Cough and Arabinogalactan Polysaccharide from the Bark of Terminalia Arjuna.

In this work we investigated the antitussive activity of the medicinal tree Terminalia arjuna. We used the stem bark for extraction and preparation of water extracted isolate and its two fractions: acetone-soluble (TA-S) and acetone precipitated (TA-P) fraction. The presence of a pectic arabinogalactan was confirmed in TA-P fraction by chromatographic and spectroscopic analysis. The antitussive activity of samples was assessed after oral administration in a dose of 50 mg.kg(-1) in healthy guinea pigs, in which cough was elicited by inhalation of citric acid (0.3 mol/L) in body plethysmograph. The water extracted isolate showed a significant ability to decrease the number of cough efforts by 64.2 %; the antitussive activity on par with that of codeine phosphate. The TA-P fraction showed the antitussive activity of 54.8 %. In contrast, TA-S fraction had only a mild antitussive activity. No changes in in vivo airway resistance were noted. We conclude that arabinogalactan is an essential component of Terminalia arjuna that underlies its antitussive action.

Soluble receptor for advanced glycation end products in late-onset neonatal infection.

OBJECTIVES: To assess the plasma levels of sRAGE (soluble receptor for advanced glycation end products) in infected and non-infected preterm neonates and to compare their diagnostic values with standard infection biomarkers. BACKGROUND: RAGE activates pathways responsible for acute and chronic inflammation. The soluble type of this receptor, sRAGE, which acts as a decoy receptor, has been linked to the severity of sepsis and its outcome. METHODS: Prospective clinical study was carried out from January 2011 to August 2013. There were 33 neonates included according to their infection status and divided into subgroups as follows: infected (I), septic (S), non-infected controls (C). RESULTS: We found significantly lower values of sRAGE in the subgroup S (905.54±220.53 pg/mL; p < 0.028), while borderline values were higher in the subgroup I vs C (2158.33±197.33 pg/mL vs 1744.80±157.74 pg/mL; p < 0.064). By analysing the interobserver concordance we detected 70 % agreement as to sRAGE values detected in neonatal late-onset infections and sepsis, while procalcitonin was used as golden standard. CONCLUSION: Plasma sRAGE values reflect the severity of the inflammatory status in late-onset infection and sepsis in preterm neonates. Our results indicate that sRAGE could be a good potential biomarker of late-onset neonatal infection and sepsis (Tab. 2, Ref. 14).

Factors attributable to the level of exhaled nitric oxide in asthmatic children.

BACKGROUND: Asthma is a heterogeneous disease with variable symptoms especially in children. Exhaled nitric oxide (FeNO) has proved to be a marker of inflammation in the airways and has become a substantial part of clinical management of asthmatic children due to its potential to predict possible exacerbation and adjust the dose of inhalant corticosteroids. OBJECTIVES: We analyzed potential factors that contribute to the variability of nitric oxide in various clinical and laboratory conditions. MATERIAL AND METHODS: Study population consisted of 222 asthmatic children and 27 healthy control subjects. All children underwent a panel of tests: fractioned exhaled nitric oxide, exhaled carbon monoxide, asthma control test scoring, blood sampling, skin prick tests, and basic spirometry. RESULTS: FeNO and other investigated parameters widely changed according to clinical or laboratory characteristics of the tested children. Asthmatics showed increased levels of FeNO, exhaled carbon monoxide, total serum IgE, and higher eosinophilia. Boys had higher FeNO levels than girls. We found a significant positive correlation between FeNO levels and the percentage of blood eosinophils, %predicted of forced vital capacity, total serum IgE levels, and increasing age. CONCLUSIONS: Various phenotypes of children's asthma are characterized by specific pattern of the results of clinical and laboratory tests. FeNO correlates with total serum IgE, blood eosinophilia, age, and some spirometric parameters with different strength. Therefore, the coexistence of atopy, concomitant allergic rhinitis/rhinoconjunctivitis, and some other parameters should be considered in critical evaluation of FeNO in the management of asthmatic children.

Effects of flavin7 on allergen induced hyperreactivity of airways.

Some studies have suggested that the polyphenolic compounds might reduce the occurrence of asthma symptoms. The aim of our experiments was to evaluate the effects of 21 days of the flavonoid Flavin7 administration on experimentally induced airway inflammation in ovalbumin-sensitized guinea pigs. We assessed tracheal smooth muscle reactivity by an in vitro muscle-strip method; changes in airway resistance by an in vivo plethysmographic method; histological picture of tracheal tissue; and the levels of interleukin 4 (IL-4), and interleukin 5 (IL-5) in bronchoalveolar lavage fluid (BALF). Histological investigation of tracheal tissue and the concentrations of the inflammatory cytokines IL-4 and IL-5 in BALF were used as indices of airway inflammation. Administration of Flavin7 caused a significant decrease of specific airway resistance after histamine nebulization and a decline in tracheal smooth muscle contraction amplitude in response to bronchoconstricting mediators. Flavin7 minimized the degree of inflammation estimated on the basis of eosinophil calculation and IL-4 and IL-5 concentrations. In conclusion, administration of Flavin7 showed bronchodilating and anti-inflammatory effects on allergen-induced airway inflammation.

Cardiac autonomic control in adolescents with primary hypertension.

BACKGROUND: Impairment in cardiovascular autonomic regulation participates in the onset and maintenance of primary hypertension. OBJECTIVE: The aim of the present study was to evaluate cardiac autonomic control using long-term heart rate variability (HRV) analysis in adolescents with primary hypertension. SUBJECTS AND METHODS: Twenty two adolescent patients with primary hypertension (5 girls/17 boys) aged 14-19 years and 22 healthy subjects matched for age and gender were enrolled. Two periods from 24-hour ECG recording were evaluated by HRV analysis: awake state and sleep. HRV analysis included spectral power in low frequency band (LF), in high frequency band (HF), and LF/HF ratio. - RESULTS: In awake state, adolescents with primary hypertension had lower HF and higher LF and LF/HF ratio. During sleep, HF was lower and LF/HF ratio was higher in patients with primary hypertension. CONCLUSIONS: A combination of sympathetic predominance and reduced vagal activity might represent a potential link between psychosocial factors and primary hypertension, associated with increased cardiovascular morbidity.

Therapeutic approach to a child with acute respiratory distress syndrome: a report of two cases.

The course of a respiratory disorder in a child may end up in respiratory failure. There are also acute non-respiratory diseases which have a great influence on the respiratory functions and often lead to the acute lung injury and sometimes to the acute respiratory distress syndrome (ARDS). A feature of respiratory function deterioration is changed in the surfactant system. We often see inhibition of its synthesis or damage to its structure. Therapy of children suffering from ARDS should be complex and rapid. Despite many recently published studies explaining the principle of this disorder, the mortality of ARDS is still very high (30-50%). There are several studies documenting successful administration of exogenous surfactant as part of a complex combined therapy of patients with ARDS, which leads to decreased mortality, improved oxygenation, and decreased need for aggressive artificial pulmonary ventilation. The authors of this article present their own experience with administration of exogenous surfactant in therapy of children with ARDS.

Changes of airway obstruction parameters in healthy children caused by mother's smoking during pregnancy.

The present study was aimed at the assessment of the impact of mother smoking during pregnancy on changes of phase angle (phi) and T(me)/T(E) index in healthy children. A hundred and twenty seven children, divided according to age (<6 months and >6 months of age) and mother smoking anamnesis were investigated by noncalibrated respiratory inductive plethysmography in the supine position. We found statistically significant changes of phi (p<0.05) and T(me)/T(E) in healthy children of non-smoking mothers against a group of smoking mother's children of up to 6 months of age. These differences were not confirmed in children older than 6 months. Moreover, in the smoking mother group, we found statistically significant changes (P<0.05) of phi and T(me)/T(E) in children of up to 6 months of age in comparison with children older than 6 month. The results revealed a negative impact of mother smoking during pregnancy represented by changes in airway obstruction parameters, which appeared especially in the group of youngest children.

Age-dependent changes of airway obstruction parameters.

The study was aimed at the assessment of the physiological range of phi and Tme/Te indices in children of up to 24 months of age, as based on noncalibrated respiratory inductive plethysmography performed in the supine position. We also examined the dependence of these indices on children's age and sex. The study was carried out in 127 healthy children. The results of the study indicate a significant decrease of phi in children aged 7-24 months in comparison with children of up to 6 months of age (P<0.001). Similarly, values of Tme/Te were found significantly higher in the group of older children (P<0.05). We did not find any appreciable sex differences in both measured parameters. The results of this study suggest that the Tme/Te index might be more stable, less age-dependent parameter of the Respitrace measurement than the phase angle j, but further research and analysis to achieve a correct verdict are warranted.

Enalapril and diltiazem co-administration and respiratory side effects of enalapril.

A persistent, chronic dry cough is the most common adverse effect of angiotensin converting enzyme (ACE) inhibitors therapy. The mechanism of this respiratory adverse effect is related to the inhibition of ACE and the accumulation of bradykinin, substance P, prostanoids and other inflammatory neuropeptides in the airways. The aim of this study was to follow the relationship between 15-day administration of enalapril and the defense reflexes (cough and bronchoconstriction) of the airways in experimental animals, as well as the possibility of their pharmacological restriction with simultaneous diltiazem administration. Cough reflex was investigated by the method of mechanical irritation of laryngopharyngeal and tracheobronchial area in non-anesthetized cats. The reactivity of tracheal smooth muscles of the airways to bronchoconstrictor mediators (histamine 10 nM - 1 mM, acetylcholine 10 nM - 1 mM and KCl 1 mM - 100 mM) was evaluated by an in vitro method in guinea pigs. Enalapril 5 mg/kg/day and diltiazem 30 mg/kg/day were administered perorally for 15 days. The results showed that long-lasting administration of enalapril resulted in a significant increase of measured cough parameters and increased reactivity of tracheal smooth muscle to histamine and KCl. Simultaneous administration of enalapril together with diltiazem significantly decreased the enalapril induced cough, and decreased enalapril induced hyperreactivity of tracheal smooth muscles to KCl. The results showed a partially protective effect of diltiazem and enalapril co-administration on the respiratory adverse effects induced by enalapril therapy.

[Social problems of porphyria]. / Problemy spoleczno--socjalne w porfirii.

Late consequences of the attacks of acute porphyrias were studied. Among 312 patients who were investigated the motor disability (neuropathy) was found in 9 patients, psychoneurological changes in 1 case and drug abuse in 7 subjects. In the group of 200 patients in remission (chosen at random) 72 persons (36%) received a disability pension. The existence of problems in change of the profession when it was necessary for health-reasons was marked. It was find that Dolargan (Pethidine) is too often applied to the patients in remission. It was made the warning that drug dependence will arise very easy in patients with porphyria.

Coexistence of hereditary coproporphyria with acute intermittent porphyria.

A new form of acute hepatic porphyria with double genetic defect--deficiency of porphobilinogen deaminase and coproporphyrinogen oxidase--is described. Among 17 studied family members this double enzymatic deficiency was found in five individuals, deficiency of porphobilinogen deaminase in four, and deficiency of coproporphyrinogen oxidase in two. Only the proband had an attack of porphyria. Apart from the proband, all family members had normal urinary PBG excretion. Increased faecal coproporphyrin excretion was found in three people. The results obtained suggest that deficiency of porphobilinogen deaminase and coproporphyrinogen oxidase can be inherited independently. coproporphyrinogen oxidase can be inherited independently.

[Porphyrin fluorescence in plasma of various types of porphyria]. / Fluorescencja porfiryn w osoczu w róznych typach porfirii.

Fluorescence spectra of plasma porphyrin were measured in 6 patients with the acute intermittent porphyria (AIP), 30 patients with variegate porphyria (PV), 2 patients with hereditary coproporphyria, 2 patients with porphyria cutanea tarda, and in 6 patients with erythropoietic protoporphyria (EPP). It was found that the excitation and emission wavelengths at which maximum fluorescence is seen may help to diagnose and differentiate PV and EPP. In patients with AIP spectrum characteristic for porphyria of such a type was noted in all patients during the attack of disease and in only 33% of patients in remission. Fluorescence spectrum was normal in asymptomatic family members. In variegate porphyria spectrum with a characteristic maximum of fluorescence was noted in all patients during an attack and remission, and 62% of the asymptomatic family members.

[Organization and results of studies on acute hepatic porphyrias in Poland]. / Organizatsiia i rezul'taty issledovaniia ostrykh pechenochnykh porfirii v Pol'she.

The organization, activities and experience of Porphyria Reference Centre of the Institute of Hematology in Poland is shown. A total of 214 families with acute hepatic porphyria were collected. The family studies in search of latent cases were conducted, and measures for preventing the disease attacks were taken. The therapy of the attacks consisted in glucose and heme arginate infusions, and hyperalimentation in the patients is stressed. The incidence rate of porphyrias in Poland, according to the material collected at the Institute of Hematology is 1:15,000 inhabitants, however, it is suggested that the true value is much higher.

Heme arginate (Normosang) in the treatment of attacks of acute hepatic porphyrias.

The treatment with heme arginate of 47 attacks of acute hepatic porphyrias are presented. Distribution of patients into three groups of severity has shown that the best clinical response is obtained when the treatment starts in the first three weeks from the beginning of the symptoms and in patients without deep involvement of the nervous system. The decrease in elimination of the precursors of heme was about 60% (mean) in comparison to the preinfusion values, non corresponding firmly with the clinical improvement.

[Acute intermittent porphyria and arterial hypertension]. / Ostra przerywana porfiria a nadcisnienie tetnicze.

A group of 40 female patients with acute intermittent porphyria from 5 to 34 years after attacks of porphyria were examined. In two patients arterial hypertension developed before attack. In 18 cases hypertension was observed in different periods of time after attack. The comparison of these findings with epidemiological data of similar group of the Polish population suggests that arterial hypertension develops earlier and more frequently in female patients with acute intermittent porphyria. Periodic control of blood pressure in patients with acute intermittent porphyria is proposed.

[Factors inducing clinical symptoms of acute hepatic porphyria 1986-1990]. / Przyczyny indukujace objawy kliniczne ostrych porfirii watrobowych w latach 1986-1990.

The most frequent cause of porphyria attacks in this time period were drugs used in symptomatic treatment (in 69 out of 195 cases). In 42 women attacks were induced by sex hormone disturbances, in 21 cases by contact with paints and lacquer in 7 by alcohol and in 3 by calorie deficiencies. The main cause of porphyria attacks in carriers of this metabolic error is lack of porphyria considering in the differential diagnosis of abdominal pains, polyneuropathy and vague mental disorders, which leads to erroneous treatment worsening the course and prognosis of the disease.