Clinical effects of erdosteine in the treatment of acute respiratory tract diseases in children.

Erdosteine has positive effects on mucus rheology and transport due to the active metabolite (Metabolite I) which contains a free thiol group. Erdosteine inhibits bacterial adhesiveness and has antioxidant properties. A synergistic effect of erdosteine with various antibiotics has been demonstrated in pharmacological and clinical studies. The present study was multicenter, randomized, double-blind and placebo-controlled. The aims of the study were to compare a combination of erdosteine with amoxicillin against an amoxicillin-placebo combination in pediatric patients with acute lower respiratory tract disease. A total of 158 patients (78 in the erdosteine group and 80 in the placebo group) were treated for 7 +/- 2 days. The efficacy parameters were cough (primary), polypnea, rhonchi, rales and body temperature (all measured at baseline, on Day 3 and at the end of treatment). Safety was assessed by strictly monitoring the occurrence of adverse events and using standard laboratory parameters. The results of the intention-to-treat analysis showed that the severity of cough was decreased by 47% at Day 3 in the erdosteine group with a statistically significant difference compared to placebo, the difference was still significant at the final visit. The decrease in the severity of rales was significantly greater at Day 3 in the erdosteine group than in the placebo group. The incidence of polypnea and rhonchi in the two groups showed similar decreases, an improvement mainly due to the antibiotic. No adverse events occurred and no adverse changes in laboratory parameters were observed. It is concluded that the combination of erdosteine and amoxicillin is a safe medication which is clinically superior to that of the antibiotic combined with placebo, especially in regard to the effects on cough.

Disseminated Langerhans cell histiocytosis: a case report with a light microscopic and ultrastructural study.

A case of disseminated Langerhans cell histiocytosis (L.C.H.) in a 9 month-old boy is reported. The clinical picture was characterized by severe multivisceral involvement with cutaneous and bone lesions. Histological examination of the skin biopsy revealed diffuse infiltration of large mononucleated histiocytes admixed with a small number of inflammatory cells. Ultrastructural examination confirmed the Langerhans cell (L.C.) phenotype by showing intracytoplasmic Birbeck granules in the proliferating histiocytes. We report the histological and ultrastructural characteristics of our case and review the diagnostic features of L.C.H. in the light of the criteria established by the Writing Group of the Histiocytic Society in 1987.

The spread of X-linked shifting gene responsible for G-6-PD deficit in series of 13,710 subjects from 4 districts of Moldavia.

Between 1985 and 1989, a sample of 13,710 subjects (5,825 males and 7,885 females) from the Vrancea, Bacau, Neamt and Suceava districts were examined for the presence of this pathological gene, 32 male hemizygotes and 13 female heterozygotes and homozygotes being detected. The incidence of G-6-PD deficit in the hemizygotes was of 0.55%. The investigations carried out in the shifting gene carriers' families revealed the way deficit is transmitted to offsprings. Hemizygotes get it from their mother while the female homozygotes either from their mother or father. The frequency of G-6-PD deficit of 0.55% in a population sample of 13,710 subjects is within the limits established by Marcu and Schneer for our country (0.1-1.8%). By comparing the frequency of 0.55% in the Vrancea, Bacau, Neamt and Suceava districts which formerly had an increased incidence of malaria (Galati - 4.01% and Husi - 5.94%) its low value could be explained by the absence of malaria factor.