Infected Control Group Research Articles

Euthyroid sick syndrome predicts the risk of ischemic stroke-associated pneumonia in the acute stage of ischemic stroke: a nested case-control study

ObjectiveIschemic stroke-associated pneumonia (iSAP) affects about 10% of acute ischemic stroke patients during hospitalization. Current prediction scales for iSAP are insufficient. Identifying early biomarkers for stroke-associated pneumonia is crucial for improving patient outcomes. This study aimed to investigate the predictive value of euthyroid sick syndrome (ESS) for iSAP in acute-stage of ischemic stroke patients.MethodsWe studied 1767 acute ischemic stroke patients within one week of symptom onset, categorizing them into an infection group (iSAP, n=376) and control group (control, n=1391). COX regression analysis was used to identify the potential risk and protected factors. Kaplan-Meier time-event curves and Log-Rank tests were performed to differentiate infection time in patients with ESS or normal T3 group.ResultsThe iSAP group had higher rates of risk factors like older age, atrial fibrillation, COPD, and ESS, along with elevated levels of WBC, CRP,and FT4 levels (all P < 0.001). Conversely, iSAP patients had lower GCS scores, eGFR, TSH, T3, FT3 (all P < 0.001) and T4 levels (P = 0.005) upon admission. No significant differences were observed in sex, smoking history, hypertension, diabetes, or LDL-C levels (P > 0.05). COX regression analysis identified age, KWST scores, leukocyte count, CRP, and ESS (all P < 0.001) as significantly correlated with iSAP. ROC analysis revealed ESS as a predictor with sensitivity of 35.64% and specificity of 87.92% for SAP prediction, like atrial fibrillation and higher than COPD and eGFR.ConclusionESS at admission predicts a higher risk of stroke-associated pneumonia in acute-stage of ischemic stroke.

Effectual Role of Plant Growth-Promoting Fungi and Fosthiazate in Controlling Tomato Root-Knot Nematode Infection: In Vivo and In Vitro Studies

Plant growth-promoting fungi (PGPF) are known to induce systemic resistance in plant diseases caused by microbial pathogens. However, the induced resistance by PGPF has not yet been elucidated in plant diseases caused by root-knot nematodes (RKNs, Meloidogyne spp.). Meloidogyne incognita can severely damage tomato plants, causing considerable losses in world yields. This study aimed to isolate and evaluate the potential of PGPF through enhancing systemic resistance, possibly through activating defense-related pathways in tomato plants, comparing to the commercial chemical nematicide, Melithorin® (fosthiazate 90%). The most potent PGPF (K7, K13, K14) were identified morphologically and molecularly as Alternaria photistica, Penicillium buchwaldii, and Aspergillus niger, respectively. We tested the efficacy of these fungi against RKN (M. incognita) both in vitro and in vivo. The results demonstrated that the commercial nematicide fosthiazate (90%) was the most effective treatment for controlling RKN J2 larvae, achieving a mortality rate of 94% after 96 hours. This was followed by the PGPF treatments, with A. niger at 92.6%, P. buchwaldii at 87.7%, Verticillium lecanii at 73.3%, and A. photistica at 47.4%. Additionally, applying A. photistica, A. niger, P. buchwaldii, and V. lecanii significantly enhanced the levels of photosynthetic pigments, total carbohydrates, and proteins in both healthy and RKN-infected plants. Notably, Melithorin® (fosthiazate 90%), A. niger, and V. lecanii led to substantial increases in root carbohydrate content, with increases of 97%, 63%, and 58%, respectively. Furthermore, Melithorin®, A. photistica, and A. niger significantly boosted shoot protein content by 68%, 65%, and 49%, respectively, compared to the infected control group. These findings indicate that both nematicide and fungal treatments effectively reduce nematode populations and improve overall plant health and nutrient composition. At the same time, the results appeared that infected plants treated with PGPF or Melithorin® showed variation in number and molecular weight of protein bands. SDS-PAGE results indicated that, the highest number of bands (twelve) was recorded in the infected plants treated with Melithorin® followed by P. buchwaldii (11 bands), A. photistica (10 bands), V. lecanii (8 bands), and A. niger (7 bands), respectively. Also, the application of Melithorin®, A. niger, and V. lecanii resulted in a significant increase in the number and weight of fruits, respectively, compared to healthy control plants. Our results suggested that A. photistica, A. niger, P. buchwaldii, and V. lecanii could be used as effective and safe nematicides against RKNs.

Advanced chelate technology-based trace minerals reduce inflammation and oxidative stress in Eimeria-infected broilers by modulating NF-kB and Nrf2 pathways

This study investigated the effects of substituting inorganic trace minerals (ITM) with advanced chelate technology-based TM (ACTM) in broiler chicken feed on productive performance, metabolic profile, humoral immunity, antioxidant status, and modulation of NF-kB and Nrf2 signaling pathways in mixed Eimeria species exposure. The study involved 480 newly hatched male broiler chickens, which were divided into 5 treatment groups, each with 6 replicate cages and 16 chickens per replicate. The experimental treatments included an uninfected negative control group fed a basal diet with recommended inorganic TM levels (NC), an infected positive control group fed the same diet (PC), a PC group supplemented with salinomycin (SAL), and two PC groups in which the basal diet was replaced with 50% and 100% ACTM instead of inorganic TM (ACTM50 and ACTM100, respectively). All groups, except for the NC group, were orally challenged with mixed Eimeria species oocysts on day 14. According to the results, the PC group showed lower feed intake, breast yield, low-density lipoprotein-cholesterol concentration, lactobacillus spp. counts, and serum IgG levels, but higher jejunal TGF-β expression versus the NC group. The broilers in the NC, SAL, and ACTM100 groups showed higher body weight gain, carcass yield, and TGF-β expression, but lower serum alkaline phosphatase activity, ileal E. coli count, and jejunal expression levels of IL-1β, IL-6, IFN-γ, Nrf2, and SOD1 compared to the PC group, with the NC group having the highest body weight gain and lowest IL-1β and Nrf2 expression levels. Furthermore, the administration of ACTM100 treatment improved feed efficiency, increased serum iron, zinc, manganese, and copper levels, enhanced total antioxidant capacity and different antioxidant enzyme activities, and reduced malondialdehyde concentration. In conclusion, complete replacement of ITM with ACTM effectively protects broilers from Eimeria infection, with similar positive effects to SAL treatment in terms of productive performance and anti-inflammatory responses and better antioxidant responses and mineral availability.

Gaultheria procumbens essential oil longevity and oxidant/antioxidant status of silver catfish Rhamdia quelen experimentally infected by Aeromonas caviae

The increase in bacterial resistance in animals and the buildup of antimicrobials in animal meat pose significant nutritional and economic challenges. Given this context, this study explored the potential of Gaultheria procumbens essential oil (GPEO) as a sustainable alternative for aquaculture, focusing on its effects against Rhamdia quelen infected with Aeromonas caviae. Longevity tests revealed that R. quelen, when treated with 5 and 10 µL/L of GPEO, displayed significantly improved survival rates compared to both the untreated infected control group and those treated with ethanol. To understand the mechanisms behind the increased survival, a subsequent experiment with a 10 µL/L GPEO treatment aimed to investigate the oxidative stress pathway. This involved measuring levels of thiobarbituric acid reactive substances (TBARS) and reactive oxygen species (ROS), alongside enzyme activities for superoxide dismutase, glutathione peroxidase, and glutathione S-transferase. Our findings showed elevated TBARS and ROS levels in the non-infected control group treated with GPEO, suggesting an increase in these enzymes as a response to ROS balance. Therefore, our data indicate that the mechanism leading to enhanced longevity in R. quelen infected and treated with GPEO does not involve the oxidative stress pathway.

The evaluation of the Theraputic Effect of Aqueous Extract of Aloe Vera on Entamoeba histolytica in Vivo

Ameobiasis caused by Entameoba spp. It is a zoonotic disease that is the most prevalent. Thus, the study was conducted to evaluate the anti-ameobiasis efficacy of aqueous Aloe vera extracts in comparison with metronidazole in laboratory mice. Stool samples were collected from patients attending in Al-karamah teching Hospital suffering from diarrhea from November 1, 2022 to February 29, 2023, and 15samples were examined for both sexes microscopic by using the lugols iodine Stain to detect infected the parasite's cysts , Isolation and purification by flotation with normal solution and preserved in potassium dichromate for the purpose of using it in causing infection in laboratory mice. The experimental study was conducted on groups of 35 mice by oral administration of parasite cysts within the range of 95 cyst / ml except for the negative control group that was drenched with physiological saline. The feces of mice inoculated with cysts of parasites were microscopically examined using the modified lugols iodine Stain, After the mice were divided into seven groups with the uninfected and untreated group kept as a healthy negative control. The first group which included 21 mice was treated after it was divided into three subgroups A, B, C for each secondary group 7 mice they were treated with aqueous extract of A.vera at different concentrations 50, 100, 150 mg/ml on the respectively, while the second group which included 21 mice on three groups A, B, and C was treated with aqueous extract of A.vera at the previous concentrations for three consecutive days for each concentration. The third group was treated with metronidazole at a concentration of mg/ ml, and the positive control group remained infected with the parasite and was not treated. After treatment a microscopic examination was performed by evaluating the excretion average of parasite cysts using a hematocytometer slide. There was a decrease in the shedding of fecal cysts in the groups treated with aqueous extract at different concentrations, reaching a complete stop when treating with the highest concentrations at the end of the treatment period. Where, the average of shedding of fecal parasite cysts of groups of mice at concentrations 50, 100, 150 mg/ml reached 18.20, 0.200, 0 cyst/ml respectively. while the avrage of shedding of cysts in the group treated with metronidazole reached 60.20 cyst/ml in comparison with the infected positive control group in which the number of cysts continued to increase to 14.863 cyst/ml at the end of the treatment period. The results of the therapeutic efficacy of A.vera extract showed percentages of 82%, 90%, 100% for the aqueous extract at concentrations 50, 100, 150 mg/ml, respectively, while the therapeutic efficacy of metranidazol reached 84% at the end of the treatment period

Antimicrobial and therapeutic potentials of the blackberry extracts against Escherichia coli infection in male albino rats.

Blackberries have garnered attention recently due to their high concentration of bioactive components like anthocyanin and their health advantages. Therefore, this study aims to determine the bioactive profile, antioxidant and antibacterial effects of blackberry extracts (BBEs). Then, evaluate the protective effect of BBEs (20%, 30% and 40%) in a rat model of 2 mL of 4-8 × 106 Escherichia coli ATTC 25922 strain colony-forming unit mL-1 oral infection on the seventh day of the experiment. Rats were divided into six groups: G1: control (C-: normal or negative group), G2: (C+: infected or positive group), G3: infected-treated group by 20% BBE, G4: infected-treated group by 30% BBE, G5: infected-treated group by 40% of BBE and G6: infected-treated group by Gentamicin. The results showed that BBE had a high content of total phenolic compounds, flavonoid, anthocyanin contents, and different vitamins (vitamins A, E and C), reaching 450, 186, 58.83 mg 100 g-1, 2.68, 2.14 and 107.46 mg 100g-1 fresh weight, respectively, which showed great antioxidant and antibacterial effects. Therefore, liver enzymes, kidney function and lipid profiles were significantly higher in the infected group than in the control or infected-treated groups. Furthermore, BBE ameliorated inflammation of the intestine and hepatocyte damage compared to the infected control group. These results suggest that consistent intake of BBE might alleviate hepatic inflammation and the gut microbiota in ways that could significantly impact human health. © 2024 Society of Chemical Industry.

Lining the small intestine with mycobacteriophages protects from Mycobacterium avium subsp. paratuberculosis and eliminates fecal shedding

Johne's disease (JD), a chronic, infectious enteritis caused by Mycobacterium avium subsp. paratuberculosis (MAP), affects wild and domestic ruminants. There is no cure or effective prevention, and current vaccines have substantial limitations, leaving this disease widespread in all substantial dairy industries causing economic, and animal welfare implications. Mycobacteriophages (MPs) have been gaining interest in recent years and are proposed as a promising solution to curtailing MAP infection. Using a well-validated infection model, we have demonstrated the preventative potential of MPs to protect dairy calves against MAP infection. Calves were supplemented daily with a phage cocktail from birth till weaning at 2 m of age and inoculated with MAP at 2 wk of age. Infection status was measured for 4.5 mo through blood, fecal, and postmortem tissue samples. Our findings highlight the remarkable efficacy of orally administered MPs. Notably, fecal shedding of MAP was entirely eliminated within 10 wk, in contrast to the infected control group where shedding continued for the entirety of the trial period. Postmortem tissue culture analysis further supported the effectiveness of MPs, with only 1 out of 6 animals in the phage-treated group testing positive for MAP colonized tissues compared to 6 out of 6 animals in the infected control group. Additionally, plaque assay results demonstrated the ability of phages to persist within the intestinal tract. Collectively, these results underscore the potential of orally administered MP cocktails as a highly effective intervention strategy to combat JD in dairy calves and by extension in the dairy industry.

Efficacy assessment of miltefosine and curcumin against Clonorchis sinensis infection.

Praziquantel (PZQ) is currently the only approved drug for treating clonorchiasis, but its poor efficacy against Clonorchis sinensis larvae has highlighted the need to develop newer drugs. In this study, to address this challenge, we investigated the anti-parasitic efficacy of miltefosine (MLT), curcumin (CUR), and PZQ against C. sinensis metacercariae (CsMC), newly excysted juvenile worms (CsNEJs), and adults. Larvicidal effects of MLT and CUR surpassed those elicited by PZQ in vitro. These two drugs exerted their effect against both CsMC and CsNEJs in a dose- and time-dependent manner. To confirm the effect of these drugs in vivo, Syrian golden hamsters were orally infected with 100 CsMC and subsequently treated with MLT, CUR, or PZQ at 1 and 4 weeks post-infection (wpi). MLT and CUR reduced the worm recoveries at 1 and 4 wpi, indicating that these drugs were efficacious against both larvae and adult C. sinensis. PZQ was only efficacious against adult worms. Interestingly, both MLT and CUR showed lower levels of C. sinensis-specific IgG responses than the infection control group, implying that worm burden and bile IgG responses could be correlated. These results indicate that MLT and CUR are efficacious against both larval and adult stages of C. sinensis, thereby highlighting their potential for further development as alternative therapeutic options for clonorchiasis.

Benznidazole/miltefosine combination improves the treatment of chagas disease

Chagas disease, caused by Trypanosoma cruzi, is one of the most prevalent parasitic diseases in Latin America. Currently, the available treatments, benznidazole and nifurtimox, have high toxicity, low solubility and reduced efficacy. This study investigates the effectiveness of combining miltefosine with benznidazole as a strategy to improve existing treatments. The research was conducted with 78 Swiss mice infected with 5000 trypomastigotes of T. cruzi (strain Y). The animals were divided into groups and treated with doses of 40mg/kg of miltefosine, administered orally for 10 consecutive or alternate days, and doses of 50 or 100mg/kg of benznidazole, administered for 20 consecutive days. Infected and uninfected control groups were included. After 150 days, the animals were sacrificed for analysis of parasitological cure. The combination of miltefosine and benznidazole demonstrated superior efficacy compared to isolated treatments. Alternating administration of 40mg/kg miltefosine with 50mg/kg benznidazole resulted in 62.5% cure, comparable to treatment with 100mg/kg benznidazole alone. The combination of 40 mg/kg of miltefosine with 100 mg/kg of benznidazole increased the cure rate to 87.5% (consecutive) and 100% (alternating). qPCR indicated a significant reduction in parasite DNA in cardiac and colonic tissues in the groups treated with the combinations. The results confirm that the combination of miltefosine with benznidazole enhances the effectiveness of the treatment, especially when miltefosine is administered every other day. This strategy can reduce the dose of benznidazole required, reducing toxicity and improving treatment adherence. Thus, the combination of drugs represents a promising approach to improving Chagas disease therapy, worthy of additional clinical investigation.

Study of the Effect of Tumor Necrosis Factor Alpha (TNF-α) Antagonist (Adalimumab) on Giardiasis in Mice

Abstract Giardia lamblia (G. lamblia) is the most common worldwide intestinal protozoal. Serum TNF-α contributes to the recovery from Giardia lamblia infection especially in the first and second week of infection. TNF-α antagonists are biologics used to treat many inflammatory diseases as rheumatoid arthritis. The present study aimed to study the effect of TNF-α antagonist (Adalimumab) on experimental giardiasis in mice by parasitological and histopathological examination. A total of 45 parasite-free laboratory-bred Swiss albino mice included into 2 main groups: test group and control group were used. Test group included mice infected with G. lamblia and receiving three intraperitoneal Adalimumab injections from days 9 till 15 post infection (pi). This group was further subdivided into 3 subgroups (Ia, Ib, Ic) according to Adalimumab doses which were 1.5, 3 and 6 mg/kg BW, received, respectively. Control group (non-Adalimumab-treated group) included a non-infected healthy group and Giardia -infected group. Monitoring the serum TNF-α level in all mice was done on two occasions (day 16 and 28 pi) by ELISA to follow variation in its level with and without administration of the drug. Infection outcome was assessed by following cyst shedding in stools of infected mice on intermittent days, counting trophozoites in intestinal wash, registering weight of animals, and recording pathological changes occurring in histopathological sections from small intestine. Highly significant increase in serum TNF-α was recorded in infected control mice on day 16 post-infection than in normal control group. Similarly, a significant increase in TNF-α level in the 3 test subgroups but attaining significant lower levels. On day 28 post infection, serum TNF- α level decreased in all infected mice with no significant differences being higher in infected control group than in non-infected control group. On assessing the effect of decreased serum TNF-α by the drug on infection outcome, highly significant increases in cyst shedding were recorded in the test group specifically group receiving 3 mg/kg BW than in control infected group on day 16 pi, and in trophozoite counts on day 28 pi. Mice weight gain was highly significant being more in control non-infected group than in control infected group. It was significantly lower in test group than normal infection control. The intestinal sections of test subgroups showed moderate to severe inflammatory reaction with more inflammatory cellular infiltration in the lamina propria causing villous shortening and blunting more than that observed in infection control group. Furthermore, lymphoid follicles and sloughing of the epithelium were only observed in test subgroups on day 16 p.i. It was concluded that TNF-α antagonist (Adalimumab) led to increased parasitic load as evidenced by cyst shedding, trophozoite count, less weight gains with moderate to severe histopathological damage in test subgroups.

Association of Serum M2BPGi Levels with Nutritional Status (Using CONUT score) in Hepatitis C Virus Related Compensated Liver Cirrhosis Patients

Abstract Background Protein-energy malnutrition (PEM), which is one of the most common complications seen in LC patients and associated with high morbidity and mortality. So, predicting the presence of PEM and providing appropriate nutritional support help improve the prognosis of those patients. Mac-2-binding protein glycosylation isomer (M2BPGi) was recently identified as a serum glycobiomarker for liver fibrosis. However, the relationship between M2BPGi and malnutrition in patients with chronic liver disease (CLD) is unclear. Aim of the Work The aim of this study is to evaluate the role of serum M2BPGi levels as a surrogate marker for malnutrition in HCV related cirrhotic patients, correlated with CONUT score as the nutritional status marker. Patients and Methods This is a Cross-sectional - Analytic study that included patients with chronic HCV infection and normal control group selected from patients attending to Hepatology Outpatient Clinics at Ain Shams University Hospital. This study was carried out from 30 patients (child A) attending to Hepatology Outpatient Clinics at Ain Shams University Hospital and 30 healthy individuals as a control. Results The M2BPGi levels increased with CONUT score. The correlation coefficient between M2BPGi and CONUT score was r = 0.315 (p = 0.05), indicating a positive weak correlation between M2BPGi and CONUT score. The cut-off for M2BPGi to predict CONUT low vs. moderate was 1.43 with a sensitivity 93.33% and specificity 100% when AUC =0.9 and CONUT moderate vs. severe was 1.7 with a sensitivity 91.67% and specificity 100% when AUC =0.9. Conclusion We found that there is correlation between M2BPGi and CONUT score and both can be useful as a marker for malnutrition in HCV related cirrhotic patients cut of point

Analysis of Risk Factors for Pulmonary Infection in Patients with Acute Leukemia after Chemotherapy

To investigate the risk factors of pulmonary infection in patients with acute leukemia (AL) after chemotherapy. A total of 294 patients with AL were collected and divided into infection group (n=93) and control group (n=201) according to whether the pulmonary infection occurred after chemotherapy. Analyze the correlation between sociodemographic data (sex, age, BMI), clinical data (disease type, ECOG score, invasive procedure, underlying disease, hormone therapy, empirical use of antibiotics, prognosis stratification, chemotherapy intensity, primitive cell count, white blood cell count, neutrophil count, duration of granulocyte deficiency, platelet count, hemoglobin, and albumin and pulmonary infection after chemotherapy. COX regression method was used to analyze the risk factors of pulmonary infection in AL patients after chemotherapy. Among 294 patients with AL, 11 died within 30 days after pulmonary infection. There were statistically significant differences in age, smoking history, ECOG score, invasive procedure, hormone therapy, empirical use of antibiotics, prognosis stratification, chemotherapy intensity, primitive cell count, neutrophil count, duration of granulocyte deficiency, platelet count, hemoglobin, albumin and fasting blood glucose between the 2 groups (P <0.05). COX regression analysis showed that smoking history, invasive procedure, unexperienced use of antibiotics, poor prognosis, long duration of granulocytopenia, low platelet level and low albumin were high risk factors for pulmonary infection in AL patients after chemotherapy (P <0.05). Smoking, invasive procedures, unexperienced use of antibiotics, poor prognosis, long duration of granulodeficiency, low platelet levels and low albumin are risk factors for pulmonary infection in AL patients after chemotherapy.

Exploring the impact of recent COVID-19 infection on perfusion and functional parameters derived from gated myocardial perfusion imaging in patients undergoing evaluation for coronary artery disease.

This study seeks to evaluate how recent COVID-19 infection affects myocardial perfusion and functional parameters derived from gated myocardial perfusion imaging in patients undergoing evaluation for coronary artery disease. The goal is to enhance our understanding of COVID-19's influence on the cardiovascular system. Conducted at Farshchian Heart Hospital from 2022 to 2023, this case-control study enrolled patients suspected of coronary artery disease, stratified into two groups: those with confirmed COVID-19 infection within the past 6months (study group) and those without prior COVID-19 infection (control group). Employing a 2-day protocol, stress testing and gated SPECT MPI were performed. Statistical analysis included descriptive statistics, Chi-square test, Student's t test, and Mann-Whitney U test. Among the 86 patients included, 43 were in each group. Significantly higher summed stress core and summed difference score values were observed in the study group compared to the control group (p < 0.05). In addition, the study group exhibited significantly altered global left ventricular ejection fraction, end-diastolic volume, and end-systolic volume (p < 0.05). Non-perfusion findings, including transient ischemic dilation and transient right ventricular visualization, were more prevalent in the study group. Recent COVID-19 infection is associated with impaired myocardial perfusion and altered functional parameters as detected by MPI. These findings underscore the intricate interplay between COVID-19 and cardiovascular health, emphasizing the importance of comprehensive evaluation and management strategies to address cardiac complications in affected individuals. Further research is warranted to elucidate the underlying mechanisms and optimize patient care in the context of COVID-19-associated cardiovascular manifestations.

#2650 A novel approach for exit site care reduces peritoneal dialysis catheter related infections

Abstract Background and Aims Peritoneal dialysis (PD) related infections, including peritonitis and catheter related infections, are associated with significant morbidity and technique failure. Various exit site care protocols are available, most allow to shower in running water after the exit site is well healed. Following an increase in exit site infections (ESI) in our dialysis unit, partially resulting from water derived organisms, we implemented a novel exit site care protocol. The protocol included complete avoidance of water exposure using stoma bag during shower; and change in antibiotic treatment from gentamycin to mupirocin. We aimed to evaluate its efficacy to decrease ESI episodes. Method A prospective single center trial. Study group included PD patients between June 2018 - May 2021 who implemented the new exit-site care protocol. They were compared to a historical control group that included all PD patients between January 2016 to May 2018. In the control group, exit-site care included a daily shower with a bactericidal cleanser containing chlorhexidine 4%, thereafter local gentamycin 0.1% was applied with sterile gauze dressing. In the study group, water exposure during daily wash was avoided using a stoma bag sealed around the catheter exit-site and the tubing. Thereafter, the exit-site was cleaned with a chlorhexidine 0.5%- alcohol 70% solution and local mupirocin 2% was applied with a sterile gauze cover. Primary outcome was catheter related infections, including ESI and tunnel infection. Secondary outcomes were peritonitis and technique loss. Results A total of 113 patients were included, 58 patients in control and 55 in study group. Mean follow up time was 13.28 ± 9.5 months in control and 16.4 12.7 months in study group. ESI rate was significantly lower in study group (0.11/patient year) compared to control group (0.71/ patient year), p&amp;lt;0.001. Time to first ESI was significantly longer in study group, χ² (1) = 25.104, p &amp;lt; 0.001 (Fig. 1). On multivariate logistic regression analysis confirmed the protective effect of the intervention on ESI risk (p &amp;lt;0.001). Longer PD vintage and active cancer predicted ESI (p = 0.01 and 0.02, respectively). There were no tunnel infections during study period compared to 3 episodes during control. Peritonitis rate was significantly lower in study group (0.19/patient years) compared to control group (0.40/patient years), p=0.011. There was no difference in time to first peritonitis episode between groups χ² (1)=2.32, p=0.128. Nine patients were lost to PD due to PD related infection in control group, compared to 5 in study group. Peritonitis related mortality occurred in one patient in control group. Conclusion Protection of exit site from water exposure in conjunction with local Mupirocin cream reduced significantly ESI and peritonitis episodes in peritoneal dialysis patients. This protocol may be more beneficial in areas of poor water quality.

The efficacy of cercarial antigen loaded on nanoparticles as a potential vaccine candidate in Schistosoma mansoni-infected mice.

Schistosomiasis is one of the most common causes of morbidity and mortality from parasitic diseases. Mass treatment has proven to be insufficient because of repeated infection after treatment and the appearance of strains resistant to drug therapy. Hence, immunization is a new approach to control the disease and limit the pathological consequences of schistosomiasis. To evaluate the prophylactic effect of Cercarial antigen (CAP) loaded on chitosan nanoparticles (CSNPs) as a potential vaccine against Schistosoma mansoni-infected mice. 130 mice divided into 2 groups were used: Group I: Control groups (50 mice) subdivided into subgroup Ia (10 mice): Non-infected mice (normal control), subgroup Ib (20 mice): Schistosoma infected mice (infected control) and subgroup Ic (20 mice): Non-infected mice receiving NPs only. Group II: Vaccinated group (80 mice) subdivided equally into subgroup IIa (CAP): Received cercarial antigen and subgroup IIb (CAP + CSNP): Received cercarial antigen loaded on chitosan NPs then both vaccinated groups were infected with S. mansoni 3 weeks following the initial vaccination dose. CAP + CSNP and CAP groups showed significant reduction in adult worms count, hepatic egg count, hepatic granulomas number and size in comparison to the infected control group. Elevation of serum IgG and IgM levels, CD4+ and CD8+ T cell frequencies, IL-4, IL-10 and INF-γ levels was more significant in CAP + CSNP group than CAP group. CAP + CSNP is a promising new preparation of Schistosomal antigens that gave better results than immunization with CAP alone. CSNPs enhanced the immune and protective effect of CAP as validated by parasitological, histopathological and immunohistochemical studies.

The financial burden of SARS-CoV-2 pregnancies in a tertiary exclusive COVID-19 maternity.

The COVID-19 pandemic had a major impact on health systems worldwide, and Romania was no exception. The impact on healthcare expenses for pregnant women was considerable, especially in COVID-19-only tertiary centers. This study aimed to analyze the impact of the COVID-19 pandemic on healthcare costs in a designated COVID-19 maternity ward. We conducted an observational study comparing pregnant women with SARS-CoV-2 (study group) to those without the infection (control group). Patients were recruited at Bucur Maternity Hospital from March 2020 to March 2022. We evaluated expenses for the entire period of hospitalization, treatment, medical supplies, and medical investigations. The study included 600 pregnant women, divided equally into two groups of 300 each. Significant cost differences were observed between the COVID-19 and non-COVID-19 groups: medication costs (664.56 EUR vs. 39.49 EUR), administrative costs (191.79 EUR vs. 30.28 EUR), and medical investigation costs (191.15 EUR vs. 29.42 EUR). The costs for a severe case of COVID-19 were about two times higher than a mild case and 70 times higher than a non-COVID-19 case (P <0.001). We identified a significant cost increase due to SARS-CoV-2 infection in our unit. The expenses were augmented by the time of hospitalization, medication, and medical investigations. COVID-19 had a significant impact on healthcare costs, mostly among pregnant women with severe disease. The strategy of operating exclusively as a COVID-19 unit proved to be inefficient and highly costly to our hospital.

Evaluation of Th1/Th2, regulatory cytokines and transcriptional factor FoxP3 in sheep immunized with a partially protective and non-protective vaccine and challenged with Fasciola hepatica

Gene expression for Th1/Th2 cytokines (IL-4 and IFN-ɣ), regulatory cytokines (TGF-β and IL-10) and the transcriptional factor FoxP3 was analyzed in the liver and hepatic lymph nodes (HLN) from sheep immunized with partially protective and non-protective vaccine candidates and challenged with Fasciola hepatica. FoxP3 T cells were also evaluated by immunohistochemistry (IHQ). The most remarkable difference between the partially protected vaccinated (V1) group and the non-protected vaccinated (V2) group was a more severe expansion of FoxP3 T cells recorded by IHQ in both the liver and HLN of the V2 group as compared to the V1 group, whereas no differences were found between the V2 group and the infected control (IC) group. Similar results were recorded for FoxP3 gene expression although significant differences among V1 and V2 groups were only significant in the HLN, while FoxP3 gene expression was very similar in the V2 and IC groups both in the liver and HLN. No significant differences for the remaining cytokines were recorded between the V1 and V2 groups, but in the liver the V2 group shows significant increases of IFN-ɣ and IL-10 as compared to the uninfected control (UC) group whereas the V1 group did not. The lower expansion of FoxP3 T cells and lower increase of IFN-ɣ and IL-10 in the partially protected vaccinated group may be related with lower hepatic lesions and fluke burdens recorded in this group as compared to the other two infected groups. The most relevant change in regulatory cytokine gene expression was the significant increase of TGF-β in the liver of IC, V1 and V2 groups as compared to the UC group, which could be related to hepatic lesions.

Correlation between inflammatory factors, autophagy protein levels, and infection in granulation tissue of diabetic foot ulcer.

To observe the expression of inflammatory factors and autophagy-related proteins in granulation tissue of diabetic foot ulcer (DFU) patients and analyze their relationship with infection. This is a retrospective cohort study. One hundred and fifty-two patients with DFU in our hospital from July 2020 to March 2022 were selected as the DFU group, including 98 cases in infection stage group and 54 cases in infection control group. The patients were further graded as the mild (51 cases), the moderate (65 cases), and the severe infection group (36 cases) according to the Wagner grading criteria. Sixty-seven patients with foot burns during the same period were selected as the control group. The distribution of pathogenic bacteria on the ulcer surface was examined using fully automated bacterial analyzer. The expression of inflammatory factors (procalcitonin [PCT], tumor necrosis factor-α [TNF-α], and interleukin-6 [IL-6]) was valued by real-time fluorescence quantitative PCR (qRT-PCR). Protein expression was measured by immunohistochemistry (IHC). The correlation was analyzed by Pearson. The surface infection of DFU patients was mostly induced by gram-negative and gram-positive bacteria, with Pseudomonas aeruginosa predominating among the Gram-negative bacteria and Staphylococcus aureus among the gram-positive bacteria. The infection stage group had higher content of PCT, TNF-α, and IL-6 and lower content of Beclin-1 and LC3 than the infection control group (p < .001). The levels of PCT, TNF-α, and IL-6 in the DFU patients with cardiovascular events were higher than those in the nonoccurrence group (p < .001). Glycated hemoglobin in patients with DFU was positively correlated with PCT, TNF-α, and IL-6 levels (p < .05), and negatively correlated with Beclin-1 and LC3 levels (p < .001). P. aeruginosa and S. aureus were predominant bacterial in DFU infections. Inflammatory factor and autophagy protein expression were closely correlated with the degree of infection.

Inactivated Flagellin-Containing Vaccine Efficacy against Ovine Enzootic Abortion.

Chlamydia abortus is the etiological agent of abortion and fetal loss in sheep, goats and bovine cattle in many countries. Even though commercially available vaccines can reduce the incidence in sheep, the development of new, safe, and effective vaccines remains high on the agenda. In this study, an evaluation was made of the efficacy of a vaccine candidate, an inactivated antigen based on the extract of outer membrane proteins of a C. abortus strain known as Chlamydia VNITIBP-21, in combination with recombinant flagellin as an adjuvant. Pregnant sheep (n = 43) were divided into three groups: an experimental vaccinated group, a control infected group and a control non-infected group. The sheep were vaccinated twice, with an interval of 3 weeks, then infected with the homologous virulent strain of Chlamydia abortus on pregnancy day 75. The vaccine candidate reduced C. abortus shedding in vaginal swabs considerably, in comparison with the control group. In addition, ewes in the experimental group experienced no abortions, while those in the control group experienced instances of abortion, as well as births of weak and nonviable lambs. The findings show that the vaccine candidate proved itself to be promising in combatting the agent of ovine abortion and fetal loss.

Comparative evaluation of silver nanoparticles and human platelet rich-plasma versus traditional therapy in the treatment of murine chronic toxoplasmosis.

Toxoplasmosis is a worldwide parasitic disease infecting about one-third of the human population. At present, licensed medications are incapable of curing human chronic infection. The present work aimed to evaluate for the first time the combination between (spiramycin and human platelet rich plasma), in addition to (spiramycin and silver-nanoparticles) in treating murine experimental toxoplasmosis using parasitological, biochemical, histopathological and immunohistochemical studies. Seventy-seven Swiss albino male mice divided into seven groups according to the treatment used as follows: (GI): control negative; (GII): control infected; (GIII): spiramycin; (GIV): Silver nanoparticles (AgNPs); (GV): Human platelet-rich plasma (HPRP); (GVI): combined spiramycin and AgNPs; (GVII): combined spiramycin and HPRP. Obtained results demonstrated that (spiramycin and AgNPs) treated group showed significant reduction of T. gondii tissue cysts number, the lowest level of serum malondialdehyde, remarkable improvement in pathological changes in different tissues of mice e.g. brain and liver and weak expression of EGFR in brain tissues of mice compared to control infected group. Moreover, AgNPs administered alone produced minimal anti-Toxoplasma results, whereas their combination with spiramycin exhibited significant therapeutic efficacy. In conclusion, combination therapy of spiramycin and AgNPs may represent a unique possible adjuvant therapy for reducing the pathogenic, toxic, and inflammatory consequences of toxoplasmosis on the brain and liver tissues in immunocompetent mice, and the expression of EGFR in brain tissues of mice is a good tool for evaluating the therapeutic improvement of murine toxoplasmosis.