CD4+ Th2 cells are directly regulated by IL-10 during allergic airway inflammation.

Interleukin-10 (IL-10) is an important regulatory cytokine required to control allergy and asthma. IL-10-mediated regulation of T cell-mediated responses was previously thought to occur indirectly via antigen-presenting cells. However, IL-10 can act directly on regulatory T cells and T helper type 17 (Th17) cells. In the context of allergy, it is therefore unclear whether IL-10 can directly regulate T helper type 2 (Th2) cells and whether this is an important regulatory axis during allergic responses. We sought to determine whether IL-10 signaling in CD4+ Th2 cells was an important mechanism of immune regulation during airway allergy. We demonstrate that IL-10 directly limits Th2 cell differentiation and survival in vitro and in vivo. Ablation of IL-10 signaling in Th2 cells led to enhanced Th2 cell survival and exacerbated pulmonary inflammation in a murine model of house dust mite allergy. Mechanistically, IL-10R signaling regulated the expression of several genes in Th2 cells, including granzyme B. Indeed, IL-10 increased granzyme B expression in Th2 cells and led to increased Th2 cell death, identifying an IL-10-regulated granzyme B axis in Th2 cells controlling Th2 cell survival. This study provides clear evidence that IL-10 exerts direct effects on Th2 cells, regulating the survival of Th2 cells and severity of Th2-mediated allergic airway inflammation.

Bacterial genotoxin functions as immune-modulator and promotes host survival.

Bacterial genotoxins are effectors that cause DNA damage in target cells. Many aspects of the biology of these toxins have been characterised in vitro, such as structure, cellular internalisation pathways and effects on the target cells. However, little is known about their function in vivo. Salmonella enterica serovar Typhi (S. Typhi) is a Gram-negative, intracellular bacterium that causes typhoid fever, a debilitating disease infecting more than 20 million people every year. S. Typhiproduce a genotoxin named typhoid toxin (TT), but its role in the contest of host infection is poorly characterized. The major obstacle in addressing this issue is that S. Typhi is exclusively a human pathogen. To overcome this limitation, we have used as model bacterium S. Typhimurium, and engineered it to produce endogenous levels of an active and inactive typhoid toxin, hereby named as TT (or genotoxic) and cdtB (or control), respectively. To our surprise, infection with the genotoxin strain strongly suppressed intestinal inflammation, leading to a better survival of the host during the acute phase of infection, suggesting typhoid toxin may exert a protective role. The presence of a functional genotoxin was also associated with an increased frequency of asymptomatic carriers.

Efeito da associação de furosemida e fenilbutazona sobre variáveis hidroeletrolíticas de cavalos antes e após a corrida / The effect of furosemide and phenylbutazone association on the fluid and electrolyte characteristics of horses before and after a race

Verificaram-se os efeitos da associação de furosemida e fenilbutazona sobre variáveis hidroeletrolíticas de cavalos antes e após a corrida. Dezenove equinos foram distribuídos em três grupos, de acordo com os protocolos de tratamento. O primeiro grupo, de cinco animais, não recebeu medicação (grupo-controle); o segundo grupo, de sete animais, foi tratado com furosemida, na dose de 1mg/kg, por via intramuscular, até quatro horas antes do páreo; o terceiro, de sete animais, recebeu furosemida, por via intramuscular, e fenilbutazona, por via intravenosa, nas doses de 1,0 e 4,4mg/kg, respectivamente, até quatro horas antes da corrida. Amostras de sangue foram colhidas antes, imediatamente após e duas horas após o páreo, para avaliação da osmolalidade plasmática e das concentrações plasmáticas de sódio, potássio e cloreto. A utilização de furosemida e da associação furosemida e fenilbutazona até 4h antes dos páreos nas dosagens descritas alterou (P<0,05) a osmolalidade plasmática dos equinos, mas não alterou (P>0,05) as concentrações de sódio, potássio e cloreto. Os páreos alteraram de forma fisiológica a osmolalidade plasmática e a concentração sanguínea de K+ devido ao exercício de alta intensidade.

The objective of this study was to verify the effects of furosemide and phenylbutazone association on fluid and electrolyte balance characteristics of horses before and after a race. Nineteen horses were divided into three groups according to treatment protocols. The first group (five animals - control) was not medicated. A second group (seven animals) was treated with furosemide (1mg/kg, intramuscular up to four hours before the race). A third group (seven animals) received furosemide (1mg/kg) and phenylbutazone (4.4mg/kg), both intramuscular, up to four hours before race. Blood samples were collected before, immediately after and two hours after a race to evaluate the plasma osmolality and sodium, potassium and chloride concentrations. The use of furosemide and furosemide plus phenylbutazone up to four hours before the race altered (P<0.05) the plasma osmolality but did not change (P>0.05) the sodium, potassium and chloride concentrations. It was not possible to determine an antagonist effect of phenylbutazone on furosemide, based on fluid and electrolyte balance. Due to the high intensity exercise, the increase in plasma osmolality and potassium concentration was attributed to the race effect.

Severe necrotizing pneumonia complicating influenza A (H1N1): the role of immunologic interaction.

This report describes the successful management of a documented necrotizing pneumonia due to Streptococcus pneumoniae in a child with pandemic influenza A (H1N1). The importance of early recognition of bacterial superinfection in patients with influenza and the immunologic interactive mechanisms between viruses and bacteria in determining respiratory diseases are highlighted. The role of modern molecular techniques in improving diagnostic microbiology sensitivity and informing consequent clinical care is emphasized.

[Nutritional status disorders prevalence rates in a sample of pediatric oncology Day Hospital patients]. / Prevalenza delle alterazioni dello stato nutrizionale in un campione di pazienti afferenti a un day hospital oncologico pediatrico.

BACKGROUND: Nutritional status is more important in children than in adults because it is necessary to support normal growth and development. In industrialized countries the prevalence of nutritional status disorders in the pediatric population are as follows: 35-40% of children are overweight/obese, while the underweight status disappeared in some reports or, when it is present, it is associated with other diseases. The aim of this study was to investigate the prevalence rates of nutritional status disorders among an unselected sample of Pediatric Oncology Day Hospital patients. METHODS: Anthropometric parameters of weight and height have been measured in patients affected with solid tumor either on-therapy or off-therapy (0-24 mo). Then Real Body Weight (% RBW) was estimated referring to National Center for Health Statistic percentiles. The sample was then divided into 4 weight classes (under-weight, normal-weight, over-weight and obese) according to % RBW. RESULTS: Overweight patients (overweight + obese) were 44.4%, and 13.9% underweight. Dividing the patients according to whether they are on-therapy or off-therapy, the prevalence of overweight was 36.9% in the former group and 52.9% in the latter, and the underweight prevalence was 26.3 vs 0%. CONCLUSIONS: Our preliminary data show that in this sample of patients on treatment obesity and overweight are present in a similar percentage of the healthy population, but underweight status prevalence is 26.3%. In the sample of patients off-therapy the underweight status disappeared while the overweight status increased. These data suggest that nutritional assessment in oncologic patients is required in order to provide nutritional strategies.

Localization of small esophageal cancers for radiation planning using endoscopic contrast injection: report on a series of eight cases.

Recently, Barrett's esophagus and early adenocarcinomas have been detected increasingly frequently in routine follow-up of patients with gastroesophageal reflux. Although surgery is the treatment of choice, some patients are medically unfit for esophagectomy and, in this case, the only alternative curative therapy is radical chemoradiation therapy. In addition, some patients who present with symptoms have small tumors that cannot be localized accurately using routine imaging techniques. This report describes a series of eight patients with small esophageal cancers in whom the tumors were successfully localized following endoscopic injection of contrast, and treated with chemoradiation therapy. The treatment was successful in seven patients. This method of tumor localization demonstrated that conventional techniques are mostly unreliable when applied to very early cancers.

[Nutritional status, obesity and metabolic control in children with type 1 diabetes mellitus]. / Stato nutrizionale, obesità ed equilibrio metabolico in soggetti in età evolutiva affetti da diabete mellito di tipo 1.

BACKGROUND AND AIMS: The aim of this study was to evaluate the nutritional status of children with type 1 diabetes and to search for possible influences of changes in body composition on aspects of diabetes. METHODS: A group of 96 diabetic subjects (41 males and 55 females) were studied, aged between 3 and 19 years old. The following parameters were examined: weight, stature, 5 skin folds, 7 circumferences, bioelectric impedance, arterial pressure, cholesterolemia, triglyceridemia, insulin dose, HbA1c and duration of disease. RESULTS: Obesity and overweight were present in 34.5% of the sample, but obesity was only observed in females (25.5%). There was also a high percentage of underweight subjects (11.5% of the entire sample). The mean values of weight BMI, 5 skin folds, 4 circumferences, FM (calculated using fold measurement and BIA) and AFA were higher in females, whereas mean values of waist/hip ratio and waist/thigh ratio and FFM (in % of body weight) were higher in males. A close correlation was also found between the 4 weight classes (underweight, normal weight, overweight, obese) and the majority of marker parameters for adiposity (5 folds, 4 circumferences, BIA, FM calculated using BIA, fold measurement and AFA). Of the other parameters examined (mean duration of disease, HbA1c assay, daily insulin dose, total cholesterolemia, triglycerididemia, arterial pressure), only the daily insulin dose showed higher values in females in 3 weight classes (underweight, normal weight and obese). Following a comparison with the control population (2469 subjects), higher mean values were found in the latter compared to diabetic subjects, but only in relation to 3 skin folds (tricipital, subscapular and suprailiac) and one circumference (forearm). CONCLUSIONS: The study shows a high frequency of overweight and obesity in children with type 1 diabetes, comparable to that in the healthy population. The finding of a higher frequency of obesity in diabetic females might be explained by their advanced puberal status, given that almost all the obese diabetic females were aged between 10 and 19 years old. The study confirms the validity of a number of anthropometric measurements (BMI, folds, circumference) and BIA in the evaluation of nutritional status in terms of body composition.

[Nutritional status, obesity, and metabolic balance in pediatric patients with type I diabetes mellitus]. / Stato nutrizionale, obesità ed equilibrio metabolico in soggetti in età evolutiva affetti da diabete mellito di tipo 1.

BACKGROUND AND AIMS: The aim of this study was to evaluate the nutritional status of children with type 1 diabetes and to search for possible influences of changes in body composition on aspects of diabetes. METHODS: A group of 96 diabetic subjects (41 males and 55 females) were studied, aged between 3 and 19 years old. The following parameters were examined: weight, stature, 5 skin folds, 7 circumferences, bioelectric impedance, arterial pressure, cholesterolemia, triglyceridemia, insulin dose, HbA1c and duration of disease. RESULTS: Obesity and overweight were present in 34.5% of the sample, but obesity was only observed in females (25.5%). There was also a high percentage of underweight subjects (11.5% of the entire sample). The mean values of weight BMI, 5 skin folds, 4 circumferences, FM (calculated using fold measurement and BIA) and AFA were higher in females, whereas mean values of waist/hip ratio and waist/thigh ratio and FFM (in % of body weight) were higher in males. A close correlation was also found between the 4 weight classes (underweight, normal weight, overweight, obese) and the majority of marker parameters for adiposity (5 folds, 4 circumferences, BIA, FM calculated using BIA, fold measurement and AFA). Of the other parameters examined (mean duration of disease, HbA1c assay, daily insulin dose, total cholesterolemia, triglycerididemia, arterial pressure), only the daily insulin dose showed higher values in females in 3 weight classes (underweight, normal weight and obese). Following a comparison with the control population (2469 subjects), higher mean values were found in the latter compared to diabetic subjects, but only in relation to 3 skin folds (tricipital, subscapular and suprailiac) and one circumference (forearm). CONCLUSIONS: The study shows a high frequency of overweight and obesity in children with type 1 diabetes, comparable to that in the healthy population. The finding of a higher frequency of obesity in diabetic females might be explained by their advanced puberal status, given that almost all the obese diabetic females were aged between 10 and 19 years old. The study confirms the validity of a number of anthropometric measurements (BMI, folds, circumference) and BIA in the evaluation of nutritional status in terms of body composition.

[Usefulness of the "targeted" clinical examination in the screening of breast tumors]. / Utilità dell'esame clinico "mirato" nello screening del tumore della mammella.

The authors report the findings from over 10,000 mammographic exams performed on female patients from 1980 to 1989. The results demonstrated that, even though mammography is still the only instrumental method available for mass screening of breast cancer, the role of clinical examination should not be underestimated. If adopted for patients with positive nodes and dense breasts, clinical examination can dramatically reduce the number of false negative cases. Biopsies required on the grounds of clinical examination only, i.e. when no malignant lesions had been detected at mammography, led to the identification of 21 breast carcinomas, a figure almost equal to the number of cases (23) detected by mammography in the absence of suspect clinical signs.

[Bezoar of the stomach. Clinical case report]. / A proposito del bezoario dello stomaco. Contributo clinico.

A clinical case of bezoar of the stomach accompanied by peptic and gastric ulcer is presented. The different types of bezoar and the reasons for their formation are described, and the clinical, laparotomic and anatomopathological picture is illustrated.

[Treatment of acute cholecystitis. Clinico-statistical findings]. / Trattamento delle colecistiti acute. Rilievi clinico-statistici.

A series of 354 patients suffering from gall bladder and/or bile way conditions and who had undergone operation in the acute phase has been reviewed. The usefulness of early operation over more wait-and-see tactics is confirmed. Shortening of mean hospitalization is particularly significant. The difference in hospital mortality is insignificant. The only complication reported is the higher frequency of suppurative accidents in the surgical wound.

[Non-appendicular primary pathology of the large intestine as a cause of emergency surgery. Clinico-statistical evaluation of its incidence in a provincial hospital]. / La patologia primitiva del grosso intestino, non appendicolare, quale causa di intervento in emergenza. Valutazione clinico statistica dell'incidenza in un ospedale provinciale.

Reference is made to the relevant literature in a description of cases of non-appendicular primary diseases of the large intestine necessitating emergency surgery at the Tradate District Hospital over the last five years. Emphasis is placed on the wide aetiological variety of these cases, their different clinical pictures, the types of operation performed, the possible complications, and the causes of death prior to discharge.

[Neoplasms of the male breast. Case report and review of the literature]. / Le neoplasie della mammella maschile. Contributo casistico e revisione della letteratura.

Fourteen cases of breast cancer in males observed between 1950 and 1974 at the Busto Arsizio Hospital Surgery Divsion are presnted. The literature is reviewed and attention is given to the incidence of this form, its symptoms and treatments, and to the length of survival after surgical management.