Đang tải... (xem toàn văn)
Pediatric Turbinate Hypertrophy tài liệu, giáo án, bài giảng , luận văn, luận án, đồ án, bài tập lớn về tất cả các lĩnh...
Int. J. Med. Sci. 2011, 8 http://www.medsci.org 239 IInntteerrnnaattiioonnaall JJoouurrnnaall ooff MMeeddiiccaall SScciieenncceess 2011; 8(3):239-244 Research Paper Long Term Persistence of IgE Anti-Influenza Virus Antibodies in Pediatric and Adult Serum Post Vaccination with Influenza Virus Vaccine Tamar A. Smith-Norowitz1,5 , Darrin Wong2, Melanie Kusonruksa2, Kevin B. Norowitz1,5, Rauno Joks3,5, Helen G. Durkin2,5, Martin H. Bluth4 1. Departments of Pediatrics, S.U.N.Y. Downstate Medical Center, Brooklyn, New York 11203, USA 2. Departments of Pathology, S.U.N.Y. Downstate Medical Center, Brooklyn, New York 11203, USA 3. Departments of Medicine, S.U.N.Y. Downstate Medical Center, Brooklyn, New York 11203, USA 4. Department of Pathology, Wayne State University School of Medicine, Detroit, Michigan, 48201, USA 5. Center for Allergy and Asthma Research, S.U.N.Y. Downstate Medical Center, Brooklyn, New York 11203, USA Corresponding author: Tamar A. Smith-Norowitz, Ph.D., SUNY Downstate Medical Ctr., Dept of Pediatrics, Box 49, 450 Clarkson Ave., Brooklyn, New York 11203, (718) 270-1295, (718) 270-3289 (fax), tamar.smith-norowitz@downstate.edu © Ivyspring International Publisher. This is an open-access article distributed under the terms of the Creative Commons License (http://creativecommons.org/ licenses/by-nc-nd/3.0/). Reproduction is permitted for personal, noncommercial use, provided that the article is in whole, unmodified, and properly cited. Received: 2010.12.22; Accepted: 2011.02.07; Published: 2011.03.18 Abstract The production of IgE specific to different viruses (HIV-1, Parvovirus B19, Parainfluenza virus, Varicella Zoster Virus), and the ability of IgE anti-HIV-1 to suppress HIV-1 production in vitro, strongly suggest an important role for IgE and/or anti viral specific IgE in viral pathogenesis. Nevertheless, the presence and persistence of IgE anti-Influenza virus antibodies has not been studied. Total serum IgE and specific IgE and IgG anti-Influenza virus antibodies were studied in children (N=3) (m/f 14-16 y/o) and adults (N=3) (m/f, 41-49 y/o) 2-20 months after vac-cination with Influenza virus (Flumist® or Fluzone®), as well as in non-vaccinated children (N=2). (UniCAP total IgE Fluoroenzymeimmunoassay, ELISA, Immunoblot). We found that serum of vaccinated children and adults contained IgE and IgG anti-Influenza virus antibodies approaching two years post vaccination. Non-vaccinated children did not make either IgE or IgG anti-Influenza antibodies. Similar levels of IL-2, IFN-γ, IL-4, and IL-10 cytokines were detected in serum of vaccinated compared with non vaccinated subjects (p>0.05), as well as between vaccinated adults compared with vaccinated children and non vaccinated subjects (p>0.05). Vaccinated children and adults continue to produce IgE anti-Influenza virus anti-bodies long term post vaccination. The long term production of IgE anti-Influenza virus an-tibodies induced by vaccination may contribute to protective immunity against Influenza. Key words: IgE, Influenza virus, Influenza virus vaccine INTRODUCTION Previous studies in our laboratory have investi-gated the role of IgE and the immune response to specific viruses including: Parvovirus B19 in children [1], HIV-1 in HIV-1 Pediatric Turbinate Hypertrophy Huynh Thi My Hien MD Nasal obstruction KAU Rabigh School of Medicine Department of Otolaryngology, Head and Neck Surgery Turbinate Anatomy Nasal cycle Cycles of swelling and constriction of the venous sinuses of the inferior turbinate and the nasal septum (Richard Kayser 1895) Medical Management Antihistamines Decongestants Topical nasal steroids/nasal saline/sinus rinses Antibiotics if sinusitis Immunotherapy if allergic Surgical Options Cold-steel turbinoplasty Lateralization/outfracture of inferior turbinate Diathermy (electrocautery) Laser Cryosurgery Microdebrider Radiofrequency Ablation Coblation Cold-steel Microdebrider Laser J Biomed Opt 20(6), 061110 (Jun 16, 2015) doi:10.1117/1.JBO.20.6.061110 Coblation Bipolar vs Coblation In a prospective, single-blinded study, Shah et al (2015): 41 patients: coblation in1 nostril and intramural bipolar cautery in the other Data:VAS, acoustic rhinometry,nasal endoscopy Coblation was significantly less painful than bipolar cautery (p = 0.03) and produced less crusting at weeks (p = 0.009) Similar in nasal obstruction (by acoustic rhinometry ) Coblation vs Microdebrider 60 patients randomized/not blinded 30 coblation/30 microdebrider 3,6, 12 month follow-up Improvement at all time points in both groups Nasal obstruction Postnasal drip Symptoms of nasal obstruction and nasal cavity better in microdebrider group at 12 months Lee JY, Lee JD Laryngoscope 116:729-734, 2006 Radiofrequency vs Submucous resection 75 patients Both techniques equally effective in short-term RF benefits: - Preserves nasal epithelium - No increased secretions or crusting - No nasal packing - Sooner return to work/activities; minimal pain May outweigh increased cost of RF wand Cavaliere M, Mottola G, Iemma M Otolaryngol Head Neck Surg 133(6): 972-978, 2005 Iranian Journal of Otorhinolaryngology No.3, Vol.23, Serial No.64, Summer-2011,89 Clinical Effectiveness of Coblation Inferior Turbinate Reduction CONCLUSIONS Inferior turbinate reduction by Coblation is effective for inferior turbinate hypertrophy Clinical benefit persists for at least months Bhattacharyya N, Kepnes LJ Otolaryngol Head Neck Surg 2003;129:365-371 Chen Y-L, Tan C-T, Huang H-M Long-term efficacy of microdebrider-assisted inferior turbinoplasty with lateralization for hypertrophic inferior turbinates in patients with perennial allergic rhinitis Laryngoscope 2008; 118:1270-1274 VIth International Congress of Pediaetric Otolaryngology in Rotterdam 29 May- 1June 1994 VIth International Congress of Pediaetric Otolaryngology in Rotterdam 29 May- 1June 1994 Surgical Reduction of Inferior Turbinates with Coblation in Children: Multi-center Trial Prospective/Controlled (CHSD/MEEI/UCLA) Assess Study nasal obstructive symptom reduction in children following Coblation turbinate reduction (12 month follow-up) Pediatric Patient Selection Typically treat children >6 years that have failed trial of medical therapy Most children