Campylobacter jejuni virulence factors: update on emerging issues and trends.

Campylobacter jejuni is a very common cause of gastroenteritis, and is frequently transmitted to humans through contaminated food products or water. Importantly, C. jejuni infections have a range of short- and long-term sequelae such as irritable bowel syndrome and Guillain Barre syndrome. C. jejuni triggers disease by employing a range of molecular strategies which enable it to colonise the gut, invade the epithelium, persist intracellularly and avoid detection by the host immune response. The objective of this review is to explore and summarise recent advances in the understanding of the C. jejuni molecular factors involved in colonisation, invasion of cells, collective quorum sensing-mediated behaviours and persistence. Understanding the mechanisms that underpin the pathogenicity of C. jejuni will enable future development of effective preventative approaches and vaccines against this pathogen.

Bisphenol-A exposure alters liver, kidney, and pancreatic Klotho expression by HSP60-activated mTOR/autophagy pathway in male albino rats.

The effect of bisphenol-A (BPA) on Klotho protein (aging-suppressing protein) expression in different body organs has not been sufficiently addressed by literature studies. The study investigated the impact of BPA on Klotho expression in multiple organs including the liver, kidney, and pancreas and suggested the involved molecular pathways. Twenty-seven male Wistar albino rats were divided into 3 equal groups: control, low-dose BPA (4.5 µg/L), and high-dose BPA (8 µg/L) groups in drinking water for 45 consecutive days. Liver, kidney, and pancreatic specimens were prepared for a gene study of Klotho, HSP60, mTOR, and ULK1 mRNA expressions. Also, the tissue specimens were measured for malondialdehyde (MDA), superoxide dismutase (SOD), and nitric oxide (NO) levels. Paraffin-embedded sections were also prepared and subjected to Hematoxylin and Eosin (H&E) staining and immunohistochemical detection of Klotho and HSP60. The results revealed an alteration in the MDA, SOD, NO tissue levels, disturbed gene expression profile, and apoptotic changes in the histological findings of the examined organs which were obvious (p < 0.05) in the high-dose group. The anti-aging Klotho gene/protein expression was reduced (p < 0.05) more in the high-dose BPA group than in the low dose. In contrast, HSP60 gene/protein expression was significantly increased (p < 0.05) more in the high dose. It was concluded that BPA exposure contributed to cell stress and markedly reduced Klotho protein expression in liver, kidney, and pancreatic tissues, possibly by modulation of the HSP60-activated mTOR/autophagy signaling.

Types, trends, and patterns of the reported antimicrobial errors to the eastern region's medical centers in Saudi Arabia: A cross-sectional study.

Introduction: Medication errors (MEs) are a huge burden on any healthcare system and have been associated with significant morbidity and mortality. The medical literature reported heavily on MEs but lacked focus on analyzing high-risk medications such as antimicrobials. Research design and methods: This was a retrospective analysis of the MEs database reported by the eastern region's medical centers in Saudi Arabia from January 1, 2019 to December 31, 2019. We used descriptive analysis to identify most common antimicrobials with errors, the stage of antimicrobial errors, type of the errors, contributing factors to the errors, and categories of errors based on the National Coordinating Council for Medication Error Reporting and Prevention (NCC-MERP) classification of errors. Results: A total of 1422 (22.1%) antimicrobial errors were identified out of 6412 MEs. Amoxicillin/Clavulanate (18%) was the most common antimicrobial reported in the database. Most errors occurred in the prescribing phase (87.6%) and included mainly incorrect doses (32.1%) and duplicate therapy (20.5%). In addition, most errors were identified as category B (72.5%). Finally, inexperienced personnel (57.9%) was the most cited contributing factor. Conclusion: This study revealed that antimicrobial errors occur primarily during prescription and that policy gaps and inexperienced staff were contributory factors. To improve, the focus should shift to physician education, clear dosing guidelines, efficient workload management, and implementing antimicrobial stewardship programs to promote appropriate antimicrobial use.

Quality of Life Among Down Syndrome Patients With and Without Congenital Heart Disease at King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

Background Congenital heart diseases (CHD) are common in Down syndrome patients who will often have additional anomalies, in which the presence of them and their management are expected to impact their quality of life (QoL). There are limited studies trying to evaluate the impact of CHD on the QoL in children with Down syndrome. Methods The present study comprised 97 Down syndrome children. The children's parents responded to phone interviews filling out TNO-AZL (Netherlands Organisation for Applied Scientific Research Academic Medical Centre) Preschool Quality of Life (TAPQOL) and TNO-AZL Child Quality of Life Parent Form (TACQOL-PF) questionnaires. Children were divided into two groups according to their age: group A (one to five years) and group B (six to 15 years). The results were analyzed using Statistical Package for Social Sciences (SPSS) software, version 21 (IBM Corp., Armonk, NY). Results CHD negatively affected motor skills in younger but not older children. All other QoL-related parameters were unaffected by CHD. Conclusion Down syndrome children with CHD demonstrated similar QoL to Down syndrome children without CHD, with the exception of having a lower motor outcome as infants/toddlers. This difference improved with time and did not exist in older children.

Extensive Cerebral Venous Sinus Thrombosis (CVST) After the First Dose of Pfizer-BioNTech BNT162b2 mRNA COVID-19 Vaccine without Thrombotic Thrombocytopenia Syndrome (TTS) in a Healthy Woman.

BACKGROUND COVID-19 is an acute respiratory disease caused by the SARS-CoV-2 virus, which was discovered in 2019. The high transmission and seriousness of COVID-19 necessitated the development of an effective vaccine to control spread of the disease. Multiple vaccines have been granted emergency use authorization (EUA) by the U.S. Food and Drug Administration, namely, the Pfizer-BioNTech, Moderna (mRNA), and the Johnson & Johnson/Janssen (vector) vaccines. As these novel vaccines have been used, adverse effects have been reported, ranging from mild myalgia to severe anaphylaxis and thrombotic events. Thrombotic consequences raised suspicion for the development of cerebral venous sinus thrombosis (CVST), which is a severe condition associated with occlusion of venous sinuses and disruption of the venous system flow. CASE REPORT A 28-year-old healthy woman presented with a 2-week history of persistent and progressive headache 4 days after receiving an mRNA COVID-19 vaccine (Pfizer-BioNTech). Cerebral computed tomography (CT) and CT venography confirmed the presence of extensive thrombus involving the left transverse and sigmoid sinus as well as the internal jugular vein. Furthermore, other than recent the COVID-19 vaccination, there were no precipitant risk factors in her clinical history or in the detailed laboratory work-up. CONCLUSIONS Headache associated with red flags following administration of any COVID-19 vaccine should prompt urgent neuroimaging to rule out secondary causes and determine the appropriate management. Our patient lacked the typical profile of CVST commonly seen following administration of the Oxford-Astrazeneca vaccine. The findings of low platelet count may indicate the peculiar pathophysiology of a thrombotic event associated with with the Pfizer vaccine.