Suppressive effects of elimination diets on T cell responses to ovalbumin in hen's egg-sensitive atopic dermatitis patients

We investigated the effect of elimination diets on T cell responses to ovalbumin (OA) in hen's egg-sensitive atopic dermatitis (AD) patients. The proliferative responses of both peripheral blood mononuclear cells (PBMCs) and T cells with monocytes to OA decreased after elimination diets, but those to Candida albicans or phytohemagglutinin (PHA) did not decrease after elimination diets. The proliferative responses of CD4⁺ T cells with monocytes to OA decreased after elimination diets. In these patients, clinical symptoms of AD improved. These results indicate that T cells, especially CD4⁺ T cells, respond to food antigens in food-specific lymphocyte responses, and that elimination diets may be able to initiate reduction of the responsiveness of food-sensitive T cells, especially CD4⁺ T cells. Moreover, the surface marker phenotypes of the T cells responding to OA were analysed. Our results showed that CD4⁺CD45RA⁺ T cells tended to increase. The increase in circulating CD4⁺CD45RA⁺ T cells might function as systemic suppression against immune responses in the skin.     

Relationship between the length of hospital stay after hip fracture surgery and ambulatory ability or mortality after discharge in Japan

Aim:  To examine whether the length of hospital stay after hip fracture surgery is related to patients' ambulatory ability or mortality after discharge.
Methods:  This is a retrospective observational study of patients who had undergone hip fracture surgery at one of three hospitals in Japan. The medical records of patients who were ≥65 years and who had hip fracture surgery within the past 2.5 years were reviewed regarding the demographics, treatments, and health outcomes during the hospital stay. A mail survey, asking about health outcomes after discharge, was sent to the study participants and/or their family members. The response rate of the survey was 70% ( n  = 149).
Results:  The patients who were discharged between 30 and 39 days after surgery had significantly lower current ambulatory ability, compared to the patients who stayed for ≥40 days, after adjusting for patient characteristics, treatments, and hospital. The patients who were discharged within 2 weeks after surgery and the patients who were discharged between 30 and 39 days after surgery had a significantly higher risk of mortality, compared to the patients who stayed in the hospital for ≥40 days, after adjustments were made.
Conclusions:  If patients are discharged to a rehabilitation hospital before they are totally recovered from surgery, the emphasis might be on their rehabilitation without adequate management of their comorbidities. Additional prospective studies are needed to determine the effects of a shorter length of hospital stay after hip fracture surgery on patient outcomes.