Emerging Associations Between Neutrophils, Atherosclerosis, and Psoriasis.

PURPOSE OF REVIEW: Atherogenesis, once thought to be a passive process, is now recognized as a dynamic, immune-driven process. The critical innate immune cells, including neutrophils, normal-density granulocytes, and their newly identified subset low-density granulocytes, are moving to the forefront of interest in cardiovascular medicine due to their abundance in atherosclerotic plaques and chronic inflammatory diseases associating with early cardiovascular disease (CVD) such as psoriasis. In this review, we discuss the emerging roles of neutrophils in CVD and how they play a potential role in early CVD observed in psoriasis patients. This review aims to describe the roles of neutrophils in both early atherosclerosis and psoriasis. RECENT FINDINGS: Recent work has demonstrated mechanistic links between vascular inflammation and neutrophil frequency. Evolving mouse models and clinical trials targeting IL-17-associated pathways continue to elucidate contributions of neutrophils in both atherosclerosis and psoriasis. Early animal, in vitro and human studies suggest an important emerging role of neutrophils in atherosclerosis and psoriasis.

Demographics of animal bite victims & management practices in a tertiary care institute in Mumbai, Maharashtra, India.

BACKGROUND & OBJECTIVES: Rabies is an important public health problem worldwide and more than 55,000 people die annually of the disease. The King Edward Memorial Hospital, Mumbai, is a tertiary referral centre where a rabies clinic runs 24 hours. In view of lack of information about the demographics of the disease in an urban environment the present study was carried out. METHODS: Data on 1000 consecutive animal bite victims presenting to the institute in 2010 were collected over a 15 wk period. An electronic database was specially created for capturing information and was modelled on the information available from the WHO expert consultation on rabies, 2005. Economic burden from the patients' perspective was calculated using both direct and indirect costs. RESULTS: The victims were largely males (771 subjects). The dog was the major biting animal (891, 89.1%).Bites were mainly of Category III (783, 78.3%). One twenty three subjects used indigenous treatments only for local wound care. Of the Category III bites, only 21 of 783 (2.7%) patients were prescribed human rabies immunoglobulin (HRIG) which was primarily for severe bites or bites close to or on the face. A total of 318 patients did not complete the full Essen regime of the vaccine. The median cost to the patient per bite was Rs. 220 (3.5 USD). INTERPRETATION & CONCLUSIONS: Our findings showed that the use of HRIG was low with less than 2 per cent of the Category III patients being prescribed it. As vaccine and HRIG continue to remain expensive, the intradermal vaccine, shorter regimes like the Zagreb regime and monoclonal antibodies may offer safer and cost-effective options in the future. Further studies need to be done in different parts of the country.