Intestinal Batf3-dependent dendritic cells are required for optimal antiviral T-cell responses in adult and neonatal mice.

Although we know a great deal about which types of dendritic cells (DCs) promote T-cell priming in the periphery, less is known about which DC subset(s) provoke antiviral responses within the gut. Here we report that conventional Zbtb46-dependent DCs were critically required for antiviral CD8+ T-cell responses against rotavirus (RV), the major cause of childhood gastroenteritis worldwide. Furthermore, we found that in adult mice, Batf3-dependent DCs were required for generating optimal RV-specific CD8+ T-cell responses. However, in contrast to mice that lack Zbtb46-dependent DCs, a significant amount of interferon gamma-producing RV-specific CD8+ T cells were still detected in the small intestine of RV-infected adult Batf3-/- mice, suggesting the existence of compensatory cross-presentation mechanisms in the absence of Batf3-dependent DCs. In contrast to adult mice, we found that Batf3-dependent DCs were absolutely required for generating RV-specific CD8+ T-cell responses in neonates. Loss of Batf3-dependent DCs also resulted in a skewed polyclonal CD4+ T-cell response in both adult and neonatal mice upon RV infection, although local and systemic RV-specific immunoglobulin A production kinetics and titers were unimpaired. Our results provide insights that inform early-life vaccination strategies against RV infection.

A role for mucosal IL-22 production and Th22 cells in HIV-associated mucosal immunopathogenesis.

Interleukin-22 (IL-22) is a cytokine with epithelial reparative and regenerative properties that is produced by Th22 cells and by other immune cell subsets. Therefore, we explored the hypothesis that disruption of the gut barrier during HIV infection involves dysregulation of these cells in the gastrointestinal mucosa. Sigmoid IL-22-producing T cell and Th22 cells were dramatically depleted during chronic HIV infection, epithelial integrity was compromised, and microbial translocation was increased. These alterations were reversed after long-term antiretroviral therapy. While all mucosal IL-22-producing T-cell subsets were also depleted very early during HIV infection, at these early stages IL-22 production by non-T-cell populations (including NKp44+ cells) was increased and gut epithelial integrity was maintained. Circulating Th22 cells expressed a higher level of the HIV co-receptor/binding molecules CCR5 and α4ß7 than CD4+ T-cell subsets in HIV-uninfected participants, but this was not the case after HIV infection. Finally, recombinant IL-22 was protective against HIV and tumor necrosis factor-α-induced gut epithelial damage in a validated in vitro gut epithelial system. We conclude that reduced IL-22 production and Th22 depletion in the gut mucosa are important factors in HIV mucosal immunopathogenesis.

Enfermedad obstructiva del tracto biliar. / Obstructive disease of the biliary tract

Se estudiaron las historias clinicas de 323 pacientes intervenidos por enfermedad obstructiva del tracto biliar en el Hospital Universitario del Valle (HUV), Cali, Colombia. Tenian enfermedad biliar obtructiva sin colangitis 203 (62.8%) pacientes y 120 (37.2%) tenian colangitis.Los sintomas y signos mas frecuentes fueron: colico biliar, vomito, defensa en el cuadrante superior derecho del abdomen, signo de Murphy positivo, ictericia y fiebre.Se encontro elevacion de las bilirrubinas en 66.6% de los pacientes. La colangiografia transparietohepatica percutanea solo se practico a 7.1% de los pacientes. En 9.9% habia enfermedad maligna y en 6.2% de los pacientes no se encontro obstruccion del tracto biliar ni enfermedad vesicular. Se encontro una relacion directa entre el grado de inflamacion y la frecuencia de complicaciones postoperatorias.A mayor inflamacion mayor numero de complicaciones, En los 323 pacientes operados se presentaron 131 (40.5%) complicaciones y la mortalidad global fue 3,1%

Practical rules to furnish death certificates / .caciones y mortalidad en el Hospital Universitario del Valle.

Se analizaron 69 pacientes a quienes se legal fornecido pelo Ministerio da Saude.de Oddi entre 1975 y 1984. Eran mayores de 40 anos 63.8%. La proporcion de mujeres a hombres fue 1.8:1. Los sintomas y signos fueron los clasicos que se presentan en pacientes con enfermedad del tracto biliar La historia clinica y los examenes de laboratorio permitieron hacer el diagnostico en una gran proporcion de casos.Los examenes radiologicos convencionales suminise de competencia do Instituto Medico Legal ciones mas frecuentes de esfinteroplastia fueron: litiasis multiple del coledoco y vias biliares, calculo enclavado en la ampolla y litiasis multiple del coledoco mas estenosis del esfinter de Oddi. La presencia de colangitis no fue una contraindicacion para practicar la esfinteroplastia que se realizo en 20,3% de pacientes con esta enfermedad. Se presentaron 27 complicaciones en el grupo, es decir, 39,1%. Murio 1 (1.4%) paciente de 59 anos de edad en septicemia y shock septico.}

Enfermedad vesicular: diagnostico, complicaciones y mortalidad en el Hospital Universitario del Valle. / Gallbladder disease: diagnosis, complications and mortality in the Hospital Universitario del Valle

Se analizan las historias clinicas de 448 pacientes operados con diagnostico de enfermedad vesicular entre 1975 y 1979 en el Hospital Universitario del Valle (HUV) en Cali, Colombia. De los pacientes 54.5%.eran mayores de 40 anos y la proporcion de mujeres a hombres fue 5:1. El 90% de los enfermos referia como antecedente dolor abdominal tipo colico.Los sintomas mas comunes fueron dolor abdominal, vomito e intolerancia a los alimentos con grasas y los signos mas frecuentes defensa en el cuadrante superior derecho, signo de Murphy positivo y fiebre. En 10% de los casos hubo ictericia demostrada por laboratorio: solo se hizo colecistografia oral a 50% de los pacientes. El 46.7% de los pacientes tenia colecistitis cronica y el 46.2% colecistitis aguda. El ileo biliar se presento en 0.9% de los pacientes e igual frecuencia se encontro para el carcinoma de la vesicula. Se le practico colecistectomia a 99.6% de los pacientes y no se les dejo drenaje a 86.2%. Los germenes aislados mas frecuentes fueron: Escherichia coli, estreptococos y Klebsiella spp. Las complicaciones postoperatorias fueron minimas y la mortalidad fue 0.9%

[The menstrual cycle and sexual relations in users of the IUD and periodic abstinence]. / Ciclo menstrual y relaciones sexuales en usuarias de dispositivo intrauterino y continencia periodica.

PIP: A prospective survey was carried between January 1974 and February 1975 among 31 fertile women with a previous history of at least 1 normal term delivery who were using IUD. 65 women using natural family planning (NFP) served as the control group and had similar age and fertility characteristics. 198 cycles corresponded with the users of NFP as compared to 112 in the IUD users. The mean of sexual intercourse in the ovulatory phase was significantly higher than that of the preovulatory phase in IUD cases. Among NFP users, coital frequency was similar during both the preovulatory and postovulatory phases. The hyperthermic phase measured from the basal body temperature (BBT) chart lasted 13.585 days in the IUD users as compared with 12.622 in users of NFP (p0.01). The preovulatory phase in IUD users was 16.95 days as compared with 14.27 days in NFP users (P0.001). Related to the BBT chart, we found that in 64% of all cases of NFP women, the BBT pattern did drop on the 1st menses day as compared with 65% of all cases of IUD women whose BBT charts did not show a drop on that day (P0.001). The findings about sexual activity (increased libido associated with the ovulatory period) among IUD users concur with the opinion of several authors. Changes in the duration of the preovulatory and postovulatory phases suggest endocrine changes in IUD cases. The pattern of BBT drop suggest the possibility of higher proportions of early pregnancy losses among IUD users. (author's)^ieng