- [HPV type determination and clinical characteristics in juvenile onset recurrent respiratory papillomatosis]. [Journal Article]
- LCLin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2016 May 05; 30(9):730-732
- Objective: To investigate the relationship between different subtypes of human papillomavirus(HPV) infection and clinical features in juvenile onset recurrent respiratory papillomatosis(JORRP) patien...
Objective: To investigate the relationship between different subtypes of human papillomavirus(HPV) infection and clinical features in juvenile onset recurrent respiratory papillomatosis(JORRP) patients. Method:Two hundred and forty cases with JORRP from 2010 to 2014 were retrospectively analyzed. HPV tpye were determined using tumor specimens taken from surgery, and all patients were divided into different groups based on HPV type. Clinical characteristics of patients from each groups were analyzed. Result:Except for HPV11 single infection or HPV6 single infection, some HPV11 and 6 co-infections were found in children with JORRP. Compared with patients with HPV6 single infection, HPV11 positive patients present an earlier age of onset, more times of operation and higher derkay score during surgery.Conclusion: JORRP in patients infected with HPV11 is more severe than that in patients with HPV6 infection in children.
- Foreign body aspiration as a cause of cryptogenic hemoptysis in a child: A case report. [Journal Article]
- MMedicine (Baltimore) 2018; 97(20):e10715
- CONCLUSIONS: This case indicates that foreign body aspiration should be considered in any child with recurrent cryptogenic hemoptysis and persistent focal lung injury. Multiple bronchoscopy is rational in order to find out the underlying reasons.
- Influenza-Associated Acute Necrotizing Encephalopathy in Siblings. [Journal Article]
- JPJ Pediatric Infect Dis Soc 2018 May 04
- Encephalopathy is an important complication associated with influenza, most frequently observed in young children, with a wide range of severity. The most severe category of influenza-associated ence...
Encephalopathy is an important complication associated with influenza, most frequently observed in young children, with a wide range of severity. The most severe category of influenza-associated encephalopathy (IAE) is acute necrotizing encephalopathy (ANE), characterized by high frequency of neurologic sequelae and fatal outcomes. We report two young siblings who developed fever and seizures with altered mental status. Influenza A(H1N1)pdm09 virus infection was identified in upper respiratory tract specimens from both patients, and neuroimaging revealed bilateral inflammatory lesions, consistent with acute necrotizing encephalopathy. Neither child had received influenza vaccination. Both children progressed to critical illness and required invasive mechanical ventilation. In addition to critical care management, both patients received high-dose corticosteroids, mannitol, anticonvulsants, and antiviral treatment of influenza. The older child recovered fully and was discharged 2 weeks after illness onset, but the younger sibling developed severe brainstem edema and cerebellar tonsillar herniation, and died on illness day 11. Both children tested positive for Ran Binding Protein 2 (RANBP2) gene mutations. RANBP2 is a genetic polymorphism associated with recurrent episodes of necrotizing encephalitis with respiratory viral infections. Annual influenza vaccination is especially important for ANE survivors, with or without RANBP2 mutations, their household contacts, and caregivers. During influenza season, close monitoring of any child with a history of neurological complications associated with respiratory illness is indicated, with prompt initiation of antiviral treatment with onset of acute respiratory illness, and influenza testing performed by molecular assay.
- Synergistic Effect of Diallyl Sulfide With Zinc Oxide Nanorods: A Novel and Effective Approach for Treatment of Acute Dermatitis in Model Animals. [Journal Article]
- FMFront Microbiol 2018; 9:586
- Besides inciting persistent and recurrent nosocomial afflictions, Staphylococcus aureus (S. aureus), a biofilm forming pathogen, poses an increased risk of several skin as well as respiratory tract i...
Besides inciting persistent and recurrent nosocomial afflictions, Staphylococcus aureus (S. aureus), a biofilm forming pathogen, poses an increased risk of several skin as well as respiratory tract infections as well. Emerging antimicrobial resistance trend asks to search for an alternate non-antibiotic based option to combat S. aureus pathogen. In the present study, we evaluated synergistic antimicrobial potential of Zinc oxide nanorods (ZnO-NRs) and diallyl sulphide (DAS) emulsion against methicillin resistant Staphylococcus aureus (MRSA). The antimicrobial assessment study suggests that the ZnO-NR and DAS emulsion effectively suppressed both sensitive S. aureus as well as MRSA isolates. The combination treatment showed enhanced activity even at a lower concentration as compared to the single treatment based on ZnO-NRs and DAS emulsion alone. The ZnO-NRs-DAS combination showed significant inhibition of MRSA biofilm as well. The data suggest that a combination therapy, comprising of ZnO-NRs and DAS emulsion, successfully treated experimental dermatitis infection caused by MRSA in mice model.
- Bioinformatics analysis and verification of key genes associated with recurrent respiratory tract infections. [Journal Article]
- IJInt J Mol Med 2018; 42(1):514-524
- We evaluated the key genes related with recurrent respiratory tract infections (RRTIs), and then elucidated the possible molecular mechanisms of RRTIs. Neutrophil was isolated from peripheral bloods ...
We evaluated the key genes related with recurrent respiratory tract infections (RRTIs), and then elucidated the possible molecular mechanisms of RRTIs. Neutrophil was isolated from peripheral bloods of the recurrent lower respiratory tract infection patients and healthy volunteers, respectively. The next generation sequencing information was obtained after RNA extraction, purification, library construction and sequencing. The sequencing information was preprocessed. Bioinformatics analysis including analysis of differentially expre-ssed genes (DEGs), Gene Ontology (GO) and pathway enrichment analysis, protein-protein interaction (PPI) analysis and transcription factors analysis were performed. The key genes were verified by real-time PCR. In total, 17 significant DEGs were obtained in case group compared with the control group by bioinformatics analysis. Then, 6 of 17 genes were detected by real-time PCR. There was statistical significance between case and control groups for peroxisome proliferator-activated receptor-γ (PPARG), prostaglandin-endoperoxide synthase 2 (PTGS2), transferrin (TF) and interleukin-10 (IL-10) (P<0.05), and there was no statistical significance between case and control groups for TIMP metallopeptidase inhibitor 1 (TIMP1) and matrix metallopeptidase 1 (MMP1). PPARG, PTGS2, TF and IL-10 are key genes associated with the progression of RRTIs. We speculate that TIMP1 and MMP1 may also be involved in the progression of RRTIs, but further studies with large number of samples are needed for verification.
- Enhanced AKT Phosphorylation of Circulating B Cells in Patients With Activated PI3Kδ Syndrome. [Journal Article]
- FIFront Immunol 2018; 9:568
- Activated PI3Kδ syndrome (APDS) is a primary immunodeficiency characterized by recurrent respiratory tract infections, lymphoproliferation, and defective IgG production. Heterozygous mutations in PIK...
Activated PI3Kδ syndrome (APDS) is a primary immunodeficiency characterized by recurrent respiratory tract infections, lymphoproliferation, and defective IgG production. Heterozygous mutations in PIK3CD, PIK3R1, or PTEN, which are related to the hyperactive phosphoinositide 3-kinase (PI3K) signaling, were recently presented to cause APDS1 or APDS2 (APDSs), or APDS-like (APDS-L) disorder. In this study, we examined the AKT phosphorylation of peripheral blood lymphocytes and monocytes in patients with APDSs and APDS-L by using flow cytometry. CD19+ B cells of peripheral blood in APDS2 patients showed the enhanced phosphorylation of AKT at Ser473 (pAKT) without any specific stimulation. The enhanced pAKT in CD19+ B cells was normalized by the addition of a p110δ inhibitor. In contrast, CD3+ T cells and CD14+ monocytes did not show the enhanced pAKT in the absence of stimulation. These findings were similarly observed in patients with APDS1 and APDS-L. Among CD19+ B cells, enhanced pAKT was prominently detected in CD10+ immature B cells compared with CD10- mature B cells. Enhanced pAKT was not observed in B cells of healthy controls, patients with common variable immunodeficiency, and hyper IgM syndrome due to CD40L deficiency. These results suggest that the enhanced pAKT in circulating B cells may be useful for the discrimination of APDS1, APDS2, and APDS-L from other antibody deficiencies.
- A novel variant in ATM gene causes ataxia telangiectasia revealed by whole-exome sequencing. [Journal Article]
- NNeurosciences (Riyadh) 2018; 23(2):162-164
- Ataxia-Telangiectasia (A-T) is an autosomal recessive disorder caused by variants in ATM gene and characterized by progressive neurologic impairment, cerebellar ataxia, and oculo-cutaneous telangiect...
Ataxia-Telangiectasia (A-T) is an autosomal recessive disorder caused by variants in ATM gene and characterized by progressive neurologic impairment, cerebellar ataxia, and oculo-cutaneous telangiectasia. Immunodeficiency with a recurrent sinopulmonary infections are observed in patients with A-T. Here, we report a novel stop codon variant, c.5944 C>T (p.Gln1982*), revealed by whole-exome sequencing in a 9-year old boy. He presented with recurrent upper respiratory tract infections, failure to thrive, developmental delay, ataxic gait, and bulbar telangiectasia.
- Top studies relevant to primary care practice. [Review]
- CFCan Fam Physician 2018; 64(4):280-285
- CONCLUSIONS: Research from 2017 produced several high-quality studies in diabetes management. These have demonstrated benefit for alternative therapies and offered evidence not previously available. This year's selection of studies also provided information on a variety of conditions and therapies that are, or might become, more common in primary care settings.
- Training Load, Immune Status, and Clinical Outcomes in Young Athletes: A Controlled, Prospective, Longitudinal Study. [Journal Article]
- FPFront Physiol 2018; 9:120
- Introduction:Beside positive effects on athlete's health, competitive sport can be linked with an increased risk of illness and injury. Because of high relative increases in train...
Introduction:Beside positive effects on athlete's health, competitive sport can be linked with an increased risk of illness and injury. Because of high relative increases in training, additional physical and psychological strains, and an earlier specialization and professionalization, adolescent athletes needs an increased attention. Training can alter the immune system by inducing a temporary immunosuppression, finally developing infection symptoms. Previous studies identified Epstein Barr Virus (EBV) as potential indicator for the immune status. In addition to the identification of triggering risk factors for recurrent infections, the aim was to determine the interaction between training load, stress sense, immunological parameters, and clinical symptoms.Methods:A controlled, prospective, longitudinal study on young athletes (n= 274, mean age: 13.8 ± 1.5 yrs) was conducted between 2010 and 2014. Also 285 controls (students, who did not perform competitive sports, mean age: 14.5 ± 1.9 yrs) were recruited. Athletes were examined 3 times each year to determine the effects of stress factors (training load: training hours per week [Th/w]) on selected outcome parameters (clinical [susceptibility to infection, WURSS-21: 21-itemWisconsin Upper Respiratory Symptom Survey], immunological, psychological end points). As part of each visit, EBV serostatus and EBV-specific IgG tiers were studied longitudinally as potential immune markers.Results:Athletes (A) trained 14.9 ± 5.6 h weekly. Controls (C) showed no lower stress levels compared to athletes (p= 0.387). Twelve percent of athletes reported recurrent infections (C: 8.5%,p= 0.153), the presence of an upper respiratory tract infection (URTI) was achieved in 30.7%. EBV seroprevalence of athletes was 60.3% (C: 56.6%,p= 0.339). Mean EBV-specific IgG titer of athletes was 166 ± 115 U/ml (C: 137 ± 112 U/ml,p= 0.030). With increasing Th/w, higher stress levels were observed (p< 0.001). Analyzes of WURSS-21 data revealed no relationship to training load (p= 0.323). Also, training load had no relation to EBV serostatus (p= 0.057) or the level of EBV-specific IgG titers (p= 0.364).Discussion:Young elite athletes showed no increased sense of stress, no higher prevalence of recurrent infections, and no different EBV-specific serological parameters compared to controls. Also, no direct relationship between training loads, clinical complaints, and EBV-specific immune responses was found. With increasing training loads athletes felt more stressed, but significant associations to EBV-specific serological parameters were absent. In summary, EBV serostatus and EBV-specific IgG titers do not allow risk stratification for impaired health. Further investigations are needed to identify additional risk factors and immune markers, with the aim to avoid inappropriate strains by early detection and following intervention.
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- Pediatric hyperimmunoglobulin E syndrome: A case series of 4 children in China. [Case Reports]
- MMedicine (Baltimore) 2018; 97(14):e0215
- Hyperimmunoglobulin E syndromes (HIES) are rare primary immunodeficiency diseases characterized by markedly elevated serum immunoglobulin (Ig) E, recurrent pneumonia, and chronic eczema. To date, inf...
Hyperimmunoglobulin E syndromes (HIES) are rare primary immunodeficiency diseases characterized by markedly elevated serum immunoglobulin (Ig) E, recurrent pneumonia, and chronic eczema. To date, information about pediatric HIES is limited. We aimed to evaluate the spectrum of clinical and immunological features in pediatric patients with HIES in China.We retrospectively reviewed the cases of 4 pediatric patients with HIES followed at the Guangzhou Women and Children's Medical Center from May 2013 to September 2017. We analyzed clinical presentation, laboratory data, immunological evaluations, imagenological characteristics, treatment, response to therapy, genetic and bronchoalveolar lavage fluid (BALF) findings, and prognosis.The common clinical features of the patients were recurrent respiratory and mucocutaneous infections and eczematoid skin lesions. In 3 of 4 patients, BALF and transbronchial lung biopsy (TBLB) demonstrated fungal pneumonia with organisms including invasive Aspergillus and Penicillium marneffei. Elevated serum IgG and IgM were detected in 3 and 2 cases, respectively, while CD4+ T and CD19+ B cells were slightly reduced in only 1 patient. Nitroblue tetrazolium tests (NBTs) were normal in all patients, and reduced natural killer cell counts were identified in 3 patients. A novel missense mutation in exon 17 (c.1593A>T, p.K531N) was identified in the signal transducer and activator of transcription 3 (STAT3) gene that has not been reported previously. One patient had 3 homozygous nonsynonymous variations of the complement receptor 2 (CR2) gene distributed in exons 10 (c.1916G>A, p.S639N) and 11 (c.1987T>C, p.S663P and c.2012G>A, p.R671H) with high frequency.This case series suggests that fungi are important respiratory pathogens in children with HIES and should be considered in cases of pneumonia in this population. The NIH scoring system does not allow diagnostic certainty, particularly in infants, because some of the common manifestations of HIES may not develop until the patient matures. Pulmonary complications must be identified in the early stage of the disease to treat them effectively. In addition, we report a mutation in STAT3 that has not been identified previously.