Complications of varicella requiring hospitalization in immunocompetent children are more frequent than previously thought.

Henoch-Schönlein purpura is the most common vasculitis of childhood. This study investigated the values of hematologic indices that can help predict internal organ involvement. The study included 112 patients followed up between January 2007 and May 2017 and 81 healthy children. Leukocyte, neutrophil, monocyte, lymphocyte and platelet counts, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP) levels were compared between patients with and without internal organ involvement. Overall, 57 (50.8%) patients had internal organ involvement. Leukocyte, neutrophil, and monocyte counts, NLR, and CRP levels were significantly higher in patients with internal organ involvement than in patients without internal organ involvement. There was no difference between the groups in terms of lymphocyte count, platelet count, and PLR. The cutoff values were found to be ≥10.8×109/L [area under the curve (AUC), 0.734] for leukocyte, ≥6.0×109/L (AUC, 0.665) for neutrophil, ≥0.710×109/L (AUC, 0.681) for monocyte, ≥3.95×109/L (AUC, 0.609) for NLR, and 2.41 mg/dL (AUC, 0.635) for CRP. Logistic regression analysis revealed that leukocyte count is a risk factor for internal organ involvement. Leukocyte, neutrophil, monocyte counts, NLR, and CRP levels are useful in predicting internal organ involvement in the acute phase of Henoch-Schönlein purpura. Leukocyte count is an important risk factor for internal organ involvement and its predictive value is more reliable than the other hematologic indices.

No abstract

Patients with cystic fibrosis (CF) have several risk factors for Clostridium difficile colonization such as frequent hospitalization and exposure to a broad array of antibiotics utilized for the control, eradication, and prophylaxis of respiratory pathogens. However, despite this high rate of colonization, the occurrence of C. difficile infection (CDI) in CF is rare. We report three children with CF who presented with severe community-associated CDI. All three children had complicated courses and one died. These children were in good health without significant morbidities, and were not frequently hospitalized nor did they receive frequent antibiotic courses. The occurrence of 3 severe cases within a 15-month period prompted us to report these cases and review the literature in regard to CDI. We reviewed the CF GI tract as possible risk factors for a high rate of C. difficile colonization in individuals with CF. Since a high percentage of individuals with CF are on gastric acid blocking agents, we also focused on gastric acid suppression as a potential risk factor for CDI.

No abstract

Low urine ghrelin levels might be relevant to pathogenesis of doxorubicin-induced NS. The reduction in urine ghrelin levels might also be associated with increased levels of urine sCTLA4 and sCD80 which reflect proteinuria.

Background and methodsSoluble-lymphocyte subsets (sCD19 + CD23+ B cells and sCD4 + CD25+ T cells), soluble-adhesion molecules (sE-selectin) and interleukin-12 (sIL-12) were assayed to evaluate the pathogenesis of steroid sensitive nephrotic syndrome in 48 patients diagnosed with steroid sensitive nephrotic syndrome (SSNS) in active (AS) and remission stages (RS).ResultsThe ratios of soluble CD19 and sCD19 + CD23 increased in patients with AS with respect to the patients with RS and controls (p < 0.05). Increased sCD19 + CD23 ratios were preserved in the patients with RS when compared with the controls (p < 0.05). Moreover, the ratios of sCD4 + CD25 lymphocyte subsets were not significantly different among the groups. Similarly, serum sIL-12 levels were not considerably disparate between the AS and RS. Serum sE-selectin levels were higher in the patients with AS relative to the controls (p < 0.01) and RS (p < 0.05). No significant correlations were noted between sE-selectin and lymphocyte subset ratios, serum sIL-12 and immunoglobulin levels. There was a positive correlation between sE-selectin, triglyceride (r = 0.757, p < 0.0001) and cholesterol (r = 0.824, p < 0.0001) levels in patients with the AS.ConclusionThe present results indicate that the patients with SSNS appear to have abnormalities in sCD23 + CD19+ cells, defect in T regulatory cell activity, and injury in endothelial cells as indicated by the presence high sE-selectin. These abnormalities might play a role in the pathogenesis of nephrotic syndrome. sIL-12 seems to have no role in pathogenesis of nephrotic syndrome reflecting normal Th1 response.

The objective of this study was to evaluate some coagulation parameters in hepatic coccidiosis experimentally induced with Eimeria stiedai in rabbits. Fourteen healthy New Zealand rabbits were equally divided into two groups. One group received no treatment, the other group was orally inoculated with 40 000 sporulated oocysts of E. stiedai in a 1 ml inoculum using a catheter. At day 24 after inoculation, blood samples were collected into sodium citrate-containing tubes to evaluate some coagulation parameters. Although statistically not significant, infected rabbits had prolonged prothrombin time and activated partial thromboplastin time compared with rabbits in the control group. A significant reduction (P < 0.05) was observed in the level of fibrinogen of infected rabbits compared with that of the controls. A slight decrease in thrombocyte counts of infected rabbits was not statistically significant.