The difficult coughing child:prolonged acute cough in children

Cough is one of the most common symptoms that patients bring to the attention of primary care clinicians. Cough can be designated as acute ( 8 weeks in duration). The use of the term 'prolonged acute cough' in a cough guideline allows a period of natural resolution to occur before further investigations are warranted. The common causes are in children with post viral or pertussis like illnesses causing the cough. Persistent bacterial bronchitis typically occurs when an initial dry acute cough due to a viral infection becomes a prolonged wet cough remaining long after the febrile illness has resolved. This cough responds to a completed course of appropriate antibiotics.

The lip:A histologic and analytical approach of relevance to esthetic plastic surgery

This is a study done for the first time to understand the histologic features of the lip deeply, quantitatively, and analytically and identify the differences between the outer, intermediate, and inner parts of the lips. Previous researchers did not tackle the histologic features of the lip from this point of view. Half lip was obtained from different well-preserved cadavers where the upper lip, lower lip, and lip angle were evaluated by coronal histologic sections. A total of 43 slides were studied and photographed using light and digital microscopes (Nikon COOLSCOPE, Nikon Corporation, Tokyo, Japan), respectively. The cadavers (26 men and 17 women) were in the age group of 45 to 65 years old, and older than 65 years. Data were entered on a study pro forma and statistically analyzed. Normal histologic features of the upper lip, intermediate, and the inner lip sections were observed. Fibrous septations that sometimes had muscular components inserting into them could be identified. In between these septations, there were loose areas (chambers). The mean numbers of chambers identified in the upper and lower lips were higher in the red areas, and more septations and chambers were identified in the lower lip. New histologic observations were classified into types 1 to 7. Significant relations were identified between the total number of septations and chambers in relation to age group and sex. Higher means of septations and chambers were detected in the age group older than 65 years, and in women as a whole. In conclusion, the findings detected in this work could explain the congenital lip pits that are familial or syndromic and many post-lip augmentation complications. © 2009 Lippincott Williams & Wilkins, Inc.

Interferon-γ stimulates CD14, TLR2 and TLR4 mRNA expression in gingival fibroblasts increasing responsiveness to bacterial challenge

Objective: To investigate the potential effects of IFN-y on the responsiveness of human gingival fibroblasts to bacterial challenge.
Design :mRNA and protein expression of CD14, TLR2 and TLR4 in human gingival fibroblasts was detected by quantitative polymerase chain reaction (Q-PCR) and flow cytometry. The effect of preincubation with IFN-y on subsequent bacterial LPS-induced expression of IL-6 and IL-8 by gingival fibroblasts was determined by ELISA. Bacterial LPS-induced IκBα degradation in human gingival fibroblasts was investigated by western blot.
Results: Human gingival fibroblasts express CD14, TLR2 and TLR4 mRNAs. IFN-y, but not IL-1B, induced mRNA expression of all three receptors and the expression of membrane bound CD14 protein. Pre-incubation of fibroblasts with IFN-y and subsequent stimulation with Escherichia coli LPS or Porphyromonas gingivalis LPS led to increased production of IL-6 and IL-8. LPS-induced pro-inflammatory cytokine production was abrogated by a blocking antibody to CD14. Both E. coli LPS and P. gingivalis LPS induced IκBα degradation in human gingival fibroblasts.
Conclusion: Our data indicate that IFN-y primes human gingival fibroblasts, through the upregulation of CD14 expression, which results in increased responsiveness to bacterial LPS challenge, as determined by pro-inflammatory cytokine production.