Immune networks: getting on to the real thing

After some ten years of faltering development, the network approach in immunology is finally heading toward steady ground. At a recent international workshop (*), experimentalists and theoreticians discussed some of the latest developments, including an impressive array of novel results and applications to fundamental properties of biological immune networks: connectivity, patterns of dynamic activity, ontogenesis, and tolerance.     

Asociación entre el hydrops endolinfático y vértigo posicional paroxístico benigno: ¿casualidad o causalidad?

IntroductionThe aim of this study was to determine the prevalence of benign paroxysmal positional vertigo (BPPV) in patients diagnosed with endolymphatic hydrops (EH) and to analyze whether this association is a factor for poor prognosis in these patients.Material and methodsA retrospective study was carried out in our department among the patients definitively diagnosed as having Ménière's disease according to the criteria of the American Academy of Otolaryngology and BPPV by the usual triggering manoeuvres.ResultsThe prevalence of BPPV in our patients with EH was 5.1%. The rate of cure with the repositioning manoeuvres is 90.9%, however success with the first manoeuvre was only 63.36%. Recurrences occurred in up to 22.22%. We found a lower success rate with the first manoeuvre in relation to the rest of the patients with BPPV without EH. This difference is statistically significant (P=0.042).DiscussionWe did not find that these patients to have a lower rate of cure with the repositioning manoeuvres or a higher rate of recurrence. But in our protocol the first manoeuvre had a lower success rate than in the rest of the patients.     

Is early diagnosis of oral cancer a feasible objective? Who is to blame for diagnostic delay?

Oral Diseases (2010) 16 , 333–342 Worldwide, oral cancer has one of the lowest survival rates and poor prognosis remains unaffected despite recent therapeutic advances. Reducing diagnostic delay to achieve earlier detection is a cornerstone to improve survival. Thus, intervention strategies to minimize diagnostic delays resulting from patient factors and to identify groups at risk in different geographical areas seem to be necessary. The identification of a ‘scheduling delay’ in oral cancer justifies the introduction of additional educational interventions aimed at the whole health care team at dental and medical practices. The access to and the kind of healthcare system in a particular country are also relevant in this context, particularly the referral system. The design of a simple, clear, fail‐safe, fast‐track referral scheme for those suspected with cancer may diminish greatly the length of the delay. Moreover, there is a need for future investigations, which are methodologically adequate, that consider cultural and geographical aspects and use patient survival as the final outcome, that are able to recognize the agents/factors responsible for diagnostic delay by patients as well as healthcare providers and those attributable to the healthcare systems.     

Early exposure to paracetamol or to antibiotics and eczema at school age: Modification by asthma and rhinoconjunctivitis

Garcia‐Marcos L, González‐Díaz C, Garvajal‐Urueña I, Pac‐Sa MR, Busquets‐Monge RM, Suárez‐Varela MM, Batlles‐Garrido J, Blanco‐Quirós A, Varela ÁL.‐S., García‐Hernández G, Aguinaga‐Ontoso I. Early exposure to paracetamol or to antibiotics and eczema at school age: modification by asthma and rhinoconjunctivitis.
Pediatr Allergy Immunol 2010.
© 2010 John Wiley & Sons A/S The association between early exposure to paracetamol or to antibiotics and eczema is conflicting. This study aims to know whether the early exposure to those drugs is associated with eczema at school age, and whether the strength of the association is modified by the presence of asthma or rhinoconjunctivitis. Children aged 6–7 (n = 13908) from the International Study of Asthma and Allergies in Childhood in Spain provided data about current asthma, rhinoconjunctivitis and eczema. Parent‐reported information was also obtained on paracetamol and antibiotic consumption during the first year of life. Logistic regression analysis with eczema as outcome and including exposure to paracetamol or to antibiotics, together with possible confounders, was carried out in the whole sample of children and in five different strata: no respiratory symptom and any respiratory symptom further subdivided into: asthma with rhinoconjunctivitis, asthma without rhinoconjunctivitis and rhinoconjunctivitis without asthma. In the whole sample, exposure to paracetamol was associated with eczema (aOR 1.56 [1.36–1.80]) as was antibiotic consumption (aOR 1.66 [1.43–1.92]). These associations did not substantially change after additionally adjusting for the other drug. A similar pattern was found among children without respiratory symptoms. In children with symptoms, adjusting for the other drug modified the association with paracetamol (aOR from 1.32 [1.03–1.71] to 1.09 [0.83–1.43]) but did not change that with antibiotics (aOR from 1.80 [1.38–2.35] to 1.81 [1.37–2.39]). Early exposure to paracetamol or to antibiotics is associated with an increased prevalence of eczema at school age. Asthma and/or rhinoconjunctivitis substantially modifies this association.     

Measurement of colonic transit time in children

Transit times through the whole colon and its segments were measured in 10 healthy children and 14 children suffering constipation secondary to myelomeningocele. The subjects ingested radio-opaque markers on three successive days, and on the fourth a plain abdominal roentgenogram was taken using fast film. In the healthy children, total colonic transit time (mean +/- SD) was 37.8 +/- 6.2 h, with segmental times of 10.8 +/- 3.5 h for the right colon, 12.2 +/- 2.7 h for the left, and 14.7 +/- 2.1 h for the rectosigmoid; upper normal limits of 17.8 h for the right colon, 17.6 h for the left, 19.1 h for the rectosigmoid, and 50.2 h for the total colonic transit time were established. In the constipated children, the total transit time was 59.9 +/- 5.4 h, with segmental times of 15.9 +/- 2.3 h for the right colon, 18.9 +/- 2.3 h for the left, and 25.0 +/- 2.6 h for the rectosigmoid. The technique described is simple, is easy to use in clinical practice, and involves a lower radiation dose than other methods. It may prove useful for measurement of colonic transit time in suitable patients.