Characterization of the IL-17 and CD4+ Th17 Cells in the Clinical Course of Dengue Virus Infections.

The aims of this study were to determine the involvement of interleukin 17 (IL-17) and IL-17-producing cells in dengue pathogenesis. Blood samples from dengue virus (DENV)-infected patients were collected on different days after the onset of symptoms. Patients were classified according to 1997 World Health Organization guidelines. Our study examined 152 blood samples from dengue fever (DF, n = 109) and dengue hemorrhagic fever (DHF, n = 43) patients and 90 blood samples from healthy controls (HC). High serum concentrations of IL-17A and IL-22 were also associated with DHF (IL-17A [DHF vs. DF, p < 0.01; DHF vs. HC, p < 0.0001]; IL-22 [DHF vs. DF, p < 0.05; DHF vs. HC, p < 0.0001]). Moreover, there was a positive correlation between serum levels of IL-17A and IL-23, a key cytokine that promotes IL-17-based immune responses (r = 0.4089, p < 0.0001). Consistent with the IL-17-biased immune response in DHF patients, we performed ex vivo activation of peripheral blood mononuclear cells (PBMCs) from DHF patients and flow cytometry analysis showed a robust IL-17-biased immune response, characterized by a high frequency of CD4+IL-17+ producing cells. Our results suggests IL-17-producing cells and their related cytokines can play a prominent role in this viral disease.

[Modified technique b-lynch compression suture with uterine atony]. / Modificación a la técnica de sutura compresiva B-Lynch en atonía uterina.

BACKGROUNDS: One of the leading causes of death in the worldwide is postpartum hemorrhage, one of the surgical resources is the use of uterine compression suture described by Christopher B-Lynch and some modifications of the technique. OBJECTIVE: To review the effectiveness of the modified technique describd by B-Lynch in early postpartum hemorrhage secondary to uterine atony refractory to medical treatment. MATERIAL AND METHODS: We performed a descriptive and case study of cases of uterine atony treated with the B-Lynch modified technique in our center between march 2012 to september 2013. RESULTS: Hemorrhage was resolved in 21 patients. Obstetric hysterectomy was required in the remaining of two patient. CONCLUSIONS: The B-Lynch modified technique by our group is effective, safe and rapid in the treatment of uterine atony. However, obstetric hysterectomy may be required as a last resort when all other uterine- conserving techniques have failed.