Concurrent Infection Research Articles

Clinical study of AIDS complicated with fungal infection

This paper presents a systematic study on the common occurrence of concurrent fungal infections in AIDS patients in clinical practice. Firstly, it introduces the epidemiological status of AIDS worldwide, emphasizing the special vulnerability to fungal infections due to the impaired immune function of AIDS patients. Subsequently, it analyzes in detail the incidence, clinical features, and diagnostic methods of common fungal infections in AIDS patients. Furthermore, it discusses the impact of fungal infections on the disease progression and prognosis of AIDS patients and provides a comprehensive review of prevention and treatment strategies. By summarizing and synthesizing the latest research findings and clinical experiences, this paper emphasizes the importance of timely diagnosis and treatment of fungal infections, and proposes directions for further research and recommendations for future clinical practice.

Gastrointestinal helminths infection of free-roaming cats (Felis catus) in Southeast Iran.

Cats in Iran are definitive hosts for several zoonotic intestinal helminths, such as Toxocara cati, Dipylidium caninum, Toxascaris leonina, Physaloptera praeputialis and Diplopylidium nolleri. This study aimed to determine the prevalence of intestinal helminth infection in free-roaming cats in southeast Iran, a region with a high free-roaming cat population. From January 2018 to December 2021, 153 cadavers of free-roaming cats from Southeast Iran were necropsied for intestinal helminth infections. The carcasses were dissected, and the digestive systems were removed. The esophagus, stomach, small intestine, caecum and colon were tightly ligated. All adult helminths were collected, preserved and identified. The prevalence of gastrointestinal helminth infections was 80.39% (123/153). Of the cats from Kerman, 73% (73/100) were infected with at least one helminth, including D. caninum 70% (70/100), T. leonina 8% (8/100) and P. praeputialis 17% (17/100). Concurrent infection with two helminth species was found in 16% (16/100) and of three species infections was found in 3% (3/100) of the cats. Of the cats from Zabol, 94.33% (50/53) were infected with at least one of the helminths, including D. caninum 69.81% (37/53), T. leonina 11.32% (6/53), P. praeputialis 37.73% (20/53) and T. cati 5.66% (3/53). Concurrent infection with two helminth species was found in 28.3% (15/53), and three species were found in 1.88% (1/53) of the cats. Helminth infections were more prevalent in older cats. There was no association between sex and infection rate. Based on the very high prevalence of zoonotic intestinal helminth infections in free-roaming cats in southeast Iran, the potential public health risk emphasizes the need for intersectoral collaboration, particularly the provision of health and hygiene education to high-risk populations, such as pre-school and school-age children.

The Role of Ureaplasma and Mycoplasma Species in Recurrent Lower Urinary Tract Infection in Females: A Scoping Review.

It is unknown if recurrent urinary tract infection in the gynecologic population is associated with Mycoplasma and Ureaplasma genitourinary infections. The purpose of this scoping review is to highlight the literature surrounding Mycoplasma and Ureaplasma infections in the setting of recurrent urinary tract infections in the gynecologic population. MEDLINE ALL and Embase were searched to retrieve articles published in or after 1950 through 2024. Studies included were those with adults over age 18, non-pregnant, diagnosed with recurrent urinary tract infection and concurrent genitourinary infection with Ureaplasma or Mycoplasma published in English. Study designs eligible were quantitative, qualitative, and mixed methods studies. Publication types were also extended to conference abstracts and unpublished data. 2 independent investigators systematically performed title/abstract screening and full-text review using standardized inclusion criteria. For disagreements in either title and abstracts or full-text articles, consensus was reached through discussion by the 2 screeners and/or a 3rd final adjudicator. Screening and data extraction were performed on Covidence, a web-based platform for systematic review management. There were 1170 studies identified before title and abstract screening. 26 full-text articles were reviewed for eligibility. Of these, 23 full-text studies were excluded. 3 studies met full inclusion criteria and data extraction was performed on these 3 studies. There were 2 additional studies included after identification via other methods. There is a need for more recent and robust studies examining the role of Ureaplasma and Mycoplasma genitourinary infections amongst gynecologic patients with recurrent urinary tract infections.

Clinical features of atypical presentations of mucocutaneous herpes simplex virus infection observed in immunosuppressed individuals. Part II: the knife-cut sign.

The knife-cut sign is a distinctive manifestation of herpes simplex virus (HSV) type 1 or HSV type 2 infection that has been described in at least 10 immunocompromised patients. It appears as an extremely painful linear erosion or fissure in an intertriginous area such as the body folds beneath the breast, or within the abdomen, or in the inguinal region. Also, concurrent HSV infection at other mucocutaneous sites, or viscera, or both have been observed. The patients had medical conditions (at least 9 patients) and/or immunosuppressive drug therapy (6 patients). The diagnosis of HSV infection was confirmed by viral culture (8 patients), biopsy (4 patients), direct fluorescence antibody testing (3 patients), immunohistochemistry staining (2 patients), polymerase chain reaction (2 patients), or Western blot serologic assay (1 patient). Knife-cut sign-associated HSV infection is potentially fatal; three patients died. However, clinical improvement or complete healing occurred in the patients who received oral valacyclovir (1 patient), or intravenous acyclovir (2 patients), or intravenous acyclovir followed by foscarnet (1 patient). In summary, HSV infection associated with a positive the knife-cut sign is a potentially fatal variant of HSV infection that occurs in the intertriginous areas of immunocompromised patients and usually requires intravenous antiviral therapy.

Malaria blood stage infection suppresses liver stage infection via host-induced interferons but not hepcidin

Malaria-causing Plasmodium parasites first replicate as liver stages (LS), which then seed symptomatic blood stage (BS) infection. Emerging evidence suggests that these stages impact each other via perturbation of host responses, and this influences the outcome of natural infection. We sought to understand whether the parasite stage interplay would affect live-attenuated whole parasite vaccination, since the efficacy of whole parasite vaccines strongly correlates with their extend of development in the liver. We thus investigated the impact of BS infection on LS development of genetically attenuated and wildtype parasites in female rodent malaria models and observed that for both, LS infection suffered severe suppression during concurrent BS infection. Strikingly and in contrast to previously published studies, we find that the BS-induced iron-regulating hormone hepcidin is not mediating suppression of LS development. Instead, we demonstrate that BS-induced host interferons are the main mediators of LS developmental suppression. The type of interferon involved depended on the BS-causing parasite species. Our study provides important mechanistic insights into the BS-mediated suppression of LS development. This has direct implications for understanding the outcomes of live-attenuated Plasmodium parasite vaccination in malaria-endemic areas and might impact the epidemiology of natural malaria infection.

Concurrent Infection with Dengue and Malaria in Adult Febrile Patients in a Tertiary Care Hospital

Concurrent Infection with Dengue and Malaria in Adult Febrile Patients in a Tertiary Care Hospital

Concurrent infection of dengue virus with malaria parasites among outpatients attending healthcare facilities in Benin city, Nigeria.

Dengue virus (DENV) and malaria parasites (MP) are among the common febrile diseases affecting the tropics and subtropics of the world. Both are mosquito-borne pathogens affecting humans and other animals. Blood samples were collected from 280 consented out-patients attending the selected hospitals and were analyzed. Malaria parasites were detected using microscopy and Malaria Ag Pf/Pan Rapid Test Device. Dengue virus was detected by serology and heminested reverse transcriptase PCR (hnRT-PCR) to target the flavivirus polymerase (NS5) gene. Malaria parasites recorded a total positivity of 151 patients (53.9%) using microscopy, while DENV antibodies (DENV IgM and DENV IgG) were positive in 16 (5.7%) and 39 (13.9%) patients, respectively. There was a concurrent infection between MP/DENV IgM in 13 (4.6%) patients and MP/DENV IgG in 27 (9.6%) patients. Molecular identification revealed DENV serotype 2 in circulation. This study documents molecular evidence of dengue virus coexisting with malaria parasites in the study population, hence the need for efficient surveillance and control system.

Dural arteriovenous fistula in the setting of cerebral venous sinus thrombosis and COVID-19 infection.

The aim of this study was to examine the presence of concurrent venous thrombosis and COVID-19 infections in patients with dural arteriovenous fistulas (dAVFs). An analysis of all patients diagnosed with dAVF via cerebral angiography by the senior author was conducted, with special attention given to the presence of cerebral venous sinus thrombosis (CVST) and COVID-19 infection. General demographics, clinical presentation, presence of CVST, and COVID-19 infection status were reported. A total of 30 patients with dAVFs were included in this study. Three patients were diagnosed with COVID-19 (10%), with one of these patients developing CVST (33%) at 6 months postinfection. Of the 27 patients not infected with COVID-19, one was diagnosed with a likely chronic CVST at the time of presentation of dAVF (4%). A total of 11 case reports and 3 retrospective studies describing patients diagnosed with CVST at or after diagnosis of dAVFs have been reported in the literature. The incidence of dAVFs in patients with CVST has been reported as 2.4%, and the incidence of dAVF has reportedly increased five- to tenfold since the COVID-19 pandemic. COVID-19 infections may pose as an emerging risk factor for the development of CVST and subsequent dAVF development. To the authors' knowledge, this study presents the first cases in the literature describing a temporal relationship between COVID-19 and development of a dAVF with CVST. The effect of both COVID-19 and associated vaccines should be further assessed in future studies to examine its impact as an effect modifier on the association of dAVF and CVST.

A comparative study on the concurrent infections with Ascaridia galli and Eimeria in broiler chickens

This study was conducted to investigate the response of two week old broiler chickens to single and concurrent infections with Ascaridia galli and Eimeria spp and the influence of timing of the infections with the hope that the results would greatly inform the improvement of control measures of the infections for better productivity of the birds. Six groups of 7 broiler chickens each were used. Five of the groups were either infected with A. galli only, caecal eimeria only, A. galli and caecal eimeria (A+E) at the same time, A. galli and later caecal eimeria (AE) or caecal eimeria isolate and later A. galli (EA). The sixth groupremained as the uninfected control birds. The dose levels were 1000 embryonated A. galli eggs and 12,000 sporulated Eimeria oocysts per chicken. Packed cell volume (PCV), body weight (BWt), faecal egg counts (EPG), faecal oocyst counts (OPG), caecal gross lesion score (GLS), and worm burden (WB). The infections had a negative impact on the birds evidenced by low PCV, low weight gain, reduced feed intake, dullness, bloody diarrhea and mortalities when compared with their uninfected controls. A drop in the PCV from day 8 to day 12 of the birds infected with AE. The AE group also had the least weight gain and least feed intake in comparison with all the other infected and the uninfected control birds. The greatest mortalities occurred in the AE group. It was concluded that the poor performance of the chickens was due to the infections, however, the severity of the infections was greatest in the AE group. It was suggested that A. galli caused immune downregulation of the chicken allowing the Eimeria to exert maximally its pathogenic effects on the birds. It is therefore strongly recommended that the infections should be diagnosed and controlled promptly particularly if they are concurrent as the effects can be disastrous especially when A. galli infection precedes Eimeria infection. Cette étude a été menée pour étudier la réponse de poulets de chair âgés de deux semaines à des infections uniques et concomitantes à Ascaridia galli et Eimeria spp et l'influence du moment des infections dans l'espoir que les résultats contribueraient grandement à l'amélioration des mesures de contrôle des infections. pour une meilleure productivité des oiseaux. Six groupes de 7 poulets de chair chacun ont été utilisés. Cinq des groupes étaient soit infectés par A. galli uniquement, par eimeria caecal uniquement, par A. galli et par eimeria caecal (A+E) en même temps, par A. galli et plus tard par eimeria caecal (AE) ou par un isolat d'eimeria caecal et plus tard par A. .galli (EA). Le sixième groupe est resté constitué d'oiseaux témoins non infectés. Les niveaux de dose étaient de 1 000 œufs embryonnés d'A. galli et de 12 000 oocystes d'Eimeria sporulés par poulet. Volume de cellules concentrées (VCC), poids corporel (PC), nombre d'œufs fécaux (NŒF), nombre d'oocystes fécaux (NOF), score de lésion brute cæcale (LBC) et charge de vers (CV). Les infections ont eu un impact négatif sur les oiseaux, comme en témoignent un faible VCC, un faible gain de poids, une consommation alimentaire réduite, une matité, une diarrhée sanglante et une mortalité par rapport à leurs témoins non infectés. Une baisse du VCC du jour 8 au jour 12 des oiseaux infectés par AE. Le groupe AE présentait également le gain de poids le plus faible et la consommation alimentaire la plus faible par rapport à tous les autres oiseaux témoins infectés et non infectés. Les mortalités les plus importantes sont survenues dans le groupe AE. Il a été conclu que les mauvaises performances des poulets étaient dues aux infections, cependant, la gravité des infections était la plus élevée dans le groupe AE. Il a été suggéré qu'A. galli provoquait une régulation immunitaire négative du poulet, permettant à l'Eimeria d'exercer au maximum ses effets pathogènes sur les oiseaux. Il est donc fortement recommandé que les infections soient diagnostiquées et contrôlées rapidement, en particulier si elles sont concomitantes, car les effets peuvent être désastreux, en particulier lorsque l'infection par A. galli précède l'infection par Eimeria.

A conserved antigen induces respiratory Th17-mediated broad serotype protection against pneumococcal superinfection

Several vaccines targeting bacterial pathogens show reduced efficacy upon concurrent viral infection, indicating that a new vaccinology approach is required. To identify antigens for the human pathogen Streptococcus pneumoniae that are effective following influenza infection, we performed CRISPRi-seq in a murine model of superinfection and identified the conserved lafB gene as crucial for virulence. We show that LafB is a membrane-associated, intracellular protein that catalyzes the formation of galactosyl-glucosyl-diacylglycerol, a glycolipid important for cell wall homeostasis. Respiratory vaccination with recombinant LafB, in contrast to subcutaneous vaccination, was highly protective against S.pneumoniae serotypes 2, 15A, and 24F in a murine model. In contrast to standard capsule-based vaccines, protection did not require LafB-specific antibodies but was dependent on airway CD4+ T helper 17 cells. Healthy human individuals can elicit LafB-specific immune responses, indicating LafB antigenicity in humans. Collectively, these findings present a universal pneumococcal vaccine antigen that remains effective following influenza infection.

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.

Audiovestibular adverse events following COVID-19 vaccinations

IntroductionEvidence regarding audiovestibular adverse events post COVID-19 vaccination to date has been inconclusive regarding a potential association. This study aimed to determine if there was an increase in audiovestibular events following COVID-19 vaccination in South-eastern Australia during January 2021–March 2023. MethodsA multi-data source approach was applied. First, a retrospective observational analysis of spontaneous reports of audiovestibular events to a statewide vaccine safety surveillance service, SAEFVIC. Second, a self-controlled case series analysis using general practice data collected via the POpulation Level Analysis and Reporting (POLAR) tool. Results and conclusionsThis study is the first to demonstrate an increase in general practice presentations of vertigo following mRNA vaccines (RI = 1.40, P <.001), and tinnitus following both the Vaxzevria® adenovirus vector and mRNA vaccines (RI = 2.25, P <.001 and 1.53, P <.001 respectively). There was no increase in hearing loss following any COVID-19 vaccinations. Our study, however, was unable to account for the potential of concurrent COVID-19 infections, which literature has indicated to be associated with audiovestibular events.Healthcare providers and vaccinees should be alert to potential audiovestibular complaints after COVID-19 vaccination. Our analysis highlights the importance of using large real-world datasets to gather reliable evidence for public health decision making.

Therapeutic management to concurrent infection of Haemoproteus columbae and Trichomonas spp. in domestic rock pigeons

Two domestic rock pigeons were presented to Veterinary Clinical Complex, VC &amp; RI, Orathanadu, TANUVAS with the history of circling, rotating its head, complete inappetence and regurgitation. On clinical examination bird appeared dull, depressed and circling of head appreciated and also noticed the presence of Pseudolynchia canariensis. Blood smear examination revealed a characteristic halter shaped gametocytes of Haemoproteus columbae encircling the nucleus of erythrocytes and the crop fluid examination revealed the presence of Trichomonas gallinae. Faecal sample examination revealed the absence of intestinal parasites. The birds were treated with oral Chloroquine @5mg/kg body weight and Metronidazole @50 mg as total dose along with the multivitamin supplementation. The whole flock in the house hold were treated with Permethrin (0.25%) spray by external application to control vector population. After five days of the treatment the clinical condition of the birds were reviewed which showed complete recovery without any complications.

COVID-19 in pulmonary critically ill patients: metagenomic identification of fungi and characterization of pathogenic microorganisms.

Fungal co-infection is prevalent in critically ill patients with COVID-19. The conventional approach applied to fungal identification has relatively low sensitivity and is time-consuming. The metagenomic next-generation sequencing (mNGS) technology can simultaneously detect a variety of microorganisms, and is increasingly being used for the rapid detection and diagnosis of pathogens. In this single-center retrospective study, we described the clinical presentation and outcomes of COVID-19 and mNGS positive for fungi in pulmonary critically ill patients during the outbreak of Omicron infection from December 2022 to January 2023. Among 43 COVID-19 patients with acute respiratory distress syndrome (ARDS) on a single intensive care unit (ICU), 10 were reported to be fungal positive using the mNGS test. The number of pathogenic microorganisms detected by mNGS was significantly higher than that via traditional methods, especially in the detection of fungi and viruses. Aspergillus infection was dominant, and most of these patients also had concurrent bacterial or viral infections. Probable or possible COVID-19-associated pulmonary aspergillosis (CAPA) was diagnosed in all 10 patients, and the prognosis was poor. Patients with COVID-19 may be at increased risk of developing fungal infections as well as concurrent bacterial or viral infections, and mNGS can be a powerful tool in identifying these infections. Clinicians should be aware of the increased risk of fungal infections in COVID-19 patients, particularly those who have underlying immunocompromising conditions, and should monitor for early signs of infection.

Mycobacterium avium Subspecies paratuberculosis Infection and Immunopathological Changes in Animals: A Review

Mycobacterium avium subspecies paratuberculosis (MAP) is a chronic granulomatous intestinal disease and causative agent of Johne’s disease (JD) in domestic and wild ruminants. This study explores the intricate dynamics of the host immune response in MAP infection and its implications for disease progression and control. Our investigation revealed the pivotal role of interleukin-10 (IL-10) in mediating the communication between the host’s innate and adaptive immunological responses. IL-10 inhibits interferon-gamma (IFN-γ) secretion, altering the balance between Th1 and Th2 responses. In the early stages, a robust Th1 response marked by increased IFN-γ production is observed, but as the disease progresses, a shift towards a humoral Th2 response occurs. Furthermore, we found that IL-10 exerts suppressive effects on macrophage (Mφ) anti-mycobacterial action, leading to increased intracellular survival of mycobacteria. IL-10 also hampers Mφ antimicrobial activity by suppressing the production of essential cytokines such as IL-12 and tumor necrosis factor alpha (TNF-α), crucial for activating natural killer (NK) cells and inducing differentiation of CD4+ T lymphocytes into Th1 effector cells. Importantly, our study sheds light on the intricate interplay between past infections or concurrent active co-infections and their influence on the immune response to unrelated pathogens in the context of paratuberculosis. This review underscores the multifaceted role of IL-10 in the immunopathological manifestation of MAP infection and host immunomodulation. These findings provide valuable insights for both animal and human research in the fight against MAP infection, emphasizing the importance of balancing immune responses and considering the influence of concurrent infections in disease progression.

The surface morphology of Atractylodes macrocephala polysaccharide and its inhibitory effect on PCV2 replication.

Porcine infection with Porcine circovirus type 2 (PCV2) causes immunosuppression, which is easy to cause concurrent or secondary infection, making the disease complicated and difficult to treat, and causing huge economic losses to the pig industry. Total polysaccharide from the rhizoma of Atractylodes macrocephala Koidz. (PAMK) is outstanding in enhancing non-specific immunity and cellular immunity, and effectively improving the body's disease resistance, indicating its potential role in antiviral immunotherapy. PAMK had the characteristics of compact, polyporous and agglomerated morphology, but does not have triple helix conformation. PCV2 infection led to the increase in LC3-II, degradation of p62 and the increase of viral Cap protein expression and viral copy number. PAMK treatment significantly alleviated PCV2-induced autophagy and inhibited PCV2 replication. Moreover, PAMK treatment significantly attenuated the increase of PINK1 protein expression and the decrease of TOMM20 protein expression caused by PCV2 infection, alleviated Parkin recruitment from cytoplasm to mitochondria and intracellular reactive oxygen species accumulation, restored mitochondrial membrane charge, alleviated viral Cap protein expression. PAMK alleviates PCV2-induced mitophagy to suppress PCV2 replication by inhibiting the Pink 1/Parkin pathway. These findings may provide new insights into the prevention and treatment of PCV2. © 2023 Society of Chemical Industry.

A novel cabazitaxel liposomes modified with ginsenoside Rk1 for cancer targeted therapy

Objective: In this study, we aim to enhance the anti-prostate cancer efficacy of cabazitaxel (CTX) and reduce its immunosuppression and systemic toxicity by developing CTX-loaded liposomes modified with ginsenoside Rk1 (Rk1/CTX-Lip). Methods: Physical and chemical properties of Rk1/CTX-Lip were investigated. We evaluated the biological functions of Rk1/CTX-Lip, both in vitro and in vivo. A subcutaneous prostate cancer (RM-1)-bearing mouse model was established to study the efficacy of Rk1/CTX-Lip inhibition in tumors. Simultaneously, a Candida albicans infection model was established in tumor-bearing mice to study the infection-relieving efficacy of Rk1/CTX-Lip. Finally, biocompatibility and in vivo safety of Rk1/CTX-Lip were evaluated. Results: We successfully prepared Rk1/CTX-Lip, achieving high CTX encapsulation efficiency (97.24 ± 0.75)% and physical stability. Rk1/CTX-Lip demonstrated evasion of macrophage phagocytosis, effective tumor tissue targeting, and a significant reduction (&gt;50%) in average tumor volume compared with Chol/CTX-Lip. Moreover, it relieved the concurrent infection burden and effectively regulated immune organs and cells, demonstrating superior biocompatibility. Conclusion: Rk1/CTX-Lip presents a promising new therapy for prostate cancer and holds potential for relieving concurrent fungal infections in cancer patients with low immunity.

Concurrent Infection of Oesophagostomum species in a Slaughtered Goat: A Case Report

The morbidity and mortality of gastrointestinal nematodes in goats made them one of the most significant parasites in the world, causing huge economic loss for farmers. It has been reported that the economic loss due to gastrointestinal parasitism was Rs. 372.35 per goat annually. In the present study, the intestinal sample was collected from a local slaughter house at Izatnagar, Bareilly, Uttar Pradesh, for screening the gastrointestinal nematodes. Initially, the pathological lesions like nodules, cyst and haemorrhagic patches etc. were examined for any parasitic infection. The found worms in the intestinal content were subjected for microscopic examination for the identification of the nematode and identified them as Oesophagostomum spp. based on buccal capsule with cephalic and cervical structures. Interestingly, both Oesophagostomum columbianum and O. asperum species were found in the same sample. The male and female Oesophagostomum species were also differentiated by examining the spicule and gubernacular length, position of the vulva and anus. This study reports the infection of Oesophagostomum spp. in a goat and the first case report of concurrent infection of O. columbianum and O. asperum in the Bareilly region of Uttar Pradesh.

Correlation between human papillomavirus protein expression and clinicopathological features in oral squamous cell carcinoma.

Given the implications of concurrent human papilloma viral infection (HPV) in the prognostic course and implications on therapeutic approached of patients with oral squamous cell carcinoma (OSCC), we seek to investigate the implications that P16 expression has on the clinical course and pathological appearance of patients with OSCC and concurrent infection. Using S-P immunohistochemistry, we examined the expression of P16 and Ki67 in 460 patients with OSCC. We compared the expression of the protein between the tumor cells and normal epithelial mucosa within the same patient. The clinical and pathological characteristics (including gender, age, histological grade, lymph node metastasis, clinical stage, clinical recurrence, tumor diameter, Ki67 proliferation index) were analyzed by stratification statistically. In total 460 cases of OSCC were identified and expression of P16 was significantly higher in the OSCC group compared to the normal mucosal epithelial group (X2 = 60.545, p = .000). There also appear to be a gender predilection as the expression was higher in females compared to males (0.218 vs. 0.144, X2 = 3.921, p = .048). Younger age also appears to be a predictive factor as those under 35 years old had higher expression of the protein compared to those over 35 years old (0.294 vs. 0.157, X2 = 4.230, p = .040). P16 positivity showed a significant positive correlation with histologic grade (X2 = 4.114, p = .043). In addition, the positive rate of P16 was higher in patients with ki67 over 85% (0.455 vs. 0.160, X2 = 6.667, p = .023). OSCC with HPV infection tends to occur more frequently in female patients and those under 35 years of age. HPV infection with expression of the P16 and ki67 protein may promote the proliferation and growth of OSCC at a higher frequency.

Abstract WP260: Higher Incidence of Cerebral Venous Thrombosis Seen During the First Year of the COVID-19 Pandemic: Insights From the National Inpatient Sample

Background: Cerebral venous thrombosis (CVT) is associated with significant risk of death and disability. Prior research has found patients with COVID-19 had higher incidences of system venous and arterial thrombosis, however, there has been little research into its impact on incidence of CVT. Objective: Determine whether the incidence of CVT was higher during the first year of the COVID-19 pandemic. Methods: A cross-sectional study utilizing data from the National Inpatient Sample (NIS) was performed. Adult patients in 2018 (n=6,051,974) were compared to those in 2020 (n=5,470,813), the first year of the COVID-19 pandemic. To prevent potential confounding by undiagnosed COVID-19, patients in 2019 were not utilized in the analysis. ICD-10 codes were utilized to identify patients with CVT along with additional diagnoses, including COVID-19 infection. Odds ratios and 95% confidence intervals were calculated and compared using t-tests. Rates of CVT were also calculated. Results: There were 731 (weighted estimate for the US population n=3,655, rate of 13.4 cases per 100,000 admissions) patients with CVT in 2020, compared to 641 patients in 2018 (weighted n=3,205, rate of 10.6 per 100,000 admissions; p-value 0.003; cOR=1.26, 95% CI=1.08-1.47). Female patients had a higher incidence of CVT in both years (58.6% versus 62.5%) with no significant between year difference. No age or race difference was identified. Hospital mortality rate among CVT patients admitted in 2020 was 5%. Twelve patients were diagnosed with concurrent COVID-19 infections. Length of stay among CVT patients admitted in 2018 and 2020 was similar (7.89 versus 8.06 days). However, CVT patients with concurrent COVID-19 had a longer hospital stay than those without COVID-19 (18 versus 8 days; p-value&lt;0.001). Conclusions: There was a significantly higher incidence of CVT among hospitalized patients during the first year of the COVID-19 pandemic compared to 2018. This finding is consistent with the previously described higher rates of thrombotic disorders during the COVID-19 pandemic and should prompt further study.