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Yvoir, Belgium

Watelet J.-B.,Ghent University | El Shazly A.,University of Liege | Collet S.,CHU Mont Godinne UCL | Doyen A.,Clinique Notre Dame Tournai
B-ENT | Year: 2012

Problems/objectives: A child's immune system has to initiate the immune response from scratch and cannot depend on a memory-type of immune response. Moreover, the immune system in newborns is also less efficient in inducing cytokine responses. In consequence, newborns and children are more susceptible to upper-airway infections and inflammation than adults. This manuscript summarises basic considerations relating to immune and inflammatory response in the upper airways and presents data about the processes involved in immunity development and maturation in children. Method: Literature review Results: Inflammation is a complex set of interactions between soluble factors and cells that can arise in any tissue in response to both exogenous (infectious, toxic...) and endogenous (auto-immune, ischaemia...) insults. It interacts actively with the adaptive immune response by launching the antigen processing and presenting phases. Reduced cytotoxic response during foetal life, poor T-lymphocyte response to mitogens, immaturity of T and B lymphocytes, inadequate cytokine synthesis, a marked deficiency of antibody production and reduced neutrophil, complement and natural killer activity are important contributors to the complex physiological deficiency of immunological function in neonates and young children. Conclusions: The importance of the control and self-limitation of the inflammatory reaction is demonstrated by observations that, in certain chronic infectious or inflammatory conditions, the inflammatory response causes more damage to the host than the microbe. Source


Collet S.,CHU Mont Godinne UCL | Vande Vannet B.,Vrije Universiteit Brussel | Watelet J.-B.,Ghent University | Gordts F.,Vrije Universiteit Brussel
B-ENT | Year: 2012

This paper outlines the normal functioning of the child's upper airway: defending the lower airway by means of air conditioning, filtration, initiation of inflammatory reactions or immune responses. We investigate the hypothetical mechanisms that explain the influence of, and interrelations between, mouth breathing and obstructive sleep apnoea on craniofacial development. We advise orthodontic diagnosis and/or intervention at a young age. Source


De Coster L.,Ghent University | Eloy P.,CHU Mont Godinne UCL | Ferdinande L.,Ghent University | Taildeman J.,Ghent University | And 2 more authors.
Rhinology | Year: 2012

Background: Composition changes of extracellular matrix (ECM) can lead to functional disorders of the upper airways (UA). The aim of this study was to systematically measure both the association patterns and the correlation degree between tissue composition parameters in UA inflammatory diseases. Methodology: Nasal samples were obtained from patients with chronic rhinosinusitis with (CRS+NP), without nasal polyps (CRS), with post-operative adhesions (S) and normal nasal mucosa (NM). A reproducible semi-quantitative method, which takes epithelial and lamina propria damages into account was applied for haematoxylin and eosin, alpha-smooth muscle actin, reticulin, elastin, laminin and collagen type IV stainings. Results: The most severe cases of epithelial shedding have been found in a significant higher amount in CRS+NP when compared with NM. The most severe cases of inflammatory reaction were mainly found in CRS+NP. CRS+NP had significantly more severe cases of oedema than NM. Excluding elastin, networks in other ECM proteins were found modified in fibrotic fields but to a lesser extend in oedematous regions in all conditions. Conclusion: Although non specific, oedema in the lamina propria is a key-feature of CRS+NP, while fibrosis, massively present in CRS and S, affects profoundly the distribution of ECM proteins in these areas. Source


Bernheim N.,H.U.D.E.R.F. | Bernheim N.,Center Comprendre et Parler | Doyen A.,Clinique Notre Dame Tournai | Doyen A.,Cliniques universitaires Saint Luc | And 5 more authors.
B-ENT | Year: 2012

Problems/objectives: A child's immune system cannot depend on a memory-type immune response and it also induces cytokine responses less efficiently. Biological conditions like allergy or cystic fibrosis, immune deficiency or gastro-oesophageal reflux can induce and maintain background inflammation in children's upper airways, making newborns and children more susceptible to upper airway infections and inflammations. This paper will describe in brief how allergy, cystic fibrosis, immune deficiency, nasal and paranasal anatomical variants, and gastro-oesophageal reflux (GOR) can affect the immune and inflammatory responses in upper airways and how they could interfere with immunity development and maturation in children. Methodology: Literature review. Results: Chronic inflammation induced by infection, allergy, cystic fibrosis or immune deficiency is multifactorial in origin and is strongly influenced by physiological, immunological, anatomical, environmental and, above all, genetic parameters. Finally, the direct role played by nasal and paranasal anatomical variants and GOR is also discussed. Conclusions: These conditions should be screened systematically in all children presenting chronic clinical features of upper airway inflammation. Source


Schoevaerdts D.,CHU Mont Godinne UCL | Agelas J.-P.,CHU Mont Godinne UCL | Ingels M.-G.,CHU Mont Godinne UCL | Jamart J.,Scientific Support Unit | And 4 more authors.
Archives of Gerontology and Geriatrics | Year: 2013

The objective of this study was to examine whether asymptomatic colonization with MDRB would affect outcomes in older patients one year after hospitalization in a geriatric ward. Patient samples were analyzed to identify specific MDRBs, including methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum beta-lactamase-producing Enterobaceriaceae (ESBLE), and vancomycin-resistant enterococci (VRE).Among 337 patients screened at hospital admission, 62 (18%) carried one or more MDRB isolates (MRSA: n=23; ESBLE: n=39; VRE: n=2). At 12 months after admission, 320 patients were interviewed by telephone (17 patients lost to follow up) to assess all-cause mortality, nursing home admissions, functional decline, and hospital readmissions. All-cause mortality rates were similar in MDRB carriers (34%; n=61) and non-carriers (30%; n=259) (P=0.512). Nursing home admission, functional decline, and hospital readmission did not differ between the two groups. In this population, predictors of mortality were: male gender (P=0.002), cognitive disorders at admission (P=0.028), low pre-albumin level at admission (P=0.048), a high level of co-morbidities (P=0.002), and a history of an acute condition in the three months prior to initial hospital admission (P=0.024). In conclusion, in this cohort of older patients, asymptomatic MDRB colonization was not significantly associated with adverse health outcomes at a one-year follow-up after hospitalization. The potential limitations of the study were the small sample size, relatively high mortality rate, and lack of MDRB reassessment during the follow-up. © 2012 Elsevier Ireland Ltd. Source

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