Typical Clinical Signs Research Articles

KRT5 missense variant in a Cardigan Welsh Corgi with epidermolysis bullosa simplex.

Epidermolysis bullosa (EB) is a group of blistering disorders that includes several subtypes, classified according to their level of cleavage. Typical clinical signs are blisters and erosions resulting from minimal trauma. The disease has been described in many mammalian species and pathogenic variants in at least 18 different genes have been identified. In the present study, we investigated a Cardigan Welsh Corgi with congenital clinical signs consistent with epidermolysis bullosa. The puppy had blisters and erosions on the paw pads, and the oral mucosa. Histologic examination demonstrated the typical clefting between the dermis and epidermis and confirmed the clinical suspicion. We obtained whole genome sequencing data from the affected puppy and searched for variants in candidate genes known to cause EB. This revealed a heterozygous missense variant, KRT5:p.(E476K), affecting the highly conserved KLLEGE motif of keratin 5. The mutant allele in the affected puppy arose owing to a de novo mutation event as it was absent from both unaffected parents. Knowledge of the functional impact of KRT5 variants in other species together with the demonstration of the de novo mutation event establishes KRT5:p.(E476K) as causative variant for the observed EBS.

ATTCT and ATTCC repeat expansions in the ATXN10 gene affect disease penetrance of spinocerebellar ataxia type 10.

SummarySpinocerebellar ataxia type 10 (SCA10) is an autosomal-dominant disorder caused by an expanded pentanucleotide repeat in the ATXN10 gene. This repeat expansion, when fully penetrant, has a size of 850–4,500 repeats. It has been shown that the repeat composition can be a modifier of disease, e.g., seizures. Here, we describe a Mexican kindred in which we identified both pure (ATTCT)n and mixed (ATTCT)n-(ATTCC)n expansions in the same family. We used amplification-free targeted sequencing and optical genome mapping to decipher the composition of these repeat expansions. We found a considerable degree of mosaicism of the repeat expansion. This mosaicism was confirmed in skin fibroblasts from individuals with ATXN10 expansions with RNAScope in situ hybridization. All affected family members with the mixed ATXN10 repeat expansion showed typical clinical signs of spinocerebellar ataxia and epilepsy. In contrast, individuals with the pure ATXN10 expansion present with Parkinson's disease or are unaffected, even in individuals more than 20 years older than the average age at onset for SCA10. Our findings suggest that the pure (ATTCT)n expansion is non-pathogenic, while repeat interruptions, e.g., (ATTCC)n, are necessary to cause SCA10. This mechanism has been recently described for several other repeat expansions including SCA31 (BEAN1), SCA37 (DAB1), and three loci for benign adult familial myoclonic epilepsy BAFME (SAMD12, TNRC6A, RAPGEF2). Therefore, long-read sequencing and optical genome mapping of the entire genomic structure of repeat expansions are critical for clinical practice and genetic counseling, as variations in the repeat can affect disease penetrance, symptoms, and disease trajectory.

Ultrasonographic Findings of Exocrine Pancreatic Insufficiency in Dogs.

Simple SummaryExocrine pancreatic insufficiency (EPI) is a syndrome characterized by insufficient synthesis of pancreatic enzymes leading to clinical symptoms of malabsorption; this pathology has also been described in dogs. No studies are present about ultrasonographic appearance of the pancreas in the course of EPI in dogs. The purpose of this retrospective study was to describe ultrasound features of the pancreas during EPI in this species. In our study, the pancreas had a significantly lower thickness compared to the reference values of healthy dogs previously proposed; however, most of the dogs did not have other ultrasonographic pancreatic alterations. Moreover, in 85% of dogs, ultrasonographic intestinal abnormal findings were also identified. Based on our study, ultrasound could be a useful tool in the diagnosis of EPI. A normal but thinned pancreas associated with sonographic intestinal signs of inflammatory bowel disease in dogs with supportive clinical signs should suggests a diagnosis of EPI.Exocrine pancreatic insufficiency (EPI) is a syndrome characterized by insufficient synthesis of pancreatic enzymes leading to clinical symptoms of malabsorption and maldigestion. There are no studies about ultrasonographic appearance of the pancreas with EPI in dogs. The purpose of this retrospective study was to describe ultrasound features of the pancreas during EPI in this species. Dogs with history and clinical signs of maldigestion, serum canine trypsin-like immunoreactivity (cTLI) values <5 µg/L, and abdominal ultrasound exam were included in the study. Size, shape, margin, echogenicity, echostructure, and pancreatic duct appearance of the right pancreatic lobe were valued. Additional sonographic intestinal findings were recorded. Thirty-four dogs were included. The mean pancreatic thickness in our population was significantly lower than the mean reference values of healthy dogs. In 68% of dogs, the pancreas had a normal ultrasound appearance. Ultrasonographic intestinal abnormal findings were identified in 85% of dogs and were suggestive of inflammatory bowel disease. Despite the fact that EPI is a functional diagnosis, ultrasound evaluation should be considered among the useful tests. The finding of a normal but thinned pancreas associated with sonographic intestinal signs of inflammatory bowel disease in dogs with typical history and supportive clinical signs could suggest a diagnosis of EPI.

Equine recurrent uveitis—A review

SummaryEquine recurrent uveitis (ERU) is still the leading cause of blindness in horses worldwide. It has a tremendous physical, emotional and economic impact on horses and their owners, respectively. This article will review the proposed aetiologies and discuss the complex and enigmatic relationship between ERU and leptospirosis as a cause. Typical clinical signs and ERU classifications will be discussed, and the current state of diagnostic testing evaluated. Much diagnostic data have been collected and published, and our thorough discussion of these results may serve to ease interpretation when routinely evaluating cases. Ultimately, the most current treatment options will be compared with regard to nonrecurrence rates, visual outcomes and associated complication rates.

Intermetatarsal Bursitis, a Novel Feature of Juxtaarticular Inflammation in Early Rheumatoid Arthritis Related to Clinical Signs: Results of a Longitudinal Magnetic Resonance Imaging Study.

Intermetatarsal bursae in the forefeet possess a synovial lining similar to joints and tendon sheaths. Inflammation of these bursae (intermetatarsal bursitis [IMB]) was recently identified as specific for early rheumatoid arthritis (RA). The present study was undertaken to determine if IMB is indeed an RA feature by assessing the following: 1) the association with other local inflammatory measures (synovitis, tenosynovitis, and osteitis), 2) the association with clinical signs, and 3) whether it responds to disease-modifying antirheumatic drug (DMARD) therapy similarly to other local inflammatory measures. One hundred fifty-seven consecutive early RA patients underwent unilateral contrast-enhanced 1.5T forefoot magnetic resonance imaging (MRI) at diagnosis. MRIs were evaluated for IMB presence and for synovitis, tenosynovitis, and osteitis in line with the RA MRI Scoring (RAMRIS) system (summed as RAMRIS inflammation). MRIs at 4, 12, and 24 months were evaluated for IMB presence and size in patients who had IMB at baseline and received early DMARD therapy. Logistic regression and generalized estimating equations were used. Anti-citrullinated protein antibody (ACPA) stratification was performed. Sixty-nine percent of RA patients had ≥1 IMB. In multivariable analysis on bursa level, presence of IMB was independently associated with local presence of synovitis and tenosynovitis, with odds ratios (OR) of 1.69 (95% confidence interval [95% CI] 1.12, 2.57) and 2.83 (95% CI 1.80, 4.44), respectively, but not osteitis. On the patient level, IMB presence was most strongly associated with tenosynovitis (OR 2.92 [95% CI 1.62, 5.24]). IMB presence was associated with local joint swelling (OR 2.7 [95% CI 1.3, 5.3]) and tenderness (OR 1.7 [95% CI 1.04, 2.9]) independent of RAMRIS inflammation. During treatment, IMB size decreased between 0 and 12 months. This decrease associated with decrease in RAMRIS inflammation, which was driven by synovitis decrease. Within ACPA-positive and ACPA-negative RA, similar results were obtained. IMB particularly accompanies inflammation of the synovial lining of joints and tendon sheaths, showed a similar treatment response after DMARD initiation, and associates with typical clinical signs. These findings suggest that IMB represents a frequently present novel RA feature of juxtaarticular synovial inflammation.

Features of the course of community-acquired pneumonia in children before and during the COVID-19 pandemic

Introduction. The basis of the work was a retrospective analysis of the course of community-acquired pneumonia (CAP) in children with COVID-19. Aim. To determine the features of the course of CAP before and during the COVID-19 pandemic in children from birth to 18 years. Materials and methods. A retrospective analysis of the medical records of ninety five children (n = 95) who were treated at the Speransky Children’s Hospital No. 9 before the pandemic (October-November 2019; n = 45) and during the COVID-19 pandemic (April-May 2020 and October-November 2020; n = 50). All the received data are processed statistically. Results. It was found that before the COVID-19 pandemic, mainly adolescents aged 13-17 years were ill, during the pandemic younger children (6-12 years old) became ill more often. With the onset of the pandemic, the course of CAP changed significantly: fever, cough, shortness of breath were typical clinical signs; local signs were more pronounced in children during the pandemic: weakened and hard breathing was more often detected. Leukocytosis and accelerated ESR prevailed in patients with CAP before the pandemic. At the same time, CRP was a more sensitive marker of inflammation. It was revealed that with the beginning of the COVID-19 pandemic, the number of atypical pneumonia decreased, which may be due to anti-epidemic measures, but the prevalence of pneumonia of unknown etiology increased. Decreased oxygen saturation was a more frequent rule in CAP during the pandemic. Lobar pneumonia prevailed in children before the pandemic, and polysegmental pneumonia prevailed in patients during the pandemic. Conclusion. The features presented by the authors of the manifestations of community-acquired pneumonia in children before and during the COVID-19 pandemic make it possible to optimize their diagnosis using clinical and laboratory signs.

Maxillary Sinus Pneumocele

Hyperpneumatization of the paranasal sinuses is a rare condition. Hypersinus, pneumosinus dilatans, and pneumocele are the three types of excessive pneumatization according to the traditional classification proposed by Urken et al. (1987). If in the first case, no treatment is required, but the latter two may be accompanied by aesthetic and/or functional disorders or may result in pressure effects on adjacent anatomical objects, therefore they require surgical correction. Maxillary sinus pneumocele is described in few publications. The presented case demonstrates typical clinical and radiographic signs of the maxillary sinus pneumocele, as well as hypersinus on the contralateral side. Cone beam computed tomography scans in combination with anamnestic and clinical data provide key information for the diagnosis of maxillary sinus pneumocele, as well as for differential diagnosis with other variants of their excessive pneumatization.

Pathogenicity of Avibacterium paragallinarum Strains from Peru and the Selection of Candidate Strains for an Inactivated Vaccine.

Worldwide, Avibacterium paragallinarum is the aetiological agent of infectious coryza in poultry. Vaccines are the best means of control, helping reduce clinical signs and colonization of this bacterium. Most vaccines are based on international reference strains, or, lately, regional strains, but, generally, without any information regarding their virulence. The characterization of the pathogenicity of 24 Av. paragallinarum strains of the three Page serogroups, including four variant strains of serogroup B, all isolated from infectious coryza outbreaks in Peru, was performed. After experimental inoculation into the infraorbital sinuses, information regarding their capacity to induce infectious coryza typical clinical signs, spreading, and colonization was recorded. Furthermore, after intraperitoneal inoculation, septicaemia and death were registered. Differences among strains in these parameters were observed, even within strains from the same serogroup. Finally, the four most pathogenic strains, one from each serogroup, were chosen to formulate an experimental vaccine that was tested successfully against homologous challenges in reducing clinical signs and colonization in vaccinated birds compared to unvaccinated ones. This is the first time that Av. paragallinarum strains from Peru were studied thoroughly for their virulence in a search for improving vaccine formulation.

Preoperative and intraoperative risk factors for post‐anaesthetic pulmonary oedema in horses

SummaryBackgroundPulmonary oedema is an uncommon but life‐threatening condition in horses. It is defined as an abnormal accumulation of liquid and solute in the extravascular tissues and spaces of the lungs, which causes oxygen diffusion impairment and a reduction in lung compliance. Diagnosis is determined by typical clinical signs, including frothy, haemorrhagic nasal discharge and respiratory distress, and can be supported by thoracic imaging and arterial blood gas analysis. In horses, post‐anaesthetic pulmonary oedema (PAPOE) is poorly reported, and there is a lack of information regarding risk factors and prognosis.ObjectivesThe objective of the study was to determine risk factors and short‐term outcome for PAPOE during the recovery period in horses.Study designA retrospective case‐control study including 17 cases and 53 controls.MethodsMedical records of clinical cases and controls over a period of four and a half years were reviewed. Short‐term outcomes and risk factors for PAPOE were investigated using conditional multivariable logistic regression analysis.ResultsAscarid impaction prevalence in PAPOE cases was significantly higher than controls (p = 0.03). In a univariable analysis, the following variables were significantly associated with PAPOE (p ≤ 0.05): gastric reflux on admission, haemorrhage during surgery, intravenous crystalloid treatment prior to admission, fresh frozen plasma and hydroxyethyl starch administration during anaesthesia. On multivariable analysis, gastric reflux on admission (OR = 7.9, 95% CI 1.1, 57.2) and fresh frozen plasma treatment during anaesthesia (OR = 9.6, 95% CI 1.2, 79.1) were found as risk factors for PAPOE. There was no significant difference in outcome between cases and controls.Main limitationsThe low number of cases, the lack of gross and histological post‐mortem examinations of the horses that did not survive and the clinical definition of PAPOE.ConclusionsGastric reflux and fresh frozen plasma administration during general anaesthesia are associated with PAPOE.

Experimental Infections of Pigs with African Swine Fever Virus (Genotype II); Studies in Young Animals and Pregnant Sows.

African swine fever is an important viral disease of wild and domestic pigs. To gain further knowledge of the properties of the currently circulating African swine fever virus (ASFV), experimental infections of young pigs (approximately 8 weeks of age) and pregnant sows (infected at about 100 days of gestation) with the genotype II ASFV Georgia/2007 were performed. The inoculated young pigs developed typical clinical signs of the disease and the infection was transmitted (usually within 3–4 days) to all of the “in contact” animals that shared the same pen. Furthermore, typical pathogical lesions for ASFV infection were found at necropsy. Inoculation of pregnant sows with the same virus also produced rapid onset of disease from post-infection day three; two of the three sows died suddenly on post-infection day five, while the third was euthanized on the same day for animal welfare reasons. Following necropsy, the presence of ASFV DNA was detected in tonsils, spleen and lymph nodes of some of the fetuses, but the levels of viral DNA were much lower than in these tissues from the sows. Thus, only limited transplacental transmission occurred during the course of this experiment. These studies contribute towards further understanding about the spread of this important viral disease in domestic pigs.

Electrodiagnostic Testing and Nerve Ultrasound of the Carpal Tunnel in Patients with Type 2 Diabetes.

In diabetic patients, controversies still exist about the validity of electrodiagnostic and nerve ultrasound diagnosis for carpal tunnel syndrome (CTS). We analyzed 69 patients with type 2 diabetes. Nerve conduction studies and peripheral nerve ultrasound of the median nerve over the carpal tunnel were performed. CTS symptoms were assessed using the Boston Carpal Tunnel Questionnaire. Polyneuropathy was assessed using the Neuropathy Symptom Score and the Neuropathy Disability Score. Although 19 patients reported predominantly mild CTS symptoms, 37 patients met the electrophysiological diagnosis criteria for CTS, and six patients were classified as severe or extremely severe. The sonographic cross-sectional area (CSA) of the median nerve at the wrist was larger than 12 mm2 in 45 patients (65.2%), and the wrist-to-forearm-ratio was larger than 1.4 in 61 patients (88.4%). Receiver operating characteristic analysis showed that neither the distal motor latency, the median nerve CSA, nor the wrist-to-forearm-ratio could distinguish between patients with and without CTS symptoms. Diagnosis of CTS in diabetic patients should primarily be based upon typical clinical symptoms and signs. Results of electrodiagnostic testing and nerve ultrasound have to be interpreted with caution and additional factors have to be considered especially polyneuropathy, but also body mass index and hyperglycemia.

Misdiagnosis of COVID-19 infection before molecular confirmation in Sulaimaniyah City, Iraq

BackgroundDuring the last 2 years, in the Kurdistan Region, Northern Iraq, there were thousands of COVID-19 cases that have not been reported officially, but diagnosed and confirmed by private laboratories and private hospitals, or clinicians based on typical clinical signs, as well as few people using home self-test after appearing of some flu-like clinical symptoms. Thus, this study aims to assess the misdiagnosis and mismanagement of cases before COVID-19 confirmation.MethodsThis study enrolled 100 consecutive patients who visited an outpatient clinic of Shar Hospital that had symptoms highly suspicious of COVID-19 infection while misdiagnosed previously to have other types of disease. Detailed questionnaires were filled for all studied patients, including age, gender, main presenting symptoms, and duration of these symptoms with the following questions: who made the false diagnosis, depending on which diagnostic test the false diagnosis was made, which medication was used for the false diagnosis, who prescribed those medications, and how long those medications were used. They were investigated by RT-PCR on their nasopharyngeal swab for confirmation.ResultsMost of the false diagnoses were typhoid (63%), influenza (14%), pneumonia (9%), gastroenteritis (5%), common cold (4%), brucellosis (4%), and meningitis (1%). Regarding the false diagnosis of cases, 92% were made by non-physician healthcare workers, and only 8% were made by physicians. All false diagnoses with typhoid, gastroenteritis, and common cold were made by non-physician healthcare workers, together with about half of the diagnosis of pneumonia and brucellosis, with statistically significant results (P < 0.001).ConclusionsWe realized that some patients had been misdiagnosed before the COVID-19 infection confirmation. Their health conditions improved drastically after correct diagnosis and treatment, and this research is considered the first research to be conducted in Iraq in this regard.

WecB Gene of Salmonella Gallinarum Plays a Critical Role in Systemic Infection of Fowl Typhoid.

Salmonella enterica serovar Gallinarum (S. Gallinarum) is a host-specific pathogen causing fowl typhoid, a severe systemic infection in poultry, which leads to substantial economic losses due to high morbidity and mortality in many developing countries. However, less is known about the pathogenic characteristics and mechanism of S. Gallinarum-induced systemic infection in chickens. In this study, we deleted the S. Gallinarum UDP-N-acetylglucosamine-1-phosphate transferase gene, which contributes to the biosynthesis of enterobacterial common antigen (ECA), and studied the pathogenicity of this wecB::Cm strain in a chicken model of systemic infection. The wecB::Cm mutant strain showed comparable growth but lower resistance to bile acid and nalidixic acid than the wild-type strain in vitro. In the oral infection model of chickens, the virulence of the wecB::Cm strain was significantly attenuated in vivo. Chickens infected with wild-type strain showed typical clinical signs and pathological changes of fowl typhoid and died between 6 and 9 days post-infection, and the bacteria rapidly disseminated to systemic organs and increased in the livers and spleens. In contrast, the wecB::Cm mutant strain did not cause chicken death, there were no significant clinical changes, and the bacterial numbers in the liver and spleen of the chickens were significantly lower than those of the chickens infected with the wild-type strain. In addition, the expression of interleukin (IL)-1β, tumor necrosis factor (TNF)-α, and CXCLi1 in the livers of wecB::Cm-infected chickens was significantly lower than that of the chickens infected with the wild-type strain. Furthermore, the attenuated wecB::Cm strain could persistently colonize the liver and spleen at low levels for up to 25 days post-infection and could induce a protective immune response in the chickens. These results indicate that the wecB gene is an important virulence factor of S. Gallinarum in the chicken model of systemic infection, and the avirulent wecB::Cm mutant could possibly be used as a live-attenuated vaccine strain for controlling fowl typhoid.

Utility and pitfalls of the electrocardiogram in the evaluation of cardiac amyloidosis

BackgroundCardiac amyloidosis is a protein misfolding disorder involving deposition of amyloid fibril proteins in the heart. The associated fibrosis of the conduction tissue results in conduction abnormalities and arrhythmias. “Classical” electrocardiogram (ECG) findings in cardiac amyloidosis include that of low voltage complexes with increased left ventricular wall thickness on echocardiography. However, this “classical” finding is neither sensitive nor specific. As cardiac amyloidosis is associated with a generally poor prognosis, the need for early recognition of this disease is important given the availability of new treatment options. In this review, we highlight 3 cases of patients with cardiac amyloidosis. Although presenting with typical clinical signs and symptoms, ECG for all 3 patients was not consistent with the classical findings described. They underwent further diagnostic tests which clinched the diagnosis of cardiac amyloidosis, allowing patients to receive targeted treatment. Through the review of the literature, we will highlight the different ECG patterns in patients with different types of cardiac amyloidosis and clinical scenarios, as well as the pitfalls of using ECG to identify the condition. Lastly, we also emphasize the current paradigms in diagnosing cardiac amyloidosis through the non‐invasive methods of echocardiography, cardiac magnetic resonance imaging, and nuclear technetium‐pyrophosphate imaging.ConclusionsElectrocardiogram is often the first investigation used in evaluating many cardiac disorders, including cardiac amyloidosis. However, classical features of cardiac amyloidosis on ECG are often not present. A keen understanding on the ECG features of cardiac amyloidosis and knowledge of the diagnostic workflow is important to diagnose this condition.

Pathological effect of different avian infectious bronchitis virus strains on the bursa of Fabricius of chickens

ABSTRACT Infectious bronchitis is an acute and highly contagious disease caused by avian infectious bronchitis virus (IBV). As well as the typical clinical respiratory signs, such as dyspnoea and tracheal rales, QX genotype strains can also cause damage to the urinary system and reproductive system. Our previous studies found that chickens infected with QX-type IBV also displayed damage to the bursa of Fabricius. To investigate the effects of different genotypes of IBV on the bursa of Fabricius, we challenged one-week-old SPF chickens with Mass, QX and TW genotype IBV strains and compared the clinical signs, gross lesions, histopathological damage, viral loads, and expression levels of inflammatory cytokines (IL-6, IL-8, IL-1ß, IFN-α,ß, γ and TNF-α). The results showed that all three strains caused tissue damage, while significant temporal variations in the viral loads of the different infected groups were detected. IBV infection seriously interfered with the natural immune response mediated by inflammatory cytokines (IFN-α, IFN-ß, IL-6 and IFN-γ) in chickens. Our results suggested that IBV has potential immunological implications for chickens that may lead to poor production efficiency. RESEARCH HIGHLIGHTS Avian coronavirus IBV is an important pathogen of chickens. IBV has potential immunological implications in chickens. The bursal viral load of different IBV strains varies significantly.

Profile of Innate Immunity in Gilthead Seabream Larvae Reflects Mortality upon Betanodavirus Reassortant Infection and Replication.

Historically, gilthead seabream (Sparus aurata) has been considered a fish species resistant to nervous necrosis virus (NNV) disease. Nevertheless, mortality in seabream hatcheries, associated with typical clinical signs of the viral encephalopathy and retinopathy (VER) disease has been confirmed to be caused by RGNNV/SJNNV reassortants. Because of this, seabream larvae at 37 and 86 days post-hatching (dph) were infected by immersion with RGNNV/SJNNV and SJNNV/RGNNV reassortants under laboratory conditions, and mortality, viral replication and immunity were evaluated. Our results show that gilthead seabream larvae, mainly those at 37 dph, are susceptible to infection with both NNV reassortant genotypes, with the highest impact from the RGNNV/SJNNV reassortant. In addition, viral replication occurs at both ages (37 and 86 dph) but the recovery of infective particles was only confirmed in 37 dph larvae,; this value was also highest with the RGNNV/SJNNV reassortant. Larvae immunity, including the expression of antiviral, inflammatory and cell-mediated cytotoxicity genes, was affected by NNV infection. Levels of the natural killer lysin (Nkl) peptide were increased in SJNNV/RGNNV-infected larvae of 37 dph, though hepcidin was not. Our results demonstrate that the seabream larvae are susceptible to both NNV reassortants, though mainly to RGNNV/SJNNV, in an age-dependent manner.

Preageing of the skin among Asian populations

AbstractSkin ageing is a complex process. Both intrinsic and extrinsic factors have a role in determining the speed, progression and phenotypic outcomes of the process. Typical clinical signs of ageing, such as wrinkles, thinning and sagging of the skin, are usually first noticed in the mid‐20s to early 30s. However, real‐world studies report that younger Asian women between the ages of 18 and 24 years are perceiving emerging signs of ageing, including dull skin, uneven skin tone, dryness, transient wrinkles, and a lack of skin firmness. These observations have led to a hypothesis that a phase of preageing may exist, where clinical signs of ageing are not yet present, but an individual starts to notice subtle changes in their skin's appearance. This paper discusses the concept of preageing in Asian populations and provides recommendations for recognising and managing the preageing process in clinical practice.

Diagnosis of Menière's disease according to the criteria of 2015: Characteristics and challenges in 96 patients.

The diagnosis of Menière's disease (MD) is made according to diagnostic criteria, the last revision of which was in 2015. For diagnosis, symptoms are weighted with audiometric findings and this can be challenging in individual patients. To analyze patient's characteristics and symptoms in a real-life cohort of 96 patients with diagnosed MD regarding sociodemographic parameters, clinical specifics, and audiometry. Prospective clinical patient registry containing demographic and socioeconomic parameters, symptoms, as well as pure-tone audiometry data. 31 patients with definite MD, and 36 with probable MD were identified. 29 patients showed typical clinical signs of MD, but did not meet the full diagnostic criteria, and were considered separately. Mean duration of symptoms prior to presentation was 3.9±4.6 years. Significant differences between categories were found regarding aural fullness, tinnitus, and fluctuating hearing. If multiple audiograms were available, 28.6 % (6/21) documented fluctuating hearing. Current diagnostic criteria probably do not represent patients with monosymptomatic presentation or an early stage very well. Long-term follow-up with repeated audiometry is advisable.

FEATURES OF THE CLINICAL COURSE OF NON-ST-SEGMENT ELEVATION ACUTE CORONARY SYNDROME DEPENDING ON THE INDICATOR OF THE PULSE WAVE VELOCITY

Pulse wave velocity (PWV) could be used as a predictor of the course of CVD. A carotid–femoral PWV above 10 m/s was determined in 2018 ESC/ESH Guidelines for the Management of Arterial Hypertension as factors influencing cardiovascular risk in patients with hypertension. Exactly the carotid–femoral PWV is considered the gold standard for arterial stiffness assessment in clinical practice. Usually PWV predict the long-term outcomes (in a few month or years) of the development of cardiovascular events. There are a lack of information about using PWV as prognostic marker in acute coronary syndrome.&#x0D; The aim: to study the features of the clinical course of the non-ST-segment elevation acute coronary syndrome (NSTE-ACS) depending on the carotid–femoral pulse wave velocity (PWV) and find out possibilities of using PWV as marker of intrahospital clinical outcomes.&#x0D; Materials and methods. 80 patients were recruited. All patients were hospitalized into myocardial infarction departments with a diagnosis of NSTE-ACS. Patients over 18 years of age who were hospitalized for the first 3 days after the onset of pain and signed the agreement to participate in the study were included. Exclusion criteria were the moderate or severe anemia, severe chronic renal failure, and chronic diseases in the acute or decompensated stage. The average age of patients was 64.5 [55; 72] years. Male patients are 45 persons (56.3%). Were performed standard general laboratory and instrumental examinations. Measuring of free DNA levels, and ischemic albumin were performed on 1st and 6th days of hospitalization. Also noninvasive measured of PWV. Noninvasive PWV measurements were performed after stabilization of the hemodynamic for excluding incorrect results due to its strong connection with current blood pressure. 2 groups were formed depend on the PWV above or less than 10 m/s. The analysis was performed by using non-parametric statistical methods (Mann-Whitney test, Wilcoxon T-test, Pearson's χ2 test). The results were considered statistically significant at p &lt;0.05.&#x0D; Results. Patients did not have a statistically significant difference in such parameters as gender, anamnestic data (hypertension, myocardial infarction, chronic heart failure, atrial fibrillation, and diabetes mellitus), hemodynamic parameters, ECG changes at the moment of hospitalization and laboratory parameters. There was a tendency that patients with elevated PWV were older (69 [55.3; 77.8] years vs. 63.5 [55.3; 70.8] years) (p = 0.077). Such parameters as left ventricular ejection fraction and discharge diagnosis were similar. Patients with elevated PWV had significantly more active cytolysis. This is proved by significantly higher levels of free DNA both on the first day and on the 6th day of hospitalization. In patients with normal PWV levels, free DNA decreased in dynamics, while in patients with PWV above 10 m / s this marker remained at the same level. It was also founded that patients with elevated PWV had delayed ischemia (on the 6th day of hospital stay), which was confirmed by a higher level of ischemia-modified albumin than in the group with PWV less 10 m / s.&#x0D; Conclusions. Patients with increased and normal PWV have quite similar group characteristic according typical clinical signs, results of laboratory and instrumental investigations. Due to the studying of free DNA and ischemia-modified albumin were clarified that PWV above 10 m/s is associated with delayed ischemia and longer tissue damage and could be used to predict it.

Isolation and Molecular Detection of Newcastle Disease Virus from Field Outbreaks in Chickens in Central Ethiopia.

BackgroundNewcastle disease is a major viral disease of poultry. The virus is a major problem for chickens in Ethiopia and there is a scarcity of updated information on the virological and molecular status of confirmation of Newcastle disease outbreak cases in the country.MethodsNewcastle disease outbreaks were investigated from February 2021 to October 2021 in central Ethiopia to isolate and detect the virus by cell culture and reverse transcriptase PCR. A total of 44 pooled tissue specimens were sampled from sick and recently dead chickens showing typical clinical signs of Newcastle disease. Virus isolation were performed using DF-1 cells and detection of the virus was done by real-time PCR.ResultsOut of 44 collected tissue samples, 38.63% (17/44) were positive on DF-1 cells. The result shows 17 of the clinically sick and dead chickens were positive for the virus by reverse transcriptase polymerase chain reaction. Based on the sample type, 54.54% (6/11) of the brain samples, 36.36% (4/11) of the intestines, 54.54% (6/11) of lung and trachea, 9% (1/11) of pooled liver, kidney, heart, and spleen samples were positive. Viruses were isolated in the proportions 37.5% (6/16), 25% (2/8), 50% (2/4), 25% (1/4), 50% (2/4) and 50% (4/8) from Sebeta, Bishoftu, Sululta, Nifas Silk, Kolfe and Yeka, respectively.ConclusionThis study showed that Newcastle disease is a major viral disease causing death of chickens in the study area. Therefore, any control approach should focus on the appropriate characterization of the virus strain causing the outbreak in the study area.