Computed Tomographic Findings of Dental Disease and Secondary Diseases of the Head Area in Client-Owned Domestic Rabbits (Oryctolagus cuniculus): 90 Cases.

Domestic rabbits have teeth that grow throughout the animal's life and are prone to disease. Clinical signs of dental disease in domestic rabbits are non-specific, and, therefore, a definitive diagnosis usually requires additional methods. This study was carried out on a group of 105 domestic rabbits aged 3 to 9 years. In total, 90 domestic rabbits with dental disease visible on CT images and other secondary diseases of the head area qualified for this study. Malocclusion was found in 57 (63.3%). Retrograde elongation of the tooth apices in the mandible was present in 39 (43.3%), and it was present in the maxilla in 48 (53%). Clinical tooth crowns were overgrown in 39 (43%). Dental abscesses were present in 54 (63%). Secondary to the presence of a dental abscess, osteomyelitis was found in 43 (79% of the animals with a dental abscess). Dental inflammatory resorption was found in 36 (40%). Secondary to dental disease, nasal cavity inflammation was found in 18 (20%). Otitis media was present in six (6.7%). The most common dental disease found in this study's animals was malocclusion secondary to abnormal clinical crown abrasion and abnormal tooth growth. In domestic rabbits, osteomyelitis is a common complication of dental abscesses. Computed tomography is an invaluable diagnostic method in the diagnosis of dental disease and secondary diseases of the head area, such as inflammation of the nasal cavities or otitis media, in pet rabbits.

Before and After: Attitude and Adverse Effects Induced by the First and Second Doses of mRNA BNT162b2 Vaccine among Healthcare Professionals in the First Weeks after Their Introduction in Poland.

BACKGROUND: In the last days of December 2020, the SARS-CoV-2 virus vaccine BNT162b2 (Comirnaty, Pfizer-BioNTech) was introduced, for the first time, for wide use in Poland. According to the vaccination schedule, healthcare workers were the first to receive the vaccine. The aim of this study was to analyse the attitudes of those who were determined to be vaccinated, with particular reference to their concerns, attitudes towards vaccination advocacy and sources of knowledge on vaccination, as well as the incidence of adverse reactions. METHODS: The study had a three-stage design. Respondents completed a self-administered questionnaire before receiving the 1st and 2nd vaccine doses and 2 weeks after receiving the 2nd dose. A total of 2247 responses were obtained (1340 responses in the first stage, 769 in the second and 138 in the third). RESULTS: The main source of knowledge on vaccination was the Internet (32%; n = 428). Of the respondents, 6% (n = 86) reported anxiety before the 1st dose of the vaccine, which increased to 20% (n = 157) before the 2nd dose. A declaration of willingness to promote vaccination among their families was made by 87% (n = 1165). Among adverse reactions after the 1st dose of the vaccine, respondents most frequently observed pain at the injection site (n = 584; 71%), fatigue (n = 126; 16%) and malaise (n = 86; 11%). The mean duration of symptoms was 2.38 days (SD 1.88). After the 2nd dose of vaccine, similar adverse reactions-pain at the injection site (n = 103; 75%), fatigue (n = 28; 20%), malaise (n = 22; 16%)-predominated among respondents. Those who declared having had a SARS-CoV-2 virus infection (p = 0.00484) and with a history of adverse vaccination reactions (p = 0.00374) were statistically more likely to observe adverse symptoms after vaccination. CONCLUSIONS: Adverse postvaccinal reactions are relatively common after Comirnaty vaccination but are usually mild and transient in nature. It is in the interest of public health to increase the knowledge of vaccine safety.

Diagnostic Challenges in Patients with Inborn Errors of Immunity with Different Manifestations of Immune Dysregulation.

Inborn errors of immunity (IEI), formerly known as primary immunodeficiency disorders (PIDs), are inherited disorders caused by damaging germline variants in single genes, which result in increased susceptibility to infections and in allergic, autoimmune, autoinflammatory, nonmalignant lymphoproliferative, and neoplastic conditions. Along with well-known warning signs of PID, attention should be paid to signs of immune dysregulation, which seem to be equally important to susceptibility to infection in defining IEI. The modern diagnostics of IEI offer a variety of approaches but with some problems. The aim of this review is to discuss the diagnostic challenges in IEI patients in the context of an immune dysregulation background.

Serum Impedance in Children with Recurrent Respiratory Infections.

The role of disturbed immunoglobulin content during recurrent respiratory tract infections (RTI) might escape recognition in practical children's diagnostics. This study aims to investigate the potential changes in serum impedance caused by a constellation of decreases in the immunoglobulin IgA, IgG, and IgM content in RTI. The control group consisted of children suffering from RTI without any evident decreases in immunoglobulins. Serum bioelectrical properties were measured using impedance spectroscopy and immunoglobulins with an immunoturbidimetric analyzer. We found that the magnitude of serum impedance was significantly smaller in the sick children with immunoglobulin deficiency when compared with those of normal immunoglobulin profile, 134.1 ± 12.8 Ω vs 141.2 ± 16.9 Ω, respectively. We conclude that serum impedance, a parameter easily measured, has the potential to unravel the immunological underlining of RTI, particularly frequent and troubling infections in children. Screening for immunological disturbance is essential for the prompt implementation of a targeted treatment.

Immunoglobulin G Deficiency in Children with Recurrent Respiratory Infections with and Without History of Allergy.

Recurrent respiratory tract infections (RTI) are one of the most common diseases in childhood. Frequent infections adversely affect the development of a child and may lead to suspicion of immunodeficiency. An additional allergy component is thought conducive to infection occurrence. In this study, we retrospectively assessed medical records of 524 children hospitalized with RTI. Patients were divided into two groups: RTI-alone (n = 394) and RTI with a history of allergy (n = 130). Overall, we found that a great majority of children with RTI had the immunoglobulin G within the normal limit, irrespective of allergy. A variable IgG deficiency, most often affecting IgG1, IgG3, and IgG4 subclass, was present in less than one-third of children. Proportions of specific IgG subclass deficiency, varying from about 10% to 40%, were similar in both RTI-alone and RTI-allergy groups. The only significant effect was a modestly smaller proportion of children with IgG4 deficiency in the RTI-allergy group when compared with the RTI-alone group. We also found that IgG deficiencies were age-dependent as their number significantly increased with children's age, irrespective of allergy. The results demonstrate a lack of distinct abnormalities in the immunoglobulin G profile which would be characteristic to a clinical history of allergy accompanying recurrent RTI in children. Thus, we conclude that the assessment of IgGs could hardly be of help in the differential diagnostics of the allergic background of RTI.

Primary Immunodeficiencies: Diseases of Children and Adults - A Review.

Primary immunodeficiencies (PIDs) belong to a group of rare congenital diseases occurring all over the world that may be seen in both children and adults. In most cases, genetic predispositions are already known. As shown in this review, genetic abnormalities may be related to dysfunction of the immune system, which manifests itself as recurrent infections, increased risk of cancer, and autoimmune diseases. This article reviews the various forms of PIDs, including their characterization, management strategies, and complications. Novel aspects of the diagnostics and monitoring of PIDs are presented.

[Recurrent respiratory tract infections in children]. / Nawracajace zakazenia dróg oddechowych u dzieci.

Respiratory diseases are among the most common disorders found in the clinical practice of every pediatrician. It is estimated that a total of 10-15% of children experience recurrent respiratory tract infections (RRTI). Unfortunately, there is no universal consensus on the definition of recurrent respiratory tract infections in children. In addition, the number of episodes taken into account to define the recurrent nature of infections varies depending on the disease (location of the ongoing infection) and its severity. The most commonly accepted definition is the occurrence of eight or more documented respiratory tract infections per year in preschool children (up to three years old) and six or more in children older than three years, in the absence of any pathological condition underlying recurrent infections. It is very important to select in the group of children suffering from RRTI those who may have primary immunodeficiency. The detailed medical history plays an important role. In cases of positive medical history for immunodeficiency, it is mandatory to conduct a detailed examination of the immune system.

[Management of acute gastroenteritis in children]. / Postepowanie w ostrej biegunce infekcyjnej u dzieci.

Acute gastroenteritis is one of the most common infection among children. An estimated 500 million children suffer from the condition worldwide each year. In developed countries the course of acute infectious diarrhea is relatively mild, symptoms usually resolve spontaneously within few days. Unfortunately high mortality rate is still a heavyweight problem in countries with low economic development. Acute diarrhea is defined as a change of the consistency of stools to loose or liquid and/ or increase of an amount of defecations to more than 3 during a day. Other symptoms of gastroenteritis include fever, nausea and vomiting. The most common cause of AGE are viruses, with rotavirus being the most frequent agent. The diagnose is based on medical interview, that include mainly precise information about duration and characteristic of occurred symptoms and epidemiological data. The most important part of diagnostic and therapeutic management is dehydration's assessment, which determine the severity of AGE and is used as one of the factors that decide about hospital admission. The majority of patients can be treated in an outpatients settings, hospitalization should be reserved for those requiring enteral or parenteral rehydration. Oral rehydration with hypoosmolar fluids is standard first-line treatment. Other effective procedures include administration of probiotics (Lactobacillus GG , Saccharomyces boulardii), racecadotril and diosmectite as antidiarrheals and ondansetron reducing the intensity of nausea and vomiting. Antibiotherapy should be only considered in exceptional situations. Acute diarrhea is commonly known medical problem, which can be easily treated by following simple, well-defined rules.

Disorders of Humoral Immunity in Children with IgG Subclass Deficiency and Recurrent Respiratory Infections.

Respiratory tract infections in children are one of the most common causes for medical consultations. When the infections are of recurring nature, they are a major reason for the diagnostics for primary immunodeficiency that is in about 65% of cases underlain by disorders of humoral immunity. This study seeks to retrospectively evaluate the history of recurrent respiratory tract infections in children with humoral disorders and the associations among deficiencies in the immune system components. We evaluated 394 children aged 3 months to 18 years. We found 49.5% (195 cases) of children with IgG deficiencies, all of whom had normal IgE levels. There were 8.4% (33 cases) of IgA deficiency, 7.4% (29 cases) of IgM insufficiency, and 4.1% (16 cases) of CD19+ cells deficiency. The elevated level of CD19+ cells was found in 27.7% (109 out of the 394 children). Immunoglobulin deficiencies often coexisted with a deficiency in another immunoglobulin class above outlined. There was an interdependence between IgA abnormality and IgG, IgG3, and IgG4 abnormalities as well as between IgM abnormality and IgG and IgG1 abnormalities. We conclude that respiratory tract infections in children are often underlain by a convergence of IgG with both IgA and IgM abnormal states. The physiopathological meaning of this convergence for the infection course and resulting functional respiratory changes remains elusive.

Analysis of differences between total IgG and sum of the IgG subclasses in children with suspected immunodeficiency - indication of determinants.

BACKGROUND: Deficits in disorders of humoral immunity associated with a deficit of antibodies are the most common primary immunodeficiency. Total IgG and IgG subclasses measurements are used to diagnose, differentiate and control in patients with primary and secondary immunodeficiencies. METHODS: The purpose of the study was to analyze the structure patients group according to difference between total IgG and sum of the IgG subclasses and to determine factors affecting the level of this difference. This study was based on data collected from 670 children referred to the Department of Clinical Immunology and Pediatrics in order to diagnose the immune disorders. For all children the level of the total of immunoglobulins IgG and of the IgG subclasses (IgG1, IgG2, IgG3, IgG4) were determined. The group of children was divided into subgroups according to gender, age (under 6 years of age, 6.5-12 years, and 12-18 years), and IgG abnormality (below the normal range, normal and above the normal range). In the patients group, the total IgG values were on average higher than sum of the IgG subclasses. RESULTS: Statistical analysis shown the all parameters under study (age, gender and IgG abnormality) influence statistically significant on the discrepancy between the sum of the IgG subclasses and total IgG. Assessment of IgG and IgG subclasses levels is based on different methods what causes the discrepancy between the sum of the IgG subclasses and total IgG. CONCLUSIONS: Standardization in that regard is crucial. In addition, we have shown the reliability of the results obtained. Despite the determination in two different laboratories and on different analyzers, as well as the freezing process does not affect the test results.