Successful Cardiac Surgical Management in a Trisomy 21 Child After Long-Term Hospitalization Associated With Bronchopneumonia and Hepatitis C Virus Seropositivity: A Case Report.

A 31-month-old girl with trisomy 21 (Down syndrome) was seen in the emergency department of pediatrics because of oxygen desaturation associated with features of lower respiratory tract infections. She was born at full term and diagnosed with congenital heart disease (CHD) having ventricular septal defect (VSD), and patent ductus arteriosus (PDA); consequently, she underwent corrective surgery after adequate optimization of treatment. Incidentally, she was detected to have the presence of anti-hepatitis C virus (HCV) antibodies. In this case report, we mainly focus on the multi-modal approach to medical and surgical management.

Remimazolam attenuates inflammation in bronchopneumonia through the inhibition of NLRP3 activity by PDPK1 ubiquitination.

Bronchopneumonia is the most common pneumonia in childhood. Therefore, we tested the effects of Remimazolam presented Bronchopneumonia and its possible mechanisms. Phillygenin increased survival rate, reduced W/D ratio, and lung injury score, and inhibited IL-1ß, IL-6, TNF-α, and INF-γ levels in mice model of bronchopneumonia. Remimazolam induced PDPK1 and p-AKT protein expressions, and suppressed NLRP3 protein expression in lung tissue of mice model. In vitro model, Remimazolam also induced PDPK1 and p-AKT protein expressions, and suppressed NLRP3 protein expression. Remimazolam also inhibited inflammation levels in vitro model. PDPK1 inhibitor, PHT-427 (100 mg/kg) reduced survival rate, increased W/D ratio and lung injury score, and promoted inflammation levels in mice model of bronchopneumonia by treated with Remimazolam. PHT-427 suppressed PDPK1 and p-AKT protein expressions and induced NLRP3 protein expression in mice model of bronchopneumonia by treated with Remimazolam. Remimazolam interlinked PDPK1 protein. Remimazolam increased the expressions of PDPK1 and p-AKT in vitro model. Remimazolam reduced PDPK1 ubiquitination in vitro model.

Effect of ultrasonographic lung consolidation on health and growth in dairy calves: A longitudinal study.

Bovine respiratory disease (BRD) is a common and complex disease process in calves. Subclinical disease exists and early detection can be challenging due to inconsistent or nonexistent clinical signs. Thoracic ultrasonography (TUS) is often used and has the potential to improve the identification of respiratory diseases. Combining systematic TUS with clinical examination allows distinguishing BRD, including upper respiratory tract disease (clinical signs of respiratory disease, but no significant lung consolidation), clinical pneumonia (clinical signs of respiratory disease along with lung consolidations), and subclinical pneumonia (no clinical signs, but lung consolidations). Data on subclinical pneumonia are scarce, particularly outside of the North American or European contexts similar to Iran in west Asia with a dry and semi-arid climate and intensive breeding systems similar to North America which breeding calves begin in individual boxes, then moving to group pens, and finally to free stall or open shed housing systems. The first objective of this longitudinal study was to use weekly ultrasonography to monitor calves from birth until weaning in an Iranian dairy herd. The second objective was to look for any association between individual lung consolidation episode or cumulative consolidation episodes on preweaning growth. Thoracic ultrasonography was performed on calves (n = 221) weekly from birth to weaning (8 wk), and scanning occasions for each calf were equally distributed with 1-wk intervals (using consolidation threshold ≥3 cm as a specific lung consolidation definition, and ≥1 cm as a more sensitive threshold). Calf body weights were recorded using a weight tape. Other information recorded were transfer of passive immunity (TPI) using serum Brix (%) ≥8.4% as adequate TPI within the first week after birth and the treatment history of the calves. The main strategy for modeling was to determine how long-term lung consolidation affects average daily gain (ADG) during the preweaning period. A linear model was used to determine the effect of the number of weeks with consolidation on ADG. Using consolidation threshold of ≥3 cm, the mean (±SD) of total ADG for calves with no consolidation episode, 1 consolidation episode, and 2 or more consolidation episodes were 0.45 (±0.10), 0.39 (±0.10), and 0.38 (±0.11) kg/d, respectively. In the final multivariable regression analysis model and based on consolidation threshold of ≥3 cm, calves with 1 and 2 or more consolidation episodes had significantly lower ADG ± standard error (SE) of 0.04 ± 0.02 kg/d, and 0.06 ± 0.02 kg/d, respectively compared with animals with no consolidation episode. A total of 20% of calves (46/229 calves that entered the study) were treated for respiratory disease based on clinical signs (based on farmer examination). The final model also included specific confounders related to ADG and their interactions with lung consolidation (TPI and BRD treatment). An overall of 86% of adequate TPI was obtained. Bovine respiratory disease treatment based on farmer diagnosis had a larger negative effect on preweaning ADG than ultrasonography-diagnosed consolidation episodes (lower ADG ± SE of 0.10 ± 0.03 kg/d). When using a more sensitive consolidation threshold (≥1 cm as consolidation), the number of weeks with consolidation was also negatively associated with the ADG in the multivariable linear regression model with significant difference of 0.05 ± 0.02 kg/d for nonconsolidated calves versus calves consolidated for 2 or more weeks and insignificant difference of 0.01 ± 0.02 kg/d for nonconsolidated calves versus calves with 1 consolidation episode.

Morbimortalidade por pneumonia no estado da Bahia no período pré e durante a pandemia de COVID-19 ­ base de dados do DATASUS / Pneumonia morbidity and mortality in the state of Bahia in the period before and during the COVID-19 pandemic ­ DATASUS database

Introdução: a pneumonia é uma infecção nos pulmões, provocada pela penetração de microrganismos. Outras infeções respiratórias, incluindo a SARS-COV-2, podem agravar a clínica do paciente. Por sua vez, esta é uma doença sistêmica, com foco pulmonar que pode gerar complicações respiratórias, dentre elas a pneumonia. Neste seguimento, estudos evidenciam que 15% dos pacientes com COVID-19 podem apresentar pneumonia leve e 5% evoluir para pneumonia grave. Objetivo: comparar a ocorrência de morbimortalidade por pneumonia no Estado da Bahia, no período pré e durante a pandemia de COVID-19. Metodologia: trata-se de um estudo ecológico, quantitativo, com dados públicos, disponíveis no Sistema Informações em Saúde da plataforma DataSUS/ TABNet, referentes ao Estado da Bahia, no período de jan./2018 a dez./2021. Foram selecionados os dados: internamentos, média de internamento, óbitos e taxa de mortalidade. Os dados foram analisados através da estatística descritiva, frequência relativa, e estatística analítica com o teste de frequências relativas U de Mann-Whitney. Resultados: o Estado da Bahia, registrou um total de 48 mil internações por pneumonia, com média de taxa de permanência de internamento de 6,4 dias e um total de 8 mil óbitos, com média de taxa de mortalidade de 16,91% ao ano. Observa-se que ocorreu redução nas internações e óbitos, e aumento na taxa de mortalidade por pneumonia, no período estudado (P<0,001). Conclusão: contudo, verificou-se que no Estado da Bahia durante o período da pandemia de COVID-19, ocorreram redução no número de internados e óbitos, e aumento na taxa de mortalidade por pneumonia, comparando-se ao mesmo período pré pandemia.

Introduction: pneumonia is an infection in the lungs, caused by exposure to microorganisms. Other respiratory infections, including SARS-COV-2, may aggravate the patient's health condition. In turn, this is a systemic disease, with a pulmonary focus that can lead to respiratory complications, including pneumonia. In this area, studies show that 15% of patients with COVID-19 may have mild pneumonia and 5% progress to severe pneumonia. Objective: to compare the occurrence of morbidity and mortality from pneumonia in the State of Bahia, in the period before and during the COVID-19 pandemic. Methodology: this is an ecological, quantitative study, with public data, available in the Health Information System of the DataSUS/TABNet platform, referring to the State of Bahia, from Jan./2018 to Dec./2021. Selected data: hospitalizations, average hospitalization, deaths and mortality rate. Data were analysed using descriptive statistics, relative frequency, and analytical statistics with the Mann-Whitney U relative frequency test. Results: the State of Bahia recorded a total of 48,000 hospitalizations for pneumonia, with an average hospitalization stay rate of 6.4 days and a total of 8,000 deaths, with an average mortality rate of 16.91% per year. It is observed that there was a reduction in hospitalizations and deaths, and an increase in the mortality rate due to pneumonia, in the studied period (P<0.001). Conclusion: however, it was found that in the State of Bahia during the period of the COVID-19 pandemic, there was a reduction in the number of hospitalizations and deaths, and an increase in the mortality rate due to pneumonia, compared to the same pre-pandemic period.

Clinical implications of Golgi protein 73 and granulocyte colony-stimulating factor and their related factors in children with bronchopneumonia

Abstract Objective: To investigate the clinical implications of Golgi glycoprotein 73 (GP73) and granulocyte colony-stimulating factor (G-CSF) in children with bronchopneumonia (BP). Methods: Seventy-two children with BP (observation group) and 81 healthy children (control group) consecutively brought to the present study's hospital between June 2019 and October 2020 were enrolled. GP73 and G-CSF levels were determined to analyze their diagnostic value for pediatric BP. High-sensitivity C-reactive protein (hs-CRP) was also measured. The clinical implications of GP73 and G-CSF in pediatric BP complicated with respiratory failure and their connections with the inflammatory response were discussed. Results: GP73 and G-CSF levels were remarkably higher in the observation group (p< 0.05). The sensitivity and specificity of combined detection (GP73+G-CSF) in predicting pediatric BP were 72.22% and 86.42%, respectively (p < 0.001 ). GP73 and G-CSF, which are closely related to X-ray classification and complications in the observation group, decreased after treatment and were positively correlated with hs-CRP (p < 0.05), especially in children complicated with respiratory failure. Regression analysis identified the independence of the course of the disease, hs-CRP, X-ray classification, GP73, and G-CSF as influencing factors of respiratory failure in children with BP (p < 0.05). Conclusion: GP73 and G-CSF, with elevated levels in children with BP, are strongly linked to disease progression and are independent influencing factors of respiratory failure, which may be the key to diagnosing and treating pediatric BP in the future.

Comprehensive Analysis of the Diagnosis and Treatment of Tracheobronchial Foreign Bodies in Children.

OBJECTIVE: To analyze the factors influencing the diagnosis and treatment of tracheobronchial foreign bodies (TFBs) in children. METHODS: The clinical data of 300 consecutive children with suspected TFBs who were admitted to our department between January 2016 and December 2019 were retrospectively collected, including demographics, diagnosis, history of foreign body inhalation, preoperative chest computed tomography (CT) findings, duration of foreign body retention, time from admission to operation, operation duration, duration of hospitalization, and complications. RESULTS: Among the 300 cases, the male:female ratio was 193:107, and the age range was 6 months to 12 years (median age: 19 months). A total of 291 cases (97.0%) involved TFBs confirmed by rigid bronchoscopy, while the other 9 cases (3.0%) involved bronchopneumonia. The diagnostic accuracy, sensitivity, and specificity of a history of foreign body inhalation and chest CT were 96.0%, 98.6%, and 11.1% and 97.7%, 97.6%, and 100%, respectively. The duration of hospitalization, time from admission to operation, and operation duration were all related to bronchopneumonia (P < .05). CONCLUSIONS: A detailed history, adequate physical examination, and preoperative imaging examination help improve the diagnostic accuracy. Preoperative bronchopneumonia in children with TFBs will increase the surgical risks and treatment costs, prolonging the duration of hospitalization.

Subacute Invasive Pulmonary Aspergillosis (IPA) Is a Challenging Diagnosis.

Aspergillus is a ubiquitous fungus whose clinical manifestations and prognosis after infection depend on the host's immune status. The disease can have an insidious course, making it a challenging diagnosis that should be considered in patients with risk factors. We report the case of a 78-year-old man with a known history of asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome and idiopathic pulmonary fibrosis on long-term therapy with high-dose oral corticosteroids, hypertension, dyslipidemia, type 2 diabetes, and hypo coagulated atrial fibrillation. He was admitted to the Emergency Department (ED) for dyspnea, productive cough, and wasting syndrome. Recent hospitalization due to pneumonia of the left upper lobe (LUE) with no agent isolation is worth mentioning, treated with levofloxacin. Due to slow improvement, he underwent bronchoscopy (BFC), which revealed friable bronchial mucosa, with isolation of Candida albicans in bronchial secretions (BS) but without evidence of neoplastic cells in the pathological anatomy (PA). He completed 14 days of itraconazole. He was discharged after partial clinical improvement. One week later, he was again admitted to a medical ward because of worsening respiratory symptoms and wasting syndrome. Laboratory findings included an elevated C-reactive protein (CRP) and sedimentation rate, hypoosmolar hyponatremia, hypoproteinemia, and hypoalbuminemia. The study of hyponatremia revealed the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), and the persistence of respiratory symptoms led us to perform a chest computed tomography (CT), which revealed a subsegmental LUE atelectasis. Due to suspicion of neoplasia, he repeated BFC with isolation of Aspergillus on the bronchoalveolar lavage (BAL) and PA. Subacute invasive pulmonary aspergillosis (IPA) was assumed and voriconazole was started. However, he had an unfavorable evolution with marked cachexia and hemorrhagic shock due to lower gastrointestinal bleeding as a complication of hypocoagulation resulting in death. Chronic exposure to corticosteroids and structural lung disease are recognized risk factors for Aspergillus infection. The presentation as a wasting syndrome associated with respiratory symptoms and SIADH raised suspicion for neoplasia, which was excluded. The PA was fundamental for the definitive diagnosis of IPA. The fatal outcome, probably attributable to late diagnosis, reinforces the importance of high clinical suspicion for Aspergillus infection in patients with risk factors.

A Case of Alveolar-Cell Carcinoma Misdiagnosed As Tubercular Bronchopneumonia.

Tuberculosis (TB) and cancer are two of the most prevalent disease across the globe. Cases of lung cancer are increasing rapidly and have now reached almost epidemic levels throughout the world. The two diseases share various radiological features and symptoms and coming to a diagnosis sometimes becomes challenging. In a situation like this, an invasive procedure to establish a diagnosis becomes necessary. We report a case of 35-year-old female presenting with cough and dyspnea, initially diagnosed as pulmonary bronchopneumonia and later found to have alveolar-cell carcinoma.

Delayed Surgical Management of Acute Type A Aortic Dissection in a Patient with Recent COVID-19 Infection and Post-COVID-19 Bronchopneumonia-Case Report and Review of Literature.

Ever since it was first described in 1760, acute type A aortic dissection has created difficulties in its management. The recent COVID-19 pandemic revealed that extrapulmonary manifestations of this condition may occur, and recent reports suggested that aortic dissection may be amongst them since it shares a common physiopathology, that is, hyper-inflammatory syndrome. Cardiac surgery with cardiopulmonary bypass in the setting of COVID-19-positive patients carries a high risk of postoperative respiratory failure. While the vast majority accept that management of type A aortic dissection requires urgent surgery and central aortic therapy, there are some reports that advocate for delaying surgery. In this situation, the risk of aortic rupture must be balanced with the possible benefits of delaying urgent surgery. We present a case of acute type A dissection with COVID-19-associated bronchopneumonia successfully managed after delaying surgery for 6 days.

Pathology of pulmonary tuberculosis: has the tiger changed it's stripes?

Background: India accounts for the highest number of TB cases globally (almost one-fifth of the global burden and almost two-thirds of the cases in South East Asia. Furthermore, the development of drug resistance of varying levels such as multi-drug resistant TB (MDR-TB), extensively-drug resistance TB (XDR-TB) and total-drug resistant TB (TDR-TB) has been on the increase, and now India also features in the 27 high-MDRTB-burden countries. Almost parallel to these developments, in the last few years, we have been encountering less common morphological forms of pulmonary TB (PTB) at autopsies. With these less common manifestations of the disease, we undertook this study to examine the changing trends in the morphological pattern of pulmonary TB over the recent years. Methods: In this 3-year retrospective study, adult autopsy cases of PTB (that significantly contributed to the final cause of death) were studied in detail. HIV-positive cases were excluded from the study. The clinical details, gross appearances of the pulmonary lesions, microscopic pattern and Ziehl-Neelsen (ZN) staining were studied. Extrapulmonary involvement and causes of death were documented. Results: Pulmonary tuberculosis as a cause of death at autopsy was seen in 130 adult patients over 3 years. The age range was between 12 to 70 years. Anti-tuberculous therapy had been administered in 33 of them, but only one patient had taken complete therapy. Dyspnea was the commonest respiratory symptom seen in 51 cases (39.2%). Tuberculous bronchopneumonia was the commonest lesion (45.3%), miliary lesions (including localized miliary) accounted for 26% while fibrocavitary lesions (including the ones not involving apex) were seen in 13% cases. Other morphologies included nodular forms of TB (13%), localized miliary lesions (11.9%), and fibrocavitary lesions, not necessarily involving the apex (11.7% of all fibrocavitary cases), and predominant pleuritis with underlying lung involvement by TB in 1 case. Many cases of TB bronchopneumonia had a bronchocentric pattern of distribution (14.7%). On microscopy, caseating granulomas were seen in 93% cases, only caseation necrosis was seen in 4.6% cases, and necrotizing granulomas with abscess-like reaction in 11.5% cases. ZN staining was positive in 92 cases (70.7%). All the extrapulmonary lesions showed caseating granulomas histologically. The final cause of death was found to be primarily tuberculous in 106 cases (81.5%), whereas in 24 cases (19.5%) pulmonary TB was attributed to the secondary cause of death. Conclusion: The typical apical involvement of secondary TB was not seen in most of our cases. This could indicate a difference in the morphology and the pattern of lung involvement in recent years. The difference in gross morphology does not affect the pattern of involvement of the lung. In our study, we have observed both; a change in morphology, i.e., more cases of TB bronchopneumonia, and a change in the pattern of involvement like nodular forms, localized miliary forms, and fibrocavitary lesions not necessarily involving the apex. We postulate that this less common manifestation of pulmonary TB is closely related to the development of multi-drug and microbial resistance posing serious medical challenges.

Knockdown of circ_0026579 ameliorates lipopolysaccharide (bacterial origin)-induced inflammatory injury in bronchial epithelium cells by targeting miR-338-3p/TBL1XR1 axis.

BACKGROUND: Circular RNAs (circRNAs) play an important regulatory role in human diseases including organ allograft rejection. The aim of this study is to clarify the functional role and molecular mechanism of circ_0026579 RNA in lipopolysaccharide (LPS)-induced bronchopneumonia injury. MATERIALS AND METHODS: Bronchial epithelial BEAS-2B cells were treated with LPS to mimic an in vitro model for bronchopneumonia. Cell viability and proliferation were analyzed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and 5-ethynyl-2'-deoxyuridine (EdU) assay. Flow cytometry assay was used to assess cell apoptosis. Caspase-3 activity was analyzed by Caspase-3 activity assay kit. The expression levels of circ_0026579 RNA, miR-338-3p, and transducin ß-like 1× related protein 1 (TBL1XR1) RNA were determined by RT-qPCR. The protein level was quantified by western blot assay. The correlation between miR-338-3p and circ_0026579 or TBL1XR1 was confirmed by dual-luciferase reporter and RNA immunoprecipitation assays. RESULTS: LPS treatment repressed proliferation but induced apoptosis and inflammatory response in BEAS-2B cells. Circ_0026579 RNA was highly expressed in patients with pneumonia. Besides, the expression levels of circ_0026579 RNA and TBL1XR1 RNA/protein were upregulated, while miR-338-3p level was decreased in LPS-treated BEAS-2B cells. Knockdown of circ_0026579 RNA or TBL1XR1 protein could abolish LPS-induced cell injury in BEAS-2B cells. Furthermore, we found that circ_0026579 RNA functioned as a "sponge" for miR-338-3p to regulate TBL1XR1 expression. Additionally, silencing circ_0026579 RNA protected BEAS-2B cells from LPS-induced bronchopneumonia injury by regulating TBL1XR1 expression. CONCLUSION: Circ_0026579 RNA knockdown promoted cell proliferation but inhibited apoptosis and inflammation in LPS-induced BEAS-2B cells through regulating miR-338-3p RNA/TBL1XR1 protein axis.

Características clinicoepidemiológicas de pacientes con infecciones intrahospitalarias en un servicio de medicina interna de Santiago de Cuba / Clinical-epidemiological characteristics of patients with hospital acquired infections in a service of internal medicine from Santiago de Cuba

Introducción: La infección nosocomial o intrahospitalaria constituye un importante problema de salud en todos los hospitales del orbe. Objetivo: Describir las características clínicas y epidemiológicas de pacientes con infecciones intrahospitalarias. Métodos: Se realizó un estudio descriptivo y transversal de 57 pacientes con infecciones intrahospitalarias, ingresados en el Servicio de Medicina Interna del Hospital Provincial Docente Clínico-Quirúrgico Saturnino Lora de Santiago de Cuba, de octubre a diciembre de 2019, para lo cual se analizaron las variables edad, enfermedades asociadas, factores predisponentes, tipo de infección y gérmenes aislados. Resultados: En la serie sobresalieron el grupo etario de 60-69 años y la hipertensión arterial como enfermedad crónica concomitante (26,0 %). Entre los factores predisponentes resultó más frecuente el tabaquismo (32,8 %) y el tipo de infección preponderante fue la bronconeumonía bacteriana (47,0 %), cuyo germen causal en la mayoría de los casos (35,1 %) fue la Klebsiella pneumoniae. Conclusiones: Las infecciones intrahospitalarias aquejaron principalmente a pacientes de edad avanzada con enfermedades crónicas asociadas, como la diabetes mellitus y la hipertensión arterial. Cabe destacar la importancia de conocer la flora microbiana existente en el servicio donde se adquiere la infección, a fin de lograr tanto la prevención como el diagnóstico oportuno y el tratamiento adecuado.

Introduction: The cross or hospital infections constitute an important health problem in all the hospitals of the world. Objective: To describe the clinical and epidemiological characteristics of patients with hospital infections. Methods: A descriptive and cross-sectional study of 57 patients with hospital acquired infections was carried out. They were admitted to the Internal Medicine Service of Saturnino Lora Clinical-surgical Teaching Provincial Hospital of Santiago de Cuba, from October to December, 2019, for which the variables age, associated diseases, predisposing factors, type of infection and isolated germs were analyzed. Results: In the series the 60-69 years age group and hypertension as concomitant chronic disease (26.0 %) were notable. Among the predisposing factors nicotine addiction (32.8 %) was more frequent and the preponderant type of infection was the bacterial bronchopneumonia (47.0 %) whose causal germ in most of the cases (35.1 %) was the Klebsiella pneumoniae. Conclusions: The hospital acquired infections mainly afflicted patients of advanced age with associated chronic diseases, as diabetes mellitus and hypertension. It is necessary to highlight the importance of knowing the existent microbial flora in the service where the infection is acquired, in order to achieve boththe prevention, the opportune diagnosis and the appropriate treatment.

Investigation of SARS-CoV-2 infection and associated lesions in exotic and companion animals.

Documented natural infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in exotic and companion animals following human exposures are uncommon. Those documented in animals are typically mild and self-limiting, and infected animals have only infrequently died or been euthanized. Through a coordinated One Health initiative, necropsies were conducted on 5 animals from different premises that were exposed to humans with laboratory-confirmed SARS-CoV-2 infection. The combination of epidemiologic evidence of exposure and confirmatory real-time reverse transcriptase-polymerase chain reaction testing confirmed infection in 3 cats and a tiger. A dog was a suspect case based on epidemiologic evidence of exposure but tested negative for SARS-CoV-2. Four animals had respiratory clinical signs that developed 2 to 12 days after exposure. The dog had bronchointerstitial pneumonia and the tiger had bronchopneumonia; both had syncytial-like cells with no detection of SARS-CoV-2. Individual findings in the 3 cats included metastatic mammary carcinoma, congenital renal disease, and myocardial disease. Based on the necropsy findings and a standardized algorithm, SARS-CoV-2 infection was not considered the cause of death in any of the cases. Continued surveillance and necropsy examination of animals with fatal outcomes will further our understanding of natural SARS-CoV-2 infection in animals and the potential role of the virus in development of lesions.

Crassicaudiasis in three geographically and chronologically distant Cuvier's beaked whales (Ziphius cavirostris) stranded off Brazil.

The Cuvier's beaked whale (CBW; Ziphius cavirostris) is a cosmopolitan marine mammal found in deep tropical and temperate waters of all oceans. CBW strandings have been recorded sporadically in Brazil; however, there is lack of information available regarding their causes of stranding and/or death. Herein, we report the epidemiologic, pathologic, morphologic parasitologic features and molecular identification of arterial and renal crassicaudiasis by Crassicauda sp. in three geographically and chronologically distant CBW stranded off Brazil. CBW-1 was an adult male stranded dead in Rio Grande do Sul State. CBW-2 was an adult female that stranded alive in Sergipe State and died shortly after. CBW-3 was and adult male that stranded dead in Santa Catarina State. The most relevant pathologic findings in these three CBW were severe, chronic proliferative mesenteric and caudal aortic endarteritis and chronic granulomatous and fibrosing interstitial nephritis with renicular atrophy and loss, and numerous intralesional Crassicauda sp. nematodes. Furthermore, CBW-1 had concomitant gram-negative bacterial pneumonia and pulmonary and hepatic thromboembolism. Morphologic analysis of renal adult nematodes identified Crassicauda sp. in the three CBW. Molecular analyses targeting the 18S and ITS-2 ribosomal loci of renal nematodes in CBW-2 and CBW-3 identified C. anthonyi. It is believed that severe arterial and renal crassicaudiasis likely resulted or contributed significantly to morbidity and death of these animals. These results expand the known geographical range of occurrence of crassicaudiasis in CBW. Specifically, the present study provides the first accounts of arterial and renal crassicaudiasis in CBW off the southern hemisphere, specifically in CBW off Brazil, and to the authors' knowledge, it is the first record of C. anthonyi in the southern Atlantic Ocean.

Total serum IL-6 and TNF-C levels in children with bronchopneumonia following treatment with methylprednisolone in combination with azithromycin.

OBJECTIVE: To analyze the expression levels of total serum interleukin (IL)-6 and tumor necrosis factor (TNF)-C in children with bronchopneumonia treated by methylprednisolone in combination with azithromycin. METHODS: Eighty-three children with bronchopneumonia were randomly divided into a test group (TG) and a control group (CG). The TG was comprised of 40 children treated with methylprednisolone combined with azithromycin, whereas the CG was comprised of 43 patients who received methylprednisolone monotherapy. The post-treatment effective rates and occurrence of adverse reactions were compared between the two groups. In addition, the resolution times of symptoms such as fever, cough, moist rale, asthma, and shadow on the lung X-ray were recorded. The levels of the inflammatory factors tumor necrosis factor-C (TNF-C) and interleukin-6 (IL-6) were measured after treatment. The quality of life was evaluated and compared based on the Medical Outcome Study (MOS) 36-Item Short-Form Health Survey (SF-36). RESULTS: The total effective rate in the TG was significantly higher than that in the CG. The expression levels of TNF-C and IL-6 in the TG were significantly lower than those in the CG. The resolution times of the clinical symptoms were significantly shorter in the TG than in the CG. The ACT (Asthma Control Test) score in the TG was significantly lower than that in the CG. The TG presented with a significantly lower incidence of adverse reactions than that the CG. CONCLUSION: The combined administration of methylprednisolone and antibiotics can effectively improve the levels of serum inflammatory factors and the clinical symptoms in children with bronchopneumonia.

MiR-216a-5p alleviates LPS-induced inflammation in the human bronchial epithelial cell by inhibition of TGF-ß1 signaling via down-regulating TGFBR2.

OBJECTIVE: Bronchopneumonia is a common respiratory infection disease and is the leading cause of hospitalization in children under 5 years of age. Inflammation is the primary response caused by bronchopneumonia. But the detailed underlying mechanism of inflammation in bronchopneumonia remains unclear. Therefore, this study focused on studying the effect of miR-216a-5p on inflammation induced by bronchopneumonia and investigate the potential mechanism underlying it. METHODS: Human bronchial epithelial cells (BEAS-2B) were stimulated using lipopolysaccha-rides (LPS) to trigger bronchopneumonia in vitro. The production of interleukin (IL)-1ß, IL-6, and Tumor necrosis factor (TNF)-α was measured using the enzyme-linked immunosorbent assay. The luciferase assay was conducted to explore the relationship between miR-216a-5p and TGFBR2. Quantitative real-time polymerase chain reaction and western blot were used to detect the gene expression. RESULTS: miR-216a-5p gene expression decreased in BEAS-2B cells stimulated by LPS. Overexpression of miR-216a-5p suppressed the elevated levels of IL-1ß, IL-6, and TNF-α induced by LPS. Transforming growth factor-beta receptor 2 (TGFBR2) proved to be a direct target of miR-216a-5p, and they negatively modulated TGFBR2 expression. In addition, overexpression of miR-216a-5p inhibited LPS-induced protein levels of TGFBR2,transforming growth factor (TGF)-ß1, and phosphorylation of SMAD family member 2 (smad2),. This ectopic expression of miR-216a-5p was restored by overexpressed TGFBR2. CONCLUSION: miR-216a-5p was decreased in LPS-stimulated BEAS-2B cells. Overexpressed miR-216a-5p suppressed LPS-induced inflammation in BEAS-2B cells by inhibition of TGF-ß1 signaling via down-regulating TGFBR2. miR-216a-5p may be a valuable target for anti-inflammation treatment in bronchopneumonia.Bronchopneumonia is a common respiratory infection disease and is the main cause of hospitalization in children under 5 years of age. Inflammation is a primary response caused by bronchopneumonia. But the detailed underlying mechanism of inflammation in bronchopneumonia remains unclear. Therefore, this study focused on studying the effect of miR-216a-5p on inflammation caused by bronchopneumonia and investigate the potential mechanism underlying it. In this study, human bronchial epithelial cells (BEAS-2B) were stimulated using lipopolysaccharides (LPS) to trigger bronchopneumonia in vitro. miR-216a-5p was decreased in BEAS-2B cells stimulated by LPS. Overexpression of miR-216a-5p suppressed the elevated levels of interleukin (IL)-1ß, IL-6, and Tumor necrosis factor (TNF)-α induced by LPS. Transforming growth factor-beta receptor 2 (TGFBR2) proved to be a direct target of miR-216a-5p, and they negatively modulated TGFBR2 expression. In addition, overexpression of miR-216a-5p inhibited LPS-induced protein levels of TGFBR2,transforming growth factor-beta 1 (TGF-ß1), and phosphorylation of SMAD family member 2 (smad2. This ectopic overexpression of miR-216a-5p was restored by overexpressed TGFBR2. In conclusion, miR-216a-5p was decreased in LPS-stimulated BEAS-2B cells. Overexpressed miR-216a-5p suppressed LPS-induced inflammation in BEAS-2B cells by inhibition of TGF-ß1 signaling via down-regulating TGFBR2. miR-216a-5p may be a valuable target for anti-inflammation treatment in bronchopneumonia.

The Participation of a Malignant Catarrhal Fever Virus and Mycoplasma bovis in the Development of Single and Mixed Infections in Beef and Dairy Cattle With Bovine Respiratory Disease.

The bovine respiratory disease (BRD) complex is a multietiological and multifactorial disease associated with a wide range of viral and bacterial pathogens. This study evaluated the contribution of specific infectious disease agents in the development of BRD in cattle from Brazil and determined if a virus within the malignant catarrhal fever virus (MCFV) group and Mycoplasma bovis, acting individually or in conjunction, can be associated with the development of BRD. Formalin-fixed paraffin-embedded pulmonary sections were used in immunohistochemical assays to determine the intralesional presence of six antigens associated with BRD: bovine alphaherpesvirus 1 (BoHV-1), bovine parainfluenza virus 3 (BPIV-3), bovine viral diarrhea virus (BVDV), bovine respiratory syncytial virus (BRSV), MCFV, and M. bovis. Pneumonia was diagnosed in 82.7% (120/145) of all cattle evaluated. Interstitial pneumonia (60%, 72/120) and suppurative bronchopneumonia (25.8%, 31/120) were the most frequent patterns of pneumonia identified. Intralesional antigens of MCFV (53.3%, 64/120) were the most frequently associated with BRD, followed by M. bovis (47.5%, 57/120), BVDV (42.5%, 51/120), BoHV-1 (28.3%, 34/120), BRSV (24.2%, 29/120), and BPIV-3 (8.3%, 10/120). Additionally, antigens of BVDV, MCFV, and M. bovis were the most frequently identified agents associated with singular and concomitant infections. The MCFV identified during this study is more likely to be ovine gammaherpesvirus 2 (OvHV-2), since OvHV-2 is the only MCFV identified within the geographical region of this study. Interstitial pneumonia with proliferative vascular lesions may be a useful histologic feature to differentiate MCFV-induced pneumonia from other viral pneumonias of cattle. These results demonstrate that MCFV and M. bovis, in single or mixed infections, can produce pneumonia in cattle and should therefore be considered as primary agents in the development of BRD.

Autopsias de pacientes con enfermedad respiratoria aguda / Autopsies of patients with acute respiratory disease

Introducción: La enfermedad respiratoria aguda es la entidad más frecuente en la vida del ser humano y las enfermedades respiratorias agudas se encuentran entre las causas de muerte. La autopsia es el mejor método del estudio del enfermo y su realización es una fortaleza del sistema de salud cubano. Objetivo: Determinar las características demográficas y morfológicas que se encontraron en las autopsias de fallecidos con enfermedad respiratoria aguda. Método: Se realizó un estudio descriptivo y de corte transversal, de los fallecidos a quienes se realizó autopsia, en el periodo de 1986 al 2019. Se estudiaron las variables edad, sexo, comorbilidades, causas de muerte y relación clínico - patológica. Resultados: La población quedó conformada por 390 autopsias que presentaban estas afecciones (2,5 por ciento). El grupo de edades entre 65 a 84 años fue el más afectado en ambos sexos. En las causas directas de muerte predominó la bronconeumonía bacteriana. Se destaca la elevada coincidencia en las causas directas de muerte y las discrepancias en las causas básicas. La línea de tendencia indica el incremento progresivo en el transcurso de los años estudiados. Conclusiones: Las características demográficas muestran que todos los grupos de edades están afectados, con predominio de 65 a 84 años, en ambos sexos. El pulmón fue el órgano más afectado en las causas directas de muerte, con predominio de la bronconeumonía, mientras que la mayoría presenta enfermedad respiratoria aguda como causa básica de muerte, con elevada discrepancia en su relación clínico patológica(AU)

Introduction: Acute respiratory disease is the most frequent entity in human life and acute respiratory diseases are among the causes of death. The autopsy is the best method of studying the patient and it is a strength of the Cuban health system. Objective: To determine the demographic and morphological characteristics found in the autopsies of the deceased with acute respiratory diseases. Method: A descriptive and cross-sectional study was carried out of the deceased who underwent autopsy, in the period from 1986 to 2019. The variables age, sex, comorbidities, causes of death and clinical-pathological relationship were studied. Results: The population was made up of 390 autopsies with these conditions (2.5 percent). The 65 to 84 age group was the most affected in both sexes. In direct causes of death, bacterial bronchopneumonia predominated. The high coincidence in the direct causes of death and the discrepancies in the basic causes stand out. The trend line indicates the progressive increase in the course of the years studied. Conclusions: The demographic characteristics show that all age groups are affected, with a predominance of 65 to 84 years, in both sexes. The lung was the most affected organ in direct causes of death, with a predominance of bronchopneumonia, while the majority had acute respiratory disease as the basic cause of death, with a high discrepancy in its clinical-pathological relationship(AU)

LncRNA NEAT1 activates MyD88/NF-κB pathway in bronchopneumonia through targeting miR-155-5p.

BACKGROUND: Bronchopneumonia is a disease of the respiratory tract. It leads to other complications and endangers life and health. Long non-coding RNA (lncRNA) participates in the occurrence and development of bronchopneumonia. Nuclear paraspeckle assembly transcript 1 (NEAT1) plays a key role in inflammatory diseases, but the function of NEAT1 in bronchopneumonia remains unclear. METHODS: RT-qPCR and Western blotting were performed to determine genes and proteins expressions. MTT was applied to test cell viability. Cell apoptosis was detected by flow cytometry. RIP was used to investigate the correlation between NEAT1 and miR-155-5p. The interaction between miR-155-5p and NEAT1 or MyD88 was evaluated by the dual-luciferase reporter gene. RESULTS: NEAT1 and MyD88 were upregulated in BEAS-2B cells by LPS, while miR-155-5p was downregulated. Knockdown of NEAT1 inhibited LPS-induced BEAS-2B cells growth inhibition by inhibiting the apoptosis. In addition, NEAT1 silencing suppressed LPS-induced inflammatory responses in BEAS-2B cells via suppression of TNF-α, IL-1ß, IL-6, and IL-18. Meanwhile, NEAT1 is directly bound to miR-155-5p to regulate MyD88/NF-κB axis, and overexpression of miR-155-5p increased cell proliferation and suppressed inflammatory factors expression levels and cell apoptosis. Furthermore, sh-NEAT1-induced inhibition of BEAS-2B cells injury was partially reversed by miR-155-5p inhibitor or MyD88 overexpression. CONCLUSION: NEAT1 silencing suppressed LPS-induced BEAS-2B cells injury and inflammation by the mediation of miR-155-5p/MyD88/NF-κB axis. Thus, our study might shed new light on exploring the new strategies for the treatment of bronchopneumonia.

Downregulation of miR­409­3p suppresses LPS­induced inflammation in human bronchial epithelial cells through SOCS3/JAK1/STAT3 signaling: The implication for bronchopneumonia.

In recent decades, the role of microRNAs (miRs) in the development of pneumonia has been reported by a number of researchers. The present study aimed to investigate the role of miR­409­3p in lipopolysaccharide (LPS)­induced human bronchial epithelial cells and the implication for bronchopneumonia. An in vitro inflammation model was established using LPS­induced BEAS­2B cells. Cell apoptosis was determined by flow cytometry. Inflammatory factors were detected by ELISA and reverse transcription­quantitative PCR. Protein levels of Janus kinase 1 (JAK1)/STAT3 and suppressor of cytokine signaling (SOCS)3 were determined by western blotting. Dual­luciferase reporter assay was performed to confirm the interaction between miR­409­3p and SOCS3. LPS treatment significantly increased miR­409­3p expression and decreased the expression levels of SOCS3 in BEAS­2B cells. Dual­luciferase reporter assay demonstrated that miR­409­3p directly targeted and negatively regulated SOCS3. Inhibition of miR­409­3p markedly decreased the levels of TNF­α, IL­6 and IL­1ß, and suppressed apoptosis induced by LPS, which was reversed by SOCS3­knockdown. The inhibition of SOCS3 significantly activated JAK1/STAT3 signaling, as well as enhancing the levels of TNF­α, IL­6 and IL­1ß, and promoting apoptosis, which was reversed by the JAK1 inhibitor Tofacitinib. Suppression of miR­409­3p improved LPS­induced inflammation through SOCS3 in LPS­treated BEAS­2B cells, and this may be caused by regulating JAK1/STAT3 signaling.