Simultaneous detection of respiratory syncytial virus types A and B and influenza virus types A and B in community-acquired pneumonia by reverse transcription-multiplex PCR

Background: Respiratory syncytial virus (RSV) types A and B and influenza A and B cause about 80–90% of viral lower respiratory tract infections. It is impossible to distinguish the cause of viral respiratory infections by their clinical presentation. Multiplex RT-PCR has a significant advantage in that it permits the simultaneous amplification of several viruses in a single reaction facilitating cost-effective diagnosis and perhaps improved clinical management.Objectives: In this study, our aim was to determine the prevalence of influenza A and B, and RSV types A and B among children with CAP, by the use of the newly developed rapid, accurate, and pathogen-specific technique of multiplex RT-PCR in order to accomplish the greatest positive effect on patient care and health care costs.Study methodology: This study is a cross-sectional study involving 24 children admitted to the Children’s Hospital of the Ain Shams University due to severe lower respiratory tract infection (LRTI). Clinical and radiological assessment of all patients was performed followed by the molecular analysis of both respiratory and blood samples of all enrolled patients simultaneously by the use of the newly available reverse transcription-multiplex PCR technique (RT-m PCR).Results: Viral pneumonia was detected in one-third of enrolled patients (8/24), with the predominance of respiratory syncytial virus A (4/8), followed by influenza A virus (3/8) and influenza B virus (1/8) while no cases of respiratory syncytial virus B was detected. The same results were identified in both blood and respiratory specimens.Conclusion: Reverse transcription-multiplex PCR technique – multiplex has a significant advantage in that it permits the simultaneous amplification of several viruses in a single reaction making it well suited for use in epidemiological studies and to improve etiology-directed clinical management of viral pneumonia.Keywords: Viral pneumonia; LRTI; Children; Reverse transcription-multiplex PCR; RSV; Influenza viruse

Effects of the total replacement of fish-based diet with plant-based diet on the hepatic transcriptome of two European sea bass (Dicentrarchus labrax) half-sibfamilies showing different growth rates with the plant-based diet

Background: Efforts towards utilisation of diets without fish meal (FM) or fish oil (FO) in finfish aquaculture have been being made for more than two decades. Metabolic responses to substitution of fishery products have been shown to impact growth performance and immune system of fish as well as their subsequent nutritional value, particularly in marine fish species, which exhibit low capacity for biosynthesis of long-chain poly-unsaturated fatty acids (LC-PUFA). The main objective of the present study was to analyse the effects of a plant-based diet on the hepatic transcriptome of European sea bass (Dicentrarchus labrax). Results: We report the first results obtained using a transcriptomic approach on the liver of two half-sibfamilies of the European sea bass that exhibit similar growth rates when fed a fish-based diet (FD), but significantly different growth rates when fed an all-plant diet (VD). Overall gene expression was analysed using oligo DNA microarrays (GPL9663). Statistical analysis identified 582 unique annotated genes differentially expressed between groups of fish fed the two diets, 199 genes regulated by genetic factors, and 72 genes that exhibited diet-family interactions. The expression of several genes involved in the LC-PUFA and cholesterol biosynthetic pathways was found to be up-regulated in fish fed VD, suggesting a stimulation of the lipogenic pathways. No significant diet-family interaction for the regulation of LC-PUFA biosynthesis pathways could be detected by microarray analysis. This result was in agreement with LC-PUFA profiles, which were found to be similar in the flesh of the two half-sibfamilies. In addition, the combination of our transcriptomic data with an analysis of plasmatic immune parameters revealed a stimulation of complement activity associated with an immunodeficiency in the fish fed VD, and different inflammatory status between the two half-sibfamilies. Biological processes related to protein catabolism, amino acid transaminations, RNA splicing and blood coagulation were also found to be regulated by diet, while the expression of genes involved in protein and ATP synthesis differed between the half-sibfamilies. Conclusions: Overall, the combined gene expression, compositional and biochemical studies demonstrated a large panel of metabolic and physiological effects induced by total substitution of both FM and FO in the diets of European sea bass and revealed physiological characteristics associated with the two half-sibfamilies

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer

Intraoperative complications of refractive small incision lenticule extraction in the early learning curve

Abdelmonem M Hamed,1,2 Shereef M Abdelwahab,1,2 Tarek T Soliman1,2 1Ebsar Eye Center, Benha, Qalyubia, Egypt; 2Ophthalmology Department, Benha University, Benha, Qalyubia, Egypt Purpose: To study the intraoperative complications of refractive small incision lenticule extraction (ReSMILE push-up technique), and to record the mean intraoperative duration time of all surgeries for the refractive surgeon in his early learning curve.Setting: Ebsar Eye Center, Benha, Egypt.Design: A prospective, single-center, cohort clinical study.Methods: This prospective, single-center, cohort clinical study was done on patients with myopia and myopic astigmatism, who were enrolled for SMILE surgeries. All the SMILE operations were performed by a single refractive surgeon (AMH), by using only the ReSMILE push-up technique.Results: A total of 190 eyes were operated upon, using the (ReSMILE push-up technique), with a mean follow-up period of 2 months. The intraoperative complications have been recorded for all patients. The mean operative duration of all cases was 4.45±1.45 minutes.Conclusion: The ReSMILE: push-up technique seems to facilitate visualization of the edge of the lenticule of the SMILE surgery, especially for the refractive surgeon in his early learning curve. Keywords: ReLEX, SMILE, ReSMILE, refractive, SMILE complication

Tension-Free Vaginal Tape versus Transobturator Tape for Treatment of Female Stress Urinary Incontinence

Objectives: The transobturator tape (TOT) is based on a similar principle as the tension-free vaginal tape (TVT), but introduced through the obturator foramen. The aim of this study was to compare these slings as surgical procedures for the treatment of stress urinary incontinence (SUI)in women.Patients and Methods: This is a retrospective case-control study including female patients with SUI, either due to urethral hypermobility or intrinsic sphincter deficiency. Thirty patients were treated with TVT (group 1) and 30 were treated with TOT (group 2). The parameters studied were: pre-operative clinical data, operative data and surgical outcome.Results: The post-operative complications in group 1 consisted of bladder perforation in one patient (3.3%), urinary retention in 3 (10%) and de novo urgency in 3 (10%). The post-operative complications in group 2 consisted of vaginal exposure in 2 patients (6.7%), de novo urgencyin 2 (6.7%) and transient urinary retention in one (3.3%). In the TVT group, objective cure was achieved in 27/30 patients (90%), while 3 patients (10%) reported subjective cure; failure was not encountered. In the TOT group, objective cure was achieved in 24/30 patients (80%) andsubjective cure in 4 patients (13.3%); and it failed in 2 patients (6.7%).Conclusion: TVT and TOT are effective procedures for the treatment of female SUI, with comparable results regarding operative time, hospital stay and the risk of complications.Key Words : Stress urinary incontinence, treatment and outcom