COVID-19 infection prevention and control management during hyperbaric oxygen therapy: a best practice implementation project.

OBJECTIVE: This implementation project compared standard operating procedures, accepted preventive measures, and disinfection procedures between the initial stage of the COVID-19 pandemic (first wave: March 15 to May 31, 2020) and the later stages of the pandemic (second and third waves: September 1, 2020 to January 31, 2021). INTRODUCTION: This project sought to improve compliance with international evidence-based guidelines and clinical standards for the prevention and control of COVID-19 infection during hyperbaric oxygen therapy taking into account the conditions of the local hospital. METHODS: Guided by the JBI evidence implementation framework, seven evidence-based audit criteria were developed for the prevention and control of COVID-19 infection during hyperbaric oxygen therapy. A questionnaire was used to measure compliance in baseline and follow-up audits. RESULTS: Differences between the baseline and follow-up audits were noted for criteria 6 and 7. Criterion 6 increased from 0% to 100% as the hyperbaric facility was equipped with certified ultraviolet-C radiation for air disinfection during the later period, but this equipment was not available in the initial period of the pandemic. Criterion 7 dropped from 100% in the baseline audit to 0% in the follow-up audit because of a significant increase in the operational burden of the treatment capacity of the facility, which made it impossible to comply with the recommended distancing between patients. CONCLUSIONS: Differences were found in preventive measures, disinfection procedures, work organization, and approach to care strategy. The project objectives were met and the implementation strategies proved effective. Larger sample sizes would need be needed to confirm the reproducibility of the results.

Comparison of Two Commercially Available Interferon-γ Release Assays for T-Cell-Mediated Immunity and Evaluation of Humoral Immunity against SARS-CoV-2 in Healthcare Workers.

Cellular immunity against SARS-CoV-2 is an important component of the immune response to the virus. At present, two such tests based on interferon-gamma release (interferon-γ release assays, IGRAs) are available-Quan-T-Cell SARS-CoV-2 by EUROIMMUN and T-SPOT.COVID by Oxford Immunotec. In this paper, we compared the results of these two tests in 90 subjects employed at the Public Health Institute Ostrava who had previously undergone COVID-19 infection or were vaccinated against that disease. To the best of our knowledge, this is the first head-to-head comparison of these two tests evaluating T-cell-mediated immunity against SARS-CoV-2. In addition, we also evaluated humoral immunity in the same individuals using the in-house virus neutralization test and IgG ELISA assay. The evaluation yielded similar results for both IGRAs, with Quan-T-Cell appearing to be insignificantly (p = 0.08) more sensitive (all 90 individuals were at least borderline positive) than T-SPOT.COVID (negative results found in five patients). The overall qualitative (presence/absence of immune response) agreement of both tests with virus neutralization test and anti-S IgG was also excellent (close or equal to 100% in all subgroups, with the exception of unvaccinated Omicron convalescents, a large proportion of whom, i.e., four out of six subjects, were IgG negative while at least borderline positive for T-cell-mediated immunity measured by Quan-T). This implies that the evaluation of T-cell-mediated immunity is a more sensitive indicator of immune response than the evaluation of IgG seropositivity. This is true at least for unvaccinated patients with a history of being infected only by the Omicron variant, but also likely for other groups of patients.

Experimental use of flow cytometry to detect bacteria viability after hyperbaric oxygen exposure: Work in progress report.

INTRODUCTION: Hyperbaric oxygen treatment (HBOT), based on inhaling pure oxygen under elevated ambient pressure, is used as adjuvant intervention to promote healing in infected wounds. Despite extensive clinical evidence of beneficial effects of HBOT in soft tissue infections the mechanism of action remains to be elucidated. The aim of this study was to evaluate the use of flow cytometry as a novel method to assess the viability of pathogenic bacteria after hyperbaric oxygen (HBO) exposure. METHODS: Bacterial strains associated with soft tissues infections: Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus were exposed to oxygen at 2.8 atmospheres absolute (atm abs) (283.6 kPa) pressure for 45, 90, or 120 min, then stained with propidium iodide and thiazole orange and analysed by flow cytometry. RESULTS: Escherichia coli and Staphylococcus aureus showed no change in viability, nor morphology, the viability of Pseudomonas aeruginosa reduced in a dose-dependent manner and Klebsiella pneumoniae also showed dye uptake after HBO. CONCLUSIONS: These initial results, indicate diverse sensitivity of bacteria to HBO, and suggest that flow cytometry can be used to monitor viability and morphological changes triggered by HBO exposure in bacteria.

The role of intestinal microbiota in the pathogenesis of colorectal carcinoma.

The symbiotic relationship between intestinal microbiota and the host is a major mechanism of prevention against the development of chronic and metabolic diseases. The intestinal microbiota provides several physiological functions of the organism from the creation of a natural functional barrier with a subsequent immunostimulatory activity up to affecting the energy metabolism of the host. Disruption of physiological intestinal microbiota is reported as one of the major etiological factors of initiation and progression of colorectal carcinoma (CRC). Chronic low-grade inflammation is associated with the development of CRC, through the production of inflammatory cytokines and reactive oxygen species. CRC occurs in association with high-protein and high-fat diets in combination with low-fiber intake. The problem of intestinal dysbiosis and oncological diseases is a multidisciplinary problem and it is necessary to focus on several fields of medicine such as public health, clinical pharmacology, and internal medicine. The aim of this review is describing the role of gut dysbiosis in pathogenesis of colorectal carcinoma.

ANCA in the diagnosis of neutrophil-mediated inflammation.

Inconsistencies in ANCA (anti-neutrophil cytoplasm autoantibodies) and other NSA (neutrophil-specific autoantibodies) terminology frequently cause incorrect indications, choices, applications and interpretations of ANCA diagnostics in routine practice, except for ANCA-associated vasculitis. A review of the current knowledge and the authors' personal experiences based on routine assessments of ANCA and other NSA are documented and presented. A better understanding of the principles and mechanisms of ANCA and other NSA responses and determination, as well as unification of their terminology could result in improvements in indications, applications and the interpretation of ANCA diagnostics in diseases other than vasculitis, especially in IBD (inflammatory bowel diseases), AILD (autoimmune liver diseases), CTD (connective tissue diseases) and other chronic neutrophil-mediated inflammatory diseases.

Multiplex assays to diagnose celiac disease.

Patients with celiac disease are sensitive to the gluten fractions of wheat. Symptoms include gastrointestinal problems and a failure to thrive in children, but may range from headaches to general malaise in adults. Thus, it is difficult to diagnose celiac disease by symptoms alone. The standard diagnostic criteria include the presence of the characteristic anti-gliadin or anti-tissue transglutaminase antibodies (anti-tTG) in serum, flattened mucosa on intestinal biopsy, and improved symptoms on a gluten-free diet. Because of the ease of use of the tTG enzyme-linked immunosorbent assay (ELISA) compared to endomysial by indirect immunofluorescence assay, there has been much more screening for celiac disease in recent years. This increased screening showed that celiac disease was more prevalent than previously believed. We compared a new multiplex assay that includes a novel form of deamidated gliadin and recombinant human tTG as the antigens to other assays using standard antigens. In addition, the new assay detects the presence of selective IgA deficiency, which shows a 10-fold increase in prevalence in patients with celiac disease compared to the general population. The combination of sensitivity and specificity of the new multiplex assay was equal or better than those for standard assays. Thus the performance, ease of use, and ability to measure three clinically important parameters in a single test make the new multiplex assay a viable alternative to standard assays in a clinical lab.