IL17RA gene variants and anti-TNF response among psoriasis patients.

Polymorphisms at genes encoding proteins involved in the pathogenesis of psoriasis (Psor) or in the mechanism of action of biological drugs could influence the treatment response. Because the interleukin (IL)-17 family has a central role in the pathogenesis of Psor, we hypothesized that IL17RA variants could influence the response to anti-TNF drugs among Psor patients. To address this issue we performed a cross-sectional study of Psor patients who received the biological treatments for the first time, with a follow-up of at least 6 months. All of the patients were Caucasian, older than 18 years old, with chronic plaque Psor, and had completed at least 24 weeks of anti-TNF therapy (adalimumab, etanercept or infliximab). The treatment response to anti-TNF agents was evaluated according to the achievement of PASI50 and PASI75 at weeks 12 and 24. Those who achieved PASI75 at week 24 were considered good responders. All patients were genotyped for the selected single-nucleotide polymorphisms (SNPs) at IL17RA gene. A total of 238 patients were included (57% male, mean age 46 years). One hundred and five patients received adalimumab, 91 patients etanercept and 42 infliximab. The rs4819554 promoter SNP allele A was significantly more common among responders at weeks 12 (P=0.01) and 24 (P=0.04). We found a higher frequency of AA versus AG+GG among responders, but the difference was only significant at week 12 (P=0.03, odd ratio=1.86, 95% confidence of interval=1.05-3.27). Thus, in the study population, the SNP rs4819554 in the promoter region of IL17RA significantly influences the response to anti-TNF drugs at week 12.

Complementary role of magnetic resonance imaging in the study of the fetal urinary system.

Urinary system birth defects represent the abnormality most often detected in prenatal studies, accounting for 30% to 50% of all structural anomalies present at birth. The most common disorders are urinary tract dilation, developmental variants, cystic kidney diseases, kidney tumors, and bladder defects. These anomalies can present in isolation or in association with various syndromes. They are normally evaluated with sonography, and the use of magnetic resonance imaging (MRI) is considered only in inconclusive cases. In this article, we show the potential of fetal MRI as a technique to complement sonography in the study of fetal urinary system anomalies. We show the additional information that MRI can provide in each entity, especially in the evaluation of kidney function through diffusion-weighted sequences.

Emprego de enxerto biológico na reconstruçäo de ferida experimental no esôfago cervical de ovinos / Use of biological graft in the reconstruction of experimental wound of the cervical esophagus in sheep

Dezoito ovelhas foram divididas em dois grupos (I e II) de nove animais, e cada grupo dividido em dois subgrupos (Ia, Ib e IIA, IIb) conforme o tempo de avaliaçäo, de 45 dias para os subgrupos a e de 60 dias para os subgrupos b. Todos os animais tiveram um segmento esofágico retangular de 2,5x1,5cm removido. Os animais do grupo I receberam enxerto de aorta canina, enquanto os do grupo II receberam enxerto de fáscia lata canina. Todos os enxertos foram previamente conservados entre 30 e 90 dias em glicerina 98 por cento. A integraçäo dos enxertos foi avaliada por meio de exame clínico (inspeçäo da ferida cirúrgica, comportamento quanto ao apetite e sede, capacidade de deglutiçäo e regurgitaçäo), hemograma completo, esofagograma contrastado e análises macroscópica e histopatológica. Concluiu-se que os tecidos enxertados foram suficientes para suportar a pressäo da passagem do alimento e para vedaçäo esofágica, oferecendo condiçöes para a regeneraçäo epitelial

[Etiology of acute respiratory infections in 87 hospitalized children]. / Etiología de las infecciones respiratorias agudas en 87 niños hospitalizados.

OBJECTIVE: The aim of this study was to assess the effectiveness of two microbiologic methods: viral culture and serology for the etiologic study of acute respiratory infections in children under 14 years of age admitted to our hospital. PATIENTS: From January 1992 to December 1993, a prospective study was carried out in 87 patients with a mean age of two years with the following diagnosis: upper respiratory tract infections (URTI) 19, laryngitis 3, bronchitis 18, bronchiolitis 18, and pneumonia 29. METHOD: Nasopharyngeal aspirates were collected for virologic culture on cell monolayers in 87 patients. Serologic studies by complement fixation test were carried out in 42 patients older than six months. RESULTS: The etiologic agent was detected in 54 (62%) of the 87 patients, being the most frequent the respiratory sincitial virus (VRS) with 18 cases (20%), followed by adenovirus (ADV) in 17 (19%) and Mycoplasma pneumoniae in 9 cases (11%). Viral culture was positive in 32 (37%), being ADV in 14 (41%), and RSV in 9 (26%). Significative serologic studies were obtained in 25 (60%) of the 42 studied patients, with VRS in 9 (32%) and M. pneumoniae in 9 (32%). Concerning clinical diagnosis, the major effectiveness corresponded to serology in pneumonia (76%), and to viral culture in URTI (63%). CONCLUSION: Viral culture and serology are useful methods for the detection of etiologic agents in acute respiratory infections. The serology effectiveness increases with age (p < 0.01) and the severity of the clinical diagnosis. Both methods have limited usefulness from clinical point of view.