Diagnosis of COVID-19 in symptomatic patients: An updated review

A group of pneumonia patients was detected in Hubei Province, in China in December 2019. The etiology of the disease was unknown. Later, the researchers diagnosed the novel Coronavirus as the causal agent of this respiratory disease. On February 12th 2020, the World Health Organization (WHO) officially named this disease Coronavirus disease 2019 (COVID-19). Consequently, the disease spread globally and became a pandemic. As there is no specific treatment for the symptomatic patients and several vaccines are approved by WHO, the efficacy and effectiveness of these vaccines are not fully understood yet and the availability of these vaccines are very limited. In addition, new variants and mutants of SARS-CoV-2 are thought to be able to evade the immune system of the host. So, diagnosis and isolation of infected individuals is advised. Currently, real-time reverse transcription-polymerase chain reaction (RT-PCR) is considered the gold standard method to detect novel Coronavirus, however, there are few limitations associated with RT-PCR such as false-negative results. This demanded another diagnostic tool to detect and isolate COVID-19 early and accurately. Chest computed tomography (CT) became another option to diagnose COVID-19 patients accurately (about 98% sensitivity). However, it did not apply to the asymptomatic carriers and sometimes the results were misinterpreted as from other groups of Coronavirus infection. The combination of RT-PCR and chest CT might be the best option in detecting novel Coronavirus infection early and accurately thereby allowing adaptation of measures for the prevention and control of the COVID-19.

Diagnosis of COVID-19 in symptomatic patients: An updated review

A group of pneumonia patients was detected in Hubei Province, in China in December 2019. The etiology of the disease was unknown. Later, the researchers diagnosed the novel Coronavirus as the causal agent of this respiratory disease. On February 12th 2020, the World Health Organization (WHO) officially named this disease Coronavirus disease 2019 (COVID-19). Consequently, the disease spread globally and became a pandemic. As there is no specific treatment for the symptomatic patients and several vaccines are approved by WHO, the efficacy and effectiveness of these vaccines are not fully understood yet and the availability of these vaccines are very limited. In addition, new variants and mutants of SARS-CoV-2 are thought to be able to evade the immune system of the host. So, diagnosis and isolation of infected individuals is advised. Currently, real-time reverse transcription-polymerase chain reaction (RT-PCR) is considered the gold standard method to detect novel Coronavirus, however, there are few limitations associated with RT-PCR such as false-negative results. This demanded another diagnostic tool to detect and isolate COVID-19 early and accurately. Chest computed tomography (CT) became another option to diagnose COVID-19 patients accurately (about 98% sensitivity). However, it did not apply to the asymptomatic carriers and sometimes the results were misinterpreted as from other groups of Coronavirus infection. The combination of RT-PCR and chest CT might be the best option in detecting novel Coronavirus infection early and accurately thereby allowing adaptation of measures for the prevention and control of the COVID-19.

Cylindrospermopsin impairs tubular transport function in kidney cells LLC-PK1

Cylindrospermopsin (CYN) has been involved in cases of poisoning in humans following ingestion. Studies have demonstrated that the kidney is the most affected organ. CYN exposure leads to low-molecular-weight proteinuria and increased excretions of the tubular enzymes in mice, suggesting the damage caused by CYN is mainly tubular. However, the mechanism involved in CYN nephrotoxicity remains unknown. Thus, in order to evaluate the effects of CYN exposure (0.1, 0.5 and 1.0 μg/mL) on tubular renal cells LLC-PK1 distinct mechanisms were analyzed by assessing cell death using flow cytometry, albumin uptake by fluorescence analysis, Na⁺/K⁺-ATPase activity by a colorimetric method, RT-qPCR of genes related to tubular transport and function as well as internalization of CYN by ELISA. In this study, CYN was found to induce necrosis in all concentrations. CYN also decreased albumin uptake as well as downregulated megalin and dab2 expression, both proteins involved in albumin endocytosis process. Moreover, CYN appears to be internalized by renal tubular cells through a receptor-mediated endocytosis. Finally, the present study demonstrates that CYN is responsible for disrupting tubular cell transport and function in LLC-PK1 cells.

Efficacy of Thermostable Newcastle Disease Virus Strain I-2 in Broiler Chickens Challenged with Highly Virulent Newcastle Virus

Newcastle disease (ND) is a major threat to poultry industry production throughout developing countries. The Newcastle disease viruses (NDVs) infecting industrialized and indigenous poultry in Iran are velogenic strains and responsible for the frequent outbreaks of ND in poultry farms even in vaccinated flocks causing serious economic losses in the commercial and indigenous poultry. However, vaccination is the only way to protect against endemic ND, and the conventional vaccines are not heat stable and consequently require complex cold-chains to be transferred to users leading to not much resistance. The present study aimed to evaluate the efficacy of thermostable NDV strain I-2 in broiler chickens vaccinated via drinking water and coated on oiled wheat grain. The horizontal transmission of I-2 strain and transmission of disease from vaccinated to unvaccinated chickens were also evaluated in this study. The obtained results showed that both routes of administration, following primary and/or secondary dose, provoked the production of necessary antibody titer and adequate protective immunity in broiler chickens. Moreover, the horizontal transmission of I-2 strain from vaccinated to unvaccinated chickens housed together induced an antibody response and protected unvaccinated chickens against a local field isolate of a virulent strain of NDV (The intravenous pathogenicity index 2.46, mean death time 59 h). Nevertheless, all unvaccinated and Newcastle challenged broilers chickens against the NDV died in this study. It is noteworthy that the transmission of the virus from challenged broiler chickens was very low to induce clinical signs in susceptible chickens. The obtained results of this study revealed the efficacy of NDV strain I-2 coated on the oiled wheat and via drinking water as it protects broiler chickens from highly virulent NDV.

Pathogenesis of H9N2 virus in Chukar partridges

Low-pathogenic avian influenza virus (H9N2) is circulating in the poultry industry of many countries in the Middle East and Asia, causing serious economic damage. In this study the clinical signs, antibody response, viral shedding and efficacy of oil emulsion vaccines in Chukar partridges were investigated until 9 days post inoculation (d.p.i.). Seventy-five Chukar partridges (Alectoris chukar) were divided randomly in three groups of challenged (Group C), vaccinated and challenged (Group VC) and control (non-vaccinated and non-challenged [Group NC]), 25 birds/group. Groups C and VC were inoculated with 0.4 ml allantoic fluid containing 10(7) median embryo infective dose/bird of A/Chicken/Iran/772/1998(H9N2) avian influenza virus. Clinical signs, antibody response, viral shedding and vaccine efficacy were evaluated and compared among these groups over 9 days. Clinical signs such as coughing and sneezing with depression and decreased feed and water consumption were observed in Group C. In Group VC only a slight decrease in food and water consumption was observed. Both Groups C and VC showed maximum antibody titre at 9 d.p.i. At 1 d.p.i. the virus was detected from all tissues in challenged group, but the virus was not detected from the spleen and caecal tonsil of Group VC. Group C showed the longest period of viral shedding in the trachea and kidney.

Administration of heparanase-III improves the survival and angiogenesis of rat skin autografts

AIM

Heparanase, a glycohydrolase enzyme, cleaves heparan sulfate in the tissue matrix. Heparan sulfate degradation causes the release of angiogenic and growth factors, leading to angiogenesis. The aim of this paper was to evaluate the angiogenic effect of heparinase-III administration on skin autograft healing in rat.

METHODS

Four groups of 14 adult male Charles River rats were enrolled. Full thickness skin autografts (15 mm in diameter) were made on the interscapular region of each rat. After 24 hours, 0.1 cc of heparanase, at the three concentrations of 0.1, 0.2, and 0.4 units, were injected intradermally into the grafts of each of the three case groups. The control group received an equal volume of the vehicle (buffered phosphate solution). After 5 days, biopsy specimens from skin grafts of 5 randomly selected rats of each group were submitted for histological studies.

RESULTS

The concentration of vessels (with 5-50 mm in diameter) in the grafts of the groups receiving 0.2 and 0.4 units of heparanase-III was significantly more than that of the control group (100.43+/-11.24 and 95.85+/-12.44 vs 71.42+/-5.22 vessels/mm(2), P<0.05). The graft survival time of the group that received 0.2 U heparanase-III was significantly longer than that of the control group (15.43+/-0.72 vs 13.23+/-0.69 days; P<0.05).

CONCLUSIONS

Heparanase-III administration improves the healing of rat skin autografts through induction of angiogenesis.

Role of gonadotropin-releasing hormone (GnRH) in the regulation of gonadal differentiation in the gilthead seabream (Sparus aurata)

It has been proposed that gonadotropin-releasing hormone (GnRH) plays an autocrine/paracrine regulatory role in mammalian and fish ovaries. The marine teleost gilthead seabream is an interesting model since, during the life span of the fish, gonadal tissues develop first as testes, which then regress allowing the development of ovarian follicles. Recent studies carried out in ovaries of the gilthead seabream have demonstrated that various GnRH transcripts as well as GnRH splicing variants are expressed. The mRNA level of several GnRH forms in the female and male areas of the switching gonad, and their possible role in this process, were further investigated. The results here reported show that sGnRH, cGnRH-II, and sbGnRH transcripts are locally expressed during gilthead seabream gonadal differentiation; the expression of the three GnRH forms was found to differ among the morphologically defined areas of the switching gonad, as demonstrated by applying reverse transcription-polymerase chain reaction (RT-PCR), together with in situ hybridization, and semiquantitative PCR analyses. Moreover, the hypothesis that GnRH forms may regulate testicular regression via an apoptotic mechanism was investigated by analyzing the different areas of switching gonads for caspase-3 activity as a measure of apoptosis. Our results showed a marked increase of caspase-3 activity in the area corresponding to the regressing testes in which a significant decrease of testosterone production was also found. The present findings demonstrate that the changes in the endogenous GnRH transcripts could be related with the gonadal differentiation in gilthead seabream, and that exogenous GnRH plays a role by stimulating apoptosis in the degenerating testis.

A gonadotropin-releasing hormone insensitive, thapsigargin-sensitive Ca2+ store reduces basal gonadotropin exocytosis and gene expression: comparison with agonist-sensitive Ca2+ stores

We examined whether distinct Ca2+ stores differentially control basal and gonadotropin (GTH-II)-releasing hormone (GnRH)-evoked GTH-II release, long-term GTH-II secretion and contents, and GTH-II-beta mRNA expression in goldfish. Thapsigargin (Tg)-sensitive Ca2+ stores mediated neither caffeine-evoked GTH-II release, nor salmon (s)GnRH- and chicken (c)GnRH-II-stimulated secretion; the latter responses were previously shown to involve ryanodine (Ry)-sensitive Ca2+ stores. Surprisingly, Tg decreased basal GTH-II release. This response was attenuated by prior exposure to sGnRH and caffeine, but was insensitive to the phosphatase inhibitor okadaic acid, the inhibitor of constitutive release brefeldin A and cGnRH-II. GTH-II-beta mRNA expression was decreased at 24 h by 2 microm Tg, and by inhibiting (10 microm Ry) and stimulating (1 nm Ry) Ry receptors. Transient increases in GTH-II-beta mRNA were observed at 2 h and 12 h following 10 microm and 1 nm Ry treatment, respectively. Effects of Tg, Ry and GnRH on long-term GTH-II secretion, contents and apparent production differed from one another, and these changes were not well correlated with changes in GTH-II-beta mRNA expression. Our data show that GTH-II secretion, storage and transcription can be independently controlled by distinct Ca2+ stores.

Effect of amlodipine, atenolol and their combination on myocardial ischemia during treadmill exercise and ambulatory monitoring. Canadian Amlodipine/Atenolol in Silent Ischemia Study (CASIS) Investigators

OBJECTIVES

This study compared the effects of amlodipine, atenolol and their combination on ischemia during treadmill testing and 48-h ambulatory monitoring.

BACKGROUND

It is not known whether anti-ischemic drugs exert similar effects on ischemia during ambulatory monitoring and exercise treadmill testing.

METHODS

Patients with stable coronary artery disease and ischemia during treadmill testing and ambulatory monitoring were randomized to receive amlodipine (n = 51) or atenolol (n = 49). Each group underwent a counterbalanced, crossover evaluation of single drug and placebo, followed by evaluation of the combination.

RESULTS

Amlodipine and the combination prolonged exercise time to 0.1-mV ST segment depression by 29% and 34%, respectively (p < 0.001) versus 3% for atenolol (p = NS). During ambulatory monitoring, the frequency of ischemic episodes decreased by 28% with amlodipine (p = 0.083 [NS]), by 57% with atenolol (p < 0.001) and by 72% with the combination (p < 0.05 vs. both single drugs; p < 0.001 vs. placebo). Suppression of ischemia during exercise testing and ambulatory monitoring was similar in patients with and without exercise-induced angina. Exercise time to angina improved by 29% with amlodipine (p < 0.01), by 16% with atenolol (p < 0.05) and by 39% with the combination (p < 0.005 vs. placebo, atenolol and amlodipine). In patients with angina, total exercise time improved by 16% with amlodipine (p < 0.001), by 4% with atenolol (p = NS) and by 19% with the combination (p < 0.05 vs. placebo and either single drug). In those patients without angina, no therapy significantly improved total exercise time.

CONCLUSIONS

Ischemia during treadmill testing was more effectively suppressed by amlodipine, whereas ischemia during ambulatory monitoring was more effectively suppressed by atenolol. The combination was more effective than either single drug in both settings.

[Norplant contraception at the Rabta Tunis maternity hospital]

612 women had the benefit of contraceptive implants in the Maternity Hospital of La Rabta in Tunis over a period of 5 years (1988-1992). This study aimed at analysing the tolerance of this method by studying a group of 508 normal women and 104 women at risk (58 women were heart-diseased, 22 nursing, 13 diabetic, 11 hypertensive). The typical woman in this group is thirty years old, having 3 children, and weighing 61 kg. The implants were most of the cases withdrawn because of problems related to the menstrual cycle that were observed in 37% of the cases, equally distributed among both groups of the series. Contraceptive implants failed in 1.79% of the cases.

Relative importance of psychologic traits and severity of ischemia in causing angina during treadmill exercise. Canadian Amlodipine/Atenolol in Silent Ischemia Study (CASIS) Investigators

OBJECTIVES

This study was conducted to compare the influence of psychologic traits versus ischemia severity on the occurrence of angina during treadmill exercise.

BACKGROUND

Some studies suggest that angina is associated with certain psychologic traits, whereas others show an association with more severe ischemia. The relative influence of these two factors and the extent to which they interact are not known.

METHODS

Off-drug treadmill exercise testing and a battery of psychologic tests were performed on 122 patients with known coronary artery disease. Psychologic tests measured sensitivity to physical symptoms, denial and deception, type A behavior, anger, hostility, depression, marital adjustment and amount of external stress. Stepwise logistic regression was used to determine the independent association of psychologic traits, ischemic threshold and exercise tolerance with the occurrence of angina.

RESULTS

Angina during treadmill exercise was reported by 66 of 122 patients. On univariate testing, angina was positively associated with sensitivity to physical symptoms (p < 0.001), type A behavior (p = 0.021) and depression (p = 0.032) and was negatively associated with exercise tolerance (p < 0.001) and work load threshold for ischemia (p < 0.01). Multivariate analysis revealed independent and additive associations of angina with sensitivity to physical symptoms (p = 0.003), exercise capacity (p = 0.003) and work load threshold for ischemia (p = 0.018). Once these were included in a logistic model, depression and type A behavior were no longer significant. Other psychologic traits showed no association with angina.

CONCLUSIONS

Sensitivity to physical symptoms, ischemic threshold and exercise tolerance are independently associated with angina, with sensitivity to physical symptoms having the stronger influence. The physiologic and psychologic mechanisms underlying symptom perception have an influence on angina that is independent of and additive to the severity of underlying ischemia.

The effect of low-dose cyclophosphamide and immunologic exposure upon growth of established Dunning R-3327-G subline rat prostate adenocarcinomas

Utilizing the Dunning rat prostate adenocarcinoma, a low dose of cyclophosphamide (CY), 30 mg/kg, administered either alone or following diethylstilbestrol (DES) therapy, was as effective as higher levels of CY (100 mg/kg) in ability to initiate tumor regression. A lower dose (10 mg/kg) of CY was initially ineffective. Animals which had been injected with tumor an additional 10 days prior to initiation of CY treatment were apparently more responsive to this mode of chemotherapy. The effect of this additional 10 days of immunologic exposure supports the belief that the activity of CY is augmented by the presence of immunologic competence. All animals which responded favorably toward therapy utilizing CY, alone or in combination with DES, were similarly able to reject subsequent tumor challenges. It is thought that low-dose CY may reduce the immunosuppressive effects observed with higher levels and presumably preserve the helper T cell population necessary to mount secondary immune responses.

Pelvic lymph node dissection in prostate cancer

The results of pelvic lymph node dissections in 105 prostate cancer patients were analyzed to compare the clinical with the pathologic stages. Twenty-four per cent of patients clinically believed to be node-negative had positive nodal involvement with cancer.

Case report of an ovarian hydatid cyst

Hydatid cyst is a parasitic disease caused by Taenia echinococcus. The first and most important site for this parasite is the liver. Secondary involvement of the pelvic organs is seen. However, the primary involvement is very rare. Here we are reporting a case with primary involvement of the ovary which underwent laparotomy and was proven by microscopic studies.