Rosai-Dorfman disease is a self-limiting condition caused by histiocyte proliferation within the sinusoids of lymph nodes and in extranodal tissue. It is a rare disease, particularly in children, that progresses with extensive lymphadenopathy. This paper reports on the case of a 2-year-old child with progressive cervical lymphadenopathy associated with persistent fever and radiological findings suggestive of lymphoma. Histopathological and immunohistochemistry studies of a lymph node biopsy established the diagnosis of Rosai-Dorfman disease. Both lymphadenopathy and fever resolved spontaneously.
Refractory congenital chylous ascites (CCA) is an uncommon clinical condition. Few cases have been described and no gold standard treatment has been defined so far. This report describes a case of refractory CCA in a newborn child which was treated by surgery. Preoperative lower-limb lymphoscintigraphy associated with intraoperative patent blue testing and fibrin glue application were useful in order to provide a successful outcome.
Clostridium difficile (Cd) toxins appear to mediate the inflammatory response in pseudomembranous colitis and/or colitis associated with the use of antibiotics. In contrast to Cd Toxin A (TxA), Cd Toxin B (TxB) has been reported not to promote fluid secretion or morphological damage in rabbits and hamsters and also does not induce neutrophil chemotaxis in vitro. However, TxB is about 1000 times more potent than TxA in stimulating the release of tumour necrosis factor‐α (TNF‐α) by cultured monocytes. In the present study, we investigated the ability of TxB to promote neutrophil migration into peritoneal cavities and subcutaneous air‐pouches of rats. We also examined the role of resident peritoneal cells in this process as well as the inflammatory mediators involved. TxB caused a significant and dose‐dependent neutrophil influx with a maximal response at 0·1 μg/cavity after 4 hr. Depleting the peritoneal resident cell population by washing the peritoneal cavity or increasing this population by pretreating the animals with thioglycollate blocked and amplified the TxB‐induced neutrophil migration, respectively. Pretreating the animals with MK886 (a lipoxygenase inhibitor), NDGA (a dual cyclo‐ and lipoxygenase inhibitor) or the glucocorticoid, dexamethasone, but not with indomethacin (a cyclo‐oxygenase inhibitor), or BN52021 (a platelet‐activating factor antagonist), inhibited the neutrophil migration evoked by TxB. Pretreatment with dexamethasone or the administration of anti‐TNF‐α serum into the air‐pouches also significantly reduced the TxB‐induced neutrophil migration. Supernatants from TxB‐stimulated macrophages induced neutrophil migration when injected into the rat peritoneal cavity. This effect was attenuated by the addition of either MK886 or dexamethasone to the macrophage monolayer and by preincubating the supernatants with anti‐TNF‐α serum. TxB also stimulated the release of TNF‐α by macrophages. Overall, these results suggest that TxB induces an intense neutrophil migration which is mediated by macrophage‐derived TNF‐α and lipoxygenase products.
Objective: To analyze the preoperative use of antibiotics in children and adolescents
requiring appendectomy.Data source: Integrative review was performed in the MEDLINE, Latin American and
Caribbean Health Sciences (LILACS) and Cochrane databases and the PubMed
portal, with no time limit. The keywords used were: appendicitis, child,
adolescent and antibacterial with Boolean AND. The articles included were
published in Portuguese, English or Spanish and whose participants were
under 18 years of age. Review articles and guidelines were excluded. The
studies were classified according to their level of evidence and 24 papers
were selected.Data collection and analysis: Seven randomized clinical trial studies (level of evidence II), eight
cohorts (level III), seven retrospective observational studies (level V) and
two historical documentary analysis (level IV) were selected. The studies
addressed antibiotics used in acute appendicitis in both uncomplicated and
complicated cases. Antibiotics initiated in the preoperative period showed a
decrease in the rates of surgical wound infections. First-line (empiric)
regimens were tested for sensitivity to microorganisms in peritoneal
material cultures, however the results were controversial. Broad-spectrum
antibiotics have been suggested in some studies because they have good
coverage, but in others they have not been recommended because of the risk
of developing bacterial resistance. Shorter administration time and earlier
change to the oral route reduced hospitalization time.Conclusions: There are several clinical protocols with different antibiotics. However,
there is no standardization concerning the type of antibiotic drug, time of
use, or route.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.