TLR4 and TLR9 Expression in Different Phenotypes of Rhinitis

Background. Toll-like receptors (TLRs) represent a family of evolutionarily conserved proteins, that represent a fundamental link between innate and adaptive immune responses. Aim. The purpose of this study was to investigate the expression of TLR4 and TLR9 in the normal nasal mucosa and in the mucosa of subjects with different phenotypes of rhinitis. Methodology. A confocal analysis of TLR4 and TLR9 (co)expression was carried out on biopsies from the inferior turbinate obtained from 4 patients affected by persistent allergic rhinitis, 8 patients with chronic rhino-sinusitis, and 6 patients with vasomotor rhinitis The results were compared with those of specimens obtained from 4 subjects undergoing nasal surgery, but with signs of nasal inflammation. Results. TLR4 and TLR9 were expressed in the healthy nasal mucosa; TLR4 and TLR9 expression was significantly decreased in allergic rhinitis. TLR4 was over expressed in the epithelium of chronic rhino-sinusitis. Both TLRs were co-expressed in the sub-epithelial infiltrate of chronic and vasomotor rhinitis, even though this expression was higher in the former compared with the latter. Conclusions. This study indicates that TLR4 and TLR9 show a different pattern of expression in different phenotypes of rhinitis, possibly related to the type and severity of the disease

COVID-19 and cutaneous manifestations: Two cases and a review of the literature

COVID-19 can affect multiple organs, including skin. A wide range of skin manifestations have been reported in literature. Six main phenotypes have been identified: i) urticarial rash, ii) confluent erythematous/maculopapular/morbilliform rash, iii) papulovesicular exanthem, iv) a chilblain-like acral pattern, v) a livedo reticularis/racemosa-like pattern, and vi) a purpuric vasculitic pattern. The pathogenetic mechanism is still not completely clear, but a role of hyperactive immune response, complement activation and microvascular injury have been postulated. The only correlation between the cutaneous phenotype and the severity of COVID-19 has been observed in the case of chilblain-like acral lesions, that is generally associated with the benign/subclinical course of COVID-19. Herein, we report two cases of SARS-CoV- 2 infection in patients who developed cutaneous manifestations that completely solved with systemic steroids and antihistamines. The first case is a female patient not vaccinated for SARS-CoV-2 with COVID-19 associated pneumonia, while the second case is a vaccinated female patient with only skin manifestations

Requirements for acquiring a high-quality house dust mite extract for allergen immunotherapy

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Elderly hypertensive patients: Silent white matter lesions, blood pressure variability, baroreflex impairment and cognitive deterioration

Introduction: Hypertension may increase the risk for stroke and is frequently associated with subcortical and periventricular white matter lesions (WML). This is considered a prognostic factor for the development of stroke and cognitive impairment, particularly in attention processes. Additionally, in elderly subjects, it is known the implications of alterations in the neural cardiovascular regulation and the cardiovascular risk. Aims: To evaluate, in asymptomatic elderly hypertensives, the association of ambulatory blood pressure values and autonomic activity with neurocognitive impairment and WML. In addition, we also evaluated the role of the autonomic nervous system particularly the vagal component, in the pathogenesis of white matter lesions. Methods: We studied 22 elderly essential hypertensive patients (69±1.1y) and as control group, 16 normotensive elderly subjects (age 67±3.2y) were also enrolled. To each one of them, a cerebral MRI was performed to classify them, by a neuro-radiologist blinded of the subject clinical status, using a 0 to 9 scale where 0 denoted no WML and 9 the most severe lesions. Twenty four hours arterial blood pressure monitoring was performed to each one of the subjects under study. Office blood pressure was measured 3 times and the mean value reported. Beat to beat finger arterial pressure monitoring (Finapres) was performed for a 2h period. During the first hour the patient remained lying supine in a quiet darkened room and during the second hour four manoeuvres: stand-up, cold pressor test, handgrip and quiet activity were randomly performed. Mean blood pressure and pulse interval values, from the two periods, and their respective variabilities, baroreflex sensitivity and power spectral analysis were calculated. Regarding neuropsychological assessment: Minimental test, attention evaluation, RAVLT, visual memory, language and executive function, geriatric depression scale, cognitive deficit rate tests were performed in all subject. Results: We found a closer correlation of WML with 24hs ABPM than with office BP readings being more evident with systolic blood pressure during the night time period. WML failed to show any correlation with SBP average values derived from the Finapres recordings in either the supine or the upright position, while it was positively and significantly related to PP in both conditions. However, beat to beat SBP variability, either in the supine or in the upright position, showed a positive and significant correlation with WML. During the resting period, BRS calculated through the sequence method (Time Domain) was similar in HT and NT subjects. However when BRS was assessed in the frequency domain a significant reduction was observed in HT compared with NT. In addition, At the time of laboratory manoeuvres implying sympathetic activation, BRS was significantly reduced as compared to the resting values being particularly evident for the HF values. In hypertensive subjects, only semantic fluency showed a significant difference (p=0.01), when compared to normotensives. When the patients were divided in older and younger than 75 years, a significant difference was observed in the delayed analysis of words, and in the phonological fluency showing a significant higher rate of pathological results in the group of patients older than 75 years. Conclusions: As previously shown, incidental WML, suggestive of silent cerebrovascular disease, is a frequent finding in elderly hypertensives. Night-time BP mean values and SBP variability in upright position seems to be the best predictor on silent cerebral WML. The vagal component of the autonomic nervous system seems to be involved in the pathogenesis of these lesions. Finally, the neurocognitive alterations are multifactorial in origin where the aging process seems to be the principal component.Fil: Ramírez, Agustín José. Fundación Favaloro; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Parati, Gianfranco. San Gerardo Hospital; Italia. University of Milan-Bicocca; ItaliaFil: Castiglioni, Paolo. Fondazione Don Gnocchi; ItaliaFil: Consalvo, Damian. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos "Ramos Mejía"; ArgentinaFil: Solis, Patricia Cristina Lourdes. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos "Ramos Mejía"; ArgentinaFil: Risk, Marcelo. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Computación; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Waissman, Paola. Fundación Favaloro; ArgentinaFil: di Rienzo, Marco. Fondazione Don Gnocchi; ItaliaFil: Mancia, Giusepe. San Gerardo Hospital; Italia. University of Milan-Bicocca; ItaliaFil: Sanchez, Ramiro A.. Fundación Favaloro; Argentin

IgE antibody repertoire in nasal secretions of children and adults with seasonal allergic rhinitis: A molecular analysis

Background: There is growing interest both in testing IgE in nasal secretions (NS) and in molecular diagnosis of seasonal allergic rhinitis (SAR). Yet, the reliability of nasal IgE detection with the newest molecular assays has never been assessed in a large cohort of pollen allergic patients. Objective: To investigate with microarray technology and compare the repertoires of specific IgE (sIgE) antibodies in NS and sera of a large population of children and adults with SAR. Methods: Nasal secretions were collected with an absorbent device (Merocel 2000®, Medtronic) and a minimal dilution procedure from 90 children and 71 adults with SAR. Total IgE (tIgE) (ImmunoCAP, Thermo Fisher Scientific (TFS)) and sIgE antibodies against 112 allergen molecules (ISAC-112, TFS) were measured in NS and serum. Results: Nasal sIgE was detectable in 68.3% of the patients. The detected nasal sIgE antibodies recognized airborne (88%), vegetable (10%), and animal food or other (<1%) allergen molecules. The prevalence and average levels of sIgE in NS and serum were highly interrelated at population level. A positive nasal sIgE antibody to a given molecule predicted the detection of the same antibody in the patient's serum with a specificity of 99.7% and a sensitivity of 40%. Conclusions: The concentration of sIgE is much lower in nasal secretions than in the serum. sIgE assays with very high analytical sensitivity and sampling methods with minimal dilution will be therefore needed to validate nasal secretions as alternative to serum in testing the sIgE repertoire

La interpretación historiográfica de Juan Bautista Bustos y el federalismo en la obra de Carlos Segreti

Aquí realizo un abordaje en las investigaciones de Carlos Segreti en problematizar la distinción entre federación y confederación. Por lo que analiza las tendencias centralistas y federalistas en las guerras civiles y las luchas de facción entre las elites. El caudillo Juan Bautista Bustos tiene un lugar privilegiado en su obra.Fil: Reyna Berrotarán, Denise. Universidad Nacional de Córdoba. Facultad de Filosofía y Humanidades. Escuela de Historia; Argentina.Fil: Giletta, Matías. Universidad Nacional de Córdoba. Facultad de Filosofía y Humanidades. Escuela de Historia; Argentina.Fil: Di Rienzo, Gloria. Universidad Nacional de Córdoba. Facultad de Filosofía y Humanidades. Escuela de Historia; Argentina.Fil: Canciani Vivanco, Verónica. Universidad Nacional de Córdoba. Facultad de Filosofía y Humanidades. Escuela de Historia; Argentina.Fil: Philp, Marta. Universidad Nacional de Córdoba. Facultad de Filosofía y Humanidades. Escuela de Historia; Argentina.Fil: Escudero, Eduardo. Universidad Nacional de Córdoba. Facultad de Filosofía y Humanidades. Escuela de Historia; Argentina.Fil: González, Alejandra Soledad. Universidad Nacional de Córdoba. Facultad de Filosofía y Humanidades. Escuela de Historia; Argentina.Fil: Rojas, Agustín. Universidad Nacional de Córdoba. Facultad de Filosofía y Humanidades. Escuela de Historia; Argentina.Fil: Bonvillani, Paola. Universidad Nacional de Córdoba. Facultad de Filosofía y Humanidades. Escuela de Historia; Argentina.Otras Historia y Arqueologí

La concepción del federalismo y el caudillo Juan Bautista Bustos en la obra de Carlos Segreti

Este capítulo significa un intento por avanzar en las investigaciones del historiador Carlos Segreti en reconstruir el federalismo argentino en diferentes dimensiones: local y nacional. Profundizando los orígenes del federalismo en el país retoma la significatividad del caudillo Juan Bautista Bustos en relación a un actuación como gobernador dictando una constitución que será influyente en la Constitución nacional de 1853. Las bases jurídicas sentadas por estos hechos representan, para Segreti, el elemento esencial de la nación argentina.Fil: Reyna Berrotarán, Denise. Universidad Nacional de Córdoba. Facultad de Filosofía y Humanidades. Escuela de Historia; Argentina.Fil: Giletta, Matías. Universidad Nacional de Villa María; Argentina.Fil: Di Rienzo, Gloria. Universidad Nacional de Córdoba. Facultad de Filosofía y Humanidades. Escuela de Historia; Argentina.Fil: Canciani Vivanco, Verónica. Universidad Nacional de Córdoba. Facultad de Filosofía y Humanidades. Escuela de Historia; Argentina.Fil: Philp, Marta. Universidad Nacional de Córdoba. Facultad de Filosofía y Humanidades. Escuela de Historia; Argentina.Fil: Escudero, Eduardo. Universidad Nacional de Córdoba. Facultad de Filosofía y Humanidades. Escuela de Historia; Argentina.Fil: González, Alejandra Soledad. Universidad Nacional de Córdoba. Facultad de Filosofía y Humanidades. Escuela de Historia; Argentina.Fil: Rojas, Agustín. Universidad Nacional de Córdoba. Facultad de Filosofía y Humanidades. Escuela de Historia; Argentina.Fil: Tobares, Javier. Universidad Nacional de Córdoba. Facultad de Filosofía y Humanidades. Escuela de Historia; Argentina.Fil: Bonvillani, Paola. Universidad Nacional de Córdoba. Facultad de Filosofía y Humanidades. Escuela de Historia; Argentina.Otras Historia y Arqueologí

Erratum to nodal management and upstaging of disease. Initial results from the Italian VATS Lobectomy Registry

[This corrects the article DOI: 10.21037/jtd.2017.06.12.]

Admixture in Latin America: Geographic Structure, Phenotypic Diversity and Self-Perception of Ancestry Based on 7,342 Individuals

The current genetic makeup of Latin America has been shaped by a history of extensive admixture between Africans, Europeans and Native Americans, a process taking place within the context of extensive geographic and social stratification. We estimated individual ancestry proportions in a sample of 7,342 subjects ascertained in five countries (Brazil, Chile, Colombia, México and Perú). These individuals were also characterized for a range of physical appearance traits and for self-perception of ancestry. The geographic distribution of admixture proportions in this sample reveals extensive population structure, illustrating the continuing impact of demographic history on the genetic diversity of Latin America. Significant ancestry effects were detected for most phenotypes studied. However, ancestry generally explains only a modest proportion of total phenotypic variation. Genetically estimated and self-perceived ancestry correlate significantly, but certain physical attributes have a strong impact on self-perception and bias self-perception of ancestry relative to genetically estimated ancestry