treated rats developed biochemical and histopathological AP after 20 hours. Histological findings of pancreatitis and serum levels of amylase and lipase were lower in group 5 compared to group 2. Pancreatic inflammation and total pathological score were statistically reduced in the tissues of the pancreas at 20 hours after the treatment of etanercept plus MP in group 5 compared to groups 2,3 and 4.In the early stage of cerulein induced AP, the administration of etanercept plus MP attenuated pancreatic inflammation and significant damage in rats

Diagnostic Contribution of Gastric and Bronchial Lavage Examinations in Cases Suggestive of Pulmonary Tuberculosis

We assessed whether acid fast bacilli (AFB) determination in gastric lavage (GL) and bronchial lavage (BL) contributes to diagnosis in cases radiologically suggestive of pulmonary tuberculosis but with either negative AFB in sputum or the inability to expectorate sputum. Of 129 cases recruited for the study, 22 were excluded due to evaluation as inactive disease or non-tuberculosis disease. The remaining 107 cases were evaluated in 2 groups. Group A consisted of 49 patients that could not expectorate sputum and from whom GL was obtained. In group B, BL was performed in 58 patients that had negative sputum smear. Smear positivity was 61.2% (30/49) and culture positivity was 30.6% (15/49) in group A, 51.7% (30/58) and 81% (47/58), respectively, in group B. Thirteen cases, in whom AFB could not be detected microbiologically but who were radiologically strongly suggestive of tuberculosis, were regarded as tuberculosis according to 'from treatment to diagnosis' criteria. In conclusion, detection of AFB positivity in the diagnosis of tuberculosis is important in terms of early initiation of treatment and detection of resistant bacilli. Therefore, we suggest that it would be helpful to obtain GL in cases where the patient is unable to expectorate sputum, and perform BL in cases with negative sputum smear.

Deaths in patients with pulmonary tuberculosis: an analysis of a chest diseases hospital in Istanbul, Turkey

To evaluate the medical records of patients with pulmonary tuberculosis in order to determine the inhospital mortality rate. Materials and Medical records of 22,651 patients with pulmonary tuberculosis admitted to Gulhane Military Medical Academia, Camlica Chest Diseases Hospital, Istanbul, Turkey from 1977 to 1999 were examined. Of the 22,651 patients, 133 [0.58%] died: 117 male and 16 female, mean age 41.5 +/- 20.7 years. The mean length of hospital stay was 15.8 ' 25.9 days and it increased yearly [p = 0.004]. There was no significant difference in hospital mortality rate of tuberculosis within years. Forty-nine patients had chronic and/or far advanced tuberculosis, 36 of them had concomitant diseases. Thirteen patients had miliary and/or tuberculous meningitis, 3 multi drug-resistant tuberculosis, another 3 had pneumothorax, and 2 empyema. These patients had significantly lower prognostic nutritional index than those patients who recovered from pulmonary tuberculosis [p = 0.025]. Inhospital mortality rate of tuberculosis did not change in the last 23 years. We suggest that pulmonary tuberculosis will continue to be a significant cause of death and therefore important health care problem for Turkey in the 21st century