Asymptomatic Forms Research Articles

Evaluation of recombinant proteins T. pallidum Тр0163 and Тр0971 as antigens for the diagnosis of syphilis using enzyme immunoassay.

Background: Many T.pallidum proteins have been evaluated for their diagnostic value. However, there are difficulties in diagnosing asymptomatic forms of syphilis, when sensitivity of serologic methods may vary considerably. Therefore, the search for more sensitive and specific antigens for the serological diagnosis of syphilis continues. Purpose of the study: To evaluate the potential of recombinant proteins T. pallidum Тр0163 and Тр0971 as candidate antigens for IgG determination in sera of syphilis patients using enzyme immunoassay. Materials and methods: Recombinant T.pallidum proteins Тр0163 and Тр0971 were produced by Cusabio (China). Sera from patients with diagnosis of primary, secondary, early latent and late latent syphilis, and from healthy individuals, were used for the indirect ELISA. A positivity coefficient was determined as the ratio of the optical density obtained for each sample to the critical optical density. The positivity coefficient was used to determine the difference between groups of syphilis patients and healthy individuals using the Mann-Whitney test. The diagnostic efficiency of the ELISA was assessed in accordance with the standard for assessing diagnostic informativeness of laboratory tests. Results: The overall diagnostic efficiency of recombinant proteins for IgG determination by enzyme immunoassay is 65,4% and 66,7% for Тр0163 and Тр0971 respectively, demonstrating specificity and positive predictive value of the study. The overall sensitivity of ELISA was not more than 68,8%. Conclusions: In order to improve syphilis diagnostics, we believe it is important to continue working with these antigens to determine the effectiveness of ELISA detecting IgM/IgG antibodies with a large number of samples.

Clinical and epidemiological characteristics of patients with pheochromocytoma and retroperitoneal paraganglioma

Introduction. Pheochromocytoma/paraganglioma (PPGL) is a rare hormonally active tumor of chromaffin tissue. Delayed diagnosis of this disease can lead to severe, even fatal, complications. Surgical treatment of PPGL without the necessary preoperative preparation can cause intraoperative uncontrolled hemodynamic impairment. In addition, since 2017, PPGL has been recognized as a malignant tumor due to the presence of metastatic potential. All these factors determine the need for early diagnosis of PPGL, which is based, first of all, on knowledge of the clinical picture by specialists in various fields.Aim. To check and confirm the epidemiological characteristics of PPGL as well as the most common clinical symptoms in the whole group of PPGL and in subgroups of clinical forms; to form a risk group for screening for PPGL.Materials and methods. There were enrolled 353 patients in the study. These patients were operated on at the St. Petersburg State University Hospital in the period from 2010 to 2022 inclusive. All the patients were verified PPGL diagnosis histologically. Clinical symptoms were assessed: a) retrospectively, by analyzing complaints and anamnesis from the initial examination in medical histories upon admission to the hospital for surgical treatment b) both in the entire group as a whole and in subgroups of clinical forms (paroxysmal, constant, mixed, asymptomatic). Statistical analysis was performed using the Python 3.11 programming language (Python Software Foundation, USA). descriptive statistics of quantitative characteristics are presented in the form of medians, first and third quartiles in me format [q1; q3], categorical features – in the form of absolute and relative frequencies in the format n (%). the frequency histogram was constructed using the Matplotlib 3.8.2 library.Results. PPGL is most common in women over 40 years of age. The most common symptoms of PPGL are the following: a feeling of rapid heartbeat (55.95%), headache (41.07%), arterial hypertension (AH) in the form of hypertensive crises (55.65%), constant increase in blood pressure (38.39%), episodes of moderate increases in blood pressure (24.11%), sweating (30.65%), general weakness and fatigue (26.19%), hot flashes or chills (24.11%). These symptoms are formed into the criteria for screening for PPGL. In the asymptomatic clinical form – lower back pain is more common (14%); with paroxysmal – panic attacks (10%); with mixed – thirst and dry mouth (10%), and with constant form – the actual constant nature of hypertension (100%).Conclusion. In a large sample of patients with a rare pathology, the most characteristic symptom complex was identified, characteristic of both PPGL and individual clinical forms. A risk group has been formed for screening for PPGL.

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Peripheral artery disease is a considered as one of the major macrovascular complications in diabetes mellitus type 2. It is chronic arteriosclerotic illness that mainly affects the lower limbs and is presented as narrowed or blocked blood vessels. The prevalence increases with the age, it affects 15-20% of persons older than 70 years age, 10-15% of the general population. Smoking and high cholesterol levels increase the risk for PAD progression in large blood vessels such as legs, while diabetes increases the risk for PAD in small blood vessels such as the feet. Critical ischemia, its most severe form can lead to limb amputation and the patient’s death, and even its asymptomatic forms are associated with a high risk of cardiovascular morbidity and mortality. Approximately more than half of all patients are asymptomatic and preventive therapy reduces the risk of complications and death, so it’s important to recognize the subclinical forms in time and to control risk factors of disease. The risk factors that can be modified are tobacco use, hypertension, hyperlipidemia, diabetes mellitus, obesity and some of them cannot be modified such as age, sex or family medical history. Diabetes mellitus type 2 is considered as the most important risk factor for development of peripheral artery disease. The experts suggest that is necessary to establish an HBA1C therapeutic target below 8% in patient with DM and PAD.

The evolution of cardiac function in patients with non-Hodgkin’s lymphoma under chemotherapy

In clinical practice, the treatment of non-Hodgkin’s lymphoma (NHL) often involves the combination of several chemotherapy agents, radiotherapy and immunotherapy. While these multimodal approaches improve the efficacy of pathology-specific treatment, they also increase the risk of cardiovascular complications, the most common of which is ventricular dysfunction induced by anti-tumor therapy. Aim of the study: Evaluation of the impact of anti-tumor treatment of NHL on the trajectory of left and right ventricular echocardiographic function. Materials and methods: 127 randomly selected patients from the hematology departments of the PSMI Institute of Oncology were included in the study. Patients were investigated during 3 visits by comprehensive echocardiography, the first visit was up to the onset of anti-tumoral treatment, the 2nd visit was 1 month after initiation and the 3rd visit at 6 months after the debut of chemotherapy. Results: During the anti-tumor treatment, a statistically significant decrease in left ventricular systolic indicators was attested by following parameters: left ventricular ejection fraction (LV EF), mean left ventricular S’, the ratio between the maximum velocity of the E wave and the flow propagation velocity (E/Vp), with an ANOVA p-value <0.001. Regarding the right ventricular systolic function, the indices reflected by TAPSE and S’ right ventricular free wall were reduced statistically significantly also (p ANOVA <0.001). The given analysis confirmed the impairment of ventricular relaxation throughout the treatment, the increase in left ventricular filling pressures, the ratio E/A and E/e’ showed a statisticallysignificant increase, parameters such as the deceleration time of the E wave, the relaxation isovolumetric time, the ratio e’/a’ did not register a statistically significant dynamic (p ANOVA = 0,897; 0,705 and 0,145 respectively). 6 months after the start of treatment, cardiac dysfunction associated with cancer therapy (CTRCD) was found in 18 patients (14,2%), 8 (6,3%) presented a moderate asymptomatic form, 7 (5,7%) had a mild asymptomatic form and 3 (2,4%) a symptomatic one.Conclusion: The left ventricular systolic function was statistically significantly reduced under the impact of the applied treatment, which was confirmed by the LV EF, the mean S’ value at the LV and the E/Vp ratio, the diastolic function having an impact through the E/A and E/e’ ratio. Regarding the function of the right ventricle, we attested statistically significant changes only in the longitudinal contraction parameters. CTRCD was confirmed in 18 patients.

Robertsonian Translocation between Human Chromosomes 21 and 22, Inherited across Three Generations, without Any Phenotypic Effect

Chromosomal translocations can result in phenotypic effects of varying severity, depending on the position of the breakpoints and the rearrangement of genes within the interphase nucleus of the translocated chromosome regions. Balanced translocations are often asymptomatic phenotypically and are typically detected due to a decrease in fertility resulting from issues during meiosis. Robertsonian translocations are among the most common chromosomal abnormalities, often asymptomatic, and can persist in the population as a normal polymorphism. We serendipitously discovered a Robertsonian translocation between chromosome 21 and chromosome 22, which is inherited across three generations without any phenotypic effect, notably only in females. In situ hybridization with alpha-satellite DNAs revealed the presence of both centromeric sequences in the translocated chromosome. The reciprocal translocation resulted in a partial deletion of the short arm of both chromosomes 21, and 22, with the ribosomal RNA genes remaining present in the middle part of the new metacentric chromosome. The rearrangement did not cause alterations to the long arm. The spread of an asymptomatic heterozygous chromosomal polymorphism in a population can lead to mating between heterozygous individuals, potentially resulting in offspring with a homozygous chromosomal configuration for the anomaly they carry. This new karyotype may not produce phenotypic effects in the individual who presents it. The frequency of karyotypes with chromosomal rearrangements in asymptomatic heterozygous form in human populations is likely underestimated, and molecular karyotype by array Comparative Genomic Hybridization (array-CGH) analysis does not allow for the identification of this type of chromosomal anomaly, making classical cytogenetic analysis the preferred method for obtaining clear results on a karyotype carrying a balanced rearrangement.

The seroprevalence of COVID-19 among people living with HIV in Morocco

The association of COVID-19 and HIV infection would seem deadly in terms of prognosis and the possibilities of viral clearance given the immunodeficiency. However, a lower seroprevalence has been reported in some studies compared to that found in the non-HIV population. The objective of this study is to determine the seroprevalence of COVID-19 among people living with HIV (PLHIV) in Morocco. This is a prospective study carried out in the infectious diseases department of the Ibn Rochd University Hospital in Casablanca. We included PLHIV who consulted the Infectious Diseases Day-Hospital service between January 18, 2021 and March 10, 2021. After informed consent, patients completed a survey and had blood drawn for SARS-CoV-2 antibody testing. The determination of IgG antibodies against SARS-CoV-2 in blood was carried out using chemiluminescence microparticle immunoassay technology. We included 418 PLHIV in the study, most patients were male (50.24%), the average age was 40 years, 90.2% of patients were on antiretroviral treatment, 56.7% had a viral load <20 copies/ml, and 47.37% had a CD4 count greater than 500 cells/μL. The IgG test was positive in 53 patients, representing a seroprevalence of 12.68%. None of the patients had clinical signs. Seroprevalence was higher in female patients (58.49%), aged between 30 and 40 years (41.51%), in patients with a negative viral load (64.15%) and a CD4 count greater than 500 cells/mm3 (49.6%). Our study showed that the seroprevalence of COVID-19 was higher among PLHIV compared to people without HIV infection. All the patients had asymptomatic forms which pushes us to evoke a theory, to demonstrate, of the action of antiretrovirals against SARS-CoV-2.

Analysis of the parasitological situation regarding eimeriosis in cattle in the Russian Federation

The purpose of the study is to review the spread of bovine eimeriosis in the territory of the Russian Federation. Objectives of the study: to analyze the epizootic situation of bovine eimeriosis in the territory of the Russian Federation. Bovine coccidiosis is widespread in many regions of Russia and in other countries of the world. The pathogens are more than 10 species of eimeria, which have a specific localization in the body of animals, as well as morphological differences from each other. Three species (E. zuernii, E. bovis and E. alabamensis) are characterized by the highest pathogenicity and are most often associated with the clinical manifestation of the disease. Mostly young animals aged from 2 weeks to 1 year are ill, and adult animals have an asymptomatic form of invasion. In many animals, eimeria causes dangerous diseases, accompanied by a decrease in productivity, the birth of weak offspring, often the death of young animals, and additional feed costs per unit of production. In livestock complexes, the incidence of calves with eimeriosis is 10–100%, and mortality is 25–60%. The maximum infection of calves and adult animals is observed in the spring and autumn periods, and in some regions in the autumn-winter period. It was found that with an increase in the density of calves in the machine, their infection with eimeria increases significantly. The invasion of calves was minimal when kept in individual machines. Given that parasites have a complex developmental biology, one of the most importantmeasures in the complex of measures ensuring the prevention and elimination of animal diseases with coccidiosis is currently still pharmacotherapy and prevention, contributing not only to the liberation of animals from parasites, but also to prevent the dispersion of the invasive origin in the environment and to prevent the threat of new infection.

SILENT ATRIAL FIBRILLATION CORRELATES WITH COGNITIVE PERFORMANCE IN OLDER PERSONS

Objective: Atrial fibrillation (AF) coexists with dementia in older population. AF often remains undiagnosed due to the occurrence in an asymptomatic form - silent AF (SAF). The aim of the study is to evaluate the relationships between cognitive performance and AF both symptomatic and silent in a representative Polish older population. Design and method: The study was conducted as a sub-analysis of the NOMED-AF, a cross-sectional observational study aiming to evaluate the epidemiology of AF in a representative, community-dwelling Polish sample of adults aged 65 years or more. Mini-Mental State Examination (MMSE) was used to assess cognitive disorders. Each study participant, regardless of AF history, was equipped with a continuous electrocardiogram wearable recording system and encouraged to wear it for up to 30 days. Results: A sample of 2203 participants from the NOMED-AF study was enrolled in the analyses (mean age 77.1 years, 48.4% female); 491 (22.3%) were diagnosed with AF (41.3% of them with SAF). The mean number of points obtained by the respondents in the MMSE was 25.8±0.1 and was significantly lower in patients with AF (25.2±0.22 vs 26±0.11) This difference between patients with arrhythmia and those without AF was present in the subgroup of subjects aged 65-79 years (26.8±0.21 vs 27.4±0.08) and absent in the older subgroup (23.6±0.36 vs 23.3±0.24) (Fig. 1a). There was a significant difference in the number of points obtained between patients with the symptomatic and silent forms of arrhythmia, with a lower score obtained in the latter group (25.8±0.26 vs 24.3±0.38), which was consistent in both age subgroups (Fig. 1b). Finally, in the multivariate logistic regression model, the impact of SAF (but not overall AF) on MMSE scores has been demonstrated. Conclusions: In the older population the presence of AF is associated with a lower MMSE score. As for the silent form of arrhythmia, this relationship is deeper and independent of other risk factors, what suggests the need for a particularly thorough assessment of cognitive disorders in patients with AF and, on the other hand, active search for asymptomatic AF in the group of patients with dementia.

Changes in the avids of IgG antibodies to the S protein of SARS-CoV-2 after coronavirus infection in medical workers of a temporary infections hospital

BACKGROUND: The effector capabilities of humoral immunity are determined not only by the amount of specific antibodies produced in response to an antigenic effect, but also by their qualitative characteristics, which include avidity ― the total strength of binding to the antigen, which determines the duration and effectiveness of post-infectious immunity to SARS-CoV-2.
 AIM: Is a selective study of the quantity and avidity of IgG antibodies to SARS-CoV-2 over time among medical workers of a temporary infectious diseases hospital in Kazan ― convalescents of COVID-19, during the period from July 2020 to July 2021.
 MATERIALS AND METHODS: Determination of IgG to the S antigen of SARS-CoV-2 by ELISA was carried out using the test system SARS-CoV-2-IgG quantitative-ELISA-BEST (Vector-Best, Russia) and expressed in BAU/ml (binding antibody units). Antibody avidity was determined using a 4.0 M urea solution and expressed as avidity indices. 1, 4 and 7 months after COVID-19 asymptomatic (n=34); mild severity (n=42); moderate severity (n=29); reinfected (n=34). When statistically processing the data, descriptive statistics methods and the Wilcoxon matched data test were used. Differences were considered significant at p 0.05.
 RESULTS: IgG avidity to SARS-CoV-2 depended on the severity of COVID-19. The highest rates of avidity indices were found in the group of those who had a moderate form of COVID-19. If in mild and asymptomatic forms there was a parallel decrease in avidity indices and IgG titer, then in moderate forms an increase in antibody titer was accompanied by a decrease in their avidity 4 months after the infection. 7 months after seroconversion, the IgG level decreased almost twofold, both in mild, asymptomatic and moderate forms. In the group of medical workers who had COVID-19 repeatedly, the initially low levels of avidity indices and antibody titers increased in parallel, while avidity indices after 7 months did not decrease, but remained high. Differences in avidity indices determined the subsequent formation of different trends in the development of the humoral immune response, which were mainly characterized by an uneven decrease in IgG and persistence of IgM antibodies for more than 1 month.
 CONCLUSIONS: The research results expand the understanding of the mechanisms of formation of the humoral immune response and the avidity of IgG antibodies against SARS-CoV-2 in the risk group ― medical workers. The level of humoral immunity decreases in the first six months and varies depending on the severity of COVID-19. The data obtained can be used to identify categories of increased risk of SARS-CoV-2 infection among healthcare workers, make decisions about immunorehabilitation and revaccination against COVID-19.

HPV replicative cycle and role of viral proteins in lesion progression

Human papillomaviruses are DNA viruses that primarily infect the stratified squamous epithelium of the genital tract mucosa. Some of these viruses are strongly associated with cervical cancer. They are sexually transmitted agents that are highly prevalent around the world. Most infections heal spontaneously, in approximately 18 to 24 months, but in some individuals, the virus persists in a latent, asymptomatic form or a productive form, causing cervical intraepithelial lesions that may progress to result in invasive cervical cancer. During productive infection, the virus executes a complex interaction program with the host cell dependent on differentiation and, through its proteins, nullifies the host cell's protective mechanisms against malignant transformation and suppresses the host's immune responses. Initial lesions may spontaneously revert, but those that reach a certain stage, if not treated, progress to malignant forms. In this review, we present some advances in the biology of HPV infection and the role of its proteins in the interaction with the host cell and its consequences.

Pilonidal disease: comparative analysis of leading professional organizations clinical guidelines

pilonidal disease is an inflammatory disease that is most often localized in the sacrococcygeal area and is characterized by the formation of a cyst or abscess with the possible secondary formation of fistulas. Pilonidal disease is a fairly common disease, according to individual studies, the incidence ranges from 26 cases per 100,000 people (USA) to 48 per 100,000 people (Germany). Men are three times more likely to suffer than women. Most often, the disease manifests itself between the ages of 18 and 30. The risk factors for developing the disease are: excess weight, increased hair growth, chronic trauma to the sacrococcygeal area and anatomical features of the gluteal cleft (its shape, depth, configuration). The occurrence and development of the disease in persons of working age often leads to a sharp decrease in work capacity and quality of life. There is still no single, generally accepted classification of pilonidal disease in the world. Today, there are 3 clinical guidelines created by professional associations (USA, Germany, Italy), based on the principles of evidence-based medicine. The purpose of the study is to perform a comparative analysis of the main points of the clinical guidelines of leading professional organizations (German National Guideline on the management of pilonidal disease, The American Society of Colon and Rectal Surgeons' Clinical Practice Guidelines for the Management of Pilonidal Disease, Consensus statement of the Italian society of colorectal surgery: management and treatment of pilonidal disease) regarding the clinical-diagnostic approach and the choice of optimal treatment tactics for patients with certain forms of pilonidal disease. In the study, a review and comparative analysis of literary sources from the scientific databases of medical literature PubMed Central (U.S. National Institutes of Health's National Library of Medicine), ScienceDirect (Elsevier publishing house), Wiley online library, Springer Link, Cochrane library, materials of the 3rd International Pilonidal Conference ( 2023, Copenhagen, Denmark) and clinical guidelines of specialized organizations of the USA, Germany and Italy. The following issues of diagnosis and treatment of diseases are selected for comparative analysis: choice of prevention method and non-surgical procedures that reduce the risk of disease recurrence; choice of treatment method and assessment of its necessity for asymptomatic pilonidal cysts; the choice of a surgical method of treatment for symptomatic pilonidal cysts; the choice of a method of surgical treatment for a recurrent form of PC. According to the performed analysis, it can be concluded that the diagnostic and therapeutic strategies reflected in the clinical guidelines are based on the evidence base and the analysis of research data conducted in the field of treatment of pilonidal disease, which leads to the existence of an essential correlation between the recommendations related to the choice of a method of prevention and non-surgical procedures that reduce the risk of recurrence of the disease, the method of treatment and assessment of its necessity for the asymptomatic form of the disease, methods of surgical treatment of the recurrent form of the disease. There are differences between clinical guidelines due to varying general consensus structures and main questions chosen to form a list of general provisions.

Comparison of time to negative conversion of SARS-CoV-2 between young and elderly among asymptomatic and mild COVID-19 patients: a cohort study from a national containment center.

We aimed to study the relationship between age and time to negative conversion of SARS-CoV-2 in patients with asymptomatic and mild forms of COVID-19. We conducted a cohort study including all patients diagnosed with COVID-19 from the national COVID-19 containment center of Tunisia. Patients were subdivided into two cohorts: (under 60 years) and (over 60 years) and were followed up until PCR negativization. Log rank test and Cox regression were applied to compare time to negative conversion between the old group and the young group. The study included 289 patients with non-severe forms of COVID-19. Age over 60 was significantly associated with delayed negative conversion in male sex (Hazard ratio (HR): 1.9; 95% CI: 1.2-3.07) and among patients with morbid conditions (HR:1.68; 95% CI: 1.02-2.75) especially diabetics (HR: 2.06; 95% CI: 1.01-4.21). This association increased to (HR:2.3; 95% CI: 1.13-4.66) when male sex and comorbidities were concomitantly present and rose to (HR: 2.63; 95% CI: 1.02-6.80) for men with diabetes. Cox regression analysis revealed a significantly delayed negative conversion in symptomatic patients. Significant interaction was observed between gender and age and between age and chronic conditions. Age is associated with delayed negative conversion of viral RNA in certain subgroups. Identifying these subgroups is crucial to know how prioritize preventive strategies in elderly.

Prognostic Factors Associated with the Severe Course of a New Coronavirus Infection

Introduction. Novel coronavirus infection (COVID-19) is a respiratory infectious disease caused by the novel severe acute respiratory syndrome 2 coronavirus (SARS-CoV-2). It is characterized by a heterogeneous course of the disease from asymptomatic and mild forms to more severe and fatal outcomes. There are many risk factors for a severe course of a new coronavirus infection, in most cases, a severe course of the disease is associated with the individual characteristics of the patient, especially with dysregulation of the immune response. In this article, we reviewed the main prognostic factors for the severity of the disease.The aim of the study is to determine the unfavorable prognostic factors associated with the severe course of a new coronavirus infection caused by the SARS-CoV-2 virus in foreign and domestic literature sources.Materials and methods. To achieve this goal, scientific publications on the new coronavirus infection caused by the SARS-CoV-2 virus were analyzed in the scientometric databases PubMed, National Center for Biotechnological Information (NCBI), Cochrane, Web of Science, Scopus, MEDLINE (2019–2022), and Russian specialized journals on infectious diseases (2019–2022). Particular attention was paid to factors influencing the severe course of a new coronavirus infection.Results. Risk factors for a severe course of a new coronavirus infection include: lipid spectrum, advanced age, hemostasis system, changes in the leukocyte count, serum markers. Mathematical models of the course of a new coronavirus infection have also been developed.Discussion. In most studies, scientists note that the uncontrolled course of COVID-19 disease is associated with a dysregulated immune response. One of the main methods of influencing the immune system is vaccination.Conclusion. There are many factors that contribute to the development of severe forms of the disease of a new coronavirus infection. However, thanks to universal vaccination against a new coronavirus infection, the frequency of severe forms of the disease and deaths has significantly decreased. Novel coronavirus infection (COVID-19) is a respiratory infectious disease caused by the novel severe acute respiratory syndrome 2 coronavirus (SARS-CoV-2).

Hepatitis E Virus (HEV) Infection Among Immunocompromised Individuals: A Brief Narrative Review.

Hepatitis E virus (HEV) is a single-stranded positive-sense RNA virus that belongs to Hepeviridae family. HEV is the most common cause of acute viral hepatitis worldwide. According to the World Health Organization (WHO), there are estimated 20 million HEV infections worldwide every year, leading to estimated 3.3 million symptomatic cases of HEV infection. The WHO estimates that HEV infection caused approximately 44,000 deaths in 2015, which represents 3.3% of mortality rates due to viral hepatitis. In low-income (LI) countries and lower-middle-income (LMI) countries, HEV is a waterborne infection induced by HEV genotype (gt) 1 and HEV gt 2 that cause large outbreaks and affect young individuals with a high mortality rate in pregnant women from South Asian countries and patients with liver diseases. HEV gt 3, HEV gt 4, and HEV gt 7 are responsible for sporadic infections with zoonotic transmission mainly through the consumption of raw or undercooked meat from different animals. Acute HEV infection is relatively asymptomatic or mild clinical form, in rare cases the disease can be moderate/severe clinical forms and result in fulminant hepatitis or acute liver failure (ALF). Furthermore, HEV infection is associated with extrahepatic manifestations, including renal and neurological clinical signs and symptoms. Pregnant women, infants, older people, immunocompromised individuals, patients with comorbidities, and workers who come into close contact with HEV-infected animals are recognized as major risk groups for severe clinical form of HEV infection and fatal outcome. Chronic HEV infection can occur in immunocompromised individuals with the possibility of progression to cirrhosis.

QTc Prolongation to Predict Mortality in Patients Admitted with COVID-19 Infection: An Observational Study.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causes Coronavirus disease 2019 (COVID-19), characterized by pulmonary infection ranging from asymptomatic forms to respiratory insufficiency and death. Evidence of cardiac involvement in COVID-19 is increasing, and systemic inflammation or direct heart damage by SARS-CoV-2 can prolong the corrected QT interval (QTc). In this observational study, a total of 333 consecutive patients admitted to the Covid Center of Verona University Hospital from November 2020 to April 2021 were included. Patients with bundle branch block, pacemaker-controlled heart rhythm and heart rate >120 beats/min were excluded. A complete electrocardiogram (ECG) was performed at admission, and QTc values of ≥440 ms for males and ≥460 ms for females were considered prolonged. Overall, 153 patients had prolonged QTc (45.5%). In multivariate logistic regression analysis, male sex (odds ratio (OR)=6.612, p=0.046), troponin (OR=1.04, p=0.015) and lymphocyte count (OR=3.047, p=0.019) were independently associated with QTc prolongation. Multivariate logistic regression showed that QTc was independently associated with mortality (OR=4.598, p=0.036). Age, sex, the ratio between the partial pressure of oxygen (PaO2) and the fraction of inspired oxygen (FiO2) (P/F), and fibrosis-4 index for liver fibrosis (FIB-4) were also independently associated with mortality. QTc interval prolongation appears to be a frequent finding in patients with COVID-19. Moreover, prolonged QTc may be predictive of more severe forms of COVID-19 and worse outcome.

Comorbidities of exudative otitis media in children: focus on cough

Introduction. Otitis media with effusion (OME) is the most common and asymptomatic form of otitis in preschool children, accompanied by the accumulation of exudate in the middle ear with the development of conductive and mixed hearing loss. The article discusses data on the nature of comorbid diseases in exudative otitis media and modern ideas about the effectiveness of a combination drug for concomitant bronchopulmonary pathology in children.Aim. To study the nature of comorbid diseases in OME and evaluate the effectiveness of a combined expectorant drug in the treatment of upper and lower respiratory tract infections.Materials and methods. 104 children diagnosed with acute and chronic otitis media with effusion were examined. All children were divided into 2 groups: Group I (50 people) with acute otitis media with effusion, Group II (54 people) with chronic otitis media with effusion. The average age of children in group I was 5.02 ± 0.48 years with the highest prevalence in the younger group (70%), the average age of children in group II was 5.87 ± 0.47 years with the highest prevalence in the preschool and primary school groups (88%). Group I children with tracheitis and bronchitis received a combined expectorant.Results and discussions. The recurrent course of otitis media with effusion is supported by allergies in 43%, and by pathology of the upper and lower respiratory tract in 34%. The development of hearing loss leads to dysarthria in 26% of cases, which can undoubtedly negatively affect the further social adaptation of the child. Complex therapy of cough with a combined expectorant gave a positive clinical effect in 95% of cases, reduced the need for systemic antibiotics by 2.5 times, shortened the duration of the disease by 1.7 times.Conclusions. Early diagnosis of comorbid diseases in AOME at a young age, timely complex treatment of bronchopulmonary pathology will prevent the development of COME with impaired speech development in older children.

Clinical Course, Laboratory Findings, and Prognosis of SARS-CoV-2 Infection in Infants up to 90 Days of Age: A Single-Center Experience and a Proposal for a Management Pathway.

To provide a comprehensive description of the clinical features, biochemical characteristics, and outcomes of infants up to 90 days old with COVID-19. Moreover, to assess the severity of the disease and propose an effective management pathway. Retrospective single-center study spanning three years. Patient data includes age, sex, symptoms, comorbidities, blood and urine test results, cultures, admission, length of stay, therapies, intensive care unit admission, and mortality. A total of 274 patients were enrolled in the study, comprising 55% males. Among them, 60 patients (22%) were under the age of 29 days, while 214 (78%) fell within the 29 to 90 days age range. The overall incidence of SARS-CoV-2 infections was 0.28 per 10,000 Pediatric Emergency Department admissions. Blood inflammatory markers showed no significant abnormalities, and there were no recorded instances of positive blood cultures. Less than 1% of infants showed urinary tract infections with positive urine cultures, and 1.5% of patients had a concurrent RSV infection. Hospitalization rates were 83% for neonates and 67% for infants, with a median length of stay (LOS) of 48 h for both age groups. None of the patients required admission to the Pediatric or Neonatal Intensive Care Unit, and only one required High Flow Nasal Cannula (HFNC). No secondary serious bacterial infections were observed, and all hospitalized patients were discharged without short-term sequelae. No deaths were reported. Infants with COVID-19 generally exhibit milder or asymptomatic forms of the disease, making home management a viable option in most cases. Blood tests, indicative of a mild inflammatory response, are recommended primarily for children showing symptoms of illness. Hospitalization precautions for infants without apparent illness or comorbidities are deemed unnecessary. Given the evolving nature of experiences with COVID-19 in infants, maintaining a high level of clinical suspicion remains imperative.

Herpes simplex virus type 1 infection in pet marmoset – case report

A 19-month-old female common marmoset (Callithrix jacchus) was presented with a 4-day history of anorexia and behavioral changes. At presentation, a combination of neurological signs, erosions, and ulcerations of the mucous membranes of the oral mucosa and mucocutaneous junction of the lips were observed, suggesting herpesvirus infection. Although etiological and symptomatic therapy was initiated immediately, the animal died the next day. A necropsy was performed, and gross pathology and pathohistology findings indicated a systemic viral infection. Definitive diagnosis was based on the results of molecular testing that demonstrated the presence of human herpes simplex virus type 1. In conclusion, marmosets are a highly susceptible host for human herpes simplex virus. To reduce the risk of infection and prevent this highly lethal disease in monkeys, contact with humans who have symptomatic or asymptomatic forms of HSV-1 should be limited and accompanied by appropriate hygiene measures.

Immunomodulation of streptozotocin induced Type 1 diabetes mellitus in mouse model by Macrophage migration inhibitory factor-2 (MIF-2) homologue of human lymphatic filarial parasite, Wuchereria bancrofti

Helminth parasites modulate the host immune system to ensure a long-lasting asymptomatic form of infection generally, mediated by the secretion of immunomodulatory molecules and one such molecule is a homologue of human host cytokine, Macrophage migratory Inhibitory Factor (hMIF). In this study, we sought to understand the role of homologue of hMIF from the lymphatic filarial parasite, Wuchereria bancrofti (Wba-MIF2), in the immunomodulation of the Streptozotocin (STZ)-induced Type1 Diabetes Mellitus (T1DM) animal model. Full-length recombinant Wba-MIF2 was expressed and found to have both oxidoreductase and tautomerase activities. Wba-MIF2 recombinant protein was treated to STZ induced T1DM animals, and after 5 weeks pro-inflammatory (IL-1, IL-2, IL-6, TNF-α, IFN-γ) and anti-inflammatory (IL-4, IL-10) cytokines and gene expressions were determined in sera samples and spleen respectively. Pro-inflammatory and anti-inflammatory cytokine levels were significantly (p<0.05) up-regulated and down-regulated respectively, in the STZ-T1DM animals, as compared to treated groups. Histopathology showed macrophage infiltration and greater damage of islets of beta cells in the pancreatic tissue of STZ-T1DM animals, than Wba-MIF2 treated STZ-T1DM animals. The present study clearly showed the potential of Wba-MIF2 as an immunomodulatory molecule, which could modulate the host immune system in the STZ-T1DM mice model from a pro-inflammatory to anti-inflammatory milieu.

Listeria monocytogenes meningoencephalitis against the background of the new coronavirus infection: a clinical case

Background: Among the bacteria that affect the central nervous system, Listeria monocytogenes (facultative intracellular bacterium) is one of the most lethal to humans and animals. Listeriosis affects domestic and farm animals (pigs, small and large cattle, horses, rabbits, less often cats and dogs), as well as domestic and ornamental birds (geese, chickens, ducks, turkeys, pigeons, parrots and canaries). L. monocytogenes can be detected in fish and seafood (shrimp). The source of L. monocytogenes infection are animals in which the disease may manifest itself or occur in erased and asymptomatic forms followed by the transition to a long-term carriage. This pathogen is found throughout the world in foodstuffs, and most cases of infection occur through the ingestion of contaminated food. Particularly susceptible to the disease are embryos, newborns, the elderly and individuals with immunodeficiencies and chronic diseases. L. monocytogenes can cause intracranial hemorrhage, meningitis, meningoencephalitis, and rhombencephalitis. Clinical case description: This paper presents our own clinical observation of the development of severe listeriosis meningoencephalitis in a 47 year-old patient against the background of the new coronavirus infection (COVID-19). We describe the details of the clinical presentation, the treatment and the favorable outcome in our patient. Conclusion: Invasive listeriosis is a rare disease. The knowledge about the clinical manifestations of this disease is needed not only for epidemiologists and infectious disease specialists, but also for physicians of other specialties. Untimely diagnosis and inadequate antibacterial therapy are dangerous leading to severe somatic and neurological complications with a lethal outcome or disability both in children and adult persons.