Postadenoidectomy hemorrhage: a two-year prospective study.

BACKGROUND/AIM: Although postoperative complications are rare, postadenoidectomy hemorrhage is one of the most frequent. The aim of this prospective study was to evaluate the incidence and timing of postadenoidectomy hemorrhage requiring hemostatic control under endotracheal anesthesia. METHODS: A two-year prospective study of patients undergoing inpatient adenoidectomy, with (n = 462) or without tonsillectomy (n = 589), was undertaken. Surgery was performed in endotracheal anesthesia using an adenoid curette. Every bleeding event which needed procedure in general anesthesia for its treatment was recorded. The timing of postadenoidectomy hemorrhage was classified as primary or secondary. RESULTS: Severe bleeding following adenoidectomy with tonsillectomy which needed hemostatic control under endotracheal anesthesia occurred in only 0.19% (2/1051) patients (average age = 7.5 years). Postadenoidectomy hemorrhage was primary in both of the patients. CONCLUSION: Severe postoperative hemorrhage requiring hemostasis under endotracheal anesthesia can be expected in a small number of children undergoing adenoidectomy with tonsillectomy.

The antitumor immune response in HER-2 positive, metastatic breast cancer patients.

The aim of this study was to determine the basis for anti-tumor immune reactivity observed in patients with human epidermal growth factor receptor-2 (HER-2) (3+) breast carcinoma using an in vitro model in which the role of the HER-2-specific monoclonal antibody Herceptin was also investigated. Patients with metastatic breast cancer who had their primary tumor resected were included in this study. Peripheral blood mononuclear cell (PBMC)-dependent cytotoxicity in the presence or absence of Herceptin were assessed using the survival of target breast adenocarcinoma MDA-MB-361 cells as a parameter in a (3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) test. We observed a significant increase in PBMC-dependent cytotoxicity when autologous serum was introduced in the assay. Furthermore, the addition of Herceptin significantly increases their cytotoxicity. These data suggest that autologous serum constitutively contains factors that might affect PBMC-dependent cytotoxic activity against HER-2 positive cancer cells.

[Pathologic conditions associated with drug-induced rhinitis]. / Patoloska stanja udruzena s medikamentnim rinitisom.

Rhinitis medicamentosa ("nose-drop-nose") is a term used for pathological condition of the nasal mucous membrane that results from long-term abuse with intranasal vasoconstrictors. The aim of this work was to examine what lead the patients with nosedropnose rhinitis to the initial usage of intranasal vasoactive drugs. In this prospective study, 92 patients with rhinitis medicamentosa were included. The evaluation of all study subjects comprised the history, ORL, microbiological and radiological examination, skin prick tests with a battery of routine respiratory and nutritive allergens and nasal cytology. The results of this study showed that the pathological conditions for initial use of intranasal vasoactive drugs were: acute upper respiratory infections in 29.3%, vasomotor rhinitis in 21.7%, allergic rhinitis in 16.3%, deviated nasal septum in 13.0%, nasal polyposis in 12%, rhinitis induced by mechanical trauma in 4.4%, and hormonal rhinitis in 3.3% of patients with rhinitis medicamentosa. In conclusion, the most common pathological conditions for developing rhinitis medicamentosa were chronic inflammatory and structural diseases manifested by permanent nasal obstruction as well as acute upper respiratory infections are.

Skin reactivity to vasomotor agents in non-eosinophilic and eosinophilic non-allergic rhinitis.

The aim of this prospective study was to examine skin reactivity to four vasomotor agents and to determine whether non-eosinophilic rhinitis patients differ from patients with eosinophilic rhinitis. Nasal cytology enabled us to classify 74 rhinitis patients into a non-eosinophilic (n = 63) and an eosinophilic group (n = 11). Skin reactivity to intradermal tests with papaverine, metacholine, histamine and compound 48/80 was measured. No significant difference for papaverine, metacholine, histamine and compound 48/80, singly, was found between the non-eosinophilic and eosinophilic group. The frequency of the total pathological skin reactivity to vasomotor agents, singly and in combinations, was greater in the eosinophilic (91 per cent) then in the non-eosinophilic group (78 per cent) but intergroup difference was not significant. These findings suggest that pathologic skin reactivity to vasomotor agents is a feature of non-eosinophilic as well as eosinophilic non-allergic rhinitis patients and indicate that no difference is noticed in the skin reactivity between these groups.

[Intradermal tests with vasomotor agents in chronic noninfectious rhinitis]. / Intradermalni testovi vazomotornim agensima kod hronicnog, neinfektivnog rinitisa.

The aim of this prospective study was to examine the skin reactivity to four vasomotor agents in chronic, non-infectious rhinitis patients, and to determine whether non-allergic rhinitis (NAR) patients differ from allergic rhinitis (AR) patients. Seventy four patients with NAR and 44 with AR were subjected to intradermal testing with papaverine (5 mg/ml), metacholine (0.02, 0.2 and 2.0 mg/ml), histamine (0.01, 0.1, 1.0 and 10.0 micrograms/ml), compound 48/80 (0.01, 0.1, 1.0 and 10.0 micrograms/ml) and saline. It was found that the frequency of pathological skin reactivity to papaverine in the patients with NAR (25/74) was significantly greater (p = 5.0 x 10(-3)) then in the patients with AR (4/44). No significant inter-group difference in skin reactivity to metacholine, histamine, compound 48/80 and saline was observed. The frequency of the total pathological skin reactivity to vasomotor agents, singly and in combinations, in patients with NAR (80%) was significantly greater (p = 0.03) than in patients with AR (61%). These findings suggested that the pathological skin reactivity to papaverine, metacholine, histamine and compound 48/80 was a feature of chronic, non-infectious rhinitis patients and it was more frequently associated with non-allergic than with the allergic etiology of rhinitis.