Ontogeny and regulation of the immune system

Classic studies in embryology and contemporary research in immunology and molecular biology have disclosed the carefully orchestrated events leading to development of the immune system and immunoregulation that ultimately provide immunohomeostasis. During ontogeny, the pluripotential stem cell emerges and differentiates into all hematopoietic lineages, including three major immunologically relevant components: T-cell differentiation occurs within the thymus; B cells appear within fetal liver, adult bone marrow, and possibly other abdominal sites; and concurrently, the monocyte-macrophage system develops. Under the influence of an array of cytokines and cellular interactions, immune regulation is established. T and B lymphocytes elaborate genetically encoded messages that acquire specificity via transposable genetic elements. Receptors and cytokines provide immune recognition, communication, regulation, and memory for antigens. Inherited and acquired defects in ontogeny and immune regulation are the basis for immunodeficiency disorders.     

Bloodstream infections in pediatric oncology outpatients: a new healthcare systems challenge.

OBJECTIVE: To investigate a perceived increase in central venous catheter (CVC)-associated bloodstream infections (BSIs) among pediatric hematology-oncology outpatients. DESIGN: A case-control study. SETTING: A pediatric hematology-oncology outpatient clinic at Fresno Children's Hospital. PATIENTS: Pediatric hematology-oncology clinic outpatients with CVCs at Fresno Children's Hospital between November 1994 and October 1997. METHODS: A case-patient was defined as any hematology-oncology outpatient with a CVC-associated BSI at Fresno Children's Hospital from November 1996 to October 1997 (study period) without a localizable infection. To identify case-patients, we reviewed Fresno Children's Hospital records for all hematology-oncology clinic patients, those with CVCs and those with CVCs and BSIs. Control-patients were randomly selected hematology-oncology outpatients with a CVC but no BSI during the study period. Case-patient and control-patient demographics, diagnoses, caretakers, catheter types, catheter care, and water exposure were compared. RESULTS: Twenty-five case-patients had 42 CVC-associated BSIs during the study period. No significant increase in CVC-associated BSI rates occurred among pediatric hematology-oncology patients. However, there was a statistically significant increase in nonendogenous, gram-negative (eg, Pseudomonas species) BSIs during summer months (May-October) compared with the rest of the year. Case-patients and control-patients differed only in catheter type; case-patients were more likely than control-patients to have a transcutaneous CVC. Summertime recreational water exposures were similar and high in the two groups. CONCLUSIONS: Hematology-oncology clinic patients with transcutaneous CVCs are at greater risk for CVC-associated BSI, particularly during the summer. Caretakers should be instructed on proper care of CVCs, particularly protection of CVCs during bathing and recreational summer water activities, to reduce the risk of nonendogenous, gram-negative BSIs.     

Adipose tissue determinations in cadavers--a comparison between cross-sectional planimetry and computed tomography

The adipose tissue surfaces in 11 slices (+/- 5 cm from the umbilicus) were compared in two cadavers using computed tomography (CT) versus planimetry of band-sawed slices of the corresponding sections. A very close correlation was found with partial correlations of around 0.90. Retroperitoneal fat formed a considerable proportion of the total adipose tissue surface in the slices. The results were similar whether fat was defined as -250 to -50, -190 to -30, or -140 to -40 Hounsfield units. These data indicate that CT measurements agree closely with a direct morphometric method and thus can be used as a 'gold standard' for future development. The fact that fat which is located extraperitoneally, but still intraabdominally, constitutes a significant proportion of the slice surface in the umbilical region indicates that data relating intraabdominal fat measurements to metabolic functions must be interpreted with caution.     

Self-Replicating RNAs Drive Protective Anti-tumor T Cell Responses to Neoantigen Vaccine Targets in a Combinatorial Approach

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Cross-sectional and longitudinal associations between cardiometabolic measures and clinical stage in young people accessing early intervention mental health services

Aim

This retrospective cohort study aimed to identify the cardiometabolic characteristics, cross-sectionally and longitudinally, associated with clinical stage in youth accessing early intervention mental health services.

Methods

Cardiometabolic data we collected in 511 young people (aged 12–25 years at entry) receiving mental health care at the early intervention services in Sydney, Australia.

Results

The majority of young people (N = 448, 87.67%) were classified in stage 1a or 1b at entry. At entry to care, there was no cross-sectional relationship between clinical stage and age, gender, fasting insulin, fasting glucose, updated homeostatic model assessment for insulin resistance (HOMA2-IR) score, BMI or waist circumference. Of the 111 (21.7%) young people initially classified at stage 1a (‘non-specific symptoms’) and the 337 (65.9%) classified in stage 1b (‘attenuated syndromes’), 40 individuals transitioned to stage 2+ (7.8%) (“full-threshold disorders”) longitudinally. No cardiometabolic factors predicted clinical stage transitions. However, those with an increase in BMI over the course of care (n = 54) were 1.46 (OR; 95% CI: 1.02–2.17) times more likely to progress to stage 2+ at follow up.

Conclusions

Whilst no relationships were found between demographic or cardiometabolic variables and clinical stage at entry to care, an increased BMI over time was associated with clinical stage transition longitudinally. Further longitudinal research is needed to understand the demographic, clinical, illness progression or treatment factors associated with changes in cardiometabolic status.     

Nasal impairment in prepubertal children.

The aim of this study was to examine changes in nasal resistance longitudinally from age 9 to 13. The study population consisted of 82 children whose nasal resistance was measured annually. The results showed that as nasal resistance significantly decreased with age, it also increased transiently at some point between ages 9 and 13. The timing of the transient change in resistance varied among individuals, but it usually occurred before age 12. No gender differences were observed. The results suggest that clinical signs of nasal impairment may periodically occur and then disappear in prepubertal orthodontic patients.