Mononuclear cell reactivity to food allergens in neonates, children and adults

A model of antigen‐specific T‐cell proliferative responses based on reciprocal patterns of responses to dietary and inhalant allergens has been suggested, the former being frequent in infancy but rare in adults, whereas the latter are preserved and expand between infancy and adulthood. We have evaluated the age‐related variations of mononuclear cell reactivity to food allergens. The cord blood mononuclear cells (CBMC) of 30 neonates without family history of atopy and the peripheral blood mononuclear cells (PBMC) of 20 healthy children and of 40 healthy adults were stimulated in vitro with β‐lactoglobulin (BLG) or ovalbumin (OVA) and the cultures were harvested after 7 days. Neonates, children and adults were compared for the percentages of positive responses and for the magnitude of response. Adult subjects showed significantly lower percentages of positive responses and reduced magnitude of response than those observed in neonates and children either in BLG or in OVA cultures. We have not observed a decrease of food allergen mononuclear cell reactivity between neonates and children for the frequency of positive responses. The magnitude of response of neonates was significantly lower than that of children in BLG cultures . Our results seem to confirm the loss of mononuclear cell reactivity to food allergens in adult age. However, other reports show conflicting data. We suggest that a rigorous standardization of the methodological steps of in vitro mononuclear cell stimulation with allergen is necessary.     

Stellenwert des Schlaganfall-MRT bei intrazerebralen und subarachnoidalen Blutungen

Intrakranielle Blutungen (ICB) machen etwa 15% aller Schlaganf?lle aus. In der Notfallsituation ist die CT der derzeitige diagnostische Standard zur Differenzierung zwischen hyperakuter ICB und zerebraler Isch?mie. Der MRT wird im Akutstadium ein geringer Stellenwert für die Diagnose einer ICB oder Subarachnoidalblutung (SAB) beigemessen und viele Autoren bescheinigen der MRT eine niedrige Sensitivit?t für hyperakute ICB. Wir geben eine übersicht über die aktuelle Literatur und charakterisieren den Stellenwert der MRT bei der Diagnose von ICB und SAB sowie hyperakuter Schlaganf?lle im Allgemeinen: MRT-Signalcharakteristika von ICB beruhen auf dem H?moglobinabbau. Bei subakuten und chronischen ICB/SAB ist die MRT der CT überlegen, bei hyperakuten ICB herrscht diesbezüglich Dissens. Deoxyh?moglobin, dessen paramagnetische Eigenschaften einen Signalverlust in suszeptibilit?tsgewichteten Sequenzen (T2*-WI) bewirken, ist das Substrat des MRT-Nachweises akuten Blutes. Vorl?ufige Daten legen eine hohe Sensitivit?t moderner Schlaganfall-MRT Protokolle auch für hyperakute ICB und SAB nahe. Au?erdem k?nnen durch die MRT zus?tzliche Informationen zur ?tiologie einer ICB oder SAB erlangt werden. Von weiterem Interesse sind perih?morrhagische pathophysiologische Abl?ufe, deren Charakterisierung bei ICB-Patienten evtl. eine Verbesserung des Therapiemanagements mit sich bringt.     

Stellenwert des Schlaganfall-MRT bei intrazerebralen und subarachnoidalen Blutungen

Zusammenfassung Intrakranielle Blutungen (ICB) machen etwa 15% aller Schlaganf?lle aus. In der Notfallsituation ist die CT der derzeitige diagnostische Standard zur Differenzierung zwischen hyperakuter ICB und zerebraler Isch?mie. Der MRT wird im Akutstadium ein geringer Stellenwert für die Diagnose einer ICB oder Subarachnoidalblutung (SAB) beigemessen und viele Autoren bescheinigen der MRT eine niedrige Sensitivit?t für hyperakute ICB. Wir geben eine übersicht über die aktuelle Literatur und charakterisieren den Stellenwert der MRT bei der Diagnose von ICB und SAB sowie hyperakuter Schlaganf?lle im Allgemeinen: MRT-Signalcharakteristika von ICB beruhen auf dem H?moglobinabbau. Bei subakuten und chronischen ICB/SAB ist die MRT der CT überlegen, bei hyperakuten ICB herrscht diesbezüglich Dissens. Deoxyh?moglobin, dessen paramagnetische Eigenschaften einen Signalverlust in suszeptibilit?tsgewichteten Sequenzen (T2*-WI) bewirken, ist das Substrat des MRT-Nachweises akuten Blutes. Vorl?ufige Daten legen eine hohe Sensitivit?t moderner Schlaganfall-MRT Protokolle auch für hyperakute ICB und SAB nahe. Au?erdem k?nnen durch die MRT zus?tzliche Informationen zur ?tiologie einer ICB oder SAB erlangt werden. Von weiterem Interesse sind perih?morrhagische pathophysiologische Abl?ufe, deren Charakterisierung bei ICB-Patienten evtl. eine Verbesserung des Therapiemanagements mit sich bringt.      

Retrospective study of children with acute pyelonephritis. Evaluation of bacterial etiology, antimicrobial susceptibility, drug management and imaging studies.

The purpose of the study was to investigate the management of pyelonephritis in a large Italian pediatric population. A total of 1,333 patients (36% male) were considered. Escherichia coli was the most frequently isolated agent (89.9%), followed by Proteus mirabilis (3.6%) and Klebsiella oxytoca (2.1%). 27% of microorganisms were resistant to amoxicillin, 4% to amoxicillin/clavulanic acid, 11% to trimethoprim-sulfamethoxazole, 2.4% to gentamicin and less than 2% to ceftazidime. Despite this resistance pattern showing that oral antibiotics, such as amoxicillin/clavulanic acid, are effective in vitro as well as parenteral antimicrobials, a parenteral antibiotic was given initially to 756 (57.2%) children. A prophylactic regimen was started in 922 patients with a rate of reinfection during prophylaxis of 9.5%; a higher rate of reinfection was observed in patients with reflux (25%) compared to children without reflux (3%) (p < 0.0001). Vesicoureteral reflux was demonstrated in 30% of patients. The number of renal abnormalities detected by DMSA in patients with and without reflux was significantly different (p < 0.001). CRP was higher in patients with scars (p < 0.02). In conclusion, pyelonephritis represents a common disease with about 2,500 days of hospitalization per year in the Veneto Region where there is a pediatric population of about 800,000 under 15 years of age. The results of antimicrobial in vitro tests indicate that amoxillicin/clavulanic acid could represent the antibiotic of choice. The high frequency of malformations, observed even in children between 6 and 12 years of age, may suggest the need of an imaging study including DMSA scan and VCUG in all age groups.     

The Swedish Childhood Diabetes Study: a Seven-fold Decrease in Short-term Mortality?

Since 1 July 1977 all Swedish children aged 0-14 years with newly diagnosed Type 1 diabetes have been recorded on a central register. Out of 3228 patients registered up to 31 December 1985, 10 children (seven boys) had died during this time period. The overall mortality was 0.75 per 1000 patient-years. When compared with the general population the standardized mortality ratio (SMR) for both sexes was 2.09 (95% confidence limits 1.14-3.83). When analysed separately for sex, the higher mortality remained significant for males only (SMR = 2.61, 1.28-5.32). Five deaths were most probably due to diabetes and the remaining five were due to accidents, other diseases and, in one case, not identifiable with certainty. In comparison with previous studies there was a very low mortality in young-onset diabetic patients. However, short-term mortality is still significantly raised even in a country with a good economic and educational patient status and easy access to free hospital care.     

The social impact of drug abuse on community life

Drug abuse is often accompanied by a devastating social impact upon community life. The present article focuses on the adverse effect of drug abuse on industry, education and training and the family, as well as on its contribution to violence, crime, financial problems, housing problems, homelessness and vagrancy.     

Abnormalities of the executive control network in multiple sclerosis phenotypes: An fMRI effective connectivity study

The Stroop interference task is a cognitively demanding task of executive control, a cognitive ability that is often impaired in patients with multiple sclerosis (MS). The aim of this study was to compare effective connectivity patterns within a network of brain regions involved in the Stroop task performance between MS patients with three disease clinical phenotypes [relapsing‐remitting (RRMS), benign (BMS), and secondary progressive (SPMS)] and healthy subjects. Effective connectivity analysis was performed on Stroop task data using a novel method based on causal Bayes networks. Compared with controls, MS phenotypes were slower at performing the task and had reduced performance accuracy during incongruent trials that required increased cognitive control. MS phenotypes also exhibited connectivity abnormalities reflected as weaker shared connections, presence of extra connections (i.e., connections absent in the HC connectivity pattern), connection reversal, and loss. In SPMS and the BMS groups but not in the RRMS group, extra connections were associated with deficits in the Stroop task performance. In the BMS group, the response time associated with correct responses during the congruent condition showed a positive correlation with the left posterior parietal → dorsal anterior cingulate connection. In the SPMS group, performance accuracy during the congruent condition showed a negative correlation with the right insula → left insula connection. No associations between extra connections and behavioral performance measures were observed in the RRMS group. These results suggest that, depending on the phenotype, patients with MS use different strategies when cognitive control demands are high and rely on different network connections. Hum Brain Mapp, 37:2293–2304, 2016. © 2016 Wiley Periodicals, Inc.     

Age at trauma exposure and PTSD risk in young adult women

The aim of the current study was to test the independent and joint contributions of 8 different types of trauma to posttraumatic stress disorder (PTSD) risk using data from a young adult female cohort. Associations of traumatic events with PTSD onset were examined using Cox proportional hazards models. Differences in risk as a function of age at trauma were tested. Childhood sexual assault, physical abuse, and neglect were stronger predictors of PTSD onset than adolescent and early adult occurrence of these events in individual models. In a model including all traumatic events, differential risk by age remained for sexual assault and physical abuse. Early sexual assault was the strongest predictor of risk, but additional traumatic events increased risk even in its presence.