Streptococcal tonsillitis as a cause of urticaria: tonsillitis and urticaria

BACKGROUND

The primary role of infections in chronic urticaria (CU) is controversial. We hypothesised that streptococcal tonsillitis (ST) could be a primary cause of CU or acute recurrent urticaria (ARU).

METHODS

Retrospective study of 14 outpatients observed between January 2000 and December 2009, with CU/ARU and clinical and/or laboratorial suspicion of an aetiopathogenic link with ST. Clinical history, objective examination and laboratorial study were looked for. Three groups were defined: spontaneous resolution of urticaria, resolution after tonsillectomy, and still symptomatic.

RESULTS

In these patients, a causal relationship between ST and urticaria is supported by: markers of streptococcal infection, the perception of a clinical relationship between tonsillitis and urticaria, the decrease of urticaria severity with early antibiotherapy to tonsillitis and urticaria resolution after tonsillectomy.

CONCLUSIONS

Our study encourages the investigation of tonsillitis in these otherwise idiopathic patients, especially until young adulthood and even in the absence of any symptoms.

The Role of Personality Traits, Attachment Style, and Satisfaction With Relationships in the Subjective Well-Being of Americans, Portuguese, and Mozambicans

Personality traits, attachment security, and satisfaction with relationships are each important predictors of subjective well-being (SWB). However, no studies have included these predictors together to analyze the unique contribution of each to SWB. Furthermore, most studies are empirically based in Western/industrialized societies, and few studies include African countries. This article addresses the unique contribution of extroversion, neuroticism, attachment security, and satisfaction with relationships to SWB across three samples of 1,574 university students: 497 from North Carolina (United States of America), 544 from Maputo (Mozambique), and 533 from Lisbon (Portugal). Structural equation modeling analysis showed that in the American sample, emotional stability was a more important predictor of global SWB than satisfaction with relationships. In the Mozambican sample, satisfaction with relationships was far more important as a predictor of SWB than emotional stability. In the Portuguese sample, emotional stability and satisfaction with relationships were equally important predictors of SWB. The main difference between the three samples was the contribution of satisfaction with relationships to SWB. Similarities between the three samples include the low or nonsignificant contributions of extroversion and attachment to SWB, above and beyond the contribution of satisfaction with relationships and neuroticism, suggesting they may be sharing variance in the prediction of SWB.

Variation of the different attributes that support the physical function in community-dwelling older adults

AIM

This study investigated the variation with age of different attributes that support the physical functioning in community-dwelling older adults having as reference scores from young adults.

METHODS

The study was a cross-sectional study. Participants were 559 older adults and 79 young adults grouped according to gender and age (Y:20-29, A:60-64, B:65-69, C:70-74, D:75-79 and E:≥ 80 years). Strength, flexibility, agility, aerobic endurance, and balance were evaluated by Fullerton tests.

RESULTS

ANOVA and Bonferroni post-hoc tests showed that compared to young, the 60-64 years group showed decreased values in almost all attributes of physical function. In older adults, additional differences were observed in females mainly between the 60-64 years group and the 70-74 years, 75-79 years, and:≥ 80 years groups, and in males between the 60-64 years group and the ≥ 80 years group (P<0.05). Comparisons between standardized physical function attributes (T-scores) done by repeated measures and contrasts demonstrated that, across age groups, agility and dynamic balance showed the highest rate loss in both genders, and lower body flexibility showed the lowest (P<0.01).

CONCLUSION

Physical function reduction seems to occur earlier in women than in men and abilities involving multiple structures such as balance, agility, and aerobic endurance showed the most loss.

T cell receptor excision circles (TREC) and recent thymic migrant cells in specific immunotherapy and respiratory allergy to Dermatophagoides pteronyssinus

INTRODUCTION

T cell receptor excision circles (TREC) on CD31+ T cells are related to recent thymic emigrant cells (RTEs). The involvement of the functional thymic tissue occurs early in the IgE-mediated allergic reaction, and in response to specific immunotherapy (SIT).

AIM

Evaluation of specific immunotherapy effects on TREC number in peripheral T cells in patients allergic to Dermatophagoides pteronyssinus (Dpt).

METHOD

85 respiratory allergic patients (both genders), 41 of them (Group II) under maintenance treatment to Dpt SIT (21 sublingual-SLIT, and 20 subcutaneous-SCIT), were selected. The allergic patients (Group I) without specific treatment were submitted to an allergen challenge test (22 nasal and 22 conjunctival). Peripheral cell analysis was performed immediately before treatment and 60 or 240 minutes after allergenic extract administration. TREC quantification was performed in CD4+CD31+ and CD8+CD31+. The results were expressed per 100.000 cells related to RTEs. Samples from 10 healthy individuals (Control - Group III) were obtained with the same method.

RESULTS

The value of TRECs on RTEs was constant in control groups. For Group I patients (nasal or conjunctival test), TREC quantification in CD31+ T cells showed relevant individual changes, even in the patients tested earlier (60 minutes), and statistical significant at 240 minutes. Both SCIT and SLIT had also demonstrated enormous individual changes, particularly on TRECs/CD4+CD31+ cells assay. Basal values in Group III were significantly higher than those observed in active patients groups.

CONCLUSION

Thymic functional activity is earlier involved in the allergic reaction and SIT IgE-mediated allergy is able to induce RTEs in the periphery, particularly TRECs/CD4+CD31+ cells. Both SLIT and SCIT showed reduced RETs in the periphery, probably due to maturation of regulatory T cells. Our results suggest a crucial role of the functional thymic tissue on the central mechanism of this therapy.

A multibiomarker approach in the clam Ruditapes decussatus to assess the impact of pollution in the Ria Formosa lagoon, South Coast of Portugal

The Ria Formosa lagoon is an ecosystem whose water quality reflects the anthropogenic influence upon the surrounding areas. In this lagoon, the clam Ruditapes decussatus has a great economical importance and has been widely used as a biomonitor. A multibiomarker approach (δ-aminolevulinic acid dehydratase, metallothionein, lipid peroxidation, acetylcholinesterase, alkali-labile phosphates, DNA damage) was applied to assess the environmental quality of this ecosystem and the accumulation of contaminants and their potential adverse effects on clams. Clams were sampled in different shellfish beds in the period between July 2007 and December 2008 and abiotic parameters (temperature, salinity, pH and dissolved oxygen of seawater and organic matter in the sediment), condition index, metals (Cd, Cu, Zn, Ni, Pb), TBTs and PAHs concentrations were measured in clam tissues. Data was integrated using Principal Component Analyses and biomarker indices: IBR (Integrated Biomarker Response) and HSI (Health Status Index). This multibiomarker approach enabled discrimination of a time and space trend between sites with different degrees of anthropogenic contamination, identifying one of them (site 2) as the most stressful and summer months as the most critical period for clams due to an increase of environmental stress (anthropogenic pressure along with extreme environmental conditions, e.g. temperature, dissolved oxygen, organic matter in the sediments, etc). The selected biomarkers provided an integrated response to assess the environmental quality of the system, proving to be a useful approach when complex mixtures of contaminants occur.

Airways hyperresponsiveness to different inhaled combination therapies in adolescent asthmatics

BACKGROUND

Inhaled combined therapy improves the pulmonary function in asthmatic patients. The effect on the airway hyperresponsiveness (AHR) and the efficacy of different pharmacological schedules is not well clarified on adolescent asthmatics.

OBJECTIVE

Evaluate the responses to different combined inhaled therapies in adolescent asthmatics and study its impact on exercise induced AHR.

METHODS

Basal lung function tests (LFT) were performed in 30 adolescents (13 to 16 years old; 19 female) with allergic asthma. They were submitted to exercise challenge test (EC) followed by bronchodilator test (BD). During 4 weeks, 15 adolescents were submitted to inhaled fluticasone/salmeterol (group A) and other 15 to inhaled budesonide/formoterol (group B). After this period, they underwent another functional evaluation as previous.

RESULTS

Before treatment, pulmonary function was similar in both groups. After 4 weeks of treatment, these groups showed an improvement of the basal LFT (p = 0.001 for FEV1 in both), decrease on bronchoconstriction induced by exercise (NS for both) and less recovery on BD response (p = 0.001 and 0.002, for FEV1 respectively groups A and B). Group B showed a better performance, with higher improvement of basal FEF 25/75 (p = 0.001), reduced bronchoconstriction response to EC (p = 0.008 for FEV1) and fewer response to BD test (p < 0.0001 for FEV1 and 0.024 for FEF 25/75) No adverse events were observed.

CONCLUSION

After 4 weeks of inhaled combined therapy, these patients improved their pulmonary function and bronchomotricity. Those under budesonide/formoterol showed the highest improvement. These medications are a safe measure in controlling the asthma in these patients.

Assessing single and joint effects of chemicals on the survival and reproduction of Folsomia candida (Collembola) in soil

Chemicals are often found in the environment as complex mixtures. There has been a large effort in the last decade to assess the combined effect of chemicals, using the conceptual models of Concentration Addition and Independent Action, but also including synergistic, antagonistic, dose-level and dose-ratio dependent deviations from these models. In the present study, single and mixture toxicity of atrazine, dimethoate, lindane, zinc and cadmium were studied in Folsomia candida, assessing survival and reproduction. Different response patterns were observed for the different endpoints and synergistic patterns were observed when pesticides were present. Compared with the previously tested Enchytraeus albidus and Porcellionides pruinosus, the mixture toxicity pattern for F. candida was species specific. The present study highlights the importance of studying toxicity of chemicals mixtures due to the observed potentiation of effects and confirms that for an adequate ecologically relevant risk assessment different organisms and endpoints should be included.