Asymptomatic Forms Research Articles

Photoplethysmography-Based Smart Devices for Detection of Atrial Fibrillation.

Atrial fibrillation is the most commonly experienced type of cardiac arrhythmia and is the most associated with substantial clinical occurrences and expenses. This arrhythmia often occurs in its "silent" asymptomatic form, revealed only after complications such as a stroke or congestive heart failure have transpired. New smart devices confer effective advantages in the detection of this heart arrhythmia, of which photoplethysmography-based smart devices have shown great potential, according to previous research. However, the solution becomes a problem as widespread use and high availability of various applications and smart devices may lead to substantial amounts of false and misleading recordings and information, causing unnecessary anxiety regarding arrhythmic occurrences diagnosed by the devices but not professionally confirmed. Thus, with most of the devices being photoplethysmography based for detection of atrial fibrillation, it is important to research devices studied up to this point to find the best smart device to detect the aforementioned arrhythmias.

COVID-19, Anosmia, and Allergies: Is There a Relationship? A Pediatric Perspective.

Background: Between June and July 2020, we evaluated children and adolescents concerning post-infection surveillance after a COVID-19 positivity during the lockdown. We aimed to assess whether the anamnestic presence of allergies could correlate with the presence of SARS-CoV-2 symptoms, and in particular with anosmia. Material and methods: For each patient, we collected anamnestic data, the presence of allergies documented by performing skin prick tests, and COVID-19 symptoms. Then, if over six years of age, each patient underwent an active anterior rhinomanometry. Results: A total of 296 patients were enrolled, of whom 105 (35.4%) reported allergies. Considering COVID-19 symptoms, 74 subjects (25%) presented an asymptomatic form, 222 (75%) reported symptoms, and anosmia recurred in 60 subjects (27.03%). A statistically significant relationship was found between allergies and symptomatic COVID-19 (p = 0.042), allergies, and anosmia (p = 0.05), and allergies and anosmia in males (p = 0.007). Moreover, anosmic patients presented a higher body mass index, older age, and a longer COVID-19 duration with statistical significance (p = 0.001, 0.001, 0.006, respectively). Conclusions: Allergic subjects seem to develop symptomatic COVID-19 more frequently and allergies appear to be a protective factor from anosmia’s onset in males.

Critical Roles of NF-κB Signaling Molecules in Bone Metabolism Revealed by Genetic Mutations in Osteopetrosis.

The nuclear factor-κB (NF-κB) transcription factor family consists of five related proteins, RelA (p65), c-Rel, RelB, p50/p105 (NF-κB1), and p52/p100 (NF-κB2). These proteins are important not only for inflammation and the immune response but also for bone metabolism. Activation of NF-κB occurs via the classic and alternative pathways. Inflammatory cytokines, such as tumor necrosis factor (TNF)-α and interleukin (IL)-1β, activate the former, and cytokines involved in lymph node formation, such as receptor activator of NF-κB ligand (RANKL) and CD40L, activate the latter. p50 and p52 double-knockout mice revealed severe osteopetrosis due to the total lack of osteoclasts, which are specialized cells for bone resorption. This finding suggests that the activation of NF-κB is required for osteoclast differentiation. The NF-κB signaling pathway is controlled by various regulators, including NF-κB essential modulator (NEMO), which is encoded by the IKBKG gene. In recent years, mutant forms of the IKBKG gene have been reported as causative genes of osteopetrosis, lymphedema, hypohidrotic ectodermal dysplasia, and immunodeficiency (OL-EDA-ID). In addition, a mutation in the RELA gene, encoding RelA, has been reported for the first time in newborns with high neonatal bone mass. Osteopetrosis is characterized by a diffuse increase in bone mass, ranging from a lethal form observed in newborns to an asymptomatic form that appears in adulthood. This review describes the genetic mutations in NF-κB signaling molecules that have been identified in patients with osteopetrosis.

Outcome of COVID-19 in children: results of a 12-month follow-up

At present, there are isolated data on the clinical outcomes of COVID-19 in children, especially those who have experienced asymptomatic and mild forms of infection.Purpose: to analyze the nature and frequency of postCOVID symptoms in children during 12 months. after recovery.Materials and methods. The influence of demographic indicators, premorbid background, severity of infection and therapy in the acute period of the disease on the nature and frequency of symptoms in 1079 children who underwent laboratory-confirmed COVID-19 was studied. The results are presented with proportions (%) and calculation of 95% confidence interval according to Klopper-Pearson. Differences between groups were assessed using Pearson’s chi-square test. Differences in the groups were considered statistically significant at p < 0,05.Results. Health disorders in the post-COVID period were observed in 8,5% of children, more often in school-children aged 7–17 years (68.4%). Concomitant conditions were found in 38,0%. In most cases, the consequences were noted after a mild form of COVID-19 (77.2%), however, 13,0% of patients experienced an asymptomatic form of infection. Among convalescents, changes in the emotional sphere (2,1%), headache (1,8%), symptoms of asthenia (1,6%), cardiovascular (1,5%), dyspeptic (1,3%) were more often observed, cognitive (1,3%) disorders, neurotic disorders (1,0%), less often respiratory (0.8%), endocrine (0,4%) and visual (0,4%) systems, musculoskeletal system were involved (0.2%). Girls were significantly more likely to have vegetative disorders, while boys were significantly more likely to suffer from cognitive functions. Various antiviral therapy options (interferon-alpha, an oral antiviral drug, or a combination thereof) in the acute period of COVID-19 did not affect the possibility of post-COVID disorders, but there was a tendency to increase the frequency in children who did not receive etiotropic treatment (control group). In 14.1% of cases, post-COVID symptoms appeared late – after 5–10 months. after recovery. The course of rehabilitation therapy, including drug treatment and non-drug methods, made it possible to quickly restore the state of health of the observed children.Conclusion. In most cases, the violations were of a functional nature, due to a disorder of autonomic regulation. Rehabilitation and dispensary observation programs will allow timely restoration of the quality of life of children who have had COVID-19, including in a mild and asymptomatic form.

Synonymous mutation rs1129293 is associated with PIK3CG expression and PI3Kγ activation in patients with chronic Chagas cardiomyopathy

Single nucleotide polymorphisms (SNPs) that do not change the composition of amino acids and cause synonymous mutations (sSNPs) were previously considered to lack any functional roles. However, sSNPs have recently been shown to interfere with protein expression owing to a myriad of factors related to the regulation of transcription, mRNA stability, and protein translation processes. In patients with Chagas disease, the presence of the synonymous mutation rs1129293 in phosphatidylinositol-4,5-bisphosphate 3-kinase gamma (PIK3CG) gene contributes to the development of the chronic Chagas cardiomyopathy (CCC), instead of the digestive or asymptomatic forms. In this study, we aimed to investigate whether rs1129293 is associated with the transcription of PIK3CG mRNA and its activity by quantifying AKT phosphorylation in the heart samples of 26 chagasic patients with CCC. Our results showed an association between rs1129293 and decreased PIK3CG mRNA expression levels in the cardiac tissues of patients with CCC. The phosphorylation levels of AKT, the protein target of PI3K, were also reduced in patients with this mutation, but were not correlated with PI3KCG mRNA expression levels. Moreover, bioinformatics analysis showed that rs1129293 and other SNPs in linkage disequilibrium (LD) were associated with the transcriptional regulatory elements, post-transcriptional modifications, and cell-specific splicing expression of PIK3CG mRNA. Therefore, our data demonstrates that the synonymous SNP rs1129293 is capable of affecting the PIK3CG mRNA expression and PI3Kγ activation.

Assessment of the impact of current COVID-19 infection on the quality of life in navy mariners

Introduction. The quality of life of navy mariners has a significant impact on the readiness to perform military tasks, which determines the relevance of studying the factors that negatively affect it. The purpose of the study is to assess the impact of a new coronavirus infection COVID-19 on the quality of life in navy mariners. Material and methods. During the period from June to July 2021, 265 navy mariners were interviewed on a WHOQOL-BREF questionnaire. The quality of life in this study is considered as a summary indicator of a person’s perception of his physical, mental, emotional and social functioning. There was carried out the calculation of relative values, arithmetic mean with a 95% confidence interval. Comparative analysis using the Mann-Whitney test, correlation and regression analysis were used. Results. 115 respondents (43.4%) noted the past COVID-19, the non-sick soldiers made up the comparison group (n = 150). Asymptomatic form was found in 15.7%, mild form - 48.7%, moderate - 32.2% and severe form - 3.5% in the general structure. In the postcovid period, asthenic syndrome (53.9%), dyspnea (38.3%), sleep disorders (17.4%), joint pain (15.7%) were noted most often. Significant differences (p = 0.041) were found in the assessment of the social well-being of the comparison group and the sick navy mariners. A significant effect of the severity of the disease was established on the assessment of the microsocial support sphere (p = 0.035), and dyspnoe - on the assessment of the self-perception sphere (p = 0.018) and microsocial support (p = 0.007). Limitations of the study. The volume of the sample population of 265 persons represented by the personnel of submarines under construction and under repair; climatogeographic features of the region; cross-sectional nature of the study. Conclusion. The new coronavirus infection has a significant impact on various areas of the quality of life of navy mariners, which makes it important to conduct full rehabilitation after COVID-19, psychological support for servicemen in submarine crews during the pandemic, conduct preventive vaccinations, improve the quality of medical examinations.

Ocular syphilis associated to HIV: A report of 2 patients treated in Marrakech, Morocco

RésuméIntroductionUne recrudescence des cas de syphilis est observée depuis plusieurs années dans de nombreux pays, surtout en ce qui concerne les sujets infectés par le VIH. Ces patients se présentent souvent avec des lésions simultanées de syphilis primaire et secondaire, ou bien avec des formes étendues de syphilis.ObservationsNous rapportons 2 observations d'uvéite syphilitique prises en charge au service de Maladies infectieuses du Centre hospitalier universitaire Mohammed VI de Marrakech. La syphilis oculaire était inaugurale chez les 2 patients séropositifs. Malheureusement, aucun d'eux n'a bénéficié d'une récupération ophtalmologique complète.ConclusionDevant toute uvéite ou papillite, il faut évoquer une infection syphilitique, d'autant que l'incidence de cette maladie est en augmentation depuis une dizaine d'années. Le traitement de la syphilis oculaire est mal codifié mais permet parfois une récupération fonctionnelle complète, s'il est précoce et adapté. La ceftriaxone pourrait être une alternative thérapeutique efficace à la pénicilline G dans le traitement de la syphilis précoce chez les individus infectés par le VIH.

Hepatitis A Virus Infection Induced Prolonged Cholestasis: A Case Report

Introduction: Hepatitis A is one of the most common causes of Viral Hepatitis among children. Children have asymptomatic or mild form of disease. Serious manifestation like cholestatic jaundice is very rare in Hepatitis A infection in young children. There have been some reports of manifestations of childhood Hepatitis A occurring in isolation. In this article a young child with Hepatitis A infection who had cholestatic jaundice is reported. The child had flu like symptoms with nausea, vomiting and loss of appetite. Methods: Routine investigations along with LFT (Liver function test) and Hepatitis viral markers were carried out which revealed hyperbilirubinemia suggestive of cholestatic jaundice with Hepatitis A positive. Conclusion: This case illustrates the importance of clinicians having a high clinical suspicion for cholestatic jaundice in patients of Hepatitis A infection.

PB2029: MULTIPLE MYELOMA AND SPINAL CORD COMPRESSION: THE EXPERIENCE OF THE HEMATOLOGY DEPARTMENT OF SFAX

Background: Spinal cord compression (SCC) is the most serious complication in Multiple myeloma (MM). An emergency that must be diagnosed and treated promptly to preserve neurological functions and save the patient’s live. Aims: We studied the clinical, biological, and radiological features of patients with MM from southern Tunisia complicated by SCC and the different modalities of treatment. Methods: It is a retrospective study over 18 years (2003-2020) which included young patients (pts) (<65years old) with MM presented SCC and treated at the hematology department of Hedi Chaker Hospital Sfax, Tunisia. Here we are interested in studying the characteristics (clinical, biological, and radiological) of affected pts, the various revealing symptoms of SCC, the possible therapeutic modalities and the outcome of patients. Results: Among 173 young pts followed with MM, 18 had SCC (10%) which was inaugural in 5 pts (27% of cases). The average age was 53 years (36- 63 years) and the sex ratio M/F= 10/8. The MM immunoglobulin type was IgG in 6 cases, IgA in 7 cases, Ig D in 1 cases and light chains in 4 cases. Symptoms of SCC included pain, motor defects, sensory deficits and bowel and bladder dysfunction in respectively 72, 11,100 and 2% of cases. While in 2 cases the SCC was asymptomatic (11%). The spinal MRI showed a cervical compression in 2 cases (11%), a dorsal compression in 8 cases (44.5%) and lumbar compression in 8 cases (44.5%). In 17 cases, lesions were first treated by radiotherapy (which did not produce regression of the compression). Decompressive laminectomy was carried out one time. All patients underwent high doses of corticosteroids. Pts were subsequently treated by different regimens of systemic therapy (DT in 12 cases, MPT in 3 cases and VTD in 3 cases). In 17 cases a definite and steady regression of the neurological symptoms was achieved. Median overall survival was 34 months after identification of SCC. At the date of last news, around 66% of the pts were dead. Summary/Conclusion: The frequency of different localizations of compression in our studies are comparable to the literature, however, the SCC rate in our series is higher than those described in the other series in literature (10% vs 5%) the same for the rate of different symptoms at diagnosis (in literature more of asymptomatic form) which could be explained by the delay in the diagnosis of MM and by the neglect of minimal symptoms by patients and their consultation only after the installation of deficient signs.

Humoral and Cellular Immune Response in Asymptomatic Dogs with Visceral Leishmaniasis: A Review.

Visceral leishmaniasis is one of the deadliest parasitic diseases in the world and affects both humans and dogs. The host immune response to Leishmania infection plays a critical role in the evolution of canine visceral leishmaniasis (CVL) and consequently in the manifestation of clinical signs. The asymptomatic form of the disease is a major concern in the diagnosis of CVL and in the transmission control of Leishmania infection. Asymptomatic dogs are found in large proportions in endemic areas and are an unquantifiable source of infection. The present review analyzes the possible relationship between the activation of the antigen-specific immune response of the host and resistance or susceptibility to CVL. The review focuses on works that address the characterization of the humoral and cellular immune response profile, at both the functional and phenotypic levels, in infected dogs. Most studies relate the absence of clinical symptomatology to an increased proliferative response and a Th1 cytokine profile. Despite the numerous findings pointing to a differential immune response in asymptomatic dogs, the contradictory results reported in this review highlight the importance of establishing a precise clinical classification of the disease, performing more longitudinal studies, and including a higher number of animals in trials.

Assessment of Knowledge and practice of Maturity Onset Diabetes of the Young (MODY) among Primary care physicians in Najran, Saudi Arabia

Background: Maturity-onset diabetes of the young (MODY) is a type of monogenic diabetes first described as a mild and asymptomatic form of diabetes mellitus that was observed in non-obese children, and young adults. With the development of genetic technology, many genes linked to MODY have been sequenced and described. MODY is a kind of diabetes inherited and a mutation in one of eleven genes causes it. MODY could be the cause of up to 5% of all diabetes cases. MODY patients, like other diabetics, have difficulty controlling their blood sugar levels. Methods: This study is a cross-sectional study among primary care physicians (PCPs) in the Najran region. The questionnaire was created following a series of conversations between a panel of experts, which included subject specialists, researchers, and language experts. Pilot study with 15 respondents was also conducted to observe the clarity of the content of the questionnaire and its validity. The questionnaire’s Cronbach alpha was computed. It was created in English and disseminated through Google forms link and in a printed form as well. The questionnaire has two main sections, one for knowledge and the other for practice with MODY. Results: 12% completely responded to questions regarding definition of MODY, 55.5% have knowledge regarding mode of inheritance of MODY, 9% were aware about the type of the MODY, 60% were aware about typical symptoms of MODY, Diagnostic tools of MODY (45%), Possible presentations of MODY (6%), Therapeutic modalities of MODY (39%), Complications of MODY (20%), Differences between MODY and T1DM and T2DM (6.8%), while overall knowledge score was 53.8%. Conclusion: This study emphasized the importance of PCPs among individuals participating in intensive teaching programs in order to promote early detection of MODY and beginning of the proper treatment for the disease. Keywords: Knowledge, practice, primary care physicians, Maturity Onset Diabetes of the Young (MODY).

Ultrasound diagnosis of pelvic veins in women of reproductive age

Introduction. Nowadays radiological diagnostics dives particular attention to the research of the pelvic veins in women. Absence of diagnostic criteria for identifying norms do not make it possible to establish the initial disease manifestations. It is also not sufficient enough to make a proper forecast about the formation of pelvic varicose veins.Objective: To study the ultrasound criteria of diagnostic parameters of pelvic veins in women of reproductive age without stated venous pathology.Materials and methods. This research examined 80 young, relatively healthy nulliparous women. The ultrasound criteria of diagnostic parameters of the following veins such as the left renal vein, ovarian veins, cluster-shaped and uterine veins, the angle between the aorta and the superior mesenteric artery, elasticity indices of the common femoral and popliteal veins were studied. Profound data analysis revealed that all patients had significant differences in the left renal vein indices. Based on this data 2 groups were formed: Group 1 (mean age 25.00 ± 3.31 years) 60 people, quite homogeneous according to the studied indices; Group 2 (mean age 24.25 ± 2.61 years) 20 people, quite heterogeneous according to the studied indices. Ultrasonography (Ultrasound examination) was performed using Logiq E9 (GE, USA) and AIXPLORER Super-Sonik Imagine, with convex, endovaginal, and linear sensors. Statistics processing was accom-plished using the StatSoft Statistica 10 software package.Results. In the general sample of patients, positive correlations were found for the following pelvic veins: ovarian veins on both sides, and cerebellar veins on the right side; and cerebellar and uterine veins on the right side. The results of the studied ultrasound parameters in Groups 1 and 2 showed that they differ significantly (p &lt; 0.05). Almost all diagnostic parameters in Group 2 were significantly higher (p &lt; 0.05), all women had anatomical aorto-mesenteric pincer.Conclusion. Ultrasonography of pelvic veins provides information on the anatomical-functional and hemodynamic state of the veins. That is important for prognostication of pelvic varicose veins and revealing asymptomatic forms of this disease.

Perception of COVID-19 by the Mentally ill Patients

Background: Patients with mental illness constitute a population at risk of being easily infected by corona virus (COVID-19), and they can also spread the infection to others by neglecting protective measures. The confrontation of this pandemic depends above all on their adherence to barrier measures, largely affected by their knowledge, perception and practices. Objectives: This work aimed to assess the perception of COVID-19 in patients with mental illness; by conducting a survey on their knowledge, attitudes and practices. Methods: This is a descriptive cross-sectional study. 118 consultant patients with schizophrenia, bipolar disorder or chronic delusional disorder agreed to participate in the study. It was conducted at the psychiatric university department at Ibn Nafis hospital in Marrakech, during the month of October 2020. We used a pre-established questionnaire. The choice of patients was made given the frequency of perception disorders, cognitive deficit and inappropriate behaviors. Results: The mean age of the participants was 38 years. The majority were male (64%), single (56%), with a low level of education (32%). The patient’s average COVID-19 knowledge score was 9.27, suggesting an overall correct answer rate of 71% on this knowledge test. Almost a quarter of the patients did have a poor knowledge of COVID-19 (30%). Notably, more than half of the patients surveyed (62%) were not aware that there are asymptomatic forms of COVID-19 infection, and that there are no specific treatment or vaccine against COVID-19 currently. Two-thirds of patients (63%) considered COVID-19 infection to be a serious and dangerous illness, twenty-five patients (21%) had given no comments, nine patients (8%) believed that it was a conspiracy, six patients (5%) thought it was a devil and four patients (3%) thought it was a lie. In terms of attitudes, more than half of the patients surveyed had expressed their fear when thinking of COVID-19, and the majority of patients (90%) ...

Place of cytology in the diagnosis of Gaucher disease: About a case

Gaucher disease is an autosomal recessive genetic disease caused by a deficiency in a lysosomal enzyme, beta glucocerebrosidase. This disease is characterized by deposits of glucosylceramide in liver, spleen and bone marrow cells. The presentation of MG is very heterogeneous, ranging from the asymptomatic form to the lethal form. Neurological forms (types 2 and 3) are present in only 5% of patients with MG and are less frequent than non-neurological forms (type 1). The formal diagnosis is established by measuring the activity of beta glucocerebrosidase in circulating leukocytes. The accumulation of glucosylceramide in macrophages gives them a characteristic morphological appearance and they are called "Gaucher cells" thus making it possible to evoke the diagnosis. We describe through this observation the practical side of hematological cytology in the diagnostic orientation of this rare and often misunderstood pathology.

Longitudinal Randomized Cohort Study of SARS-CoV-2 Antibody Seroprevalence in the St. Petersburg Population.

Introduction. Since the detection of the first COVID-19 patient, 2 years have passed, during which more than 287,862,000 people have fallen ill globally, of which about 1.9% died. The implementation of SARS-CoV-2 control programs required efforts from almost all countries. An important direction in the fight against COVID-19 has been the formation of herd immunity, the main tool for managing the pandemic. Study goal. The aim of the study was to assess the seroprevalence of antibodies (Abs) to SARS-CoV-2 nucleocapsid (Nc) and receptor binding domain (RBD) in the St. Petersburg population during the COVID-19 pandemic. Materials and methods. A longitudinal cohort randomized monitoring study of Ab seroprevalence (SARS-CoV-2 Nc, RBD) was organized and conducted according to a unified methodology developed by Rospotrebnadzor with the participation of the St. Petersburg Pasteur Institute. For this purpose, a cohort was formed of 1000 volunteers who participated in all five stages of seromonitoring. The cohort was divided into seven age groups: 1–17; 18–29; 30–39; 40–49; 50–59; 60–69; 70; and older (70+) years. Seropositivity levels (Nc, RBD) were assessed by quantitative and qualitative enzyme immunoassays. During the second year of monitoring, some volunteers were vaccinated with the GamCOVIDVac (84%) or EpiVacCorona (11.6%) vaccines approved in Russia. Statistical processing was carried out using Excel 2010. Confidence intervals for shares and percentages (95% CI) were calculated using the method of A. Wald and J. Wolfowitz with adjustment (A. Agresti, B.A. Coull). The statistical significance of differences was calculated by z-test, using the appropriate online calculator (p < 0.05) unless indicated. Results. There was a trend toward an increase in Nc seropositivity in stages 1–3 of seromonitoring, with a decrease in stages 4–5 among children and adults. The share of RBD seropositive steadily increased during all five stages of seromonitoring. The most frequent finding was low anti-RBD Abs levels (22.6–220 BAU/mL). High Ab levels were recorded statistically significantly less frequently. Asymptomatic forms were observed in 84–88% of SARS-CoV-2 seropositive volunteers. By the fifth stage of monitoring, this indicator significantly decreased to 69.8% (95% CI: 66.1–73.4). The monitoring revealed a statistically significant increase in anti-RBD Abs alongside a statistically significant decrease in the proportion of Nc seropositives. This dynamic was especially characteristic of persons vaccinated with GamCOVIDVac. Conclusion. Prior to the use of specific vaccines, a seroprevalence of anti-Nc Abs was noted. After the introduction of the GamCOVIDVac vaccine in adults, a decrease in the level of anti-Nc Abs was noted due to an increase in the proportion of RBD seropositive persons.

Seroprevalence and changing trend of dengue in a tertiary care hospital, Bhubaneswar, Odisha: Four-year retrospective study

Dengue virus is a single stranded positive sense RNA virus belonging to the genus flavivirus family flaviviridae. Dengue fever is a seasonal and emerging acute mosquito borne arbo-viral illness affecting tropical and sub-tropical countries. This illness ranges from a mild asymptomatic form to severe dengue hemorrhagic fever (DHF) with or without dengue shock syndrome (DSS). This study was conducted to know the seroprevalence and changing trend of Dengue virus in a tertiary care hospital, Bhubaneswar, Odisha, India. Over a period of four years from August 2016 to December 2019, a total of 5147 blood samples from clinically suspected dengue patients were received in department of Microbiology laboratory. Serum was separated and subjected to enzyme immunoassay for detection of both Non Structural (NS1) antigen and IgM antibody.During this study period, a total of 5147 blood samples were processed from suspected dengue cases, out of which 1314(25%) samples were found to be positive by different serological markers like NS1 Antigen (Ag), IgM antibody(Ab), or both NS1 Ag &amp; IgM Ab. The overall seroprevalence rate was found to be 25%. In this study period of four years, the year-wise seroprevalence rate was found to be 12% (153) in the year 2016 and was 26% (350) in the year 2017 and was 40% (522) in the year 2018, and was 22% (289) in the year 2019. It clearly shows that there is an increase in the dengue cases.

Features of the population immunity to SARS-CoV-2 development in staff members of medical organizations during the spread of COVID-19

Background. The ongoing COVID-19 pandemic generates the urgent need of monitoring the herd immunity among healthcare workers as a high-risk group for infection.&#x0D; Aim. Determining the level and structure of population immunity to SARS-CoV-2 in the medical workers during the second peak of COVID-19 from August to November 2020.&#x0D; Material and methods. The study involved 15,158 medical workers from 91 medical organizations of the Republic of Tatarstan. The age of the examined stuff members varied from 18 to 74 years, the average age was 45.480.1016 years, most of them were women (13 627, 89.870.258%). Testing for the presence of total antibodies (immunoglobulin classes G, A and M) to SARS- CoV-2 was performed once by the enhanced chemiluminescence method. Statistical processing was carried out by methods of variation statistics and correlation analysis according to the Pearson method using MS Excel and WinPepi.&#x0D; Results. Seroprevalence to SARS-CoV-2 in medical workers was 35.230.388%. An increase in seropositive individuals level from 27.440.265% in August to 57.910.499% in November and an increase in the average geometric mean titer of total antibodies (immunoglobulin classes A, M, G) from 84.43 in August to 101.09 in November 2020 were detected. The level of individuals with antibodies increased with age from 18 to 59 years and decreased in group of 6070 years. The largest proportion of seropositive to SARS-CoV-2 individuals was found among junior (42.011.384%) and middle grade (37.50.527%) medical staff of hospitals for patients with COVID-19, ambulance and emergency stations. Among the seropositive to the SARS-CoV-2 workers the proportion of asymptomatic forms of infection was 84.970.498%. According to the level of seroprevalence, municipal districts of the Republic of Tatarstan were divided into three groups: moderate 8.939.0; average 42.949.6, high level 53.164.4.&#x0D; Сonclusion. An increase in seroprevalence to SARS-CoV-2 was revealed among medical workers of the Republic of Tatarstan from August to November 2020 during the second peak of COVID-19.

Trends in cocirculation of oncogenic HPV genotypes in single and multiple infections among theunvaccinated community.

Cocirculation of multiple human papillomavirus (HPV) infections with low, probably high, and high‐risk genotypes are to be associated with various grades of infections and cancer progression. The oncogenic high‐risk HPVs are distributed and cocirculated throughout the world. This study was investigated to identify HPV genotypes related to genital disorders in unvaccinated women. The subjects were referred from clinics to a molecular lab for HPV testing in Iran as a low‐coverage vaccinated country. HPVs DNAs of cervical scrapping and genital tissue specimens of 1,133 un‐vaccinated women were genotyped using an in vitro diagnostic line probe (reverse hybridization) assay. In addition, phylogenetic trees were constructed on 100 MY09/MY11 polymerase chain reaction (PCR) amplicons of common genotypes of HPV L1 gene by Sanger sequencing. The mean age of the population study was 32.7 ± 8.0 and the mean age of HPV‐positive cases was 31.6 ± 7.8. HPV DNA was detected in 57.8% (655/1133) of women subjects and 42.2% (478/1133) of cases were undetected. Among 655 HPV‐positive cases, 639 subjects (56.4%) were related to defined genotypes and 16 subjects (1.4%) were untypeable. The highest prevalence rate of HPV genotypes was identified in the 25–34 years. The top 6 dominant HPVs in single and multiple genotypes were HPV6 (284/655 [43.4%]), HPV16 (111/655 [16.9%]), HPV31 (72/655 [11%]), HPV53 (67/655 [10.2%]), HPV11 (62/655 [9.5%]), and HPV52 (62/655 [9.5%]). Moreover, single, multiple and untypeable HPV genotypes were diagnosed as follows: 1 type (318/655 [48.5%]), 2 types (162/655 [24.8%]), 3 types (83/655 [12.7%]), 4 types (42/655 [6.5%]), more than 5 types (34/655 [5.3%]), and 1.4% un‐typeable subjects. The sequenced partial L1 gene of HPV genotypes (GenBank databases under the accession numbers: MH253467‐MH253566) confirmed and determined the cocirculated HPV genotypes' origins and addressed helpful insights into the future viral epidemiology investigations. Multiple HPV infections and cocirculation of various oncogenic HPV genotypes among the normal population (women and men) with asymptomatic forms are still challenging in unvaccinated communities. The preventive and organized surveillance programs for HPV screening are needed to be considered and compiled by health policy makers of low or unvaccinated countries.

Multisystem inflammatory syndrome-related refractory cardiogenic shock in adults after coronavirus disease 2019 infection: a case series

BackgroundA novel multisystem inflammatory syndrome in children (MIS-C) temporally associated with the coronavirus disease 2019 (COVID-19) infection has been reported, arising weeks after the peak incidence of COVID-19 infection in adults. Patients with MIS-C have been reported to have cardiac involvement and clinical features overlapping with other acute inflammatory syndromes such as Kawasaki disease, toxic shock syndrome, and macrophage activation syndrome. Multisystem inflammatory syndrome in children may follow COVID-19 infection, most of the time after its asymptomatic form, even though it can lead to serious and life-threatening illness.Case summaryIn this case series, we discuss two cases of young adults with no former medical history who fit with the criteria defined in MIS-C. They both developed a refractory cardiogenic shock and required intensive care treatment including mechanical circulatory support, specifically the use of venous–arterial extracorporeal membrane oxygenation. They were both treated early with intravenous immune globulin and adjunctive high-dose steroids. They recovered ad integrum in less than 2 weeks.DiscussionMultisystem inflammatory syndrome in children occurs 2–4 weeks after infection with severe acute respiratory syndrome coronavirus 2. Patients with MIS-C should ideally be managed in an intensive care environment since rapid clinical deterioration may occur. It would be preferable to have a multidisciplinary care to improve outcomes. Patients should be monitored for shock. Elucidating the mechanism of this new entity may have importance for understanding COVID-19 far beyond the patients who have had MIS-C to date. The pathogenesis seems to involve post-infectious immune dysregulation so early administration intravenous immune globulin associated with corticosteroids appears appropriate. It implies early recognition of the syndrome even in young adults.

Acute Arterial Thrombosis of Lower Extremities in COVID-19 Patients.

Clinical signs and symptoms of COVID-19 varied from asymptomatic forms to severe, life-threatening conditions that required treatment in intensive care units. These severe forms of illness are connected with a hypercoagulable state due to excessive inflammation, hypoxia, immobilisation, and altered angiotensin-converting enzyme 2 (ACE-2). In total, 17 COVID-19 positive patients were diagnosed with peripheral arterial thrombosis (AT), 13 of them had COVID-19 pneumonia. Laboratory findings in patients with X-ray confirmed pneumonia showed a four times higher neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP) and three times higher lactate dehydrogenase level (LDH) than patients without confirmed pneumonia. Patients with pneumonia had significantly more bilateral occlusions of the lower extremities and a significantly higher percentage with complete occlusion of the arteries than patients without pneumonia. The rate of limb loss was 35.3%. They were all from the group with COVID-19 pneumonia. Ten out of thirteen patients with pneumonia died due to acute respiratory distress syndrome (ARDS). All patients without pneumonia were discharged from the hospital. The aim of this retrospective study was to report the incidence of arterial thrombosis of lower extremities and their complications in the acute phase of the infection among COVID-19 patients admitted to the hospital for treatment.