Moderate Infection Research Articles

Skin Manifestations Among Patients Admitted with COVID-19: A Cross-Sectional Study at a University-Based Tertiary Hospital in Jordan.

COVID-19 pandemic hit the entire world with severe health and economic consequences. Although the infection primarily affected the respiratory system, it was soon recognized that COVID-19 has a multi-systemic component with various manifestations including cutaneous involvement. The main objective of this study is to assess the incidence and patterns of cutaneous manifestations among moderate-to-severe COVID-19 patients who required hospitalization and whether there was a prognostic indication for cutaneous involvement and the outcome in terms of recovery or death. This is a cross-sectional observational study that included inpatients who were diagnosed with a moderate or severe COVID-19 infection. The demographic and clinical data of patients were assessed including age, sex, smoking, and comorbidities. All patients were examined clinically for the presence of skin manifestations. Patients were followed for the outcome of COVID-19 infection. A total of 821 patients (356 females and 465 males) aged 4-95 years were included. More than half of patients (54.6%) aged >60 years. A total of 678 patients (82.6%) had at least one comorbid condition, mostly hypertension and diabetes mellitus. Sixty-two patients (7.55%) developed rashes; 5.24% cutaneous and 2.31% oral. The rashes were then grouped into five major types: group A, Exanthema: morbilliform, papulovesicular, varicella-like. Group B, Vascular: Chilblain-like lesions, purpuric/petechial, livedoid lesions. Group C, Reactive erythemas: Urticaria, Erythema multiforme. Group D, other skin rashes including flare-up of pre-existing disease, and O for oral involvement. Most patients (70%) developed rash after admission. The most frequent skin rashes were reactive erythema (23.3%), followed by vascular (20.9%), exanthema (16.3%), and other rashes with flare-ups of pre-existing diseases (39.5%). Smoking and loss of taste were associated with the appearance of various skin rashes. However, no prognostic implications were found between cutaneous manifestations and outcome. COVID-19 infection may present with various skin manifestations including worsening of pre-existing skin diseases.

The Role of General Health and Health Literacy in Self-Care Behaviors of Patients with Covid-19

Background: Self-care is an important concept in controlling COVID-19 disease and a simple and effective way to maintain and improve health. This study aimed to examine the role of general health and health literacy in predicting the self-care behaviors of patients with COVID-19. Methods: This research was a cross-sectional study with a predictive correlational design. The sample consisted of 385 patients with mild to moderate COVID-19 infection referring to the COVID-19 diagnosis and treatment center in Shahid Beheshti Hospital in Kashan City, Iran, from June to September 2021. The subjects were under quarantine at home and were recruited by convenience sampling. The data were collected by the general health questionnaire (GHQ-28), the Iranian health literacy questionnaire (IHLQ), and a researcher-made questionnaire on self-care behaviors in patients with COVID-19 (SCB-COVID-19). The Pearson correlation coefficient, t-test, and logistic regression were used for data analysis in SPSS software, version 19. The significance level was set at P<0.05. Results: The Mean±SD scores of self-care behaviors, health literacy, and general health of the subjects were 224.89±21.49, 63.78±21.28, and 50.99±12.81, respectively. There were significant relationships between self-care behaviors and health literacy (r=0.567, P=0.001) and self-care behaviors and general health (r=235, P=0.001). Logistic regression showed that about 42% of self-care behaviors score changes are explained by health literacy and general health variables (R2=0.42) Conclusion: The results showed that self-care behaviors score changes are explained by health literacy and general health in COVID-19 patients. Our results can integrate into the body of knowledge to help improve the health and well-being of populations in the COVID-19 outbreak.

First Report of Rose Apple Leaf Spot Caused by Colletotrichum siamense in Thailand.

The rose apple (Syzygium samarangense (Blume) Merr. & L.M.Perry) plant has been commonly cultivated in Thailand. In May of 2022, leaf spot disease of rose apple was discovered in Chiang Mai Province, Thailand, with approximately 30% disease incidence. The typical symptoms initially showed brown spots (0.1 to 0.5 mm in diameter) with a yellow halo surrounding. These spots then expanded with black edges and the infected leaves appear blighted and desiccated. In humid conditions, pale yellow conidiomata formed on the lesions. Small pieces (5 × 5 mm2) of the margins between lesions and the healthy tissue were surface disinfected with 1% NaClO for 1 min, 70% ethanol for 30 s, and washed three times with sterile distilled water. Tissues were placed on potato dextrose agar (PDA) and incubated at 25 ºC for three days. Three fungal isolates (SDBR-CMU419, SDBR-CMU420, and SDBR-CMU421) were obtained that exhibited similar morphology. Fungal colonies appeared white to gray with cottony mycelia after incubation on PDA at 25 ºC for one week. All fungal isolates produced asexual morph on PDA. Setae were 5590 × 2.53.5 µm, brown with 13-septa, cylindrical base, and tip rounded. Conidiophores were hyaline to pale brown, septate, and branched. Conidiogenous cells were hyaline to pale brown, cylindrical to ampulliform, 2050 µm long (n = 50). Conidia were one-celled, hyaline, smooth-walled, aseptate, straight, cylindrical, end round, guttulate, 1017 × 35 µm (n = 50). Appressoria were mostly formed from mycelia, oval to irregular, brown to dark brown, smooth-walled, 610 × 57 µm (n = 50). Morphologically, all fungal isolates resembled to Colletotrichum (Weir et al. 2012; Jayawardena et al. 2021). The internal transcribed spacer (ITS) region of the ribosomal DNA, actin (act), β-tubulin (tub2), calmodulin (CAL), and glyceraldehyde-3-phosphate dehydrogenase (GAPDH) were amplified using primer pairs ITS5/ITS4 (White et al. 1990), ACT-512F/ACT-783R (Carbone and Kohn 1999), T1/T22 (O'Donnell and Cigelnik 1997), CL1C/CL2C (Weir et al. 2012), and GDF1/GDR1 (Templeton et al. 1992), respectively. The ITS (ON740892 to ON740894), act (ON759242 to ON759244), tub2 (ON759245 to ON759247), CAL (ON759248 to ON759250), and GAPDH (ON759251 to ON759253) sequences were deposited in GenBank. Multi-gene (combined data set of ITS, GAPDH, CAL, act, and tub2) maximum phylogenetic analyses indicated that all fungal isolates clustered with C. siamense ICMP 18578 (type strain) with strong statistical (99% ML) support. For pathogenicity test, asymptomatic leaves, stems and fruits detached from healthy plants were surface disinfected using 0.1% NaClO for 3 min, washed three times with sterile distilled water, and air-dried. A uniform wound (3 pores, 1 mm in width) was made at the equator of each leaf, stem and fruit using aseptic needles. Mycelial plugs (5 mm in diameter) and conidia suspensions (1 × 106 conidia/ml) of each fungal isolate grown on PDA at 25 ºC for one week were used to inoculate both wounded and unwounded samples by the detached method (Huda‑Shakirah et al. 2022; Suwannarach et al. 2022). Plugs of PDA and sterile distilled water were used as controls. Ten replications were performed for each treatment and the experiment was repeated twice. All inoculated samples were incubated in a moist chamber at 25 ºC with 90% relative humidity. The disease severity index was used to evaluate the specimens (Acar et al. 2008; Ngegba et al. 2017). After one week, both wounded and unwounded leaves that inoculated with mycelial plugs and conidia suspensions showed brown leaf spots and a weak infection. Mycelial plugs inoculated on both wounded and unwounded fruits revealed a moderate infection, but inoculation of conidia suspensions showed a weak infection. No symptoms of disease were observed on the inoculated stems. Control leaves, stems and fruits remained asymptomatic. The pathogen C. siamense was re-isolated from spot and rot lesions on PDA in order to fulfill Koch's postulates. Phoulivong et al. (2012) reported that C. siamense is a causal agent of fruit rot in rose apples cultivated in Lao and Thailand. To our knowledge, this is the first report of C. siamense causing leaf spots on rose apple plants in Thailand. Importantly, these findings will provide crucial information for epidemiologic studies and in the development of appropriate management strategies for this newly emerging disease.

Relationships between Inflammatory Biomarkers and Fatigue among Patients with Moderate and Severe COVID-19.

Patients with moderate or severe COVID-19 infection suffer from varying levels of fatigue; however, there is a lack of understanding regarding the effect of inflammation on fatigue; and whether these relationships differ according to the severity of the infection. To assess the relationships between selected inflammatory biomarkers and fatigue levels among hospitalized Jordanian patients with moderate or severe COVID-19 infection. A quantitative cross-sectional design was used. A total of 352 participants were recruited for the study. Data regarding fatigue type and level were collected using the Chalder fatigue scale. Laboratory test results regarding several selected inflammatory biomarkers (e.g., ESR, CRP, IL-6, D-dimer, and others) were collected from patient records. The severity of the COVID-19 infection was determined using the criteria of the Ministry of Health in Jordan based on the results of O2% (oxygen saturation). The mean scores of the total fatigue level significantly differed between the two levels of the severity of COVID-19 infection (moderate and severe levels) (t = -3.0, p < 0.05). Similar findings were observed with physiological fatigue (t = -3.50, p < 0.05), and no significant difference was observed in psychological fatigue. Out of the selected inflammatory markers, only neutrophil and lymphocyte count had a significant influence on total fatigue level. The level and type of fatigue was affected by the severity of the disease. However, the disease process itself represented by the levels of the inflammatory markers showed little influence on fatigue. The implications such as continuous screening of fatigue, and monitoring of the levels of the inflammatory markers are important to assist in diagnosing and managing COVID-19 patients. Furthermore, the relationship between the inflammatory process and fatigue is complex and requires further exploration.

Mycobacterium avium subsp. paratuberculosis in Sheep and Goats in Austria: Seroprevalence, Risk Factors and Detection from Boot Swab Samples.

This study aimed to investigate the prevalence of Mycobacterium avium subsp. paratuberculosis (MAP) in small ruminants in Austria by testing 22,019 serum samples with ELISA for the presence of specific antibodies. Furthermore, detailed investigations in five MAP-infected goat herds were carried out by ELISA, qPCR and bacterial culture. The found animal-level apparent MAP seroprevalence was 2.0% for goats and 0.7% for sheep (calculated true prevalence 3.5% and 1.2%, respectively). Herd-level apparent MAP seroprevalence was 11.1% for goat herds and 8.9% for sheep flocks. Significant risk factors for seropositivity in goat herds were: herd size, animal trading, farmed as a dairy herd, Animal Health Service membership and cohabitation with farmed game. For sheep flocks, seroprevalence was significantly higher in flocks with animal trading and where cattle or goats were kept in the flock, respectively. The overall apparent within-herd MAP seroprevalence in the five goat farms investigated was 21.8% (11.7%-28.0%, calculated true seroprevalence 38.6%) and an overall rate of MAP shedding of 12.3% was detected (5.0%-24.7%). It was possible to identify MAP by culture using boot swab samples in each herd. The results indicated a moderate MAP infection rate in small ruminants in Austria.

The predictive value of laboratory tests in oro-maxillofacial infection of different severity.

We aimed to investigate the value of individual laboratory tests and combinations of tests for predicting disease severity. We retrospectively reviewed 62 patients with space infections in the oral and maxillofacial head and neck regions. Patients were divided into three groups according to severity. Laboratory tests associated with disease severity were identified. As the severity of infection increased, leukocytes, neutrophils, C-reactive protein (CRP), procalcitonin (PCT), soluble interleukin receptor (sILR) 2, IL6, and creatinine (CR) increased. In the ROC analysis of group 1 (moderate infection) versus group 2 (severe infection), the area under the curve (AUC) values for leukocytes (AUC = 0.724), neutrophils (AUC = 0.714), PCT (AUC = 0.762) and a combination of the 3 tests (AUC = 0.768) suggested a strong predictive value. Furthermore, in the ROC analysis of group 2 (severe infection) versus group 3 (extremely severe infection), the AUC values for CRP (AUC = 0.84), PCT (AUC = 0.799), sIL2R (AUC = 0.937), IL6 (AUC = 0.863) and a combination of the four tests (AUC = 0.943) suggested a strong predictive value. Leukocytes, neutrophils, and PCT were associated with multispace infection and high severity. CRP, PCT, sIL2R, and/or IL6 were associated with extremely severe infections occurring in the oral and maxillofacial head and neck regions.

E053 Effectiveness of colchicine among patients with COVID-19 infection: a randomised, open labelled, clinical trial

Abstract Background/Aims In November 2019, there were abundant cases of COVID-19 for which the first case was reported in Wuhan, China. Cytokine storm syndrome is the severe immune reaction that may cause a severe tissue response in COVID-19 patients. Colchicine has an important role in inhibiting activation of NLRP3 inflammasome that predispose to decrease cytokine production. This study aimed to evaluate whether colchicine is effective in treatment of COVID-19 patients or not. Methods A randomized, open labelled, clinical trial of colchicine for the treatment of COVID-19, allocated between 8th May to 18th June 2021. Patients with mild, moderate, or severe COVID-19 infection; confirmed by real time PCR (RT-PCR) and/or lung involvement confirmed by computed tomography scan compatible with COVID-19. The colchicine tablet dosage was 0.5mg twice daily for 14 days added to the standard treatment versus control group who received standard treatment without colchicine, with the trial registration ID: NCT04867226. The study was conducted in Erbil City, Iraq with the endpoints being clinical, laboratory parameters duration of hospitalization and side effects. Results 80 patients participated in the study. Fewer patients in the colchicine group had musculoskeletal symptoms (17.5%, p: 0.001) in comparison to the patients, who received control treatment. The serum ferritin level in most of patients who treated with colchicine returned to normal in contrast to the control group, whose serum ferritin level was still high (p: 0.041). Similarly, the average of CRP and D-dimer after treatment among the colchicine group participants was significantly lower than the control group, the P-values were 0.011 and 0.043, respectively. The colchicine group patients stayed for a shorter duration at the hospital (18.4 days) compared to the control group (24.24 days). P-value was 0.009. In addition to that the response and cure rate were higher in the colchicine group (56%) in the comparison to control group (43.1%) Table 1: Laboratory Parameters with musculoskeletal symptoms and duration of hospitalization of both Treatment Regimens.. Conclusion The colchicine drug can be effective in treating patients with COVID-19 infection by improving musculoskeletal symptoms and inhibiting inflammatory biomarkers; it is also effective in reducing duration of hospitalization. Disclosure A.M. jalal: None. S. Aref: None. D. Albustany: None.

Identification of species, intensity, and prevalence of Vannamei shrimp (Litopenaeus vannamei) ectoparasites in traditional ponds North Gorontalo

Vannamei shrimp (Litopenaeus vannamei) production continues to decline due to parasitic attacks on ponds in North Gorontalo Regency. Ectoparasites are one of the factors that can cause failure in the cultivation of vannamei shrimp. This study aims to determine the type of ectoparasites, intensity, and prevalence of vannamei shrimp cultured in traditional ponds in the North Gorontalo Regency. The sampling of the research was carried out at five research stations. The sampling of this research was taken at random in 5 plots of ponds and the total number of shrimps as many as 150 tails. At each station, samples were taken of 30 vannamei shrimp. Sampling using fishing gear in the form of nets. The observed samples were 8-10 cm in size alive. Observations of ectoparasites were carried out microscopically using a Zeis Binocular microscope with 10x magnification. Data analysis used descriptive analysis of the types of ectoparasites, intensity, and, the prevalence of ectoparasites found. The results of the study found four types of ectoparasites found in vannamei shrimp, namely Zoothanium sp., Epistylis sp., Carchesium sp., and Vorticella sp. The intensity of ectoparasite attack on shrimp was categorized as low to moderate infection, namely 4-7 individuals/shrimp. The prevalence rate is 80-100% with the category of moderate to very severe infection.Keywords:EctoparasitesPrevalenceIntensityVannamei shrimp

Endogenous Endophthalmitis in COVID-19 Patients: A Case Series and Literature Review

ABSTRACT Purpose To report outcomes in cases of endogenous endophthalmitis (EE) following COVID-19 infection. Material and methods In a retrospective study, patients with EE, who had a recent history of COVID-19 infection requiring hospital admission were recruited. Necessary demographic details, details of ocular examination, and microbiological details were collected. Results Six patients (10 eyes), with a mean age of 48 + 19.80 years were included. The mean duration of onset of ocular symptoms from the time of diagnosis of COVID was 28.16 + 16.15 days. 8 eyes required surgical intervention, whereas 2 eyes were managed conservatively. Three patients were positive for Candida albicans, two patients were positive for Aspergillus fumigatus, and one patient was a presumed bacterial EE. The majority of the eyes had favorable functional and anatomical outcomes during the post-operative period. Conclusion High-dose corticosteroid therapy in the management of moderate and severe COVID-19 infection may be associated with EE, predominantly fungal.

Post-COVID symptoms and recovery times in hospitalized mild and moderate COVID-19 patients

Settings and Design: Retrospective online cross-sectional analytical study. Introduction: Infection with SARS-CoV-2 virus led to COVID-19 pandemic with varied clinical manifestations and multisystem involvement, which persisted beyond acute stage. To evaluate the post discharge symptoms in hospitalized mild and moderate COVID-19 patients during the initial phase of pandemic. Factors associated with post-COVID symptoms and delayed recovery times were determined. Materials and Methods: One hundred and thirty-two hospitalized patients of mild or moderate COVID-19 infection diagnosed by a positive real-time polymerase chain reaction, responded to an online questionnaire. They were followed up monthly, telephonically for post-COVID symptoms and recovery times. Microsoft Excel-Student's t-test, Fischer's exact test, Chi-square test. Results: The mean age of the patients was 51.14 ± 13.78 years with male: female ratio, 1: 0.29. 80.35% had post-acute COVID symptoms. Most frequent symptoms were cough in 37.9%, breathlessness in 36.4% and fatigue in 34.8%. New onset symptoms were insomnia in 16.67%, anxiety in10.6%, depression in 9.8%, loss of libido in 5.3%. Long COVID syndrome occurred in four patients. The factors significantly associated with post-COVID symptoms were older age, comorbidities, longer hospitalization, and moderate COVID infection, whereas delayed recovery times were associated with older age, female gender, and moderate COVID illness. Conclusions: Post-COVID symptoms occur in majority of the patients. Persistent symptoms are dry cough, dyspnea, fatigue, anosmia, and ageusia. They are significantly associated with older age, underlying comorbidities, prolonged hospitalization, and moderate COVID infection. Complete recovery occurs in most patients but delayed recovery is seen in females, elderly, and moderate COVID infection. Few may develop long COVID syndrome. The following core competencies are addressed in this article: Patient care and procedural skills, Medical knowledge.

Key points of anti-tumor treatment in breast cancer patients with SARS-CoV-2 infection.

Internationally, the outbreak of coronavirus disease 2019 (COVID-19) has become the most serious public health emergency. With the adjustment of the prevention and control policies, China downgraded the management of COVID-19 from Class A to Class B, causing new challenges in the clinical management of patients with breast cancer. It is necessary to formulate clinical strategies for timely and reasonable anti-tumor treatment after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. By combing the relevant evidence and summarizing the anti-tumor treatment experience for breast cancer patients with SARS-CoV-2 infection in various regions, the expert panel of the Breast Cancer Professional Committee of the Chinese Society of Clinical Oncology (CSCO-BC) discussed and voted on hot and difficult issues of this situation timely. Based on the vote results, combined with domestic and foreign guidelines and consensus, the key points of treatment and management of breast cancer patients who were infected with COVID-19 have been established to provide suggestions and recommendations for clinical practice, such as restart time of anti-tumor treatment, application of anti-tumor drugs and other considerations. In the formulation of this key point, we mainly focus on mild to moderate and asymptomatic infection patients who account for the largest proportion of COVID-19 patients, and propose diagnosis and treatment recommendations for breast cancer patients with different infections and after SARS-CoV-2 infection, aiming to provide a reference for clinical diagnosis and treatment.

Risk of Long Covid in children infected with Omicron or pre-Omicron SARS-CoV-2 variants.

Risk of Long Covid in children infected with Omicron or pre-Omicron SARS-CoV-2 variants.

Identification of RdRp inhibitors against SARS-CoV-2 through E-pharmacophore-based virtual screening, molecular docking and MD simulations approaches

The outbreak of novel Coronavirus, an enduring pandemic declared by WHO, has consequences to an alarming ongoing public health menace which has already claimed several million human lives. In addition to numerous vaccinations and medications for mild to moderate COVID-19 infection, lack of promising medication or therapeutic pharmaceuticals remains a serious concern to counter the ongoing coronavirus infections and to hinder its dreadful spread. Global health emergencies have called for urgency for potential drug discovery and time is the biggest constraint apart from the financial and human resources required for the high throughput drug screening. However, computational screening or in-silico approaches appeared to be an effective and faster approach to discover potential molecules without sacrificing the model animals. Accumulated shreds of evidence on computational studies against viral diseases have revealed significance of in-silico drug discovery approaches especially in the time of urgency. The central role of RdRp in SARS-CoV-2 replication makes it promising drug target to curtain on going infection and its spread. The present study aimed to employ E-pharmacophore-based virtual screening to reveal potent inhibitors of RdRp as potential leads to block the viral replication. An energy-optimised pharmacophore model was generated to screen the Enamine REAL DataBase (RDB). Then, ADME/T profiles were determined to validate the pharmacokinetics and pharmacodynamics properties of the hit compounds. Moreover, High Throughput Virtual Screening (HTVS) and molecular docking (SP & XP) were employed to screen the top hits from pharmacophore-based virtual screening and ADME/T screen. The binding free energies of the top hits were calculated by conducting MM-GBSA analysis followed by MD simulations to determine the stability of molecular interactions between top hits and RdRp protein. These virtual investigations revealed six compounds having binding free energies of −57.498, −45.776, −46.248, −35.67, −25.15 and −24.90 kcal/mol respectively as calculated by the MM-GBSA method. The MD simulation studies confirmed the stability of protein ligand complexes, hence, indicating as potent RdRp inhibitors and are promising candidate drugs to be further validated and translated into clinics in future.

Ovine gastrointestinal parasite burden and the impact of strategic anthelmintic treatment in community-based breeding sites in Ethiopia.

In Ethiopia, small ruminants contribute significantly to livelihoods and food security but productivity is low with high disease burden and essential endoparasite control not widely practiced. The current study assessed worm burden and its control in three districts in Ethiopia. All sheep older than 3 months in nine villages were treated en-masse with albendazole and triclabendazole twice a year from 2018 to 2021. Treatments were administered under field conditions by animal health workers. Pre- and post-treatment data were assessed looking at fecal egg presence/absence and fecal egg per gram (EPG) count. A total of 1,928 and 735 sheep were examined before and after deworming, respectively. Before treatment worms were detected in 54.4% (95% CI: 52.2-56.6) of sheep. Strongylid (30.4%) and Fasciola (18.2%) were the most frequently identified parasites. Animals living in wet mid-highland environments were more than 23 times more likely to have strongylid eggs in their feces and 5 times more likely to have eggs from any gastrointestinal tract (GIT) parasites detected, as compared to animals living in moist highland agro-ecology. Over the course of the 2018-2021 community intervention there was total elimination of animals with a high worm burden (EPG > 1,500), and elimination of a third of those with moderate infections. Mild infections remained, largely accounted for by strongylid, which remains at low levels in healthy sheep. However, there were signs of emerging drug resistance. Generally, sheep in smallholder systems in Ethiopia experience a needlessly large economic burden from GIT worms. Routine therapy reduces this burden but smart strategies are needed to limit the onset of drug resistance.

Serological Detection of Sarcocystiosis in Buffaloes

The study aimed to serologically detect the prevalence of Sarcocystis infection in buffaloes using the indirect enzyme-linked immunosorbent assay (ELISA) for the first time in Iraq. An overall 184 buffaloes of different ages and sexes were selected randomly from the regions of Wasit province (Iraq) from March to June (2022), and subjected to draining of venous blood under aseptic conditions. After centrifugation, the obtained sera were examined by indirect ELISA. Totally, 33.15% of study animals were positive for IgG antibodies. According to their concentrations, the ODs level showed a significant increase (P&lt;0.0186) in mild infection (63.93%) when compared to moderate (27.87%) and strong (8.2%) infections. Subsequently, values of mild, moderate, and strong infections were 0.330 ± 0.01, 0.554 ± 0.019 and 0.912 ± 0.031 nm, respectively. Regarding age and sex factors, significantly higher positivity (P&lt;0.0469) was shown in buffaloes aged &gt;10 years old (57.89%); while the lowest was seen in those &lt;1 year (13.64%). Subsequently, older buffaloes appeared significantly (P&lt;0.0192) at higher risk (2.1685) when compared to other age groups. Females recorded an obvious increase (P&lt;0.05) in positivity (35.95%) and risk (1.8569) in comparison with males; 19.35% and 0.5385, respectively. The results indicate that ELISA is of great value in the diagnosis of sarcocystosis.

Fetal Diaphragmatic Excursion Is Decreased in Hospitalized Pregnant Women Infected with COVID-19 during the Second and Third Trimesters.

In the present study, we aimed to evaluate coronavirus disease 2019 (COVID-19) infection effects on fetal diaphragm thickness and diaphragmatic excursion, which together show the quality of diaphragmatic contractions. One hundred and ninety-two pregnant women were included in this prospective case-control study. Patients were divided into four groups according to their COVID-19 infection history in their second or third trimester: hospitalized COVID-19-infected pregnant women group (n = 48), outpatient COVID-19-infected pregnant women group (n = 48), common cold (COVID-19 polymerase chain reaction negative) pregnant women group (n = 48), and noninfected healthy controls (n = 48). The number of patients was determined by power analysis following the pilot study. All participants underwent an ultrasound examination to determine fetal diaphragm parameters at 32 to 37 weeks of gestation. Demographic characteristics were similar among the four groups. The gestational age at ultrasound examination and gestational age at delivery were similar among the groups. Neonatal intensive care unit (NICU) admission rate was significantly higher in the hospitalized COVID-19-infected pregnant women group than the other groups. The fetal diaphragm thickness during inspiration and expiration, and fetal costophrenic angles at inspiration and expiration were similar among the groups. Fetal diaphragmatic excursion was significantly decreased in the hospitalized COVID-19-infected pregnant women group compared with the other groups. Our results indicated that moderate maternal COVID-19 infection decreased fetal diaphragmatic excursion, and ultrasonographic evaluation of fetal diaphragmatic excursion before delivery can provide critical information to predict whether infants will require NICU admission. · Diaphragm ultrasound as a new technique for characterizing the diaphragm's structure and function.. · Fetal diaphragmatic excursion is decreased in the presence of moderate COVID-19 infection.. · Ultrasonographic evaluation of fetal diaphragmatic excursion provides critical information to predict NICU admission..

Use of Oral Antivirals Ritonavir-Nirmatrelvir and Molnupiravir in Patients with Multiple Myeloma Is Associated with Low Rates of Severe COVID-19: A Single-Center, Prospective Study

In patients with multiple myeloma (MM), SARS-CoV-2 infection has been associated with a severe clinical course and high mortality rates due to the concomitant disease- and treatment-related immunosuppression. Specific antiviral treatment involves viral replication control with monoclonal antibodies and antivirals, including molnupiravir and the ritonavir-boosted nirmatrelvir. This prospective study investigated the effect of these two agents on SARS-CoV-2 infection severity and mortality in patients with MM. Patients received either ritonavir-nirmatrelvir or molnupiravir. Baseline demographic and clinical characteristics, as well as levels of neutralizing antibodies (NAbs), were compared. A total of 139 patients was treated with ritonavir-nirmatrelvir while the remaining 30 patients were treated with molnupiravir. In total, 149 patients (88.2%) had a mild infection, 15 (8.9%) had a moderate infection, and five (3%) had severe COVID-19. No differences in the severity of COVID-19-related outcomes were observed between the two antivirals. Patients with severe disease had lower neutralizing antibody levels before the COVID-19 infection compared to patients with mild disease (p = 0.04). Regarding treatment, it was observed that patients receiving belantamab mafodotin had a higher risk of severe COVID-19 (p < 0.001) in the univariate analysis. In conclusion, ritonavir-nirmatrelvir and molnupiravirmay prevent severe disease in MM patients with SARS-CoV-2 infection. This prospective study indicated the comparable effects of the two treatment options, providing an insight for further research in preventing severe COVID-19 in patients with hematologic malignancies.

The effects of pine mistletoe (Viscum album subsp. austriacum) on the growth of Scots pine and Crimean pine in Turkey

AbstractIn this study, the effect of pine mistletoe (Viscum album subsp. austriacum) on basal area increment of Crimean pine and Scots pine was investigated. Dendrochronological data were collected from 223 (71 uninfected and 152 infected) Crimean pines and 195 (77 uninfected and 118 infected) Scots pines located in Kastamonu province of Turkey in 2014. Infected sample trees were classified as light, moderate or severe infection levels. Growth trends and basal area increment loses were compared between uninfected and infected trees for the periods of the last 10, 20 and 30 years. In addition, infection status of forest stands was investigated using temporary sample plots; 27 plots in Crimean pine stands and 26 plots in Scots pine. Results demonstrated that basal area increments were negatively affected by pine mistletoe for both species. Mean basal area increment losses of infected trees for the last decade were determined as 24% for Scots pine and 26% for Crimean pine. Basal area increment losses varied by infection levels (light, moderate and severe) as follows: 25%, 20% and 28% for Scots pines and 20%, 32% and 9% for Crimean pines. Scots pine stands were more severely infected by pine mistletoe than Crimean pine stands. There were negative correlations between number of infected trees and stand density for both species, while positive correlation was detected between the number of infected trees and mean diameter for Scots pine. The results of this study indicate that the pine mistletoe infection has negative effect on radial growth of Scots pine and Crimean pine trees. The results can be an important contribution to the forest management and protection activities in mistletoe‐infected stands.

Tungiasis infection among primary school children in Northeastern Tanzania: prevalence, intensity, clinical aspects and associated factors

To investigate the prevalence, intensity, clinical aspects and factors associated with tungiasis infection among primary school children in Northeastern Tanzania. A quantitative school-based cross-sectional study was conducted among 401 primary school children. Participants were assessed through clinical examination to look for embedded Tunga penetrans in their hands, feet, arms and legs. A structured questionnaire was used to enquire about factors associated with tungiasis infection. The data were analysed using descriptive statistics, Chi-squared test and logistic regression, with p<0.05 taken to indicate significance. The overall prevalence of tungiasis infection was 21.2%. Of the 85 tungiasis-infested children, 54 [63.5%, 95% confidence interval (CI) 53.1-74.1] had mild infection, 25 (29.4%, 95% CI 19.0-39.6) had moderate infection, and six (7.1%, 95% CI 1.2-12.9) had heavy infection. A moderate level of knowledge was significantly associated with high odds of tungiasis infection [adjusted odds ratio (AOR) 3.16, 95% CI 1.50-6.67], while not keeping a dog/cat at home was a protective factor (AOR 0.47, 95% CI 0.25-0.89). Moderate prevalence of tungiasis infection was observed among primary school children favoured by factors related to the host, parasitic agent and environment. There is a need for a health education programme in schools encouraging use of appropriate footwear (closed shoes), use of locally accessible repellents (coconut oil), fumigation of households, and washing dogs/cats with insecticides.

Features of the Formation of Seroprevalence to SARS-CoV2 in the Population of the Republic of Tatarstan during the Spread of COVID-19

Relevance. It is relevant to study the features of the formation and duration of the humoral immune response to a new coronavirus infection in a high-risk group of infection - among medical workers. Aims. To study the dynamics of the levels of specific antibodies (IgM and IgG) to SARS-CoV2 in unvaccinated MRs of the temporary infectious diseases hospital to assess the trends of the individual humoral immune response to a new coronavirus infection. Materials and methods. We monitored IgM and IgG to SARS-CoV-2 in 68 unvaccinated healthcare workers monthly from July 2020 to July 2021 by two-stage direct solid-phase ELISA using the test systems «SARS-CoV-2-IgG-ELISA-BEST» and «SARS-CoV-2-IgM-ELISA-BEST», Russia. Among them, there were 26.5% men and 73.5% women, the average age was 43.5 ± 1.51 years, doctors 52.9%, paramedical personnel 36.8% and junior staff 10.3%. 69.1% had a history of clinical manifestations of COVID19, among them 42.7% had a mild infection, 20.6% had a moderate infection, and 5.9% had a severe infection, 30.9% were asymptomatic. Statistical processing were carried out using the methods of variation statistics using the Excel statistical package and the WinPepi software product (version 11.65). Results. A decrease in the geometric mean value of IgM titers to SARS-CoV-2 (average monthly decrease of 6.40%) and an increase in the geometric mean value of IgG titers (average monthly increase of 4.26%). An individual assessment of the dynamics of antibodies from the day with the first positive result showed a decrease in the geometric mean values of antibody titers and IgM and IgG to SARS-CoV-2 (monthly average decrease of -23.56% and -1.18%, respectively). An individual assessment of the immune response made it possible to distinguish three groups according to the dynamics of IgM: M0 -IgM in the blood were absent (50 ± 5.7446%); M1 -IgM persisted for 1–2 months, followed by a rapid decrease in titer (16.176 ± 3.7943%); M2 – IgM remained in the blood for three or more months (33.824 ± 5.1033%). By the nature of the dynamics of IgG MR were divided into four troupes. With a downward trend in IgG titer: G0 – IgG does not exceed 95% of the upper confidence limit of the individual trend in any of the samples taken (19.118 ± 4.7686%), G1 – does not exceed 95% of the upper confidence limit of the individual trend starting from 3 months after the start observations (4.412 ± 2.4903%), G2 – there is an excess of 95% of the upper confidence limit of the individual trend starting from 3 months after the start of observation (69.118 ± 5.6027%); G3 – with a trend of increasing IgG titer (7.353 ± 3.1651%). Сonclusions. The results of serological monitoring as a whole indicate the formation of herd immunity in this cohort. Monitoring the intensity of the individual immune response to SARS-CoV-2 throughout the year reflects the natural course of the infectious process and is the basis for vaccination against COVID-19. The results of serological monitoring can be used to predict the epidemiological situation, plan specific and non-specific COVID-19, personalization of vaccination.