Abstract:

Background/Objectives: the SARS-CoV-2 (COVID-19) pandemic has significantly impacted a large portion of the global population. Numerous studies have investigated the potential outcomes of Coronavirus infection in pregnant women, aiming to identify variables that may be associated with either improved or worsened outcomes. In this context, nutritional factors have occasionally been hypothesized to play a potentially important role in preventing adverse obstetric outcomes in pregnant women affected by COVID-19. We conducted a comprehensive literature review to examine the relationship between COVID-19 and nutrition. Our objective was to provide an updated and state-of-the-art overview of the interactions between nutrition, COVID-19 infection during pregnancy, and perinatal, obstetric, and neonatal outcomes. Methods: we conducted a comprehensive literature search in electronic databases, namely PubMed, Medline, and Embase, focusing on the relationship between COVID-19 and the role of diet and micronutrients in pregnancy. Results: an adequate nutritional intake, coupled with a healthy lifestyle, along with the consumption of probiotics and prebiotics and the supplementation of specific micronutrients, appears to play a crucial role in preventing adverse outcomes and pregnancy complications associated with COVID-19. Conclusions: obstetric research must continue to advance preventive strategies against the SARS-CoV-2 virus, including those focused on nutrition.

Abstract: Envelope viruses infecting human individuals can originate from two sources: either from an intermediary animal that transmits the virus to humans, or from another infected human. During a pandemic such as SARS-CoV-2, identifying the intermediate host or the primary human source presents a significant challenge. This complex task is typically addressed through genetics-based approaches, including metagenomic analysis, phylogenetic and phylodynamic rooting methods, integrated with epidemic simulations. We propose a novel method to investigate these primary viral sources. During their replication cycle, envelope viruses hijack materials from host cellular compartments such as the endoplasmic reticulum (ER), the Golgi apparatus (GA) and the ER-Golgi intermediate compartment (ERGIC). Biochemical, morphological, and functional differences in the membranes of ER, GA, and ERGIC can be detected not only across mammalian species but also among individual humans. These variations arise from a complex interplay of genetic, epigenetic, metabolic, environmental, and age-related factors. We propose utilizing lipidomics to identify unique lipid signatures in the compositions of the viral envelopes that are co-opted from the host cell’s organelles. Since interspecies and interhuman lipidic differences could significantly impact the composition of viral envelopes derived from host membranes, molecular disparities might serve as critical markers for tracing the source of viral particles. This approach could enable the identification not only of the mammalian sources of human spillover, but also provide insights into the age, medical condition, genetics, and ethnic background of the first human host.

Abstract: Dengue infection has been associated with oxidative stress (OS) induction; however, whether such a response predicts the development of complications remains unknown. We conducted a case-control study (1:2 ratio) nested within a cohort of febrile patients with a presumptive or confirmed diagnosis of dengue. Incident cases were patients who developed hypotension or severe bleeding during the follow-up, whereas controls did not. Total antioxidant status (TAS), superoxide dismutase (SOD), and glutathione peroxidase activity (GPx) were quantified in serums obtained ≤96 hours from disease onset. The association between each biomarker and complications was evaluated by estimating adjusted odds ratios (ORs) using logistic regression. We evaluated 132 patients (median age: 19.0 years; 58.2% males). TAS and SOD were higher among cases than controls (2.1 versus 1.7 mM and 6.7 versus 60 U/mL, respectively), and the opposite was observed for GPx (128.1 versus 133.7 mmol/min/ml); however, none of these contrasts reached statistical significance. In the multivariate analysis, higher levels of TAS and SOD were associated with a higher likelihood of complications up to 3.5 mM (OR=2.46; 95%CI: 1.10 - 5.53) and 8.0 U/mL (OR=1.69; 95%CI: 1.01 - 2.83), respectively. GPx did not show an association with hypotension or severe bleeding. Our results suggest that the induction of OS during the acute phase of dengue infection might be a prognostic factor of hypotensive and hemorrhagic complications.

Abstract: Background/Objectives: Very preterm body composition at term shows potential as a biomarker of later health outcomes, but effects from in-hospital formula versus human milk (HM) intake studies are confounded by effect from fortifier. We investigated the impact of in-hospital unfortified HM (UHM), fortified HM (FHM), and preterm formula (PTF) intake on very preterm body composition at term. Methods: Pre-planned secondary analysis of the PREterM FOrmula Or Donor milk (PREMFOOD) trial. Infants born <32 weeks were randomized to either (i) unfortified mother’s own milk (MM) and/or unfortified pasteurised human donor milk (DM) (UHM) (ii) fortified MM and/or fortified DM (FHM), or (iii) unfortified MM and/or preterm formula (PTF) from birth to 35+0 weeks post menstrual age. Main outcomes were anthropometry and magnetic resonance imaging body composition at term. Comparison between exclusive UHM (ExUHM: UHM >99% n=23) and predominant (Pr) actual feed exposure groups: PrPTF (PTF>50% n=7); PrFHM (FHM >50% n=17), and PrUHM (UHM 50-99% n=15). Results: At term, compared to ExUHM group, PrPTF group had 274.3g (95% CI: 30.1 to 518.5) more Non-Adipose Tissue Mass (NATM) and a 1.11 (95% CI: 0.38 to 1.84) greater increase in wieght z-score from birth, while both PrPTF and PrFHM had greater increases in length z- scores from birth. Conclusions: High formula intake was associated with maximal gains in NATM at term, and these gains were not matched by early fortification of HM. Alteration of body composition at term with prolonged or delayed HM fortification, and relation to later health outcomes are important research questions.

Abstract: Background. Unilateral basal ganglia calcinosis (BGC) is a rare radiological finding that can be diagnosed on CT and MRI but often presents challenges for clinicians and radiologists in determining its underlying cause. So far, only a few potential causes that could explain unilateral basal ganglia calcification have been described in the literature. Case Report. A 54-year-old Caucasian male was admitted to a tertiary university hospital due to the sudden onset of speech impairment and right-sided weakness. The patient had no significant medical history prior to this event. Non-enhanced computed tomography (NECT) of the brain revealed no evidence of acute ischemia, CTA shows acute MCA M2 segment occlusion. CT perfusion (CTP) maps reveal an extensive penumbra-like lesion, which is potentially reversible upon achieving successful recanalization. However, a primary neoplastic tumor with calcifications in the basal ganglia was initially interpreted as the potential cause, therefore, acute stroke treatment with intravenous thrombolysis was contraindicated. A follow-up CT examination at 24 hours revealed an ischemic lesion localized to the left insula, predominantly involving the left parietal lobe and the superior gyrus of the left temporal lobe. Subsequent gadolinium-enhanced brain MRI revealed small blood vessels draining into the subependymal periventricular veins on the left basal ganglia. Digital subtraction angiography was conducted, confirming the diagnosis of venous angioma. Conclusion. Unilateral BGC caused by venous angioma is a rare entity with unclear pathophysiological mechanisms and heterogeneous clinical presentation. It may mimic conditions such as intracerebral hemorrhage or hemorrhagic brain tumors, complicating acute stroke management, as demonstrated in this case. Surrounding tissue calcification may provide a valuable radiological clue in diagnosing venous angiomas DVAs and vascular malformations.

Abstract: Despite significant advancements, prosthetic hernia repair continues to face unacceptably high complication rates, including postoperative discomfort and chronic pain. These issues often stem from poor biological responses, such as the formation of stiff scar tissue and mesh shrinkage, commonly associated with traditional static meshes and plugs. Recent studies have challenged the conventional approach of reinforcing the groin through fibrotic incorporation of meshes, particularly in light of new evidence on the degenerative origins of many types of abdominal hernias such as groin hernias. In response, the Stenting & Shielding (S&S) Hernia System, a newly designed 3D dynamic device, has been developed for dissection free laparoscopic placement to permanently obliterate hernia defects. Unlike conventional meshes, this device induces a probiotic biological response, promoting viable tissue growth rather than fibrotic plaque formation. In a porcine experimental model, the S&S device demonstrated the development of a great amount of muscle fibers, alongside nervous and vascular structures, within well-perfused connective tissue. Histological analysis of biopsy specimen excised from the experimental animals revealed progressive muscle fiber maturation from early myocyte development in the short term to fully developed muscle bundles in the long and extra-long term. The enhanced biological response observed with the S&S device suggests a promising shift in hernia repair, potentially reversing the degenerative processes of hernia formation and promoting tissue regeneration. The S&S Hernia System described here can be classified not merely as a conventional hernia implant, but as part of a new category of hernia devices: the dynamic regenerative scaffold.

Abstract:

Background

Alopecia areata is a skin disease that affects patients’ quality of life and social participation and it exerts an economic burden of patients and implicitly their family. To date, this is the first study to quantify the economic burden of alopecia areata for both pediatric and adult patients.

Objective

This cost of illness study seeks to quantify the economic burden of alopecia areata for patients aged <20 years and 20+ years for both mild and severe forms of alopecia areata using retrospective and prospective data sources, both incidence and prevalence-based approaches. This cost of illness study is mixed as it employs both top-down and bottom-up approaches.

Results

The results of this cost of illness study show that for adults, for both prevalence and incidence-based approach, the highest costs are the direct costs attributable to medical services and associated costs, and the indirect costs due to work absenteeism. Regarding the pediatric population segment, the highest costs were due to treatment, associated expenses and productivity costs inquired by caregivers.

Conclusion

This is the first study to quantify the burden of alopecia areata in Romania, for both pediatric and adult patients. Our study highlights that out-of-pocket costs pose an immense burden on patients and their caregivers. Our estimations emphasize that patients with AA should be considered when planning health services delivery and health services and medicine reimbursement.

Abstract:

The ISH and IHC assays for assessing HER2 are now recommended by the American Society of Clinical Oncologists and the College of American Pathologists, but there are an increasing number of published studies describing alternative diagnoses at the molecular level. Inspired by these studies, we established a laboratory-developed test (LDT) to analyze HER2 status not only at the gene expression level but also at the gene copy number level. The results were reported according to the concordant results of the DNA and RNA approaches. We also obtained fully agreeing results in ten blindly analyzed samples using the quantitative real-time PCR method and IHC. The topic of this short communication will hopefully contribute to allowing IVD-certified diagnostics based on HER2 gene expression profile or copy number to be tested in the Czech Republic as well.

Abstract: Background/Objectives: In this study we aimed to assess the impact of Covid-19 pandemic period on the epidemiological trend of thyroid pathology in a university hospital in Romania. Methods: We performed a 6-years retrospective study (2017-2022) including all patients who underwent thyroid surgery, registered in the Pathology Department, Emergency County Hospital, Târgu-Mureș, Romania (n=971). Thyroid lesions were grouped into 3 major categories: (1) benign, non-tumoral, (2) benign, tumoral and (3) malignant, tumoral. To assess the impact of Covid-19 pandemic on the annual rate of thyroid surgeries and thyroid pathology, data were analyzed in comparison: before Covid-19 (2017-2019) versus Covid-19 and post-Covid-19 (2020-2022) period. Results: A significant decrease in the mean number of thyroid specimens per year was observed in the Covid-19 and post-Covid-19 period, compared to the previous period (131 versus 192 cases, p=0.0023). Thyroid benign lesions were the most frequent, but their prevalence was significantly lower during the pandemic period (50.8%), compared to the previous period (58.6%) (p=0.017). Benign tumors were rare, revealing similar occurrence rates in both periods. By contrast, the annual rate of malignant tumors increased significantly during Covid-19 and post-Covid-19 period (26.3% versus 35.4%, p=0.002), the most common histopathological type being papillary thyroid carcinoma. Conclusion: Along with Covid-19 pandemic (year 2020), due to reduced access to medical investigations, many thyroid cancers remained undiagnosed in our hospital. Consequently, this has led to an increased prevalence of malignant cases in the years that came after.

Abstract: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel human coronavirus, emerged in late 2019 and rapidly evolved into a pandemic around the world. The COVID-19 pandemic has dramatically changed the epidemiology and seasonality of other traditional res-piratory viruses e.g., influenza, respiratory syncytial virus, enterovirus, etc. These traditional respiratory viruses share similarity in transmission mode and clinical symptoms with SARS-CoV-2 but may differ in clinical outcomes and management. Co-infection between SARS-CoV-2 and one or more traditional respiratory viruses have been reported in the literature but showed mixed evidence in clinical outcomes. With SARS-CoV-2 evolving into mild Omicron variants, it is believed that SARS-CoV-2 co-circulates with other respiratory viruses, which in return affect the epidemiology and clinical course of respiratory viral infections. In response to these changes, multiplex molecular testings for SARS-CoV-2 and one or more traditional respiratory viruses are attracting more attention in the field and have been developed into a variety of testing modalities. In this review, we describe the epidemiology and clinical significance of traditional respiratory viruses and their co-infection with SARS-CoV-2 in the post-COVID era. Further, we review the principle of multiplex molecular testings and their application to the detection of respiratory viruses and their co-infections. Altogether, this review not only sheds light on epidemiology and clinical significance of respiratory viral infections and co-infections in the post-COVID era and but only provides insights on the laboratory-based diagnosis of respiratory viral infections using multiplex molecular testing.