Trichinella spp. Infection in European Polecats (Mustela Putorius Linnaeus, 1758) from Romania.

The European polecat (Mustela putorius Linnaeus, 1758) is in decline in Romania, often living near human settlements, from mountains to lowlands. They feed on a wide variety of small animals, including rodents, such as mice or rats. The occurrence of this parasite in polecats from Romania was mentioned only once in 1991, but the parasite species was not confirmed by molecular biology. The study aimed to investigate the occurrence of Trichinella spp. in European polecats from Romania and to identify the parasite species by molecular tools. A total of 75 wild European polecats were examined by trichinoscopy and artificial digestion. A large number of animals were examined because of their wide distribution in Romanian territory and their presence near human settlements. For species determination, the positive muscle samples and the larvae recovered from artificial digestion were collected for DNA isolation and further processed by means of Multiplex PCR. Only two polecats from southern Romania tested positive for Trichinella spp. infection. During trichinoscopy examination, 48 (in a polecat from Giurgiu County) and 78 (in a polecat from Ialomița County) cysts were found in the tested (56 samples/animal) tissue samples. Artificial digestion revealed infection with 2466 larvae/100 g of muscle in the polecat from Ialomița and 254/100 g in the polecat from Giurgiu. The Multiplex PCR indicated the occurrence of Trichinella spiralis in the polecat from Giurgiu and a co-infection with T. spiralis and T. britovi in the polecat from Ialomița. The current study confirms through molecular biology, the occurrence of T. spiralis and T. britovi, as well as the occurrence of co-infection with these two Trichinella species in European polecats from Romania.

Risk of hepatitis B virus reactivation in hepatitis B virus + hepatitis C virus-co-infected patients with compensated liver cirrhosis treated with ombitasvir, paritaprevir/r + dasabuvir + ribavirin.

Hepatitis B virus may reactivate in patients with chronic hepatitis C treated with direct-acting antivirals. The aim of this study was to investigate the risk of hepatitis B virus (HBV) reactivation in HBV + hepatitis C virus (HCV)-co-infected patients with compensated liver cirrhosis treated with paritaprevir/ombitasvir/ritonavir, dasabuvir with ribavirin. We reviewed prospectively gathered data from a national cohort of 2070 hepatitis C virus patients with compensated liver cirrhosis who received reimbursed paritaprevir/ombitasvir/r, dasabuvir with ribavirin for 12 weeks from the Romanian National Health Agency during 2015-2016. Twenty-five patients in this cohort were HBs antigen positive (1.2%); 15 untreated with nucleotide analogues agreed to enter the study. These patients were followed up: ALT monthly, serology for HBV and DNA viral load at baseline, EOT and SVR at 12 weeks. Hepatitis B virus (HBV)-co-infected patients were all genotype 1b and 52% females, with a median age of 60 years (51 ÷ 74); 76% were pretreated with peginterferon + ribavirin; 72% were with severe necroinflammatory activity on FibroMax assessment; 40% presented comorbidities; and all were HBe antigen negative. Hepatitis C virus (HCV) SVR response rate was 100%. Hepatitis B virus (HBV)-DNA viral load was undetectable in 7/15 (47%) before therapy, and for the other 8 patients, it varied between below 20 and 867 IU/mL. Five patients (33%) presented virological reactivation (>2 log increase in HBV-DNA levels) during therapy. One patient presented with hepatitis associated with HBV reactivation, and two started anti-HBV therapy with entecavir. Hepatitis B virus (HBV) virological reactivation was present in 33% in our patients. Generally, HBV-DNA elevations were mild (<20 000 IU/mL); however, we report one case of hepatitis associated with HBV reactivation.

EMERGENCY SURGICAL TRACHEAL DECOMPRESSION IN A HUGE RETROSTERNAL GOITER.

INTRODUCTION: Over the past decades, several definitions and classifications of cervico-mediastinal goiters have been proposed. We analyzed and discussed the clinical presentation, the diagnostic procedures and the surgical technique in relation to post-operative complications and long-term results in a case of a sixty-six years old obese, hypertensive female admitted in the Thoracic Surgery Department with respiratory distress (inspiratory dyspnea, stridor) progressively aggravating during the latest month. METHODS: Cervico-thoracic CT scan revealed the existence of a cervico-mediastinal huge goiter which developed mostly intrathoracic (2/ 3 of the goiter). It determined a tracheal compression, reducing its caliber by two thirds, and its displacement to the right side. The proposed surgical procedure was total thyroidectomy and it involved a bipolar approach (transcervical and transsternal) through a partial upper cervico-sternotomy. RESULTS: The complete removal of the goiter and the decompression of the trachea have been achieved. Postoperative results were very satisfactory, with the absence of the respiratory distress. The histological examination revealed a multinodular goiter with epithelium hyperplasia. CONCLUSION: The presence of a complicated cervico-mediastinal goiter with severe respiratory distress required a surgical excision as the main and immediate treatment option. The surgical procedure represented a milestone for both the anesthesiologist (difficult intubation, with a thin tracheal tube in the absence of the jet ventilation technology) and for the surgeon. The goiter's excision from the visceral mediastinum was very difficult because of its huge dimensions and close relations with trachea and great vessels (anterior) and esophagus, erector spinal muscles and the spine (posterior).

'Immunogenetics of Aging': report on the activities of the 15th International HLA and Immunogenetics Working Group and 15th International HLA and Immunogenetics Workshop.

'Immunogenetics of Aging' is a component that was first included in the 14th International HLA and Immunogenetics Workshop (IHIWS) and developed further within the 15th Workshop. The aim of this component was to assess the impact of human leukocyte antigen (HLA) genes, cytokine genes, and some innate immunity genes such as killer-cell immunoglobulin-like receptors (KIRs) and mannose-binding lectin 2 (MBL2) in successful aging and their contribution to the better understanding of immune dysfunction in old age. Within the 15th IHIWS new populations were included in the analysis. Additional cytokine gene polymorphisms were assessed and innate immunity genes were analyzed for possible relevance in longevity. The results showed that longevity might be associated with anti-inflammatory cytokine gene profiles, decreased frequency of interleukin-10 (IL-10) and transforming growth factor-B1 haplotypes associated with a low level of gene expression, and increased frequency of haplotypes determining a high level of expression. Extended tumor necrosis factor-A and IL-12B genotypes were also likely relevant to longevity. Data also showed that innate immunity genes are associated with susceptibility to infections in the elderly and showed that these genes might be an important genetic marker in aging. Decreased frequencies of KIR2DS5 and A1B10 haplotypes, and an increased proportion of MBL2-deficient haplotypes were found in the group with higher cytomegalovirus-specific IgG antibody levels. Together, these studies emphasize the relevance of genes regulating immune functions in maintaining human longevity and stress the importance of further clarifying their impact on successful aging.

Cytokine gene polymorphisms support diagnostic monitoring of Romanian multiple myeloma patients.

INTRODUCTION: Cytokines and their receptor genes are very polymorphic. SNPs in the promotor region of the gene may influence the rate of cytokine secretion and may affect the biological activity of the encoded cytokine. A number of cytokines and cytokine receptors have been directly linked to the development of human cancers. The aim of our study was to determine the cytokine gene polymorphism in Romanian multiple myeloma patients. MATERIAL AND METHODS: Cytokine genotyping was performed in 80 patients and 100 healthy blood donors using molecular biology methods (SSP-Invitrogen, USA). RESULTS: Analyzing each polymorphic site, there was an increased frequency of the following genotypes in patients compared to control group: Interleukin-1beta (IL-1ß) pos.+3962 TT, IL-12 pos.-1188 CC, gamma-Interferon (γ-IFN) pos.+874 AA, Transforming Growth Factor- beta1 (TGF- ß1) codon10 TT, IL-2 pos.-330 TG and pos.+166 TT, Interleukin-4Receptor alpha (IL-4Rα) pos.-33 TC, IL-10 pos.-1082 GG and pos.-592 CC, IL-6 pos.-174 GG. It should be noted that almost one third of multiple myeloma patients had IL-6 pos.-174 GG genotype and 62% IL-10 GCC haplotype. These identified haplotypes are high interleukins producer, and this fact was confirmed by serum IL-6 and IL-10 levels performed by ELISA and enhanced chemiluminiscence methods. CONCLUSION: These markers could be successfully used, together with other specific clinical and biological parameters, as reliable individualized prognostic factors in multiple myeloma patients.

Pycnogenol efficacy in the treatment of systemic lupus erythematosus patients.

A pilot study was performed to evaluate the efficacy of Pycnogenol treatment in systemic lupus erythematosus (SLE) patients. Eleven SLE patients were treated with first line medication according to disease activity and in addition, six of them received Pycnogenol and five a placebo. The SLE disease activity index (SLEDAI), serum anti-dsDNA antibodies, fibrinogen, C-reactive protein levels, erythrocyte sedimentation rate, production of reactive oxygen species (ROS) by neutrophils, spontaneous apoptosis and p56(lck) specific activity in peripheral blood lymphocytes were evaluated. Pycnogenol treatment determined a significant reduction of ROS production, apoptosis, p56(lck) specific activity and erythrocyte sedimentation rate. In addition, the decrease of SLEDAI was significant in the Pycnogenol treated group compared with the placebo group (p = 0.018). The results obtained suggest that Pycnogenol could be useful for second line therapy to reduce the inflammatory feature of SLE.

Growth factors secreted by the GH3 rat pituitary tumor cell line. Study of their autocrine mitogenic activity in cultured GH3 cells, A431 cells and human fibroblasts.

The pathogenesis of pituitary tumors is still controversial. Little is known about the effects of growth factors on pituitary growth, despite most of them having well-documented mitogenic actions in other tissues. We have investigated the secretion of growth factors by the rat pituitary tumor cell line, GH3 and also have studied their mitogenic effects in other two non-pituitary human cell lines, A431 and fibroblasts. Size-exclusion chromatography of acidic extracts of GH3 cells yielded two peaks of mitogenic activity when GH3 cells were used as potential targets. One peak of growth-promoting activity (> 5 KDa) stimulated [3H] thymidine incorporation into GH3 cells (201% above control). Another peak (2-3 KDa) also stimulated [3H] thymidine incorporation into GH3 cells (162% above control). The first peak of autocrine action represented 60% and the second one, 40% of the total peaks mitogenic activity. GH3 pooled fractions A, B, C, D, corresponding to the GH3 peaks of autocrine growth-stimulating activity significantly enhanced [3H] thymidine incorporation into A431 cells and human fibroblasts. In A431 cells, the first peak of mitogenic activity represented 46.7%, and the second one, 53.2% from the total peaks mitogenic activity. In fibroblasts, the GH3 pooled fractions produced just one peak of growth-stimulating activity, which increased [3H] thymidine incorporation (175% above control). Our data provide the indications that (1) cultured rat pituitary tumor cells GH3 secrete two autocrine growth factors which may have a role on their development and maintenance; (2) these factors, which have yet to be characterized, are potent mitogens for malignant non-pituitary cells such as human squamous carcinoma cell line, A431, as well as for human fibroblast cell line.