Diagnostic value of the reaction at the bacillus calmette-guérin vaccination site in kawasaki disease / Utilidade diagnóstica da reação do sítio de vacinação bacillus calmette-guérin na doença de kawasaki

ABSTRACT Objective: To describe the case of an infant - diagnosed with incomplete Kawasaki disease - who developed BCG scar reactivation. Case description: A 6-month-old patient was admitted to hospital with fever associated with ocular hyperemia, cervical lymphadenopathy, and hyperemic lips, and remained hospitalized for 12 days. The physical examination revealed an inflammatory reaction at the site of the BCG scar, leading to the diagnosis of incomplete Kawasaki disease. The patient was treated with venous immunoglobulin, but presented recurrence of Kawasaki disease, with subsequent onset of coronary artery disease. Comments: BCG scar reactivation is an important finding in countries where the vaccine is routinely given and may be a useful marker for early diagnosis of Kawasaki disease, especially in its incomplete form.

RESUMO Objetivo: Descrever o caso de um lactente - com diagnóstico de Doença de Kawasaki incompleta - que desenvolveu reativação da cicatriz da vacina BCG. Descrição do caso: Um paciente de 6 meses de idade foi admitido no hospital com febre, associada à hiperemia ocular, linfadenomegalia cervical e fissuras labiais, permanecendo hospitalizado por 12 dias. Apresentava, no exame físico, reação inflamatória no local da cicatriz da vacina BCG, tendo sido feito o diagnóstico de Kawasaki incompleto. O paciente foi tratado com imunoglobulina venosa, mas apresentou recorrência da doença, com posterior surgimento de coronariopatia. Comentários: A reativação da BCG é um achado importante na doença de Kawasaki em países onde a vacina é aplicada de forma rotineira e pode ser um marcador útil para o diagnóstico precoce da doença de Kawasaki, principalmente em sua forma incompleta.

Tuberculosis extra-pulmonar en niños bajo 15 años de edad internados en el Centro Hospitalario Pereira Rossell, Uruguay / Extrapulmonary tuberculosis in children under the age of 15 hospitalized at the Pereira Rossell Hospital Center, Uruguay

Resumen Introducción: La tuberculosis es un problema de salud pública de alta prevalencia. Los niños constituyen una población de riesgo de enfermar y evolucionar a formas graves. Objetivo: Describir la frecuencia, características epidemiológicas, clínicas y evolutivas de los pacientes bajo 15 años de edad, internados por tuberculosis extra-pulmonar (TBCEP) en el Centro Hospitalario Pereira Rossell-Uruguay, durante 2009 a 2019. Pacientes y Métodos: Estudio descriptivo, retrospectivo, revisión de historias clínicas y registros de la Comisión Honoraria para la Lucha Antituberculosa. Variables: edad, sexo, nexo epidemiológico, clínica, confirmación diagnóstica, tratamiento y complicaciones. Resultados: Se registraron 77 casos de TBCEP, fueron hospitalizados en este centro 45 (58%). Media de edad 7 años, varones 25 (56%). Todos recibieron vacuna BCG. Se identificó nexo epidemiológico en 28 (62%). Las formas de TBCEP fueron: pleural 26 (58%), sistema nervioso central (SNC) 9 (20%), linfoganglionar 4 (9%), cutánea 2 (5%), ósea 1 (2%), peritoneal 1 (2%), pleural-peritoneal 1 (2%), ósea-SNC 1 (2%). Confirmación etiológica hubo en 23 (51%): mediante cultivo 16, GeneXpert 5, por ambos 2. Completaron tratamiento 36 (80%). Presentaron complicaciones 4 (9%): status convulsivo 2, hemorragia cerebral 1, fallo orgánico múltiple 1. Conclusiones: La TBCEP ocurrió en niños previamente sanos. El diagnóstico requiere alto índice de sospecha y la confirmación el empleo simultáneo de varias técnicas diagnósticas.

Abstract Background: Tuberculosis is a public health problem. Children constitute a population at risk of becoming ill and evolving into serious forms. Aim: To describe the frequency, epidemiological, clinical and evolutionary characteristics of children under 15 years of age hospitalized for extrapulmonary tuberculosis (EPTB) at the Pereira Rossell Hospital-Uruguay, during 2009-2019. Methods: Descriptive, retrospective study, review of medical records and records of the Honorary Commission for the Fight Against Tuberculosis. Variables: age, sex, epidemiological and clinical link, diagnostic confirmation, treatment and complications. Results: 77 cases of EPTB were registered, 45 (58%) were hospitalized in this center. Average age 7 years, males 25 (56%). All received the Bacillus Calmette-Guérin vaccine. An epidemiological link was identified in 28 (62%). The forms of EPTB were: pleural 26 (58%), central nervous system (CNS) 9 (20%), lymphoganglionic 4 (9%), cutaneous 2 (5%), bone 1 (2%), peritoneal 1 (2%), pleural- peritoneal 1 (2%), bone-CNS 1 (2%). Etiology was confirmed in 23 (51%): by culture 16, GeneXpert 5, by both 2. Thirty-six (80%) patients completed treatment. Four (9%) presented complications: convulsive state 2, cerebral hemorrhage 1, multiple organ failure 1. Conclusions: EPTB occurred in previously healthy children. The diagnosis requires a high index of suspicion and the confirmation of the simultaneous use of several diagnostic techniques.

Assessment of vaccine wastage in an immunization clinic of a tertiary care hospital, Kolkata, West Bengal

Background: Universal Immunization Programme was launched by Government of India in 1985 with the aim of immunizing all children and pregnant women across the country free of cost. However high vaccine wastage and lack of proper vaccine management could not meet the demand and increased the cost.Methods: A descriptive record based study was conducted in the immunization clinic of KPC Medical College and Hospital. Vaccination records of all children and pregnant women attending clinic from 1st July 2018 to 30th June 2019 was retrieved from the immunization registers.Results: Wastage rate was found to be highest for bacillus Calmette–Guérin vaccine vaccine (68.9%) and lowest for oral polio vaccine (27.7%). Wastage rate was higher for 10 dose vial vaccine compared to 5 dose vial and 20 dose vial vaccine and the differences were statistically significant (p<0.00001).The wastage rate was higher for lyophilized vaccine compared to liquid vaccine and for injectable vaccine compared to oral vaccine. These differences were also statistically significant (p<0.00001).Conclusions: Thus regular monitoring of immunization sessions should be done to estimate the vaccine wastage in each session. Reducing wastage is expected to increase the quality and efficiency of the programme and also reduce the cost without compromising the coverage.

Effects of Yinzhihuang Oral Solution on Immunological Liver Injury / 中国药房

OBJECTIVE:To investigate the effects of Yinzhihuang oral solution on immunological liver injury (ILI). METHODS:Male mice were randomly divided into blank group (normal saline), model group (normal saline), bifendate group(150 mg?kg-1),high dosage group (Yinzhihuang oral solution 30 mL?kg-1), medium dosage group (Yinzhihuang oral solution 20 mL?kg-1) and low dosage group (Yinzhihuang oral solution 10 mL?kg-1). All rats were given medicine via i.g. gtt for 10 days. ILI model was induced by intravenous injection of bacillus calmette-guerin vaccine (BCG) and lipopolysaccharides (LPS). The content of IL-6 and TNF-? were detected by ELISA. The levels of ALT, AST, MDA and SOD were detected by spectrophotometer. RESULTS:Compared with model group, the level of ALT, AST, MDA, IL-6 and TNF-? were decreased significantly in high dosage, medium dose and low dosage groups (P

Expressions of Chemokine Receptor CXCR3 and Its Ligand Interferon-?-Inducible Protein-10 in Lung Tissue of Asthmatic Model Mice and Their Significances / 实用儿科临床杂志

Objective To observe the expressions of the chemokine receptor CXCR3 and its ligand IFN-?-inducible protein-10(IP-10) in lung tissue of asthmatic model mice and to explore further the effect of dexamethasone(DEX)and bacillus Calmette-Guerin vaccine(BCG)on the expressions of CXCR3 and IP-10.Methods Forty Kunming mice were randomly divided into 4 groups:asthmatic group,DEX group,BCG group and control group,10 in each group.Mice were sensitized and challenged with ovalbumin (OVA) to establish asthmatic models.Ten mice in DEX group were administrated DEX (2 mg/kg) by abdomen injection 30 min before challenge (DEX group).Ten mice in BCG group were injected BCG(0.025 mg) intradermally 7,3,and 1 days before sensitization.The mice in control group mice were treated with 9 g/L saline instead of OVA.Mice of each group were executed 24 hours after the final challenge.Their lung tissue were paraffin embedded,sliced and stained by HE.The expressions of CXCR3 and IP-10 protein in lung tissue of mice were detected by immunohistochemistry.Results Distinct differences were discovered in the expressions of CXCR3(F=4.602 P=0.008) and IP-10(F=4.207 P=0.012) among the 4 groups.The expressions of CXCR3 and IP-10 in lung tissue of mice in asthmatic group were significantly higher than those in control group (Pa=0.002),while that in DEX group were significantly lower than that in asthmatic group (P=0.029,0.019).There were no significant difference between the BCG group and asthmatic group.Conclusions The chemokine receptor CXCR3 and its ligand IP-10 play an important roles in mechanisms in the pathogenesis of asthma.DEX and BCG can interfere the expressions of CXCR3 and IP-10 in varying degress.

Effect of Bacillus Calmette-guerin vaccine on apoptosis of lymphocytes in athmatic BALA/c mice / 中国呼吸与危重监护杂志

Objective To explore the effect of Bacillus Calmette guerin vaccine (BCG) on apoptosis of lymphocytes in asthmatic BALC/c mice Methods Asthmatic BALB/c mice model established by inhaling ovalbumin was treated by BCG Lymphocytes apopotic index and DNA damage index were determined by comet method and xylidine method,respectively Results Apoptosis index and DNA damage percentage of peripheral blood and BALF lymphocytes were significantly elevated after BCG treatment( P

An Experimental Study of Phyllanthus urinaria for Counteracting Immune Liver Injury in Mice / 中药新药与临床药理

Objective To evaluate the protective action of Phyllanthus orinaria(PU)for immune liver injury in mice.Methods Forty-eight NIH mice were allocated randomly to high-dose(HG)PU group,low-dose(LG)PU group,bifenbate group(BG),normal control group(NCG),and model group(MG).From the first day of establishing the models,20 g ? kg-1 of PU solution was given for gastric perfusion(GP)to HG PU group,10 g ? kg-1 of PU solution for GP to LG PU group,0.15 g?kg-1 of bifenbate solution for GP to BG group,and the equal amount of normal saline to the normal control group and the model group,qd for 12 days.Serum ALT level and visceral parameters of liver and spleen were determined,and the liver pathological feature was also examined.Results The ALT level,parameters of liver and spleen were markedly decreased in BG group(P 0.05).Conclusion PU has a good effect on counteracting the immune live injury in mice by markedly decreasing the activity of serum transaminase and visceral parameters of liver and spleen,and improving the necrosis of hepatic cells.