The prevalence of pulmonary embolism in non-hospitalised de-isolated patients diagnosed with mild COVID-19 disease

Background. Pulmonary embolism (PE) is a known complication of COVID-19 disease. The mechanism of thromboembolic events appears to be stimulated by excessive thrombin production, inhibition of fibrinolysis and deposition of antiphospholipids and thrombi, as well as microvascular dysfunction in multiple vascular beds. The occurrence of PE has been well demonstrated in hospitalised patients with severe disease. Very few data are available on its incidence or prevalence in non-hospitalised patients diagnosed with a milder form of the disease.Objectives. To assess the prevalence of PE in non-hospitalised patients diagnosed with mild COVID-19 who presented with raised D-dimer levels and persistent or new-onset cardiopulmonary symptoms.Methods. This was a retrospective study conducted in the Department of Nuclear Medicine at Universitas Academic Hospital, Bloemfontein, South Africa. We reviewed the studies of 65 non-hospitalised patients with COVID-19 referred to the department from July 2020 to January 2021 for a perfusion-only single-photon emission computed tomography/computed tomography (SPECT/CT) study or a ventilation/perfusion (VQ) SPECT/CT study. All 65 patients had raised D-dimer levels with persistent, worsening or new-onset cardiopulmonary symptoms after the diagnosis of COVID-19.Results. Sixty-five patients were studied. The median (interquartile range) age was 46 (41 - 54) years and the majority (88.2%) were female. There were 22 patients (33.8%) with lung perfusion defects in keeping with PE. Two of these patients had a false-negative computed tomography pulmonary angiography (CTPA) study for PE performed the same day as their VQ SPECT/CT study.Conclusions. We confirm a high prevalence of PE in non-hospitalised patients diagnosed with mild COVID-19 who presented with raised D-dimer levels and persistent or new-onset cardiopulmonary symptoms. We recommend that irrespective of disease severity, hospitalised and non-hospitalised patients with COVID-19 presenting with persistent or new-onset cardiopulmonary symptoms and raised D-dimer levels should be investigated further for PE.

Determinants of outcome in newborns with respiratory distress in Osogbo, Nigeria

Background: Respiratory distress is one of the commonest presentations necessitating hospital admission in newborn unit. Regardless of the cause, if not recognized and managed quickly, respiratory distress can escalate to apnoea, respiratory failure, cardiopulmonary arrest and death.Methods: A cross-sectional and descriptive study of newborns with respiratory distress admitted into the SCBU of LAUTECH Teaching Hospital, Osogbo, Nigeria. Respiratory distress was diagnosed by grunting, inspiratory stridor, nasal flaring and tachypnea (more than 60 breaths per minute), retractions in the intercostal, subcostal, or supracostal spaces and cyanosis. At admission, every neonate had a complete physical examination.Results: Of 625 babies admitted, 384 (61.4%) were males while 241 (38.6%) were females and 164 (26.2%) had respiratory distress. Respiratory distress was commoner among the preterms than term newborns. c2 = 44.7, p = 0.001. Leading causes of respiratory distress among the preterms were hyaline membrane disease, septicaemia, while among the term babies were perinatal asphyxia, transient tachypnoea of newborn and meconium aspiration. Sixty (36.6%) of the 164 babies with respiratory distress died. While 40.2% of the preterms died mainly from causes like hyaline membrane disease and septicaemia, 31.3% of term babies died from causes like perinatal asphyxia and meconium aspiration. Mortality from hyaline membrane disease was 46.9%, while perinatal asphyxia and meconium aspiration accounted for 38.9% and 40.0% respectively.Conclusions: Respiratory distress is therefore, a very common neonatal problem and it causes death of more than third of those affected. Emphasis should be geared towards reduction of preterm delivery, control of asphyxia and neonatal sepsis in order to reduce neonatal mortality in our environment

Biological and Non-Biological Methods for Lignocellulosic Biomass Deconstruction

Owing to their abundance and cost-effectiveness, lignocellulosic materials have attracted increasing attention in clean energy technologies over the last decade. However, the complex polymer structure in these residues makes it difficult to extract the fermentable sugars. Therefore, various pretreatment regimes have been used resulting in the breaking of lignocelluloses’ physical and chemical structures, thereby enhancing the availability of the polysaccharides which are subsequently hydrolysed into different biocommodities. This chapter provides an evaluation of some of the latest exploited methodologies that are used in the pretreatment of lignocellulosic materials. Moreover, the chapter discusses the advantages and disadvantages of each method

Evaluation of Methods for the Analysis of Untreated and Processed Lignocellulosic Biomasses

The overall efficiency of the transformation of lignocellulosic materials to usable products as chemicals and fuels must be governed by adequate analysis of products before and after treatments. Using some promising technologies, lignocelluloses which are biomasses from marine plant and trees, grains, food and non-food crops, and woodbased can give products as fuel alcohol and other chemicals. Various methods of transformation from feedstock to valuable end products are discussed in the scientific literature. Therefore, yields must justify methods used for biomass transformations. As a result, adequate compositional analysis of these processing stages is needed. In this chapter, standard common methods such as gravimetric, chromatography, spectroscopic and their variations for analysis on both untreated and treated lignocelluloses are highlighted. The ease of the use and challenges with recommendations to their applicability to quantifying lignocelluloses fractionations for reproducibility and to be representative are discussed. With biomass technology, virtually all and even more products that can be produced from fossil energy can also be produced from biomass energy. Adequate analysis is therefore necessary

Treatment After Anterior Cruciate Ligament Injury: Panther Symposium ACL Treatment Consensus Group

© The Author(s) 2020. Treatment strategies for anterior cruciate ligament (ACL) injuries continue to evolve. Evidence supporting best-practice guidelines for the management of ACL injury is to a large extent based on studies with low-level evidence. An international consensus group of experts was convened to collaboratively advance toward consensus opinions regarding the best available evidence on operative versus nonoperative treatment for ACL injury. The purpose of this study was to report the consensus statements on operative versus nonoperative treatment of ACL injuries developed at the ACL Consensus Meeting Panther Symposium 2019. There were 66 international experts on the management of ACL injuries, representing 18 countries, who were convened and participated in a process based on the Delphi method of achieving consensus. Proposed consensus statements were drafted by the scientific organizing committee and session chairs for the 3 working groups. Panel participants reviewed preliminary statements before the meeting and provided initial agreement and comments on the statement via online survey. During the meeting, discussion and debate occurred for each statement, after which a final vote was then held. Ultimately, 80% agreement was defined a priori as consensus. A total of 11 of 13 statements on operative versus nonoperative treatment of ACL injury reached consensus during the symposium. Overall, 9 statements achieved unanimous support, 2 reached strong consensus, 1 did not achieve consensus, and 1 was removed because of redundancy in the information provided. In highly active patients engaged in jumping, cutting, and pivoting sports, early anatomic ACL reconstruction is recommended because of the high risk of secondary meniscal and cartilage injuries with delayed surgery, although a period of progressive rehabilitation to resolve impairments and improve neuromuscular function is recommended. For patients who seek to return to straight-plane activities, nonoperative treatment with structured, progressive rehabilitation is an acceptable treatment option. However, with persistent functional instability, or when episodes of giving way occur, anatomic ACL reconstruction is indicated. The consensus statements derived from international leaders in the field will assist clinicians in deciding between operative and nonoperative treatment with patients after an ACL injury

The unique resistance and resilience of the Nigerian West African Dwarf goat to gastrointestinal nematode infections

<p>Abstract</p> <p>Background</p> <p>West African Dwarf (WAD) goats serve an important role in the rural village economy of West Africa, especially among small-holder livestock owners. They have been shown to be trypanotolerant and to resist infections with <it>Haemonchus contortus </it>more effectively than any other known breed of goat.</p> <p>Methods</p> <p>In this paper we review what is known about the origins of this goat breed, explain its economic importance in rural West Africa and review the current status of our knowledge about its ability to resist parasitic infections.</p> <p>Conclusions</p> <p>We suggest that its unique capacity to show both trypanotolerance and resistance to gastrointestinal (GI) nematode infections is immunologically based and genetically endowed, and that knowledge of the underlying genes could be exploited to improve the capacity of more productive wool and milk producing, but GI nematode susceptible, breeds of goats to resist infection, without recourse to anthelmintics. Either conventional breeding allowing introgression of resistance alleles into susceptible breeds, or transgenesis could be exploited for this purpose. Appropriate legal protection of the resistance alleles of WAD goats might provide a much needed source of revenue for the countries in West Africa where the WAD goats exist and where currently living standards among rural populations are among the lowest in the world.</p