Inflammatory Reaction In Patients Research Articles

THE CONTENT OF CYTOKINES REGULATING INFLAMMATION IN NASAL FLUSHING IN CHRONIC RHINOSINUSITIS IN ELDERLY AND SENILE PERSONS

ABSTRACT
 BACKGROUND. Chronic rhinosinusitis is a heterogeneous sinonasal inflammatory disease with constant symptoms and recurrent exacerbations, which affects about 10% of the world's population. Age-related changes in the nasal mucosa (involutive immunodeficiency, atrophic changes, etc.) can affect the course of the inflammatory process, which, in turn, should be borne in mind when planning therapeutic interventions.
 AIMS - to study the features of local production of IL-4, IL-6, IL-8, IL-10 in elderly and senile persons with chronic rhinosinusitis.
 MATERIALS AND METHODS. The study included patients aged 45 to 90 years with a confirmed diagnosis of "chronic rhinosinusitis" in the acute stage, who gave written informed consent to the study. The exclusion criteria were: age up to 45 years; allergic rhinitis; primary immunodeficiency; smoking; oncological disease of any organ system; chronic polypous rhinosinusitis; acute (exacerbation of chronic) diseases of other localization; vaccination; use of immunotropic drugs for 3 months before the start of the study. The scope of the laboratory examination included determination of the concentration of cytokines IL-4, IL-6, IL-8, IL-10 in nasal secretions by enzyme immunoassay.
 RESULTS. The analysis of the determined values showed that the maximum level of IL-4 was determined in younger persons with rhonic rhinosinusitis 45-59 years old compared with older persons. In our study, the maximum content of IL-6 occurred in a group of patients aged 75-90 years, while the cytokine level significantly exceeded IL-6 in a group of healthy age-related patients, which indicates a more pronounced inflammatory reaction in patients of the oldest group with chronic rhinosinusitis. Cytokine levels above 600 pg/ml were found mainly in patients with chronic rhinosinusitis. Patients of group 4 had high IL-10 values and their values went beyond the range of the comparison groups.
 CONCLUSION. The maximum level of macrophage-monocytic cytokines (IL-6 and IL-8) and anti-inflammatory IL-10 is determined in nasal flushing in patients with chronic rhinosinusitis aged 75-90 years, the highest detectable values of IL-4 are characteristic of patients aged 45-59 years.

Effects of PCNL under the guidance of hologram technology on stress response and renal injury factors in patients with complex kidney stones

Background: To investigate the effect of percutaneous nephrolithotomy (PCNL) guided by holographic image technology on stress response and renal injury factors in patients with complex renal calculi.
 Methods: A retrospective analysis was conducted on the clinical data of 70 patients admitted to our hospital between August 2022 and June 2023 who had complex kidney stones. The patients were divided into two groups, namely, group A and group B, based on whether they received guidance from preoperative holographic imaging technology. Group A consisted of forty patients who underwent PCNL after undergoing renal CT examination prior to surgery, while Group B included thirty patients who underwent PCNL guided by holographic imaging technology. Various indexes, including operative factors, stress response, inflammatory response, renal injury factors, renal function, complication rate, and the rate of achieving complete stone clearance in a single procedure, were compared between the two groups.
 Results: In group B, the puncture time and operation time of the target calyces were shorter compared to group A, additionally, the intraoperative blood loss in group B was lower than that in group A (P<0.05). 24 h after surgery, group B exhibited higher levels of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) compared to group A, additionally, the level of malondialdehyde (MDA) in group B was lower than that in group A (P<0.05). 24 h after surgery, group B exhibited lower levels of tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), IL-1, and hypersensitive C-reactive protein (hs-CRP) compared to group A (P<0.05). Furthermore, group B showed lower levels of neutrophil gelatinase-associated lipid carrier protein (NGAL), inducible protein-8-like molecule 2 (TIPE2), and β2-microglobulin (β2-MG) than group A at the 7-day mark (P<0.05). 24 h after the operation, There was no statistically significant difference observed in the levels of SCr, BUN, between group A and group Bgroup B(P > 0.05); however, exhibited lower levels of CysC compared to group A (P < 0.05). Additionally, there were no significant differences in postoperative complications between group B and group A (P>0.05). Furthermore, one month after surgery, the one-time stone clearance rate in group B was significantly higher than that in group A (P<0.05).
 Conclusion: PCNL under the guidance of hologram technology can shorten the time of puncture target calyce and operation, reduce the amount of intraoperative blood loss, effectively reduce the postoperative stress reaction and inflammatory reaction of patients, reduce the level of renal injury factors, improve renal function, and increase the one-time stone clearance rate.

Extracellular DNA level as an indicator of the activity of inflammatory reactions in patients with rheumatoid arthritis and asthma

BACKGROUND: We performed a clinical and laboratory examination of patients with rheumatoid arthritis and bronchial asthma. Nosologies were selected to examine extracellular DNA changes in the blood during immunopathological processes based on generally accepted views on the role of helper balance in disease pathogenesis. The degree of disease activity in rheumatoid arthritis primarily depends on the severity of inflammatory changes in the joints; therefore, it is closely associated with a shift in the balance of helpers toward the Th1. According to today’s concepts, the pathogenesis of asthma is determined by the intensive production of specific antibodies, which are controlled by activated Th2 lymphocytes. AIM: To study extracellular DNA changes in the blood of patients during immunopathological processes depending on the Th1/Th2 balance ratio and compare these data with the parameters of standard laboratory tests and indicators of neutrophil activities and their ability to netosis. METHODS: Extracellular DNA concentration was determined using the Quant-ITTM PicoGreen fluorescent reagent for double-stranded DNA. Neutrophils isolated in a double-density gradient of ficoll–urografin were cultured with or without the addition of phorbol myristate acetate followed by Sytox Green. RESULTS: The studied immunopathological conditions had significantly decreased extracellular DNA levels in the plasma of patients with asthma, which sharply contrasted with its increase in patients with arthritis. Laboratory parameters confirmed the presence of local inflammation in patients with asthma without obvious symptoms of a systemic inflammatory response, while in patients with arthritis, inflammatory changes in the joints were accompanied by an increased C-reactive protein level, indicating a systemic reaction of the body in response to inflammatory stimuli. CONCLUSIONS: Thus, the state of the Th1/Th2 balance is assumed as one of the significant regulators that determined the extracellular DNA concentration in the blood. According to the proposed hypothesis, the shift in this ratio toward the predominance of Th1 cells should promote the development of inflammatory processes in the body and increase the amount of extracellular DNA, while a shift in the balance of helpers toward the dominance of Th2 lymphocytes should suppress these processes and consequently decrease the extracellular DNA in the blood.

The effect of combined physiotherapy on humoral immunity, cytokine profile and inflammatory reactions in patients with rhinosinusitis polyposa

In patients with rhinosinusitis polyposa, activation of type 2 eosinophilic inflammation with an increase in serum concentrations of interleukins 4, 5, and 13 and immunoglobulins A, M, G, and E is noted. At the same time, the relationship between these indicators and the quality of life of the patient is sharply intensified, which indicates the appearance of pathological correlation pleiades. The drug Dupilumab has a normalizing effect on the inflammatory component of the disease and optimizes the cytokine regulation of humoral immunity. The additional use of an alternating magnetic field somewhat enhances these effects, whereas the maximum therapeutic effect was provided by the use of the drug, an alternating magnetic field, and low‑intensity infrared laser therapy.

Lipid peroxidation and liver damage in double and simple common bile duct ligation models in male Sprague-Dawley rats

AimsBacterial translocation, defined as the presence of living bacteria or bacterial fragments in both mesenteric lymph nodes or systemic circulation, can cause a severe inflammatory reaction in patients with cirrhosis. This study aimed to compare lipid peroxidation associated with liver damage in different experimental models of bile duct ligation: proximal double ligation and transection versus proximal simple ligation versus sham. Materials and methodsSixty-two male rats underwent one of three bile duct surgical interventions: proximal double ligation and transection (n = 22); proximal simple ligation (n = 19); or sham operation (n = 21). We performed microbiological culture of mesenteric lymph nodes; portal and cava blood, spleen and liver cultures; and histological analysis of liver parenchyma. Samples of blood and liver were obtained at laparotomy for malondialdehyde quantification. Key findingsSerum malondialdehyde levels were significantly higher in simple ligature animals (3.7 nmol/mg, standard deviation [SD] 2.1) compared to controls (1.6 nmol/mg SD 0.5; p = 0.001) or double ligature (0.3 nmol/mg SD 0.3; p = 0.001). Liver malondialdehyde levels were significantly higher in animals subjected to double ligation vs controls (9.0 nmol/mg SD 2.8 vs. 1.7 nmol/mg SD 1.0; p = 0.0007) and simple ligature (2.9 nmol/mg SD 2.0; p = 0.0001). Overall incidence of bacterial translocation was similar in simple and double ligatures (22.2 % and 21 % respectively), and significantly higher than in controls. Significancethe type of bile duct ligation influences the type and localization of lipid peroxidation, but does not influence the development of bacterial translocation.

Features of inflammatory reactions in patients with juvenile depression with a clinically high risk of psychosis

To determine the levels of pro-inflammatory and anti-inflammatory cytokines and inflammatory markers such as C-reactive protein, leukocyte elastase, α1-proteinase inhibitor, autoantibodies to neuroantigens in the blood of patients with adolescent depression with clinical high risk for psychosis (CHR-P) and to study the relation of these biological markers to the features of psychopathological symptomatology of the patients. Eighty young adults, aged 16-24 years, with the first depressive episode (F32.1-2, F32.38, F32.8) were studied. Based on the presence of attenuated positive symptoms in the structure of depression, all patients were divided into two groups: with CHR-P (clinical group, n=58) and without CHR-P (comparative group, n=22). The HDRS-21, SOPS, and SANS were used for psychometric assessment of the patients. Serum levels of cytokines TNF-α, IL-6, IL-8, IL-10, and concentration of C-reactive protein (CRP) were determined. Leukocyte elastase (LE) activity, α1-proteinase inhibitor (α1-PI) activity, and plasma levels of autoantibodies to S100B protein and myelin basic protein (MBP) were assessed. Both groups of patients were characterized by the high levels of inflammation as assessed by LE (250.5 (226.2-280.8) nmol/min·ml vs 248.3 (226.8-284.5) nmol/min·ml) and α1-PI activity (44.4 (37.5-50.1) IE/ml vs 45.2 (36.4-49.9) IE/ml). Higher levels (p<0.05) of IL-6 (1.22 (0.64-2.2) pg/ml), CRP (0.93 (0.18-3.18) mg/l), and TNF-α/IL-10 (0.34 (0.2-0.47)) were detected in the group with CHR-P. This group was also characterized by higher levels of antibodies to the S100B protein 0.78 (0.69-0.84 units of opt.density) compared with the group without CRH-P (p<0.05). In each clinical group, different correlations between clinical, psychometric and biological parameters were revealed. The results confirm the involvement of inflammation in the development of depression in youth and indicate a different role of the inflammatory markers analyzed in the formation of CHR-P. The differences in the spectrum of inflammatory markers in depressed patients suggest a more pronounced pro-inflammatory potential in the group with CHR-P.

Investigation of the Relationship between the Use of Statins with the Mortality Rate and Duration of Hospitalization Due to Covid-19

Introduction: Statins are a group of lipid-lowering medications that have anti-inflammatory and immune system-modulating effects. Considering the existence of severe inflammatory reactions in patients with covid-19, this study aimed to investigate the effects of statins on the mortality rate of covid-19 patients.Materials and Methods: The present research is a descriptive-analytical case-control study that was carried out in the first half of 2021 at Kowsar Hospital in Semnan, Iran. The study was conducted on 191 patients taking statins as the case group and 191 patients with no history of taking statins. Demographic and clinical information of the patients who met the inclusion criteria of the research were extracted from the files and collected in the researcher's questionnaire. Finally, the results were statistically analyzed using SPSS software version 26.Results: In this study, a case group of 191 people, who had a history of taking statins, and a control group of 191 people, who did not use statins, were investigated. The average age of people was 64.7 years. Among the studied patients, 51.7% were men and 48.3% were women. Most of the patients were hospitalized for 4 days. Also, 351 patients were discharged and 32 people died. After analyzing the data, no significant relationship was observed between the use of statin and mortality due to Covid-19.Discussion and Conclusion: According to the results of this study, no relationship was observed between the use of statins and the reduction of mortality caused by covid-19.

Electrochemically based targeted metabolomics for uric acid, xanthine, and hypoxanthine in plasma samples for early diagnosis of acute renal failure after cardiopulmonary bypass using rGO-GCE

Cardiopulmonary bypass (CPB) may cause a systemic inflammatory reaction in patients during cardiac surgery due to the interaction of blood with heart-lung machine circuits. This inflammation may lead to organ failure. One of the most severe complications of cardiac surgery is the development of acute renal failure (ARF). Early diagnosis of ARF using fast, accurate, and sensitive methods may prevent ARF development. Therefore, we developed and validated an electroanalytical method for simultaneous analysis of three biomarker candidates, uric acid (UA), hypoxanthine (HXA), and xanthine (XA), from plasma samples. Their quantification was performed using reduced graphene oxide modified glassy carbon electrode (rGO-GCE) synthesized through rapid one-step electropolymerization. The characterization studies of rGO-GCE with cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS), and scanning electron microscope (SEM) analyses showed a successful surface modification of GCE with rGO. The electrochemical oxidations of the biomarkers were examined using square wave voltammetry (SWV) with the rGO sensor in 0.1 M phosphate-borate (PB) buffer (pH 7). Various operational parameters, including pH and type of supporting electrolyte, instrumental parameters, electro polymerization cycles, and GO concentration, were optimized. Under optimum conditions, good linear responses were obtained for three metabolites (R2 > 0.99). The LOQ of the method was 0.12 μM for UA, 0.13 μM for XA, and 0.43 μM for HXA. The developed method was successfully applied to patient plasma samples of ARF (n = 9) and control (n = 17) collected at five-time points of CPB. The UA, HXA, and XA levels were significantly altered in ARF patients. The results showed the applicability of the developed method for early diagnosis of ARF developed after CPB.

Comparison of Inflammatory Cytokine Levels between Single-Port and Three-Port Thoracoscopic Lobectomy in the Treatment of Non-Small-Cell Lung Cancer

Introduction Thoracoscopic minimally invasive surgery is the main method for the treatment of lung cancer. The reduction of surgical trauma can effectively reduce the intraoperative and postoperative inflammatory reaction. The aim of the study is to compare the intraoperative and postoperative inflammatory reactions in patients with non-small-cell lung cancer (NSCLC) treated by single-port thoracoscopic surgery and three-port thoracoscopic surgery. Methods A total of 68 NSCLC patients (stages I and II) of thoracoscopic surgery were selected and randomly divided into two groups where they received either single-port thoracoscopic surgery or three-port thoracoscopic surgery. Intraoperative and postoperative serum inflammatory markers (C-reactive protein, CRP; serum amyloid A protein, SAA; and interleukin 6, IL-6) were detected using the enzyme-linked immunosorbent assay. Results The CRP level of the single-port group was significantly lower than that of the three-port group during surgery, the first day after surgery, and third day after surgery (P < 0.05). The level of IL-6 in the single-port group was significantly lower than that in the three-port group during surgery on the first and third days after surgery (P < 0.05). The level of SAA in the single-port group was also significantly lower than that in the three-port group on the first and third days after surgery (P < 0.05). Conclusion Compared with three-port thoracoscopic surgery, single-port thoracoscopic surgery could reduce the inflammatory response and improve the recovery of NSCLC patients. Single-port thoracoscopic surgery is worthy of further promotion in the current treatment field of NSCLC in terms of reducing intraoperative and postoperative inflammatory reactions.

Effect of Enhanced Recovery after Surgery with Integrated Traditional Chinese and Western Medicine on Postoperative Stress Response of Patients with Gastrointestinal Tumors.

Objective To investigate the effect of enhanced recovery after surgery (ERAS) with integrated traditional Chinese and Western medicine on postoperative stress response of patients suffering from gastrointestinal tumors. Methods A total of 74 patients with gastrointestinal tumors who underwent surgical treatment in our hospital from April 2019 to March 2021 were recruited and randomized into the control group and the observation group (1 : 1). The control group received routine treatment and care, while the observation group received ERAS plus integrated traditional Chinese and Western medicine. Clinical observation was performed regarding changes in preoperative mood and postoperative pain level in each group. Changes in expression levels of plasma cortisol, C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-β (TNF-β) before and after surgery were detected in each group. Time of patients' first fart and defecation and complications after surgery in each group were recorded. Results The visual analogue scale (VAS) of patients in the observation group after 12 and 24 h of surgery was significantly lower than that in the control group (12 h: observation group 2.0 (1.00, 3.00) vs. control group 4.00 (3.00, 5.00), p = 0.001; 24 h: observation group 2.00 (1.00, 3.00) vs. control group 3.00 (2.00, 5.00), p = 0.005). The preoperative anxiety degree of patients in the two groups was not statistically significant (p = 0.489). The plasma cortisol level of patients in the observation group after 24 and 48 h of surgery was significantly lower than that in the control group (24 h: observation group 426.54 ± 52.15 nmol/L vs. control group 508.32 ± 41.08 nmol/L, p = 0.001; 48 h: observation group 287.19 ± 44.24 nmol/L vs. control group 362.57 ± 43.46 nmol/L, p = 0.001). Patients' postoperative CRP, IL-6, IL-8, and TNF-β expression levels in the observation group were remarkably lower than those in the control group at all time points. The first postoperative defecation came earlier in the observation group than that in the control group (observation group 76.00 h (64.50, 87.50) vs. control group 89.00 h (73.50, 116.00), p = 0.007). There was 1 postoperative urinary tract infection in the observation group and 1 postoperative intestinal obstruction and 1 incisional wound infection in the control group. Conclusion ERAS with integrated traditional Chinese and Western medicine could effectively reduce the postoperative stress response and inflammatory reaction in patients with gastrointestinal tumors, contributing to the safe and quick recovery of gastrointestinal functions of patients.

Risk of Attacks by Blackflies (Diptera: Simuliidae) and Occurrence of Severe Skin Symptoms in Bitten Patients along the Eastern Border of the European Union.

The components of blackfly (Diptera: Simuliidae) saliva secreted during feeding on humans and animals induce various pathological reactions manifested by skin lesions and systemic symptoms. In this study, we describe 43 cases of severe skin lesions induced by blackfly bites and analyze their potential causes. Based on the results of a survey of 418 patients, we identified periods with risk of blackfly attacks and their environmental determinants in the eastern part of the European Union. Especially strong inflammatory reactions after blackfly bites were reported in patients with concomitant cardiovascular diseases (mainly with venous insufficiency), metabolic diseases, and bacterial infections. Enhanced symptoms of simuliosis were also observed in other patients attacked by these insects only once or repeatedly. The greatest number of blackfly attacks in the study area is recorded from May to July, with a peak in June (38.73%) in the afternoon (37.10%) and evening (33.03%), when patients are in fields, forests, or their households. The case analysis indicates interactions of various factors in the development of severe inflammatory reactions in patients bitten by blackflies. Therefore, it is recommended that subjects exposed to the presence of blackflies during their work or rest should limit the length of their stay in a vulnerable environment during the highest seasonal and daily activity of these insects. It is also necessary to take measures to reduce the number of blackflies and popularize methods for prophylaxis of their attacks.

Effect of dexmedetomidine administration on analgesic, respiration and inflammatory responses in patients undergoing percutaneous endoscopic lumbar discectomy: a prospective observational study

BackgroundLocal anesthesia has been recommended for percutaneous endoscopic lumbar discectomy (PELD) in recent years; however, the efficacy, including oxidative stress, inflammatory reactions and ventilation effects, when intravenous dexmedetomidine (DEX) is administered during PELD has not been described.MethodsSixty adult patients undergoing PELD were randomly allocated to either an intravenous DEX sedation group (Group A) or a normal saline group (Group B). Respiratory data, including minute ventilation (MV), tidal volume (TV), and respiratory rate (RR), were recorded using a respiratory volume monitor (RVM), and peripheral oxygen saturation (SpO2) was monitored by pulse oximetry. The visual analog score (VAS) was used to assess the level of pain. The serum levels of inflammatory biomarkers including interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were to assess inflammatory reactions. The serum levels of oxidative stress biomarkers including malondialdehyde (MDA) and glutathione peroxidase (GSH-PX) were also recorded to evaluate oxidative stress.ResultsThere were no significant differences in RR, MV, TV and SpO2 between the two groups at any time point (P > 0.05). Group B exhibited lower serum levels of GSH-PX (P < 0.0001) and higher serum levels of MDA (p < 0.0001) than Group A at the end of surgery. Twenty-four hours after surgery, Group B exhibited higher serum levels of IL-6 (P = 0.0033), TNF-α (P = 0.0002), and MDA (P < 0.0001) and lower serum levels of GSH-PX (P < 0.0001) than Group A. In addition, Group A exhibited lower VAS (P < 0.0001) than Group B during surgery.ConclusionsDEX administration using RVM not only provides analgesia without ventilatory depression but also alleviates oxidative stress and inflammatory reactions in patients undergoing PELD.

The presence of E-selectin in the myocardium indicates a sustained inflammatory reaction in patients with dilated cardiomyopathy

BackgroundIt is still uncertain whether de-novo expression of E-selectin in endothelial cells may be considered an additional marker of chronic inflammation in heart failure (HF). MethodsWe studied 393 consecutive patients (313 M, 80 F) with HF secondary to dilated cardiomyopathy in whom the right ventricular endomyocardial biopsy was performed. For immunohistochemistry, HLA class I and II, E-selectin (ELAM-1), CD3 + lymphocytes and CD68 + macrophages were studied. Patients were divided into two groups: Group A, with ELAM-1 (+), and Group B with ELAM-1 (-) in the biopsy sections. ResultsOf all patients, 140 (35.6%) subjects were presented with ELAM-1 expression in endomyocardial biopsies. Patients in the Group A had a significantly lower LV ejection fraction compared to those from the Group B (31.3 ± 12.9 vs. 34.2 ± 12.7; 95% CI, 0.3–5.6, P = 0.029) and they showed a higher mean number of CD3 (+) lymphocytes in the biopsy sections, P = 0.006. In addition, ELAM-1 reasonably correlated with CD3 lymphocytes (r = 0.3, P < 0.001). ConclusionsOur findings suggest that de-novo ELAM-1 expression in endothelial cells may be a useful marker of chronic inflammation in the biopsies of patients with HF secondary to dilated cardiomyopathy.

The (apparent) antibody paradox in COVID-19

ABSTRACT Introduction The immunological response to COVID-19 is only partly understood. It is increasingly clear that the virus triggers an inappropriate host inflammatory reaction in patients experiencing severe disease. Areas covered The role of antibodies in COVID-19 remains to be fully defined. There is evidence for both protection and harm in different clinical syndromes triggered by SARS-CoV-2. Many patients dying from COVID-19 had both high titers of antibodies to SARS-CoV-2 and elevated viral loads. The uncertain protective role of humoral immunity is mirrored by the lack of benefit of therapeutic convalescent plasma infusions in COVID-19. In contrast, there is increasing evidence that a vigorous T-cell response is protective. Delayed or low avidity T cell reactions were seen in patients suffering severe COVID-19. Expert opinion These observations suggest T cell responses to SARS-CoV-2 are the dominant long-term protective mechanism following either infection or vaccination. The magnitude and quality of the antibody response is likely to reflect underlying T cell immunity to SARS-CoV-2. Much of what has been learned about COVID-19 will need to be revised following the recent rapid emergence and dominance of the omicron variant of SARS-CoV-2.

Late inflammatory reactions in patients with soft tissue fillers after SARS-CoV-2 infection and vaccination: A systematic review of the literature.

IntroductionSoft tissue fillers are used for cosmetic and reconstructive purposes, and soft tissue filler procedures are among the most common nonsurgical procedures in the USA. Although soft tissue filler procedures are relatively quick and safe, adverse events such as late inflammatory reactions have been reported with every filler product. Infections and vaccinations have been proposed as potential triggers for late inflammatory reactions (LIRs), and it is therefore not surprising that these adverse events have been reported after SARS‐CoV‐2 infection and vaccination. Therefore, this review aims to give a detailed overview of these cases.Materials and methodsA literature search was undertaken on LIRs in patients with a history of soft tissue filler use after SARS‐CoV‐2 infection or vaccination. This systematic review was reported according to the PRISMA guidelines. We searched the electronic database PubMed from January 2020 to August 2021. Data on patient characteristics, filler characteristics, clinical findings, and treatment options were included.ResultsThis review included 7 articles with a total of 19 patients with LIRs after SARS‐CoV‐2 infection or vaccination. Three patients with postinfection LIRs and 16 patients with postvaccination LIRs were reported. These LIRS mainly occurred in females who had HA injections for cosmetic purposes. Three patients with postinfection LIRs had symptoms of facial swelling and/or lip angioedema in a matter of weeks. Sixteen patients reported reactions after SARS‐CoV‐2 vaccination (13 following Moderna vaccination and 3 after Pfizer vaccination, after both the first and second doses) from 13 hours up to three weeks. These patients presented with similar clinical symptoms as patients with postinfection LIRs. All patients were treated in a conservative manner.DiscussionThis review shows a relationship between LIRs and SARS‐CoV‐2 infection and vaccination. In the case of vaccination, these adverse events have been reported only after Moderna and Pfizer vaccinations. The reported adverse events are generally minor and self‐limiting, and we encourage patients with soft tissue fillers to participate in vaccination programs.

Lentigo Maligna on a Difficult Location of the Face Treated with 5% Imiquimod: A Case Report of 2-Year Follow-Up.

Topical imiquimod is an off-label alternative treatment for lentigo maligna used when surgery cannot be performed. Severe inflammatory response induced by this drug may generate many complaints and force patients to discontinue use. We present a case in which interval treatment with 5% topical imiquimod was implemented for severe inflammatory response. An 82-year-old Caucasian woman presented with a large, irregularly pigmented lesion on her left cheek within the scar of a previously excised melanocytic lesion diagnosed as junctional nevus. Based on dermatoscopical examination confirmed by histopathological description, lentigo maligna was diagnosed. Since the lesion was large and covered the lower left eyelid and due to the risk of disfigurement, the patient refused surgical excision. Therefore, treatment with imiquimod 5% once daily, five times per week, was offered. After 5 weeks, the treatment was stopped because of intense inflammatory reaction and ulceration. On the follow-up visit after 3 months, videodermatoscopical examination revealed changes in the pigmentation of the lentigo maligna including the presence of residual gray dots and fading of the previous dark brown and black colors. The inflammatory response had almost resolved. The second course of treatment with imiquimod five times a week was implemented again for 5 weeks, and after a 2-month interval the third course with the same regimen was started. Total clearance of the lesion was achieved, which was confirmed by videodermatoscopical examination. During the 2-year follow-up, no relapse was observed based on dermatoscopical examination. We propose interval treatment with topical imiquimod 5% lentigo maligna for severe inflammatory reactions in patients with contraindications to surgery. This could help patients overcome this typical response effect and decrease their cessation of treatment.

Influence of nimodipine combined with ulinastatin on neurological function and inflammatory reaction in patients with cerebral vasospasm after subarachnoid hemorrhage

ObjectiveThis study aimed to discuss the influence of nimodipine+ulinastatin on the neurological function and inflammatory reaction in patients with cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH). MethodsOverall, 90 patients with CVS after SAH who were admitted to our hospital were enrolled in this study and randomly divided into research and control groups (n = 45 for both groups). On the basis of conventional therapy, patients in the control group were injected with ulinastatin and those in the research group were injected with ulinastatin+nimodipine through an intravenous drip for 7 days with the others the same as those of the control group. ResultsBlood flow velocity in all cerebral arteries was lower in the research group than in the control group after treatment (P < 0.05). Calcitonin gene-related peptide and nitric oxide levels were higher in the research group than in the control group after treatment (P < 0.05). Endothelin levels were lower in the research group than in the control group (P < 0.05). The total effective rate was higher in the research group than in the control group (P < 0.05). Glasgow Coma Scale scores were higher in the research group than in the control group (P < 0.05). ConclusionThe drug combination of nimodipine and ulinastatin improved blood flow and neurological function in patients with CVS after SAH and enhanced the therapeutic efficacy; the underlying mechanism may be associated with the regulation of vascular endothelial dilatation function and the inhibition of relevant inflammatory factors’ expression.

Vernal keratoconjunctivitis activity induces decrease of ocular surface CD14, TLR-4 and TLR-9 expression.

CD14 is involved in the modulation of immune reaction via toll-like receptors (TLR) and may influence the development of allergic diseases. The role of CD14 in vernal keratoconjunctivitis (VKC) has not yet been investigated. The aim of this study is to evaluate changes of tear soluble sCD14 and conjunctival CD14, TLR-4 and 9 expression in patients with VKC in the active and quiescent phases. Eighteen patients with VKC during active inflammation (group A, N = 9), in the quiescent phase (group Q, N = 5) and after recovery (group R, N = 4) and 10 healthy subjects were included. Expression of sCD14 in tears and of CD14, TLR-4, and TLR-9 by conjunctival epithelium were evaluated by Western Blot in all groups. Expression of tear sCD14 and of conjunctival CD14, TLR-4, and TLR-9 was significantly decreased in group A when compared with healthy subjects and with VKC group Q and R. Lower expression of sCD14, CD14, TLR-4, and TLR-9 were significantly correlated with the severity of papillary reaction, while the lower sCD14 was correlated with severity of conjunctival hyperemia. Tear sCD14, and conjunctival CD14, TLR4, and TLR-9 decreased during ocular surface inflammatory reaction in patients with VKC. CD14 and TLRs ocular surface evaluation may represent biomarkers of VKC activity and novel therapeutic target.

Changes of urine isolates of Escherichia coli and Klebsiella pneumoniae biofilm affect monocytes\u2019 response

The Gram negative rods as Escherichia coli and Klebsiella pneumoniae belong to the most common etiology agents of urinary tract infections. The aim of our study was to assess the diversity of biofilm formed in different urinary tract diseases and their impact on monocytes’ adherence and activation. The bacteria were obtained from patients with different kidney problems. Some of the patients were after renal transplantation, some of them were not. Changes in the size and granularity of monocytes, as well as their adherence to biofilm, were assessed using FACSVerse flow cytometer after 1 h co-incubation of monocytes and bacterial biofilm in 37 °C. The obtained results were validated against monocytes incubated without bacteria. The isolates from patients with chronic kidney disease formed the most adherent biofilm regardless the presence or absence of inflammatory reaction. Adherence of monocytes also increased during therapy with immunosuppressive agents, but monocytes’ response was different when cyclosporine or tacrolimus were used. Additionally the presence of inflammatory reaction in patients with kidney disease modified the monocytes response when the immunosuppressive drugs were used. Considering the obtained results, we conclude that the changes of monocytes’ morphology in response to biofilm formed by Gram negative rods could become a tool to detect urinary tract infection, especially in those groups of patients, where the knowledge of ongoing inflammation is important and the standard tools fail to detect it.

Application of Seamless Nursing in the Treatment of Uremia with HD Combined with HP and its Effect on the Occurrence of Inflammatory Reaction in Patients

Application of Seamless Nursing in the Treatment of Uremia with HD Combined with HP and its Effect on the Occurrence of Inflammatory Reaction in Patients