18F-FDG and 68Ga-FAPI PET/CT for Evaluating Periprosthetic Joint Infection and Aseptic Loosening in Rabbit Models

Purpose We built a loosening model based on the original infection model of rabbit and evaluated the performance characteristics of 18F-FDG and 68Ga-FAPI in infection and loosening. Methods After surgery, the rabbits were divided into four groups, six in the control group and 10 in the loosening, S. aureus and S. epidermis groups. PET/CT and serological examination were performed every two weeks for three times. After sacrificed, micro-CT, tissue culture, pullout test and scanning electron microscope were performed. Results As for 18F-FDG, performances of control and loosening groups were similar. SUVmax of S. aureus had been consistently in the high range than that of S. epidermis. As for 68Ga-FAPI, control group had the lowest SUVmax in the second week and increased gradually. SUVmax of loosening group began exceed control group since the second week. SUVmax of S. aureus in the second week was the lowest among four group and raised as the number of weeks increased and equalled to SUVmax of S. epidermis in the sixth week. Linear regressions between SUVmax and serology showed that 18F-FDG was positively correlated with CRP and IL-6 while 68Ga-FAPI revealed negative and positive correlation with CRP and IL-6 in the second and sixth week. Besides, both SUVmax and MTV of 18F-FDG or 68Ga-FAPI were negatively correlated with BV/TV and BS/TV. Conclusion In this longitudinal observation, 68Ga-FAPI showed greater sensitivity than 18F-FDG in detecting diseases, and 68Ga-FAPI had not intestinal and muscular uptake. MTV of 68Ga-FAPI were larger than 18F-FDG, which meant that 68Ga-FAPI had the potential to define the scope of lesions more accurately. Finally, SUVmax could not differentiate loosening and infection in 68Ga-FAPI, further study about diagnostic criteria was warranted.

Serological and immuno-histopathological detection of Paramphistomum epiclitum infection in large ruminant population in Punjab, Pakistan

Recent molecular identification of Paramphistomum epiclitum in Pakistan raises concerns about its epidemiology and pathologies in infected tissues of ruminants. The present study aimed to find the seroepidemiological and histopathological record of Paramphistomum epiclitum from cattle and buffaloes. Indirect ELISA on animal sera and histology of infected rumen with hematological and biochemical analyses were performed. The overall prevalence of P. epiclitum was noted as 15.3% in the abattoir survey and 37.6% in the serological examination. The sensitivity and specificity of the diagnostic test were 100% and 83.3% respectively. The paramphistomosis was significantly (p= 0.001) higher during August (6.4%) followed by September (5.4%), whereas the lowest prevalence was recorded during April (0.4%). The hematological and biochemical variations showed significant increase in total leukocyte count (p= 0.002), alanine aminotransferase (p= 0.05), glucose (p= 0.01) and cholesterol (p = 0.024) levels. However, significant decrease in the level of erythrocyte (p= 0.019), hemoglobin (p= 0.001), mean corpuscular haemoglobin concentration (p= 0.05), mean corpuscular volume (p= 0.038) and platelets count (p= 0.048) was observed. The histopathology of rumen tissue showed haemorrhages, atrophy of ruminal papillae, sloughed mucosa, cellular vacuolation, and infiltration of lymphocytes inflammatory cells. The present study provides the prevalence and histopathological record of P. epiclitum in Pakistan for the first time in order to take control measures in the country.

Half-Year Longitudinal Seroprevalence of SARS-CoV-2-Antibodies and Rule Compliance in German Hospital Employees

COVID-19, which is caused by SARS-CoV-2, is an occupational health risk, especially for healthcare employees due to their higher exposure and consequently higher risk of symptomatic and asymptomatic infections. This study was designed to determine the longitudinal seroprevalence of specific immunoglobulin-G (IgG) antibodies in employees in a hospital setting. All employees in a secondary care hospital, including healthcare and non-healthcare workers, were invited to participate in this single-center study. After an initial screening, a 6-month follow-up was carried out, which included serological examination for SARS-CoV-2 IgG antibodies and a questionnaire for self-reported symptoms, self-perception, and thoughts about local and national hygiene and pandemic plans. The seroprevalence of SARS-CoV-2 IgG antibodies was 0.74% among 406 hospital employees (0.75% in healthcare workers, 0.72% in non-healthcare workers), initially recruited in April 2020, in their follow-up blood specimens in October 2020. In this study, 30.54% of the participants reported using the official German coronavirus mobile application and the majority were content with the local and national rules in relation to coronavirus-related restrictions. At the 6-month follow-up, the 0.74% seroprevalence was below the reported seroprevalence of 1.35% in the general German population. The prevalence in healthcare workers in direct patient care compared with that in workers without direct patient contact did not differ significantly. Further follow-up to monitor the seroprevalence in the high-risk healthcare sector during the ongoing global pandemic is essential.

Spontaneous Bacterial Peritonitis Secondary to Cirrhosis of the Liver due to Echinococcosis: Case Report in Brazilian Indigenous

Background: Echinococcosis is an endemic disease in the Neotropical region of the Americas caused by Echinococcus spp. Most of the cases come from the Amazon region, where a disease is popularly called “paca disease”, due to the population's habit of eating the meat of Cuniculus paca. Case Report: We report 72-year-old Indigenous male presents cirrhosis complications caused by echinococcosis since 2010 confirmed by serological examination (titer 1:2560) and inactive cysts in imaging methods. Conclusion: Inactive cysts in echinococcosis are a source of complications such as liver cirrhosis and spontaneous bacterial peritonitis.

Biosafety of a novel covered self-expandable metal stent coated with poly(2-methoxyethyl acrylate) in vivo

Covered self-expandable metal stents (CSEMS) are often used for palliative endoscopic biliary drainage; however, the unobstructed period is limited because of sludge occlusion. The present study aimed to evaluate the biosafety of a novel poly(2-methoxyethyl acrylate)-coated CSEMS (PMEA-CSEMS) for sludge resistance and examine its biosafety in vivo. Using endoscopic retrograde cholangiopancreatography, we placed the PMEA-CSEMS into six normal porcine bile ducts and conventional CSEMS into three normal porcine bile ducts. We performed serological examination and undecalcified histological analysis at 1, 3, and 6 months during follow-up. In the bile ducts with PMEA-CSEMS or conventional CSEMS, we observed no increase in liver enzyme or inflammatory marker levels in the serological investigations and mild fibrosis but no inflammatory response in the histopathological analyses. Thus, we demonstrated the biosafety of PMEA-CSEMS in vivo.

White matter abnormalities of the brain: similar to multiple sclerosis in adolescence

Also known as Devic's disease, neuromyelitis optica (NMO) is an autoimmune inflammatory disease that affects the central nervous system, considerably similar to multiple sclerosis (MS). This study aimed to compare the similarities of the clinical feature presented with similar cases found in the medical literature, addressing the symptoms, diagnosis, and treatment. This is a descriptive, retrospective, and qualitative study, done through the technique of direct observation. An adolescent male patient came to our service complaining of weakness in the lower limbs and urinary retention and, subsequently, urinary incontinence, during hospitalization. After undergoing magnetic resonance imaging of the skull, a large lesion with a demyelinating characteristic was evident through the T2 and FLAIR sequences, hyperintense in the white matter of the right cerebral hemisphere, with the exuberant enhancement of the contrasted image. Subsequently, he presented weakness in the left dimidium of the body, with progressive worsening in some days, with the impossibility of walking. The treatment was initiated with pulse therapy of methylprednisolone and interferon beta, obtaining an excellent clinical control of the disease. Thus, diagnostic confirmation was only possible thanks to the identification of a single brain white matter lesion through imaging and serological examination, which constituted a tool of great importance for the differential diagnosis that made it possible to exclude multiple sclerosis and allowed the establishment of timely treatment for neuromyelitis optica.

Psoriasiform Secondary Syphilis: A Pitfall in Diagnosis

Secondary syphilis in Acquired Immune Deficiency Syndrome (AIDS) patient’s have variety of skin manifestations. Failure to recognize the manifestations of secondary syphilis can cause delaying the therapy. The recognition of the characteristics of skin lesions as well as serology examination and histopathology help the physicians for making the diagnosis. A 24-year-old male who was diagnosed with HIV previously came with chief complaint of scaly red plaques on the palms and soles. The similar lesions were also notedover the face especially the perioral region.Patient also noted to have also alopecia on the eyebrows and eyelashes. Patient was diagnosed with psoriasis vulgaris from previous physician and treated with unknown therapy. Serological examination revealed reactive TPHA and high titer of VDRL. Skin biopsy was done and it has features of psoriasis but without pathognomonic signs. The patient then was treated with single dose of benzathine penicillin G 2,4 million units which provided excellent improvement.Secondary syphilis is called "great imitator" because of its broad manifestations. It has been widely reported that secondary syphilis has been misdiagnosed as psoriasis and seborrheic dermatitis. Characteristics of the lesion, serological examination and histopathology play significant role in establishing the diagnosis.

Identification of a small-scale pig farm infected with Brucella suis linked to a clinical case of human brucellosis in Buenos Aires province, Argentina

Here we report a case of human brucellosis due to Brucella suis in a person who worked in a small-scale pig farm. The farm had no history of clinical brucellosis, and signs of the disease were not observed upon clinical examination of the animals. Serum from all the 3 boars, 16/22 sows and 9/25 gilts was obtained for serological examination by Buffered Plate Agglutination Test (BPAT), Rose Bengal Test (RBT) and Fluorescent Polarization Assay (FPA). Bacteriological culture and Direct Fluorescence Antibody Test (DFAT) were performed in tissue samples from a seropositive boar and a sow. Specific antibodies were detected in 53 % (10/19) adult pigs, while all sampled gilts were seronegative. B. suis biovar 1 was isolated from one boar. In contrast, while the bacterium was not isolated from any tissue from a seropositive sow, it was detected by DFAT. From the bacteriological and serological evidence of B. suis endemic infection in the pig farm and the lack of preventive measures and biosecurity practices, it is concluded that the person most likely acquired the disease from the infected animals or by contact with contaminated environment in the farm.

Mapping geographical areas at risk for tick-borne encephalitis (TBE) by analysing bulk tank milk from Swedish dairy cattle herds for the presence of TBE virus–specific antibodies

Background The vector-borne human viral zoonosis tick-borne encephalitis (TBE) is of growing concern in Sweden. The area where TBE is considered endemic has expanded, with an increasing geographical distribution of Ixodes ricinus as the tick vector and a rising number of reported TBE cases in humans. Efforts to map TBE risk areas have been carried out by sentinel monitoring, mainly based on individual sampling and analysis of wild and domestic animals, as well as ticks, for tick-borne encephalitis virus (TBEV). However, the interpretation of the geographical distribution has been hampered by the patchy and focal nature of TBEV occurrence. This study presents TBEV surveillance data based on antibody analysis of bulk tank milk collected from dairy herds located throughout Sweden before (May) and after (November) the vector season. A commercial TBEV antibody ELISA was modified and evaluated for use in this study. Results The initial comparative TBEV antibody analysis revealed a good correlation between milk and serum antibody levels from individually sampled cows. Also, the TBEV-antibody levels for the mean-herd serum showed good comparability with TBEV antibody levels from bulk tank milk, thus indicating good predictability of seroprevalence when analysing bulk tank milk from a herd. Analyses of bulk tank milk samples collected from 616 herds in May and 560 herds in November showed a geographical distribution of TBEV seropositive herds that was largely consistent with reported human TBE cases. A few TBEV-reactive herds were also found outside known locations of human TBE cases. Conclusion Serological examination of bulk tank milk from dairy cattle herds may be a useful sentinel surveillance method to identify geographical presence of TBEV. In contrast to individual sampling this method allows a large number of animals to be monitored. TBEV seropositive herds were mainly found in coastal areas of southern Sweden similar to human TBE cases. However, some antibody-reactive herds were found outside known TBE areas at the time of the study.