Effects of Cefixime on Immune Functions and Inflammatory Factors in Children with Urinary Tract Infection and Targeted Nursing Strategies

Objective: This study aims to explore the effects of cefixime on immune functions and inflammatory factors in children with urinary tract infection and to investigate its nursing strategies. Methods: A total of 161 children with urinary tract infection who were diagnosed in our hospital from November 2019 to November 2021 were selected. All children were treated with cefixime and received targeted nursing strategies. The indices of immune functions and the levels of inflammatory factors were compared before and after the treatment. The satisfaction degree of children’s family members, recurrence rate and incidence of adverse reactions were measured. Results: The levels of CD3+, CD4+ and CD4+/CD8+ in children after the treatment were significantly higher but the CD8+ level was significantly lower than those before the treatment (p < 0.001). The levels of C-reactive protein, tumour necrosis factor-α and interleukin-6 after the treatment were lower than those before the treatment (p < 0.001). The average score of nursing satisfaction of children’s family members was (84.53 ± 13.65) points, with the total satisfaction degree of 90.68% (146/161). Within 6 months after the treatment, only six children had urinary tract infection again and the recurrence rate was 3.73% (6/161). During the treatment, seven children had adverse reactions to the drug, with an incidence rate of 4.35% (7/161). Conclusions: Cefixime can improve the immune function of children with urinary tract infection and reduce the levels of inflammatory factors. The implementation of targeted nursing strategies can improve clinical satisfaction and reduce the recurrence rate of the disease and thus can be helpful to establish a comprehensive and efficient clinical program for children with urinary tract infection (AU)

Abnormalities in subsets of B and T cells in Mexican patients with inborn errors of propionate metabolism: observations from a single-center case series

BACKGROUND: Propionate inborn errors of metabolism (PIEM), including propionic (PA) and methylmalonic (MMA) acidemias, are inherited metabolic diseases characterized by toxic accumulation of propionic, 3-hydroxypropionic, methylcitric, and methylmalonic organic acids in biological fluids, causing recurrent acute metabolic acidosis events and encephalopathy, which can lead to fatal outcomes if managed inadequately. PIEM patients can develop hemato­logical abnormalities and immunodeficiency, either as part of the initial clinical presentation or as chronic complications. The origin and characteristics of these abnormalities have been studied poorly. Thus, the aim of the present work was to evaluate and describe lymphoid, myeloid, and erythroid cell population profiles in a group of clinically stable PIEM patients. METHODS: This was a retrospective study of 11 nonrelated Mexican PIEM patients. Clinical, bio­chemical, nutritional, hematological, and lymphocyte subsets were analyzed. RESULTS: Despite being considered clinically stable, 91% of patients had hematological or immu­nological abnormalities. The absolute lymphocyte subset counts were low in all patients but one, with CD4+ T-cell lymphopenia, being the most common one. Furthermore, of the 11 stud­ied subjects, nine presented with a low CD4/CD8 ratio. Among the observed hematological alterations, bicytopenia was the most common (82%) one, followed by anemia (27%). CONCLUSION: Our results contribute to the landscape of immunological abnormalities observed previously in PIEM patients; these abnormalities can become a life-threatening chronic com­plications because of the increased risk of opportunistic diseases. These findings allow us to propose the inclusion of monitoring immune biomarkers, such as subsets of lymphocytes in the follow up of PIEM patients

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Inmunohistoquímica de las lesiones cutáneas en la lepra y las leprorreacciones / No disponible

Objetivos: 1. Evaluar la immunohistoquimica de los granulomas de la lepra en las muestras de biopsias cutáneas de pacientes con lepra tuberculoide y lepromatosa, con respecto a la presencia y distribución de células T CD4+, CD8+ y CD28+, células CD 68+ y células CD1a+. 2. Evaluar los hallazgos inmunohistoquimicos observados en leprorreacciones. Metodología: Estudio descriptivo. Se seleccionaron para el estudio biopsias cutaneas, en las que se había diagnosticado clínica e histopatologicamente lepra entre el 1.8.2016 al 31.5.2017 en el Instituto Medico Gubernamental, Kozhikode. Se estudió la immunohistoquimica de las lesiones cutáneas en lepra y leprorreacciones, observando específicamente la distribución de células CD4/ CD8/ CD28/ CD68/ CD1a en la lepra en distintos escenarios. Resultados: En el estudio se incluyeron veintiséis casos tuberculoides y 14 lepromatosos. Todos los granulomas independientemente del tipo de enfermedad presentaron tinción positiva por CD4 y CD68. Dos de los 14 casos lepromatosos (14・3%), y 15/26 (57・7%) de las muestras tuberculoides presentaron expresion CD4 de moderada a fuerte. Se detectó negatividad CD28 en cuatro casos tuberculoides (15・4%) y en 10 lepromatosos (71・4%). La expresion CD4 moderada a fuerte se detectó en más del 70% de los T1R incremento mientras que en los demás grupos solo fue de 20%-50%. Más del 80% de las T1R estáticas e incremento presentaban positividad CD28, mayor de que el 30%-50% registrado en otros grupos. Conclusiones: Los resultados revelan que la inmunohistoquimica tiene un papel en aclarar los complejos procesos inmunológicos empleados en la lepra y las leprorreacciones

Objectives: 1. To study the immunohistochemistry of leprosy granulomas in the skin biopsy specimens of patients with tuberculoid and lepromatous leprosy, with respect to the presence and arrangement of CD4+, CD8+ and CD28+ T cells, CD 68+ cells and CD1a+ cells. 2. To study the immunohistochemistry findings observed in leprosy reactions. Design: Descriptive study. Skin biopsies in which the clinical and histopathological diagnosis of leprosy was reported between 1.8.2016 to 31.5.2017 in the Government Medical College, Kozhikode, were selected for the study. Immunohistochemistry of the skin lesions in leprosy and leprosy reactions was studied, looking specifically for the distribution of CD4/ CD8/ CD28/ CD68/ CD1a positive cells in leprosy at different scenarios. Results: Twenty-six tuberculoid and 14 lepromatous cases were included in the study. All granulomas irrespective of disease type showed positive staining for CD4 and CD68. Two of the 14 lepromatous leprosy cases (14・3%), and 15/26 (57・7%) tuberculoid specimens manifested moderate to strong CD4 expression. CD28 negativity was documented in four tuberculoid (15・4%) and 10 lepromatous cases (71・4%). Moderate to strong CD4 expression was noted in more than 70% of upgrading T1R while a similar finding was documented in only 20%-50% of other groups. More than 80% of static and upgrading T1R showed CD28 positivity, which was higher than the 30%-50% positivity recorded in other groups. Conclusions: The observations of the current study indicate a role for immunohistochemistry analysis in delineating the complex immunological processes involved in leprosy and leprosy reactions

¿Cuál es su diagnóstico? / What is your diagnosis?

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Effect of phototherapy on B and T lymphocytes in Egyptian infants suffering from neonatal jaundice

BACKGROUND: Neonatal jaundice is one of the most common problems that affect newborn infants, and phototherapy is usually used for treatment. OBJECTIVES: Evaluation of the effect of phototherapy on neonatal immune system through measuring the percentage of B and T lymphocytes and determining the frequency of development of infections and need for hospitalisation during the first six months of life. METHODS: A prospective cohort study was conducted on 50 full term new-borns; 25 with indirect hyperbilirubinaemia and treated with conventional phototherapy and 25 healthy matched neonates as untreated controls. The percentages of CD19+, CD4+ and CD8+ lymphocytes were measured by flow cytometry before phototherapy and 72h after exposure. Follow-up of the study group for the occurrence of infections for a period of six months after phototherapy. RESULTS: The study showed a significant difference in CD19+ lymphocytes percentage between patients before phototherapy and controls (P value<0.01), also a significant correlation between serum levels of total bilirubin in patients and CD19+ lymphocytes percentage (P value<0.05). There was no significant difference between the percentages of CD19+, CD4+ and CD8+ lymphocytes in patients before or after 72h of exposure to phototherapy (P value>0.05). Also, there was no correlation between the percentages of CD19+, CD4+ and CD8+ lymphocytes after 72h of exposure to phototherapy and the occurrence of infections (Gastrointestinal tract and Respiratory tract infection) after six months of follow-up (P value>0.05). More studies are needed with larger number of patients to determine the effect of phototherapy on immune system

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Tumor endobronquial solitario debido a sarcoidosis: imagen de broncoscopia de autofluorescencia / Solitary Endobronchial Tumor Due to Sarcoidosis: An Autofluorescence Bronchoscopic

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Granulomas cutáneos no infecciosos en inmunodeficiencia común variable / Non-infectious skin granulomas in a common variable immunodeficiency

La inmunodeficiencia variable común es una inmunodeficiencia primaria por hipogamaglobulinemia de IgG e IgA poco frecuente en la población. Clásicamente se presenta durante la juventud y se diagnostica durante la investigación de infecciones respiratorias y gastrointestinales a repetición. Estos pacientes pueden además presentar enfermedades autoinmunes, inflamatorias, neoplásicas, malabsorción y problemas granulomatosos no infecciosos, que afectan el pulmón, ganglios, bazo, hígado, y menos usualmente la piel. Presentamos el caso de una paciente diagnosticada de inmunodeficiencia variable común que se presenta en la consulta dermatológica con múltiples nódulos eritemato-costrosos en miembros, donde se hallaron únicamente granulomas asépticos (AU)

Common variable immunodeficiency is a rare, primary immunodeficiency characterized by hypogammaglobulinemia of IgG and IgA. It classically presents as recurrent respiratory and gastrointestinal infections in young patients, who may also have autoimmune and inflammatory disease, malignancies, malabsorption and non-infectious granulomas, mainly located in the lung, lymph nodes, spleen, liver and, less frequently, in the skin. We report the case of a patient diagnosed with common variable immunodeficiency who presented in the dermatology clinic with multiple, erythematous, crusted nodules on the limbs. Only aseptic granulomas were found (AU)

Therapeutic implications of IL-17A blockade in psoriasis

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IL-17 in psoriasis. The final frontier or just another brick in the wall?

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Linfoma intestinal de células T asociado a enteropatía y sin relación con enfermedad celíaca / Enteropathy-associated intestinal t-cell lymphoma without celiac disease

La enteropatía asociada a linfoma de células T tipo II es un linfoma intestinal infrequente. Presentamos el caso un varón de 73 años con diarrea y pérdida de peso. La biopsia duodenal presentaba atrofia e infiltrado de linfocitos irregulares. La inmunohistoquímica detectó positividad para CD3, CD8, CD56 con reordenamiento monoclonal del TCR. El genotipifación de HLA-DQ era DQ5/DQ9. El test para EBVRNA fue negativo. Antes del tratamiento específico quimioterápico ingresó por infección respiratoria, y falleció por causa independiente del linfoma. El diagnóstico diferencial de los procesos linfoproliferativos CD56-positivo incluye EATL tipo II, linfoma intestinal primario de células T/NK y linfoma de células T hepatoesplénico.El paciente presentaba CD8 y CD56+ marcadores que permiten descartar EALT tipo I. la genotipificación HLA-DQ no corresponde a enfermedad celíaca, y la biopsia presentaba proliferación de linfocitos con atipias. El linfoma intestinal primario de células T/NK se caracteriza principalmente por ausencia de CD8 y del reordenamiento monoclonal del TCR presentes en este caso(AU)

Type II enteropathy-associated T-cell lymphoma (EATL) is an uncommon intestinal lymphoma. We report the case of a 73-year-old man with diarrhea and weight loss. Duodenal biopsy showed atrophy and infiltration of irregular lymphocytes. Immunohistochemistry was positive for CD3, CD8, and CD56 with monoclonal TCR rearrangement. The HLA-DQ genotype was DQ5/DQ9. The Epstein-Barr virus RNA test was negative. Before specific chemotherapy could be administered, the patient was admitted to hospital for a respiratory infection and died from a cause unrelated to his lymphoma. The differential diagnosis of CD56-positive lymphoproliferative processes include type II EATL, primary T-cell/natural killer-cell intestinal lymphoma and hepatosplenic T-cell lymphoma. The patient had CD8 y CD56+ markers that allowed type I EATL to be excluded. The HLA-DQ genotype did not correspond to celiac disease and the biopsy showed proliferation of lymphocytes with atypia. The primary intestinal T-cell/natural killer-cell lymphoma was characterized mainly by the absence of CD8 and monoclonal reassortment of the TCR present in this case (AU)

T cells in sputum of asthmatic patients are activated independently of disease severity or control

Background: T cells play an important role in bronchial asthma. Although airway CD4+ T cells have been extensively studied previously, there are hardly any studies relating CD8+ T cell activation and disease symptoms. Objectives: The aim of this study was to analyse the association between T cell activation in induced sputum T cells and asthma severity and control; and to evaluate T cell subpopulations in the same subgroups. Methods: Fifty allergic asthmatic patients were recruited and lung function testing was performed. Airway cells were obtained by sputum induction via inhalation of hypertonic saline solution. CD3, CD4, CD8, CD28, CD25 and CD69 were studied by flow cytometry in whole induced sputum and peripheral blood cells. Results: Total induced sputum T cells and CD8+ T cells had a higher relative percentage of the activation markers CD25 and CD69 in comparison with peripheral blood. In sputum, the relative percentage of CD25 was higher in CD4+ T cells when compared to CD8+ T cells and the reverse was true regarding CD69. However, neither disease severity nor control were associated with the relative percentage of CD25 or CD69 expression on T cells in sputum. Conclusions: Both CD4+ and CD8+ T cells are activated in the lungs and peripheral blood of asthmatic patients. However, with the possible exception of CD69+ CD8+ T lymphocytes in the sputum, there is no association between T cell activation phenotype in the target organ and disease severity or control (AU)

Placas hiperqueratósicas palmoplantares / Palmoplantar hyperkeratotic plaques

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Respuesta inmunitaria celular adaptativa frente a la infección por el virus de la hepatitis C / Adaptive cell immune response against the hepatitis C virus infection

El virus de la hepatitis C (VHC) infecta alrededor de 175 millones de personas en el mundo y es una de las principales causas de enfermedad hepática crónica. Menos de una tercera parte de las personas expuestas controlan el virus espontáneamente después de la infección aguda, mientras que el resto evoluciona a la cronicidad. La resolución de la infección se ha asociado al componente celular de la respuesta inmunitaria del huésped. No se conoce bien qué distingue una respuesta inmunitaria celular exitosa frente al VHC. Una interpretación integral de los diversos hallazgos experimentales permite una mejor comprensión del porqué del fracaso inmunitario en la infección crónica por el VHC

Hepatitis C virus (HCV) infects around 175 million people worldwide and is one of the leading causes of chronic liver disease. Less than one third of patients infected with HCV are able to spontaneously clear the virus during acute infection, while most patients evolve to chronic infection. Control of viral replication has been associated to the cellular component of the host immune response. It is not fully understood what distinguish a successful cellular immune response. An integral interpretation of the numerous experimental findings may allow a better understanding of the immune mechanisms involved in the inability of the immune system to successfully control chronic HCV infection

Toxicidad pulmonar inducida por sales de oro / Gold salt-induced lung disease

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Mecanismos inmunológicos de inducción de tolerancia a aloinjertos / No disponible

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Vacunación con DNA: una perspectiva inmunológica / DNA vaccination: an immunological perspective

La vacunación con DNA es una nueva y prometedora estrategia para la prevención y el tratamiento de muchas enfermedades debido a su habilidad para inducir una respuesta inmunitaria tanto humoral como celular, frente al antígeno codificado por el DNA recombinante. Una vez inoculado en el huésped, el DNA se introduce en las células, donde el antígeno se expresa y se procesa para ser después reconocido por el sistema inmunitario como si se tratase de una infección natural. Esta tecnología presenta grandes esperanzas para ser usada en la inmunoterapia del cáncer y se espera que llegue a ser el método preferido para la próxima generación de vacunas, particularmente adecuadas contra infecciones intracelulares para las que no hay vacunas efectivas. Esta revisión se centra en los mecanismos por los cuales la vacunación con DNA es capaz de inducir una respuesta inmunitaria y los abordajes que se están llevando a cabo para su optimización. También se ofrece una visión general sobre las aplicaciones de la vacunación con DNA (AU)

Respuesta inmune en niños con infección intestinal por giardia lamblia, Cryptosporidium parvum y enterobius vermicularis / Inmune response in children with intestinal parasitic infection for Giardia lamblia, Cryptosporidium parvum and Enterobious vermicularis

El objetivo de este estudio es determinar la respuesta inmune sérica en niños con parasitosis intestinal al diagnóstico y tres meses después sin infección. Fueron recogidas 3036 muestras de 1959 niños y 939 pruebas de cello de 688 niños para investigación parasitaria. De los 155 niños con parásitos, 86 con un único parásito fueron seguidos en este estudio. Veintiséis con Giardia lamblia fueron tratados con tinidazol y metranidazol, cuarente con Enterobius vermicularis con palmoato de prantel y veinte con Cryptosporidium parvum sólo con tratamiento sintomático. Las inmunoglobulinas séricas fueron determinadas mediante nefelometria cinética CD4+ y CD8+ por citometria de flujo y anticuerpos monocionales marcados con fluorescencia. Existe un incremento signficativo de IgA en pacientes con Giardia lamblia y de IgG para Cryptosporidium parvum, entre la fase aguda de parasitación y tres meses después sin infección. No existen diferencias para IgM. Hay un descenso significativo en los tres tipos de parasitación para IgE entre el diagnóstico y tres meses después sin infección. No hemos encontrado diferencias significativas para CD4+, CD8+ y CD4+ / CD8+. Los pacientes con parasitosis intestinal presentan modificaciones inmunológicas significativas en la fase aguda de parasitación. Actualmente, el mecanismo mediante el cual el sistema inmune responde en las personas inmunocompetes es escasamente conocido. La respuesta inmunológica podría reflejar las alteraciones surgidas en la mucosa intestinal en contacto con el parásito (AU)

To determine prospectively plasma levels of immunes response in children with intestinal parasitic infection and three months after without infection. Three thousand thirty-six faecal stool samples were collected form 1959 children, and 939 cello-tape anal swabs form 688 children, were performed for intestinal parasite searching. From 155 children with parasitic infection, 86 were followed during this study. Twenty-six children with Giardi lamblia infection were treated with tinidazoie and metronidazole. Pyrantel palmoate symptomatic treatment. Serum inmune globulin, were determined for kinetic nephelometric, CD4+ and CD8+ for cytometric of flow and monoclonal atibodies marked with fluorescence. There were significant increases of IgA for Giardi lamblia and of IgG for Cryptosporidium parvum. No statistical difference was found for IgM. There were significant differences among the three types of parasites for IgE. There were a decrease significant of IgE among diagnosis and three months without infection for all types of parasites. No statistical difference was found for CD4+ CD8+ and C4/CD8. Patients with intestinal parasitic infection have alteration immunology´s significances. The mechanism with which the immune system of an inmunocompetent host responds to intestinal parasitic infection is still poorly understood. the immune response should reflect he pathology at the intestinal mucous site (AU)