COVID-19 in a Patient Treated for Granulomatosis with Polyangiitis: Persistent Viral Shedding with No Cytokine Storm

Introduction: The coronavirus disease COVID-19 is considered a pandemic disease that has developed rapidly all over the world. As of today, it is unclear whether immunosuppression confers an increased risk for pulmonary complications, or conversely, whether it can be a protective factor with respect to a cytokine storm. Case description: We report the case of a 55-year-old male patient with granulomatosis with polyangiitis treated with rituximab who was infected with COVID-19 pneumonia. To the best of our knowledge, only 1 case has been reported in the literature with similar characteristics. The patient had a non-classic evolution of clinical symptoms with persistent fever and viral shedding, in addition to a negative serology.Conclusion: This case emphasizes the management and immunity response to COVID-19 pneumonia in such patients. Data are still needed regarding patients who have prolonged B-cell depletion, which may put the patient at a higher risk for reinfection

Prediction of the survival and functional ability of severe stroke patients after ICU therapeutic intervention

<p>Abstract</p> <p>Background</p> <p>This study evaluated the benefits and impact of ICU therapeutic interventions on the survival and functional ability of severe cerebrovascular accident (CVA) patients.</p> <p>Methods</p> <p>Sixty-two ICU patients suffering from severe ischemic/haemorrhagic stroke were evaluated for CVA severity using APACHE II and the Glasgow coma scale (GCS). Survival was determined using Kaplan-Meier survival tables and survival prediction factors were determined by Cox multivariate analysis. Functional ability was assessed using the stroke impact scale (SIS-16) and Karnofsky score. Risk factors, life support techniques and neurosurgical interventions were recorded. One year post-CVA dependency was investigated using multivariate analysis based on linear regression.</p> <p>Results</p> <p>The study cohort constituted 6% of all CVA (37.8% haemorrhagic/62.2% ischemic) admissions. Patient mean(SD) age was 65.8(12.3) years with a 1:1 male: female ratio. During the study period 16 patients had died within the ICU and seven in the year following hospital release.</p> <p>The mean(SD) APACHE II score at hospital admission was 14.9(6.0) and ICU mean duration of stay was 11.2(15.4) days. Mechanical ventilation was required in 37.1% of cases. Risk ratios were; GCS at admission 0.8(0.14), (p = 0.024), APACHE II 1.11(0.11), (p = 0.05) and duration of mechanical ventilation 1.07(0.07), (p = 0.046). Linear coefficients were: type of CVA – haemorrhagic versus ischemic: -18.95(4.58) (p = 0.007), GCS at hospital admission: -6.83(1.08), (p = 0.001), and duration of hospital stay -0.38(0.14), (p = 0.40).</p> <p>Conclusion</p> <p>To ensure a better prognosis CVA patients require ICU therapeutic interventions. However, as we have shown, where tests can determine the worst affected patients with a poor vital and functional outcome should treatment be withheld?</p

First record of Olive Pyralid Moth, Euzophera pinguis (Haworth, 1811) on olive trees in Lebanon (Lepidoptera, Pyralidae)

Olive tree, Olea europaea L., is one of the oldest and the most important cultivated tree in Lebanon. However, olive production is affected by several pests and diseases, mainly the olive fruit fly Bactrocera oleae (Gmelin) and the peacock spot caused by the ascomycetous fungus Spilocaea oleagina (Castagne) S. Hughes. In September 2015, swelling and cracking of olive tree barks were observed in the region of Hasbaya and West Bekaa. Examination of infected trees showed larvae of Olive Pyralid Moth Euzophera pinguis (Haworth) burrowing into bark and branches. The survey conducted in these two regions shows that this pest is well established in Hasbaya, while no other infection is reported in West Bekaa. E. pinguis is a new invasive pest on olive trees in Lebanon and the potential risk to disseminate to other areas of olive production is very high.Premier signalement de la Pyrale des troncs de l’olivier, Euzophera pinguis (Haworth, 1811) au Liban (Lepidoptera, Pyralidae). L’oléiculture est l’une des cultures les plus anciennes et la plus importante au Liban. Cependant, la production des olives est menacée par plusieurs ravageurs et maladies, principalement la Mouche de l’olive Bactrocera oleae (Gmelin) et l’ OEil de paon, maladie provoquée par le champignon Ascomycète Spilocaea oleagina (Castagne) S. Hughes, causant des pertes économiques très importantes. En septembre 2015, un nouveau ravageur, Euzophera pinguis (Haworth), la Pyrale des troncs de l’olivier, a été détecté pour la première fois dans les régions de Hasbaya et de Bekaa-Ouest. Les chenilles de ce ravageur invasif ont creusé des galeries dans l’écorce des troncs et des branches entraînant le dépérissement des arbres infectés. La surveillance effectuée dans ces deux régions a montré que l’insecte est bien installé à Hasbaya alors qu’aucune nouvelle infestation est signalée à Bekaa-Ouest. E. pinguis est un nouveau ravageur pour les oliveraies libanaises et le risque potentiel d’extension à d’autres régions est très élevé.Moussa Zinette, Choueiri Elia, Youssef Amira, El Riachy Milad. First record of Olive Pyralid Moth, Euzophera pinguis (Haworth, 1811) on olive trees in Lebanon (Lepidoptera, Pyralidae). In: Bulletin de la Société entomologique de France, volume 122 (1),2017. pp. 57-60

Limiting the Spread of Multidrug-Resistant Bacteria in Low-to-Middle-Income Countries: One Size Does Not Fit All

The spread of multidrug-resistant organisms (MDRO) is associated with additional costs as well as higher morbidity and mortality rates. Risk factors related to the spread of MDRO can be classified into four categories: bacterial, host-related, organizational, and epidemiological. Faced with the severity of the MDRO predicament and its individual and collective consequences, many scientific societies have developed recommendations to help healthcare teams control the spread of MDROs. These international recommendations include a series of control measures based on surveillance cultures and the application of barrier measures, ranging from patients’ being isolated in single rooms, to the reinforcement of hand hygiene and implementation of additional contact precautions, to the cohorting of colonized patients in a dedicated unit with or without a dedicated staff. In addition, most policies include the application of an antimicrobial stewardship program. Applying international policies to control the spread of MDROs presents several challenges, particularly in low-to-middle-income countries (LMICs). Through a review of the literature, this work evaluates the real risks of dissemination linked to MDROs and proposes an alternative policy that caters to the means of LMICs. Indeed, sufficient evidence exists to support the theory that high compliance with hand hygiene and antimicrobial stewardship reduces the risk of MDRO transmission. LMICs would therefore be better off adopting such low-cost policies without necessarily having to implement costly isolation protocols or impose additional contact precautions

Prediction of the survival and functional ability of severe stroke patients after ICU therapeutic intervention-3

<p><b>Copyright information:</b></p><p>Taken from "Prediction of the survival and functional ability of severe stroke patients after ICU therapeutic intervention"</p><p>http://www.biomedcentral.com/1471-2377/8/24</p><p>BMC Neurology 2008;8():24-24.</p><p>Published online 26 Jun 2008</p><p>PMCID:PMC2443378.</p><p></p

Prediction of the survival and functional ability of severe stroke patients after ICU therapeutic intervention-2

<p><b>Copyright information:</b></p><p>Taken from "Prediction of the survival and functional ability of severe stroke patients after ICU therapeutic intervention"</p><p>http://www.biomedcentral.com/1471-2377/8/24</p><p>BMC Neurology 2008;8():24-24.</p><p>Published online 26 Jun 2008</p><p>PMCID:PMC2443378.</p><p></p

Prediction of the survival and functional ability of severe stroke patients after ICU therapeutic intervention-4

<p><b>Copyright information:</b></p><p>Taken from "Prediction of the survival and functional ability of severe stroke patients after ICU therapeutic intervention"</p><p>http://www.biomedcentral.com/1471-2377/8/24</p><p>BMC Neurology 2008;8():24-24.</p><p>Published online 26 Jun 2008</p><p>PMCID:PMC2443378.</p><p></p

WAO-ARIA consensus on chronic cough - Part II: Phenotypes and mechanisms of abnormal cough presentation — Updates in COVID-19

International audienceBackground: Chronic cough can be triggered by respiratory and non-respiratory tract illnesses originating mainly from the upper and lower airways, and the GI tract (ie, reflux). Recent findings suggest it can also be a prominent feature in obstructive sleep apnea (OSA), laryngeal hyperresponsiveness, and COVID-19. The classification of chronic cough is constantly updated but lacks clear definition. Epidemiological data on the prevalence of chronic cough are informative but highly variable. The underlying mechanism of chronic cough is a neurogenic inflammation of the cough reflex which becomes hypersensitive, thus the term hypersensitive cough reflex (HCR). A current challenge is to decipher how various infectious and inflammatory airway diseases and esophageal reflux, among others, modulate HCR. Objectives: The World Allergy Organization/Allergic Rhinitis and its Impact on Asthma (WAO/ ARIA) Joint Committee on Chronic Cough reviewed the current literature on classification, epidemiology, presenting features, and mechanistic pathways of chronic cough in airway-and reflux-related cough phenotypes, OSA, and COVID-19. The interplay of cough reflex sensitivit