Timing of corticosteroids in non-severe non-hospitalized COVID-19 patients: open-label, two-center, randomized controlled study (TICS-COV19 study)

Background/Aims@#Corticosteroids (CSs) are frequently used in coronavirus disease 2019 (COVID-19); however, their utility remains controversial in mild to moderate cases. The timing of CSs initiation during the disease course remains unaddressed. The study aims to evaluate the impact of early CSs in non-severe COVID-19. @*Methods@#A randomized controlled, open-label study was conducted on 754 COVID-19 patients randomized into a study group (n = 377) in which patients received CSs with COVID-19 protocol and a control group (n = 377) in which patients received COVID-19 protocol only. @*Results@#Both groups were comparable regarding baseline characteristics, presenting symptoms, and inflammatory markers. The composite endpoint (need for O2, need for hospitalization or 28-day mortality) was significantly (p = 0.004) lower in the CS group 42 (11.14%) versus the control group 70 (18.67%) with odds ratio 0.55 (95% confidence interval [CI], 0.36 to 0.83), absolute risk reduction 7.53% (95% CI, 2.46% to 12.59%) and number needed to treat of 13.29 (95% CI, 7.94 to 40.61). Regarding severity at day 10, only (11.1%) of the study group patients were severe versus (18.7%) of the control group patients (p < 0.001). The median time-to-return to daily activity in the CS group was 8.0 days, while in the control group, it was 22.0 days (p < 0.001). @*Conclusions@#In non-severe COVID-19, CS may decrease hospitalization, severity, and mortality.

Facile synthesis of insulin fusion derivatives through sortase A ligation

Insulin derivatives such as insulin detemir and insulin degludec are U.S. Food and Drug Administration (FDA)-approved long-acting insulin currently used by millions of people with diabetes. These derivatives are modified in C-terminal B29 lysine to retain insulin bioactivity. New and efficient methods for facile synthesis of insulin derivatives may lead to new discovery of therapeutic insulin. Herein, we report a new method using sortase A (SrtA)-mediated ligation for the synthesis of insulin derivatives with high efficiency and functional group tolerance in the C-terminal B chain. This new insulin molecule (Ins-SA) with an SrtA-recognizing motif can be conjugated to diverse groups with N-terminal oligoglycines to generate new insulin derivatives. We further demonstrated that a new insulin derivative synthesized by this SrtA-mediated ligation shows strong cellular and

Metabolomics strategies to discover new biomarkers associated to severe allergic phenotypes

In the last decades have emerged new technological platforms that allow evaluation of genes, transcripts, proteins, or metabolites of a living being, so-called omics sciences. More importantly, new technics for their integration have provided access to a complete set of information of the current conditions and features of a specific biological sample in a precise moment. Thus, omic sciences are now considered an essential tool for patient stratification in base to their severity, to understand disease progression and to identify new biomarkers. Severe patients, that are out of control, provide an excellent model to understand disease evolution and to identify new intervention and biomarkers strategies. Here we discuss the use of metabolomics to understand severity in allergic diseases in a strategy that opens new insights as well as identify new biological systems relevant for allergy progression. Metabolomics strategies are based in parallel evaluation of different allergy severity models by mean of untargeted analysis that allows the identification of potential biomarkers. Overlapping of different biomarkers in multiple models, provides information of general as well as specific biological systems involved in each model. Later a selected panel of biomarkers will be used in a target method to explore the diagnosis potential to stratify allergic patients.

Effectiveness of L-asparaginase-based regimens compared to anthracycline-based regimens in newly diagnosed extranodal NK/T-cell lymphoma, nasal type: a single Mexican center experience

BACKGROUND: Extranodal NK/T-cell lymphoma, nasal type (ENKTCL) has a high prevalence in Asia and Latin American countries, such as Mexico, where it encompasses 40% of all T-cell non-Hodgkin lymphomas. Historically, responses to anthracycline-based therapies have been disappointing. Since data about the effectiveness of L-asparaginase-based regimens in Mexico are limited, we compared both therapies in our center. METHODS: We performed a retrospective cohort of patients with newly diagnosed ENKTCL, who were divided into two groups for treatment and analysis (group 1: L-asparaginase-based regimen and group 2: anthracycline-based regimen) between 2001 and 2016. RESULTS: Of 36 patients with newly-diagnosed ENKTCL, 33 received at least one cycle of chemotherapy (22 in group 1 and 11 in group 2). Over a median follow-up interval of 17 months (range, 0–167), a complete response (CR) was observed in 45.5% of patients in group 1, compared to 27% of group 2 (P=0.45). Progression was more frequently observed in group 2 than in group 1 (54.5% vs. 18.4%, P=0.04). The median overall survival (OS) was 44 months in group 1, compared to 5 months in group 2 (P=0.012). The multivariate analysis showed that failure to achieve a CR after first-line therapy was the only significant factor for OS (HR, 3.04; 95% CI, 1.4–6.5; P=0.005). CONCLUSION: L-asparaginase-based regimens for patients with newly-diagnosed ENKTCL confer a survival advantage over anthracycline-based regimens.

Single and co-breeding of different mosquito species in fogging-free and dengue risk areas in West Malaysia

@#Ovitrap surveillance was carried out in fifteen localities encompassing foggingfree and dengue risk areas in West Malaysia to determine on the dispersal and prevalence of single and co-breeding of mosquito larvae particularly Aedes. Ovitraps were sited randomly indoors and outdoors within human settlements in all study areas. All the localities exhibited positive ovitraps with single breeding of Ae. albopictus that ranged between 64.29% and 100.00%. These findings indicated Ae. albopictus as the predominant container-breeding species in all study areas. The co-breeding of Ae. aegypti with Ae. albopictus larvae (34 ovitraps), Ae. albopictus with Culex quinquefasciatus larvae (32 ovitraps) as well as Cx. quinquefasciatus with Armigeres subalbatus larvae (1 ovitrap) were also detected in certain study localities. Interestingly, co-breeding of Ae. albopictus with Ar. subalbatus larvae as well as Ae. albopictus with Uranotaenia sp. larvae in Malaysia is reported for the first time in the present study. Better understanding of the co-breeding scenario involving different species of mosquito larvae is needed to ensure the efficacy of vector control actions to be conducted.

Pattern of ocular trauma in Benghazi eye hospital, Benghazi, Libya

Background: This study was conducted to determine the pattern of ocular trauma in Benghazi- Libya Methods: All cases of ocular trauma admitted to Benghazi eye hospital from January 2011 to August 2012 were retrospectively reviewed for open- or closed-globe injury (OGI or CGI). Data extracted included age, sex, residence, initial and final visual acuity (VA), cause and treatment of injury. The injuries were classified by Ocular Trauma Classification System.Results: Out of the 805 patients, there were 540 patients (67.0%) with Closed Globe Injury and 254 patients (31.5%) with Open Globe Injury and 11 patients (1.3%) with mixed trauma. Conclusion: This analysis shows a pattern of eye injury largely similar to reports from other parts of the world. Eye injury affected mainly younger age groups and road traffic accidents were the most common cause

Community-acquired bacteremia in Paediatrics: Epidemiology, aetiology and patterns of antimicrobial resistance in a tertiary care centre, Malaysia

bacteremia continues to be one of the major causes of morbidity and mortality despite the existence of numerous antimicrobial agents. this study aimed to provide a Malaysian perspective on paediatric community-acquired bacteraemia based on the documentation of epidemiology and antimicrobial profile of the isolated pathogens.

Prevalence and antimicrobial resistance pattern of bacterial strains isolated from patients with urinary tract infection in Messalata Central Hospital, Libya

OBJECTIVES@#To investigate the prevalence of urinary tract infection among patients at Messalata Central Hospital, Libya, to identify the causative bacteria, and to explore their resistance pattern to antimicrobials.@*METHODS@#A total number of 1153 urine samples were collected from patients, who attended daily to Messalata Central Hospital, Libya, in a study extended for one year. Antimicrobial susceptibility testing and isolates typing were done using Phoenix BD (BD diagnostic). Resistance was confirmed manually using agar disk diffusion method.@*RESULTS@#Of the 1153 urine samples tested, 160 (13.9%) samples were positive, from which 17 different, solely Gram negative, uropathogens were identified. Escherichia coli were the most prevalent (55.6%) bacteria, followed by Klebsiella pneumoniae subspecies pneumoniae (16.3%), Proteus mirabilis (6.3%), Pseudomonas aeruginosa (5.6%), Enterobacter cloacae and Klebsiella oxytoca (2.5%, each), Citrobacter koseri and Providencia rettgeri (1.9%, each), Acinetobacter baumannii, Enterobacter aerogenes and Proteus vulgaris (1.3%, each), and Aeromonas caviae, Citrobacter freundii, Cronobacter sakazakii, Enterobacter amnigenus biogroup 2, Pseudomonas putida and Serratia marcescens (0.6%, each). The isolated uropathogens showed increased levels of resistance ranged from 10.5% to 64.5%, with an overall resistance of 28.9%. Amikacin was the most effective antimicrobial followed by Imipenem and Meropenem (0%, 0.6% and 2.5% resistance, respectively); while, Cephalothin and Ampicillin were the least (80.6% and 90.0% resistance, respectively) effective.@*CONCLUSIONS@#The obtained results emphasized the emergence of highly resistant bacteria to most of tested antimicrobials and raise the alarm for physicians to change their treatment pattern depending on antimicrobial susceptibility results.

Prevalence and antimicrobial resistance pattern of bacterial strains isolated from patients with urinary tract infection in Messalata Central Hospital, Libya

Objectives To investigate the prevalence of urinary tract infection among patients at Messalata Central Hospital, Libya, to identify the causative bacteria, and to explore their resistance pattern to antimicrobials. Methods A total number of 1 153 urine samples were collected from patients, who attended daily to Messalata Central Hospital, Libya, in a study extended for one year. Antimicrobial susceptibility testing and isolates typing were done using Phoenix BD (BD diagnostic). Resistance was confirmed manually using agar disk diffusion method. Results Of the 1 153 urine samples tested, 160 (13.9%) samples were positive, from which 17 different, solely Gram negative, uropathogens were identified. Escherichia coli were the most prevalent (55.6%) bacteria, followed by Klebsiella pneumoniae subspecies pneumoniae (16.3%), Proteus mirabilis (6.3%), Pseudomonas aeruginosa (5.6%), Enterobacter cloacae and Klebsiella oxytoca (2.5%, each), Citrobacter koseri and Providencia rettgeri (1.9%, each), Acinetobacter baumannii, Enterobacter aerogenes and Proteus vulgaris (1.3%, each), and Aeromonas caviae, Citrobacter freundii, Cronobacter sakazakii, Enterobacter amnigenus biogroup 2, Pseudomonas putida and Serratia marcescens (0.6%, each). The isolated uropathogens showed increased levels of resistance ranged from 10.5% to 64.5%, with an overall resistance of 28.9%. Amikacin was the most effective antimicrobial followed by Imipenem and Meropenem (0%, 0.6% and 2.5% resistance, respectively); while, Cephalothin and Ampicillin were the least (80.6% and 90.0% resistance, respectively) effective. Conclusions The obtained results emphasized the emergence of highly resistant bacteria to most of tested antimicrobials and raise the alarm for physicians to change their treatment pattern depending on antimicrobial susceptibility results.

Preoperative selection of endometrial cancer patients at low risk for lymph node metastases: useful criteria for enrollment in clinical trials / 부인종양

No abstract available.

Oral health-related quality of life changes following third molar surgery in a Jordanian population: effect of demographic and clinical factors on the immediate postoperative period

This study aimed to evaluate oral health-related quality of life [OHRQOL] changes following third molar surgery, and investigate demographic and clinical variables' effect on [OHRQOL] in the first postoperative week. 45 subjects had surgical removal of lower third molar/s by one surgeonat Jordan University hospital from March 2011 to November 2011, following a standardized protocol. Patients' demographics and clinical data were recorded. [OHRQOL] was evaluated before surgery using the Oral Health Impact Profile [OHIP]-14. On postoperative days [PD] 1, 3, 5 and 7, patients completed the [OHIP]-14 and the condition-specific [HRQOL] instrument. A significant deterioration in OHRQOL was seen on [PD]1[P=0.000], and [PD]3 [P=0.000], except for psychological discomfort and disability domains. On [PD]5, no difference was found, however, females had significantly lower OHRQOL levels than males on [OHIP]-14 [P=0.008] and the domains: physical [P=0.048], psychological [P=0.016] and social disability[P=0.018]. Third molar surgery was associated with deterioration in patients' OHRQOL on the first three postoperative days. Females had a slower recovery, with no effect of other factors on patients' recovery pattern

A comparative evaluation of dengue diagnostic tests based on single acute serum samples for laboratory confi rmation of acute dengue

A prospective study was carried out to evaluate the sensitivity of dengue NS1 antigen-capture ELISA in comparison with dengue virus isolation, conventional RT-PCR and real-time RT-PCR for laboratory confi rmation of acute dengue based on single-acute serum samples. Four primary healthcare centres were involved to recruit patients with clinical diagnosis of dengue illness. Patient’s demographic, epidemiological and clinical information were collected on a standardized data entry form and 5 ml of venous blood was collected upon consent. In the laboratory, six types of laboratory tests were performed on each of the collected acute serum sample. Of the 558 acute serum samples collected from 558 patients with clinical diagnosis of dengue from mid-August 2006 to March 2009, 174 serum samples were tested positive by the dengue NS1 antigen-capture ELISA, 77 by virus isolation, 92 by RT-PCR and 112 by real-time RT-PCR. A total of 190 serum samples were tested positive by either one or a combination of the four methods whereas, only 59 serum samples were tested positive by all four methods. Thus, based on singleacute serum samples, 190 of the 558 patients (34.1%) were laboratory-confi rmed acute dengue. The overall test sensitivity was 91.6%, 40.5%, 48.4% and 58.9% for dengue NS1 antigen-capture ELISA, virus isolation, conventional RT-PCR and real-time RT-PCR respectively. Statistically, dengue NS1 antigen-capture ELISA was the most sensitive and virus isolation was the least sensitive test for the laboratory confi rmation of acute dengue based on single-acute serum specimens. Real-time RT-PCR was signifi cantly more sensitive than the conventional RT-PCR.

Patient satisfaction with primary health care services in Bahrain

The Study was conducted using a cross - sectional survey An Arabic questionnaire used conducted for Bahraini patients attending East Riffa Health centre, in order to assess The patients satisfaction with the health services over a period of two weeks [1 st to 14 th September 2001]. During the study 200 patients were interviewed- Questionnaires were collected and analyzed. However the total [49%] were satisfied about primary health care services, [41.5%] of patients were borderline in their satisfaction, and [9.5%] of them were not satisfied. The reasons of patients' dissatisfaction were lack of communication skills by the receptionist [29.5%], long waiting time [35%], short consultation time [42%], poor physician greeting [16%], poor physician examination [34.5%], poor physician explanation [31.5%], poor physician management [29%], and Inadequate drug supply in the pharmacy [41.5%]. Patients suggested improving communication skills of primary health care team [27.5%], to reduce waiting time [31%], to increase consultation time [38%], to improve physician training [15.5%], and to improve quality and quantity of drug supply to the pharmacy [39%]. Consumer's expectation has to be taken in consideration when planning and adopting health care policy