Automated System for Multiplexing Detection of COVID-19 and Other Respiratory Pathogens.

OBJECTIVE: Infectious diseases are global health challenge, impacted the communities worldwide particularly in the midst of COVID-19 pandemic. The need of rapid and accurate automated systems for detecting pathogens of concern has always been critical. Ideally, such systems shall detect a large panel of pathogens simultaneously regardless of well-equipped facilities and highly trained operators, thus realizing on-site diagnosis for frontline healthcare providers and in critical locations such as borders and airports. METHODS & RESULTS: Avalon Automated Multiplex System, AAMST, is developed to automate a series of biochemistry protocols to detect nucleic acid sequences from multiple pathogens in one test. Automated processes include isolation of nucleic acids from unprocessed samples, reverse transcription and two rounds of amplifications. All procedures are carried out in a microfluidic cartridge performed by a desktop analyzer. The system was validated with reference controls and showed good agreement with their laboratory counterparts. In total 63 clinical samples, 13 positives including those from COVID-19 patients and 50 negative cases were detected, consistent with clinical diagnosis using conventional laboratory methods. CONCLUSIONS: The proposed system has demonstrated promising utility. It would benefit the screening and diagnosis of COVID-19 and other infectious diseases in a simple, rapid and accurate fashion. Clinical and Translational Impact Statement- A rapid and multiplex diagnostic system proposed in this work can clinically help to control spread of COVID-19 and other infectious agents as it can provide timely diagnosis, isolation and treatment to patients. Using the system at remoted clinical sites can facilitate early clinical management and surveillance.

Ibuprofen Lyell's Syndrome In An Eight-Year-Old Child.

Lyell's syndrome or toxic epidermal necrolysis (TEN) is a rare but serious drug-like toxiderma. Treated as a recent extensive burn in intensive care, its management must be urgent, and adapted in order to improve the vital prognosis of patients and reduce their mortality. We report a severe case of Lyell's syndrome occurring 24 hours after oral administration of an anti-inflammatory drug (ibuprofen) as a self-medication in an eight-year-old child.

Le syndrome de Lyell (nécrolyse épidermique toxique - NET) est une toxidermie médicamenteuse rare mais grave. Son prise en charge, urgente, doit être réalisée en CTB car elle s'approche de celle d'un brûlé. Nous rapportons le cas d'une NET survenue 24h après la prise orale, en automédication, d'ibuprophène.

[Epidemiology and mortality factors of acute intoxication in intensive care in Bouaké (Ivory Coast) from 2015 to 2018]. / Epidemiologie et facteurs de mortalite des intoxications aiguës en reanimation a Bouake (Cote d'Ivoire) de 2015 a 2018.

INTRODUCTION: Acute poisoning is a common reason for admission to intensive care. OBJECTIVE: To describe the epidemiological profile, to analyze the mortality factors of patients admitted to intensive care for acute intoxication. PATIENTS AND METHODS: A retrospective, descriptive and analytical study covering four years (from January 1, 2015 to December 31, 2018) .Includes patients admitted to intensive care in Bouaké for acute intoxication. The variables studied were: socio-demographic characteristics, intoxication characteristics, clinical, therapeutic, evolutionary and prognostic characteristics. RESULTS: Of a total of 1476 admissions during the study period, 131 patients were admitted for acute intoxication, with a hospital prevalence of 8.8%. The average age was 19 (range: 1 month to 70 years). The sex ratio was 0.84. The majority of poisonings occurred at home (94%). Psychiatric history was present in 11% of patients. The poisoning occurred in urban areas in 72% of cases. The place of intoxication was the family home in 94% of cases. The nature of the intoxication and the type of poison toxin depended on the age of the intoxicated patients. The average admission time was 7.38 hours ± 12 hours (range: 30 minutes to 72 hours). The poisoning was symptomatic in 93% of the patients. The clinical symptoms observed were: gastrointestinal (70%), respiratory (62%) and neurological (43%). Vomiting attempts associated with self-medication were performed in 69% of patients. The substances used for self-medication were: palm oil (80%) and milk (20%). The treatment in intensive care was initially symptomatic then secondarily adapted to the nature of the incriminated or suspected toxin. The use of tracheal intubation and mechanical ventilation was necessary for 10% of the patients. The average stay in hospital was 1.64 ± 1.5 days (range: 1 to 10 days). The lethality was 8%. The factors of poor prognosis were the existence of a cardiovascular collapse (p <0.001), the presence of a deep coma (p <0.001) and the use of mechanical ventilation (p <0. 001). CONCLUSION: Acute intoxication is a public health problem in Bouaké and requires preventive action.

INTRODUCTION: Les intoxications aiguës constituent un motif fréquent d'admission en réanimation. OBJECTIF: Décrire le profil épidémiologique, analyser les facteurs de mortalité des patients admis en réanimation pour intoxications aiguës. PATIENTS ET MÉTHODES: Etude rétrospective, descriptive et analytique, portant sur quatre ans (du 1er janvier 2015 au 31 décembre 2018).Etaient inclus les patients admis en réanimation à Bouaké pour une intoxication aiguë. Les variables étudiées étaient: les caractéristiques sociodémographiques, les caractéristiques de l'intoxication, les caractéristiques cliniques, thérapeutiques, évolutives et le pronostic. RÉSULTATS: Sur un total de 1476 admissions durant la période d'étude, 131 patients ont été admis pour une intoxication aiguë, soit une prévalence hospitalière de 8,8 %. L'âge moyen était de 19 ans (extrême : 1 mois et 70 ans). Le sex-ratio était de 0,84. La majorité des intoxications avaient eu lieu au domicile (94 %). Les antécédents psychiatriques étaient présents chez 11% des patients. Les intoxications avaient lieu en milieu urbain dans 72% des cas. Le lieu de l'intoxication était le domicile familial dans 94% des cas. La nature de l'intoxication et le type de toxique incriminé était fonction de l'âge des patients intoxiqués. Le délai moyen d'admission était de 7,38 heures ± 12heures (extrêmes: 30 mn et 72 heures). Les intoxications étaient symptomatiques chez 93% des patients. Les symptômes cliniques observés étaient : gastro-intestinaux (70%), respiratoires (62 %) et neurologique (43%). Des tentatives de vomissements associées à une automédication ont été réalisées chez 69% des patients. Les substances utilisées pour l'automédication étaient : l'huile de palme (80 %) et de lait (20%). Le traitement en réanimation était initialement symptomatique puis secondairement adapté à la nature du toxique incriminé ou suspecté. Le recours à l'intubation trachéale et à la ventilation mécanique a été nécessaire chez 10% des intoxiqués. Le séjour moyen en hospitalisation a été de 1,64±1,5 jours (extrêmes : 1 et 10 jours). La létalité était de 8 %. Les facteurs de mauvais pronostic étaient : l'existence d'un collapsus cardiovasculaire (p <0,001), la présence d'un coma profond (p <0,001) et la réalisation d'une ventilation mécanique (p <0,001). CONCLUSION: Les intoxications aiguës constituent un problème de santé publique à Bouaké et nécessite des actions de prévention.

Reverse Binding Mode of Phosphotyrosine Peptides with SH2 Protein.

Discerning the different interaction states during dynamic protein-ligand binding is difficult. Here we apply site-specific cysteine-α-chloroacetyl cross-linking to scrutinize the binding between the Src homology 2 (SH2) domain and phosphotyrosine (pY) peptides, a highly dynamic interaction that is a key to cellular signal transduction. From a model SH2 protein to a set of representative SH2 domains, we showed here that a proximity-induced cysteine-α-chloroacetyl reaction cross-linked two spatially adjacent chemical groups as a result of the binding interaction, and reciprocally, the information about the interaction states can be deduced from the cross-linked products. To our surprise, we found SH2 domains can adopt a reverse binding mode with "single-pronged", "two-pronged", and "half" pY peptides. This finding was further supported by a set of 500 ns molecular dynamics simulations. This serendipitous finding defies the canonical theory of SH2 binding, suggests a possible answer about the source of the versatility of SH2 signaling, and sets a model for other protein binding interactions.

[Fatal Toxic Epidermal Necrolysis Induced by Diclofenac Re-Administration in the Teaching Hospital of Bouaké (Côte d'Ivoire)]. / Syndrome de Lyell d'évolution fatale suite à la réadministration de diclofénac, au CHU de Bouaké (Côte d'Ivoire).

Lyell's syndrome or toxic epidermal necrolysis is an acute and severe cutaneous adverse drug reaction with a significant morbidity and mortality. It is a very rare condition but a vital emergency with a poor prognosis. The diagnosis is clinical and confirmed by a cutaneous biopsy showing a necrosis of the epidermis. It can be due to many drugs including non-steroidal anti-inflammatory drugs. We report a case of fatal Lyell's syndrome after oral re-administration of diclofenac in a patient with a previous history of diclofenac-related Stevens-Johnson syndrome, four years back.

Nous rapportons un cas de syndrome de Lyell mortel après réadministration orale de diclofénac chez un patient ayant des antécédents de syndrome de Stevens-Johnson lié au diclofénac quatre ans auparavant.

[Acute respiratory distress syndrome secondary to a viper envenomation in children]. / Syndrome de détresse respiratoire aiguë secondaire à une envenimation vipérine chez l'enfant.

Viper envenomation is responsible for inflammatory disorders, hemorrhagic complications, and local or extended necrosis. The occurrence of respiratory complications such as Acute Respiratory Distress Syndrome (ARDS) is exceptional. We report on the case of a 15-year-old with no particular history who had, 24h after a viper bite, swelling of the right lower limb associated with blood dyscrasia. Despite the administration of antivenom treatment, the progression was marked by the onset of ARDS and the patient's death within 48h.

Brain lesions in eclampsia: A series of 39 cases admitted in an Intensive Care Unit.

The aim of this study was to identify the encephalic lesions in the eclampsia occurrences. Within a period of 18 months, computed tomography (CT) of the brain was performed in all patients admitted in intensive care for eclampsia. These CTs were analyzed and intracerebral lesions were identified. Thirty-nine patients were included. We noted 10 cases of ischemic stroke, 9 cases of cerebral edema, and 3 cases of hemorrhagic stroke and subarachnoid hemorrhage. The CT scan came back to normal in 20 eclamptic patients. Overall, delays in obstetric and intensive care and time of completion of the CT were long. CT has allowed highlighting in patients with eclampsia varied intracerebral lesions. The early performance of the CT is therefore essential for a better support of patients.