Immunoassay Techniques Highlighting Biomarkers in Immunogenetic Diseases

Diagnosis of autoimmune diseases is crucial for the clinician and the patient alike. The immunoassay techniques most commonly used for this purpose are immunohistochemistry, ELISA, and Western blotting. For the detection of more specific biomarkers or the discovery of new ones for diagnostic purposes and as therapeutic targets, microarray techniques are increasingly used, for example, protein microarray, Luminex, and in recent years, surface plasmon resonance imaging. All of these technologies have undergone changes over time, making them easier to use. Similar technologies have been invented but responding to specific requirements for both diagnostic and research purposes. The goals are to study more analytes in the same sample, in a shorter time, and with increased accuracy. The reproducibility and reliability of the results are also a target pursued by manufacturers. In this chapter, we present these technologies and their utility in the diagnosis of immunogenetic diseases

MICROBIOME ANALYSIS IN PATIENTS WITH PSORIASIS

Psoriasis is a skin condition that occurs as a result of the interaction between predisposing genetic factors, immunological factors and external triggers. Studies have highlighted the important role played by Staphylococcus aureus or Streptococcus pyogenes in inducing, maintaining or exacerbating psoriasis lesions. Thus, the study of skin microbe in patients with psoriasis is considered to be extremely important and complementary to genetic and immunological research. New advances in new generation sequencing technologies allow for a better understanding of genetic mechanisms alteration in psoriasis. Studies performed so far show variable results, apparently due to the associated limitations, which imply that a standardized protocol for the sampling and processing of analyzed samples is a priority measure

The country of origin: a brake or an accelerator when buying a car

This research aims to analyse the perception of the country of origin effect on the choice of a future car by the holders of a driving license, which are already possessing a car at the present moment. To solve the research problem, we can say that the results of this study would aim to answer the following questions: To what extent is the car’s brand country of origin and manufacturing country known by its owners? Is there a relationship between the perceived car’s brand country of origin image and its perceived quality? Are the brand’s country of origin and the country of manufacture factors influencing the decision to purchase a car? Is there a connection between the perceived reliability of a car and the perception related to the country of its origin? To respond to these questions, a street survey on 100 subjects (50 men and 50 women) from Iasi, aged between 18 and 65, having a driving license and a personal car was conceived. The sampling method is random, the study being exploratory. The results can be used to issue a series of assumptions about the country of origin effect on the decision to purchase new cars and other goods

Dosimeters: measuring occupational UV exposure's involvement in skin cancer development

Introduction: Solar exposure is a major causative factor for multiple skin pathologies. Even though UV radiation is the most important factor implicated in skin cancer pathogenesis, still, few European countries recognize UV occupational-induced skin cancer as an occupational disease, Romania not being part of this category. The objectives of this study were to evaluate the UV exposure doses in agriculture and construction workers and to establish efficient protective measures. Materials and methods: In our Department, a prospective, observational, analytical study was conducted, including six outdoor workers (in construction and agriculture), over a period of three summer months (July, August, September). Subjects were asked to wear personal dosimeters and the following parameters were analyzed: profession, duration of exposure, UV exposure doses, skin aspect, preexisting preventive measures. Results: The wearing of dosimeters was well tolerated by all subjects, without any interference with daily professional activities. Daily UV radiation doses ranged from 1.79 SED (tractor driver) to 19 SED (agriculture worker). Maximum UVR doses were recorded between 10:00 am and 4 pm. Clinical examination was made after measurements, with no detectable skin changes. Conclusion: Even though workers in agriculture and construction in Romania are exposed to significant UV doses, with 40% more than the general population, these professions are not recognized as high-risk professions for developing skin tumors. More prospective and retrospective studies are necessary for more significant statistical results and for demonstrating the necessity of introducing primary, secondary and tertiary preventive measures

RECOMMENDED STRATEGIES FOR ATOPIC DERMATITIS MANAGEMENT IN ROMANIA

Atopic dermatitis (AD) is a chronic inflammatory skin disease with a relapsing course that has a significant impact on the quality of life of both patients and their families. The pathogenesis of AD is due to a multitude of factors and can be associated with other allergy-related diseases, including asthma, food allergies or rhinitis. Treatment of AD aims to reduce duration, severity, and frequency of disease exacerbations. Understanding the maintenance of skin barrier integrity by continuing the use of basic therapy can prevent breaks. Patient and family education is important

Nutritional status and eating disorders among medical students from the Cluj-Napoca University centre

International audienceBackground and aimsThe nutritional disorders are modifiable predisposing factors of the current leading causes of morbidity and premature mortality, such as cardiovascular diseases, diabetes and cancers. An early recognition of appropriate interventions could decrease the burden of medical costs and increase the healthy life expectancy. The aims of our study were the description of nutritional status, its associated factors, and the detection of eating disorders among Romanian medical students of the “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca.MethodsA cross-sectional study was conducted during the 2015–2016 academic year, including medical students from all study years, by an online questionnaire. The statistics, both descriptive and inferential, were calculated using EpiInfo.ResultsA total of 222 students from the University Romanian section were included, with a sex-ratio (men:women) of 0.22. The average body mass index of the medical students included was 21.3±3.3 kg/m2, for females it was 20.7±3 kg/m2 and for males 23.9±3.1 kg/m2. For the nutritional disorders such as overweight, the prevalence among males (30%) had a net predominance (p<0.001) over females (4.4%), while for underweight, it was prevalent only for female students (20.3%). Overweight was associated with low academic performance (odds ratio (OR)=7.2; 95% confidence interval (95% CI): 1–53.94), smoking (OR=2.4; 95% CI: 1–5.76) and binge drinking (OR=3; 95% CI: 1.26–7.25). Eating disorders were reported by 25.7% of the students and were significantly more prevalent in students in the second academic study cycle (47.4%; 95% CI: 34.7–60.3%) and in students with jobs (7%; 95% CI: 2.3–16.1%).ConclusionsIn this survey, two different distribution models of nutritional disorders for both genders were identified, with the predominance of overweight among men. Eating disorders were more prevalent among students in the second study cycle and those with jobs at the same time

Remote rating of atopic dermatitis severity using photo-based assessments:Proof-of-concept and reliability evaluation

BACKGROUND: Digital imaging of dermatological patients is a novel approach to remote assessment and has recently become more relevant since telehealth and remote decentralized clinical trials are gaining ground. OBJECTIVE: We aimed to investigate whether photographs taken by a smartphone are of adequate quality to allow severity assessments to be made and to explore the usefulness of an established atopic dermatitis severity assessment instrument on photograph evaluation. METHODS: During scheduled visits in a previously published study, the investigating doctor evaluated the severity of atopic dermatitis using the Scoring AD (SCORAD) index and took photographs of the most representative lesions (target lesions) with both a smartphone and a digital single-lens reflex camera (DSLR). The photographs were then assessed by 5 dermatologists using the intensity items of the SCORAD (iSCORAD), which consists of erythema, oedema/papulation, excoriations, lichenification, oozing/crusts, and dryness (scale 0-3, maximum score 18). The mean iSCORAD of the photographs was calculated and compared with in-person assessments using Pearson correlation and Bland-Altman plots. Intraclass correlation coefficients were used for interrater reliability. RESULTS: A total of 942 photographs from 95 patients were assessed. The iSCORAD based on smartphone photographs correlated strongly with the evaluations performed in person (iSCORAD: r=0.78, P<.001; objective SCORAD: r=0.81, P<.001; and total SCORAD: r=0.78, P<.001). For iSCORAD specifically, a Bland-Altman plot showed a difference in mean score of 1.31 for in-person and remote iSCORAD. In addition, the interrater agreement between the 5 rating dermatologists was 0.93 (95% CI 0.911-0.939). A total of 170 lesions were photographed, and the difference in mean scores was 1.32, 1.13, and 1.43 between in-person and remote evaluations based on photographs taken by a DSLR camera, a smartphone without flash, and a smartphone with flash, respectively. CONCLUSIONS: In terms of quality, remote atopic dermatitis severity assessments based on photographs are comparable to in-person assessments, and smartphone photos can be used to assess atopic dermatitis severity to a similar degree as photographs from a DSLR camera. Further, the variation in how the dermatologists in this study rated the iSCORAD based on the photographs was very low

Whole genome sequencing snapshot of multi-drug resistant Klebsiella pneumoniae strains from hospitals and receiving wastewater treatment plants in Southern Romania.

We report on the genomic characterization of 47 multi-drug resistant, carbapenem resistant and ESBL-producing K. pneumoniae isolates from the influent (I) and effluent (E) of three wastewater treatment plants (WWTPs) and from Romanian hospital units which are discharging the wastewater in the sampled WWTPs. The K. pneumoniae whole genome sequences were analyzed for antibiotic resistance genes (ARGs), virulence genes and sequence types (STs) in order to compare their distribution in C, I and E samples. Both clinical and environmental samples harbored prevalent and widely distributed ESBL genes, i.e. blaSHV, blaOXA, blaTEM and blaCTX M. The most prevalent carbapenemase genes were blaNDM-1, blaOXA-48 and blaKPC-2. They were found in all types of isolates, while blaOXA-162, a rare blaOXA-48 variant, was found exclusively in water samples. A higher diversity of carbapenemases genes was seen in wastewater isolates. The aminoglycoside modifying enzymes (AME) genes found in all types of samples were aac(6'), ant(2'')Ia, aph(3'), aaD, aac(3) and aph(6). Quinolone resistance gene qnrS1 and the multi-drug resistance oqxA/B pump gene were found in all samples, while qnrD and qnrB were associated to aquatic isolates. The antiseptics resistance gene qacEdelta1 was found in all samples, while qacE was detected exclusively in the clinical ones. Trimethroprim-sulfamethoxazole (dfrA, sul1 and sul2), tetracyclines (tetA and tetD) and fosfomycin (fosA6, known to be located on a transpozon) resistance genes were found in all samples, while for choramphenicol and macrolides some ARGs were detected in all samples (catA1 and catB3 / mphA), while other (catA2, cmIA5 and aac(6')Ib / mphE and msrE) only in wastewater samples. The rifampin resistance genes arr2 and 3 (both carried by class I integrons) were detected only in water samples. The highly prevalent ARGs preferentially associating with aquatic versus clinical samples could ascribe potential markers for the aquatic (blaSHV-145, qacEdelta1, sul1, aadA1, aadA2) and clinical (blaOXA-1, blaSHV-106,blaTEM-150, aac(3)Iia, dfrA14, oqxA10; oqxB17,catB3, tetD) reservoirs of AR. Moreover, some ARGs (oqxA10; blaSHV-145; blaSHV-100, aac(6')Il, aph(3')VI, armA, arr2, cmlA5, blaCMY-4, mphE, msrE, oqxB13, blaOXA-10) showing decreased prevalence in influent versus effluent wastewater samples could be used as markers for the efficiency of the WWTPs in eliminating AR bacteria and ARGs. The highest number of virulence genes (75) was recorded for the I samples, while for E and C samples it was reduced to half. The most prevalent belong to three functional groups: adherence (fim genes), iron acquisition (ent, fep, fyu, irp and ybt genes) and the secretion system (omp genes). However, none of the genes associated with hypervirulent K. pneumoniae have been found. A total of 14 STs were identified. The most prevalent clones were ST101, ST219 in clinical samples and ST258, ST395 in aquatic isolates. These STs were also the most frequently associated with integrons. ST45 and ST485 were exclusively associated with I samples, ST11, ST35, ST364 with E and ST1564 with C samples. The less frequent ST17 and ST307 aquatic isolates harbored blaOXA-162, which was co-expressed in our strains with blaCTX-M-15 and blaOXA-1