[Development and evaluation of ultrasound navigation for free-hand biopsies of small masses in the head and neck area]. / Entwicklung und Evaluation einer Ultraschallnavigation für Freihandbiopsien kleiner Raumforderungen im Kopf-Hals-Bereich.

BACKGROUND: Ultrasound is an important imaging method in the head and neck area. It is readily available, dynamic, inexpensive, and does not involve radiation exposure. Interventions in the complex head and neck anatomy require good orientation, which is supported by navigation systems. OBJECTIVE: This work aimed to develop a new ultrasound-controlled navigation system for taking biopsies of small target structures in the head and neck region. METHODS: A neck phantom with sonographically detectable masses (size: 8-10 mm) was constructed. These were automatically segmented using a ResNet-50-based deep neural network. The ultrasound scanner was equipped with an individually manufactured tracking tool. RESULTS: The positions of the ultrasound device, the masses, and a puncture needle were recorded in the world coordinate system. In 8 out of 10 cases, an 8­mm mass was hit. In a special evaluation phantom, the average deviation was calculated to be 2.5 mm. The tracked biopsy needle is aligned and navigated to the masses by auditory feedback. CONCLUSION: Outstanding advantages compared to conventional navigation systems include renunciation of preoperative tomographic imaging, automatic three-dimensional real-time registration that considers intraoperative tissue displacements, maintenance of the surgeon's optical axis at the surgical site without having to look at a navigation monitor, and working freely with both hands without holding the ultrasound scanner during biopsy taking. The described functional model can also be used in open head and neck surgery.

The protection conferred against virulent Newcastle disease virus (vNDV) genotype VII by commercial double recombinant HVT vaccines and NDV live-attenuated vaccine as prime/boost vaccination regimens in commercial broiler chickens carrying maternally-derived antibodies (MDAs) against NDV.

Vaccines against vNDV are readily available and potentially protective; nevertheless, improved vaccination protocols are required to prevent clinical disease and discontinue the spread of the virus. This study assessed the effectiveness of two commercial recombinant herpesvirus of turkey vector vaccines (rHVT-NDV-IBDV) that express the fusion (F) protein of NDV and the virus protein 2 (VP2) of infectious bursal disease virus (IBDV). In commercial broilers with maternally-derived antibodies (MDAs) the efficacy of the rHVT-NDV-IBDV vaccines was evaluated when administered alone, in combination with live-attenuated NDV vaccine at one-day-old, or as part of a prime/boost strategy. The vaccinated birds were challenged with the genotype VIId vNDV strain (NDV/chicken/Egypt/1/2015) at various ages (14, 24 and 35 days). In comparison to sham-vaccinated control birds, the applied vaccination regimens were able to reduce or prevent mortality and virus shedding and clinical disease. Two weeks post-application, the two vector vaccines were serologically reactive with the MDAs and induced protective immune responses against the F protein. In the instance of early challenge at 14 days old, the combination of recombinant rHVT-NDV-IBDV with a live vaccine offered better protection and reduced virus shedding compared to the vector vaccine alone. Boosting with live NDV vaccine at 14 days old increased the protective effect of the vector vaccines and reduced virus shedding and the clinical index after challenge at 24 days old. Both combining and/or boosting with live vaccine together with the vector vaccine provided better protection and minimized virus shedding compared with vaccination with vector vaccine only in the instance of 5-week-old challenge.

First Report of Duck Hepatitis A Virus 3 from Duckling Flocks of Egypt.

Duck hepatitis A viruses (DHAV-1, DHAV-2, and DHAV-3) are the predominant causes of duck virus hepatitis (DVH), a disease of ducklings that leads to massive morbidities, mortalities, and economic losses. As a duck-producing country, Egypt suffered lately from several attacks of DVH, despite the regular vaccination of birds. Between Spring 2016 and Summer 2018, 54 duckling flocks in the Sharkia province of Egypt were tested using the reverse-transcription PCR (RT-PCR) based on the DHAV-3D targeting primers. Of them, 27.8% (15/54) were positive. Upon retesting of positive samples using RT-PCR and duck hepatitis A virus (DHAV)-3 VP1-based primers, 33.3% (5/15) contained DHAV-3 RNA. For further analysis at the molecular level, the VP1 and the 3D genes were sequenced using the same primer sets used earlier. The phylogenetic trees confirmed that study sequences belonged to DHAV-3. However, they were displayed as a separate cluster following a geographically dependent distribution. They were also completely unrelated to the Egyptian DHAV-1-based vaccine. This was further confirmed by low nucleotide and amino acid identities in relation to this vaccine. In addition, the VP1 and 3D genes had the same phylogenetic topography. The study VP1 sequences had three unique amino acid substitutions (L59, V208 only in one strain, and C219). As far as we know, this is the first report on DHAV-3 outside Asia, particularly in Egypt. Accordingly, the vaccination strategy against DHAV should be quickly updated to avoid further dissemination of the virus. The epidemiology, pathogenicity, and evolution of DHAV-3 should be carefully monitored in Egypt.

Molecular and phenotypic characterization of Escherichia coli isolated from broiler chicken flocks in Egypt.

Avian pathogenic Escherichia coli (APEC) infection is responsible for great economic losses to the poultry industry worldwide and there is increasing evidence of its zoonotic importance. In this study, 219 E. coli isolates from 84 poultry flocks in Egypt, including 153 APEC, 30 avian fecal E. coli (AFEC), and 36 environmental E. coli, were subjected to phylogenetic grouping and virulence genotyping. Additionally, 50 of these isolates (30 APEC from colisepticemia and 20 AFEC) were subjected to a more-extensive characterization which included serogrouping, antimicrobial susceptibility analysis, screening for seven intestinal E. coli virulence genes (stx1, stx2, eae, espP, KatP, hlyA, and fliCh7), multilocus sequence typing (MLST), pulsed-field gel electrophoresis (PFGE), and in vivo virulence testing. More than 90% of the total APEC examined possessed iroN, ompT, hlyF, iss, and iutA, indicating that Egyptian APECs, like their counterparts from the United States, harbor plasmid pathogenicity islands (PAIs). The majority of APEC and AFEC were of phylogenetic groups A, B1, and D. For the 50-isolate subgroup, more than 70% of APEC and 80% ofAFEC were multidrug resistant. Among the subgroup of APEC, MLST analysis identified 11 sequence types (ST) while seven STs were found among AFEC. Based on PFGE, the genetic relatedness of APEC and AFEC ranged from 50%-100% and clustered into four primary groups at 50% similarity. Two of the eight APEC strains tested in chickens were able to induce 25% mortality in 1-day-old chicks. APECs were distinguished from AFECs and environmental E. coli by their content of plasmid PAI genes, whereas APEC isolated from colisepticemia and AFEC were not distinguishable based on their antimicrobial resistance patterns, as both groups were multidrug resistant. Avian E. coli strains from broiler flocks in Egypt show similar sequence types to E. coli associated with human infection.

Abdominal sacrohysteropexy for uterovaginal prolapse: a prospective study on 33 cases.

OBJECTIVE: To evaluate the results of abdominal sacrohysteropexy using polypropylene mesh in women with uterovaginal prolapse, wishing to preserve their uteri. DESIGN: Prospective observational study. SETTING: Tertiary referral Gynecology centre. SUBJECTS: Thirty-three women with symptomatic uterovaginal prolapse operated on by the same surgeon. SURGICAL METHOD: Sacrohysteropexy performed using polypropylene mesh extending between the back of the uterus at the uterosacral ligaments and the sacrum. MAIN OUTCOME MEASURES: Subjective and objective relief of uterine prolapse and operative and post-operative complications. RESULTS: The mean age of the women was 46 years (range 29-65). All were multiparous with mean weight of 83.3 kg (70-96). Pelvic organ prolapse (POP-Q) stage 2 was found in 27 cases (81.8%) and stage 3 in six women (12.2%). Mean operative time was 45.76 min (30-75), and mean hospital stay was 2.45 days. One case suffered rectal injury, one case had median sacral vein injury, both were repaired immediately. Two cases had delayed voiding recovery. The mean follow up time was 6 months. At follow up, only two cases showed recurrence, and the objective and subjective success rates at 6 months were 93.93 and 81.8%, respectively. CONCLUSIONS: Abdominal sacrohysteropexy is a safe, efficient surgical technique for treatment of uterine prolapse in women who desire to preserve the uterus. This procedure has a high success rate and is an easy technique with short learning curve.

Complete genome sequence of a virulent Newcastle disease virus isolated from an outbreak in chickens in Egypt.

The complete genome sequence of a virulent Newcastle disease virus (NDV) isolated from chickens in Egypt was determined and compared to the sequence of NDV strains isolated from different parts of the world. The genome is 15,186 nucleotides (nt) long and consists of 6 genes in the order of 3'-N-P-M-F-HN-L-5'. The genome contains a 55-nt leader region at the 3' end and a 114-nt trailer region at the 5' end. Interestingly, the phylogenetic analysis showed that strain Egypt is closely related with the NDV strains isolated in China. In addition, the sequence of the fusion protein cleavage site of strain Egypt was identical to that of the NDV strain recently isolated in Mali. Determination of complete genome sequences of additional NDV strains from Africa is necessary to understand the epidemiology of currently circulating viruses in Africa.