Perioperative Severe Anaphylaxis to Paracetamol in a Child.

The data on perioperative anaphylaxis (PA) in children is limited and usually reported with neuromuscular blocking agents and antibiotics. However we present a first pediatric case who developed PA with paracetamol unlike the literature.

Allergic rhinitis may impact the recovery of pulmonary function tests after moderate/severe asthma exacerbation in children.

BACKGROUND: During an asthma exacerbation, pulmonary function test parameters (PFTs) return to their baseline values within a few weeks. Factors affecting the recovery of PFTs other than the severity of exacerbation are not well known. OBJECTIVE: The primary aim of the study was to determine the risk factors for recovery of PFTs > 7 days after a moderate to severe asthma exacerbation in children. METHODS: Children who had moderate to severe asthma exacerbation performed serial prebronchodilator PFTs on days 1, 3, 7 of the exacerbation and then once weekly until their PFTs reached a plateau. All children received systemic corticosteroid for 3 days and inhaled salbutamol as long as they needed. RESULTS: Fifty-seven children were recruited. When all PFTs were considered, 42% and 74% of children recovered within 7 and 14 days, respectively. The last recovered PFT parameter was FEF25-75 . Allergic rhinitis (AR) (P = 0.016), persistent AR (P = 0.005), and severe asthma exacerbation (P = 0.009) were significantly higher in children whose PFTs recover >7 days; only severe asthma exacerbation was different for recovery >14 days (P = 0.048). Logistic regression analysis revealed that AR and severe asthma exacerbation increase the recovery of PFTs > 7 days by 4.3 (95% CI: 1.29-14.67) and 8.1 (95% CI: 1.51-44.43), respectively. CONCLUSIONS: Recovery of PFTs during a moderate/severe asthma exacerbation may take up to 4 weeks. Apart from severity of the exacerbation, AR is a significant factor affecting the recovery time of PFTs and therefore may impact asthma management. This issue reinforces the combined treatment of AR and asthma.

Prognostic factors for renal cell carcinoma: Trakya University experience from Turkey.

The purpose of the present study is to evaluate the prognostic factors of patients with renal cell carcinoma. The treatment results such as distant metastasis-free survival and overall survival of 59 previously untreated patients were retrospectively analysed. Median follow-up was 17.5 months (3.8-88.5 months). Overall survival was 22.4 months (3-87 months). Distant metastasis developed in 35 (59%) patients. The Eastern Cooperative Oncology Group (ECOG) performance status (P=0.022), tumour size (P=0.025) and lymphatic invasion (P<0.0001) were significantly effective prognostic factors for distant metastasis-free survival on multivariate analysis. Related to overall survival, gender (P=0.025), ECOG performance status (P=0.027), nuclear grade (P=0.002), tumour size (P=0.029), T stage (P=0.044), nodal involvement (P=0.003), surgical margin (P=0.046), renal sinus invasion (P<0.0001), perineural growth (P=0.001) and lymphatic invasion (P<0.0001) were significant prognostic factors on univariate analysis. Gender (P=0.008), ECOG performance status (P=0.027), tumour size (P=0.025) and lymphatic invasion (P<0.0001) retained their significance on multivariate analysis. We concluded that the most important prognostic factors for patients with renal cell carcinomas are ECOG performance status, tumour size and lymphatic invasion.

Prognostic factors other than the performance status and age for glioblastoma multiforme: a single-institution experience.

PURPOSE: To evaluate the survival of patients with glioblastoma multiforme (GBM) and analyse the prognostic factors influencing survival. PATIENTS AND METHODS: Seventy-eight consecutive patients with GBM treated with radiotherapy (RT) and temozolomide (TMZ) (in 21 patients) between 1999 and 2006 were retrospectively analysed. RESULTS: Sixty-seven (85.5%) patients had undergone gross total or subtotal resection before RT. The median overall survival was 9.8 months, and significantly influenced by age (p=0.02), Karnofsky performance status (p=0.001), RT (p<0.0001), gender (p=0.02), concomitant TMZ (p=0.003), RT waiting time (p=0.014), and treatment time (p=0.01) in univariate analysis. In multivariate analysis, older age (p=0.03), male gender (p=0.01), absence of concomitant TMZ (p=0.008), RT dose below 60 Gy (p=0.03), RT waiting time more than 20 days (p=0.01), and treatment time more than 76 days (p=0.0072) were poor prognosticators. CONCLUSION: This study emphasizes the importance of female gender, dose and duration of RT, and RT waiting time in patients with glioblastoma multiforme.