No abstract available.
Acetylcysteine*

Objectives: This study aimed to determine the effectiveness of N-acetylcysteine (NAC) in reversal of liver enzyme abnormalities among pediatric patients with dengue induced liver injury. Materials and Methods: The preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P 2020) declaration was used to create this systematic review. The study population included children (<18 years old) diagnosed with dengue-associated Liver Injury and given NAC. The outcome of interest was full recovery. A search was performed in PubMed/MEDLINE, EMBASE, Google Scholar, HERDIN PLUS, WPRIM, clinicaltrials.gov, and Cochrane databases on March 2023. The New Castle-Ottawa Quality Assessment Scale was adapted for risk of bias assessment for cohort studies. Results: Three case series and one pre-post cohort study published from 2013 to 2022 were included. The studies were of acceptable quality. In two studies with overall 10 pediatric patients given NAC for dengue-related ALF, all recovered without adverse events. In one study with 4 patients given NAC, half survived with their liver function tests returning to normal values. Finally, in one comparative study, the durations of time before the liver function tests returned to normal levels, and the mortality rates between those treated with and without N-acetyl cysteine were not significantly different. All studies reported no occurrence of adverse drug reaction related to NAC. Conclusion This systematic review shows limited evidence on the effectiveness of NAC in the reversal of liver enzymes among pediatric patients because of the low incidence of dengue induced liver injury seen in observational studies. Given that NAC is reported by all four studies to be accessible, effective, and with no attributable adverse events, its use can be considered. However, clinicians must still be cautioned given the limited available evidence.
Acetylcysteine

Acetylcysteine ; urine ; Humans ; Hydrocarbons, Brominated ; metabolism ; urine

PURPOSE: Acute acetaminophen intoxication is a common occurrence that can cause lethal complications. In most domestic emergency departments, clinicians tend to treat acetaminophen intoxication based on patients' history alone, simply due to the lack of a rapid acetaminophen laboratory test. We performed a 20-month study of intoxication patients to determine the correlation between the history of patients and serum laboratory tests for acetaminophen. METHODS: We took blood samples from 280 intoxication patients to evaluate whether laboratory findings detected traces of acetaminophen in the sample. Patients were then treated according to their history. Laboratory results came out after patients'discharge. Agreement between patients' history and laboratory results were analyzed. RESULTS: Among the 280 intoxicated patients enrolled, 38 patients had positive serum acetaminophen concentrations; 18 out of 38 patients did not represent a history suggesting acetaminophen intoxication. One patient without the history showed toxic serum acetaminophen concentration. Among the patients with the history, two patients with toxic serum acetaminophen concentration did not receive N-acetylcysteine (NAC) treatment due to their low reported doses, while other 2 patients without significant serum acetaminophen concentration did receive NAC treatment due to their high reported doses. CONCLUSION: This study showed a good overall agreement between history and laboratory test results. However, some cases showed inconsistencies between their history and laboratory test results. Therefore, in treating intoxication patients, a laboratory test of acetaminophen with rapid results should be available in most domestic emergency departments.
Acetaminophen* ; Acetylcysteine ; Diagnosis ; Emergency Service, Hospital ; Humans

BACKGROUND: To determine whether N-acetylcysteine(NAC) reduces methemoglobin. METHOD: We carried out an in vivo experiment in rats, weighed about 300g. Each rat was ingested 200mg of dapsone(4,4'diaminodiphenyl sulphone) to induce methemo- globinemia. After 1 hour, 30 rats were received NAC 160mg(2ml) and another 30 rats, served as control, were received 2ml of normal saline orally,4 times hourly. Serum methemoglobin concentrations were checked 1,6, and 24 hours after dapsone ingestion. RESULT: The methemoglobin concentrations on each time were 27.1+/-5.8%,23.5+/-8.8%, 17.1+/-6.4%(mean+/-SD) in control group and 25.5+/-6.3%, 25.5+/-8.8%, 65.5+/-31.2%(mean+/-SD) in NAC group. There were no differences on methemoglobin concentrations at 1 and 6 hours between two groups(P>.05). At 24 hours, the methemoglobin concentrations of NAC group was significantly higher than those of control group(P<.01). CONCLUSION: NAC had no therapeutic effects on dapsone induced methemoglobinemia in this experimental setting.
Acetylcysteine* ; Animals ; Dapsone ; Eating ; Methemoglobin ; Methemoglobinemia* ; Rats

BACKGROUND: BACTEC MGIT 960 system(Becton Dickinson, USA; MGIT 960) is a fully automated, noninvasive culture system for mycobacteria, which has been regarded as a sensitive and least labor-intensive method. This study was purposed to evaluate the performance of MGIT 960 compared to BACTEC 460 TB radiometric system(Becton Dickinson, USA; BACTEC 460) and Ogawa media. METHODS: A total of 1,067 clinical specimens submitted from April to June in 1999 was cultured for acid fast bacilli(AFB). All specimens were digested, decontaminated by the 6% sodium hydroxide(final concentration of 1.5%) and 0.5% N-acetyl-L-cysteine method. All specimens were inoculated into three kinds of media: a MGIT, a BACTEC 12B, and an Ogawa medium. The AFB recovered from cultures were identified to M. tuberculosis complex and MOTT by NAP test. RESULTS: Of 106 isolates of M. tuberculosis recovered from all culture systems, 101(95.3 %) were detected in the MGIT 960, 95(89.6%) in the BACTEC 460 and 76(71.7%) on Ogawa media. MGIT 960 plus Ogawa media detected 104(98.1%) isolates and BACTEC 460 plus Ogawa media recovered 96(90.6%) isolates. The mean time required for detection of M. tuberculosis was 12.7+/-5.8 days with MGIT 960, 16.2+/-7.7 days with BACTEC 460, and 22.8+/-9.5 days with Ogawa media. The contamination rate were 5.1% for MGIT 960, 2.7% for BACTEC 460, and 6.7% for Ogawa media. CONCLUSIONS: MGIT 960 is a sensitive and rapid method to isolate M. tuberculosis.
Acetylcysteine ; Mycobacterium tuberculosis* ; Mycobacterium* ; Sodium ; Tuberculosis

Contrast-induced nephropathy (CIN) affects in-hospital, short- and long-term morbidity and mortality. It also leads to prolonged hospital stay and increased medical cost. Given the potential clinical severity of CIN, there has been considerable interest in the development of preventative strategies to reduce the risk of contrast-induced renal deterioration in at-risk populations. A number of pharmacologic and mechanical preventive measures have been attempted, but no method other than adequate periprocedural hydration has been conclusively successful. Since its introduction in 2000, N-acetylcysteine (NAC) has been widely investigated, albeit with conflicting findings for its nephroprotection capability in patients receiving contrast media procedures. However, there is still virtually no definitive evidence of effectiveness of NAC. Although the exact mechanism responsible for the protective action of NAC from renal function deterioration remains unclear, the antioxidant and vasodilatory properties of NAC have been suggested as the main mechanisms. This review summarizes the current status of NAC as a potential agent to prevent renal functional deterioration and its limitations.
Acetylcysteine ; Angiography ; Contrast Media ; Humans ; Length of Stay ; Renal Insufficiency

OBJECTIVETo establish the method of high-performance liquid chromatography HPLC for the determination of N-acetyl-S-(2-carbamoylethyl)-cysteine (AAMA) in urine.

METHODSAfter acid hydrolysis, AAMA in urine was converted into S-2-carboxyethyl cysteine (CEC). CEC reacted with the derivative reagent ophthalaldehyde and formed the derivative with strong fluorescence absorption. The HPLC-fluorescence detector was applied, with an excitation wavelength of 340 nm and an emission wavelength of 450 nm.

RESULTSUrinary AAMA demonstrated an excellent linearity in the range of 5.3~123.5 μmol/L, with a correlation coefficient of 0.9994. The minimum detectable concentration was 0.1 μmol/L (the volume of urine sample was 1.0 ml), the recovery of standard addition was 97.4%~104.2%, and the between-run precision was 2.3%~4.3%. The sample could be stored in the refrigerator for at least 7 days at a temperature of 4℃.

CONCLUSIONThe method is simple, with a low cost, a high sensitivity, and good precision and accuracy, and the instrument and equipment commonly seen in laboratories are applied. Therefore, this method is worthy of wide application.

Inhibition of Rho-associated coiled coil-containing kinase (ROCK) has been reported to promote differentiation of neuronal cells. Here, we examined the effect of Y-27632, a ROCK inhibitor, on the outgrowth of neurites in PC12 cells. Y-27632 caused a rapid induction of neurite outgrowth in PC12 cells in a time-dependent manner. The neurite outgrowth, triggered by Y-27632, was accompanied by Rac1 activation, and was attenuated by Rac1 inhibitor NSC23766, in a concentration-dependent manner. Y-27632 also induced an increase in the production of reactive oxygen species (ROS). Pretreatment with N-acetylcysteine, an ROS scavenger, inhibited the ROS generation and neurite outgrowth in response to Y-27632. These results indicate that the activation of Rac1 and the generation of ROS contribute to the neurite outgrowth triggered by Y-27632 in PC12 cells.
Acetylcysteine ; Animals ; Neurites* ; Neurons ; PC12 Cells* ; Phosphotransferases ; Reactive Oxygen Species*

BACKGROUND/AIMS: To evaluate the adjuvant effects of N-acetylcysteine (NAC) on first-line sequential therapy (SQT) for Helicobacter pylori infection. METHODS: Patients with H. pylori infections were randomly assigned to receive sequential therapy with (SQT+NAC group, n=49) or without (SQT-only group, n=50) NAC. Sequential therapy consisted of rabeprazole 20 mg and amoxicillin 1 g for the first 5 days, followed by rabeprazole 20 mg, clarithromycin 500 mg and metronidazole 500 mg for the remaining 5 days; all drugs were administered twice daily. For the SQT+NAC group, NAC 400 mg bid was added for the first 5 days of sequential therapy. H. pylori eradication was evaluated 4 weeks after the completion of therapy. RESULTS: The eradication rates by intention-to-treat analysis were 58.0% in the SQT-only group and 67.3% in the SQT+NAC group (p=0.336). The eradication rates by per-protocol analysis were 70.0% in the SQT-only group and 80.5% in the SQT+NAC group (p=0.274). Compliance was very good in both groups (SQT only/SQT+NAC groups: 95.2%/100%, p=0.494). There was no significant difference in the adverse event rates between groups (SQT-only/SQT+NAC groups: 26.2%/26.8%, p=0.947). CONCLUSIONS: The H. pylori eradication rate was numerically higher in the SQT+NAC group than in the SQT-only group. As our data did not reach statistical significance, larger trials are warranted.
Acetylcysteine* ; Amoxicillin ; Clarithromycin ; Compliance ; Helicobacter pylori* ; Helicobacter* ; Humans ; Metronidazole ; Rabeprazole