Clinical utility of ambulatory ECG monitoring and 2D-ventricular strain for evaluation of post-COVID-19 ventricular arrhythmia.

BACKGROUND: A relatively common complication of COVID -19 infection is arrhythmia. There is limited information about myocardial deformation and heart rate variability (HRV) in symptomatic post COVID patients presented by ventricular arrhythmia. AIM OF THE STUDY: Our goal was to assess 2D-ventricular strain and heart rate variability indices (evaluated by ambulatory ECG monitoring) in post-COVID-19 patients suffering from ventricular arrhythmia. METHODS: The current observational case-control study performed on 60 patients one month after they had recovered from the COVID-19 infection. Thirty healthy volunteers served as the control group. Each participant had a full medical history review, blood tests, a 12-lead surface electrocardiogram (ECG), 24-h ambulatory ECG monitoring, and an echo-Doppler examination to evaluate the left ventricular (LV) dimensions, tissue Doppler velocities, and 2D-speckle tracking echocardiography (2D-STE) for both the LV and right ventricular (RV) strain. RESULTS: Symptomatic post-COVID patients with monomorphic premature ventricular contractions (PVCs) showed a substantial impairment of LV/RV systolic and diastolic functions, LV/RV myocardial performance (MPI) with reduced indices of HRV. Patients with higher versus lower ventricular burden had poorer functional status, higher levels of inflammatory biomarkers and reduced parameters of HRV (New York Heart Association (NYHA) class: 2.1 ± 0.9 vs. 1.5 ± 0.6, p < 0.001, C-reactive protein (CRP): 13.3 ± 4.1 vs. 8.3 ± 5.9 mg/L, p < 0.0001, low frequency/high frequency (LF/HF): 3.6 ± 2.4 vs. 2.2 ± 1.2, p < 0.002, the root mean square of the difference between successive normal intervals (rMSSD): 21.8 ± 4.7 vs. 29.3 ± 14.9 ms, p < 0.039 and the standard deviation of the RR interval (SDNN): 69.8 ± 19.1 vs.108.8 ± 37.4 ms, p < 0.0001). The ventricular burden positively correlated with neutrophil/lymphocyte ratio (NLR) (r = 0.33, p < 0.001), CRP (r = 0.60, p < 0.0001), while it negatively correlated with LV-global longitudinal strain (GLS) (r = -0.38, p < 0.0001), and RV-GLS (r = -0.37, p < 0.0001). CONCLUSIONS: Patients with post-COVID symptoms presented by ventricular arrhythmia had poor functional status. Patients with post-COVID symptoms and ventricular arrhythmia had subclinical myocardial damage, evidenced by speckle tracking echocardiography while having apparently preserved LV systolic function. The burden of ventricular arrhythmia in post-COVID patients significantly correlated with increased inflammatory biomarkers and reduced biventricular strain.

Short communication: Caseins and α-lactalbumin content of camel milk (Camelus dromedarius) determined by capillary electrophoresis.

Camel milk has unique physical, nutritional, and technological properties when compared with other milks, especially bovine. Because proteins confer many of the properties of milk and its products, this study aimed to determine the proteins of camel milk, their correlations, and relative distribution. Raw milk samples were collected from 103 dromedary camels in the morning and evening. Capillary electrophoresis results showed wide variation in the concentrations (g/L) of proteins between samples as follows: α-lactalbumin, 0.3 to 2.9; αS1-casein, 2.4 to 10.3; αS2-casein, 0.3 to 3.9; ß-casein, 5.5 to 29.0; κ-casein, 0.1 to 2.4; unknown casein protein 1, 0.0 to 3.4; and unknown casein protein 2, 0.0 to 4.6. The range in percent composition of the 4 caseins were as follows: αS1, 12.7 to 35.3; αS2, 1.8 to 20.8; ß, 42.3 to 77.4; and κ, 0.6 to 17.4. The relative proportion of αS1-, αS2-, ß-, and κ-caseins in camel milk (26:4:67:3, wt/wt) differed from that of bovine milk (38:10:36:12, wt/wt). This difference might explain the dissimilarity between the 2 milks with respect to technical and nutritional properties.

Exploring the risk of microplastics to pollinators: focusing on honey bees.

The rapid increase in global plastic production and usage has led to global environmental contamination, with microplastics (MPs) emerging as a significant concern. Pollinators provide a crucial ecological service, while bee populations have been declining in recent years, and MPs have been recognized as a new risk factor contributing to their losses. Despite the pervasive distribution and persistence of MPs, understanding their risks to honey bees remains a critical knowledge gap. This review summarizes recent studies that investigate the toxicity of MPs on honey bee health from different perspectives. The findings revealed diverse and material-/size-/dosage-dependent outcomes, emphasizing the need for comprehensive assessments in the follow-up studies. MPs have been detected in honey and in bees' organs (e.g., gut and brain), posing potential threats to bee fitness, including altered behavior, cognitive abilities, compromised immunity, and dysfunction of the gut microbiota. It should be noticed that despite several laboratory studies suggesting the aforementioned adverse effects of MPs, field/semi-field experiments are still warranted. The synergistic toxicity of MPs with other environmental contaminants (pesticides, antibiotics, fungicides, heavy metals, etc.) still requires further investigation. Our review highlights the critical need to understand the relationships between MPs, pollinators, and the ecosystem to mitigate potential risks and ensure the sustainability of vital services provided by honey bees.

School closures and student contact patterns.

To determine how school closure for pandemic (H1N1) 2009 affected students' contact patterns, we conducted a retrospective questionnaire survey at a UK school 2 weeks after the school reopened. School closure was associated with a 65% reduction in the mean total number of contacts for each student.

The effects of camel chymosin and Withania coagulans extract on camel and bovine milk cheeses.

Withania coagulans (W. coagulans) extract and camel chymosin have aspartic protease capable of coagulating milk for cheese production. This study investigated the quality of camel and bovine milk cheeses coagulated using Withania extracts, came chymosin, and their mixture in two experiments. In Experiment (1), a factorial design with four factors (W. coagulans, camel chymosin, incubation time, and incubation temperature) was performed. The effect of these factors on cheese's yield and hardness were assessed. An enzyme concentration corresponding to a 36 µg/L of milk of W. coagulans, 50 IMCU/L of camel chymosin, holding time of 4 h, and incubation temperature of 60 °C provided the optimal textural hardness for both camel and bovine milk cheeses. Seven treatments were analyzed in experiment (2) were analyzed for physicochemical properties, yield, and sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGEitation). The results showed that pure Withania extract exhibited the lower coagulating effect resulting in cheeses with low yield, hardness, fat, protein, and total solids. The SDS-PAGE electropherograms of camel cheese showed several low molecular weight bands as compared to bovine cheese. This phenomenon is due to excessive proteolysis in camel cheese, which we believed is caused by the presence of endogenous enzymes.

Use of near and mid infra-red spectroscopy for analysis of protein, fat, lactose and total solids in raw cow and camel milk.

Milk samples (150 cow and 217 camel milk samples) were analyzed for protein, fat, lactose and total solids by near and mid-infrared transmission spectroscopy. Excellent positive correlations between the two methods were obtained for both types of milk (p < 0.001); for protein (r ≥ 0.96), fat (r ≥ 0.99), lactose (r = 0.82) and total solids (r = 0.90). The mean of the relative difference ((MIR values - NIR values)/0.5 (MIR values + NIR values) × 100%) for cow and camel milk were, for protein (+8.2 & +13.4%), fat (-9.3 & +0.9%), lactose (-5.4 &-0.7%) and total solids (-2.2 &-3.4%), respectively. The difference between the two methods may be due to the effects of differences in milk homogeneity, especially with respect to casein micelles and fat globules.

Effects of Pasteurization and High-Pressure Processing of Camel and Bovine Cheese Quality, and Proteolysis Contribution to Camel Cheese Softness.

The effects of high-pressure processing (HPP) compared to thermal treatments on the quality of camel vs. bovine cheeses were studied. The study showed that camel milk has a lower microbial load compared to bovine milk, which is maintained during 7 days' storage of the processed milk. The effect of three HPP treatments (350, 450, and 550 MPa for 5 min at 4°C) and two pasteurization treatments (65°C for 30 min and 75°C for 30 s) on the quality of soft unripened camel and bovine milk cheeses were accessed. The cheeses were evaluated for pH, yield, proximate composition, textural and rheological properties, microstructure, and protein profile by SDS-PAGE electrophoresis. The effects of the treatments on cheese's hardness were different between the camel and bovine cheeses; while heat treatment at 65°C for 30 min gave the hardest bovine milk cheese (1,253 ± 20), HPP treatment at 350 MPa for 5 min gave the highest value for camel milk cheese (519 ± 5) (p < 0.05). The hardness of the cheeses was associated with low yield and moisture content. SDS-PAGE electrophoresis revealed that extensive proteolysis might have contributed to the softness of camel cheeses compared to bovine and suggested the involvement of some residual enzyme activities.

Analgesic and Respiratory Effects of Two Doses of Morphine as an Adjunct to Bupivacaine in Ultrasound-Guided Transversus Abdominis Plane Block in Upper Abdominal Surgery.

BACKGROUND: Opioid receptors are present at the terminals of afferent peripheral nerves; therefore, administration of opioids peripherally might provide a significant analgesic effect. OBJECTIVES: We investigated the analgesic efficacy of 2 different doses of morphine in bilateral subcostal single-injection ultrasound-guided transversus abdominis plane (TAP) block in abdominal surgery. STUDY DESIGN: Randomized, controlled, double-blind trial. SETTING: University hospital. METHODS: We enrolled 90 patients (aged 18-60 years) who were scheduled for elective upper abdominal surgeries and received TAP block for postoperative analgesia. Patients received 20 mL bupivacaine 0.5% (group B) only or combined with 10 mg morphine (group BM10) or 15 mg morphine (group BM15). Study drugs were diluted with saline solution 0.9% to 40 mL volume and bupivacaine concentration of 0.25% and injected 20 mL on each side. Primary outcome was the verbal rating pain scale (VRS) over the first 24 hours postoperatively. Secondary outcomes were time to first request for analgesics, total analgesic consumption, lung spirometry, and adverse effects. RESULTS: Compared with group B, patients in BM10 and BM15 groups showed significantly lower postoperative VRS scores at rest and during cough. Patients in BM15 group had lower VRS scores at the 24th hour postoperatively at rest (P = 0.034) and during cough (P = 0.040), compared with group BM10, with no significant difference at other timepoints. The median time to first request for intravenous patient controlled analgesia (PCA) nalbuphine was 10 hours (range, 6-12 hours) in group B versus 15 hours (8-18 hours; P = 0.000) and 16 hours (10-23 hours; P = 0.000) in BM10 and BM15 groups, respectively. Total consumption of nalbuphine PCA in BM15 group was 12 mg (6-18 mg) compared with 26 mg (20-34 mg; P = 0.000) and 18 mg (12-24 mg; P = 0.000] in groups B and BM10, respectively, with a significant difference between BM10 and BM15 groups (P = 0.000) and without significant adverse effects. LIMITATIONS: A limitation was a small sample size. CONCLUSIONS: Addition of morphine to bupivacaine in single-injection subcostal TAP block controlled pain and reduced opioid requirements after abdominal surgery in a dose-dependent manner. KEY WORDS: Abdominal surgery, analgesia, transversus abdominis plane block, morphine.

Augmentation versus No Augmentation for Immediate Postextraction Implants.

PURPOSE: To assess the effects of augmentation versus no augmentation in patients restored with immediate postextraction single-tooth implants on implant failure and patient satisfaction. MATERIALS AND METHODS: We searched the Cochrane Oral Health Group Trial Register, Cochrane Central Register of Controlled Trials, MEDLINE, and the WHO International Clinical Trial Registry Platform (22 March 2017). Two reviewers independently assessed trials for inclusion and risk of bias, extracted data, and checked for accuracy. We have expressed results as risk ratio or mean differences, together with their 95% confidence intervals. RESULTS: We included six studies (287 participants). Two trials compared no augmentation versus bone graft augmentation and reported no implant failures in both groups after a follow-up period of 6 months (20 implants) and 1 year (34 implants). One trial compared bone graft augmentation versus membrane augmentation and reported no difference in implant failure between both groups after 6 months (risk ratio (RR) 0.98, 95% confidence interval (CI) 0.06 to 15.31) or 1 year of follow-up (RR 0.33, 95% CI 0.01 to 7.86), and no implants were lost after 3 years. Three trials compared membrane augmentation versus combined bone graft and membrane augmentation, and there was no difference between the groups after six months of follow-up in implant failure (RR 5.13, 95% CI 0.63 to 41.93) or after 1 year (RR 0.38, 95% CI 0.02 to 9.05). There was insufficient evidence regarding patient satisfaction in all the included trials. CONCLUSIONS: In patients restored with immediate postextraction single-tooth implants, there is insufficient evidence to recommend simultaneous augmentation or a certain augmentation protocol to enhance implant survival and patient satisfaction. This trial is registered with PROSPERO (CRD42017054439).

Mycobacterial interspersed repetitive unit typing of Mycobacterium tuberculosis compared to IS6110-based restriction fragment length polymorphism analysis for investigation of apparently clustered cases of tuberculosis.

An evaluation of the utility of IS6110-based restriction fragment length polymorphism (RFLP) typing compared to a combination of variable number tandem repeat (VNTR) typing and mycobacterial interspersed repetitive unit (MIRU) typing was undertaken. A total of 53 patient isolates of Mycobacterium tuberculosis from four presumed episodes of cross-infection were examined. Genomic DNA was extracted from the isolates by a cetyl trimethylammonium bromide method. The number of copies of tandem repeats of the five loci ETR(A) to ETR(E) and 12 MIRU loci was determined by PCR amplification and agarose gel electrophoresis of the amplicons. VNTR typing identified the major clusters of strains in the three investigations in which they occurred (each representing a different evolutionary clade: 32333, 42235, and 32433). The majority of unrelated isolates (by epidemiology and RFLP typing) were also identified by VNTR typing. The concordance between the RFLP and MIRU typing was complete, with the exception of two isolates with RFLP patterns that differed by one band each from the rest of the major epidemiologically linked groups of isolates in investigation A. All of these isolates had identical MIRU and VNTR types. A further pair of isolates differed in the number of tandem repeat copies at two MIRU alleles but had identical RFLP patterns. The speed of the combined VNTR and MIRU typing approach enabled results for some of the investigations to be supplied in "real time," influencing choices in contact tracing. The ease of comparison of results of MIRU and VNTR typing, which are recorded as single multidigit numbers, was also found to greatly facilitate investigation management and the communication of results to health care professionals.