RESUMEN
OBJECTIVES: Our study aimed to evaluate the cytokine levels in pediatric chronic non-bacterial osteomyelitis (CNO) patients and compare these with other immune-mediated diseases and healthy controls. METHODS: In this prospective study, we included 42 children with CNO, 28 patients with non-systemic juvenile idiopathic arthritis (JIA), 17 children with insulin-dependent diabetes mellitus (IDDM), and 30 healthy age-matched controls. In each of the CNO patients and comparison groups, the levels of 14-3-3-η protein, S100A8/A9 protein, interleukin-4 (IL-4), interleukin-17 (IL-17), interleukin-18 (IL-18), interleukin-1ß (IL-1ß), tumor necrosis factor-α (TNF-α) were measured by ELISA assay. RESULTS: All studied cytokines in the CNO patients were significantly higher than controls, and IDDM, 14-3-3-η protein, IL-18, IL-4, IL-17, IL-1ß, and TNF-α were less than in JIA patients. In the discriminant analysis, ESR, 14-3-3 protein, S100A8/A9, IL-18, IL-4, and TNF-α can discriminate CNO from JIA, and 14-3-3 protein, S100A8/A9, IL-18, IL-17, IL-4, and TNF-α can distinguish CNO from other diseases and HC. CONCLUSION: The increased level of pro-inflammatory cytokines confirms the role of monocyte-driven inflammation in CNO patients. Cytokines may prove valuable as biomarkers and potential therapeutic targets for CNO.
Asunto(s)
Artritis Juvenil/sangre , Citocinas/sangre , Diabetes Mellitus Tipo 1/sangre , Osteomielitis/sangre , Estudios de Casos y Controles , Niño , Preescolar , Enfermedad Crónica , Femenino , Humanos , Huésped Inmunocomprometido , Masculino , Análisis Multivariante , Sensibilidad y EspecificidadRESUMEN
The risk of death is significantly higher in HIV-infected patients with tuberculosis (TB). This study aims to evaluate the impact of demographic, clinical and laboratory characteristics on the treatment outcome and mortality of TB/HIV co-infected patients in a tertiary TB centre in Iran. In total, 111 patients were recruited from 2004 to 2007. Mycobacteriological studies and demographic, clinical, and laboratory data from all patients were analysed and predictors of unsuccessful outcomes as well as mortality were determined. The mean age for all 111 TB-HIV patients was 38 ± 9 years (range 22-70) and 107 (96.3%) were men; 104 (93.7%) had a history of drug abuse and 96 (86.4%) had a history of imprisonment. The method of HIV transmission was intravenous drug use in 88 (79.3%). Twenty-three (20.7%) had a history of Category 1 (CAT I) TB treatment and six (5.4%) Category 2 (CAT II) treatment. Combination antiretroviral therapy (cART) was given to 48 (43.2%). No significant associations were found between treatment outcomes or mortality and gender, smoking, drug and alcohol abuse, imprisonment, method of transmission, history of CAT I and CAT II treatments, CD4 counts or adverse effects (P > 0.05). Administration of cART led to significantly better outcomes (P < 0.001). Lower serum albumin levels and low body weight were significantly associated with mortality.
Asunto(s)
Infecciones por VIH/parasitología , Tuberculosis/virología , Adulto , Antirretrovirales/uso terapéutico , Femenino , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Infecciones por VIH/mortalidad , Humanos , Irán/epidemiología , Masculino , Persona de Mediana Edad , Factores de Riesgo , Resultado del Tratamiento , Tuberculosis/tratamiento farmacológico , Tuberculosis/epidemiología , Tuberculosis/mortalidadRESUMEN
This study aims to explore how the long period of uncertainty about possible relocation affects the marital quality of the population in the Golan Heights and what forms of coping with this ongoing stress are used. The results, based on both quantitative and qualitative data, indicate a circular process in which the level of stress generated by the uncertainty varies with marital quality and with other personal and family resources, such as potency and an appreciation of the spouse's ability to cope with the stress. Four ways of coping with the uncertainty were observed in in-depth interviews: fighting, ignoring, postponing, and planning. The results are discussed in terms of their meaning for possible systemic interventions.
Asunto(s)
Emigración e Inmigración , Matrimonio/psicología , Calidad de Vida , Estrés Psicológico/psicología , Adaptación Psicológica , Adulto , Femenino , Humanos , Israel , Masculino , Persona de Mediana Edad , Población Rural , Encuestas y Cuestionarios , Población UrbanaRESUMEN
This article describes and analyzes a 2-year supervision process with social workers and family therapists who live and work under conditions of uncertainty on the West Bank. The systemic orientation used in this specific approach to supervision emphasizes the double role of the therapist: one as part of the therapeutic system, and the second as a member of the same community that is living in political uncertainty. The analysis revealed that a long-term supervision process, in which the supervisor encouraged a containing context, was meaningful to the group. As a result of this secure atmosphere, the group was ready to talk about painful issues like loss as the result of war and terrorist attacks, loss as a result of immigration, and loss of ideals. Furthermore, the members of the group were ready to confront the possibility of relocation and their role in such a situation. The techniques used in the process, such as narrative and metaphors, were implemented by the members in their daily professional interventions. The flexibility between working on regular professional issues and issues related to stress and uncertainty seemed useful to the supervision, as well as the political dialogue that was created between the supervisor and the group.