Persistent symptoms and conditions among children and adolescents hospitalised with COVID-19 illness: a qualitative study.

OBJECTIVES: There is limited in-depth research exploring persistent symptoms and conditions among children and adolescents who contracted COVID-19 illness that required hospitalisation. The main objective of this study was to conduct qualitative interviews among families who had a child hospitalised with COVID-19 illness to elucidate their child's physical, mental and social health outcomes months after initial acute infection. DESIGN, SETTING AND PARTICIPANTS: A qualitative study that composed of in-depth interviews among families with a child hospitalised with COVID-19 illness in one large urban US paediatric healthcare system. Parents (N=25) were recruited from an ongoing quantitative study to estimate the prevalence of long COVID in children hospitalised with COVID-19 illness. During in-depth interviews, parents were invited to describe their child's post-COVID-19 symptoms and experiences. Interviews were audiotaped, transcribed and coded in NVivo. RESULTS: Seven themes were identified concerning the child's prolonged COVID-19 experiences: (1) post-traumatic stress disorder, (2) social anxiety, (3) severe symptoms on reinfection, (4) worsened pre-existing conditions, (5) lack of insurance coverage for costly treatments, (6) access and utilisation of support systems and (7) overall resilience and recovery. Four parent-specific themes were identified: (1) fear of COVID-19 unknowns, (2) mixed messaging from health information sources, (3) schools being both a support system and a hindrance and (4) desire for and access to support systems. CONCLUSIONS: A subset of children who were hospitalised with COVID-19 illness are experiencing a range of serious mental health impacts related to persistent COVID-19 symptoms. Clinical and public health support strategies should be developed to support these children and their families as they reintegrate in school, social and community activities.

Design, Synthesis, and Toxicological Activities of Novel Insect Growth Regulators as Insecticidal Agents against Spodoptera littoralis (Boisd.).

As a result of some major problems that come from using insecticides, the use of safe alternatives to these pesticides has become very necessary. Thus, a novel series of predicted toxicologically active urea, thiourea, thiosemicarbazide, oxadiazole, pyrazole, and triazine derivatives have been synthesized in a pure form to be lufenuron analogues as insect growth regulators which were screened and examined against Spodoptera littoralis (Boisd). The structure of synthesized compounds was established by means of spectroscopic and elemental analyses. Compounds b5, b2, b3, and a4 showed high insecticidal toxicity, and their LC50 values for the second larvae instar were found to be 26.63, 46.35, and 60.84 ppm, respectively, whereas the LC50 value for lufenuron as a reference insecticide was 17.01 ppm.

Biomarkers of imidacloprid toxicity in Japanese quail, Coturnix coturnix japonica.

The in vivo effect of the oral sublethal doses of 3.014 mg kg-1 of IMI (1/25 LD50) for 1, 7, 14, and 28 days every other day on Japanese quail was investigated. The results revealed that certain biomarkers in the selected tissues of the quail such as acetylcholinesterase (AChE), butyrylcholinesterase (BuChE), aminotransaminases (alanine aminotransferase, ALT, and aspartate aminotransaminase, AST), phosphatases (acid phosphatase, ACP, and alkaline phosphatase, ALP), lactate dehydrogenase (LDH), adenosine-triphosphatase (ATPase), glutathione-S-transferase (GST), lipid peroxidation (LPO), and blood glucose showed significant inductions, while significant reductions in the levels of glutathione-reduced (GSH), deoxyribonucleic acid (DNA), and ribonucleic acid (RNA) were noticed. In this study, the molecular mechanisms of the toxic effects of imidacloprid on quails were elucidated regarding neurotoxicity, hepatotoxicity, oxidative stress, lipid peroxidation, antioxidant activity, and genotoxicity. Because IMI induced alterations in the levels of these biomarkers in Japanese quail; therefore, Japanese quail as a wild avian can be used as a suite bioindicator to detect imidacloprid toxicity.

Ghrelin polymorphism/TRPV1 receptor expression in Egyptian IBS patients.

INTRODUCTION/OBJECTIVE: Irritable bowel syndrome is a functional gastrointestinal disorder. Ghrelin is a peptide hormone which affects gastrointestinal motility. We have studied the association between ghrelin gene polymorphism, ghrelin expression, and their effect on TRPV1 correlating this with IBS manifestations in the Egyptian patients. METHODS: Participants included 60 IBS patients meeting the Rome III criteria and 60 controls similar in age and gender were recruited. Whole blood samples were used for genotyping of Ghrelin polymorphisms rs696217. Colonic biopsies were processed for mRNA expression analysis of ghrelin and TRPV1. RESULTS: The rs696217 GG genotype frequency was higher in patients (78.3%) compared to controls (57%). According to GT\TT genotype there was significant difference between IBS and control group: 21.7%, 43% respectively (p = 0.0126). In allele frequency distribution, G allele in the IBS group was 87.5% while in the control group was 74%.T allele presents in 12.5% of IBS patients and 26% in the control group (p = 0.010). The genotype frequencies did not significantly differ between IBS subtypes. TRPV1 mRNA levels in were significantly increased in IBS patients than in controls (p < 0.05), while GHRL mRNA expression was significantly decreased (p < 0.05). The IBS-C group showed significantly higher levels of TRPV1 and lower levels of GHRL mRNA expression (p < 0.05) CONCLUSIONS: we showed that ghrelin rs696217 might have a role in IBS, as those patients carrying the GG genotype showed a significant decrease in ghrelin mRNA expression, with a subsequent significant increase in TRPV1 gene expression, and could explain some of the IBS manifestations.

Hepatocellular carcinoma post direct anti hepatitis C viral agents; clinical features

Background: Direct Anti Hepatitis C Viral Agents (DAAs) were introduced for Hepatitis C Virus (HCV) infection management, which resulted in high sustained virological response (SVR) in many countries and a low failure rate. However, hepatocellular carcinoma (HCC) post DAAs therapy is controversial; few studies related aggressive pattern HCC to DAAs. Therefore, we aimed to study the hepatocellular carcinoma relation to direct anti-hepatitis C viral drugs. Patients and Methods: This observational cross-sectional study included 67 adults Egyptian HCC patients associated with HCV diagnosed at the Zagazig University Hospitals, who were divided into two groups according to DAAs treatment. Results: HCC is more common in male patients (77.6%) of all studied cases, and those are treated by DAAs (62.7%). The median age of HCC post-DAA was 63(48-83), while 58 (45-75) in HCC patients without DAA, with no significant difference p= 0.053. HCC presented in the non-DAAs treated group, mainly decompensating by hematemesis (HM) (32%). While in the post-DAAs group, HCC was significantly diagnosed primarily with abdominal pain at 31%. There is no significant difference as regards the liver status with frequent liver cirrhosis in both groups, 14(56%) and 32(76.2%). Conclusion: DAAs therapy of HCV added no specific pattern association for hepatocellular carcinoma.

Effect of N-acetylcysteine on attenuation of chlropyrifos and its methyl analogue toxicity in male rats.

The attenuating effect of 150 mg/kg of N-acetylcysteine (NAC) against the oral administration of 7.88 and 202.07 mg/kg/day for 14 days of either chlropyrifos-ethyl (CPE-E) or chlropyrifos-methyl (CPF-M), respectively, in male rat was investigated using biochemical and genetic markers. Biomarkers such as acetylcholinesterase (AChE), butyrylcholinesterase (BuChE), paraoxonase (PON), adenosine 5'-triphosphatase (ATP-ase), glutathione-S-transferase (GST), catalase (CAT), glutathione reduced (GSH) in serum showed a significant decline in their levels, while calcium (Ca+2), cytochrome C reduction (CYC-R), lipid peroxidation (LPO), nitric oxide (NO) levels showed a significant increase in serum of treated rats. Regarding the genotoxic parameters, when rats are treated either with CPE-E or CPF-M, liver DNA, chromosomal aberration (CA), and micronucleated polychromatic erythrocytes (MnPCE) significantly increased, while the mitotic index (MI) and polychromatic erythrocytes (PCE)/ normochromatic erythrocytes (NCE) ratio were significantly decreased. However, the administration of NAC following the intoxication of CPF-E or CPF-M attenuated the tested biochemical and genotoxic markers. It can be concluded that NAC can be used to ameliorate the toxicity of certain organophosphorus compounds such as CPF-E and CPF-M.

Development and validation of a novel enzyme-linked immunosorbent assay for monitoring ethylene thiourea in soil and vegetable samples.

A novel enzyme-linked immunosorbent assay (ELISA) was developed for the detection of ethylene thiourea (ETU); a metabolite of ethylenebisdithiocarbamates (EBDCs) fungicides such as mancozeb. The ELISA performed well under optimal conditions based one limit of detection (0.201 ng mL-1), sensitivity (IC50 3.71 µg mL-1), recovery (81.6-102.7%) and relative standard deviation (<12.5%). This method was used to determine ETU residues in soil and vegetables after 0, 1, 3, 5, 7 and 10 days following mancozeb application. Concentrations of ETU gradually increased in the soil up to the tenth day of application. While in tomato and potato samples, the maximum concentrations of ETU residues were reached on the third and fifth days, respectively, and then dissipated with half-lives of 1.33 and 4.33 days, respectively. The method was simple, rapid, cost-effective, environmentally friendly, and has the potential for high sample throughput.

Effect of sample type and storage conditions on Golgi membrane protein 73 stability.

GP73 is a transmembrane glycoprotein that increases in viral and non-viral liver diseases, especially in hepatocellular carcinoma. This study aims to evaluate the effect of sample type and storage conditions on GP73 concentration. Twenty subjects were enrolled in this study. Serum and citrated plasma samples were collected. Both were subjected to different time intervals and storage temperature. Baseline GP73 concentrations ranged from 1.7 to 16.9 ng/mL in serum samples, and from 1.1 to 15.3 ng/mL in citrated plasma (Mann-Whitney U test, p = .1). The acceptable change limit for GP73 was 6.1%. As the highest value of the median percentage deviation was -5.3% in both sample types at different storage condition so, deviations were within the accepted limits. But there were considerable variations in the GP-73 concentrations after 2 cycles of freezing and thawing at -20 °C. This study shows that both serum and citrated plasma can be used for the measurement of GP73 concentration. GP73 seems to be stable under common storage conditions, but it may be unstable with frequent cycles of freezing and thawing.

Determination of glyphosate residues in Egyptian soil samples.

A sensitive linker-assisted enzyme-linked immunosorbent assay (L'ELISA) was developed for the analysis of glyphosate in Egyptian soil samples. Polyclonal glyphosate antibodies were produced from rabbits immunized with glyphosate protein conjugate. The conjugate was prepared by activating the carboxylic groups of proteins; thyroglobulin or bovine serum albumin with 1-ethyl-3- (3-diaminopropyl) carbodiimide hydrochloride and N-hydroxysulfosuccinimide followed by directly coupled to the amino group of glyphosate. The L'ELISA used succinic anhydride to derivatize glyphosate, which mimics the epitopic attachment of glyphosate to thyroglobulin. L'ELISA recognized the derivatized glyphosate with a limit of detection (LOD) of 0.8 ng g-1 and sensitivity (IC50 value) of 0.018 µg g-1. The recovery values of the spiked soil samples with different concentrations of glyphosate were in the range of 87.4-97.2%. Good correlation was achieved between L'ELISA and conventional high-pressure liquid chromatography (HPLC) with fluorescence detection. This study demonstrated the utility and convenience of the sensitive, simple, practical and cost-effective L'ELISA method for glyphosate analysis in soil samples. Also, it is ideal for rapid screening of a large number of environmental samples.

Clinical inquiries. What is the best management for patients who have a TIA while on aspirin therapy?

Alternative antiplatelet therapy for stroke prevention is indicated for patients who experience transient ischemic attacks (TIAs) while on aspirin therapy (strength of recommendation [SOR]: A, based on 1 meta-analysis and 1 randomized controlled trial). The combination of aspirin and extended-release dipyridamole reduces the risk of stroke following a TIA (SOR: A). Thieno-pyridines (eg, clopidogrel and ticlopidine) are an alternative for patients at high risk for a cardioembolic event. Ticlopidine reduces the risk of stroke following TIA, specifically showing benefit for patients previously on aspirin (SOR: A). Clopidogrel has not shown significant reduction in reoccurrence of stroke and has not been studied for patients with a previous TIA. Aspirin and a thieno-pyridine do not provide significant additional reduction in secondary strokes (SOR: A).

Oral health of children with juvenile idiopathic arthritis.

OBJECTIVE: s. To estimate dental disease indices and temporomandibular joint (TMJ) dysfunction in children with juvenile idiopathic arthritis (JIA). METHODS: Indices were recorded for dental caries, bacterial dental plaque, gingival inflammation, and TMJ dysfunction in children with JIA and matched controls. RESULTS: There was no significant difference in dental caries experience or the mean plaque score between children with JIA and controls. The mean gingivitis score for the permanent teeth only was significantly greater in the JIA children compared with the controls (p = 0.02). There was a significantly greater proportion of children with JIA with signs of both left and right TMJ dysfunction (p = 0.05, p = 0.02) and symptoms (p = 0.0001, p = 0.0001) compared with controls. CONCLUSION: The low caries rate was attributed to the fact that children with JIA had received preventive dental care from an early age combined with sugar free medication.