The Use of Thoracic Ultrasound to Predict Transudative and Exudative Pleural Effusion

Objectives: Pleural effusion is a common reason for hospital admission with thoracentesis often required to diagnose an underlying cause. This study aimed to determine if the imaging characteristics of TUS effectively differentiates between transudative and exudative pleural fluid. Methods: Patients undergoing TUS with pleural fluid analysis were retrospectively identified at a single center between July 2016 and March 2018. TUS images were interpreted and characterized by established criteria. We determined diagnostic performance characteristics of image criteria to distinguish transudative from exudative pleural effusions. Results: 166 patients underwent thoracentesis for fluid analysis of which 48% had a known malignancy. 74% of the pleural effusions were characterized as exudative by Light’s Criteria. TUS demonstrated anechoic effusions in 118 (71%) of samples. The presences of septations on TUS was highly specific in for exudative effusions (95.2%) with high positive predictive values (89.5%) and likelihood ratio (2.85). No TUS characteristics, even when adjusting for patient characteristics such as heart failure or malignancy, were sensitive for exudative effusions. Conclusions: Among our cohort, anechoic images did not allow reliable differentiation between transudative and exudative fluid. Presence of complex septated or complex homogenous appearance was high specific and predictive of exudative fluid.

Where did the Central European populations of Ornatoraphidia flavilabris (Costa) come from? (Neuropterida, Raphidioptera, Raphidiidae)

Ornatoraphidia flavilabris (Costa, 1851) is one of 15 snakefly species occurring in southern parts of Central Europe. It is a polycentric Mediterranean faunal element with refugia in the Apennine Peninsula and the Balkan Peninsula. Two phylogeographic questions are dealt with in this paper: (1) Is it possible to differentiate, morphologically or genetically, the Balkanic populations from the Italian? (2) Did the species reach Central Europe from the Balkan or Apennine Peninsula? These questions were investigated using morphological and molecular biological methods. No morphological characters were uncovered which could serve to differentiate specimens from either distribution center. However, differences were detected in cox1, cox3 and 28S genes which allow for a reliable differentiation. Central European populations were largely identical with populations from Italy, but distinctly different from specimens from Greece. This could lead one to assume that the species migrated from Italy to Central Europe, although colonization from the southeast would appear easier due to more favorable orographic conditions. This discrepancy may be explained by the apparent absence of O. flavilabris from the large central part of the Balkan Peninsula, so that a gap exists between the southern and northern areas inhabited by O. flavilabris. Moreover, the species does not occur in eastern parts of Europe. Thus it would be more probable to assume that the occurrence of the species in the northwest Balkan Peninsula can be traced to migrations from the Apennine Peninsula to areas north and northeast of the Adriatic Sea, where O. flavilabris may have colonized the southeast of Central Europe. A migration of Adriatomediterranean faunal elements from the northwest Balkan Peninsula to Central Europe might be of more significance than previously assumed.

Cross-species amplification of microsatellites and identification of polyploid hybrids by allele dosage effects in Cobitis hankugensis × Iksookimia longicorpa hybrid complex (Actinopterygii: Cypriniformes: Cobitidae)

During the course of evolution, numerous taxa abandoned canonical sex and reproduced asexually. Examination of the Cobitis hankugensis × Iksookimia longicorpa asexual complex already revealed important evolutionary discoveries tackling phenomena like interspecific hybridization, non-Mendelian inheritance, polyploidy, and asexuality. Yet, as in other similar cases, the investigation is hampered by the lack of easily accessible molecular tools for efficient differentiation among genomotypes. Here, we tested the cross-species amplification of 23 microsatellite markers derived from distantly related species and investigated the extent to which such markers can facilitate the genome identification in the non-model hybrid complex. We found that 21 out of 23 microsatellite markers were amplified in all genomotypes. Five of them could be used for easy diagnostics of parental species and their hybrids due to species-specific amplification profiles. We also noted that three markers, i.e., IC654 and IC783 derived from Cobitis choii Kim et Son, 1984 and Iko_TTA01 from Iksookimia koreensis (Kim, 1975), had dosage-sensitive amplification efficiencies of species-specific alleles. This could be further used for reliable differentiation of genome composition in polyploids. The presently reported study introduces a noninvasive method applicable for the diagnosis of ploidy and genome composition of hybrids, which are not clearly distinguished morphologically. We showed that very detailed information may be obtained even from markers developed in distantly related taxa. Hybridization is being increasingly recognized as a driving force in evolution. Yet, proper detection of hybrids and their ploidy is particularly challenging, especially in non-model organisms. The present paper evaluates the power of microsatellite cross-amplification not only in the identification of hybrid forms but also in estimating their genome dosage on an example of a fish taxon that involves asexuality, hybridization as well as ploidy variation. It thus demonstrates the wide applicability of such cheap and non-invasive tools.

Increased levels of S100A8/A9, IL-1ß and IL-18 as a novel biomarker for recurrent tonsillitis

Background Acute tonsillitis represents one of the most frequent reasons patients seek primary medical care and otorhinolaryngology consultation. Therefore, recurrent episodes of acute tonsillitis (RAT), also called chronic tonsillitis, exhaust a substantial amount of medical and financial resources. Diagnosis of tonsillitis depends on a physical examination, which therefore does not allow for a reliable differentiation between viral and bacterial infection. However, the frequency of bacterial infections during the previous three years is currently being used as the major deciding factor in patient selection for tonsillectomy. The aim of the present study was to determine an objective biomarker to help in the identification of patients suffering from recurrent tonsillitis. Results By analyzing a panel of cytokines and chemokines in serum and saliva of patients with RAT compared to healthy controls, increased levels of IL-1ß (153.7 ± 48.5 pg/ml vs 23.3 ± 6.6 pg/ml, p = 0.021), IL-18 (120.2 ± 16.5 vs 50.6 ± 9.3 pg/ml, p = 0.007) and/or S100A8/A9 (996 ± 102 ng/ml vs 546 ± 86 ng/ml, p = 0.042) could be observed in patients suffering from RAT. Cut-off values of these parameters were determined and combined to a new RAT-score allowing for reliable identification of patients suffering from recurrent tonsillitis with a sensitivity of 95% and a specificity of 88%. Conclusion The RAT-score represents the first objective criterion as a tool for the diagnosis of recurrent tonsillitis and it also improves patient selection for tonsillectomy.

CROSS-SPECIES AMPLIFICATION OF MICROSATELLITES AND IDENTIFICATION OF POLYPLOID HYBRIDS BY ALLELE DOSAGE EFFECTS IN COBITIS HANKUGENSIS AND IKSOOKIMIA LONGICORPA HYBRID COMPLEX

Background. During the course of evolution, numerous taxa abandoned canonical sex and reproduced asexually. Examination of the Cobitis hankugensis - Iksookimia longicorpa asexual complex already revealed important evolutionary discoveries tackling phenomena like interspecific hybridization, non-Mendelian inheritance, polyploidy and asexuality. Yet, as in other similar cases, the investigation is hampered by the lack of easily accessible molecular tools for efficient differentiation among genomotypes. Material and methods. Here, we tested the cross-species amplification of 23 microsatellite markers derived from distantly related species and investigated the extent to which such markers can facilitate the genome identification in non-model hybrid complex. Results. We found that 21 out of 23 microsatellite markers amplified in all genomotypes. Five of them could be used for easy diagnosticity of parental species and their hybrids due to species-specific amplification profiles. We also noted that three markers, i.e. IC654 and IC783 derived from Cobitis choii and Iko_TTA01 from Iksookimia koreensis, had dosage-sensitive amplification efficiencies of species-specific alleles. This could be further used for reliable differentiation of genome composition in polyploids. Conclusions. The present study introduces a noninvasive method applicable for diagnosis of ploidy and genome composition of hybrids, which are not clearly distinguished morphologically. We showed that very detailed information may be obtained even from markers developed in distantly related taxa.

Informative significance of serum cytokines and their importance for development of metabolic syndrome with arterial hypertension in elderly persons

Metabolic syndrome (MS) is among the main public health challenges worldwide, leading to significant labor losses, increased costs for treatment and rehabilitation of the patients. The aim of the present study was to identify the informative serum interleukins, by determining the odds ratio in elderly patients with MS and hypertension. The main group of 86 patients with MS and arterial hypertension (AH) aged 60-75 years was examined under clinical conditions. The inclusion criteria were as follows: age of 60-75 years, presence of MS, primary hypertension (grade II-III), absence of acute myocardial infarction, malignant neoplasms, disorders of cerebral circulation, kidney failure over last 6 months. Diagnostics of MS and hypertension was carried out in accordance with Expert Guidelines from the Russian Research Society of Cardiology on the MS Diagnosis and Treatment. Our first study of a large range of serum interleukins in elderly patients with MS and hypertension allowed us to reveal the inversely directed changes in pro- and anti-inflammatory cytokine contents. Combined AH/MS in elderly persons is accomplished by sufficient increase of the most proinflammatory cytokines, and vice versa, by significant decrease in anti-inflammatory cytokines in blood serum. This finding clearly points to importance of immunological regulatory systems for initiation of AH with MS at older age. Pro- and anti-inflammatory serum interleukins are actively involved into the AH/MS development in elderly accompanied by their pronounced imbalance. The mentioned immune reactions could underlie the MS/AH condition. High risk of this disorder is connected with changed production of proinflammatory cytokines (IL-8, IL-1β), like as anti-inflammatory serum interleukins (IL-4, IL-10), with predominance of the former. The above interleukins should be considered dominant diagnostic markers of AH/MS in elderly persons. Measurement of serum interleukins and discriminant-based approach allows highly reliable differentiation of elderly patients with AH/MS from similar individuals without this disorder.

Value of copeptin and S100B protein in the differential diagnosis of central vertigo and peripheral vertigo

Objective To investigate the usefulness of copeptin and S100B levels in the differentiation of central and peripheral vertigo. Methods Ninety patients were included in the study. Copeptin and S100B levels were measured using the enzyme-linked immunosorbent assay method. Results The time between symptom onset and presentation to the emergency department was longer in the patients diagnosed with central vertigo. S100B and copeptin levels were significantly higher in central vertigo patients. The confirmed cut-off value was 17 for the S100B level and 1.65 for the copeptin level. Conclusion Quick and reliable differentiation between central and peripheral vertigo is important to reduce the length of hospital stay of patients in the emergency department, and for patient comfort. S100B and copeptin levels are potential biomarkers in the differential diagnosis of central vertigo and peripheral vertigo for patients whose aetiology of vertigo cannot be differentially diagnosed with history-taking and physical examination.

Probe-Based Real-Time qPCR Assays for a Reliable Differentiation of Capripox Virus Species

Outbreaks of the three capripox virus species, namely lumpy skin disease virus, sheeppox virus, and goatpox virus, severely affect animal health and both national and international economies. Therefore, the World Organization for Animal Health (OIE) classified them as notifiable diseases. Until now, discrimination of capripox virus species was possible by using different conventional PCR protocols. However, more sophisticated probe-based real-time qPCR systems addressing this issue are, to our knowledge, still missing. In the present study, we developed several duplex qPCR assays consisting of different types of fluorescence-labelled probes that are highly sensitive and show a high analytical specificity. Finally, our assays were combined with already published diagnostic methods to a diagnostic workflow that enables time-saving, reliable, and robust detection, differentiation, and characterization of capripox virus isolates.

Differentiation of Capripox Viruses by Nanopore Sequencing

The genus capripoxvirus (CaPV), family Poxviridae, includes three virus species: goatpox virus (GPV), sheeppox virus (SPV) and lumpy skin disease virus (LSDV). CaPV causes disease outbreaks with consequent economic losses in Africa and the Middle East. LSDV has recently spread to Southeast Europe. As CaPVs share 96–97% genetic similarity along the length of the entire genome and are difficult to distinguish using serological assays, simple, reliable and fast methods for diagnosis and species differentiation are crucial in cases of disease outbreak. The present study aimed to develop a field-applicable CaPV differentiation method. Nanopore technology was used for whole genome sequencing. A local database of complete CaPV genomes and partial sequences of three genes (RPO30, P32 and GPCR) was established for offline Basic Local Alignment Search Tool (BLAST). Specificities of 98.04% in whole genome and 97.86% in RPO30 gene runs were obtained among the three virus species, while other databases were less specific. The total run time was shortened to approximately 2 h. Functionality of the developed procedure was proved by samples with high host background sequences. Reliable differentiation options for the quality and capacity of hardware, and sample quality of suspected cases, were derived from these findings. The whole workflow can be performed rapidly with a mobile suitcase laboratory and mini-computer, allowing application at the point-of-need with limited resource settings.