Severe Allergy as a Chronic Inflammatory Condition From a Systems Biology Perspective.

Persistent and unresolved inflammation is a common underlying factor observed in several and seemingly unrelated human diseases, including cardiovascular and neurodegenerative diseases. Particularly, in atopic conditions, acute inflammatory responses such as those triggered by insect venom, food or drug allergies possess also a life-threatening potential. However, respiratory allergies predominantly exhibit late immune responses associated with chronic inflammation, that can eventually progress into a severe phenotype displaying similar features as those observed in other chronic inflammatory diseases, as is the case of uncontrolled severe asthma. This review aims to explore the different facets and systems involved in chronic allergic inflammation, including processes such as tissue remodelling and immune cell dysregulation, as well as genetic, metabolic and microbiota alterations, which are common to other inflammatory conditions. Our goal here was to deepen on the understanding of an entangled disease as is chronic allergic inflammation and expose potential avenues for the development of better diagnostic and intervention strategies.

Systemic sclerosis induced by the use of cocaine: is there an association?

The association between cocaine abuse and systemic sclerosis (SSc) is rarely described. Two new cases of this association are presented: two young adults, after using inhaled cocaine for a few years, were diagnosed with SSc. While a 24 year-old white female patient presented with diffuse SSc with multiple digital ulcers and scleroderma renal crisis (SRC), a 27 year-old male patient presented limited SSc with skin ulcers and digital gangrene, rapidly evolving to death due to massive intestinal hemorrhage. The authors performed a literature search and found only eight previously published cases. The clinical picture of these patients shows a predominance of vascular involvement, including multiple ulcers and SRC. There is no association with specific SSc autoantibodies. The concomitance of alcohol and other drugs abuse, as well as the presence of drug adulterers, complicates a clear understanding of the role of cocaine in SSc patients.

Impact of climate change on vector transmission of Trypanosoma cruzi (Chagas, 1909) in North America.

Climate change can influence the geographical range of the ecological niche of pathogens by altering biotic interactions with vectors and reservoirs. The distributions of 20 epidemiologically important triatomine species in North America were modelled, comparing the genetic algorithm for rule-set prediction (GARP) and maximum entropy (MaxEnt), with or without topographical variables. Potential shifts in transmission niche for Trypanosoma cruzi (Trypanosomatida: Trypanosomatidae) (Chagas, 1909) were analysed for 2050 and 2070 in Representative Concentration Pathway (RCP) 4.5 and RCP 8.5. There were no significant quantitative range differences between the GARP and MaxEnt models, but GARP models best represented known distributions for most species [partial-receiver operating characteristic (ROC) > 1]; elevation was an important variable contributing to the ecological niche model (ENM). There was little difference between niche breadth projections for RCP 4.5 and RCP 8.5; the majority of species shifted significantly in both periods. Those species with the greatest current distribution range are expected to have the greatest shifts. Positional changes in the centroid, although reduced for most species, were associated with latitude. A significant increase or decrease in mean niche elevation is expected principally for Neotropical 1 species. The impact of climate change will be specific to each species, its biogeographical region and its latitude. North American triatomines with the greatest current distribution ranges (Nearctic 2 and Nearctic/Neotropical) will have the greatest future distribution shifts. Significant shifts (increases or decreases) in mean elevation over time are projected principally for the Neotropical species with the broadest current distributions. Changes in the vector exposure threat to the human population were significant for both future periods, with a 1.48% increase for urban populations and a 1.76% increase for rural populations in 2050.

Eosinophilic fasciitis during pregnancy: case report and review of literature.

The authors describe the case of a 23-year-old woman who was referred to the rheumatologist due to symmetrical and progressive stiffness, induration, and swelling of arms and thighs at the 12th week of her first gestation. The characteristic clinical aspect of 'peau d'orange', associated to the histopathologic results of the deep biopsy of the skin confirmed the diagnosis of eosinophilic fasciitis. Treatment with oral prednisone, at an initial dose of 1 mg/kg/day, was effective and rapidly tapered to 10 mg/day till the birth of a healthy newborn. A literature review showed only one previous description of pregnancy and eosinophilic fasciitis.

Health literacy interventions for immigrant populations: a systematic review.

BACKGROUND: Health literacy is considered a social health determinant that influences improvement in health, patient empowerment and reduction in inequalities. There is a lack of health literacy interventions for vulnerable social groups (i.e. immigrants), and nurses have shown little familiarity with the concept. AIM: This study aimed to identify and analyse whether interventions directed at immigrant populations improve the functional (basic reading, writing and arithmetic skills), interactive (social and cognitive skills) and critical (advanced cognitive and social skills in critically analyzing information and making informed decisions) dimensions of health literacy, taking into account the role played by nursing in these interventions. METHODS: A systematic review of four databases including PubMed, PsycINFO, the Cochrane Library and ERIC was conducted to identify relevant articles published between 2000 and 2015. Thirty-four articles met the inclusion criteria, and nine articles used a validated instrument. RESULTS: Few specific health literacy interventions for immigrant populations were found. The main findings of the studies showed positive changes in functional health literacy. However, the interventions were less effective in improving interactive and critical health literacy. LIMITATIONS: Several of the findings of this review were based on studies that had their own limitations. The assessment of the articles was not blinded, and the review was restricted to articles written in Spanish and English. CONCLUSIONS: The interventions studied were reported as being effective in improving health literacy in immigrants, particularly the functional aspects. Regarding the role played by nursing, this review observed little involvement. IMPLICATIONS FOR NURSING AND HEALTH POLICY: It is important for educational strategies to include health literacy dimensions. The concept of health literacy should be included as a Nursing Outcomes Classification and in its subsequent validation taxonomy. To promote community health, health literacy must be a prioritized objective of health management and policies.

Shifts in the ecological niche of Lutzomyia peruensis under climate change scenarios in Peru.

The Peruvian Andes presents a climate suitable for many species of sandfly that are known vectors of leishmaniasis or bartonellosis, including Lutzomyia peruensis (Diptera: Psychodidae), among others. In the present study, occurrences data for Lu. peruensis were compiled from several items in the scientific literature from Peru published between 1927 and 2015. Based on these data, ecological niche models were constructed to predict spatial distributions using three algorithms [Support vector machine (SVM), the Genetic Algorithm for Rule-set Prediction (GARP) and Maximum Entropy (MaxEnt)]. In addition, the environmental requirements of Lu. peruensis and three niche characteristics were modelled in the context of future climate change scenarios: (a) potential changes in niche breadth; (b) shifts in the direction and magnitude of niche centroids, and (c) shifts in elevation range. The model identified areas that included environments suitable for Lu. peruensis in most regions of Peru (45.77%) and an average altitude of 3289 m a.s.l. Under climate change scenarios, a decrease in the distribution areas of Lu. peruensis was observed for all representative concentration pathways. However, the centroid of the species' ecological niche showed a northwest direction in all climate change scenarios. The information generated in this study may help health authorities responsible for the supervision of strategies to control leishmaniasis to coordinate, plan and implement appropriate strategies for each area of risk, taking into account the geographic distribution and potential dispersal of Lu. peruensis.

Post-fundoplication symptoms and complications: Diagnostic approach and treatment. / Síntomas y complicaciones posfunduplicatura: abordaje diagnóstico y tratamiento.

Laparoscopic Nissen fundoplication is currently considered the surgical treatment of choice for gastroesophageal reflux disease (GERD) and its long-term effectiveness is above 90%. Adequate patient selection and the experience of the surgeon are among the predictive factors of good clinical response. However, there can be new, persistent, and recurrent symptoms after the antireflux procedure in up to 30% of the cases. There are numerous causes, but in general, they are due to one or more anatomic abnormalities and esophageal and gastric function alterations. When there are persistent symptoms after the surgical procedure, the surgery should be described as "failed". In the case of a patient that initially manifests symptom control, but the symptoms then reappear, the term "dysfunction" could be used. When symptoms worsen, or when symptoms or clinical situations appear that did not exist before the surgery, this should be considered a "complication". Postoperative dysphagia and dyspeptic symptoms are very frequent and require an integrated approach to determine the best possible treatment. This review details the pathophysiologic aspects, diagnostic approach, and treatment of the symptoms and complications after fundoplication for the management of GERD.

[Nutritional status and socio-epidemiological features of schoolchildren, WHO 2007]. / Estado nutricional y características socioepidemiológicas de escolares chilenos, OMS 2007.

INTRODUCTION: Current Chilean childhood obesity fi res are within the highest in the world. OBJECTIVE: To describe the nutritional status of Quilpué schoolchildren and its relationship with demographic and socioeconomic variables. METHODS: The nutritional status (OMS 2007) of 1091 schoolchildren was assessed using measurements of height and weight obtained in the "Pilot School Health Program" conducted in the schools of the Municipal Corporation of Quilpué, which included pupils from kindergarten to 4th grade. The program described above, as well as SINAE databases, were used for the Healthcare and School Vulnerability Index (SVI) variables, respectively, as well as the the number of hours of physical education, type of lunches, and the presence of vendors at school, were obtained using a questionnaire in schools. RESULTS: Obesity was observed in 26.3% of students, and a further 27.7% were overweight. Obesity was more frequent in boys (32.3%) compared to girls (20.1%) (P<.01); in third grade (31.8%) (P=.01); if lunches were parental choices (26.7%) (P<.01); and with the presence of school vendors (26.3%) (P=.01). No significant differences in socioeconomic status regarding BMI were found, but the most vulnerable children (municipal schools, high SVI, Fonasa A healthcare) had lower average height and higher rates of chronic malnutrition (height <-2 SD). CONCLUSIONS: A high prevalence of obesity was found in this study, which highlights the need for monitoring and nutrtional intervention strategies at school age (which once finalized, the Healthy Child Surveillance does not carry out any more controls), taking into account the most vulnerable sectors.

Magnetic resonance based morphometric analysis of the tentorial notch.

BACKGROUND: The study of the tentorial notch can improve the understanding of brain injury mechanisms. Tentorial morphology has been analysed primarily in cadaveric studies. However, the postmortem effect can cause variability in the measurements. The objective was to evaluate the morphometry of the tentorial notch and the third cranial nerve on living subjects using magnetic resonance imaging (MRI). MATERIALS AND METHODS: A retrospective cross-sectional study was performed. Using consecutive cases, 60 MRI scans were analysed for tentorial notch morphology. Maximum notch width (MNW), notch length (NL), interpedunculoclival (IC) distance, apicotectal (AT) distance, third cranial nerve (CN-III) distance, and inter- CN-III angle, were obtained. For the classification of the tentorial notch quartile distribution technique for MNW, NL, AT distance, and IC distance were used. RESULTS: According to the quartile of the MNW, patients were stratified into narrow, midrange, and wide groups. Using the NL quartile groups, they were also classified as short, midrange, and long. With these, the tentorial notch could be classified into eight types. Statistical differences between genders in the MNW and inter-CN-III angle were found, as well as a strong positive correlation between NL and AT distance, and between right and left CN-III distances. CONCLUSIONS: There were differences between the cadaveric samples and living subjects in the CN-III distances. This difference could be explained by the dehydration of brain volume in the postmortem process which may cause nerve elongation. Morphometry of the tentorial notch and its neurovascular relations allows a better understanding of the mechanisms of brain herniation.

Characterization and application of a coating of starch extracted from avocado (Persea americana L. cv. Hass) seeds as an alternative to reduce acrylamide content in French fries.

The starch extracted from avocado (Persea americana L. cv. Hass) seeds was characterized and used in the preparation of an edible coating to reduce the oil uptake and acrylamide content in French fries. Starch characterization was carried out using Differential Scanning Calorimetry, Fourier transform infrared spectrophotometry, gelatinization, and scanning electron microscopy. Uncoated (UFF) and coated (CFF) French fries were compared and evaluated for moisture, water activity (Aw), fat, color, firmness, acrylamide content, and sensorial analysis. The extracted starch presented a high crystalline structure and good stability to mechanical work and heat treatments. The CFF French fries showed significantly higher Aw, color parameter a*, but lower luminosity and acrylamide content than UFF samples. Similarly, the CFF samples tended to decrease the fat content, although without statistical differences. Avocado seed starch can be an economical and technically feasible alternative to the food industry as an effective coating to reduce acrylamide content in French fries.

Study of spontaneous recurrent seizures and morphological alterations after status epilepticus induced by intrahippocampal injection of pilocarpine.

Epileptic seizures are clinical manifestations of neuronal discharges characterized by hyperexcitability and/or hypersynchrony in the cortex and other subcortical regions. The pilocarpine (PILO) model of epilepsy mimics temporal lobe epilepsy (TLE) in humans. In the present study, we used a more selective approach: microinjection of PILO into the hilus of the dentate gyrus (H-PILO). Our main goal was to evaluate the behavioral and morphological alterations present in this model of TLE. Seventy-six percent of all animals receiving H-PILO injections had continuous seizures called status epilepticus (SE). A typical pattern of evolution of limbic seizures during the SE with a latency of 29.3 ± 16.3 minutes was observed using an analysis of behavioral sequences. During the subsequent 30 days, 71% of all animals exhibited spontaneous recurrent seizures (SRSs) during a daily 8-hour videotaping session. These SRSs had a very conspicuous and characteristic pattern detected by behavioral sequences or neuroethiological analysis. Only the animals that had SE showed positive Neo-Timm staining in the inner molecular layer of the dentate gyrus (sprouting) and reduced cell density in Ammon's horn pyramidal cell subfield CA1. However, no correlation between the intensity of sprouting and the mean number and total number of SRSs was found. Additionally, using Fluoro-Jade staining, we observed neurodegeneration in the hilus and pyramidal cell subfields CA3 and CA1 24 hours after SE. These data indicate that H-PILO is a reliable, selective, efficient, low-mortality model that mimics the acute and chronic behavioral and morphological aspects of TLE.

Organelle calcium-derived voltage oscillations in pacemaker neurons drive the motor program for food-seeking behavior in Aplysia.

The expression of motivated behaviors depends on both external and internally arising neural stimuli, yet the intrinsic releasing mechanisms for such variably occurring behaviors remain elusive. In isolated nervous system preparations of Aplysia, we have found that irregularly expressed cycles of motor output underlying food-seeking behavior arise from regular membrane potential oscillations of varying magnitude in an identified pair of interneurons (B63) in the bilateral buccal ganglia. This rhythmic signal, which is specific to the B63 cells, is generated by organelle-derived intracellular calcium fluxes that activate voltage-independent plasma membrane channels. The resulting voltage oscillation spreads throughout a subset of gap junction-coupled buccal network neurons and by triggering plateau potential-mediated bursts in B63, can initiate motor output driving food-seeking action. Thus, an atypical neuronal pacemaker mechanism, based on rhythmic intracellular calcium store release and intercellular propagation, can act as an autonomous intrinsic releaser for the occurrence of a motivated behavior.

[Autoimmune pancreatitis: case report.]. / Pancreatitis autoinmune: informe de un caso.

Autoimmune pancreatitis represents a chronic inflammatory pancreatic disease with distinct clinical, morphologic and histopathological features. We report the case of a 64 year old man with obstructive jaundice in whom the imaging studies showed diffuse enlargement of the pancreas, and a mass in its head. Fine needle aspiration biopsy of the mass guided by endoscopic ultrasound showed lymphocytic infiltration and fibrosis. The size of the pancreas, laboratory abnormalities, and clinical manifestations subsided promptly after treatment with steroids. Autoimmune pancreatitis should be included in the differential diagnosis of patients with obstructive jaundice and/or pancreatic masses.

Two new records of helminth parasites of domestic cat from Uruguay: Alaria alata (Goeze, 1782) (Digenea, Diplostomidae) and Lagochilascaris major Leiper, 1910 (Nematoda, Ascarididae).

Eight helminth taxa were recovered from the necropsy of four stray domestic cats from Colonia Miguelete, county of Colonia, Uruguay. Two of them are recorded for the first time for domestic cats in that country: Alaria alata (Goeze, 1782) from the small intestine (which is also the first trematode species found in domestic cat in Uruguay), and Lagochilascaris major Leiper, 1910 from the pharynx. The remaining helminth species found were Toxocara mystax (Zeder, 1800) and Spirometra sp. from the small intestine, Trichuris serrata (von Linstow, 1879) from the caecum, Eucoleus aerophilus (Creplin, 1839) from the trachea, and Pearsonema feliscati (Diesing, 1851) from the urinary bladder. Moreover, four female specimens of an unidentified Spiruroidea were collected from the stomach and small intestine of one host.

[Reproducibility, correlation and concordance of the Abbreviated Dietary Score questionnaire]. / Reproducibilidad, correlación y concordancia de un cuestionario abreviado del Dietary Score.

OBJECTIVE: The objective of this study was to evaluate the reproducibility, correlation and concordance of the abbreviated Dietary Score (aDS) used in the IBERICAN study. MATERIAL AND METHODS: A cross-sectional study was performed in order to assess the reproducibility of the aDS using a test-retest. Its internal consistency was evaluated using Cronbach's alpha, and reliability of the measurements using the intraclass correlation coefficient (ICC). From the food frequency questionnaire (FFQ) of the PREDIMED-Plus study, adherence to a Mediterranean diet pattern was evaluated using DS, and its correlation and agreement with aDS was assessed. In both cases the lineal regression, Bland-Altman, and kappa index techniques were used. RESULTS: A total of 142 subjects participated, mostly men (56.3%), with a mean age of 64.6±4.9 years. In terms of reproducibility, a Pearson correlation coefficient of 0.538 was obtained; a mean of the differences of 2.03 points, and a weighted kappa index of 0.400 (95% CI=0.295-0.577). The instrument had good internal consistency (Cronbach's alpha=0.699), as well as good reliability (CCI=0.931). The aDS had a correlation coefficient with the DS of 0.517, a mean difference of 1.19 points, and a weighted kappa index of 0.450 (95% CI=0.366-0.532). CONCLUSIONS: The aDS has moderate reproducibility and a good correlation and agreement with the DS, so it can be a useful tool in Primary Care to assess adherence to the Mediterranean diet.

Amblyomma triste Koch, 1844 (Acari: Ixodidae): hosts and seasonality of the vector of Rickettsia parkeri in Uruguay.

Amblyomma triste Koch, 1844, the tick species most frequently involved in human bites in Uruguay, has been implicated as a vector of human rickettsiosis. Seasonal abundance of adult A. triste was examined by standard flagging at three sites where human tick bites and cases of the disease have been reported. Adult tick activity occurred from August to February (end of winter to mid summer in the southern hemisphere) with a peak in spring. Activity declined in step with decreasing temperatures and photoperiod during winter. This period of activity coincides with seasonal outbreaks of human rickettsiosis in the region. In a small mammal survey, the Sigmodontinae rodents Scapteromys tumidus (Waterhouse, 1837) and Oxymycterus nasutus (Waterhouse, 1837) and the small marsupial Monodelphis dimidiata (Wagner, 1847) were the main hosts for immature A. triste. Immature ticks were observed on hosts in November, well within the period of peak adult abundance. In stored collections, immature ticks were most often collected from January to March. These data suggest that one generation might be completed in 1 year. The main animal host for adult A. triste at our study sites was the domestic dog. Humans were afflicted by the tick in rural and suburban settlements where other host animals are scarce or extinct and where dogs are common.

Improving outcome in congenital diaphragmatic hernia - experience of a tertiary center without ECMO.

BACKGROUND: Congenital diaphragmatic hernia (CDH) has a high mortality rate, representing a therapeutic challenge. Prenatal diagnosis (PND) is essential in defining optimal perinatal strategy, particularly delivery planning. Hospital Pediátrico de Coimbra is the referral centre for all neonatal surgery, particularly CDH, for the central region of Portugal. The aim was to evaluate clinical management and outcome of newborns with CDH. METHODS: An exploratory retrospective study made up of newborns admitted to PICU with CDH was undertaken between January 1995 and December 2014. Two groups were formed based on their year of admission: group A (1995- 2004) and group B (2005- 2014) and were compared. RESULTS: The mean birth weight of the 69 newborns admitted was 2.762 ± 696 g; the median of the gestational age was 38 weeks. Associated malformations were observed in 28 (40.5%) and 15 (21.7%) had a right-sided diaphragm defect. The global mortality was 13.0%; in group A was significantly higher than in group B (22.2 vs 3.0%; p = 0.029). A reduction in mortality throughout the years was confirmed after adjusting for POS score (OR = 0.77; 95% CI: 0.62- 0.96, p = 0.021). PND was made in 30.6% of cases in the group A and 66.7% in the group B (p = 0.03). Tertiary perinatal hospital birth was achieved in 60% of newborns in the group A versus 84.8% in group B (p = 0.022). Maximum fraction of inspired oxygen showed a statistically significant difference between the two study groups (60% vs 40%; p = 0.009). CONCLUSIONS: A significant decrease in mortality was observed throughout the study. The authors highlight the increase in prenatal diagnosis and an improvement in perinatal care with planning delivery as important contributors to these results.

[Complex fractures of the clavicles lateral third]. / Fracturas complejas del tercio lateral de la clavícula.

BACKGROUND: Fractures of the lateral third of the clavicle represent 18% of all clavicle fractures. Even though non-displaced fractures can be managed conservatively, displaced fractures have a non-union percentage of 30%. Multiple approaches have been proposed to manage the displaced fractures. The objective of this study was to record the prevalence of fractures of the lateral third of the clavicle with involvement of the clavicular-acromial joint, as well as to briefly review the treatment performed in our center and compare it with the current literature. MATERIAL AND METHODS: Retrospective, cross-sectional, descriptive and observational study, which consisted in a review of the records of patients with a diagnosis of fracture of the lateral third of the clavicle with an injury to the clavicular-acromial joint. RESULTS: Lateral third fractures accounted for 24% of all clavicle fractures. Distribution by sex: 10: 2, men: women. Left shoulder predominance, 8:4. The predominant maneuvers were anatomical plate for the lateral third of the clavicle (50% of the cases), coracoclavicular cerclage technique plus resection of the lateral third of the clavicle (25%), plate hook (8.3%), Mumford combined with Waever/Dunn (8.3%), anchor plus Kirschner rods (8.3%). DISCUSSION: The choice of the appropriate treatment will depend on the type of fracture and specific characteristics of each patient. We suggest the use of the coracoclavicular cerclage technique in cases in which the lateral fragment is multifragmented, irreducible or smaller in size than its osteosynthesis would allow, performing plasty of clavicular and coracoclavicular ligaments.

ANTECEDENTES: Las fracturas del tercio lateral de la clavícula representan 18% de todas las fracturas de clavícula. A pesar de que las fracturas no desplazadas pueden manejarse conservadoramente, las desplazadas tienen un porcentaje de no unión de 30%. Múltiples manejos han sido propuestos para las fracturas desplazadas. El objetivo de este estudio fue registrar la prevalencia de fracturas del tercio lateral de la clavícula con afectación de la articulación acromioclavicular, así como hacer una revisión breve del tratamiento realizado en nuestro centro y compararlo con la literatura actual. MATERIAL Y MÉTODOS: Estudio retrospectivo, transversal, descriptivo y observacional, que consistió en una revisión de los expedientes de los pacientes con diagnóstico de fractura del tercio lateral de la clavícula con lesión de la articulación acromioclavicular. RESULTADOS: Las fracturas del tercio lateral representaron 24% de todas las fracturas de clavícula. Distribución por sexos: 10:2, hombres:mujeres. Predominio: hombro izquierdo, 8:4. Los manejos predominantes fueron placa anatómica para tercio lateral de la clavícula (50% de los casos), técnica de cerclaje coracoclavicular más resección del tercio lateral de la clavícula (25%), placa gancho (8.3%), Mumford combinado con Waever/Dunn (8.3%), ancla más varillas Kirschner (8.3%). DISCUSIÓN: La elección del tratamiento adecuado dependerá del tipo de fractura y las características específicas de cada paciente. Sugerimos el uso de la técnica de cerclaje coracoclavicular en los casos en que el fragmento lateral sea multifragmentado, irreductible o de tamaño menor al que permitiría su osteosíntesis, realizando plastía de ligamentos acromioclaviculares y coracoclaviculares.

Kinetics of antibodies in sera, saliva, and urine samples from adult patients with primary or secondary dengue 3 virus infections.

OBJECTIVES: The kinetics of three serological markers (IgM, IgA, and IgG) in serum, saliva, and urine samples from adult patients with primary or secondary dengue infection were studied. DESIGN: Serum, saliva, and urine samples were collected from 22 patients with clinical and confirmed dengue 3 virus infection during the outbreak in Havana City in 2001. They were tested by capture IgM (MAC-ELISA), IgA (AAC-ELISA), and IgE (EAC-ELISA) and IgG ELISA inhibition method (EIM) to detect specific dengue antibodies. RESULTS: Similar kinetics were observed in IgM, IgA, and IgG antibodies in saliva and IgA and IgG in urine samples from secondary cases compared with kinetics in serum samples, although the values were lower. No IgG antibody was detected in saliva and urine samples in primary cases and IgM antibody was not detected in urine samples from either primary or secondary infection. All secondary cases were positive for IgG in saliva and urine samples at day 7. The kinetics of specific IgE antibodies in primary and secondary cases were different. CONCLUSIONS: The kinetics of three serological markers (IgM, IgA, and IgG) in serum, saliva, and urine samples from adult patients with primary or secondary dengue 3 virus infection were studied for the first time, showing its behavior and usefulness in dengue virus diagnosis. The specific IgE could play a role as a serological marker in secondary infections.