Sarcomatoid urothelial carcinoma accompanied by elevated serum beta-HCG: Two case reports

Sarcomatoid urothelial carcinoma is a rare and aggressive variant. Serum beta-hCG levels are used as a tumor marker in gestational trophoblastic diseases and germ cell tumors, but may also be elevated in high-grade bladder cancers. Here, we report two urothelial carcinoma cases with sarcomatoid differentiation that relapsed early after surgery with elevated serum beta-hCG levels. The first case was a 65-year-old female and the second case was a 67-year-old man with sarcomatoid urothelial carcinoma located in the ureter and renal pelvicalyceal system, both of them relapsed with elevated beta-hCG serum level to 146.8 mIU/ mL and 242 mIU/mL, respectively. They died a few months after initial diagnosis;4.9 and 2.5 months respectively. Both sarcomatoid variant and beta-hCG expression were associated with poor prognosis and advanced stage. However, beta-hCG is not used as a tumor marker in urinary tract cancers yet, and its relationship with variant pathologies has not been clarified. We need multi-centered studies to reveal this relationship.Copyright © 2023, Derman Medical Publishing. All rights reserved.

Drugs Used in Azerbaijan During COVID-19 and Their Effectiveness

Introduction: We investigated the efficacy of the antiviral medications used for the treatment of Coronavirus disease-2019 (COVID-19). Materials and Methods: Various information was collected applying antiviral medications to 150 people in different groups of 30 people with each being in a different clinical condition. Paralelly radiological (X-ray of lungs, Chest KT) and laboratory analyses (hemogram, CRP, ferritin, LDH, coagulograma panel, D-dimer, procalcitonin, ALT, AST, keratin, albumin) were tracked. Results: Efficacy of medication were as follows: Umifenovir mainly with slightly ill and moderetely severe and pregnant patients 33%, lopinavir and ritonovir on moderately severe patients 28%, favipiravir on moderately severe patients and patients without the need of oxygen 41%, remdesevir mainly on patients in need of oxygen and the patients in need of intenive care 58%, molnupiravir on severe patient groups and the patients particularly at the beginning stage of clinical complaint 69%. Conclusion: Remdesevir and molnupiravir were estimated to be more effective on the tratment of COVID-19.

Patterns of Inflammatory Cell Infiltration in the Lungs of Patients with COVID-19, An Autopsy Study

Background: SARS-CoV-2 causes diffuse alveolar damage, lymphocyte infiltration in the lungs and a cytokine storm. In this study we examined inflammatory cell infiltrates in the lungs of patients with COVID-19. Design: Eighteen COVID-19 autopsy cases (COVID group), 9 non-COVID cases with diffuse alveolar damage (DAD, non-COVID group), and eleven controls without lung diseases were included. Immunostainings for CD3, CD4, CD8, CD68 and broad-spectrum keratins were performed. Results: The average age of COVID-19 patients was 64.4±2.1 years. The most common co-morbidities were hypertension (12/17, 70.6%), diabetes mellitus (9/17, 52.9%) and chronic kidney disease (3/17, 17.6%). The survival duration of 17 patients with available clinical information was 21.2 ± 3.4 days (range 7-53 days) after onset of symptoms. Patients younger than 67 years old (namely young patients thereafter, N=9) survived 26.4 ± 5.9 days after onset of symptoms, which was significantly longer than those greater than 67 years old (namely older patients thereafter, 15.2 ± 1.4 days, N=8, P<0.05). The younger patients had significantly lower platelet counts (107.7 ± 33.2 x 109/L, N=8) than the older ones (224.6 ± 42.4 x 109/L, N=8, P<0.05). Conversely, the younger patients had much higher absolute lymphocyte counts (1.5 ± 0.4 x 109/L, N=7) than the older ones (0.7 ± 0.1 x 109/L, N=8, P<0.05). Interestingly, the patients with low platelet counts (<100 x 109/L) survived longer than those with higher platelet counts (P<0.05). Patients with high troponin levels (>0.2 ng/ml) had shorter survival duration after onset of symptoms (16.8 ± 1.9 days) than those with low troponin levels (30.8 ± 8.0 days, P<0.05). Patients with macrophages >130/HPF, CD3+ T cells >145/HPF, CD8+ T cells <30/HPF and CD8+/CD4+ ratio<1 had a shorter survival time compared to those with macrophages <130/HPF, CD3+ T cells <145/HPF, CD8+ T cells >30/HPF and CD8+/CD4+ ratio>1, respectively. Conclusions: Patients' age > 67 years, blood troponin levels >0.2 ng/ml, platelet count >100 x 109/L, lung macrophages >130/HPF, CD3+ T cells >145/HPF, CD8+ T cells <30/HPF, and CD8/CD4 ratio <1 were associated with shorter survival duration after onset of symptoms.

Demonstration of virulence factors of Trichosporon species isolated from clinical samples during the COVID 19 pandemic - A study from a tertiary care medical college hospital from South India

Background:Genus Tricosporon consists of basidiomycetous yeast that form a part of the human microbiota.They cause an array of human diseases, both in imunocompetant and immunocompromised patients. They are the second most commonly reported cause of disseminated infections in humans. Their ability to form Biofilms make them a potential agent of Catheter associated Fungemia. They exhibit virulence factors like Biofilm formation, hemolysis and produce enzymes like proteases and phospholipases that increases the pathogenicity by breaking down the proteins and dis- rupting the host cell membranes. The proteolytic activity plays an important role in its pathogenicity by facilitating inva- sion through degradation of keratin and collagen. Methods:This observational period study was performed at our hospital from 20/06/2020 to 20/10/2020.The isolates were subjected to tests to demonstrate virulence factors. Determination of phospholipase activity was performed using using egg yolk agar, hemolytic activity by SDA with 7% sheep blood, esterase activity was determined by using Tween -80 opacity test medium and the production of Biofilm formation was done by micro titre plate method. All results were recorded. The isolates were confirmed by MALDI TOF mass spectrometry. Results:1.Colony morphology 2.Urease production using christensons urea agar (2%) 3.Phenotypic and Biochemical test result were per- formed and tabulated. Proteomic confirmation results are awaited. [Formula presented] Conclusions:Knowing the virulence factor and the commonly occurring Trichosporon species aids in understanding the pathogenesis and to plan strategic treatment modalities

The negative impact of the hominin's DPP4 gene inherited from neanderthals to pandemic of COVID-19

Background: According to preliminary sequences from 2010, 99.7% of the nucleotide sequences of the modern human and Neanderthal genomes are identical, compared to humans sharing around 98.8% of sequences with the chimpanzee. In contrast, the difference between chimpanzees and modern humans is approximately 1,462 mtDNA base pairs. Materials and Methods: Neanderthal-inherited genetic material is found in all non-African populations and was initially reported to comprise 1 to 4% of the genome. This fraction was later refined to 1.5 to 2.1%. We had gone through many researches of Neanderthals affected gene flow in humans. Results: It is estimated that 20% of Neanderthal DNA currently survives in modern humans. Modern human genes involved in making keratin, a protein constituent of skin, hair, and nails, have especially high levels of introgression. For example, approximately 66% of East Asians contain a POUF23L variant introgressed from Neanderthals, while 70% of Europeans possess an introgressed allele of BNC2. Our finding shines a light on an enzyme called dipeptidyl peptidase4 (DPP4). Scientists already know the protein allows another coronavirus, which causes Middle Eastern respiratory syndrome (MERS), to bind to and enter human cells. The new analysis, of DPP4 gene variants among COVID-19 patients, suggests the enzyme also provides SARS-CoV-2 with a second door into our cells, along with its usual infection route via the angiotensin-converting enzyme 2 (ACE2) receptor on cell surfaces. Conclusion: Most Europeans, Asians, and Native Americans harbor a handful of genes from Neanderthals, up 1.8% to 2.6% of their DNA. Studies of ancient DNA in Neanderthal fossils have shown the hominin's DPP4 gene subtly differs from the typical human one. Conclusion: The hominin's DPP4 gene inherited from Neanderthals plays a major role in Immune System Disorders and Lower Immune response in many diseases. This gene plays a major role in affecting humans with COVID-19 and spreading it through the world. All humans contain this gene from 1 to 4%. East Asians, Europeans, Middle and south Americans conveys more, hence, native Africans contain less amounts of hominin's DPP4 gene. Therefore, East Asians, Europeans, Middle and south Americans are prone to severe COVID-19.

Long-term effects of face masks on skin characteristics during the COVID-19 pandemic.

BACKGROUND: Nowadays, face masks are a crucial part of our daily life. Previous studies on their impact on the skin usually focused on the adverse effects of face masks. Few studies have assessed their influence on skin characteristics. In a previous study, we identified the short-term effects of wearing face masks. Herein, we describe the long-term skin effects of face masks, for a period of 6 months. MATERIALS AND METHODS: Healthy volunteers (19 men and women), who wore face masks, participated in the study from June 2020 to December 2020. In all participants, skin characteristics such as trans-epidermal water loss (TEWL), skin hydration, skin elasticity, skin pore area, skin keratin amount, skin temperature, skin redness, skin temperature, skin redness, and skin color were measured three times. RESULTS: TEWL, skin hydration, skin elasticity, skin pore area, skin keratin amount, and skin color changed significantly after 6 months. TEWL, skin hydration, skin pore area, skin keratin amount, and skin color were significantly different between the mask-wearing and non-mask-wearing areas. CONCLUSION: Long-term daily use of face masks can alter skin characteristics. Special care should be focused on the mask-wearing regions.

State-of-the-Art Dermatophyte Infections: Epidemiology Aspects, Pathophysiology, and Resistance Mechanisms.

The burden of fungal infections is not widely appreciated. Although these infections are responsible for over one million deaths annually, it is estimated that one billion people are affected by severe fungal diseases. Mycoses of nails and skin, primarily caused by fungi known as dermatophytes, are the most common fungal infections. Trichophyton rubrum appears to be the most common causative agent of dermatophytosis, followed by Trichophyton interdigitale. An estimated 25% of the world's population suffers from dermatomycosis. Although these infections are not lethal, they compromise the quality of life of infected patients. The outcome of antidermatophytic treatments is impaired by various conditions, such as resistance and tolerance of certain dermatophyte strains. The adage "know your enemy" must be the focus of fungal research. There is an urgent need to increase awareness about the significance of these infections with precise epidemiological data and to improve knowledge regarding fungal biology and pathogenesis, with an emphasis on adaptive mechanisms to tackle adverse conditions from host counteractions. This review outlines the current knowledge about dermatophyte infections, with a focus on signaling pathways required for fungal infection establishment and a broad perspective on cellular and molecular factors involved in antifungal resistance and tolerance.

Basal-like Progenitor Cells: A Review of Dysplastic Alveolar Regeneration and Remodeling in Lung Repair.

Despite the central importance of the respiratory system, the exact mechanisms governing lung repair after severe injury remain unclear. The notion that alveolar type 2 cells (AT2s) self-renew and differentiate into alveolar type 1 cells (AT1s) does not fully encompass scenarios where these progenitors are severely affected by disease, e.g., H1N1 influenza or SARS-CoV-2 (COVID-19). Intrapulmonary p63+ progenitor cells, a rare cell type in mice but potentially encompassing more numerous classic basal cells in humans, are activated in such severe injury settings, proliferating and migrating into the injured alveolar parenchyma, providing a short-term "emergency" benefit. While the fate of these cells is controversial, most studies indicate that they represent a maladaptive repair pathway with a fate restriction toward airway cell types, rarely differentiating into AT2 or AT1 cells. Here, we discuss the role of intrapulmonary basal-like p63+ cells in alveolar regeneration and suggest a unified model to guide future studies.

Salvianolic acid B ameliorates psoriatic changes in imiquimod-induced psoriasis on BALB/c mice by inhibiting inflammatory and keratin markers via altering phosphatidylinositol-3-kinase/protein kinase B signaling pathway.

Salvianolic acid B (SAB) is an active phytocomponent of a popular Chinese herb called Radix Salvia militiorrhiza with numerous biological properties. The anti-psoriasis activity of SAB was examined by evaluating various psoriasis inflammatory and keratin markers against imiquimod (IMQ)-induced psoriasis on BALB/c mice. Totally 50 healthy BALB/c mice were evenly divided into 5 groups including control, drug control (SAB; 40 mg/kg), IMQ-induced psoriasis (5%), IMQ exposure and treated with SAB (40 mg/kg), or standard methotrexate (MTX; 1 mg/kg). Mice supplemented with either SAB or MTX significantly lowered the values of psoriasis area severity index (PASI), erythema, scaling, skin thickness, inflammatory markers (interleukin [IL]-22/23/17A/1ß/6) and lipid peroxidation product (malondialdehyde). Also, IMQ exposed BALB/c mice treated with SAB or MTX display lesser histopathological changes with enhanced antioxidant activities (catalase, superoxide dismutase). Moreover, the protein expression of keratin markers (K16 and K17) and phosphatidylinositol-3-kinase (PI3K)/protein kinase B (Akt) signaling proteins (pAkt/Akt and pPI3K/PI3K) were significantly downregulated after administration with SAB and MTX as compared with IMQ induced mice. Taking together, SAB and MTX significantly ameliorate psoriatic changes by inhibiting psoriatic inflammatory and keratin markers through abolishing PI3K/Akt signaling pathway. However, further studies (clinical trials) are needed to confirm the anti-psoriatic property of SAB before recommending to psoriasis patients.