Follow-up evaluation of the immunological status of children admitted for acute cerebral nervous system infections: a retrospective study (vol 47, 22, 2021)

background acute cerebral nervous system infections (ACNS) may cause death or severe complications even to promptly treated children. the role of the immune system in influencing the course and the outcome of meningitis has been studied but it is not yet completely understood. the aim of the research is to ascertain whether children who experienced ACNS infection had a normal immune system. methods patients under 18 years of age admitted at bambino gesu children from January 2006 till June 2016 for meningitis were asked to participate to the follow-up study. the immune status was evaluated both clinically and by laboratory investigations. results most of the patients over 3 years at follow up had at least one immunological alteration at follow-up evaluation (74%). considering ACNS infection etiology, certain pathogens were almost exclusive of patients affected by some immunological alteration, regardless of their age. discussion our preliminary results indicate that sub-clinical immunological defects may be associated to ACNS pediatric infections. moreover, to the best of our knowledges, this is the first study correlating pathogens to immune evaluation in ACNS infections. It is, however, important to underline the high frequency of persistent immunological alterations in the analyzed patients. further studies are needed to confirm our conclusions. conclusions we recommend an immunological assessment at follow up evaluation in children who experienced an ACNS infection

Different Innate and Adaptive Immune Responses to SARS-CoV-2 Infection of Asymptomatic, Mild, and Severe Cases

SARS-CoV-2 is a novel coronavirus, not encountered before by humans. The wide spectrum of clinical expression of SARS-CoV-2 illness suggests that individual immune responses to SARS-CoV-2 play a crucial role in determining the clinical course after first infection. Immunological studies have focused on patients with moderate to severe disease, demonstrating excessive inflammation in tissues and organ damage. In order to understand the basis of the protective immune response in COVID-19, we performed a longitudinal follow-up, flow-cytometric and serological analysis of innate and adaptive immunity in 64 adults with a spectrum of clinical presentations: 28 healthy SARS-CoV-2-negative contacts of COVID-19 cases; 20 asymptomatic SARS-CoV-2-infected cases; eight patients with Mild COVID-19 disease and eight cases of Severe COVID-19 disease. Our data show that high frequency of NK cells and early and transient increase of specific IgA, IgM and, to a lower extent, IgG are associated with asymptomatic SARS-CoV-2 infection. By contrast, monocyte expansion and high and persistent levels of IgA and IgG, produced relatively late in the course of the infection, characterize severe disease. Modest increase of monocytes and different kinetics of antibodies are detected in mild COVID-19. The importance of innate NK cells and the short-lived antibody response of asymptomatic individuals and patients with mild disease suggest that only severe COVID-19 may result in protective memory established by the adaptive immune response

The Developing Human Connectome Project: a minimal processing pipeline for neonatal cortical surface reconstruction

The Developing Human Connectome Project (dHCP) seeks to create the first 4-dimensional connectome of early life. Understanding this connectome in detail may provide insights into normal as well as abnormal patterns of brain development. Following established best practices adopted by the WU-MINN Human Connectome Project (HCP), and pioneered by FreeSurfer, the project utilises cortical surface-based processing pipelines. In this paper, we propose a fully automated processing pipeline for the structural Magnetic Resonance Imaging (MRI) of the developing neonatal brain. This proposed pipeline consists of a refined framework for cortical and sub-cortical volume segmentation, cortical surface extraction, and cortical surface inflation, which has been specifically designed to address considerable differences between adult and neonatal brains, as imaged using MRI. Using the proposed pipeline our results demonstrate that images collected from 465 subjects ranging from 28 to 45 weeks post-menstrual age (PMA) can be processed fully automatically; generating cortical surface models that are topologically correct, and correspond well with manual evaluations of tissue boundaries in 85% of cases. Results improve on state-of-the-art neonatal tissue segmentation models and significant errors were found in only 2% of cases, where these corresponded to subjects with high motion. Downstream, these surfaces will enhance comparisons of functional and diffusion MRI datasets, supporting the modelling of emerging patterns of brain connectivity

Persistent B cell memory after SARS-CoV-2 vaccination is functional during breakthrough infections

Breakthrough SARS-CoV-2 infections in fully vaccinated individuals are considered a consequence of waning immunity. Serum antibodies represent the most measurable outcome of vaccine-induced B cell memory. When antibodies decline, memory B cells are expected to persist and perform their function, preventing clinical disease. We investigated whether BNT162b2 mRNA vaccine induces durable and functional B cell memory in vivo against SARS-CoV-2 3, 6, and 9 months after the second dose in a cohort of health care workers (HCWs). While we observed physiological decline of SARS-CoV-2-specific antibodies, memory B cells persist and increase until 9 months after immunization. HCWs with breakthrough infections had no signs of waning immunity. In 3-4 days, memory B cells responded to SARS-CoV-2 infection by producing high levels of specific antibodies in the serum and anti-Spike IgA in the saliva. Antibodies to the viral nucleoprotein were produced with the slow kinetics typical of the response to a novel antigen

Using Narratives and Portraits to Foster Reflexivity and Learning from Experience in Healthcare Organizations in Italy and Norway

This chapter positions the narrative approach as consolidated practice in the field of organizational studies, and explores and expands its potential to detect the interpretations that practitioners make of the realities in which they live, thus to grasp their cultural, social, personal, practical features. The use of ad hoc narratives as an art-based method is discussed as a way to foster reflexivity and learning from experience. Narratives are presented with illustrative examples from two different healthcare fields as a means for detecting material and symbolic dimensions, the weaving of roles, objects, critical incidents, shifting points, routine in use, which can be elaborated on, developing negotiation and relational processes. The distinctive feature of this approach is the relational texture that develops around a narrative and reflexive space, which is a basic condition in our proposal of art-based intervention