ABSTRACT
OBJECTIVES: We aimed to analyze whether the expression of inflammatory and antiviral genes in respiratory syncytial virus (RSV)-infected infants' peripheral blood is associated with bronchiolitis progression. METHODS: We conducted a prospective study on 117 infants between 2015 and 2023. The expression levels of nine genes were quantified by quantitative polymerase chain reaction. Infants were classified according to their clinical evolution during hospital admission: (i) non-progression (n = 74), when the RSV bronchiolitis severity remained stable or improved; (ii) unfavorable progression (n = 43), when the RSV bronchiolitis severity increased. The association analysis was performed by logistic regression, adjusted by age, gender, prematurity, and RSV bronchiolitis severity in the emergency room. RESULTS: Infants were 57.3% male, and the median age of the study population was 61 days. Thirty-five infants (30.7%) were admitted to the intensive care unit after hospital admission. Univariate logistic models showed that tumor necrosis factor (TNFα) and chemokine (C-C motif) ligand (CCL5) gene expression at baseline were inversely associated with unfavorable progression, which was confirmed by multivariate analyses: TNFα (adjusted odds ratio = 0.8 [95% confidence interval = 0.64-0.99], P-value = 0.038) and CCL5 (adjusted odds ratio = 0.76 [95% confidence interval = 0.62-0.93], P-value = 0.007). CONCLUSIONS: An inadequate immune response to RSV, characterized by reduced gene expression levels of CCL5 and TNFα in peripheral blood, was associated with an unfavorable progression of RSV bronchiolitis.
Subject(s)
Bronchiolitis , Respiratory Syncytial Virus Infections , Respiratory Syncytial Virus, Human , Female , Humans , Infant , Male , Bronchiolitis/genetics , Bronchiolitis/complications , Bronchiolitis/metabolism , Chemokines , Gene Expression , Ligands , Prospective Studies , Respiratory Syncytial Virus Infections/genetics , Respiratory Syncytial Virus, Human/genetics , Tumor Necrosis Factor-alpha/geneticsABSTRACT
Las LTP (lipid transfer proteins) son una familia de proteínas presentes en diferentes alimentos. La sintomatología de la alergia a las LTP es muy variable, desde clínica leve hasta sistémica, en ocasiones, presentando síntomas únicamente en presencia de cofactores. Se presenta el caso de una paciente de 11 años que acude a urgencias con clínica de anafilaxia tras ingesta previa de fruta mientras realizaba ejercicio físico, destacando la importancia de la historia clínica y la sospecha diagnóstica en el enfoque de esta entidad (AU)
LTP (lipid transfer proteins) are a family of proteins present in different foods. The symptomatology of allergy to LTP is highly variable, ranging from mild to systemic. Sometimes, symptoms are only present in the presence of cofactors.We present the case of an 11-year-old female patient who presented to the emergency department with anaphylaxis following previous ingestion of fruit while doing physical exercise, highlighting the importance of the clinical history and diagnostic suspicion in the approach to this entity. (AU)
Subject(s)
Humans , Female , Child , Food Hypersensitivity/diagnosis , Food Hypersensitivity/drug therapy , Anaphylaxis/etiology , Fruit/adverse effects , Risk FactorsABSTRACT
El desprendimiento de retina es una patología infrecuente en Pediatría y presenta diferencias con respecto a los casos que se dan en la edad adulta. Predomina en varones escolares. El subtipo más frecuente es el regmatógeno y la principal causa son los traumatismos, sin olvidar otras causas como las sindrómicas y lesiones no accidentales. El abordaje de esta patología es quirúrgico, aunque el éxito anatómico de la cirugía no implica buen resultado funcional. Presentamos el caso de un niño en el que se detectó una disminución unilateral importante de la agudeza visual en consulta programada (AU)
The retinal detachment is an infrequent pathology in pediatrics and presents differences with the cases that occur in adulthood. It predominates in school-age boys. The most frequent subtype is rhegmatogenous and the main cause is trauma, without forgetting other causes such as syndromic and non-accidental injuries. The approach to this pathology is surgical, although the anatomical success of the surgery does not imply a good functional result. We present the case of a child in whom a significant unilateral decrease in visual acuity was detected in a scheduled consultation (AU)
