ABSTRACT
The interrelations and sequencing of interleukins are complex (inter)actions where each interleukin can stimulate the secretion of its preceding interleukin. In this paper, we attempt to summarize the currently known roles of IL-4, IL-13, IL-31, and IL-33 from a multi-disciplinary perspective. In order to conduct a comprehensive review of the current literature, a search was conducted using PubMed, Google Scholar, Medscape, UpToDate, and Key Elsevier for keywords. The results were compiled from case reports, case series, letters, and literature review papers, and analyzed by a panel of multi-disciplinary specialist physicians for relevance. Based on 173 results, we compiled the following review of interleukin signaling and its clinical significance across a multitude of medical specialties. Interleukins are at the bed rock of a multitude of pathologies across different organ systems and understanding their role will likely lead to novel treatments and better outcomes for our patients. New interleukins are being described, and the role of this inflammatory cascade is still coming to light. We hope this multi-discipline review on the role interleukins play in current pathology assists in this scope.
ABSTRACT
Preventing mother-to-child HIV transmission is a strategy to eliminate new infections to move toward a world free of HIV/AIDS. The aim of this study is to assess the effectiveness of the perinatal infection prevention program in a single center from southeast Romania. Newborns of HIV-positive mothers from 2005 to 2020 were followed-up until the age of two in a retrospective study. The transmission rate from HIV-positive mothers to living children was zero, but neonatal mortality, preterm birth and birth defects were still high. The peculiarity of our study is the high proportion of mothers with a nosocomial pattern of HIV transmission. Intensifying the efforts for accurate implementing the interventions for the prevention of mother-to-child HIV transmission, a long time follow-up for HIV-exposed uninfected children and new research on related HIV pregnancies are necessary to reach the objective of a new generation free of HIV.
ABSTRACT
The cytokine storm from the evolution of severe cases of COVID-19, requiring strong immunosuppressive therapies, has raised the issue of reactivation of hepatitis B virus (HBV) infections in these patients. An analysis of the first observational studies in patients with COVID-19 and immunosuppressive therapy and HBV infection along with special clinical cases was presented, as well as personal experience on a series of cases (a group of 958 patients with COVID-19), compared with the analysis of studies performed on patients with HBV infection that underwent biological therapies for psoriasis and personal experience (a group of 81 psoriasis patients treated with biological therapies). Clinical studies have revealed that HBV reactivation in patients undergoing biological therapies for psoriasis, can be prevented with monitoring and treatment protocols and thus, these therapies have been demonstrated to be safe and effective. In COVID-19, immunosuppressive therapies are short-lived but in high doses, and the conclusions of clinical trials are contradictory, but there are published cases of HBV reactivation, which requires a unitary attitude in the prevention of HBV reactivation in these patients. An algorithm was presented for monitoring and treatment of HBV infection for patients with psoriasis treated with biological therapy and the conditions when this protocol can be used for patients with COVID-19 and immunosuppressive therapy.
ABSTRACT
Purpose: The COVID-19 pandemic was noted for the high degree of contagion and the large number of cases, as well as for the various clinical forms, from asymptomatic towards rapid evolution to death. The hospitals limited care capacity imposed the need to identify some markers of unfavorable evolution. The purpose of our study is to identify the parameters correlated with COVID-19 unfavorable evolution and to draw the profile of the patient at risk of unfavorable evolution. This set of parameters will help the doctor in deciding whether to hospitalize a patient and in choosing the treatment. Patients and Methods: We performed a prospective, observational, actively controlled study on 849 patients with COVID-19, hospitalized in the Second Clinic of "Sf. Cuv. Parascheva" Infectious Diseases Clinical Hospital Galati, Romania, between 1.03.2020-30.11.2020. Results: The parameters statistically significant modified at the admission of the patients with COVID-19 unfavorable evolution were age, oxygen saturation, D-dimers, creatine kinase (CK), troponin, erythrocytes sedimentation rate (ESR), leukocytes, lymphocytes, neutrophils, platelets, hemoglobin (Hb), aspartate transaminase (AST), total and direct bilirubin (TBIL, DBIL), urea, creatinine, serum glucose. Strong correlations were observed between the unfavorable evolution and the admission values of D-dimers, AST, TBIL and between D-dimers and AST, which suggests that D-dimers levels can be considered predictive for the alteration of liver function and for the negative prognosis of the patient. Conclusion: Coagulation disorders and acute respiratory failure are the prevailing causes of death from COVID-19. Together with other parameters that constitute the risk profile for severe COVID-19 evolution, the D-dimers dosing at admission proved to be extremely useful in the management of COVID-19.
ABSTRACT
The coronavirus disease 2019 (COVID-19) pandemic imposed arestructuring of global health systems by rethinking spaces used for the care of these patients and the additions of intensive care, infectious diseases and pneumology departments. This paper provides evidence on the presence of severe acute respiratory syndrome coronavirus 2 in hepatocytes and its direct cytopathic activity, as well as the degree of liver damage due to drug toxicity, inflammation and hypoxia in COVID-19. A review of clinical trials has quantified liver damage through both pathology and biochemistry studies. Additionally, we briefly present the results of a study conducted in our clinic on 849 patients admitted for COVID-19 treatment, of which 31 patients had pre-existing chronic liver disease and 388 patients had values above the normal limit for alanine aminotransferase, aspartate aminotransferase, and total bilirubin. It was observed that patients with abnormal liver tests were significantly statistically older, had more comorbidities and had a higher percentage of unfavourable evolution (death or transfer to intensive care). The conclusion of this paper is that the main causes of liver damage are direct viral aggression, coagulation dysfunction and endothelial damage, and patients with impaired liver function develop more severe forms of COVID-19 which requires special care by a multidisciplinary team that includes a hepatologist.
ABSTRACT
The beginnings of the human immunodeficiency virus (HIV) pandemic are closely linked to dermatological conditions. A large part of the population living with HIV (PLWH) has a series of skin conditions that determine at some point, a visit to the dermatologist. The introduction of highly active antiretroviral therapy (HAART) more than 20 years ago has diminished the range of dermatological conditions, with improved immunosuppression of CD4 lymphocytes. The study aimed to describe the prevalence of the diagnosed type of skin changes in PLWH receiving antiretroviral therapy and their stratification according to the degree of immunodeficiency. A prospective study was conducted on 57 PLWH evaluated monthly at an HIV outpatient clinic, from a tertiary hospital in southeastern Romania. Clinical examination and dermoscopy revealed the existence of a wide range of dermatological conditions; all 57 patients (100%) being diagnosed with one or more dermatological conditions. As our study shows, the prevalence of different dermatoses among PLWH varies depending on the geographical region. At the same time, under HAART, the image of dermatoses associated with decreased immunity from HIV infection has changed. The skin changes of PLWH no longer fully follow the classical staging, based on the degree of immunosuppression.
ABSTRACT
Given that the pesticide and fungicide residues determination in honey is not a routine analysis in Romania, information on these emerging contaminants is useful for consumer's safety. High resolution mass spectrometry technique was applied by Q-Exactive Orbitrap LC-MS/MS to identify and quantify environmental contaminants in honey. A list of 25 compounds, biocides and antifungals was selected for the method development, based on the occurrence in the Romanian environment and their potential usage in agriculture. The method was applied for 18 various honey samples collected in different geographic regions of Romania. Eleven compounds were present in the honey samples: carbendazim, enilconazole, hexaconazole, penconazole, tebuconazole, flusilazole, thiabendazole, terconazole, cyproconazole, propiconazole, metalaxyl. Targeted MS/MS analyses were performed for confirmation. The measured quantities ranged from 1.7-7.2 µg kg-1, lower than MRLs established by the legislation. The most abundant compound was enilconazole (imazalil), which was detected in fourteen samples. To the best of our knowledge, the present study is the first one concerning antifungal contamination of honey in Romania. The results proved that the tested honey samples are safe for human consumption.
