Study of the retina and optic nerve microvascular bed using optical coherence tomography-angiography in post-COVID-19 patients

Introduction. Signs of angioretinopathy are revealed in 7–27.7 % of post-COVID-19 patients. Optical coherence tomographyangiography (OCT-A) allows performing life-time evaluation of structural and microvascular retinal changes in patients after the new coronavirus infection. Aim. To investigate and to compare main microcirculatory parameters of capillary retinal and optic nerve plexuses using OCT-A in patients after COVID-19 of different severity degree. Materials and methods. The main group consisted of 54 people (108 eyes), who recovered from COVID-19 during 3 preceding months. According to the COVID-19 course severity degree, patients were divided into 3 sub-groups. 22 healthy volunteers (44 eyes) were included in the control group. All patients underwent OCT-A. In the angiography regimen, entire vascular density (VD) and that of every sector in the limits of superficial (SCP) and deep (DCP) capillary plexuses, radial peripapillary capillaries (RPC), and in the foveal avascular zone (FAZ). Results. All over parameters investigated no significant differences between control group patients and those of the sub-group with mild COVID-19 course. In patients with moderately severe infectious process course a significant decrease in VD SCP (P<0.01), as well as decrease in VD RPC (P<0.01). In patients with severe and critically severe disease course there was an decrease of VD DCP in the foveal area (P=0.016) and VD FAZ (P<0.01). VD indices correlations with thickness of retinal layers, in which these vascular plexuses are located. In any of the groups, there was no statistically significant enlargement of the FAZ area and no structural optic disc changes. Conclusion. In post-COVID-19 patients, there are signs of capillary blood flow reduction in retinal SCP and RPC, which is proportional to the prior infection severity degree. Associated to COVID-19 microangiopathy is a significant ophthalmologic sign of the new coronavirus infection. Microvascular changes of the retina could play a role of of a new biomarker reflecting the severity degree of the entire vascular system impairment in COVID-19.

Associations of SNP rs_7927894 of FLG gene and TARC/CCL17 with atopic dermatitis in children

One of the main genetic factors of the development of atopic dermatitis (AD) in children are single nucleotide polymorphisms (SNP) of the filagrin gene (FLG), particularly rs_7927894 FLG. One of the mostly studied and promising AD marker chemokines (CK) is the thymusE and activation regulated chemokine (TARC/CCL17). Purpose – to detect the associations and role of different variants of SNP rs_7927894 FLG gene and TARC/CCL17 in children suffering different AD clinical proE files (CP) – isolated or combined with comorbid atopic disorders (AtD). Materials and methods. The main group comprised 39 patients aged 3 to 18 years, suffering the isolated AD or combined with comorbid AtD. The control group comprised 47 patients aged 3 to 18 years, suffering the pathology of gastrointestinal tract without clinical signs of atopy. All the patients of the main and control groups had undergone detection of the genotype variants of SNP rs_7927894 FLG gene by real-time polymerase chain reaction and detection of TARC/CCL17 serum concentrations in venous blood. The cutEoff value of statistical significance was set as p<0.05. Results. The incidence and association of genotype variants C/C, C/T and T/T SNP rs_7927894 FLG gene in patients of cohorts of the studied groups were detected as follows: C/T rs_7927894 FLG was significantly the most common in the general main group (56.4%, p<0.05), within the cohort of CP AD isolated (61.1%, p<0.05) and CP of AD combined with comorbid AtD (52.4%, p<0.05). There were detected the associations of studied SNP with AD: C/T rs_7927894 FLG is significantly directly associated with AD (r=0.291, p<0.05), C/C rs_7927894 FLG has a reverse association with a trend to significance (r=-0.194, p=0.07). Mean serum concentrations of TARC/CCL17 did not differ significantly among patients cohorts of the main and control groups, respectively: general main group — 615.8 pg/ml, main with a CP AD isolated — 651.3 pg/ml, main with a CP of AD combined with comorbid AtD — 585.4 pg/ml, control — 608.4 pg/ml (p>0.05). Associations of serum TARC/CCL17 concentrations were determined as follows: elevation trending to significance within increasing AD severity degree (r=0.290, p=0.07) and significant elevation within the AD exhacerbation period (r=0.426, p<0.05). No significant association of TARC/CCL17 as to AD patients compared to the control group was detected in our study (r=-0.027, p>0.05). Conclusions. The genotype heterozygote variant C/T rs_7927894 FLG is significantly the most common and associated with all AD CP in children — isolated and combined with comorbid AtD. Variant C/C rs_7927894 of FLG gene is significantly reversely associated with AD in children. Serum concentrations of TARC/CCL17 did not reveal any significant differences between the AD patients and nonEatopic ones. However, they significantly elevate within AD exacerbation phase and trending to significance within AD severity degree increase in children. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: atopic dermatitis, children, associations, polymorphism, filaggrin, thymus- and activation regulated chemokine.

Quantitative chest CT combined with plasma cytokines predict outcomes in COVID-19 patients

Despite extraordinary international efforts to dampen the spread and understand the mechanisms behind SARS-CoV-2 infections, accessible predictive biomarkers directly applicable in the clinic are yet to be discovered. Recent studies have revealed that diverse types of assays bear limited predictive power for COVID-19 outcomes. Here, we harness the predictive power of chest CT in combination with plasma cytokines using a machine learning approach for predicting death during hospitalization and maximum severity degree in COVID-19 patients. Patients (n=152) from the Mount Sinai Health System in New York with plasma cytokine assessment and a chest CT within 5 days from admission were included. Demographics, clinical, and laboratory variables, including plasma cytokines (IL-6, IL-8, and TNF-α) were collected from the electronic medical record. We found that chest CT combined with plasma cytokines were good predictors of death (AUC 0.78) and maximum severity (AUC 0.82), whereas CT quantitative was better at predicting severity (AUC 0.81 vs 0.70) while cytokine measurements better predicted death (AUC 0.70 vs 0.66). Finally, we provide a simple scoring system using plasma IL-6, IL-8, TNF-α, GGO to aerated lung ratio and age as novel metrics that may be used to monitor patients upon hospitalization and help physicians make critical decisions and considerations for patients at high risk of death for COVID-19.

An Integrated Disease Management of Oil Palms Affected by Bud Rot Results in Shorter Recovery Times

Bud rot is a limiting disease that affects most oil palm crops destroying thousands of hectares in Latin America. Bud rot (BR) is caused by the oomycete Phytophthora palmivora (Butler). Integrated disease management (IDM) technology has been used to control the disease, which slows down the progress of the disease, allowing palm recovery. However, the effect of this technology on the recovery speed of treated palms is not well known. We studied the time taken for palm recovery from BR under the integrated management approach. The study was carried out on 21 oil palm commercial cultivars dura × pisifera (D × P) and O × G hybrids affected by BR in the Colombian oil palm Central Zone. The analysis included different recovery times (RT), the severity degree, time of the year (wet or dry season), number of reinfections, and cultivar. The RT of bud rot-affected palms ranges from 103 to 315 days, with an average of 202.8 days when an IDM is used. RT was lower than that reported in the diseased palms without IDM (540 days). According to the severity degree, the RT lasted 202 days for severity degree 1, 198 days for severity degree 2, and 222 with severity degree 3 and 4. In comparison, there was no significant difference between dry and rainy seasons in RT. Differences between cultivars were found; however, under IDM, all cultivars showed low RT. The IDM has a positive impact in reducing the RT to BR. Low RT has indirect effects minimizing potential yield losses, improving the number of successfully recovered palms, and reducing the risk of disease dissemination.

The Commonest Negative Behavioral Manifestations among Kindergarten Children in the Post-Terrorist Phase

Behavioral and emotional disorders represent one of the commonest problems facing children in particular and disturbing their parents and educators in general. This is because Iraqi people have long been living in difficult conditions and faced various terrorists’ operations, such as killing, destruction, robbery, and looting. Such operations are said to be one of the reasons that leads to the development of such disorders, and may negatively affect the psyche of the child and be reflected on his behavior as represented by playing with the IPad for hours, and suffering from nightmares. Accordingly, the current research aims to examine specifically the commonest negative behavioral disorders among kindergarten children during the post-terrorist phase. To achieve this objective, the researchers prepared a tool for measuring the commonest behavioral manifestations among kindergarten children, and distributed it to a sample of (160) children’s female teachers and mothers; each using a multi-stage method. Results have shown that the computed value of (t-test) reached (17.793) for female teachers’ estimations and (6,653) for mother's estimations. That is, the computed value is greater than the tabulated, (1.96), at the level of significance (0.05) and degree of freedom (159.( The highest degree of severity belongs to the behavioral aspect of playing with the iPad for long hours according to the teachers’ estimates. It has scored (3.843) with a weight percentage that is equal to (96.075). However, the same behavioral aspect has a severity degree that is equal to (3.59) with a weight percentage reaches (89.825) from the parent’s perspectives. As for the second manifestation, thinking of the death of a family member, its severity has scored (3.593) with a weight percentage of (89.82) according to the parents’ estimates, whereas the severity degree of the behavioral manifestation, suffering from disturbing dreams and nightmares, is (3.55) with a weight percentage....

Correlation between cholesterol levels and the severity of Parkinson disease

Background: Parkinson disease is the second most common neurodegenerative disease after dementia Alzheimer. In neurodegenerative disease such as PD, there is a disturbance of cholesterol metabolism in the brain that could affect plasma cholesterol level. Laboratory test of cholesterol level could be used as an alternative parameter in assessing the severity degree of PD. Our objectives in this study are to analyze the correlation between cholesterol level and the severity of PD. Methods: This study is a cross sectional study. The sample is collected from patients with PD that came too neurology clinic in Prof Dr. R. D. Kandou Manado Hospital. Patients will then be assessed whether they meet the inclusion criteria which is examined using unified Parkinson disease rating scale (UPDRS) questionnaire and Hoehn and Yahr (H and Y). If the inclusion criteria are met, subject will be tested for total cholesterol, high density lipoprotein (HDL), and low density lipoprotein (LDL) levels in plasma.Results: There are 60 subjects of PD patients with mean age 64.37±8.26 years old. Male subjects were more dominant (53.3%) than female. Total cholesterol level and LDL have moderate negative correlation with UPDRS I, UPDRS II, UPDRS III, and UPDRS total score. Total cholesterol and LDL level also has moderate negative correlation with H and Y severity.Conclusions: There is a moderate negative correlation between total cholesterol level and LDL with PD severity degree based on H&Y degree and UPDRS I, II, III, and UPDRS total score.

Data-Driven Mathematical Modeling and Dynamical Analysis for SARS-CoV-2 Coinfection with Bacteria

The ongoing coronavirus disease-2019 (COVID-19) pandemic caused by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) has serious influences on human health and economy. The available clinical data suggest that patients infected by SARS-CoV-2 have the possibility of simultaneous infection of bacteria. In this study, we present a data-driven mathematical model for coinfection of SARS-CoV-2 and bacteria to investigate the dynamics of COVID-19 progress. Specifically, based on the statistical analysis of different clinical data from China and some other countries, a system model with ordinary differential equations (ODEs) in four variables, i.e. SARS-CoV-2, bacteria, neutrophils and lymphocytes, is established. We further validate our model through theoretical analysis and fitting of different clinical data. Moreover, through numerical simulations and bifurcation analysis, we find that bacterial infection and immune-related parameters in certain ranges lead to the system transitions among three steady states, i.e. mild, severe and death. We also analyzed the influence of the time it takes for patients to switch from a high-risk area to a low-risk area on the recovery time. These results reveal that the coinfection of viruses and bacteria can explain the changes in neutrophils and lymphocytes, and that initial bacterial infection and immune-related parameters have great influences on the severity degree and mortality in COVID-19 patients. Together, our model and quantitative analysis suggest that preventing bacterial infection and enhancing immune ability during the early phase of infections could be a potential treatment option for high-risk COVID-19 patients.

Relationships between morphological indicators of the tibia and soft tissues lesions and some biochemical blood indicators in patients with traumatic osteomyelitis

Aim. Research aim was to find statistical differences of biochemical indicators of blood and morphometric indicators of crural tissue lesion and relationships between them in patients with traumatic osteomyelitis of the tibia with trophic disturbances in extremity. Material and methods. The work material includes data from 28 patients with traumatic osteomyelitis which was combined with trophic tissue disturbances of different manifestation degree. The levels of procalcitonin, lactate dehydrogenase and acetylcholinesterase of blood serum were estimated. In crural tissues quantitative biochemical, gradual morphometric indicators, frequencies of occurrence of different manifestation degree cases and relationships “clinic – biochemistry – pathomorphology” were defined histologically. Results. Average values of procalcitonin, lactate dehydrogenase and acetylcholinesterase in patients with traumatic osteomyelitis of the tibia, combined with trophic disturbances in crural tissues, are significantly higher, than average values of these indicators in intact donors. In the majority of the patients with chronic traumatic osteomyelitis in crural tissues pathological changes were found out, which by clinical estimations are considered as trophic disturbances. They represent a combination of discirculatory, ischemic-necro­tic, exsudative, productive-inflammatory, and also reparative processes which in total create a composite picture of complex lesion and can persist for many years. As closest relations, according to values of association coefficient, concerning certain biochemical indicators, can be noted such clinical indicators: “degree of bone fragments non-consolidation” and “severity of trophic disturbances in bone tissue (by clinical estimation)”, concerning defined morphometric indicators – such biochemical indicators: “level of procalcitonin” and “level of lactate dehydrogenase” in blood serum. Among morphometric lesion indicators the closest relations concerning biochemical indicators were revealed: in bones – “the form of the pathological focus of traumatic osteomyelitis” and “presence of sequesters”, in soft tissues – “exsudative inflammation in internal membrane of a focus capsule”. Conclusions. In chronic traumatic osteomyelitis combined with trophic disturbances of crural tissues, there are relationships between some clinical, biochemical and morphological indicators of the extremity tissues condition. A deviation of metabolism indicators from norm can serve as biochemical markers in definition of severity degree and efficiency of treatment in patients.

Conservative treatment of the longitudinal flatfeet in children

Introduction. A significant percentage of the musculoskeletal system pathology in children is currently fall on the foot pathology – longitudinal flatfeet, which is not only a medical, but also a social problem. The incidence of this pathology is up to 58% of the total orthopedic foot pathology. Traditional methods of treatment and prevention of mild (I– II severity) longitudinal flatfeet (LF), which are known today (massage, physiotherapy exercises, the use of orthopedic devices, electromyostimulation) do not give a significant effect and a stable, long-term result. This makes us look for more effective methods of conservative treatment of LF of the I– II severity degree, which have a pathogenic orientation and physiological effect. Purpose of the work: to develop the most effective algorithm for the complex conservative treatment of LF, depending on the severity, hemodynamic disorders, deformity options, foot rigidity. Materials and methods. Conservative treatment was carried out in 62 patients aged 10– 18 years with LF of the I– II severity degree. Depending on the clinical manifestations and examination results, the treatment was carried out in two stages. At the first stage, serial casting was used (in the presence of concomitant deformations – silicone pelottes were used). Results. The results of the two-stage conservative treatment of LF demonstrate the effectiveness of serial casting in combination with the use of silicone pelottes and biostimulators in comparison with traditional methods of foot correction. Conclusions. Algorithms for conservative treatment of LF were developed, depending on the severity, nature of the deformity, hemodynamic disorders and muscle tone of the lower leg and foot.