Illness tracking in SARS-CoV-2 tested persons using a smartphone app: a non-interventional, prospective, cohort study.

There are few data on the range and severity of symptoms of SARS-CoV-2 infection or the impact on life quality in infected, previously healthy, young adults such as Swiss Armed Forces personnel. It is also unclear if an app can be used to remotely monitor symptoms in persons who test positive. Using a smartphone app called ITITP (Illness Tracking in Tested Persons) and weekly pop-up questionnaires, we aimed to evaluate the spectrum, duration, and impact of symptoms reported after a positive SARS-CoV-2 test according to sex, age, location, and comorbidities, and to compare these to responses from persons who tested negative. We followed up 502 participants (57% active participation), including 68 (13.5%) positive tested persons. Hospitalisation was reported by 6% of the positive tested participants. We found that positives reported significantly more symptoms that are typical of COVID-19 compared to negatives. These symptoms with odds ratio (OR > 1) were having difficulty breathing (OR 3.35; 95% CI: 1.16, 9.65; p = 0.03), having a reduced sense of taste (OR 5.45; 95% CI: 1.22, 24.34; p = 0.03) and a reduced sense of smell (OR 18.24; 95% CI: 4.23, 78.69; p < 0.001). Using a random forest model, we showed that tiredness was the single symptom that was rated as having a significant impact on daily activities, whereas the other symptoms, although frequent, had less impact. The study showed that the use of an app was feasible to remotely monitor symptoms in persons infected with SARS-CoV-2 and could be adapted for other settings and new pandemic phases such as the current Omicron wave.

Acquired immune deficiency syndrome (AIDS) and late presentation in Poland - data from Test and Keep in Care (TAK) Polska project.

OBJECTIVES: Late presentation (LP) at HIV diagnosis is associated with worse prognosis and an increase in the number of new infections. We analyse the proportion of patients diagnosed late and factors related to LP in Poland in 2016-2017. METHODS: Data were obtained from 13 out of 17 HIV centres in Poland from 2016 and 2017, including date of diagnosis, age, sex, transmission route, anti-hepatitis C virus (anti-HCV), Venereal Diseases Research Laboratory (VDRL) antibodies, AIDS diagnosis, baseline HIV viral load and CD4 count. RESULTS: Out of 1522 patients, 88.9% were male with median age of 33.6 years. Men who have sex with men (MSM) comprised 69.4% of all new infections, heterosexual route of transmission (HTX) 18.2% and injecting drug use (IDU) 4.7%. Late presenters comprised 44.8% of the study group. Factors associated with LP were female sex [odds ratio (OR) = 1.5, 95% confidence interval (95% CI): 1.09-2.08], older age (OR = 1.59, 95% CI: 1.42-1.79 per decade), route of transmission (HTX: OR = 1.96, 95% CI: 1.50-2.56; IDU: OR = 3.17, 95% CI: 1.92-5.37), positive HCV results (OR = 1.90, 95% CI: 1.23-2.95) and syphilis diagnosis (OR = 2.06, 95% CI: 2.29-3.31). Adjusting for these factors, the only independent factors associated with LP were age (OR = 1.52, 95% CI: 1.35-1.71) and route of transmission (HTX: OR = 1.73, 95% CI: 1.23-2.44; IDU: OR = 2.24, 95% CI: 1.25-4.10). CONCLUSIONS: Late presentation in Poland follows European trends. A total of 44.8% of all newly diagnosed patients in Poland continue to present late or at the AIDS stage. Independent factors associated with LP/AIDS were older age, IDU and HTX. Patients from these groups should be targeted to improve early diagnosis and medical care.

Potential role for Streptococcus gordonii-derived hydrogen peroxide in heme acquisition by Porphyromonas gingivalis.

Streptococcus gordonii, an accessory pathogen and early colonizer of plaque, co-aggregates with many oral species including Porphyromonas gingivalis. It causes α-hemolysis on blood agar, a process mediated by H2 O2 and thought to involve concomitant oxidation of hemoglobin (Hb). Porphyromonas gingivalis has a growth requirement for heme, which is acquired mainly from Hb. The paradigm for Hb heme acquisition involves the initial oxidation of oxyhemoglobin (oxyHb) to methemoglobin (metHb), followed by heme release and extraction through the actions of K-gingipain protease and/or the HmuY hemophore-like protein. The ability of S. gordonii to mediate Hb oxidation may potentially aid heme capture during co-aggregation with P. gingivalis. Hemoglobin derived from zones of S. gordonii α-hemolysis was found to be metHb. Generation of metHb from oxyHb by S. gordonii cells was inhibited by catalase, and correlated with levels of cellular H2 O2 production. Generation of metHb by S. gordonii occurred through the higher Hb oxidation state of ferrylhemoglobin. Heme complexation by the P. gingivalis HmuY was employed as a measure of the ease of heme capture from metHb. HmuY was able to extract iron(III)protoporphyrin IX from metHb derived from zones of S. gordonii α-hemolysis and from metHb generated by the action of S. gordonii cells on isolated oxyHb. The rate of HmuY-Fe(III)heme complex formation from S. gordonii-mediated metHb was greater than from an equivalent concentration of auto-oxidized metHb. It is concluded that S. gordonii may potentially aid heme acquisition by P. gingivalis by facilitating metHb formation in the presence of oxyHb.

Assessment of systemic and pulmonary arterial remodelling in women with systemic sclerosis.

OBJECTIVES: Systemic sclerosis (SSc) leads to pulmonary circulation dysfunctionand there are some indications of systemic circulation impairment. We evaluated the influence of SSc on the elastic properties of large systemic arterial walls and potential correlations between systemic and pulmonary circulation involvement. METHOD: We examined 75 consecutive women (mean age 53.13±10.1 years) with confirmed SSc [mean disease duration (DD) 7.1±9.1 years] and 21 age-matched female volunteers (mean age 52.6±8.3 years, ns). Pulse wave velocity (PWV) and transthoracic echocardiography were performed. SSc patients were divided into two groups according to the median of DD: ≤3 years (39 patients) and >3 years (36 patients). RESULTS: Patients with DD>3 years had higher PWV than those with DD≤3 years and controls (log PWV: 2.23±0.23 vs. 2.13±0.16 and vs. 2.11±0.16 m/s; p=0.028 and 0.029, respectively). In addition, echocardiographic indices showed impaired right ventricular (RV) function in the patients with DD>3 years. Also in these SSc patients, PWV correlated with clinical and echocardiographic parameters of pulmonary circulation: age (r=0.64, p<0.0001), acceleration time of pulmonary ejection (AcT; r=-0.38, p=0.021), and tricuspid regurgitation peak gradient (TRPG; r=0.34, p=0.04). Multiple linear regression analysis showed that PWV was independently associated with DD (ß=0.22, p==0.02), AcT (ß=-0.215, p=0.03), and age (ß=0.44, p<0.001). CONCLUSIONS: In patients with SSc lasting more than 3 years, the disease is characterized by increased stiffness of the large systemic arteries. Longer duration of SSc leads simultaneously to the increased stiffness of the large systemic arteries and to the progressive impairment of RV function and its coupling to the pulmonary arterial bed.

Effect of tibial subluxation on the measurements for tibial tuberosity advancement in dogs with cranial cruciate ligament deficiency. An ex vivo study.

OBJECTIVES: The main objectives were to evaluate the impact of femorotibial subluxation on the preoperative measurements for tibial tuberosity advancement (TTA) by defining radiographic landmarks and testing the repeatability for assessing cranial tibial subluxation (CTS). Also, we aimed at developing a formula to calculate the necessary adjustment in measurement of TTA in stifles with CTS. METHODS: Forty stifles were used to examine the influence of CTS on preoperative TTA measurements before and after transection of the cranial cruciate ligament. Mediolateral radiographs were obtained and measurements performed by three investigators. The observed variabilities were assessed by inter- and intra-observer differences. RESULTS: Measurements of CTS and preoperative TTA showed a good to excellent inter- and intra-observer correlation. We found a significant influence of CTS on TTA measurements and developed a formula to calculate the necessary adjustment in measurement of TTA in stifles with CTS. CONCLUSION: We found a correlation between the tibial subluxation and the measurements for TTA, with the latter decreasing with increasing subluxation. This has to be taken into account when measuring the advancement in stifles with complete rupture of the cranial cruciate ligament. We provided a formula to calculate the necessary addition to the measured advancement.

Fur homolog regulates Porphyromonas gingivalis virulence under low-iron/heme conditions through a complex regulatory network.

Porphyromonas gingivalis is a key pathogen responsible for initiation and progression of chronic periodontitis. Little is known about the regulatory mechanisms of iron and heme uptake that allow P. gingivalis to express virulence factors and survive in the hostile environment of the oral cavity, so we initiated characterization of a P. gingivalis Fur homolog (PgFur). Many Fur paralogs found in microbial genomes, including Bacteroidetes, confirm that Fur proteins have a tendency to be subjected to a sub- or even neofunctionalization process. PgFur revealed extremely high sequence divergence, which could be associated with its functional dissimilarity in comparison with other Fur homologs. A fur mutant strain constructed by insertional inactivation exhibited retarded growth during the early growth phase and a significantly lower tendency to form a homotypic biofilm on abiotic surfaces. The mutant also showed significantly weaker adherence and invasion to epithelial cells and macrophages. Transcripts of many differentially regulated genes identified in the fur mutant strain were annotated as hypothetical proteins, suggesting that PgFur can play a novel role in the regulation of gene expression. Inactivation of the fur gene resulted in decreased hmuY gene expression, increased expression of other hmu components and changes in the expression of genes encoding hemagglutinins and proteases (mainly gingipains), HtrA, some extracytoplasmic sigma factors and two-component systems. Our data suggest that PgFur can influence in vivo growth and virulence, at least in part by affecting iron/heme acquisition, allowing efficient infection through a complex regulatory network.

Increased release of soluble CD163 by the peripheral blood mononuclear cells is associated with worse prognosis in patients with systemic sclerosis.

PURPOSE: CD163 is a scavenger receptor which is exclusively expressed on monocytes/macrophages and participates in modulation of inflammatory response. We aimed to evaluate ex vivo production of soluble CD163 (sCD163) by peripheral blood mononuclear cells (PBMC) from patients with systemic sclerosis (scleroderma, SSc). MATERIAL/METHODS: Concentration of sCD163 was measured by commercially available ELISA kit in the PBMC suparnates from 23 SSc patients and 16 age- and sex-matched healthy controls (HC). Eighteen SSc patients were subsequently followed for at least three years or until death whichever happened earlier. Disease progression was defined as death due to SSc-related organ complication, development of a new or progression of pre-existing SSc-related organ involvement. RESULTS: PBMC from SSc patients released significantly greater amounts of sCD163 as compared with HC (p<0.05). No significant associations between release of sCD163 by PBMC and baseline clinical or laboratory parameters of the disease could be found. However, concentration of sCD163 in cell culture supernates was significantly higher in 6 SSc patients who experienced subsequent progression of the disease as compared with 12 SSc patients with stable disease course over a 3-year follow-up period (p<0.05). CONCLUSIONS: We show, for the first time, that PBMC from SSc release significantly greater amounts of sCD163 than do PBMC from healthy subjects. Evaluation of sCD163 production by PBMC ex vivo may serve as a new biomarker of disease progression. Further studies are required to evaluate the role of sCD163 in the development of SSc.

Peripheral blood mononuclear cells from patients with systemic sclerosis spontaneously secrete increased amounts of vascular endothelial growth factor (VEGF) already in the early stage of the disease.

PURPOSE: To investigate the capacity of the peripheral blood mononuclear cells (PBMC) from patients with systemic sclerosis (SSc) to produce vascular endothelial growth factor (VEGF), and to identify clinical associations of altered production of VEGF by PBMC in SSc. In addition, correlation with another pro-angiogenic cytokine, TNF-related weak inducer of apoptosis (TWEAK), was evaluated. METHODS: PBMC were isolated from 25 patients with SSc and 17 healthy controls (HC). VEGF and TWEAK were measured in the supernatants of cultured PBMC using commercially available ELISA kits. RESULTS: PBMC from SSc patients spontaneously released significantly greater amounts of VEGF as compared with HC. Production of VEGF was comparable between patients with early SSc and those with longer disease duration, and in both SSc groups higher than in HC. Patients without active digital ulcers produced significantly greater amounts of VEGF as compared with HC, while there was no significant difference in the production of VEGF between SSc patients with active digital ulcers and HC. VEGF/TWEAK ratio was significantly higher in PBMC from SSc patients than in HC indicating that high production of VEGF is not paralleled by increased release of TWEAK in SSc. CONCLUSIONS: PBMC form SSc patients produce increased amounts of VEGF already in the early stage of disease. There is an imbalance in the profile of pro-angiogenic mediators produced by PBMC in SSc which might contribute to the pathogenesis of SSc. Further studies should address clinical significance of our findings.

Osteochondral defects of the talus treated by mesenchymal stem cell implantation--early results.

The purpose of this study was to present early results of talus cartilage defects treatment with autologous mesenchymal stem cells CD34+ implantation technique. Nine (9) patients were treated, due to IV degree chondromalation (by ICRS). The applied standard procedure included: clinical examination, AP and lateral x-ray, MRI, preoperative, as well as during control examination. The surgical procedure consisted of the defect's debridement, harvesting and fixation of the periosteal flap and CD34+ implantation. Clinical results were assessed after 6 months to 3 years by clinical examination, Magee score and MRI. Good and very good clinical results were obtained and confirmed by MRI in 8 cases. In one case, cartilage hypertrophy was noted. There were no delamination and infection signs.

A comparative morphological study of direct nerve implantation and neuromuscular pedicle methods in cross reinnervation of the rat skeletal muscle.

PURPOSE: The study was undertaken to evaluate the recovery of rat skeletal muscles reinnervated by crossed direct nerve implantation and crossed neuromuscular pedicle graft. MATERIAL AND METHODS: The animals (157) were divided into 3 groups. In the first group--direct nerve implantation --(DNI) 52 animals, the peroneal nerve was transected and implanted into the gastrocnemius muscle of the hind limb of the rats. In the second group (53 animals)--the neuromuscular pedicle (NMP) of the peroneal nerve was elevated and transferred to the gastrocnemius muscle. The third group consisted of 52 healthy animals. Muscle function was examined by electrophysiological methods (evoked electromyography and muscle isometric tetanic tension) and by morphological methods (reinnervated muscle weight, microscopic examinations, morphometric and histochemical examinations). RESULTS: The weight of reinnervated muscles in the first 3 weeks decreased. The lowest values of muscle weights were noted at 4 weeks. At the end of the experiment muscle weight in the first group was 64.3% of the control group and in the second group 65.2%. Morphometric, histological and histochemical analysis were performed after 12 and 36 weeks. At 12 weeks of the experiment the diameter of reinnervated muscle fibers in the second group was statistically higher than in the first group. At that time the process of reinnervation was more advanced than in the first group. At 36 weeks there were no statistical differences between the two groups. An increase in the number of muscle fibers was noted as the processes of reinnervations progressed. At the site of nerve (or pedicled nerve-muscle) implantation new motor end plates were formed. CONCLUSIONS: We consider that reinnervation of the experimentally paralyzed muscle is possible after crossed DNI and after NMP neurotization. The reinnervation with the NMP technique is quicker than with the DNI. Based on the morphological examinations--both methods guarantee only a partial recovery of the function of the paralyzed muscle.

[Maternal plasma and amniotic fluid interleukin-6 and tumor necrosis factor-alpha levels in imminent preterm labor]. / Stezenie interleukiny-6 i czynnika martwicy nowotworu-alpha w surowicy krwi i plynie owodniowym ciezarnych z zagrazajacym porodem przedwczesnym.

DESIGN: Our purpose was to investigate the maternal plasma and amniotic fluid interleukin-6 and tumor necrosis factor-alpha levels in women with imminent preterm labour. MATERIAL AND METHODS: The present study was designed to evaluate IL-6 and TNF-alpha levels in 93 pregnant women with threatened preterm labour and 40 women with normal pregnancy. Maternal blood samples were collected by routine forearm venipuncture at admission during routine laboratory tests. Amniotic fluid was collected through hysterectomy during caesarean delivery from women at term but not in labour and by amniotomy or hysterectomy from women with preterm labour. RESULTS: Maternal plasma and amniotic fluid IL-6 and TNF-alpha concentrations were significantly elevated in women with preterm labour (premature rupture of membranes and uterine contractions) compared to gestationally matched, non-labouring controls.

[Maternal plasma and amniotic fluid interleukin-6 levels in imminent preterm labor]. / Stezenie interleukiny-6 w surowicy krwi i plynie owodniowym ciezarnych z zagrazajacym porodem przedwczesnym.

Our purpose was to investigate the maternal plasma and amniotic fluid interleukin-6 levels in women with preterm labour. The present study was designed to evaluate IL-6 levels in 93 pregnant women with threatened preterm labour and 40 normal pregnant. Maternal blood samples were collected by routine forearm venipuncture at admission during routine laboratory tests. Amniotic fluid was collected during hysteretomy during caesarean delivery from women at term but not in labour and by amniotomy or hysteretomy from women with preterm labour. Maternal plasma and amniotic fluid IL-6 concentrations were significantly elevated in women in preterm labour (premature rupture of membranes and uterine contractions) compared to gestationally matched, non-laboring controls.

[Efficacy of amnioinfusion in anhydramnios at term before induction of labor and newborn outcome]. / Wplyw amnioinfuzji przedporodowej na przebieg indukcji porodu i stan noworodka w ciazy z malowodziem.

Oligohydramnios complicates about 0.5-5% of pregnancies and is associated with an increased rate of perinatal morbidity and mortality. Our purpose was determine the effectiveness of amnioinfusion before induction of labour in reducing the incidence of fetal distress in pregnancies with anhydramnios at term. The rate of cesarean sections performed for fetal distress was higher in the control group (57.1%) than in the amnioinfused group (20.3%). Anhydramnios was associated with an increased abnormalities fetal heart rate. Amnioinfusion is effective option for the prevention of fetal distress in anhydramnios at term.

[N-acetyl-beta-glucosaminidase (NAG) activity in parturients with placental insufficiency in postmature pregnancy and with EPH-gestosis]. / Aktywnosc N-acetylo-beta-glukozoaminidazy (NAG) u rodzacych z niewydolnoscia lozyska w ciazy przenoszonej i z EPH-gestoza.

NAG activity evaluation was carried out in parturients' blood and placental homogenates in regular pregnancies (n = 46) and complicated with biological postmaturity (n = 30) and EPH-gestosis (n = 24). It was revealed that in the blood of parturients with pregnancy complicated with gestosis there was considerable increase of NAG activity (2.43 +/- 1.02 microKat/kg). Lower activity level was found in parturients with entopic pregnancy (1.93 +/- 0.87 microKat/kg), and the lowest in those with postmature pregnancy (1.78 +/- 0.56 microKat/kg). The placental homogenates presented statistically significant differences--the highest in postmature pregnancy (6.37 +/- 2.01 mKat/kg), lower in pregnancy complicated with gestosis (4.85 +/- 1.52 mKat/kg) and the lowest in normal pregnancy (3.52 +/- 1.21 mKat/kg). The elevated activity in blood serum of parturient with gestosis may indicate kidney damage in the course of disease. High activity in homogenate may indicate the processes of placental degradation in postmature pregnancy. There is no evidence of correlation between NAG activity in blood and activity in placental tissue.

[The role of endothelium in normal pregnancy and pregnancy complicated by preeclampsia]. / Rola sródblonka naczyniowego w ciazy prawidlowej i powiklanej EPH gestoza.

Endothelial cell dysfunction is thought to play a role in preeclampsia and the reduced production by vascular endothelial cells of the antiaggregatory and vasodilatory factors is well documented. The present study was designed to evaluate endothelial cells function in preeclamptic and healthy pregnant subjects. The nitric oxide plasma concentration in women with preeclampsia was significantly lower as compared with normotensive pregnant women. A significant increase in ET concentration was found in preeclamptic women as compared with normal pregnant patients and normal non-pregnant. The plasma concentrations of von Willebrand factor were significantly increased in healthy pregnancy as compared with preeclamptic patients. The results of our study demonstrate a significant endothelial cells damage in preeclamptic patients. Whether these observations contribute to the vascular pathophysiologic features of preeclampsia remains to be proved.

[The role of nitric oxide and blood platelets in pathogenesis of preeclampsia]. / Rola tlenku azotu (NO) i plytek krwi w patogenezie EPH gestozy.

The aim of this study was to evaluate the concentration of nitric oxide and the platelet function in preeclamptic and normal pregnant women. The patients with preeclampsia had new hypertension (diastolic blood pressure consistently > or = 90 mmHg with previously lower readings), new proteinuria and generalized oedema that subsequently regressed after delivery. Blood was collected by routine forearm venipuncture before delivery. The following parameters were evaluated: nitric oxide, beta-TG and PF4. The nitric oxide plasma concentration in women with preeclampsia was significantly lower compared with normotensive pregnant women. beta-TG and PF4 concentrations were significantly increased in patients with preeclampsia. Whether these observations contribute to the vascular pathophysiologic features of preeclampsia remains to be proved.

[Epidemiological analysis of congenital infections in newborns]. / Analiza epidemiologiczna wrodzonych bakteryjnych infekcji u noworodków.

The aim of this study was to review 2567 deliveries in the District Hospital in Bialystok in 1997. In 2388 term labours and 179 preterm ones we noticed the congenital infections; in 90 (3.8%) and in 58 (32.4%) newborns respectively. The main etiologic factors of infections were Escherichia coli and Staphylococcus epidermidis in term newborns and Staphylococcus epidermidis and Escherichia coli in preterm babies. Clinical signs of the urinary tract infection were most frequent in mature infants, whereas the sepsis was quite common in premature newborns.

[Meigs syndrome--diagnostic difficulties]. / Zespól meigsa--trudnosci diagnostyczne.

Meigs' syndrome in 68 years woman with pleural effusion and ovarian tumour was described. The cause of the pleural liquid in Meigs' syndrome is still not clear. New views on the pathogenesis and diagnostic methods of pleural liquids causes were presented.

[Pulmonary alveolar proteinosis--diagnostic problem]. / Proteinoza pecherzyków plucnych. Problem diagnostyczny.

A case of a 37 years old woman with suspicion of sarcoidosis is presented. However, the course of disease was not typical for sarcoidosis. The previous diagnosis was verified. The results of bronchoalveolar lavage and histological examination of lung biopsy sample revealed features characteristic for pulmonary alveolar proteinosis. The diagnostic methods, clinical course of disease and the ways of treatment are presented.

C-reactive protein concentration in the sera of pregnant women with imminent premature parturition and preterm amniorrhea.

C-reactive protein (CRP) levels were evaluated during spontaneous labour, in imminent premature parturition (IPP) and after preterm rupture of oocyst membranes (PROM). Increasing CRP level during spontaneous labour was found in 16.6% parturients. Elevated CRP level in patients with IPP makes it impossible to predict premature labour. In parturients with PROM, increase in CRP level makes further infection predictable only in a few cases.