Refine
Has Fulltext
- yes (150)
Is part of the Bibliography
- yes (150)
Year of publication
Document Type
- Journal article (148)
- Doctoral Thesis (1)
- Other (1)
Language
- English (150) (remove)
Keywords
- children (11)
- inflammation (9)
- preterm infants (8)
- bronchopulmonary dysplasia (5)
- infection (5)
- influenza (5)
- IL-10 (4)
- Medizin (4)
- Ureaplasma parvum (4)
- autoimmunity (4)
- disease (4)
- immunotherapy (4)
- juvenile idiopathic arthritis (4)
- macrophages (4)
- monocytes (4)
- pediatric (4)
- treatment (4)
- vaccination (4)
- CRMO (3)
- HBMEC (3)
- NK cells (3)
- T cells (3)
- Th17 (3)
- Ureaplasma urealyticum (3)
- burden (3)
- cells (3)
- cytokines (3)
- immunization (3)
- physical activity (3)
- preterm birth (3)
- surfactants (3)
- therapy (3)
- B cells (2)
- CNO (2)
- COVID-19 (2)
- Children (2)
- Cystic fibrosis (2)
- DIRA (2)
- Exercise capacity (2)
- Exercise testing (2)
- Germany (2)
- PAPA (2)
- Physical activity (2)
- Pädiatrie (2)
- Rheumatologie (2)
- SARS-CoV-2 (2)
- T cell receptor excision circles (2)
- TLR4 (2)
- TNF-α (2)
- Tregs (2)
- Wilms' tumor (2)
- animal model (2)
- blood–brain barrier (2)
- bone (2)
- cancer (2)
- case report (2)
- chronic non-bacterial osteomyelitis (2)
- chronic nonbacterial osteomyelitis (2)
- chronic recurrent multifocal osteomyelitis (2)
- cord blood (2)
- cystic fibrosis (2)
- deficiency (2)
- efficacy (2)
- endothelial cells (2)
- epithelial cells (2)
- expression (2)
- flow cytometry (2)
- gene (2)
- glucocorticoids (2)
- hospitalizations (2)
- hypophosphatasia (2)
- hypoxia (2)
- immunoblotting (2)
- in vitro (2)
- innate immunity (2)
- leukemia (2)
- medicine (2)
- meningitis (2)
- messenger RNA (2)
- neonates (2)
- nervous system (2)
- neuroinflammation (2)
- pediatric adrenocortical cancer (2)
- pediatric adrenocortical tumor (2)
- pediatrics (2)
- preterm (2)
- preterm infant (2)
- regulatory T cells (2)
- sepsis (2)
- sustained inflammation (2)
- transplantation (2)
- treatment guidelines (2)
- tumor (2)
- tumor microenvironment (2)
- ACP5 (1)
- AD-AID (1)
- AICDA (1)
- AID-ΔE4a (1)
- ALPL (1)
- ARDS (1)
- Abatacept (1)
- Accelerometry (1)
- Age (1)
- Allogeneic stem cell transplantation (1)
- Anti-TNF-alpha agents (1)
- Antibody (1)
- Apoptosis (1)
- Aspergillus (1)
- Aspergillus fumigatus (1)
- Autoinflammation (1)
- B cell (1)
- B-cell (1)
- B4GALT7 gene (1)
- BPD (1)
- Bevacizumab (1)
- Big picture (1)
- Blood stream infection (1)
- Body composition (1)
- Bone health (1)
- Bronchopulmonary dysplasia (1)
- C-reactive protein (1)
- C5a (1)
- C5aR1 (1)
- CAR-T cells (1)
- CCN2 (1)
- CD105 (1)
- CD3/19 depletion (1)
- CD34 selection (1)
- CD62L (1)
- CD8 (1)
- CDR3 sequences (1)
- CMV (1)
- CNS cancer (1)
- CNS integrity (1)
- CTGF (1)
- CVID (1)
- CXCL5 (1)
- CXCL8 (1)
- CXCR2 (1)
- Cardiovascular disease (1)
- Caspase (1)
- Central venous access (1)
- Childhood cancer survivors (1)
- Chimeric Antigen Receptor T cells (1)
- Chorioamnionitis (1)
- Cigarette smoking (1)
- Coverage (1)
- Cushing (1)
- Cytokine GM-CSF (1)
- DC vaccination (1)
- DNA methylation (1)
- DNA-binding proteins (1)
- DWI (1)
- Deutschland (1)
- Disease severity (1)
- Diseases (1)
- Dixon (1)
- E. coli (1)
- ECORN-CF Projekt (1)
- ESPED (1)
- EU-RHAB registry (1)
- England (1)
- Epidemiology (1)
- Epidural Analgesia (1)
- Erratum (1)
- Escherichia coli (1)
- European experience (1)
- Exacerbation (1)
- Exercise intervention (1)
- Extraocular eye muscles (1)
- FADS (1)
- Foxp3 (1)
- GLDN variant (1)
- Gamma (1)
- Gastroenteritis (1)
- Glut1DS (1)
- Graft-versus-host disease (1)
- Grippe (1)
- H441 (1)
- HLA-G gene (1)
- HPP (1)
- HRQOL (1)
- Healthcare Cost (1)
- Healthcare Economics (1)
- Hemagglutination inhibition (1)
- Hickman catheter (1)
- Hospitalisation (1)
- Hospitalization (1)
- ICD-10 (1)
- IL-1 beta (1)
- IL-1 blockade (1)
- IL-10 expression (1)
- IL-12B (1)
- IL-12p40 (1)
- IL-17A-inhibition (1)
- IL12B (1)
- IMR-90 (1)
- IgG (1)
- Immunogenicity (1)
- Immunosenescence (1)
- Immunotherapy (1)
- Impfplan (1)
- Impfung (1)
- Incidence (1)
- Incontinentia pigmenti (1)
- Infectious disease (1)
- Influenza (1)
- Influenza vaccination (1)
- JIA (1)
- Jugend (1)
- Juvenile idiopathic arthritis (1)
- Keuchhusten (1)
- Kindergarten (1)
- LCCS11 (1)
- LND (1)
- LNE (1)
- Labour Analgesia (1)
- Labour Pain (1)
- Late-effects (1)
- Longitudinal analysis (1)
- Lung disease, (1)
- Lymphocytes (1)
- M1/M2 macrophages (1)
- MDSC (1)
- MHC I (1)
- MHC II (1)
- MRI spectroscopy (1)
- MTL30 (1)
- Majeed (1)
- Majeed-Syndrome (1)
- Masern (1)
- Mechanisms (1)
- Medicine (1)
- Meningitis (1)
- Metastases (1)
- Minor histocompatibility antigen mismatch transplantation (1)
- Mucopolysaccharidosis IIIa (1)
- Mumps (1)
- Muscle function (1)
- Muscle power (1)
- NADPH oxidase (1)
- Naive T cells (1)
- Necrotizing enterocolitis (1)
- Neuroinflammation (1)
- OPT (1)
- Oxygen uptake (1)
- P67(PHOX) (1)
- PAPA syndrome (1)
- PET/CT (1)
- PLAG1 rearrangement (1)
- POEM (1)
- PU.1 (1)
- Paediatric (1)
- Patient Controlled Analgesia (1)
- Patient Satisfaction (1)
- Pediatric (1)
- Pediatric malignancy (1)
- Phosphorylation (1)
- Physical fitness (1)
- Pneumococcal vaccination (1)
- Port (1)
- Preterm birth (1)
- Prevalence (1)
- Quality of life (1)
- Questionnaire (1)
- RNA isolation (1)
- RSV-A ON1 (1)
- RTPS1 (1)
- RTPS2 (1)
- Randomized controlled trial (1)
- Regulatory T cells (1)
- Regulatory T-cells (1)
- Remifentanil (1)
- Respiratory tract infection (1)
- Retinopathy (1)
- Rhabdomyosarcoma (1)
- Risk (1)
- Rituximab (1)
- Rotavirus (1)
- Röteln (1)
- SB332235 (1)
- SIRP-alpha (1)
- SMAD signaling (1)
- Safety (1)
- Schnitzler syndrome (1)
- Surveillance (1)
- T cell plasticity (1)
- T lymphocytes (1)
- T-cell (1)
- T-cell responses (1)
- TB (1)
- TCR diversity (1)
- TH1-induced senescence (1)
- TH17 cells (1)
- TLR agonists (1)
- TMJ (1)
- TNAP (1)
- TREC (1)
- TRECs (1)
- T\(_H\)17 cells (1)
- Telomere (1)
- Telomeres (1)
- Th9 (1)
- Thrombosis (1)
- Tocilizumab (1)
- Toll-like receptor signaling (1)
- Treg (1)
- Trousseau's syndrome (1)
- United States (1)
- Universal mass vaccination (1)
- Ureaplasma (1)
- Ureaplasma species (1)
- VEGF (1)
- VIBE (1)
- VLBW (1)
- Vaccination (1)
- Vaccine (1)
- Varicella (1)
- Varizellen-Virus (1)
- Viruses (1)
- Vorschulkind (1)
- Wechsler intelligence scale (WISC-IV) (1)
- Wilm's tumor (1)
- achalasia (1)
- activity (1)
- acute (1)
- acute ITP (1)
- acute graft-versus-host disease (1)
- adenocarcinoma of the lung (1)
- adolescents (1)
- adrenal cancer (1)
- adrenal surgery (1)
- adrenalectomia (1)
- adrenocortical adenocarcinoma (1)
- adrenocortical carcinoma (1)
- adults (1)
- adverse pulmonary outcomes (1)
- aging (1)
- airway remodeling (1)
- alkaline phosphatase (1)
- allogeneic stem cell transplantation (1)
- alloreactive T cells (1)
- alveolar epithelium in vitro model, claudin-1, claudin-3, claudin-4, claudin-5 (1)
- amniotic infection (1)
- anaplastic medulloblastoma (1)
- antenatal inflammation (1)
- anti inflammation (1)
- anti-tumor agents (1)
- antibacterial activity (1)
- antibiotic resistance (1)
- antibiotic therapy (1)
- antibiotic use (1)
- antibody (1)
- antidepressants (1)
- antimicrobial activity (1)
- antimicrobial resistance (1)
- antimicrobial stewardship (1)
- antinuclear antibodies (1)
- anuria (1)
- anxiety disorders (1)
- apoptosis (1)
- arterial hypotension (1)
- arthrogryposis (1)
- asfotase alfa (1)
- asymmetry (1)
- atypical chemokine receptor 3 (1)
- atypical teratoid rhabdoid tumors (1)
- autoimmune encephalitis (1)
- autoinflammation (1)
- autologous stem cell transplantation (1)
- axonopathy (1)
- barrier (1)
- beta-D-glucan (1)
- biomarker (1)
- bioreactor culture (1)
- bisphosphonate treatment (1)
- blastocysts (1)
- bleding disorders other than hemophilia (1)
- bleeding score (1)
- bone autoinflammation (1)
- bovine lactoferricin (1)
- brain development (1)
- brain tumor (1)
- breast cancer (1)
- breastfeeding (1)
- breath-hold (1)
- bronchopulmonary dysplasia (BPD) (1)
- bullae (1)
- caffein (1)
- caffeine (1)
- cancer microenvironment (1)
- cancer stem cells (1)
- cancer vaccines (1)
- cancer-targeted IL-12 (1)
- cardiogenic (1)
- cardiovascular risk (1)
- cell therapy (1)
- cellular signalling networks (1)
- central venous catheter (1)
- cerebral calcification (1)
- childhood leukemia (1)
- chorioamnionitis (1)
- chronic pulmonary insufficiency of prematurity (1)
- cidofovir (1)
- clinical application (1)
- clinical trial (1)
- cloning (1)
- coagulopathy (1)
- cognitive profile (1)
- combinatorial drug predictions (1)
- combined therapy (1)
- common variable immunodeficiency (1)
- complication (1)
- computer modelling (1)
- condyle pathomorphology (1)
- congenital dyserythropoietic anemia (1)
- connective tissue disorder (1)
- continuous positive airway pressure (CPAP) (1)
- corticosteroids (1)
- coverage (1)
- craniosynostosis (1)
- cytokine (1)
- cytoskeleton (1)
- cytotoxic effect (1)
- dendritic cells (1)
- depression (1)
- derivatives (1)
- desmoplastic small round cell tumor (1)
- diagnosis (1)
- diagnostic delay (1)
- diaphragmatic hypomotility (1)
- differentiation (1)
- diffusion-weighted MRI (1)
- disease severity (1)
- double negative B cells (1)
- drug therapy (1)
- dry lung syndrome (1)
- dual guidance (1)
- dysplasia (1)
- early onset sepsis (1)
- endogenous pulmonary stem cells (1)
- endoglin (1)
- epidemiology (1)
- epitope mapping (1)
- essential tremor (1)
- exercise intervention (1)
- exercise testing (1)
- exercise tolerance (1)
- exposure (1)
- extracellular vesicles (1)
- extracorporeal membrane oxygenation (1)
- extracranial malignant rhabdoid tumor (1)
- factor XIII deficiency (1)
- fetal lung (1)
- fibrosis (1)
- follow up (1)
- forearm (1)
- fungal infection (1)
- gadoxetic acid (1)
- galactomannan (1)
- galectin-1 (1)
- galectin-3 (1)
- galectin-9 (1)
- gender gap (1)
- gene expression (1)
- general practitioner (1)
- genetics (1)
- genome-wide association study (1)
- genotype-phenotype correlation (1)
- germline mutation (1)
- glioblastoma multiforme (1)
- gliomedin (1)
- graft-versus host (1)
- group 3 (1)
- health (1)
- healthcare costs (1)
- healthy children (1)
- hematology (1)
- hemorrhagic (1)
- hemostasis and thrombosis (1)
- henoch-schönlein purpura (1)
- hospital exemption (1)
- hospitalization (1)
- human brain endothelium (1)
- human brain microvascular endothelial cells (1)
- human cerebral endothelial cells (1)
- human monocytes (1)
- humanized mice (1)
- humans (1)
- hyper-IgM syndrome type 2 (HIGM2) (1)
- hyperfibrinolysis (1)
- hyperoxia (1)
- hypertrophic osteodystrophy (1)
- hypogammaglobulinemia (1)
- imaging (1)
- immaturity (1)
- immune reconstitution (1)
- immune response (1)
- immunocytokine (1)
- immunodeficiency (1)
- immunoglobulins (1)
- immunology (1)
- immunomodulation (1)
- immunosenescence (1)
- immunotherapies (1)
- inattention/hyperactivity (1)
- infection spread (1)
- infections: pneumonia (1)
- infectious diseases management (1)
- inflammatory diseases (1)
- inhibit (1)
- innate immune response (1)
- intelligence (1)
- intensive care (1)
- interferon gamma (1)
- interleukin-8 (1)
- interleukin-9 (1)
- interventional radiology (1)
- intravenous immunoglobulins (1)
- invasiveness (1)
- ischemia/reperfusion injury (1)
- juvenile progressive respiratory insufficiency (1)
- ketogenic dietary therapy (KDT) (1)
- knowledge (1)
- lactoferricin B (1)
- late onset sepsis (1)
- lethality rate (1)
- lines (1)
- lipoblastoma (1)
- liquid biopsy (1)
- live-attenuated influenza vaccine (1)
- long-term outcome (1)
- loop region (1)
- luciferase (1)
- lung (1)
- lung injury (1)
- lung transplantation (1)
- lymph node dissection (1)
- lymphadenectomy (1)
- lymphocytes (1)
- lymphoplasmacellular osteomyelitis (1)
- maintenance therapy (1)
- malignant glioma (1)
- maternal critical care (1)
- measles (1)
- mechanisms (1)
- mesenchymal stromal cell (1)
- meta-analysis (1)
- metabolic reprogramming (1)
- metabolic syndrome (1)
- metanalysis (1)
- metastasis-associated in colon cancer 1 (MACC1) (1)
- methylation (1)
- mhc molecules (1)
- mice (1)
- microbiome (1)
- middle cerebral artery occlusion (1)
- migration (1)
- mineralization (1)
- modular tumor tissue models (1)
- monocyte subsets (1)
- monocyte-derived DC (1)
- mouse models (1)
- movement disorder (1)
- movement disorders (1)
- multiple myeloma (1)
- multiple sclerosis (1)
- multiresistance (1)
- multi‑center cohort study (1)
- murine model (1)
- mutation (1)
- mutational targeting (1)
- myeloid (1)
- naive T cells (1)
- near infrared spectroscopy (1)
- neoepitope-derived peptides (1)
- neonatal immunology (1)
- neonatal meningitis (1)
- neonatal morbidity (1)
- neonatal outcome (1)
- neonatal renal failure (1)
- neonate (1)
- neuroblastoma (1)
- neuroblastoma – diagnosis (1)
- neurocognitive outcome (1)
- neutrophils (1)
- newly diagnosed ITP (1)
- non-invasive respiratory support (1)
- non-invasive ventilation (1)
- non-responder (1)
- nutrition education (1)
- observational (1)
- obstetrics (1)
- oligohydramnios sequence (1)
- orthotopic xenograft (1)
- osteomalacia (1)
- outcome (1)
- outpatient (1)
- p.R245H (1)
- p.S298P (1)
- paediatric cancer (1)
- pancreatic carcinoma (1)
- panic disorder (1)
- partially-supervised (1)
- participation in clinical trials (1)
- pediatric adrenocortical adenoma (1)
- pediatric adrenocortical carcinoma (1)
- pediatric immune thrombocytopenia (1)
- pediatric patients (1)
- pediatric stem cell transplantation (1)
- pediatrician (1)
- perioperative bleeding (1)
- peroral endoscopic myotomy (1)
- persistence (1)
- phosphorylation (1)
- platelet disorders (1)
- polymicrobial infection (1)
- polymorphism (1)
- population coverage (1)
- post-pandemic (1)
- potter sequence (1)
- prediction (1)
- pregnancy (1)
- prematurity (1)
- preschool children (1)
- preterm children (1)
- prevention program (1)
- primary antibody deficiency (1)
- primary care (1)
- primary immunodeficiencies (1)
- primary schoolchildren (1)
- probiotic prophylaxis (1)
- prognostic factors (1)
- prognostic marker (1)
- promoter (1)
- prophylaxis (1)
- prostaglandin E2 (1)
- protein expression (1)
- quality of life (1)
- quality-control (1)
- radiotherapy (1)
- randomised controlled trial (1)
- rare bone disease (1)
- rare diseases (1)
- rat (1)
- re-aim framework (1)
- real-time PCR (1)
- recommendations (1)
- refractory aGvHD (1)
- region (1)
- regional cerebral oxygenation saturation (1)
- regulatory dendritic cells (1)
- renal tubular dysgenesis (1)
- reoxygenation (1)
- resident memory T cells (1)
- resistant acid phosphatase (1)
- resolution (1)
- respiratory distress (1)
- respiratory distress syndrome (RDS) (1)
- respiratory-distress-syndrome (1)
- retroperitoneal tumor (1)
- review (1)
- rhabdomyosarcoma (1)
- rheumatoid arthritis (1)
- rickets (1)
- risk factors (1)
- safety (1)
- scoliosis (1)
- seasonal influenza (1)
- septic (1)
- serum (1)
- shock (1)
- shuttle run test (1)
- skin-to-skin contact (1)
- soft tissue sarcoma (1)
- soluble endoglin (1)
- somatic hypermutation (1)
- spectrum (1)
- speech motor impairment (1)
- spondylodysplastic Ehlers-Danlos syndrome (1)
- spondyloenchondrodysplasia (1)
- standard (1)
- stem/progenitor cells (1)
- steroid-resistant aGvHD (1)
- strength and difficulties (1)
- streptococci (1)
- stroke (1)
- suppression (1)
- suppressive function (1)
- surfactant (1)
- surfactant protein-A (1)
- surveillance (1)
- survey (1)
- sustained lung inflation (SLI) (1)
- sweat osmolality (1)
- sweat secretion rate (1)
- synovial fluid (1)
- synovitis (1)
- synthetic peptides (1)
- synthetic surfactant (1)
- systematic review (1)
- systemic lupus erythematosus (1)
- systemic sclerosis (1)
- teeth (1)
- telomere length (1)
- telomeres (1)
- therapeutic vaccines (1)
- therapy response (1)
- thermoregulation (1)
- thymectomy (1)
- thymus (1)
- tight junctions (1)
- tool (1)
- totally implantable venous access port (1)
- trained immunity (1)
- transcription factors (1)
- transmission (1)
- transmission model (1)
- trap (1)
- tremor (1)
- tumor-infiltrating lymphocytes (1)
- tumor-specific CD8+ T cells (1)
- tumors (1)
- tumour immunology (1)
- type I interferonopathy (1)
- vaccination program (1)
- vaccine (1)
- varicella (1)
- varicella-zoster virus immunosuppression (1)
- vascular access (1)
- vascular disturbances (1)
- vascular homeostasis (1)
- vasculitis (1)
- vasopressin (1)
- viral (1)
- volume (1)
- young children (1)
- zebrafish (1)
Institute
- Kinderklinik und Poliklinik (150) (remove)
Sonstige beteiligte Institutionen
- Department of Medicinal Chemistry, University of Vienna, Althanstraße 14, 1090 Vienna, Austria (1)
- Department of Paediatric Radiology, Institute of Diagnostic and Interventional Radiology, Josef-Schneider-Straße 2, Wuerzburg 97080, Germany (1)
- Department of Pediatrics, Pediatrics I, Innsbruck Medical University, Anichstr. 35, 6020, Innsbruck, Austria (1)
- Department of Pharmaceutical Technology and Biopharmaceutics, University of Vienna, Althanstraße 14, 1090 Vienna, Austria (1)
- Interdisciplinary Center for Clinical Research (IZKF), Würzburg, Germany (1)
- Interdisziplinäres Zentrum für Klinische Forschung (IZKF) (1)
EU-Project number / Contract (GA) number
- 229289 (1)
- 241778 (1)
- 609,020 (1)
- HEALTH-F2-2009-241778 (1)
Immune checkpoint blockade therapy is beneficial and even curative for some cancer patients. However, the majority don’t respond to immune therapy. Across different tumor types, pre-existing T cell infiltrates predict response to checkpoint-based immunotherapy. Based on in vitro pharmacological studies, mouse models and analyses of human melanoma patients, we show that the cytokine GDF-15 impairs LFA-1/β2-integrin-mediated adhesion of T cells to activated endothelial cells, which is a pre-requisite of T cell extravasation. In melanoma patients, GDF-15 serum levels strongly correlate with failure of PD-1-based immune checkpoint blockade therapy. Neutralization of GDF-15 improves both T cell trafficking and therapy efficiency in murine tumor models. Thus GDF-15, beside its known role in cancer-related anorexia and cachexia, emerges as a regulator of T cell extravasation into the tumor microenvironment, which provides an even stronger rationale for therapeutic anti-GDF-15 antibody development.
Background
Juvenile idiopathic arthritis (JIA) is often accompanied by pathomorphological changes to the temporomandibular joint (TMJ). By analyzing orthodontical orthopantomograms of JIA patients the aims of the study were a) classification of condyle changes, b) quantification of bony asymmetries of condylar destruction and c) detection of relationships between disease duration and TMJ-involvement.
Patients/Methods
46 caucasian JIA-patients (28 female; 18 male; < 16.0 years) were enrolled, each joint (n = 92) was morphologically assessed by means of orthopantomogram, quantitatively analysed and compared with duration of general disease. Condyle morphology was assessed using the Billiau scale for severity of destruction [1]. The quantitative analysis was based on ratios of condyle, ramus and mandible height.
Results
Patients were divided into groups (Group I – slightly affected, n = 36; Billiau severity 0–2; condyle findings: X-ray normal, condyle erosions, condylar flattening; Group II – severely affected, N = 10; Billiau severity 3–4; condyle findings: condylar flattenings and erosions, unilateral/bilateral complete loss of condyles), based on morphological analysis of condylar destruction. Duration of disease was significantly longer in Group II (8.9 ± 5.2 years) than in Group I (4.6 ± 4.7 years). Asymmetries of condyle, ramus and mandible height, quantitatively analysed by contralateral comparison, were significantly more marked in patients of Group II than of Group I.
Conclusions
Orthopantomogram imaging can be used in orthodontics clinical routine to detect TMJ-pathologies and is an important reference for monitoring progression of JIA. Classification into severe and slightly affected TMJ is possible by analysis of condylar pathomorphology. An association between degree of destruction, extent of lower jaw asymmetry and disease duration is suggested by the results.
Background
Children with different underlying malignant diseases require long-term central venous access. As for port systems in a pectoral position, peripherally implanted port systems in the forearm revealed high levels of technical and clinical success in adult cohorts.
Objective
To investigate the technical and clinical outcomes of percutaneous central venous port implantation in the forearm in adolescents.
Materials and methods
Between April 2010 and August 2020, 32 children ages 9 to 17 years with underlying malignancy received 35 totally implantable venous access ports (TIVAPs) in the forearm. All venous port systems were peripherally inserted under ultrasound guidance. Correct catheter placement was controlled by fluoroscopy. As primary endpoints, the technical success, rate of complications and catheter maintenance were analyzed. Secondary endpoints were the side of implantation, vein of catheter access, laboratory results on the day of the procedure, procedural radiation exposure, amount of contrast agent and reasons for port device removal.
Results
Percutaneous TIVAP placement under sonographic guidance was technically successful in 34 of 35 procedures (97.1%). Procedure-related complications did not occur. During the follow-up, 13,684 catheter days were analyzed, revealing 11 complications (0.8 per 1,000 catheter-duration days), Of these 11 complications, 7 were major and 10 occurred late. In seven cases, the port device had to be removed; removal-related complications did not occur.
Conclusion
Peripheral TIVAP placement in the forearms of children is a feasible, effective and safe technique with good midterm outcome. As results are comparable with standard access routes, this technique may be offered as an alternative when intermittent venous access is required.
Background
Chronic non-bacterial osteomyelitis (CNO) is an autoinflammatory disorder of the skeletal system of yet unknown etiology. Patients present with local bone pain and inflammation and - to our experience - often suffer from functional impairment with significant disabilities of daily life. The objective of this study was to assess physical activity, fitness and health-related quality of life (HRQOL) in adolescents with established diagnosis of CNO versus healthy controls (HC).
Methods
15 patients with CNO and 15 age and gender matched HC aged 13–18 years, completed questionnaires, performed an incremental exercise test with gas exchange measures up to voluntary fatigue and wore an accelerometer over 7 days at home to assess physical activity behavior.
Results
At the time of assessment, 5 CNO patients were in clinical, one in radiological and 5 in clinical and radiological remission. 7 did not receive any therapy at the time of assessment. The results of the exercise test and of the accelerometry did not show any significant difference between CNO and HC. However, reported sports participation was lower in patients with CNO and PedsQL3.0 and 4.0 showed significant lower values in most of the scores indicating reduced HRQOL.
Conclusion
Although most CNO patients showed a favorable course of disease without any relevant differences in objective measurements of physical activity and fitness versus HC at the time of assessment, questionnaires revealed perceived limitations. Further studies are needed to measure HRQOL and to validate questionnaires in patients with CNO against objective measures including more participants with a higher level of disease activity.
Background
Increasing bacterial resistance to antibiotics is a serious problem worldwide. We sought to record the acquisition of antibiotic-resistant Escherichia coli (E. coli) in healthy infants in Northern Thailand and investigated potential determinants.
Methods
Stool samples from 142 infants after birth, at ages 2wk, 2mo, 4 to 6mo, and 1y, and parent stool samples were screened for E. coli resistance to tetracycline, ampicillin, co-trimoxazole, and cefazoline by culture, and isolates were further investigated for multiresistance by disc diffusion method. Pulsed-field gel electrophoresis was performed to identify persistent and transmitted strains. Genetic comparison of resistant and transmitted strains was done by multilocus sequence typing (MLST) and strains were further investigated for extra- and intra-intestinal virulence factors by multiplex PCR.
Results
Forty-seven (33%) neonatal meconium samples contained resistant E. coli. Prevalence increased continuously: After 1y, resistance proportion (tetracycline 80%, ampicillin 72%, co-trimoxazole 66%, cefazoline 35%) almost matched those in parents. In 8 infants (6%), identical E. coli strains were found in at least 3 sampling time points (suggesting persistence). Transmission of resistant E. coli from parents to child was observed in only 8 families. MLST showed high diversity. We could not identify any virulence genes or factors associated with persistence, or transmission of resistant E. coli. Full-term, vaginal birth and birth in rural hospital were identified as risk factors for early childhood colonization with resistant E. coli.
Conclusion
One third of healthy Thai neonates harboured antibiotic-resistant E. coli in meconium. The proportion of resistant E. coli increased during the first year of life almost reaching the value in adults. We hypothesize that enhancement of infection control measures and cautious use of antibiotics may help to control further increase of resistance.
Hyper-IgM syndrome type 2 (HIGM2) is a B cell intrinsic primary immunodeficiency caused by mutations in AICDA encoding activation-induced cytidine deaminase (AID) which impair immunoglobulin class switch recombination (CSR) and somatic hypermutation (SHM). Whereas autosomal-recessive AID-deficiency (AR-AID) affects both CSR and SHM, the autosomal-dominant form (AD-AID) due to C-terminal heterozygous variants completely abolishes CSR but only partially affects SHM. AR-AID patients display enhanced germinal center (GC) reactions and autoimmune manifestations, which are not present in AD-AID, suggesting that SHM but not CSR regulates GC reactions and peripheral B cell tolerance. Herein, we describe two siblings with HIGM2 due to a novel homozygous AICDA mutation (c.428-1G > T) which disrupts the splice acceptor site of exon 4 and results in the sole expression of a truncated AID variant that lacks 10 highly conserved amino acids encoded by exon 4 (AID-ΔE4a). AID-ΔE4a patients suffered from defective CSR and enhanced GC reactions and were therefore indistinguishable from other AR-AID patients. However, the AID-ΔE4a variant only partially affected SHM as observed in AD-AID patients. In addition, AID-ΔE4a but not AD-AID patients revealed impaired targeting of mutational hotspot motives and distorted mutational patterns. Hence, qualitative defects in AID function and altered SHM rather than global decreased SHM activity may account for the disease phenotype in these patients.
Immunization of preterm infants: current evidence and future strategies to individualized approaches
(2022)
Preterm infants are at particularly high risk for infectious diseases. As this vulnerability extends beyond the neonatal period into childhood and adolescence, preterm infants benefit greatly from infection-preventive measures such as immunizations. However, there is an ongoing discussion about vaccine safety and efficacy due to preterm infants’ distinct immunological features. A significant proportion of infants remains un- or under-immunized when discharged from primary hospital stay. Educating health care professionals and parents, promoting maternal immunization and evaluating the potential of new vaccination tools are important means to reduce the overall burden from infectious diseases in preterm infants. In this narrative review, we summarize the current knowledge about vaccinations in premature infants. We discuss the specificities of early life immunity and memory function, including the role of polyreactive B cells, restricted B cell receptor diversity and heterologous immunity mediated by a cross-reactive T cell repertoire. Recently, mechanistic studies indicated that tissue-resident memory (Trm) cell populations including T cells, B cells and macrophages are already established in the fetus. Their role in human early life immunity, however, is not yet understood. Tissue-resident memory T cells, for example, are diminished in airway tissues in neonates as compared to older children or adults. Hence, the ability to make specific recall responses after secondary infectious stimulus is hampered, a phenomenon that is transcriptionally regulated by enhanced expression of T-bet. Furthermore, the microbiome establishment is a dominant factor to shape resident immunity at mucosal surfaces, but it is often disturbed in the context of preterm birth. The proposed function of Trm T cells to remember benign interactions with the microbiome might therefore be reduced which would contribute to an increased risk for sustained inflammation. An improved understanding of Trm interactions may determine novel targets of vaccination, e.g., modulation of T-bet responses and facilitate more individualized approaches to protect preterm babies in the future.
Ureaplasma species (spp.) are considered commensals of the adult genitourinary tract, but have been associated with chorioamnionitis, preterm birth, and invasive infections in neonates, including meningitis. Data on mechanisms involved in Ureaplasma-driven neuroinflammation are scarce. The present study addressed brain inflammatory responses in preterm lambs exposed to Ureaplasma parvum (UP) in utero. 7 days after intra-amniotic injection of UP (n = 10) or saline (n = 11), lambs were surgically delivered at gestational day 128–129. Expression of inflammatory markers was assessed in different brain regions using qRT-PCR and in cerebrospinal fluid (CSF) by multiplex immunoassay. CSF was analyzed for UP presence using ureB-based real-time PCR, and MRI scans documented cerebral white matter area and cortical folding. Cerebral tissue levels of atypical chemokine receptor (ACKR) 3, caspases 1-like, 2, 7, and C–X–C chemokine receptor (CXCR) 4 mRNA, as well as CSF interleukin-8 protein concentrations were significantly increased in UP-exposed lambs. UP presence in CSF was confirmed in one animal. Cortical folding and white matter area did not differ among groups. The present study confirms a role of caspases and the transmembrane receptors ACKR3 and CXCR4 in Ureaplasma-driven neuroinflammation. Enhanced caspase 1-like, 2, and 7 expression may reflect cell death. Increased ACKR3 and CXCR4 expression has been associated with inflammatory central nervous system (CNS) diseases and impaired blood–brain barrier function. According to these data and previous in vitro findings from our group, we speculate that Ureaplasma-induced caspase and receptor responses affect CNS barrier properties and thus facilitate neuroinflammation.
Purpose
In selected cases of severe Cushing’s syndrome due to uncontrolled ACTH secretion, bilateral adrenalectomy appears unavoidable. Compared with unilateral adrenalectomy (for adrenal Cushing’s syndrome), bilateral adrenalectomy has a perceived higher perioperative morbidity. The aim of the current study was to compare both interventions in endogenous Cushing’s syndrome regarding postoperative outcomes.
Methods
We report a single-center, retrospective cohort study comparing patients with hypercortisolism undergoing bilateral vs. unilateral adrenalectomy during 2008–2021. Patients with adrenal Cushing’s syndrome due to adenoma were compared with patients with ACTH-dependent Cushing’s syndrome (Cushing’s disease and ectopic ACTH production) focusing on postoperative morbidity and mortality as well as long-term survival.
Results
Of 83 patients with adrenalectomy for hypercortisolism (65.1% female, median age 53 years), the indication for adrenalectomy was due to adrenal Cushing’s syndrome in 60 patients (72.2%; 59 unilateral and one bilateral), and due to hypercortisolism caused by Cushing’s disease (n = 16) or non-pituitary uncontrolled ACTH secretion of unknown origin (n = 7) (27.7% of all adrenalectomies). Compared with unilateral adrenalectomy (n = 59), patients with bilateral adrenalectomy (n = 24) had a higher rate of severe complications (0% vs. 33%; p < 0.001) and delayed recovery (median: 10.2% vs. 79.2%; p < 0.001). Using the MTL30 marker, patients with bilateral adrenalectomy fared worse than patients after unilateral surgery (MTL30 positive: 7.2% vs. 25.0% p < 0.001). Postoperative mortality was increased in patients with bilateral adrenalectomy (0% vs. 8.3%; p = 0.081).
Conclusion
While unilateral adrenalectomy for adrenal Cushing’s syndrome represents a safe and definitive therapeutic option, bilateral adrenalectomy to control ACTH-dependent extra-adrenal Cushing’s syndrome or Cushing’s disease is a more complicated intervention with a mortality of nearly 10%.