Methodological bases of differential detection of the EBV1/EBV2 and HHV6A/HHV6B

In Russia, of the whole variety of EBV- and HHV6-etiology diseases, only infectious mononucleosis is subject to official statistical reporting, which significantly complicates an objective assessment of their etiological structure, incidence rate, characteristics of the development of the epidemic process. Currently, information on the genetic heterogeneity of EBV, even at the level of the main types (EBV1 and EBV2), as well as HHV6A and HHV6B, their prevalence and clinical significance are limited mainly by foreign data. In Russia, there are isolated publications devoted to this issue. At the same time, the study of the circulation of genetic types (variants) and the use of this information in the implementation of epidemiological surveillance of some other infections have already become routine practice. One of the key issues is the level of development of laboratory support for molecular genetic monitoring. The purpose of this work was to improve the methodological base of differential detection of HHV6A/B and the main types of EBV. The material for the study was peripheral blood leukocytes of children aged 1-15 years with acute infectious mononucleosis (n = 50) and without clinical symptoms of this disease (n = 29). The detection and quantification of EBV DNA and HHV6 DNA was performed using real-time PCR. For differential determination of EBV1/EBV2 and HHV6A /HHV6B, an optimized one-round PCR with electrophoretic detection of amplification products in an agarose gel was used. According to the results of our own research, the frequency of detection of EBV DNA and HHV6 DNA in acute infectious mononucleosis was 74% and 72%, and in the control group - 35% and 74%, respectively. It was found that among the examined children of the Nizhny Novgorod region, EBV1 and HHV6B prevail in the viral population, which is consistent with existing views about their geographical distribution in the adjacent territories. EBV2 was found in a single sample in the control group only. HHV6A was not detected in any of the studied groups. The methodological approach optimized in this work makes it possible to separately detect HHV6A/HHV6B and the main types of EBV according to a single laboratory protocol, and in combination with an additional stage of DNA concentration increases the diagnostic sensitivity of PCR analysis, minimizes the proportion of discordant and false negative results. Such an integrated approach can be applied for diagnostic, epidemiological and research purposes.

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Inflammatory activity in the cerebrospinal fluid a decade after acute infectious mononucleosis

10.26226/morressier.5b75785c5aff7400151f3aaa ◽

2018 ◽

Author(s):

Daniel Jons ◽

Oluf Andersen

Keyword(s):

Cerebrospinal Fluid ◽

Infectious Mononucleosis ◽

Inflammatory Activity ◽

Acute Infectious Mononucleosis

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Dynamics of symptoms of genitourinary menopausal syndrome and the frequency of recurrence of lower urinary tract infection in women in periand postmenopausal patients with combined therapy with Trioginal®

GYNECOLOGY ◽

10.26442/20795696.2018.6.180119 ◽

2018 ◽

Vol 20 (6) ◽

pp. 67-72

Author(s):

D Yu Pushkar ◽

M Yu Gvozdev

Keyword(s):

Urinary Tract ◽

Lower Urinary Tract ◽

Urine Culture ◽

Objective Assessment ◽

Control Group ◽

Urination Disorders ◽

Menopausal Syndrome ◽

Tract Infections ◽

Two Stages ◽

Lower Urinary

Material and methods. The study included patients (n=164) in peri- and postmenopause, having a laboratory-confirmed picture of the genitourinary menopausal syndrome - atrophic vulvovaginitis and suffering from recurrent lower urinary tract infections (UTI) - cystitis and urethritis. All patients underwent standard antibacterial therapy (ABT) UTI in accordance with the results of bacteriological urine culture according to Russian clinical guidelines on urology. Against the background of ABT, 164 patients received additional therapy with Trioginal® (the study group - SG) containing estriol, micronized progesterone and Lactobacillus casei rhamnosus Doderleini 35 (LCR 35) lactobacillus strain. Trioginal® was administered intravaginally in two stages: for 20 days, 2 capsules per day, then for 10 days, 1 capsule per day. In the comparison group - CG (n=67) with ABT, Ovipol Klio® (estriol monopreparation) was additionally intravaginally used in two stages: for 14 days, 1 suppository per day, then for 2 weeks, 1 suppository 2 times a week. The control group consisted of 30 patients receiving only standard ABT UTI, local hormone therapy for vulvovaginal atrophy (VVA) was not performed. The observation period was 12 months after the end of the course of therapy. At all stages of treatment, a subjective and objective assessment of the severity of urination disorders and urogenital atrophy (UDI-6 questionnaire), their impact on the quality of life of patients (questionnaire IIQ-7), indicators of bacteriuria, bacterial urine culture and vaginal biocenosis, frequency of undesirable phenomena were carried out. According to the initial characteristics of the group of patients were comparable. Results. At all stages of the study, in the group of patients who received therapy with the use of the Trioginal® drug, there was a significant improvement in the clinical picture of urination disorders compared to the CG and the control (main) group - MG (in SG - 18% at the end of therapy versus 100% before the start of therapy; CG - 26 % versus 100% respectively; Ledger - 58% versus 100% respectively; p

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The vagaries of IgM: a case report of EBV infection with concomitantly false-positive IgM for CMV, VZV, and HSV

The Egyptian Journal of Internal Medicine ◽

10.1186/s43162-020-00006-z ◽

2020 ◽

Vol 32 (1) ◽

Author(s):

Raai Mahmood ◽

Khalid Mohamed ◽

Naba Saeed ◽

Kadhim Al-Banaa ◽

Jonathan Zimmerman ◽

...

Keyword(s):

Infectious Mononucleosis ◽

Total Bilirubin ◽

Viral Infections ◽

Total Bilirubin Level ◽

Peripheral Blood Smear ◽

Cross Reactivity ◽

Immunoglobulin M ◽

Case Presentation ◽

Ebv Infection ◽

Acute Infectious Mononucleosis

Abstract Background Serum IgM (immunoglobulin M) testing is commonly used to diagnose acute viral infections. However, most clinicians are unaware of the vagaries of IgM testing, including antigenic cross-reactivity between multiple viruses and risk misdiagnosis. Case presentation We report a case of infectious mononucleosis with concomitantly positive IgM for EBV, CMV, VZV, and HSV. A 26-year-old man presented with acute infectious mononucleosis picture. His blood work showed a total bilirubin level of 7.7 mg/dl, ALT 1077 U/L, AST 806 U/L, ALP 325 U/L, and INR 1.0. Monospot was positive; peripheral blood smear showed atypical lymphocytes; however, because EBV infectious mononucleosis does not typically cause elevation of liver enzymes over 1000, other etiologies were explored. Tests for hepatitis A, B, C, HIV, ANA, and ASMA returned negative. IgM for EBV-VCA, CMV, HSV, and VZV all returned positive, and the diagnosis of EBV IM was called into question. Subsequent tests of CMV and HSV PCR for viral load were negative (VZV was not clinically suspected), and later on, EBV-EBNA returned negative and EBV-VCA IgM and IgG returned positive, confirming the diagnosis of acute EBV infection. Conclusion We believe that IgM seropositivity can result from cross-reactivity among several viruses (especially herpes viruses), and although often relied on, a positive IgM should not serve as the sole determinant for diagnosis of acute viral infections.

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Objective assessment of nasal resistance among electronic cigarette users

The Journal of Laryngology & Otology ◽

10.1017/s0022215121001432 ◽

2021 ◽

pp. 1-4

Author(s):

S W Lim ◽

AB Zulkiflee

Keyword(s):

Tobacco Smoking ◽

Repeated Measures ◽

Airway Resistance ◽

Electronic Cigarettes ◽

Objective Assessment ◽

Control Group ◽

Nasal Airway ◽

Nasal Resistance ◽

Short Term ◽

Nasal Airway Resistance

Abstract Background Electronic cigarettes have been a popular alternative to tobacco smoking. The effect of tobacco smoking on nasal airway resistance has been investigated before; however, the effect of the aerosol generated by electronic cigarettes is still unknown. This study aimed to evaluate the short-term effects of e-cigarettes on nasal airway resistance. Methods Sixty-one participants were recruited into a vapers group and a control group. The vapers group was instructed to smoke for 5 minutes, and their nasal resistance was measured pre-procedure and at 1 and 5 minutes post-procedure. The results were compared between both groups. Results Repeated measures analysis of variance demonstrated that vaping has no statistically significant effect on total nasal airway resistance. Conclusion Although the differences between both groups were not statistically significant overall, the vapers group showed a reduction in nasal airway resistance in the short term.

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Effect of exergaming on wellbeing of residents in a nursing home: a single blinded intervention study

Aging Clinical and Experimental Research ◽

10.1007/s40520-021-01903-1 ◽

2021 ◽

Author(s):

Marlies Gunst ◽

Isabelle De Meyere ◽

Hannah Willems ◽

Birgitte Schoenmakers

Keyword(s):

Intervention Study ◽

Positive Impact ◽

Objective Assessment ◽

Intervention Group ◽

Social Contact ◽

Mental Wellbeing ◽

Vulnerable Groups ◽

Future Research ◽

Control Group ◽

Average Intensity

Abstract Introduction To improve the quality of life in nursing homes, meaningful activities and social contact are indispensable. Exergames can play a role addressing these needs. Methods In a randomized single blinded controlled intervention study, we investigated the effect of playing exergames on general wellbeing, fun and on social interaction. Results Thirty-five residents participated: 18 residents took part in the intervention group and 17 in the control group. The median mental wellbeing score of the intervention group increased from 42/50 to 45. The median sleep score of the intervention increased from 23/30 to 28. The median pain score of the intervention group improved from 18/20 to 20. The median score on subjective cognition increased from 24/30 to 26 while the mean scores on the objective assessment decreased from 1.8/2 to 1.7. Coaches gave an average fun score of 8.9/10 and an average intensity of exercise score of 11.6/20. Residents and coaches appreciated the social contact. Coaches reported a high feasibility (average of 4.1/5) but a low accessibility and a high intensity of supervision. Conclusions Exergaming is a feasible and pleasant complement to the usual activities with a positive impact on wellbeing, sleep, pain, and perceived cognition. Future research should focus on vulnerable groups and aim to develop a study in an implementation design.

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The diagnostic value of EBV-DNA and EBV-related antibodies detection for nasopharyngeal carcinoma: a meta-analysis

Cancer Cell International ◽

10.1186/s12935-021-01862-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Weixing Liu ◽

Gui Chen ◽

Xin Gong ◽

Yingqi Wang ◽

Yaoming Zheng ◽

...

Keyword(s):

Nasopharyngeal Carcinoma ◽

Test Performance ◽

Meta Analysis ◽

Diagnostic Value ◽

Cochrane Library ◽

Control Group ◽

Summary Receiver Operating Characteristic ◽

Ebv Dna ◽

The Difference ◽

Sensitivity Specificity

Abstract Background Numerous individual studies have investigated the diagnostic value of EBV-DNA, EA-IgA, VCA-IgA, EBNA1-IgA and Rta-IgG detection for nasopharyngeal carcinoma (NPC), but the conclusions remain controversial. This meta-analysis aimed to determine the value of EBV-DNA, EA-IgA, VCA-IgA, EBNA1-IgA and Rta-IgG detection in the diagnosis of NPC. Methods PROSPERO registration number: CRD42019145532. PubMed, EMBASE, Cochrane Library, and Chinese data libraries (Wanfang, CNKI, and CBM) were searched up to January 2019. The pooled sensitivity, specificity, and positive likelihood, negative likelihood, and diagnostic odds ratios were conducted in this meta-analysis. Summary receiver operating characteristic curves evaluated the test-performance global summary. Publication bias was examined by Deek’s funnel plot asymmetry test. Results Forty-seven studies with 8382 NPC patients (NPC group) and 15,089 individuals without NPC (Control group) were included in this meta-analysis. The sensitivity, specificity, positive likelihood (+ LR), negative likelihood (-LR), DOR and AUC of EBV-DNA in diagnosis of NPC were: 0.76 (95% CI 0.73–0.77), 0.96 (95% CI 0.95–0.97), 14.66 (95% CI 9.97–21.55), 0.19 (95% CI 0.13–0.28), 84 (95% CI 50.45–139.88), 0.96 (SE: 0.001), and 0.55 (95% CI 0.54–0.57), 0.96 (95% CI 0.96–0.97), 12.91 (95% CI 9.55–17.45), 0.35 (95% CI 0.29–0.43), 39.57 (95% CI 26.44–59.23), 0.94 (SE: 0.002) for the EA-IgA, and 0.85 (95% CI 0.84–0.85), 0.89 (95% CI 0.88–0.89), 6.73 (95% CI5.38–8.43), 0.17 (95% CI 0.12–0.23), 43.03 (95% CI 31.51–58.76), 0.93 (SE: 0.007) for the VCA-IgA, and 0.86 (95% CI 0.85–0.88), 0.87 (95% CI 0.88–0.90), 7.55 (95% CI 5.79–9.87), 0.16 (95% CI 0.13–0.19), 50.95 (95% CI 34.35–75.57), 0.94 (SE: 0.008) for the EBNA1-IgA, and 0.70 (95% CI 0.69–0.71), 0.94 (95% CI 0.94–0.95), 9.84 (95% CI 8.40–11.54), 0.25 (95% CI 0.21–0.31), 40.59 (95% CI 32.09–51.35), 0.95 (SE: 0.005) for the Rta-IgG. The EBV-DNA had larger AUC compared with other EBV-based antibodies (P < 0.05), while the difference between EA-IgA, VCA-IgA, EBNA1-IgA and Rta-IgG was not statistically significant (P > 0.05). Conclusions EBV-DNA, VCA-IgA, EBNA1-IgA and Rta-IgG detection have high accuracy in early diagnosis NPC. In addition, EBV-DNA detection has the higher diagnosis accuracy in NPC. On the other hand, EA-IgA is suitable for the diagnosis but not NPC screening.

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Clinical value of a screening tool for tumor predisposition syndromes in childhood cancer patients (TuPS): a prospective, observational, multi-center study

Familial Cancer ◽

10.1007/s10689-021-00237-1 ◽

2021 ◽

Author(s):

Floor A. M. Postema ◽

Saskia M. J. Hopman ◽

Corianne A. J. M. de Borgie ◽

Cora M. Aalfs ◽

Jakob K. Anninga ◽

...

Keyword(s):

Screening Tool ◽

Clinical Care ◽

False Negative ◽

Negative Control ◽

Control Group ◽

Clinical Value ◽

Variant Of Uncertain Significance ◽

Multi Center Study ◽

Center Study ◽

Genetic Consultation

AbstractRecognizing a tumor predisposition syndrome (TPS) in a child with cancer is of clinical relevance. Earlier we developed a screening tool to increase diagnostic accuracy and clinical efficiency of identifying TPSs in children with cancer. Here we report on the value of this tool in clinical practice. TuPS is a prospective, observational, multi-center study including children newly diagnosed with cancer from 2016 to 2019 in the Netherlands. Children in whom a TPS had been diagnosed before the cancer diagnosis were excluded. The screening tool consists of a checklist, 2D and 3D photographic series and digital assessment of these by a clinical geneticist. If a TPS was suspected, the patient was assessed positive and referred for routine genetic consultation. Primary aim was to assess the clinical value of this new screening tool. Of the 363 included patients, 57% (208/363) were assessed positive. In 15% of patients (32/208), the 2D photographic series with (n = 12) or without (n = 20) 3D photographs were decisive in the positive assessment. In 2% (4/208) of positive assessed patients, a TPS was diagnosed, and in an additional 2% (4/208) a germline variant of uncertain significance was found. Thirty-five negatively assessed patients were evaluated through routine genetic consultation as controls, in none a TPS was detected. Using the screening tool, 57% of the patients were assessed as suspected for having a TPS. No false negative results were identified in the negative control group in the clinical care setting. The observed prevalence of TPS was lower than expected, due to selection bias in the cohort.

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