Arterial immune protein expression demonstrates the complexity of immune responses in Kawasaki disease arteritis.

A more complete understanding of immune-mediated damage to the coronary arteries in children with Kawasaki disease (KD) is required for improvements in patient treatment and outcomes. We recently reported the transcriptional profile of KD coronary arteritis, and in this study sought to determine protein expression of transcriptionally up-regulated immune genes in KD coronary arteries from the first 2 months after disease onset. We examined the coronary arteries of 12 fatal KD cases and 13 childhood controls for expression of a set of proteins whose genes were highly up-regulated in the KD coronary artery transcriptome: allograft inflammatory factor 1 (AIF1), interleukin 18 (IL-18), CD74, CD1c, CD20 (MS4A1), Toll-like receptor 7 (TLR-7) and Z-DNA binding protein 1 (ZBP1). Immunohistochemistry and immunofluorescence studies were performed to evaluate protein expression and co-localization, respectively. AIF1 was expressed transmurally in KD arteritis and localized to macrophages and myeloid dendritic cells. CD74, which interacts with major histocompatibility complex (MHC) class II on antigen-presenting cells, localized to the intima-media. CD1c, a marker of myeloid dendritic cells, was expressed in a transmural pattern, as were IL-18 and CD20. ZBP1 and TLR-7 were up-regulated compared to controls, but less highly compared to the other proteins. These findings provide evidence of antigen presentation and interferon response in KD arteritis. In combination with prior studies demonstrating T lymphocyte activation, these results demonstrate the complexity of the KD arterial immune response.

Procedimiento enfermero en criocirugía prostática / No disponible

Se nos presenta una técnica de cirugía mínimamente invasiva que, sin perder eficacia, ofrece múltiples ventajas para el paciente y para la Administración. De la adopción de esta técnica nace una serie de cuestiones como el aprendizaje de la técnica y su aparataje y la necesidad de crear una herramienta de trabajo (procedimiento enfermero) con un triple objetivo claro y definido, consistente en ayudar a la enfermera quirúrgica en su trabajo, aumentar el beneficio para el paciente y coordinarse correctamente con el resto del equipo quirúrgico. Dicho proceder se desarrolla a lo largo del artículo, concluyendo los autores que el trabajo de enfermería es fundamental e insustituible en el equipo quirúrgico para conseguir resultados óptimos con alta calidad y coordinar todos los recursos humanos y materiales capaces de proporcionar cuidados sanitarios a la población (AU)

A technique of minimumly invasive surgery appears to us, that without losing effectiveness, offers manifold advantages for the patient and the administration. Of the adoption of this technique a series of questions like the learning of the technique and its instruments is born and the necessity to create a tool of work (procedure nurse) with three clear and defined objective triple, consisting of helping to the surgical nurse in their work, increasing to the benefit the patient and to coordinate itself correctly with the rest of the surgical team. Concluding the authors who the work of infirmary is fundamental and irreplaceable in the surgical team to obtain optimal results with high quality and to coordinate all the human and material resources able to provide sanitary cares to the population (AU)