ABSTRACT
BACKGROUND AND AIMS: Early diagnosis of biliary atresia (BA), particularly distinguishing it from other causes of neonatal cholestasis (NC), is challenging. This study aimed to design and validate a predictive model for BA by using the data available at the initial presentation. METHODS: Infants presenting with NC were retrospectively identified from tertiary referral hospitals and constituted the model design cohort (n = 148); others were enrolled in a prospective observational study and constituted the validation cohort (n = 21). Clinical, laboratory, and abdominal ultrasonographic features associated with BA were assessed. A prediction model was developed using logistic regression and decision tree (DT) analyses. RESULTS: Three predictors, namely, gamma glutamyl transpeptidase (γGT) level, triangular cord sign (TC sign), and gallbladder abnormalities, were identified as factors for diagnosing BA in multivariate logistic regression, which was used to develop the DT model. The area under the receiver operating characteristic (ROC) curve (AUC) value for the model was 0.905, which was greater than those for γGT level, TC sign, or gallbladder abnormalities alone in the prediction of BA. CONCLUSION: A simple prediction model combining liver function and abdominal ultrasonography findings can provide a moderate and early estimate of the risk of BA in patients with NC.
Subject(s)
Biliary Atresia , Cholestasis , Gallbladder Diseases , Infant , Infant, Newborn , Humans , Biliary Atresia/diagnostic imaging , Biliary Atresia/complications , Retrospective Studies , Ultrasonography , Cholestasis/etiology , Early Diagnosis , Diagnosis, DifferentialABSTRACT
Macrophage-mediated inflammation plays essential roles in multiple-organ injury. Sinensetin (SNS) at least exhibits anti-inflammation, antioxidant, and antitumor properties. However, the underlying mechanism of SNS-targeted macrophage-mediated inflammation remains elusive. In the present study, our results showed that SNS suppressed lipopolysaccharide (LPS)-induced inflammation to ameliorate lung and liver injuries. Mechanistically, SNS significantly inhibited M1-type macrophage polarization and its NLRP3 inflammasome formation to significantly decrease tumor necrosis factor α (TNFα) and IL-6 expression, while increasing IL-10 expression. Moreover, SNS interacted and activated SIRT1 to promote NRF2 and its target gene SOD2 transcription, which subsequently decreased LPS-induced inflammation. SIRT1 knockdown impaired the effects of SNS on the inhibition of macrophage polarization, NLRP3 inflammasome formation, and NRF2/SOD2 signaling. Taken together, our results showed that SNS is a potential and promising natural active ingredient to ameliorate inflammatory injury via activating SIRT1/NRF2/SOD2 signaling.
ABSTRACT
Mycobacterium tuberculosis (MTB) as a causative organism of empyema thoracis is rare, especially in children. An 8-year-old boy with tuberculous empyema and no history of contact with tuberculosis presented with minimal symptoms other than mild deformity of the chest wall. He had been vaccinated with bacillus Calmette-Guérin. A chest CT scan demonstrated intrathoracic lymphadenopathy, thickened and calcified pleural rind and rib thickening adjacent to the empyema. The diagnosis was confirmed by post-operative histopathological examination, positive acid-fast stains and DNA PCR. In countries with a high burden of tuberculosis, MTB should be considered in the differential diagnosis of empyema despite minimal symptoms.
Subject(s)
Empyema, Tuberculous/diagnosis , Child , Chronic Disease , Diagnosis, Differential , Empyema, Tuberculous/diagnostic imaging , Humans , Male , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: Paragonimiasis, particularly hepatic paragonimiasis (HP), is a type of zoonotic parasitic disease rarely encountered in infants. There have been only a few reports of HP, and no case of HP has been reported in an infant. CASE PRESENTATION: A 15-month-old girl presented with persistent mild fever with a duration of 1 month, hepatomegaly, and low-density lesions in the right hepatic lobe on abdominal ultrasound and computer tomography. Pathological examination and serum antibody detection were performed to verify HP. The diagnosis of HP was established based on findings of Charcot-Leyden crystals on liver lesion biopsy and antibodies against paragonimus westermani detected by enzyme-linked immunosorbent assay. After initiation of praziquantel (75 mg/kg/day for 3 days), all clinical findings promptly improved and the patient was discharged. CONCLUSION: It is very important to consider paragonimiasis in the clinical examination of infants from an area with paragonimiasis epidemic presenting with fever, hepatomegaly, low-density lesions in the liver.
Subject(s)
Liver Diseases, Parasitic/diagnosis , Paragonimiasis/diagnosis , Female , Humans , InfantABSTRACT
BACKGROUND: Paragonimiasis infection has no specific symptoms or typical radiologic findings, leading to the possibility of misdiagnosis. Thus, the objective of this study was to analyze clinical and radiological features, and treatment outcome of paragonimiasis in children in Southwest China to improve the awareness of this disease. METHODS: We retrospectively reviewed the records of children diagnosed with paragonimiasis in West China Second University Hospital between 2005 and 2016. The confirmed diagnosis of paragonimiasis was based on epidemiology history and seropositivity for paragonimiasis and/or detection of paragonimus eggs. Clinical, laboratory, and imaging findings of patients were examined in order to summarize risk factors, clinical characteristics, and treatment outcomes of these patients. RESULTS: A total of 123 patients were included; of them 112 (91.1%) lived in villages and 72 (58.5%) had a history of consuming freshwater crabs. Patients with paragonimiasis most frequently showed respiratory symptoms, including cough (26.0%, 32/123) and tachypnea (16.3%, 20/123), and gastrointestinal symptoms, including abdominal pain (26.8%, 33/123), abdominal distention (22.8%, 28/123), and vomiting (13.0%, 16/123). Laboratory examination showed elevated white blood cell (WBC) counts in the peripheral blood in 89 (72.4%) patients and eosinophilia in 102 (82.9%) patients. Tuberculosis (TB) coinfection was found in 4 (3.3%) patients. Main imaging findings included: effusions (90.4%), lymphadenopathy (40.4%), pulmonary ground-glass opacities (36.2%), cystic lesions (18.1%), and pleural thickening (17.0%). Twenty-nine patients (23.6%) received more than 1 course of praziquantel (PZQ). Additionally, 4 (19.0%) of 21 patients who were discharged from the hospital without complete treatment required rehospitalization for residual serous effusions. Moreover, patients from pericardial effusion group showed longer hospital stays and less elevated WBC counts than those from nonpericardial effusion group. CONCLUSION: Paragonimiasis should be considered in patients from endemic areas, especially in those with gastrointestinal and/or respiratory symptoms, elevated WBC count, eosinophilia, and serous effusions. Additionally, longer hospital stay may be necessary in cases of paragonimiasis associated with pericardial effusions.
Subject(s)
Paragonimiasis/diagnosis , Paragonimiasis/therapy , Adolescent , Anthelmintics/administration & dosage , Biomarkers/blood , Biomarkers/cerebrospinal fluid , Child , Child, Preschool , China/epidemiology , Early Diagnosis , Endemic Diseases , Enzyme-Linked Immunosorbent Assay , Female , Humans , Infant , Length of Stay , Male , Paragonimiasis/epidemiology , Paragonimiasis/physiopathology , Patient Readmission , Pericardial Effusion/diagnosis , Pericardial Effusion/epidemiology , Pericardial Effusion/etiology , Pericardial Effusion/therapy , Praziquantel/administration & dosage , Retrospective Studies , ShellfishABSTRACT
Antecedentes/Objetivo. Describir el perfil epidemiológico de la portación nasal de cepas de Staphylococcus aureus (S. aureus), su resistencia a antibióticos y la presencia de los genes de leucocidina de Panton-Valentine (LPV) y mecA en niños en edad escolar que viven en zonas de gran altitud del sudoeste de China. Métodos. En el estudio transversal, se analizaron hisopados nasales de estudiantes a fin de detectar S. aureus. Se realizó la prueba de la reacción en cadena de la polimerasa (RCP) para identificar los genes de LPV y mecA. Resultados. Del total de 314 niños, se detectó S. aureus en el 5,10% (16/314). La resistencia de las cepas aisladas a la penicilina, eritromicina, clindamicina, rifampicina y cefoxitina fue del 100%, 81,3%, 81,3%, 0,0% y 6,3%, respectivamente. Ninguna de las cepas mostró resistencia a la vancomicina. Se detectó la expresión del gen mecA en 3 cepas aisladas, y 10 cepas aisladas dieron resultado positivo para el gen de LPV. Conclusión. Se detectó S. Aureus en el 5,10% (16/314) de la población del estudio; el 0,96% (3 /314) presentó S. Aureus resistente a la meticilina (SARM). Además, se detectó la expresión de los genes de LPV y mecA en 10 y 3 cepas aisladas, respectivamente.
Background/Aim. To describe the epidemiological profile of nasal carriage of Staphylococcus aureus (S. aureus) strains, its antibiotic resistance and mecA and Panton Valentine leukocidin (PVL) genes presence, in school children residing in high altitude areas of Southwestern China. Methods. The cross sectional study screened nasal swabs taken from students for S. aureus. PCR was performed to identify mecA and PVL genes. Results. Of the total 314 children 5.10% (16/314) was detected S. aureus. The resistance of isolated strains to penicillin, erythromycin, clindamycin, rifampicin and cefoxitin was 100%, 81.3%, 81.3%, 0.0%, and 6.3% respectively. No strains demonstrated resistance to vancomycin; expression of mecA gene was detected in 3 isolates and 10 isolates were PVL-positive. Conclusion. S. aureus was detected in 5.10% (16/314) of the study population; 0.96% (3/314) had methicillin resistant S. aureus (MRSA); expression of the mecA and PVL genes were detected in 3 and 10 isolates respectively.
Subject(s)
Humans , Male , Female , Child , Staphylococcus aureus/drug effects , Carrier State/microbiology , Nose/microbiology , Altitude , Staphylococcus aureus/isolation & purification , Staphylococcus aureus/genetics , Bacterial Proteins/genetics , Bacterial Toxins/genetics , China , Cross-Sectional Studies , Drug Resistance, Bacterial , Penicillin-Binding Proteins/genetics , Exotoxins/genetics , Leukocidins/geneticsABSTRACT
BACKGROUND/AIM: To describe the epidemiological profile of nasal carriage of Staphylococcus aureus (S. aureus) strains, its antibiotic resistance and mecA and Panton Valentine leukocidin (PVL) genes presence, in school children residing in high altitude areas of Southwestern China. METHODS: The cross sectional study screened nasal swabs taken from students for S.aureus. PCR was performed to identify mecA and PVL genes. RESULTS: Of the total 314 children 5.10% (16/314) was detected S.aureus. The resistance of isolated strains to penicillin, erythromycin, clindamycin, rifampicin and cefoxitin was 100%, 81.3%, 81.3%, 0.0%, and 6.3% respectively. No strains demonstrated resistance to vancomycin; expression of mecA gene was detected in 3 isolates and 10 isolates were PVL-positive. CONCLUSION: S. aureus was detected in 5.10% (16/314) of the study population; 0.96% (3/314) had methicillin resistant S.aureus (MRSA); expression of the mecA and PVL genes were detected in 3 and 10 isolates respectively.
ANTECEDENTES Y OBJETIVO: Describir el perfil epidemiológico de la portación nasal de cepas de Staphylococcus aureus (S. aureus), su resistencia a antibióticos y la presencia de los genes de leucocidina de Panton-Valentine (LPV) y mecA en niños en edad escolar que viven en zonas de gran altitud del sudoeste de China. MÉTODOS: Describir el perfil epidemiológico de la portación nasal de cepas de Staphylococcus aureus (S. aureus), su resistencia a antibióticos y la presencia de los genes de leucocidina de Panton-Valentine (LPV) y mecA en niños en edad escolar que viven en zonas de gran altitud del sudoeste de China. RESULTADOS: Del total de 314 niños, se detectó S. aureus en el 5,10% (16/314). La resistencia de las cepas aisladas a la penicilina, eritromicina, clindamicina, rifampicina y cefoxitina fue del 100%, 81,3%, 81,3%, 0,0% y 6,3%, respectivamente. Ninguna de las cepas mostró resistencia a la vancomicina. Se detectó la expresión del gen mecA en 3 cepas aisladas, y 10 cepas aisladas dieron resultado positivo para el gen de LPV. CONCLUSIÓN: Se detectó S. Aureus en el 5,10% (16/314) de la población del estudio; el 0,96% (3 / 314) presentó S. Aureus resistente a la meticilina (SARM). Además, se detectó la expresión de los genes de LPV y mecA en 10 y 3 cepas aisladas, respectivamente.
