No abstract

Background/AimsTreatment with antiviral neuraminidase inhibitors suppresses influenza viral replication and antigen production, resulting in marked attenuation of mucosal immunity and mild suppression of systemic immunity in mice. This study investigated the effects of immunomodulator clarithromycin (CAM) supplementation on mucosal and systemic immunity in pediatric patients with influenza treated with neuraminidase inhibitors.MethodsA retrospective, non-randomized case series study was conducted among five treatment groups of 195 children aged 5.9±3.3 years infected with influenza A in 2008/2009 season. The five treatment groups were oseltamivir (OSV), zanamivir (ZNV), OSV+CAM, ZNV+CAM and untreated groups. Anti-viral secretory IgA (S-IgA) levels in nasal washes and IgG levels in sera were measured. The re-infection rate was analyzed among the same five treatment groups in the 2009/2010 season.ResultsTreatment of influenza with OSV and ZNV for 5 days attenuated the induction of anti-viral S-IgA in nasal washes and anti-viral IgG in serum, compared with the untreated group. The combination of CAM plus OSV or ZNV boosted and restored the production of mucosal S-IgA and systemic IgG. The re-infection rates in the subsequent season were significantly higher in the OSV and ZNV groups than the untreated, while CAM+OSV and CAM+ZNV tended to reduce such rate.ConclusionsCAM restored the attenuated anti-viral mucosal and systemic immunity and reduced the re-infection rate in the subsequent year in pediatric patients with influenza treated with OSV and ZNV.

DiscussionThe incidence of giardiasis in housed infants with diarrhoea (3%) was low; the higher incidence in itinerant infants (12 %) was Case report This Japanese boy was 11 years when he first visited our clinic. Family history was not remarkable. He had been the product of a term, uncomplicated pregnancy and had weighed 2 -9 kg at birth. Labour and delivery had been normal. He had attained all the early motor milestones at the appropriate ages and walked at 15 months. At 3 years it was noticed that his gait was waddling and wide-based; he could not run or jump as other children. He was admitted to a hospital with suspected muscular dystrophy. At 4 years bilateral inguinal hernias were repaired. At 10 years he began to complain of pains in the legs. At 11 he was admitted to hospital because of muscular weakness and wasting, and because he tired easily; he had difficulty in climbing stairs and could not lift heavy objects above his head.He was then a slender boy with an excessive lumbar lordosis; height was 133 3 cm (-1 SD) and weight 20-1 kg (-2 5 SD). Blood pressure was

No abstract

No abstract