RESUMEN
Kawasaki disease (KD) is a medium vessel systemic vasculitis that predominantly occurs in children below five years of age. It is an acute febrile condition in which coronary artery aneurysms and myocarditis are the most common cardiovascular complications. It is most often characterized by hypercytokinemia. The etiopathogenesis of KD is not fully understood. The present review synthesizes the recent advances in the pathophysiology and treatment options of KD. According to different studies, the genetic, infections and autoimmunity factors play a major role in pathogenesis. Several susceptibility genes (e.g. caspase 3) and cytokines (e.g. IL-2, IL-4, IL-6, IL-10, IFN-gamma and TNF-alpha) have been identified in KD. Patients with high cytokine levels are predisposed to KD shock syndrome. The importance of respiratory viruses in the pathogenesis of the disease is unclear. Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may induce in children and adults an abnormal systemic inflammatory response. This syndrome shares characteristics with KD. It has been called by many terms like MIS-C (Multisystem Inflammatory Syndrome in Children), PIMS-TS (pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2), hyperinflammatory shock syndrome, cytokine storm (cytokine release syndrome) or simply, Kawasaki-like syndrome. The cytokine's role in the development of KD or Kawasaki-like syndrome being triggered by COVID-19 is controversial. The presences of the antiendothelial cell autoantibodies (AECAs) together with the newly developed hypothesis of immunothrombosis are considered potential pathogenic mechanisms for KD. In consequence, the diagnosis and treatment of KD and Kawasaki-like syndrome, one of the most common causes of acquired heart disease in developed countries, are challenging without a clearly defined protocol.
Asunto(s)
COVID-19 , Síndrome Mucocutáneo Linfonodular , COVID-19/complicaciones , Niño , Citocinas , Humanos , Síndrome Mucocutáneo Linfonodular/complicaciones , Síndrome Mucocutáneo Linfonodular/diagnóstico , Síndrome Mucocutáneo Linfonodular/terapia , SARS-CoV-2 , Síndrome de Respuesta Inflamatoria SistémicaRESUMEN
The work studies the survival of added selected probiotic bacteria Lactobacillus acidophilus (S1), Lactobacillus casei (S2), and Lactobacillus plantarum96 (S3) in semi-hard cheese with low-cooking curd during the maturation process. Cheeses were made according to the standard procedure (Polyfood SI 050 device). Probiotic lactobacilli strains Lactobacillus acidophilus (S1), Lactobacillus casei (S2), and Lactobacillus plantarum96 (S3) used in this study were added into the milk before the renneting process. The manufactured cheeses were matured for 6 months at the temperature of 10 °C. Cheese samples were taken for pH and titratable acidity measurements, lactobacilli enumeration, and chemical analysis at 30, 60, 90, 120, 150 and 180 days of maturation. At the end of the experiment (180 days) the cheese samples were analyzed also for the amount of lactic acid and protein contents. Initial numbers of lactobacilli inoculated into the milk (10(8) CFU mL(-1)) decreased during the first 2 weeks of maturation and reached from 2.15 10(7) CFU g(-1) in S1 cheese to 4.32 10(7) CFU g(-1) in S3 cheese. The number of Lactobacillus acidophilus strain bacteria at the beginning of the maturation period was 2.47.10(7) CFU g(-1) and declined until day 120 of maturation to the number of 0.45 10(6) CFU g(-1). In the last month of the experiment day 180 the viable cell numbers started to rise up to the final number of 0.41 10(7) CFU g(-1). The numbers of Lactobacillus plantarum96 varied around 10(8) CFU g(-1) during the whole period of the experiment. According to our results it was detected that in all experimental cheeses, the used probiotic lactobacilli reached the values above 10(6) CFU g(-1). Thus the legislated and therapeutic minimum limits set for the products containing probiotic bacteria for human diet were fulfilled.
RESUMEN
Even though guidelines for diagnosing celiac disease have been compiled and accepted by a number of expert associations, this disease continues to be under-diagnosed in children and, particularly, in adults. This is even though numerous scientific papers, short case studies and review papers have been published highlighting this issue and consensually supporting screening methods. In addition, research results by reputable Czech and Slovak authors suggest that, at present, only a small proportion of all cases of celiac disease are correctly diagnosed. Considering this, methods to diagnose the disease in its initial stage are continuously being sought. Biopsy of the mucosa of the small intestine remains the gold standard when diagnosing celiac disease. Within the targeted diagnostic algorithm, less invasive techniques should precede biopsy. These are applied mainly in cases of atypical forms of the disease and are based on an examination of serum autoantibodies. Their application and use is advantageous from many perspectives. However, practical clinical experience showed that they are not always sufficiently specific and sensitive. Using their own experience and published literature, the authors discuss the issues of screening and diagnosing celiac disease. It is obvious that targeted screening will undoubtedly uncover new, mainly atypical forms of celiac disease, while some cases shall remain undiagnosed. The diagnosis of celiac disease can be made on the basis of clinical, laboratory and histopathological correlation, respecting possible difficulties.