ABSTRACT
The host immune system is engaged in a constant battle with microorganisms, with the immediate detection of pathogenic invasion and subsequent signalling acting as crucial deterrents against the establishment of a successful infection. For this purpose, cells are equipped with a variety of sensors called pattern recognition receptors (PRR), which rapidly detect intruders leading to the expression of antiviral type I interferons (IFN). Type I IFN are crucial cytokines which exert their biological effects through the induction of hundreds of IFN-stimulated genes (ISGs). The expression profile of these ISGs varies depending on the virus. For a small subset of ISGs, their anti- or even proviral effects have been revealed, however, the vast majority are uncharacterised. The spotlight is now on herpesviruses, with their large coding capacity and long co-evolution with their hosts, as a key to understanding the impact of ISGs during viral infection. Studies are emerging which have identified multiple herpesviral antagonists specifically targeting ISGs, hinting at the significant role these proteins must play in host defence against viral infection, with the promise of more to come. In this review, we will discuss the current knowledge of the complex interplay between ISGs and human herpesviruses: the antiviral role of selected ISGs during herpesviral infections, how herpesviruses antagonise these ISGs and, in some cases, even exploit them to benefit viral infection.
ABSTRACT
INTRODUCTION: There is no clear consensus on the management of accidental ingestion of caustic substances in paediatrics. The aim of this study was to determine the profile of the paediatric population treated due to caustic ingestion in a Healthcare Centre. PATIENTS AND METHOD: A descriptive study was conducted on patients treated for the ingestion of caustic substances in our hospital during the period 2008-2011. RESULTS: A total of 12 patients were treated, with a mean age of 3.8 years (1-13 years), with the majority males (58.8%). An alkaline product was ingested by 58.3%, and an acid by 41.6%. The majority (58.3%) did not refer to symptoms and the remainder referred to vomiting (33.3%), odynophagia (16.6%), haematemesis (8.3%), hyper-salivation (8.3%) and shortness of breath (8.3%). Oral cavity lesions were observed in 75% of cases. All, except one, were accidental. An endoscopy was performed on all of them (100%) between 12 and 24hours post-ingestion, with pathological findings in 41.6%. In the group that ingested an alkali, 2 (16.6%) patients had lesions, one a grade 2B and one a grade 3 oesophagitis. In the acid ingestion group, 4 (33.3%) patients had lesions; one grade 1-2A oesophagitis, two acute non-erosive gastritis, and one acute haemorrhagic gastritis. A follow-up endoscopy was performed depending on the previous endoscopic findings. Only two patients presented with complications. CONCLUSIONS: Emphasis is placed on the endoscopic evaluation in the first 24hours of deliberate asymptomatic ingestions, as well as a strict follow-up in those that ingested acids, due to delayed associated lesions.
Subject(s)
Burns, Chemical/etiology , Caustics/toxicity , Endoscopy/methods , Esophageal Stenosis/chemically induced , Adolescent , Burns, Chemical/diagnosis , Burns, Chemical/pathology , Caustics/chemistry , Child , Child, Preschool , Esophageal Stenosis/pathology , Esophagitis/chemically induced , Esophagitis/diagnosis , Esophagitis/pathology , Female , Follow-Up Studies , Gastritis/chemically induced , Gastritis/diagnosis , Gastritis/pathology , Humans , Infant , Male , Time FactorsABSTRACT
Introdución: La ingesta accidental de cáusticos en pediatría no dispone de un consenso claro de actuación. El objetivo de este estudio fue caracterizar la población pediátrica atendida por ingesta de cáusticos en un centro asistencial. Pacientes y método: Estudio descriptivo de los pacientes atendidos en nuestro hospital por la ingesta de cáusticos durante el período 2008-2011. Resultados: Se atendieron 12 pacientes, edad media de 3,8 años (1-13 años). Predominio de varones (58,8%). Un 58,3% ingirió producto alcalino y un 41,6% ácido. El 58,3% no refería sintomatología, el resto refirió vómitos (33,3%), odinofagia (16,6%), hematemesis (8,3%), sialorrea (8,3%) y dificultad respiratoria (8,3%). El 75% presentaron lesiones en la cavidad oral. Todos, salvo un caso, fueron accidentales. Se realizó endoscopia al 100% entre las 12 y 24 h postingesta con hallazgos patológicos en un 41,6%. En el grupo ingesta de álcalis 2 pacientes presentaron lesiones (16,6%): una esofagitis grado 2B y una grado 3. En el grupo ingesta de ácidos 4 pacientes (33,3%) presentaron lesiones: una esofagitis aguda grado 1-2A, 2 gastritis agudas no erosivas y una gastritis aguda hemorrágica. Se realizó endoscopia de control según los hallazgos endoscópicos previos. Solo 2 presentaron complicaciones posteriores. Conclusiones: Destacamos la valoración endoscópica en las primeras 24 h en todas las ingestas sintomáticas y deliberadas, así como la reevaluación estrecha en las ingestas ácidas, por asociar lesiones diferidas.
Introduction: There is no clear consensus on the management of accidental ingestion of caustic substances in paediatrics. The aim of this study was to determine the profile of the paediatric population treated due to caustic ingestion in a Healthcare Centre. Patients and method: A descriptive study was conducted on patients treated for the ingestion of caustic substances in our hospital during the period 2008-2011. Results: A total of 12 patients were treated, with a mean age of 3.8 years (1-13 years), with the majority males (58.8%). An alkaline product was ingested by 58.3%, and an acid by 41.6%. The majority (58.3%) did not refer to symptoms and the remainder referred to vomiting (33.3%), odynophagia (16.6%), haematemesis (8.3%), hyper-salivation (8.3%) and shortness of breath (8.3%). Oral cavity lesions were observed in 75% of cases. All, except one, were accidental. An endoscopy was performed on all of them (100%) between 12 and 24 hours post-ingestion, with pathological findings in 41.6%. In the group that ingested an alkali, 2 (16.6%) patients had lesions, one a grade 2B and one a grade 3 oesophagitis. In the acid ingestion group, 4 (33.3%) patients had lesions; one grade 1-2A oesophagitis, two acute non-erosive gastritis, and one acute haemorrhagic gastritis. A follow-up endoscopy was performed depending on the previous endoscopic findings. Only two patients presented with complications. Conclusions: Emphasis is placed on the endoscopic evaluation in the first 24 hours of deliberate asymptomatic ingestions, as well as a strict follow-up in those that ingested acids, due to delayed associated lesions.
