Empyema in children.

Empyema is the infection of the fluid in the pleural space due to different causes. The most common cause of empyema in children is parapneumonic effusion. Although its frequency has decreased significantly with the use of antibiotics, it is still a significant cause of morbidity and mortality worldwide. The main aim in the treatment of empyema is to drain the pleural cavity to provide reexpansion of the compressed lung, to treat the parenchymal infection with appropriate antibiotic therapy, and to prevent complications that may develop in the acute and chronic periods. Treatment options for this disease vary depending on the stage of the disease. Treatment success in childhood empyema detected at an early stage is high. The diagnosis and treatment of empyema in children differs from adults. Due to rapid tissue regeneration in childhood, healing can occur without the need for aggressive treatment options.

Investigation of the effects of different drugs on the prevention of intrapleural adhesion in a rat model.

Background: The aim of this study was to investigate the antifibrinolytic and anti-inflammatory effects of hesperidin, tenoxicam and enoxaparin on intrapleural adhesions in an experimental rat model. Methods: A total of 52 healthy adult male Wistar Albino rats from the same colony were randomly divided into six groups as sham (Group 1), surgical control (Group 2), low-dose hesperidin (Group 3), high-dose hesperidin (Group 4), tenoxicam (Group 5), and enoxaparin (Group 6). All subjects underwent left thoracotomy and except for the sham group, an adhesion model was applied and, postoperatively, the drugs were administered intraperitoneally. On Day 11 postoperatively, the rats were sacrificed and their blood levels of interleukin-1ß and interleukin-10 were examined and they were evaluated for pleural adhesion area, adhesion severity score, mesothelial cell proliferation score, mononuclear cell infiltration score, and macrophage infiltration score in the collagen layer. Results: The lowest adhesion area and adhesion severity score were found in Group 6. There was a statistically significant difference between Group 2 and Group 6 and between Group 3 and Group 6 in terms of both parameters (p=0.04 and p=0.02). As for adhesion area, a statistically significant difference was found between Group 5 and Group 6 (p=0.04). Statistically significant differences were also found between Group 2 and Group 5 in terms of mesothelial cell proliferation scores and between Group 1 and Group 4 in terms of mononuclear cell infiltration scores (p=0.03 and p=0.02). Conclusion: Enoxaparin, tenoxicam, and high-dose hesperidin act at different points to prevent adhesion in rats.

Comparison of the effects of alpha lipoic acid and dexpanthenol in an experimental tracheal reconstruction animal model.

OBJECTIVES: To investigate the positive effects of intraperitoneal administration of alpha-lipolic acid (ALA) and dexpanthenol (DXP) on wound healing after tracheal surgery in rats. METHODS: The study was carried out at Necmettin Erbakan University, Konya, Turkey, from January 2014-2019. A total of 30 healthy and adult Sprague-Dawley type female rats were included in the study. For the experiment, rats were randomly divided into 3 groups: ALA group (n=10), DXP group (n=10), and control group (n=10). After trachea surgery, 100 mg/kg/day ALA was given to group ALA and 100 mg/kg/day intraperitoneal DXP to group DXP for 15 days, and the rats were sacrificed on the 21st day. The excised tracheal sections were evaluated and graded for inflammatory cell infiltration, angiogenesis, fibroblast proliferation, collagen deposition, and epithelial regeneration to evaluate wound healing. RESULTS: Inflammation was found to be less in both the ALA and DXP groups. With the Mann-Whitney test, it was determined that inflammation was less in the ALA group than in the DXP group (C-D [p=0.097] and C-A [p=0.024]). On the other hand, no statistically significant difference was found in epithelial regeneration (p=0.574; >0.05), angiogenesis (p=0.174; >0.05), fibroblast proliferation, and collagen deposition (p=0.102; >0.05). CONCLUSION: Alpha-lipolic acid injected intravenously after tracheal reconstruction in patients can prevent restenosis by reducing inflammation without adversely affecting wound healing.

Diagnostic value of platelet-to-lymphocyte ratio in patients with solitary pulmonary nodules.

Introduction: Nodules detected in the lung parenchyma should be considered as malignant until proven otherwise, and the necessary tests should be performed for diagnosis. Aim: To calculate the preoperative platelet-to-lymphocyte ratio (PLR) in patients with malignant lung nodules and to investigate the diagnostic value of this ratio in determining the histopathology of the nodule. Material and methods: Ninety-one patients who were operated on for a malignant nodule in the lung between September 2010 and September 2020 were included in the study. The PLR was calculated by dividing the absolute platelet count by the absolute lymphocyte count. These values were compared with the histopathological diagnoses of the resected tumor tissue. Patients with primary lung malignancy were classified as group 1 (n = 54), and lung metastases of other organs were classified as group 2 (n = 37). Results: The mean PLR was 127.27 ±46.82 in the first group and 183.56 ±93.49 in the second group. There was a statistically significant difference in PLR values between the two groups, and PLR was higher in group 2. There was no statistically significant difference between the two groups in terms of lymph node positivity, nodule size and SuvMax values. A moderately strong, significant and same-sided correlation was observed between nodule size and SuvMax values in the first group of patients (r = 0.48, p = 0.001). Conclusions: PLR values less than 89.41 indicate that the histopathological result may be a lung-derived malignancy. However, in cases where the PLR is detected above 165.6, it would be appropriate to interpret another previously detected malignancy as metastasis to the lung.

Retrograde intrarenal surgery for nephrolithiasis in a 2-year-old boy with type 1 glycogen storage disease: a case report.

Treatment for renal stone in a 2-year-old boy with glycogen storage disease type 1 (GSD-1) is reported. To our knowledge, this is the first published report of a child with GSD-1 treated by retrograde intrarenal surgery.