Targeted Therapies for Hepatocellular Carcinoma Treatment: A New Era Ahead-A Systematic Review.

Hepatocellular carcinoma (HCC) remains one of the most common malignancies and the third cause of cancer-related death worldwide, with surgery being the best prognostic tool. Among the well-known causative factors of HCC are chronic liver virus infections, chronic virus hepatitis B (HBV) and chronic hepatitis virus C (HCV), aflatoxins, tobacco consumption, and non-alcoholic liver disease (NAFLD). There is a need for the development of efficient molecular markers and alternative therapeutic targets of great significance. In this review, we describe the general characteristics of HCC and present a variety of targeted therapies that resulted in progress in HCC therapy.

COVID-19-associated pneumonia in Swyer-James-MacLeod syndrome: A case report.

Coronavirus disease 2019 (COVID-19) exerts differential effects on various individuals. The majority of infected individuals experience mild-to-moderate disease and usually recover, without requiring hospitalization. It has been reported that those who have underlying chronic diseases are more susceptible to infection and may thus develop significantly more serious illness. As a result, COVID-19 may aggravate pre-existing respiratory illnesses, such as interstitial lung disease, chronic obstructive pulmonary disease and asthma. Swyer-James-MacLeod syndrome is an uncommon clinical condition marked by post-infectious infantile bronchiolitis obliterans. Traditionally, the diagnosis is made in infancy following an investigation for reoccurring respiratory infections, although in rare cases, the diagnosis is made in adulthood. The present study describes the case of a 45-year-old patient with Swyer-James-MacLeod syndrome hospitalized due to COVID-19, which is the first one to be reported. To the best of our knowledge, there are currently no data available on the effects of COVID-19 in these individuals, stheir optimal therapy, or the impact of COVID-19 vaccination on their clinical course. Thus, it is hoped that the present study sheds some light into this condition.

COVID-19-associated pneumonia in Swyer-James-MacLeod syndrome: A case report

Coronavirus disease 2019 (COVID-19) exerts differential effects on various individuals. The majority of infected individuals experience mild-to-moderate disease and usually recover, without requiring hospitalization. It has been reported that those who have underlying chronic diseases are more susceptible to infection and may thus develop significantly more serious illness. As a result, COVID-19 may aggravate pre-existing respiratory illnesses, such as interstitial lung disease, chronic obstructive pulmonary disease and asthma. Swyer-James-MacLeod syndrome is an uncommon clinical condition marked by post-infectious infantile bronchiolitis obliterans. Traditionally, the diagnosis is made in infancy following an investigation for reoccurring respiratory infections, although in rare cases, the diagnosis is made in adulthood. The present study describes the case of a 45-year-old patient with Swyer-James-MacLeod syndrome hospitalized due to COVID-19, which is the first one to be reported. To the best of our knowledge, there are currently no data available on the effects of COVID-19 in these individuals, stheir optimal therapy, or the impact of COVID-19 vaccination on their clinical course. Thus, it is hoped that the present study sheds some light into this condition.

COVID-19 and Acute Pancreatitis: A Systematic Review of Case Reports and Case Series.

BACKGROUND: Coronavirus disease 2019 (COVID-19) presents mainly with mild symptoms and involvement of the respiratory system. Acute pancreatitis has also been reported during the course of COVID-19. OBJECTIVE: Our aim is to review and analyze all reported cases of COVID-19 associated acute pancreatitis, reporting the demographics, clinical characteristics, laboratory and imaging findings, comorbidities and outcomes. DATA SOURCES: We conducted a systematic search of Pubmed/MEDLINE, SciELO and Google Scholar to identify case reports and case series, reporting COVID-19 associated acute pancreatitis in adults. STUDY SELECTION: There were no ethnicity, gender or language restrictions. The following terms were searched in combination:"COVID-19" OR "SARS-CoV-2" OR "Coronavirus 19" AND "Pancreatic Inflammation" OR "Pancreatitis" OR "Pancreatic Injury" OR "Pancreatic Disease" OR "Pancreatic Damage". Case reports and case series describing COVID-19 associated acute pancreatitis in adults were included. COVID-19 infection was established with testing of nasal and throat swabs using reverse transcription polymerase chain reaction. The diagnosis of acute pancreatitis was confirmed in accordance to the revised criteria of Atlanta classification of the Acute Pancreatitis Classification Working Group. Exclusion of other causes of acute pancreatitis was also required for the selection of the cases. DATA EXTRACTION: The following data were extracted from each report: the first author, year of publication, age of the patient, gender, gastrointestinal symptoms due to acute pancreatitis, respiratory-general symptoms, COVID-19 severity, underlying diseases, laboratory findings, imaging features and outcome. DATA SYNTHESIS: Finally, we identified and analyzed 31 articles (30 case reports and 1 case series of 2 cases), which included 32 cases of COVID-19 induced acute pancreatitis. CONCLUSION: COVID-19 associated acute pancreatitis affected mostly females. The median age of the patients was 53.5 years. Concerning laboratory findings, lipase and amylase were greater than three times the ULN while WBC counts and CRP were elevated in the most of the cases. The most frequent gastrointestinal, respiratory and general symptom was abdominal pain, dyspnea and fever, respectively. The most common imaging feature was acute interstitial edematous pancreatitis and the most frequent comorbidity was arterial hypertension while several patients had no medical history. The outcome was favorable despite the fact that most of the patients experienced severe and critical illness. LIMITATIONS: Our results are limited by the quality and extent of the data in the reports. More specifically, case series and case reports are unchecked, and while they can recommend hypotheses they are not able to confirm robust associations. CONFLICT OF INTEREST: None.

Increased Influenza Vaccination Coverage among Members of the Athens Medical Association Amidst COVID-19 Pandemic.

Healthcare workers are at high risk of influenza virus infection as well as of transmitting the infection to vulnerable patients who may be at high risk of severe illness. The aim of this cross-sectional study was to investigate the prevalence and related factors of influenza vaccination coverage (2020-2021flu season), among members of the Athens Medical Association in Greece. This survey employed secondary analysis data from a questionnaire-based dataset on COVID-19 vaccination coverage and associated factors from surveyed doctors, registered within the largest medical association in Greece. All members were invited to participate in the anonymous online questionnaire-based survey over the period of 25 February to 13 March 2021. Finally, 1993 physicians (60% males; 40% females) participated in the study. Influenza vaccination coverage was estimated at 76%. Logistic regression analysis demonstrated that older age (OR = 1.02; 95% C.I. = 1.01-1.03), history of COVID-19 vaccination (OR = 2.71; 95% C.I. = 2.07-3.56) and perception that vaccines in general are safe (OR = 16.49; 95% C.I. = 4.51-60.25) were found to be independently associated factors with the likelihood of influenza vaccination coverage. Public health authorities should maximize efforts and undertake additional actions in order to increase the percentage of physicians/health care workers (HCWs) being immunized against influenza. The current COVID-19 pandemic offers an opportunity to focus on tailored initiatives and interventions aiming to improve the influenza vaccination coverage of HCWs in a spirit of synergy and cooperation.

COVID-19 induced hypoparathyroidism: A case report.

Low levels of serum calcium, elevated levels of serum phosphorus and absent or abnormally low levels of serum parathyroid hormone characterize hypoparathyroidism, a rare endocrine deficiency illness. Hypoparathyroidism is caused by injury to the parathyroid gland as a result of surgery or autoimmune disease. In addition, hypoparathyroidism may develop due to genetic causes or infiltrative diseases. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is characterized by multi-organ involvement, including the dysfunction of endocrine glands. Previous studies have demonstrated that SARS-CoV-2 infection induces endocrine tissue damage via various mechanisms, including direct cell damage from viral entry to the glands by binding to the angiotensin converting enzyme 2 receptors and replication, vasculitis, arterial and venous thrombosis, hypoxic cell damage, immune response and the cytokine storm. The effects of the new coronavirus, coronavirus disease 2019 (COVID-19) on the parathyroid glands have received limited attention. Hypoparathyroidism has been observed in a small number of individuals as a result of SARS-CoV-2 infection. The present study describes the case of a patient with primary hypoparathyroidism induced by COVID-19. Clinicians should also keep in mind that, despite the fact that SARS-CoV-2 has no known tropism for the parathyroid glands, it can result in primary hypoparathyroidism and decompensation of old primary hypoparathyroidism.

Evaluation of Knowledge, Attitudes and Practices Related to Self-Testing Procedure against COVID-19 among Greek Students: A Pilot Study.

The COVID-19 pandemic has had a major impact on health, economy, society and education. In the effort to return to normalcy, according to the instructions of the Greek Government for the resumption of the operation of schools, a screening Rapid Antigen Detection Test with the method of self-testing is required for students twice per week, for the early identification and isolation of positive cases. We aimed to pivotally investigate the knowledge, attitudes and practices related to self-testing procedures against COVID-19 among Greek students. A questionnaire was distributed to a convenient sample of students in the region of Athens. Information about the vaccination coverage against SARS-CoV-2 was also obtained. Our study included 1000 students, with 70% of them having an average grade at school. Most of the participants were aware of coronavirus (98.6%) and the self-test (95.5%). The vast majority of students (97%) performed self-testing twice per week, with the 70% them being assisted by someone else. Nearly one sixth of the participants had been infected by COVID-19 (14%) while 36% of them have already been vaccinated against SARS-CoV-2. In conclusion, we report high compliance with the COVID-19 self-testing procedure among students in Attica, Greece. Older age adolescents are more likely to not comply with the regulations of self-testing. Consequently, tailored interventions targeted at older age adolescents are warranted in order to increase the acceptability of self-testing.

Exacerbation of bronchiectasis by Pseudomonas putida complicating COVID-19 disease: A case report

Novel coronavirus infection presents with greater severity in individuals with comorbid chronic lung diseases. Bronchiectasis is an illness characterized by permanent enlargement of the airways, presenting with chronic cough and sputum production and vulnerability to lung infections. Bronchiectasis is not a common comorbid disease in patients with COVID-19 disease and bronchiectasis exacerbation rates were decreased during the pandemic. However, COVID-19 disease is associated with worse outcomes in patients with bronchiectasis and patients with bronchiectasis are more susceptible to SARS-CoV-2 infection development. Pseudomonas putida is an opportunistic pathogen, causing infections mostly in immunocompromised hosts and is not a frequent bacterial colonizer in patients with bronchiectasis. This present study reports a rare case of exacerbation of bronchiectasis by Pseudomonas putida complicating COVID-19 disease in an immunocompetent 70-year-old woman. Clinicians should be aware that SARS-CoV-2 infection is probably a precipitating factor of bronchiectasis exacerbation while bronchiectasis is a risk factor for greater severity of SARS-CoV-2 infection. [ FROM AUTHOR] Copyright of Experimental & Therapeutic Medicine is the property of Spandidos Publications UK Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Asymptomatic SARS-CoV-2 infection in an unvaccinated 97-year-old woman: A case report.

Coronavirus disease (COVID-19) is an infection caused by the newly detected coronavirus, SARS-CoV-2. The majority of individuals will exhibit mild to moderate illness. Older individuals, and those suffering from co-existing diseases have a greater probability of experiencing a serious illness. Moreover, elderly patients have higher mortality rates than younger patients, especially those who are unvaccinated. Asymptomatic infection is mostly observed in individuals who are younger, as younger patients are more likely to exhibit a stronger immune response to the infection; aging is characterized by the decline immune function. In this article, a rare case of an unvaccinated 97-year-old woman is described who was admitted to Laiko General Hospital due to altered levels of consciousness, hypotension and a hematoma of the thoracic region, and tested positive for SARS-CoV-2 nucleic acid in a nasopharyngeal specimen and positive for IgG antibodies against the SARS-CoV-2 spike protein without a history of consistent manifestations, indicating a past asymptomatic infection.

Exacerbation of bronchiectasis by Pseudomonas putida complicating COVID-19 disease: A case report.

Novel coronavirus infection presents with greater severity in individuals with comorbid chronic lung diseases. Bronchiectasis is an illness characterized by permanent enlargement of the airways, presenting with chronic cough and sputum production and vulnerability to lung infections. Bronchiectasis is not a common comorbid disease in patients with COVID-19 disease and bronchiectasis exacerbation rates were decreased during the pandemic. However, COVID-19 disease is associated with worse outcomes in patients with bronchiectasis and patients with bronchiectasis are more susceptible to SARS-CoV-2 infection development. Pseudomonas putida is an opportunistic pathogen, causing infections mostly in immunocompromised hosts and is not a frequent bacterial colonizer in patients with bronchiectasis. This present study reports a rare case of exacerbation of bronchiectasis by Pseudomonas putida complicating COVID-19 disease in an immunocompetent 70-year-old woman. Clinicians should be aware that SARS-CoV-2 infection is probably a precipitating factor of bronchiectasis exacerbation while bronchiectasis is a risk factor for greater severity of SARS-CoV-2 infection.

The Impact of Peripheral Eosinophil Counts and Eosinophil to Lymphocyte Ratio (ELR) in the Clinical Course of COVID-19 Patients: A Retrospective Study.

BACKGROUND/AIM: Eosinophils are blood cells responsible for response against parasites and allergens. Eosinophil to lymphocyte ratio (ELR) is a biomarker for inflammatory conditions. Our aim was to evaluate the role of eosinophils and ELR in COVID-19 patients. PATIENTS AND METHODS: The study included 96 patients hospitalized with COVID-19. They were classified into moderate to severe cases and critical cases. Eosinophils and ELR were determined in both groups, in patients that died or survived and were correlated to duration of hospitalization. RESULTS: There was a statistically significant decrease in eosinophils and ELR between patients that died and patients that survived (p<0.05), and in mean values of the two biomarkers (p<0.05 for eosinophils and p<0.05 for ELR) between patients hospitalized for more or less than 15 days among those with moderate to severe disease. CONCLUSION: Lower eosinophil counts and ERL could probably predict worse outcome in COVID-19 patients.