Pediatric Cushing syndrome: An early sign of an underling cancer predisposition syndrome.

Beckwith-Wiedemann syndrome (BWS) is a genetic overgrowth and cancer predisposition syndrome that can be associated with a spectrum of clinical features including isolated lateralized overgrowth, macrosomia, macroglossia, organomegaly, omphalocele/umbilical hernia, and distinct facial features. Because of a range of clinical presentations and molecular defects involving Chromosome 11p15, many cases will fall within what is now being defined as the Beckwith-Wiedemann spectrum (BWSp). Cushing syndrome (CS) in infants is a rare neuroendocrinological disease associated with hypercortisolism that has rarely been reported in patients with BWS. Here, we describe the first case of a 5-month-old male with CS secondary to paternal uniparental disomy of Chromosome 11p without additional clinical signs or symptoms of BWS. This case continues to expand the phenotypic spectrum of BWSp.

Phytochemical and antioxidant properties of some Cassia species.

In this study, the antioxidant activity of aqueous and ethanol extracts of four plants from the genus Cassia were evaluated by various antioxidant assays, including ferric reducing antioxidant power (FRAP), DPPH free radical scavenging, metal chelating activity, phosphomolybdenum reducing power, hydrogen peroxide radical scavenging, hydroxyl radical scavenging, deoxyribose degradation and ß-carotene bleaching assay. The various antioxidant activities were compared to standard antioxidant such as ascorbic acid. All the extracts showed antioxidant activity in the tested methods. Among the four species, Cassia auriculata has been found to possess highest activity in most of the tested models. In addition to the antioxidant activity, the total phenolics and flavonoids were measured in the extracts. The ethanolic extract exhibited highest phenolics and flavonoid contents and had also shown potent antioxidant activity in comparison to the aqueous extracts. The possible antioxidant mechanism of the ethanol extract can be due to its hydrogen or electron donating and direct free radical scavenging properties. Hence, the ethanol extract represents a source of potential antioxidants that could be used in pharmaceutical industries.

Hemodynamic effects of vecuronium in patients with coronary artery disease.

The hemodynamic effects of vecuronium 0.2 mg/kg were investigated in 11 patients with coronary artery disease. Vecuronium, at a dose double the ED90, produced 90% neuromuscular block in a mean time of 163 +/- 7 s, and was not associated with any significant hemodynamic changes. The results suggest that vecuronium can safely be used in cardiac patients.

Hemodynamic effects of diazepam-vecuronium-fentanyl sequence for induction of anesthesia for coronary artery surgery.

The hemodynamic effects of diazepam (0.2 mg/kg)--vecuronium (0.2 mg/kg)--fentanyl (10 micrograms/kg) sequence was investigated when used for induction of anesthesia and tracheal intubation in eleven patients undergoing CABG. The parameters monitored included HR, SBP, PAP and PCWP. Also, EKG was monitored via a modified V5 lead and C.O was measured by thermodilution. SVR, PVR and SV were computed from the measured parameters. Following induction of anesthesia by diazepam-vecuronium-fentanyl sequence, there was a decrease in SBP by 20.0% (P less than 0.05), in HR by 15.7% (P less than 0.001) in C.O by 13.3% (P less than 0.01) and in SVR by 13.6% (P less than 0.05) of control value. There were no changes in PAP, PCWP, PVR and SV. Coronary perfusion pressure and heart rate product were both decreased following this induction sequence. However, the percentage decrease in PR was higher than that of CPP, affecting favorably the myocardial oxygen supply-demand balance. Orotracheal intubation was followed by an increase of HR by 10.7% (P less than 0.05), SVR by 13% (P less than 0.05) and PCWP by 26% (P less than 0.05) of preceding value. However, all these values did not reach the control awake values. It was concluded that diazepam (0.2 mg/kg)--vecuronium (0.2 mg/kg)--fentanyl (10 micrograms/kg) sequence does not produce serious hemodynamic changes when used for induction of anesthesia and tracheal intubation in patients undergoing coronary artery bypass surgery.