Interleukin-12 suppresses filaria-induced pulmonary eosinophilia, deposition of major basic protein and airway hyperresponsiveness

Tropical Pulmonary Eosinophilia (TPE) is a severe form of allergic asthma caused by the host inflammatory response to filarial helminths in the lung microvasculature, and is characterized by pulmonary eosinophilia, increased filarial-specific IgG and IgE antibodies, and airway hyperresponsiveness. The current study examined the effect of IL-12 on pulmonary eosinophilia, deposition of eosinophil major basic protein and airway hyperresponsiveness in mice inoculated i.v. with Brugia malayi microfilariae. Injection of recombinant murine IL-12 modulated the T helper (Th) response in the lungs from Th2- to Th1-like, with elevated IFN-γ, and decreased IL-4 and IL-5 production. Consistent with this shift in cytokine response, antigen-specific IgG2a was elevated, and IgG1 and total serum IgE were decreased. In addition, eosinophils in BAL fluid from IL-12 treated mice were reduced from 56% to 11%, and there was no detectable MBP on respiratory epithelial cells. Importantly, IL-12 suppressed airway hyperresponsiveness compared with saline-injected control animals. Taken together, these data clearly demonstrate that by modulating Th associated cytokine production, IL-12 down-regulates filaria-induced lung immunopathology .     

Children’s experiences of participation in the cleft lip and palate care pathway

International Journal of Paediatric Dentistry 2012; 22: 442–450 Aim. This qualitative study sought to explore children’s perspectives on their participation in the cleft lip and palate care pathway. Design. Eight boys and nine girls (aged 8–17 years), with a range of cleft types and who were patients at a British dental hospital each took part in two child‐centred interviews which incorporated participatory activities. An initial interview focused on children’s general life stories, and these often encompassed a discussion about cleft lip and/or palate. A follow‐up interview explored specific aspects of the condition and its related treatment. Results. Data revealed the varying roles that young people can play in decision‐making, which can be described as active or passive. In addition, the dynamic degree of participation was highlighted with patients occupying different roles throughout the care pathway. Conclusion. The research provides an insight into treatment decisions, and how young people, their families, and clinicians interact to arrive at these. Findings provide further evidence to support the important contribution young patients can make in their own treatment choices.     

The aetiology of preterm labour

Summary. Factors associated with spontaneous preterm birth were analysed in 254 primigravidae who gave birth to singleton infants between 28 and 36 completed weeks gestation in Aberdeen City District between 1978 and 1982. In 144 women labour followed premature rupture of the membranes and in 110 the membranes were intact and labour began with contractions. Among those with intact membranes, unmarried women and teenagers were over represented to a significant extent compared with all primigravidae. Among those with premature rupture of the membranes, the distribution of age and marital state was similar to that in all primigravidae, but the birthweight centile distribution showed a significant shift towards light-for-dates babies. It is argued that there may be two distinct categories of pregnancies that end in spontaneous preterm labour.     

Increased serum creatinine associated with severe primary hypothyroidism

A case of myxoedema due to Hashimoto's thyroiditis associated with a significant increase in serum creatinine is reported. Thyroid hormone replacement therapy resulted in normalization of the serum biochemistry within 1 month.     

Retrobulbar block fails to prevent an increase in serum cortisol concentration on emergence from anaesthesia after cataract surgery

We have studied 30 elderly patients undergoing cataract surgery,allocated randomly to receive general anaesthesia, local anaesthesiaby retrobulbar block or general anaesthesia combined with retrobulbarblock given after induction. Retrobulbar block alone preventedthe increases in circulating cortisol and glucose values whichoccurred in those patients receiving general anaesthesia alone.Retrobulbar block given after induction of general anaesthesia,however, suppressed the cortisol and glucose responses duringsurgery, but did not prevent a marked increase in cortisol concentrationsduring the immediate postoperative period. The results suggesta hormonal response to emergence from anaesthesia which hashitherto been masked by the stress response to surgery itself.(Br. J. Anaesth. 1994; 72: 119–121).     

INTERHEMISPHERIC SUBDURAL HAEMATOMA FOLLOWING HEAD INJURY

A case of interhemispheric subdural haematoma following head injury is reported. The clinical and computerized axial tomographic (CT) features of this unusual complication are described together with the surgical management.