Epidemiological Trend of Paediatric COVID-19 in First and Second Wave of Corona Pandemic — An Observational Study

Objective : To compare the epidemiological trend of COVID-19 in pediatric patients in First and Second wave of Corona pandemic. Material and Methods : Data of all RTPCR samples for SARS-CoV-2 collected between June, 2020 and June, 2021, were retrospectively analyzed and compared between pediatric and adults in 1st and 2nd wave of pandemic in Central Hospital, North Western Railway Jaipur Rajasthan. Results : Total 9766 samples were collected, out of it paediatric samples were 533 which is 5.47% of total. 137 out of 533 paediatric samples reported positive for SARS-CoV-2. Overall paediatric positivity rate is 25.7% and adult positivity rate is 28.4%. Positivity rate, Hospitalization and death rate in First wave in paediatric population is 20.7%, 0% and 0% and for adult 29.5%, 30% and 0.29% respectively. In Second wave positivity rate, hospitalization and death rate for pediatric is 30.5%, 2.4%, 0% and for adult it is 27.7%, 32.8% and 5.16% respectively. Conclusion : Overall adult and paediatric positivity is comparable. Pediatric positivity increased significantly by 47.3% in Second wave specially in age group 6 to 12 years. Positivity is more in male child as compared to female. Though in Second wave more paediatric patients reported positive and 2 cases (2.4 %) required hospitalization also but no severe COVID infection or death was reported in children in this study

Infection of human papillomavirus and head and neck cancer / 中华肿瘤杂志

High-risk human papillomavirus (HPV)-related cancers consist of cervical cancer, anal cancer, penile cancer, vulvar cancer, vaginal cancer, and head and neck cancer (HNC). Of these, the disease burden of HNC is second only to cervical cancer. HNC mostly originates from malignant lesions of squamous epithelial cells and mainly includes oral cavity cancer, pharyngeal cancer (including nasopharyngeal cancer, oropharyngeal cancer, and hypopharyngeal cancer), and laryngeal cancer. Tobacco use, alcohol abuse, and HPV infection are three primary risk factors. Recently, there is an upward trend of HNC incidence globally, especially in high-income countries. In China, the disease burden and trends of HPV-related HNC are still not clear. A few small sample size and single-center studies suggest a high HPV prevalence and increasing trend in HNC. Methodological differences in HPV testing and regional variabilities still exist among these studies. Among the anatomic sites, oropharyngeal cancer has been shown to be caused by HPV infection, but the association of HPV with other sites is still under debate. In addition, there is a paucity of relevant studies. Here, this review narrates the association between HPV infection and HNC, compares the differences between global and Chinese studies, and then explores the importance of HPV infection in various anatomical sites. The main objective is to highlight the research on HPV-related HNC and promote relevant prevention and treatment programs.

Effects of mild cognitive impairment on perceived facial trustworthiness for older adults / 中华行为医学与脑科学杂志

Objective:To explore the effects of mild cognitive impairment (MCI) on perceived facial trustworthiness for older adults.Methods:From May to June 2019, 30 young subjects (young group) were recruited, and 30 young older adults (young elderly group), 30 middle older adults (middle elderly group), and 30 elderly (elderly group) with normal cognition were recruited. At the same time, 30 older adults with normal cognition (cognitive normal elderly group) and 30 older adults with MCI (MCI elderly group) were recruited. All subjects were scored on the trustworthiness of young and elderly faces.SPSS 26.0 software was used to conduct a multivariate analysis of variance on the data to explore the differences in perceived facial trustworthiness among elderly people of different ages and elderly people with different cognitive function.Results:(1) A comparison of the facial trustworthiness scores of young and elderly faces among the young group, young elderly group, middle elderly group, and elderly group showed that, interaction between face age and age was significant ( F(3, 116)=6.30, P=0.001), the main effect of face age was significant ( F(1, 116)=23.18, P<0.001), and the main effect of age group was significant ( F(3, 116)=11.88, P<0.001). Simple effect analysis showed that the facial trustworthiness scores of elderly faces in the young elderly group (5.02±0.85), middle elderly group (5.15±0.55), and the elderly group (4.87±1.03) were higher than that in the young group (3.74±0.71), and with a statistically significant difference (all P<0.001). There were no significant differences in the facial trustworthiness scores of elderly faces among the young elderly group, middle elderly group, and elderly group (all P>0.05). There were no statistically significant differences in the facial trustworthiness scores of young face among different age groups ( P>0.05). (2)The comparison of facial trustworthiness scores among the young group, cognitive normal elderly group, and the MCI elderly group showed that, the interaction between face age and cognition was significant ( F(2, 87)=8.33, P<0.001), the main effect of face age was significant ( F(1, 87)=5.97, P<0.01), and the main effect of cognition was significant( F(2, 87)=39.37, P<0.001). Simple effect analysis showed that the facial trustworthiness scores of elderly faces in cognitive normal elderly group was higher than those in the young group and the MCI elderly group( P<0.001). There were no significant differences in the facial trustworthiness scores of elderly faces among young group and the MCI elderly group ( P=0.191). The facial trustworthiness scores of young faces in cognitively normal elderly group and young group were higher than those in the MCI elderly group( P<0.05). There was no statistically significant difference in the facial trustworthiness scores of young faces between cognitively normal elderly group and young group ( P=0.134). Conclusion:There is a positive effect on the perceived facial trustworthiness in older adults with normal cognition, but there is no positive effect on the perceived facial trustworthiness in the older adults with MCI. Cognitive decline affects perceived facial trustworthiness in the elderly.

Prevalence of Novel Corona Virus (Severe Acute Respiratory Syndrome Coronavirus 2) and its Uncertain Future in the Different Regions of Punjab

Background: Coronavirus disease?19 (COVID?19), produced by the severe acute respiratory syndrome coronavirus 2 (SARS?CoV?2), has become a global pandemic, giving rise to a serious health threat globally. Many countries have seen a two?wave pattern in there reported cases during the period of pandemic. Similarly, our country has reported the first peak between March and October 2020 followed by the second peak between April and June 2021. Objectives: The objective of this study was conducted to describe the spatiotemporal patterns and early epidemiological features of COVID?19 cases from November 2020 to May 2021 in the central (Majha) region of Punjab state of India which was considered as the epicenter of the infection. Methods: The multiplexed real?time reverse transcription–polymerase chain reaction (RT?PCR) method was used to detect SARS?CoV?2, with co?amplification of specific target genes using real?time PCR kits. Results: During the second wave, test positivity rate for COVID?19 in our laboratory (the central region of Punjab) was recorded as 4.8%. The study revealed that an increased sustained proportion of COVID?19 incidence is present in young adult age group (20–39 years) with 8.65% positive rate followed by the older age group and least in young ones. It was observed that during the second wave, more symptomatic individuals are positive (10.26%) alongside it was also observed that male population (5.61%) was more prone to infection in comparison to females (3.78%). Whole?genome sequencing carried out on 120 random samples selected from all the districts of Majha region of Punjab state showed two prominent strains, namely alpha variant (95 cases) and delta variant (19 cases). Conclusion: A higher positivity rate in the second wave demonstrates the rapid spread of the new emerging virus variants and warrants the implementation of strict vaccination regimes and quarantine in the affected region.

Time to blood culture positivity as a predictor of clinical outcome among septic patients

@#<p style="text-align: justify;"><strong>Introduction:</strong> In the setting of Sepsis, Blood Culture is one of the important diagnostic tools in aiding a clinician to determine the offending pathogen. Following the Sepsis Bundle, Blood Culture is obtained at two sites before initiation of antibiotics. However, blood Cultures are one of the expensive tests wherein some clinicians find it unnecessary and costly. This study would provide more information regarding positive blood cultures among septic patients as a prognostic tool regarding the time to positivity. Reporting Time to Positivity would aid clinicians in the severity of the infection and could be used as a clinical predictor of mortality. This study investigated the optimal cutoff point of the time to positivity to predict mortality and the association between time to positivity of blood cultures with mortality among septic patients.</p><p style="text-align: justify;"><strong>Methods:</strong> This was a single-center cross-sectional study with a retrospective chart review of septic patients with positive blood cultures. The optimal cutoff point of time to positivity was determined and associated with mortality.</p><p style="text-align: justify;"><strong>Results:</strong> 405 adult in-patients with sepsis in Makati Medical Center from April 1, 2017, to April 30, 2018, were reviewed. The suggested optimal cutoff TTP is ?19.1 hours, with sensitivity 79.78%, specificity 28.48%, accuracy 39.75%, Youden's index 8.26%. The overall mortality rate is 21.98%. The mortality rate was higher in the TTP < 19.1 group at 23.91% compared to the >19.1 hours group. Predictors associated with mortality are age, liver comorbidity, genitourinary source of infection, and short TTP.</p><p style="text-align: justify;"><strong>Conclusion:</strong> A short TTP was associated with higher mortality rates. TTP can be clinically used to predict poorer outcomes. Therefore, patients with a short TTP should be monitored more closely, and appropriate antibiotics should have been initiated.</p>

SARS-CoV-2 infection rates after different vaccination schemes: An online survey in Turkey

Objective: To identify effects of various nationwide vaccination protocols on the evolution of new SARS-CoV-2 infections among adult population and to evaluate the safety of mRNA (BioNTech/ Pfizer) vaccine. Methods: Totally 10 735 adult volunteers that received at least one dose of BioNTech/Pfizer or triple doses of CoronaVac participated in this cross-sectional-online survey between 1 and 10 September 2021. The information was collected covering a 5-month period from April 2021 to September 2021. Information about people who were vaccinated with only single and double dose CoronaVac were not included in this study. Results: At least one side effect after single and double dose of BioNTech/Pfizer and triple doses of CoronaVac were observed in 42.1%, 42.5% and 10.9%, respectively. The most common side effects were shoulder/arm pain, weakness/fatigue, muscle/joint pain and headache. The side effects were the most frequent in single BioNTech/Pfizer, while it was the least in triple CoronaVac. The rate of positive PCR tests before vaccination was 17.6%, and decreased to 3.0% after vaccination. The rates of positive SARS CoV-2-PCR were 18.8%, 3.5%, 3.1%, 0.5% and 4.6% in single BioNTech/Pfizer, double BioNTech/Pfizer, double CoronaVac+single BioNTech/Pfizer, double CoronaVac+double BioNTech/Pfizer and triple CoronaVac, respectively. While 1.8% of PCR positive COVID-19 cases needed intensive unit care in the pre-vaccination period, intensive care unit was required in 0%, 1.5%, 2.4%, 0% and 4.2% after single BioNTech/ Pfizer, double BioNTech/Pfizer, double CoronaVac+single BioNTech/ Pfizer, double CoronaVac+double BioNTech/Pfizer and triple CoronaVac, respectively. Reinfection rate after vaccination was 0.4%. Conclusions: The rarity of COVID-19 infection after vaccination suggests that efficacy of vaccines is maintained. On the other hand, the data underscore the critical importance of continued public health mitigation.

Effect evaluation of optimizing blood culture testing process / 中华检验医学杂志

Objective:To evaluate whether the time to positive (TTP), handling time after positive alarm and turnaround time (TAT) of bacteremia blood culture can be shortened by optimizing blood culture workflow.Methods:This study was conducted retrospectively. Positive blood culture samples collected from Peking University People′s Hospital from January 1, 2014 to June 30, 2021 were analyzed in stages. In the traditional process stage of this study (2014), 502 bottles of positive blood culture samples were included in the analysis. In the first stage of process optimization (2016), the working time of staff was increased to 22:00, and 976 positive blood culture specimens were included in the analysis. In the second stage of process optimization (2018), the rapid identification process of MALDI-TOF MS was added, and a total of 1 029 bottles of positive blood culture samples were included. In the third stage of process optimization (2020) with the introduction of the new VIRTUO BACT/ALERT system. The difference of TTP, handling time after positive alarm and TAT of whole process in different stages of traditional process and process optimization were compared. All data were statistically significant when P<0.05 using rank-sum test. Results:In the traditional process stage (2014), the median quartile time of handling time after positive alarm was 55.70 (47.35, 68.45) h. In the first stage of process optimization (2016), the median quartile time of handling time after positive alarm was 47.25 (33.88, 59.96) h, and the handling time after positive alarm in the first stage of process optimization was significantly shorter than that in the traditional process stage ( Z=?10.734, P<0.001). In the second stage of process optimization (2018), the median quartile time for handling time after positive alarm was 47.18(36.41, 59.40) h, and 12.18% of the preliminary identification results of Gram-negative bacilli before 17:00 could be reported to the clinic before audit. In the third stage of process optimization (2020), the median quartile of TTP and TAT were 39.56 (21.52, 62.65) h and 78.16(64.68, 99.72) h respectively in the original BACT/ALERT 3D system. The new VIRTUO BACT/ALERT system had a median quartile of 37.03(21.08, 58.22) h for TTP and 73.41(62.88, 89.48) h for TAT. VIRTUO BACT/ALERT 3D had a significantly shorter TTP than BACT/ALERT 3D ( Z=?2.273, P=0.023), the TAT of VIRTUO BACT/ALERT system was significantly shorter than that of BACT/ALERT 3D system ( Z=?4.040, P<0.001). Conclusion:By improving the blood culture process of microbiology laboratory in many aspects and measures, the processing time of blood culture in each stage can be shortened and clinical benefits can be obtained.

Factors Associated with High-grade Smear Positivity Levels in Pulmonary Tuberculosis

ABSTRACT Objective: The high-grade level of smear acid-resistant bacilli (ARB) positivity has been linked to increased infectiousness in pulmonary tuberculosis (TB). The ability to predict infectiousness is important in the management of the disease. The present study aimed to investigate the relationship between smear results, the clinical features, and the levels of radiological involvement of TB. Methods: A total of 245 cases diagnosed with pulmonary TB were admitted to the study. Data including age, sex, case definition, numbers and characteristics of symptoms, smear results, smear positivity grades, and levels of radiological involvement were recorded. Relations between smear results and other data were determined via cluster tree and regression analysis. Results: The group with only coughing had higher rates of both positive smear and high smear positivity levels (p = 0.014 and p = 0.02, respectively) compared to the group without coughing. Similarly, the groups with moderate or high radiological involvement showed significantly higher rates of both positive smear and high smear positivity level when compared to the group exhibiting low radiological involvement (p < 0.001). Conclusion: Patients with coughing and a moderate to high level of radiological involvement should be closely monitored due to their high-level risk of transmission.

Influence of euthanasia, the intensity of inflammatory lesion and viral load in the laboratory diagnosis of rabies in cattle

ABSTRACT: This research reports the use of different diagnostic tests in cattle, naturally infected by Rabies lyssavirus (RABV), and correlates the positivity of the tests with the clinical moment of euthanasia, the intensity of the inflammatory lesion and viral load. It also highlights the possibility of euthanasia in early stages of the disease as a way to improve animal welfare. For that, samples of 34 bovine brains were collected for analysis, preserved in 10% buffered formaline and refrigerated with subsequent freezing. The samples were subjected to direct immunofluorescence antibody technique (DFAT) tests, viral isolation in cell culture (VICC), histopathology with hematoxylin and eosin staining (HE), immunohistochemistry (IHC), Shorr stainied neural tissue smears (DSS), Reverse transcription polymerase chain reaction (RT-PCR) and polymerase chain reaction by quantitative reverse transcriptase (qRT-PCR). The areas used for analysis were the cerebellum, parietal telencephalon and thalamus. Samples with Negri bodies (NBs) or immunostaining in at least one of the analyzed areas were considered positive. For the study of the intensity of histological lesions, the lesions were classified into grades 0, 1, 2 and 3 and the positivity of the test in the presence or absence of NBs in one of the three areas analyzed. To verify the influence of the disease clinical evolution, 4-four groups of analysis were created according to the animals clinical status at moment of the euthanasia, being: M1 = animal euthanized while standing, M2 = euthanized when in sternal recumbence, M3 = euthanized when in lateral recumbence, M4 = animal with natural death. Of the 34 brains evaluated, IHC was positive in 100% of cases, DFAT was positive in 97.05% of them, and in this negative sample the presence of RABV was confirmed by VICC. NBs ere seen in 88.23% of the cases, and the DSS test was positive in 82.35% of them. All diagnostic techniques showed positive cases in all groups analyzed. Each case was positive in at least two diagnostic methods. All cases that contained NBs were positive for rabies in the other tests. In this study, it was observed that the variables analyzed (intensity of injury and clinical evolution at the moment of euthanasia) had an influence only on HE and DSS techniques, which are based on NB research to form the diagnosis, but did not interfere with the effectiveness of the diagnosis performed by detecting the viral antigen performed by DFAT and IHC. All isolated RABV samples included in the present study have a genetic lineage characteristic of hematophagous bats Desmodus rotundus. The evaluation of qRT-PCR showed that the amount of virus did not interfere in the positivity of the tests. This work shows that IHC and DFAT are safe diagnostic techniques. They are capable of detecting RABV even in euthanized animals in the early stages of clinical evolution with mild intensities of histological lesions.

RESUMO: Esta pesquisa relata a utilização de diferentes testes de diagnóstico em bovinos, naturalmente infectados pelo Rabies lyssavirus (RABV), e correlaciona a positividade dos testes com o momento clínico da eutanásia, a intensidade da lesão inflamatória, e a carga viral. Salienta também a possibilidade da eutanásia em estágios precoces da doença como forma de melhorar o bem-estar animal. Para isso amostras de 34 encéfalos bovinos foram coletados para análise, conservadas em formol tamponado 10% e sob refrigeração com posterior congelamento. As amostras foram submetidas aos testes de imunofluorescência direta (IFD), isolamento viral em cultivo de células (IVCC), histopatologia com coloração de hematoxilina e eosina (HE), imuno-histoquímica (IHQ), esfregaço direto com coloração de Shorr (EDS), reação da polimerase em cadeia por transcriptase reversa (RT-PCR) e reação da polimerase em cadeia por transcriptase reversa quantitativo (qRT-PCR). As áreas utilizadas para análise foram o cerebelo, telencéfalo parietal e tálamo. Foram consideradas positivas as amostras que apresentaram Corpúsculo de Negri (CNs) ou imuno-marcação em ao menos uma das áreas analisadas. Para o estudo da intensidade das lesões histológicas, as lesões foram classificadas em graus 0, 1, 2 e 3 e a positividade do teste na presença ou ausência de CN em uma das três áreas analisadas. Para verificar a influência da evolução clínica da doença foram criados 4 grupos de análise conforme o estado clínico do animal no momento da eutanásia, sendo: M1 = animal eutanasiado em estação, M2 = eutanasiado em decúbito esternal, M3 = eutanasiado em decúbito lateral, M4 = animal com morte natural. Dos 34 encéfalos avaliados a IHQ foi positiva em 100% dos casos, a IFD foi positiva em 97,05%, sendo que na amostra negativa a presença de RABV foi confirmada por IVCC. A histologia com HE, através da visualização das CNs, foi positiva em 88,23 % dos casos, e o teste de EDS, foi positivo em 82,35%. Todas as técnicas de diagnóstico apresentaram casos positivos em todos os grupos analisados. Cada caso foi positivo em, pelo menos, dois métodos de diagnóstico. Todos os casos que continham CN foram positivos para raiva nos demais testes. Nesse estudo observou-se que as variáveis analisadas intensidade de lesão e evolução clínica no momento da eutanásia tiveram influência somente nas técnicas de HE e EDS, que se baseiam na pesquisa do CN para formação do diagnóstico, mas não interferiram na eficácia do diagnóstico realizado através da detecção do antígeno viral realizado por IFD e IHQ. Todas as amostras RABV isoladas incluídas no presente estudo apresentam linhagem genética característica de morcegos hematófagos Desmodus rotundus. A avaliação de qRT-PCR demostrou que a quantidade de vírus não interferiu na positividade dos testes. Esse trabalho mostra que a IHQ e a IFD são técnicas seguras de diagnóstico e que mesmo em animais eutanasiados em estágios iniciais de evolução clínica com intensidades leve de lesões histológicas, são capazes de detectar o RABV.

Influence of euthanasia, the intensity of inflammatory lesion and viral load in the laboratory diagnosis of rabies in cattle / Influência da eutanásia, intensidade da lesão inflamatória e carga viral no diagnóstico laboratorial da raiva em bovinos

This research reports the use of different diagnostic tests in cattle, naturally infected by Rabies lyssavirus (RABV), and correlates the positivity of the tests with the clinical moment of euthanasia, the intensity of the inflammatory lesion and viral load. It also highlights the possibility of euthanasia in early stages of the disease as a way to improve animal welfare. For that, samples of 34 bovine brains were collected for analysis, preserved in 10% buffered formaline and refrigerated with subsequent freezing. The samples were subjected to direct immunofluorescence antibody technique (DFAT) tests, viral isolation in cell culture (VICC), histopathology with hematoxylin and eosin staining (HE), immunohistochemistry (IHC), Shorr stainied neural tissue smears (DSS), Reverse transcription polymerase chain reaction (RT-PCR) and polymerase chain reaction by quantitative reverse transcriptase (qRT-PCR). The areas used for analysis were the cerebellum, parietal telencephalon and thalamus. Samples with Negri bodies (NBs) or immunostaining in at least one of the analyzed areas were considered positive. For the study of the intensity of histological lesions, the lesions were classified into grades 0, 1, 2 and 3 and the positivity of the test in the presence or absence of NBs in one of the three areas analyzed. To verify the influence of the disease clinical evolution, 4-four groups of analysis were created according to the animal's clinical status at moment of the euthanasia, being: M1 = animal euthanized while standing, M2 = euthanized when in sternal recumbence, M3 = euthanized when in lateral recumbence, M4 = animal with natural death. Of the 34 brains evaluated, IHC was positive in 100% of cases, DFAT was positive in 97.05% of them, and in this negative sample the presence of RABV was confirmed by VICC. NBs ere seen in 88.23% of the cases, and the DSS test was positive in 82.35% of them. All diagnostic techniques showed positive cases in all groups analyzed. Each case was positive in at least two diagnostic methods. All cases that contained NBs were positive for rabies in the other tests. In this study, it was observed that the variables analyzed (intensity of injury and clinical evolution at the moment of euthanasia) had an influence only on HE and DSS techniques, which are based on NB research to form the diagnosis, but did not interfere with the effectiveness of the diagnosis performed by detecting the viral antigen performed by DFAT and IHC. All isolated RABV samples included in the present study have a genetic lineage characteristic of hematophagous bats Desmodus rotundus. The evaluation of qRT-PCR showed that the amount of virus did not interfere in the positivity of the tests. This work shows that IHC and DFAT are safe diagnostic techniques. They are capable of detecting RABV even in euthanized animals in the early stages of clinical evolution with mild intensities of histological lesions.(AU)

Esta pesquisa relata a utilização de diferentes testes de diagnóstico em bovinos, naturalmente infectados pelo Rabies lyssavirus (RABV), e correlaciona a positividade dos testes com o momento clínico da eutanásia, a intensidade da lesão inflamatória, e a carga viral. Salienta também a possibilidade da eutanásia em estágios precoces da doença como forma de melhorar o bem-estar animal. Para isso amostras de 34 encéfalos bovinos foram coletados para análise, conservadas em formol tamponado 10% e sob refrigeração com posterior congelamento. As amostras foram submetidas aos testes de imunofluorescência direta (IFD), isolamento viral em cultivo de células (IVCC), histopatologia com coloração de hematoxilina e eosina (HE), imuno-histoquímica (IHQ), esfregaço direto com coloração de Shorr (EDS), reação da polimerase em cadeia por transcriptase reversa (RT-PCR) e reação da polimerase em cadeia por transcriptase reversa quantitativo (qRT-PCR). As áreas utilizadas para análise foram o cerebelo, telencéfalo parietal e tálamo. Foram consideradas positivas as amostras que apresentaram Corpúsculo de Negri (CNs) ou imuno-marcação em ao menos uma das áreas analisadas. Para o estudo da intensidade das lesões histológicas, as lesões foram classificadas em graus 0, 1, 2 e 3 e a positividade do teste na presença ou ausência de CN em uma das três áreas analisadas. Para verificar a influência da evolução clínica da doença foram criados 4 grupos de análise conforme o estado clínico do animal no momento da eutanásia, sendo: M1 = animal eutanasiado em estação, M2 = eutanasiado em decúbito esternal, M3 = eutanasiado em decúbito lateral, M4 = animal com morte natural. Dos 34 encéfalos avaliados a IHQ foi positiva em 100% dos casos, a IFD foi positiva em 97,05%, sendo que na amostra negativa a presença de RABV foi confirmada por IVCC. A histologia com HE, através da visualização das CNs, foi positiva em 88,23 % dos casos, e o teste de EDS, foi positivo em 82,35%. Todas as técnicas de diagnóstico apresentaram casos positivos em todos os grupos analisados. Cada caso foi positivo em, pelo menos, dois métodos de diagnóstico. Todos os casos que continham CN foram positivos para raiva nos demais testes. Nesse estudo observou-se que as variáveis analisadas intensidade de lesão e evolução clínica no momento da eutanásia tiveram influência somente nas técnicas de HE e EDS, que se baseiam na pesquisa do CN para formação do diagnóstico, mas não interferiram na eficácia do diagnóstico realizado através da detecção do antígeno viral realizado por IFD e IHQ. Todas as amostras RABV isoladas incluídas no presente estudo apresentam linhagem genética característica de morcegos hematófagos Desmodus rotundus. A avaliação de qRT-PCR demostrou que a quantidade de vírus não interferiu na positividade dos testes. Esse trabalho mostra que a IHQ e a IFD são técnicas seguras de diagnóstico e que mesmo em animais eutanasiados em estágios iniciais de evolução clínica com intensidades leve de lesões histológicas, são capazes de detectar o RABV.(AU)

Study on Metallo-Beta Lactamase Producing Pseudomonas Species in Clinical Isolates of a Tertiary Care Hospital of Western Odisha.

Pseudomonas species are responsible for 10% of hospital acquired infection especially in an ICU set up and in burn patients. Metallo-beta lactamase production is the most common mechanism of resistance to carbapenem which is the most commonly used drug to treat Pseudomonas. Local prevalence of MBL producing Pseudomonas is important information to both microbiologist and clinician to formulate hospital infection control strategy. This cross-sectional descriptive study was conducted in a tertiary care hospital of western Odisha to detect MBL prevalence among clinical isolates of Pseudomonas species.METHODS187 Pseudomonas strains (165 P. aeruginosa and 22 P. putida) isolated in different clinical samples in Vitek 2 system were checked for imipenem resistance (MIC>8 µl/ml). All imipenem resistance strains were checked for MBL production by combined disc test with imipenem, and MBL production was confirmed by MBL E test.RESULTSAmong 187 Pseudomonas strains 12.20% were carbapenem resistant and 9% were MBL producing. About 74% of carbapenem resistant Pseudomonas strains were MBL positive. MBL positivity rate was much higher in Pseudomonas putida (27.20%) compared to Pseudomonas aeruginosa (7%) and in ICU (14.20%) compared to IPD (9.20%) or OPD (6.80%). Colistin was the most effective (97%) antibiotic against MBL producing Pseudomonas.CONCLUSIONSIt is better to prevent MBL Pseudomonas than to cure it as most of the antibiotics were found to be ineffective against it. In our study MBL production rate in clinical isolate of Pseudomonas was low (9%) compared to other studies in India.

Role of Sputum Induction in Sputum Smear Negative and Chest X-Ray Suggestive of Pulmonary Tuberculosis

Background: Sputum induction is a procedure used forpatients who have difficulty in spontaneously producingsputum. So we have planned to conduct a study to find out therole of sputum induction in TB patients to increase the yield ofsputum smear positivity in sputum smear negative pulmonarytuberculosis patients and the role of sputum induction intuberculosis suspected patients having cough withoutexpectoration.Materials & Methods: The present study was carried out in 50patients admitted with clinical & radiological featuressuggestive of pulmonary tuberculosis in the Department of TB& Respiratory diseases, R.N.T Medical College, Udaipur. Studyprotocol includes detailed history, clinical examination, routineblood investigations including ESR, chest x-ray, sputuminduction and smear study by Ziehl-Neelson staining was doneto all the patients included in the study.Results: Our study showed that the total numbers of caseswere 50, among which 40 (80%) cases were in the age groupof below 60 years. Males in the study are 31 (62%) andfemales are 19 (38%). ESR was elevated to more than 30mm/hr in 46 (92%) cases and less than 30mm/hr in 4 (8%)cases. Sputum production were absent in 40 (80%) cases.Maximum 30 (60%) cases had moderate disease, 14 (28%)cases had minimal disease and 6 (12%) cases hadfar advanced disease on chest x-ray. 30 (60%) cases had nocavity on chest x-ray and 20 (40%)cases had cavity.30(60%)cases had bilateral disease (B/L) and 20 (40%) caseshad unilateral disease (U/L) on chest x-ray.Conclusion: We concluded that the identification of smearpositivity through sputum induction method with 3%hypertonicsaline that allows sampling of the airways in a noninvasivefashion and is a less expensive approach than the techniquelike bronchial biopsy, bronchoalveolar lavage and gastriclavage.

Prevalence of Chlamydia pneumoniae seropositivity in early pregnancy and its association with preeclampsia among primigravidae in Indian population

Background: Preeclampsia (PE) is a multifactorial disease that might be caused by a concurrent or preceding inflammatory stimulus. Inflammatory changes similar to those reported in chronic Chlamydia pneumoniae infection are seen in PE. It is suggested that persistent or chronic Chlamydia pneumoniae infection might have a role in the pathogenesis of PE and antichlamydial treatment in early pregnancy may prevent reactivation of infection and hence the development of preeclampsia.Methods: This randomized interventional study was conducted to determine the prevalence of C.pneumoniae IgG seropositivity in early pregnancy, its association with PE and the effect of treatment with oral azithromycin. A total of 330 primigravidae included in the study were followed up till delivery. C.pneumoniae IgG antibodies measured by ELISA technique at 14-20 weeks of gestation revealed seropositivity in 32.4%. These women were at higher risk of developing severe PE (odds’ ratio 3.2) as compared to the C. pneumoniae seronegative cases.Results: Treatment with oral azithromycin resulted in reduction in the occurrence of PE amongst the C.pneumoniae seropositive cases; as well as significant reduction in the incidence of low birth weight babies in the C.pneumonie seropositive group (p<0.001, ARR= 0.204).Conclusions: Pregnant women who were C.pneumonia IgG seropositive are at higher risk of developing severe preeclmapsia as compared to the C.pneumoniae seronegative cases. This association needs to be further evaluated.

Scale of Positive and Negative Affects (EAPN-10): Evidence of its Psychometric Adequacy / Escala de Afetos Positivos e Negativos (EAPN-10): Evidências de sua Adequação Psicométrica / Escala de Afectos Positivos y Negativos (EAPN-10): Evidencias de su Adecuación Psicométrica

Abstract This study aimed to gather psychometric evidence of the Scale of Positive and Negative Affects (EAPN-10) within the Brazilian context. Three studies were performed (N = 911). Study 1 considered 296 undergraduate students (MAge = 23.8; 59.1% females), who answered the EAPN-10 and a demographic questionnaire. Exploratory factor analysis revealed a two-factor structure [positive affects (α = .82) and negative affects (α = .81)], explaining 59.7% of the total variance. Study 2 took into account the participation of 313 undergraduate students (MAge = 23.3; 57.2% females), who answered the same instruments. Confirmatory factor analysis corroborated the two-factor structure (e.g., CFI = .92), which was invariant across males and females (e.g., ΔCFI < .01), with alphas greater than .70. Finally, Study 3's participants were 302 university students (MAge = 23.1; 54.3% females), who answered the aforementioned instruments as well as measures of vitality, positivity, optimism, anxiety, depression and stress. Supporting their criterion validity, positive affects (α = .83) were positively correlated with well-being indicators, and negative affects (α = .80) were positively correlated with indicators of psychological discomfort. In conclusion, the EAPN-10 is a psychometrically adequate measure that can be employed to assess people's affects and their correlates within the Brazilian context.

Resumo Este estudo objetivou reunir evidências psicométricas da Escala de Afetos Positivos e Negativos (EAPN-10) no contexto brasileiro. Realizaram-se três estudos. O Estudo 1 considerou 296 estudantes universitários (MIdade = 23,8; 59,1% mulheres), os quais responderam a EAPN-10 e perguntas demográficas. A análise fatorial exploratória revelou uma estrutura bifatorial [afetos positivos (α = 0,82) e afetos negativos (α = 0,81)], explicando 59,7% da variância total. No Estudo 2 participaram 313 estudantes universitários (MIdade = 23,3; 57,2% mulheres), que responderam os instrumentos do estudo anterior. A análise fatorial confirmatória corroborou a estrutura bifatorial (e.g., CFI = 0,92), que se mostrou invariante entre homens e mulheres (e.g., ΔCFI < 0,01), tendo alfas superiores a 0,80. Por fim, o Estudo 3 reuniu 302 estudantes universitários (MIdade = 23,1; 54,3% mulheres), que responderam os instrumentos prévios e medidas de vitalidade, positividade, otimismo, ansiedade, depressão e estresse. Atestando evidências de sua validade de critério, os afetos positivos (α = 0,83) se correlacionaram positivamente com os indicadores de bem-estar, enquanto os negativos (α = 0,80) o fizeram com aqueles de mal-estar psicológico. Conclui-se que a EAPN-10 é psicometricamente adequada, podendo ser empregada para conhecer os afetos e seus correlatos no contexto brasileiro.

Resumen Este estudio ha tenido como objetivo reunir evidencias psicométricas de la Escala de Afectos Positivos y Negativos (EAPN-10) en el contexto brasileño. Se realizaron tres estudios. El Estudio 1 consideró 296 estudiantes universitarios (MEdad = 23.8, 59.1% mujeres), que contestaron a la EAPN-10 y preguntas demográficas. El análisis factorial exploratorio ha indicado una estructura bifactorial [afectos positivos (α = .82) y afectos negativos (α = .81)], explicando el 59.7% de la varianza total. En Estudio 2 reunió 313 estudiantes universitarios (MEdad = 23.3, 57.2% mujeres), que contestaron los instrumentos del estudio anterior. El análisis factorial confirmatorio ha corroborado la estructura bifatorial (CFI = .92), que se mostró invariante entre varones y mujeres (ΔCFI < .01), con alfas superiores a .70. Por último, el Estudio 3 contó con 302 estudiantes universitarios (MEdad = 23.1, 54.3% mujeres), que contestaron a los instrumentos previos y medidas de vitalidad, positividad, optimismo, ansiedad, depresión y estrés. Confirmando evidencias de validez de criterio, los afectos positivos (α = .83) se han correlacionado positivamente con los indicadores de bienestar, mientras que los negativos (α = .80) lo hicieron con aquellos de malestar psicológico. Concluyendo, la EAPN-10 se ha mostrado psicometricamente adecuada, pudiendo ser empleada para conocer los afectos y sus correlatos en el contexto brasileño.

An Event-related Potential Study of Error-monitoring Deficits in Female College Students Who Participate in Binge Drinking

OBJECTIVE: This study investigated error-monitoring deficits in female college students with binge drinking (BD) using event-related potentials (ERPs) and the modified Flanker task. METHODS: Participants were categorized into BD (n=25) and non-BD (n=25) groups based on the scores of the Korean-version of the Alcohol Use Disorder Identification Test (AUDIT-K) and the Alcohol Use Questionnaire (AUQ). The modified Flanker task, consisting of congruent (target and flanker stimuli are the same) and incongruent (target and flanker stimuli are different) conditions, was used to evaluate error-monitoring abilities. RESULTS: The BD group exhibited significantly shorter response times and more error rates on the Flanker task, as well as reduced error-related negativity (ERN) amplitudes compared with the non-BD group. Additionally, ERN amplitudes measured at FCz and Cz were significantly correlated with scores on the AUDIT-K and AUQ in the whole participants. The BD and non-BD groups did not show any significant differences in error positivity amplitudes. CONCLUSION: The present results indicate that college students with BD have deficits in error-monitoring, and that reduced ERN amplitudes may serve as a biological marker or risk factor of alcohol use disorder.

Self-positivity bias in implicit information processing amongcollege students with depressive traits / 中国心理卫生杂志

Objective:To explore whether there is self-positivity bias in implicit information processing among college students with depressive traits.Methods:Forty-two college students of the depressive-trait group [Trait Depression Scale (T-DEP) T＞60 and Trait Anxiety Inventory (T-AI) T＜60] and 42 cases of the non-depressive-trait control group [T-DEP and T-AI T＜60] were selected.They performed positive and negative words judgment tasks under self or other primed conditions by adopting the supraliminal attitude-prime paradigm, and the difference in reaction time between the two groups was compared.Result:The interaction effects between primed conditions and emotional words in depressive-trait group were not significant [F (1, 41) =1.56, P=0.218].There was significant interaction effect between primed conditions and emotional words in the control group [F (1, 41) =55.43, P＜0.001], and the reaction time of self-positive words and other-negative words in self-positivity bias was shorter than other-positive words and self-negative words outside the bias [ (602.64±20.03) ms, (654.56±20.41) ms vs. (663.19±20.78) ms, (678.64±20.70) ms, Ps＜0.001].Conclusion:It suggests that there may be no self-positivity bias in the implicit information processing of depressive-trait college students, and non-depressive-trait ones show the implicit self-positivity bias.

Cluster Containing More Than 20 CD3-Positive Cells in Bone Marrow Biopsy Is a Candidate Prognostic Indicator in Peripheral T-Cell Lymphoma, Not Otherwise Specified

Assessment of bone marrow (BM) involvement in peripheral T-cell lymphoma, not otherwise specified (PTCL) is straightforward in cases of extensive involvement but difficult in cases of minimal to partial involvement. We evaluated the usefulness of CD3 as an immunohistochemical marker for assessing BM involvement in PTCL patients. BM biopsies of 92 PTCL patients were immunohistochemically stained for CD3, CD4, CD8, CD20, and CD56, and evaluated by two hematopathologists. CD3 positivity was graded according to the proportion of CD3-positive cells and the number of CD3-positive cells in a cluster. These criteria were used to determine the cut-offs at which significant differences in progression-free survival (PFS) and overall survival (OS) were observed. Multivariate analysis controlling the International Prognostic Index (IPI) score and its individual factors revealed that >20 CD3-positive cells in a cluster adversely affected PFS (relative risk [RR], 2.1; 95% confidence interval [CI], 1.0–4.3; P=0.047) and OS (RR, 2.4; 95% CI, 1.1–5.1; P=0.028) independent of IPI score. A cluster with >20 CD3-positive cells is a candidate indicator for BM involvement in PTCL.

Can Histochemical c-mpl Positivity in Bone Marrow be a Predictor for Splenectomy in Immune Thrombocytopenia?

Purpose: Splenectomy is used as the second line therapy in patients with immune thrombocytopenia (ITP). However, there is no parameter predicting splenectomy decision. Thrombopoietin is the main regulator of platelet count through its receptor c-mpl. The aim of the present study was to evaluate immune histochemical Cloned Myeloid Leukemia Virus (c-mpl) positivity in bone marrow specimens of ITP patients with or without splenectomy indications. Methods: Pre-splenectomy bone marrow was stained for c-mpl, that was taken from 24 patients with ITP and who had splenectomy as well as bone marrow samples from 30 patients with ITP who did not have splenectomy. Results: c-mpl negativity was higher in splenectomized patients (n: 23) compared to patients without splenectomy (n:18). A significant difference was found for platelet counts before and after splenectomy. Our study show that, c-mpl positivity was statistically significant in patient group who did not have splenectomy. In the patient group who had the splenectomy, c-mpl was not associated with refractory status. Conclusion: The significant level of c-mpl negativity might be the useful parameter for splenectomy indication in patients with immune thrombocytopenia.

Effect of the Standardization of Diagnostic Tests on the Prevalence of Diabetes Mellitus and Impaired Fasting Glucose

BACKGROUND: Without standardization of medical laboratory's testing practices, there is an increase in false diagnoses when relying on test results. However, the effect of test standardization is difficult to assess numerically. This study's purpose is to quantify the effect of the standardization level of a laboratory on the prevalence of diabetes mellitus (DM) and impaired fasting glucose (IFG). METHODS: Laboratories were classified into three levels: ‘highly-standardized laboratory,’‘basically-standardized laboratory,’ and ‘non-standardized laboratory.’ Based on the results of Korean External Quality Assessment Scheme (KEQAS), the cutoff values for diagnosis of DM and IFG were recalculated, given false positive and false negative rates. RESULTS: The prevalence of DM and IFG in the population as a whole was estimated using the 2013 Korea National Health and Nutrition Examination Survey (KNHANES) database. When the prevalence of DM from KNHANES was 11.88% (95% confidence interval [CI], 10.59%–13.17%), the proportion with a systematic false error ranged from 10.91% (95% CI, 9.65%–12.17%) to 13.09% (95% CI, 11.74%–14.45%). The prevalence of IFG varied from 13.59% (95% CI, 12.25%–14.91%) to 40.49% (95% CI, 38.54%–42.43%), in contrast to 24.58% (95% CI, 22.85%–26.31%) of the reference value. The prevalence of DM and IFG tended to be over- and under-estimated more as the laboratory standardization level became lower, respectively. CONCLUSION: Our study proved that standardization of clinical laboratory tests is an important factor affecting the prevalence estimation of national disease statistics based on the simulation using KNHANES data.

Usefulness of Two-Step Algorithm with Earlier Growth Detection in Anaerobic Bottle and Time to Positivity to Predict Candida glabrata Fungemia / 대한임상미생물학회지

BACKGROUND: Fast identification of Candida glabrata is important, because empirical antifungal therapy for fungemia with C. glabrata and non-C. glabrata varies. We proposed an algorithm for rapid presumptive diagnosis to identify fungemia with C. glabrata using earlier or only growth from anaerobic bottles and longer time to positivity (TTP) in blood cultures. METHODS: Positivity and TTP using the BacT/Alert 3D system (bioMerieux Inc, USA) with resin bottles (FA Plus and FN Plus) were analyzed in 215 candidemia patients from June 2014 to June 2016 in a university-affiliated hospital in Korea. RESULTS: A higher proportion of earlier or only growth from anaerobic bottles was observed in C. glabrata (38.8%, 7/18) than in C. albicans (7.6%, 8/105), C. parapsilosis (10.5%, 4/138), and C. tropicalis (9.2%, 5/54) (P=0.006). The mean (±standard deviation) TTP for C. glabrata was 41.7 h (±16.3 h) compared with 26.7 h (±15.9 h) for C. albicans, 33.4 h (±8.4 h) for C. parapsilosis, and 23.1 h (±17.3 h) for C. tropicalis (P 31.4 h. CONCLUSION: This two-step algorithm in the BacT/Alert 3D system could be the basis for an initial empirical antifungal therapy for fungemia with C. glabrata prior to final identification.