Mechanism of Neonatal Intestinal Injury Induced by Hyperoxia Therapy

High concentration oxygen is widely used in the treatment of neonates, which has a significant effect on improving blood oxygen concentration in neonates with respiratory distress. The adverse effects of hyperoxia therapy on the lung, retina, and neurodevelopment of newborns have been extensively studied, but less attention has been paid to intestinal damage caused by hyperoxia therapy. In this review, we focus on the physical, immune, and microorganism barriers of the intestinal tract and discuss neonatal intestinal tract damage caused by hyperoxia therapy and analyze the molecular mechanism of intestinal damage caused by hyperoxia in combination with necrotizing enterocolitis.

LESION OF THE RESPIRATORY TRACT IN CROHN’S DISEASE IN A CHILD OF 6 YEARS OLD

The article is devoted to rare extraintestinal manifestations of Crohn's disease (CD) in children, primarily to the respiratory tract. A review of the literature on this problem in children's practice is presented. On the example of clinical case, data on the classification, pathogenesis, clinical picture, diagnosis, differential diagnosis and treatment of CD with respiratory tract damage in a young child are summarized.

Metabolomics Diagnosis of COVID-19 from Exhaled Breath Condensate

Infection from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can lead to severe respiratory tract damage and acute lung injury. Therefore, it is crucial to study breath-associated biofluids not only to investigate the breath’s biochemical changes caused by SARS-CoV-2 infection, but also to discover potential biomarkers for the development of new diagnostic tools. In the present study, we performed an untargeted metabolomics approach using a bidimensional gas chromatography mass spectrometer (GCxGC-TOFMS) on exhaled breath condensate (EBC) from COVID-19 patients and negative healthy subjects to identify new potential biomarkers for the noninvasive diagnosis and monitoring of the COVID-19 disease. The EBC analysis was further performed in patients with acute or acute-on-chronic cardiopulmonary edema (CPE) to assess the reliability of the identified biomarkers. Our findings demonstrated that an abundance of EBC fatty acids can be used to discriminate COVID-19 patients and that they may have a protective effect, thus suggesting their potential use as a preventive strategy against the infection.

White matter integrity in patients with classic trigeminal neuralgia: a multi-node automated fiber tract quantification study

Objective To study the characteristics of point-by-point destruction of white matter tracts in patients using automated fiber tract quantification (AFQ). Methods Thirty-four classic trigeminal neuralgia (CTN) patients and 34 healthy control (HC) subjects underwent 3.0 T diffusion tensor magnetic resonance imaging and T1-weighted imaging. The fractional anisotropy (FA) and mean diffusivity (MD) of 100 nodes of 20 fiber tracts were analyzed by AFQ, and the correlations of the FA and MD with the visual analogue scale (VAS) pain score were assessed. Results The FA values of the left thalamic radiation (middle segment), left corticospinal tract, callosum forceps minor, and right uncinate fasciculus were significantly lower in CTN patients than in the HC group. The MD of the left thalamic tract (middle segment), left corticospinal tract, right superior longitudinal fasciculus, and left superior longitudinal fasciculus (anterior segment) were significantly higher in the CTN group. Additionally, the VAS pain score in CTN patients was positively correlated with FA and negatively correlated with MD. Conclusion Specific fiber tract nodes were damaged in CTN patients, which was related to the VAS pain score. Multi-node quantitative studies of fiber tract damage are valuable for understanding the white matter tract damage pattern in CTN patients.

Post-traumatic Anton’s Syndrome and Its Rehabilitation Challenges: A Case Report

Objectives: Anton’s syndrome is a rare clinical phenomenon characterized by acquired cortical blindness without the self-awareness of blindness. Patients with this syndrome tend to deny their visual deficits. The literature on the rehabilitation of individuals with Anton’s syndrome is sparse. Methods: We describe a 26-year-old patient who developed Anton’s syndrome in the background of anterior visual tract damage and multiple intracranial bleedings after traumatic brain injury. He presented with visual agnosia and confabulations that were only detected 2 months after trauma. He received 4 months of multidisciplinary rehabilitation care as an outpatient. His comprehensive program consisted of (a) compensatory strategies, (b) restorative strategies, and (c) counseling sessions. Although he showed significant improvement in terms of functional gain with rehabilitation, he still had visual deficits with occasional visual anosognosia that required 24-h supervision. Conclusion: Anton’s syndrome in traumatic brain injury should not be overlooked. A prompt diagnosis is vital to initiate appropriate rehabilitation measures.

Delayed positive COVID19 nasopharyngeal test, a case study with clinical and pathological correlation

Background There are various reasons for delayed positive nasopharyngeal PCR tests for coronavirus disease 2019 (COVID19) in not only asymptomatic but also severely diseased patients. The pathophysiological attributes are not known. We explore this possibility through a case report. Case presentation A 64-year-old male with history of pulmonary fungal infection, asthma and chronic pulmonary obstructive disease (COPD), diabetes, coronary artery disease presented with shortness of breath, fever and chest image of ground opacity, reticular interstitial thickening, highly suspicious for COVID19. However, nasopharyngeal swab tests were discordantly negative for four times in two weeks, and IgG antibody for COVID19 was also negative. However, serum IgE level was elevated. No other pathogens are identified. His symptoms deteriorated despite corticosteroid, antibiotics and bronchodilator treatment. Bronchoalveolar lavage (BAL) and open lung wedge biopsy were performed for etiology diagnosis. They demonstrated COVID19 viral RNA positive fibrosing organizing pneumonia with respiratory tract damage characterized by suspicious viral cytopathic effect, mixed neutrophilic, lymphoplasmacytic, histiocytic and eosinophilic inflammation and fibrosis besides expected asthma and COPD change. One week later, repeated COVID19 nasopharyngeal tests on day 40 and day 49 became positive. Conclusion Our case and literature review indicate that allergic asthma and associated high IgE level together with corticosteroid inhalation might contribute to the delayed positive nasopharyngeal swab in upper airway; COPD related chronic airways obstruction and the addition of fibrosis induced ventilator dependence and poor prognosis in COVID19 pneumonia, and should be therapeutically targeted besides antiviral therapy.

Damage control for renal trauma: the more conservative the surgeon, better for the kidney

Urologic trauma is frequently reported in patients with penetrating trauma. Currently, the computerized tomography and vascular approach through angiography/embolization are the standard approaches for renal trauma. However, the management of renal or urinary tract trauma in a patient with hemodynamic instability and criteria for emergency laparotomy, is a topic of discussion. This article presents the consensus of the Trauma and Emergency Surgery Group (CTE) from Cali, for the management of penetrating renal and urinary tract trauma through damage control surgery. Intrasurgical perirenal hematoma characteristics, such as if it is expanding or actively bleeding, can be a reference for deciding whether a conservative approach with subsequent radiological studies is possible. However, if there is evidence of severe kidney trauma, surgical exploration is mandatory and entails a high probability of requiring a nephrectomy. Urinary tract damage control should be conservative and deferred because this type of trauma does not represent a risk in acute trauma management.

Control of chronic coronavirus infection in cats with the use of Phosprenyl and Gamavit

Feline enteropathogenic coronavirus affects the intestinal epithelium and causes inflammation of the intestinal mucosa in cats. In adult cats, the infection is usually asymptomatic, but the constant circulation of the coronavirus in the feline population can increase the likelihood of mutation leading to appearance of the virulent strain of the virus that cause feline infectious peritonitis - a deadly disease that develops in 5-10% of cats carrying the coronavirus. The aim of this work was to study the effect of the drugs Phosprenyl and Gamavit on the course of coronavirus infection in cats. A total of 29 cats were monitored. The diagnosis was confirmed by the detection of antibodies by the IHA method, as well as by ultrasound examination of the abdominal organs. Prescribed treatment: Phosprenyl per os, 1 ml , twice a day, course 2-4 months; Gamavit 1 time a day, s/c, course 10 days, with a repeated course after 3 weeks; 3-4 times. As symptomatic therapy, drugs were used to improve the condition of the stool. At the end of treatment, symptoms of gastrointestinal tract damage disappeared in all patients. If before the start of treatment, most patients showed signs of anemia (a decrease in the number of red blood cells and hemoglobin levels), leukocytosis with a predominance of segmented neutrophils, characteristic of infectious and inflammatory processes, and increased ESR, then at the end of therapy, these indicators were completely normalized. Thus, long-term therapy with the use of Phosprenyl and Gamavit helps to control the course of coronavirus infection in cats, prevent its exacerbation and transition to a highly lethal form of infectious peritonitis.