Association of the polymorphism of the Toll-like receptor (TLR)-3 and TLR-9 genes with hepatitis C virus-specific cell-mediated immunity outcomes among Egyptian health-care workers.

Variations in the immune response could explain resistance to hepatitis C virus (HCV) infection. Toll-like receptor gene (TLR)-3 is an innate detector of dsRNA viruses, and the TLR-9 gene recognizes bacterial and viral unmethylated cytosine-phosphate-guanosine (CpG) motifs. We previously reported that the TLR-3.rs3775290 CC genotype was associated with HCV chronicity and that the TLR-9 gene played no major role in this infection. This study identified the role of TLR-3.rs3775290 (c.1377C/T), TLR-9.rs5743836 (-1237T→C) and TLR-9.rs352140 (G2848A) gene polymorphisms in predicting the outcome of HCV-specific cell-mediated immunity (CMI) among Egyptian health-care workers (HCWs). We enrolled 265 HCWs in this study and divided them into four groups. Group 1: 140 seronegative-aviraemic HCWs; group 2: 20 seronegative-viraemic HCWs; group 3: 35 subjects with spontaneously resolved HCV infection; and group 4: 70 chronic HCV HCWs (patients). All subjects were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis for the TLR-3.rs3775290, TLR-9.rs5743836 and TLR-9.rs352140 single nucleotide polymorphisms (SNPs). We also quantified HCV-specific CMI in the four groups using an interferon (IFN)-γ enzyme-linked immunospot (ELISPOT) assay in response to nine HCV genotype 4a, overlapping 15mer peptide pools covering the whole viral genome. No statistically significant difference was found between CMI-responding subjects with different HCV states and TLR-3.rs3775290 or TLR-9.rs352140 genotypes. However, there was a significant relationship between the outcome of the HCV-specific CMI and the TLR-9.rs5743836 genotype among the responding subjects (P = 0·005) and the chronic HCV patients (P = 0·044). In conclusion, TLR-9.rs5743836 SNP, but not TLR-3.rs3775290 or TLR-9.rs352140 genotypes, could predict the outcome of HCV-specific CMI responses among Egyptians infected with genotype-4.

Comprehensive study on in vitro propagation of some imported peach rootstocks: in vitro explant surface sterilization and bud proliferation.

The present study was conducted in the Laboratory of Tissue Culture, Horticulture Department, Faculty of Agriculture, Damietta University, Egypt. The objective of this study was to establish a micropropagation protocol suitable for three imported peach rootstocks: Okinawa (P. persica), Nemared (P. persica × P. davidiana) × P. persica), and Garnem (P. dulcis × P. persica) in vitro. The results showed that soaking the explants in sodium hypochlorite (NaOCl) at 20% for 15 min produced the highest responsiveness (82.81%), survival (96.61%), with the lowest mortality (3.14%) and contamination (0.24%). Explants of the Garnem genotype had the best response (89.12%), survival (90.62%), lowest mortality (0.00%), and highest contamination (9.37%) when compared to the other genotypes. In comparison with axillary buds, the shoot tip displayed the highest responsiveness, survival, and death (100, 87.40, and 12.59%, respectively), as well as the least significant contamination (0.00%). Additionally, the percentages of responsive, survived, dead, and contaminated explants at the various collection dates varied significantly. The 6-benzylaminopurine (BAP) concentrations used (3 to 5.0 mg/L) demonstrated similar behavior in terms of in vitro proliferation, with rates of 3.77 to 6.11, 4.33 to 8.88, and 3.33 to 7.44 shoot numbers per explant for the Okinawa, Nemared, and Garnem peach rootstocks, respectively, indicating that the number of shoot proliferations is genotype-dependent. Additionally, using 5.0 mg/L BAP in combination with 0.2 mg/L IBA significantly increased average shoot proliferation (96.29%), number of shoots per explant (7.48), and average leaf number/explant (16.33) compared to the other treatments. Based on these results, adventitious bud development was enhanced during in vitro multiplication of the Okinawa, Nemared, and Garnem peach rootstocks by the synergistic interaction of indole-butyric acid (IBA) and 6-benzylaminopurine (BAP).

Prevalence of vitamin D deficiency among patients attending Post COVID-19 follow-up clinic: a cross-sectional study.

OBJECTIVE: Post-COVID-19 syndrome appears to be a multi-organ illness with a broad spectrum of manifestations, occurring after even mild acute illness. Limited data currently available has suggested that vitamin D deficiency may play a role in COVID-19 cases. However, to our knowledge, no study has examined the frequency of vitamin D deficiency in post-COVID-19 cases and its effect on the symptom severity. The aim of this study is to both screen the frequency of vitamin D deficiency in post-COVID-19 syndrome patients and to study its relation to persistent symptoms. PATIENTS AND METHODS: A cross-sectional, single-center study was conducted involving all cases attending post-COVID-19 follow-up clinic from November 2020 to May 2021. Complete history, clinical examination, and laboratory analysis [kidney functions, serum calcium, C-reactive protein, serum ferritin, Serum 25-(OH) vitamin D] was done as well as HRCT chest. RESULTS: The study included 219 post-COVID-19 cases, 84% had deficient vitamin D levels (< 20 ng/dL); 11.4% had insufficient level (20-30 ng/dL) and only 4.9 % reported normal level. There was no link between levels of vitamin D with either the acute or post-COVID-19 symptoms in the studied groups. CONCLUSIONS: Despite the prevalence of vitamin D deficiency among the study population, no association was observed between the levels of vitamin D and post-COVID-19 symptoms. It appears that post-COVID-19 syndrome pathophysiology involves a more complex interaction with the immune system. Dedicated clinical trials are advised to better study vitamin D levels and the related disease severity in COVID-19 patients.

Non-hospitalised COVID-19 patients have more frequent long COVID-19 symptoms.

BACKGROUND: Long COVID-19 syndrome refers to the persistence of symptoms for more than 12 weeks after the start of acute symptoms. The pathophysiology of this syndrome is not yet clear.OBJECTIVE: To assess long COVID-19 symptoms in hospitalised and non-hospitalised patients.METHODS: A cross-sectional survey was used. The study included 262 patients who were divided into two groups based on their hospital admission history: 167 (63.7%) were not hospitalised, while 95 (36.3%) were hospitalised.RESULTS: Long-COVID was reported in 157 out of 262 patients (59.9%), and was significantly more frequent in non-hospitalised patients (68.3% vs. 45.3%; P < 0.001). During the acute phase, hospitalised patients had more respiratory symptoms (95.9% vs. 85.6%), while non-hospitalised patients had more neuropsychiatric symptoms (84.4% vs. 69.5%; P < 0.05). Constitutional and neuropsychiatric symptoms were the most frequently reported persistent symptoms in both groups, but all persistent symptoms were more frequent in the non-hospitalised group (P < 0.005).CONCLUSION: Long COVID-19 symptoms affect both hospitalised and non-hospitalised patients. Neuropsychiatric manifestations were the most common persistent COVID-19 symptoms. Rehabilitation and psychotherapy could be advised for all recovered COVID-19 patients. Non-hospitalised COVID-19 patients should be counselled to contact healthcare providers whenever needed.

[Cor pulmonale as a sequela of tonsillar hypertrophy]. / Cor pulmonale als Folge von Tonsillenhypertrophie.

Cor pulmonale secondary to adenotonsillar hypertrophy is reported in two children. Repeated attacks of upper respiratory tract infection, snoring during sleep and finally signs of right heart insufficiency and mild cyanosis at exertion led to the diagnosis. Pulmonary hypertension was proved by electrocardiography, echocardiography and cardiac catheterization. Tonsillectomy and/or adenoectomy released the cardiac symptoms.

[Noninvasive diagnosis in the evaluation of shunt size in children with atrial septal defect--an evaluation scheme]. / Nichtinvasive Diagnostik zur Beurteilung der Shuntgrösse bei Kindern mit Vorhofseptumdefekt--ein Beurteilungsschema.

A cumulative score of five non-invasive diagnostic procedures is used to predict the size of the shunt in atrial septal defect (type II) in children. Each of those diagnostic managements being represented by zero, plus one, or two points: a higher score value refers to a more significant shunt volume. Summing up the points you will find 10 to 7 in an atrial septal defect that is worth being operated. In 6 and 5 points the prediction is unsure by scoring. Values of 4 or less points indicate a septal defect with no significant shunting. The validity of this scoring system has been tested in 35 children each examined by heart catheterization.

[Thromboembolism as a complication of Pudenz-Heyer drainage with cardiac shunt]. / Die Thromboembolie als Komplikation bei Pudenz-Heyer-Drainage mit kardialer Ableitung.

We report the case of a 2.7 year old boy with ventriculoatrial Pudenz Heyer shunt for hydrocephalus internus presenting with symptoms suggestive of shunt infection. 2D-echocardiography showed a pedunculated right atrial thrombus that prolapsed through the tricuspid valve in diastole. Scintigraphy of the lungs showed multiple defects suggestive of embolism. The thrombus was excised after exploratory surgery with cardiopulmonary bypass. No organisms could be isolated from the thrombus. In ventriculo-atrial Pudenz Heyer shunt thrombi and embolism are possible complications. The regular use of 2D-echocardiography in order to detect these thrombi at a very early stage is discussed.

[A rare combination: persistent ductus arteriosus and pulmonary stenoses. Is there a correlation with rubella embryopathy?]. / Die seltene Kombination: persistierender Ductus arteriosus und Pulmonalstenosen. Besteht ein Zusammenhang mit der Rötelnembryopathie?

The combination of patent ductus arteriosus, valvular pulmonary stenosis and/or peripheral pulmonary stenosis is very rare. We examined 23 children with this entity. In 9 children there were findings suggestive of rubella syndrome. 17 of the 23 children were born predominantly between October and March. Most of them showed low birth weights. Regarding the cardiac involvement there was no difference between the children with signs of rubella syndrome and those without noncardiac manifestations. In many children the symptoms of the patent ductus are leading. On evaluation of the noninvasive diagnostic procedures the ECG showed often a right ventricular hypertrophy and the x-ray of the chest showed in most cases a cardiac enlargement. In all patients a heart catheterization was necessary to establish the diagnosis. The review of the literature and the interpretation of our findings seems to suggest that the combination of a patent ductus arteriosus with pulmonary stenosis is a typical manifestation of rubella infection in the heart.

[Short- and long-term problems in dilatation of untreated aortic isthmus stenosis in children]. / Kurz- und Langzeitprobleme bei der Dilatation der nativen Aortenisthmusstenose im Kindesalter.

We examined problems and complications during and after balloon dilation of native coarctation of the aorta in 31 children with a mean age at first dilation of 5.77 +/- 5.4 years (0.08-16 years), who had a total of 37 balloon dilations. Twenty-six patients were restudied 3 to 24 months after the first procedure. In six patients, because of recoarctation, further dilations were performed. In two patients the second procedure was not successful and they required surgery. In 14/37 (37.8%) dilations the routine sedation was insufficient. The retrograde catheter could be introduced percutaneously in all but one patient. Because of small femoral arteries the introduction of the balloon catheter was not possible in three cases (8.1%). In three more patients (8.1%) the adequate catheters were not in stock. Complications included: transfusion because of blood loss in six patients (16.2%), chest pain in three (8.1%), rupture of balloon in three (8.1%), thrombectomy in three (8.1%), and partial reopening of ductus arteriosus in one patient. Duration of hospital stay was a mean of 1.81 days +/- 1.65 (range 1-9 days). Ninety percent of the patients were discharged within 2 days. On follow-up (range: 3-50 months), eight patients (21.6%) had a weak femoral pulse, of whom only one had an absent pulse, eight patients (21.6%) had paradoxical hypertension despite good dilation and no significant gradients, and only one patient showed a small aneurysm. We conclude that balloon angioplasty of native coarctation is a successful and relatively safe method of treatment of native coarctation. The most serious complication is arterial occlusion of the affected leg.(ABSTRACT TRUNCATED AT 250 WORDS)