Respiratory syncytial virus (RSV) glycoprotein G mimics fractalkine, a CX 3 C chemokine, which mediates chemotaxis of leukocytes expressing its receptor, CX 3 CR1. The aim of this study was to examine the relationship between RSV infection and expression of perforin and IFN- in CX 3 CR1-expressing peripheral blood CD8 + T cells. Samples were collected from infants with RSV bronchiolitis, both in the acute and convalescence phase (n=12), and from their age-and sex-matched healthy controls (n=15). Perforin expression and IFN- secretion in CX 3 CR1 + CD8 + T cells were assessed by four-color flow cytometry. The NF-B p50 and p65 subunit levels were also determined as markers of RSV-induced inflammation. Study results showed perforin and CX 3 CR1 expression to be significantly lower in the convalescent phase of infected infants than in healthy controls. There was no significant difference in IFN- secretion and NF-B binding activity between two time-points in RSV-infected infants, or when compared to healthy controls. Infants with prolonged wheezing had lower acute-phase CX 3 CR1 levels in peripheral blood. These data indicate existence of an event persisting after acute RSV infection that is able to modulate effector functions of cytotoxic T cells, and also link disease severity with CX 3 CR1 expression.
Abstract:To prevent the development of malnutrition in hospitalized children, it is important to develope an early identification of nutritional depletion, ideally at the time of admission to the hospital. In 2009 Hulst et al. proposed new guidelines for assessing the nutritional status of hospitalized children called STRONGkids questionnaire (Screening Tool Risk on Nutritional Status and Growth). This study was designed to describe the current prevalence of malnutrition on admission to a pediatric gastroenterology hospital unit and to compare the value and feasibility of STRONGkids scoring system versus anthropometric World Health Organization (WHO) criteria in identifying children at risk of developing malnutrition during hospital stay. The prospective observational study involved 124 children hospitalized at the Department of Pediatrics, University Hospital Center Zagreb. Nutritional status and risk for malnutrition were estimated by STRONGkids questionnaire and anthropometric measurements of subjects. Statistical analysis was performed using the computer program STATISTICS 10, StatSoft. Inc. 1984-2011; using descriptive statistics, Fisher's exact (FE) test and non-parametric Kruskal-Wallis (KW) test. Total malnutrition was observed in 18.5% of patients. Larger number of children at risk for malnutrition were identified by STRONGkids questionnaire than by anthropometric measurements (STRONGkids questionnaire: 75.8%; anthropometric measures: 40.3%). Patients that lost weight during hospitalization (33.1%) were further analyzed: 8/41 were not detected to be at risk by either method, 11/41 were identified by STRONGkids and anthropometry, and 22/41 were detected only by STRONGkids (Fisher's exact test p=0,08). This study justifies the inclusion of the STRONGkids questionnaire in the initial evaluation of children on admission to the hospital, in order to recognize those who need special nutritional support and thus prevent the development of malnutrition during hospitalization.
IgE is 268IU/ml. Specific IgE to Tomato-0.02, Strawberry-0.01, Kiwi fruit-0.03, . Thyroid function test, MRI brain were normal. Investigations performed for Wilson's disease, which were unremarkable. Coeliac screen was normal. Hereditary angioedema scree is normal There was no record of basal serum tryptase level. Treatment Initial diagnosis of idiopathic anaphylaxis made. Later with new neurological and eye symptoms, diagnosis of mast cell activation syndrome suspected, and he was started on trial of oral sodium cromoglycate capsules.In next clinic follow up, his symptoms were completely resolved and feedback from school was excellent in terms of concentration. Discussion Symptoms of allergic disorders are very wide. Mast cell activation syndrome especially with multisystem involvement should be a differential to Idiopathic Anaphylaxis.
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