Evidence of SARS-CoV-2 infection in postmortem lung, kidney, and liver samples, revealing cellular targets involved in COVID-19 pathogenesis.

There is an urgent need to understand severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-host interactions involved in virus spread and pathogenesis, which might contribute to the identification of new therapeutic targets. In this study, we investigated the presence of SARS-CoV-2 in postmortem lung, kidney, and liver samples of patients who died with coronavirus disease (COVID-19) and its relationship with host factors involved in virus spread and pathogenesis, using microscopy-based methods. The cases analyzed showed advanced stages of diffuse acute alveolar damage and fibrosis. We identified the SARS-CoV-2 nucleocapsid (NC) in a variety of cells, colocalizing with mitochondrial proteins, lipid droplets (LDs), and key host proteins that have been implicated in inflammation, tissue repair, and the SARS-CoV-2 life cycle (vimentin, NLRP3, fibronectin, LC3B, DDX3X, and PPARγ), pointing to vimentin and LDs as platforms involved not only in the viral life cycle but also in inflammation and pathogenesis. SARS-CoV-2 isolated from a patient´s nasal swab was grown in cell culture and used to infect hamsters. Target cells identified in human tissue samples included lung epithelial and endothelial cells; lipogenic fibroblast-like cells (FLCs) showing features of lipofibroblasts such as activated PPARγ signaling and LDs; lung FLCs expressing fibronectin and vimentin and macrophages, both with evidence of NLRP3- and IL1ß-induced responses; regulatory cells expressing immune-checkpoint proteins involved in lung repair responses and contributing to inflammatory responses in the lung; CD34+ liver endothelial cells and hepatocytes expressing vimentin; renal interstitial cells; and the juxtaglomerular apparatus. This suggests that SARS-CoV-2 may directly interfere with critical lung, renal, and liver functions involved in COVID-19-pathogenesis.

SARS-CoV-2: theoretical analysis of the proposed algorithms to the enhancement and segmentation of high-resolution microscopy images-Part II.

Today is a reality that the novel coronavirus SARS-Cov-2 has become a global pandemic. For this reason, the study of real microscopic images of this coronavirus is of great importance, as it allows us to carry out a more precise research on it. However, as we pointed out in a former paper as reported by Roberto Rodríguez (SARS-CoV-2: Enhancement and Segmentation of High-Resolution Microscopy Images. Part I", Sent to Signal, Image and Video Processing Video Processing, Springer, New York, 2020), many times these microscopic images present some blurring problems, which are always susceptible to be improved. The aim of this work is to carry out a theoretical analysis of the proposed algorithms to enhancement and segmentation of these microscopic images, which is important for the design and development of future algorithms before new epidemics.

SARS-CoV-2: preliminary study of infected human nasopharyngeal tissue by high resolution microscopy.

BACKGROUND: The novel coronavirus SARS-CoV-2 is the etiological agent of COVID-19. This virus has become one of the most dangerous in recent times with a very high rate of transmission. At present, several publications show the typical crown-shape of the novel coronavirus grown in cell cultures. However, an integral ultramicroscopy study done directly from clinical specimens has not been published. METHODS: Nasopharyngeal swabs were collected from 12 Cuban individuals, six asymptomatic and RT-PCR negative (negative control) and six others from a COVID-19 symptomatic and RT-PCR positive for SARS CoV-2. Samples were treated with an aldehyde solution and processed by scanning electron microscopy (SEM), confocal microscopy (CM) and, atomic force microscopy. Improvement and segmentation of coronavirus images were performed by a novel mathematical image enhancement algorithm. RESULTS: The images of the negative control sample showed the characteristic healthy microvilli morphology at the apical region of the nasal epithelial cells. As expected, they do not display virus-like structures. The images of the positive sample showed characteristic coronavirus-like particles and evident destruction of microvilli. In some regions, virions budding through the cell membrane were observed. Microvilli destruction could explain the anosmia reported by some patients. Virus-particles emerging from the cell-surface with a variable size ranging from 80 to 400 nm were observed by SEM. Viral antigen was identified in the apical cells zone by CM. CONCLUSIONS: The integral microscopy study showed that SARS-CoV-2 has a similar image to SARS-CoV. The application of several high-resolution microscopy techniques to nasopharyngeal samples awaits future use.

SARS-CoV-2: enhancement and segmentation of high-resolution microscopy images-Part I.

Possibly, and due to poor eating habits and unhealthy lifestyle, many viruses are transmitted to human people. Such is the case, of the novel coronavirus SARS-Cov-2, which has expanded of exponential way, practically, to whole world population. For this reason, the enhancement of real microscopic images of this coronavirus is of great importance. Of this way, one can highlight the S-spikes and visualizing those areas that show a high density, which are related to active zones of viral germination and major spread of the virus. The SARS-Cov-2 images were captured from nasopharyngeal samples of Cuban symptomatic individuals (RT-PCR positives for SARS-CoV-2) and processed via scanning electron microscopy. However, many times these microscopic images present some blurring problems, and the S-spikes do not look well defined. Therefore, the aim of this work is to propose new computational methods to carry out enhancement and segmentation of SARS-Cov-2 high-resolution microscopic images. The proposed strategy obtained very satisfactory results, and we validated its performance, together with specialist physicians, on a set of 1005 images. Due to the importance of the obtained results, this first work will be addressed to the application of the proposed algorithm. A second paper will deeply analyze the theory related to these algorithms.

Morphological and molecular characterization supporting Amblyomma mixtum presence in Cuba.

Amblyomma cajennense Fabricius, 1787 (Acari: Ixodidae) is a widely distributed tick taxon. Recent studies have reassessed this taxon as a complex of six species. Amblyomma mixtum Koch, 1844 has been suggested by some authors as the only species of this complex that is present in Cuba. Other authors have pointed a niche overlapping for A. mixtum and A. cajennense s.s. in the country. Detailed taxonomic studies on the Cuban species belonging to this complex are needed in order to evaluate their current distribution according to the recent classification. This study aimed to characterize Cuban populations from the A. cajennense complex by using tick samples obtained from 3 occidental provinces and 1 central province of the country. Morphological identification and measurements of the main relevant taxonomic structures were conducted by using Scanning Electron Microscopy. Phylogenetic analyzes were carried out with 16S ribosomal RNA, internal transcribed spacer 2 and the subunit I of mitochondrial cytochrome c oxidase gene sequences. The results of these studies demonstrated that all samples belonged to the species A. mixtum (Koch, 1844). This study constitutes the first molecular characterization of this Amblyomma species in Cuba. Further studies will be necessary in order to corroborate if A. cajennense s.s. is also present in the island.

ABC para los cuidados de enfermería a pacientes con enfermedad terminal en Atención Primaria de Salud / ABC for Nursing Care to Terminal Patients in Primary Health Care

Fundamento: el enfermo terminal padece un proceso agudo o crónico que lo sumerge en una situación crítica y lo conduce a la muerte. Cuando curar ya no es posible, el objetivo se centra en proporcionar al moribundo bienestar y alivio, por eso es muy importante la adecuada orientación a las enfermeras encargadas de cuidar a estos enfermos. Objetivo: elaborar un ABC para los cuidados de enfermería a pacientes con enfermedad terminal en Atención Primaria de Salud. Métodos: investigación realizada en el Policlínico Docente Área VI del municipio de Cienfuegos, en el periodo de enero a junio de 2012, para confeccionar el ABC para cuidados de enfermería a pacientes con enfermedad terminal en Atención Primaria de Salud. Se emplearon los métodos teóricos de análisis y síntesis e inducción deducción y empíricos: análisis de documentos y tormenta de ideas. Resultados: el ABC para el cuidado de enfermería al enfermo terminal quedó conformado para las etapas: inicial o de estabilidad, sintomática o de estado, de declive y final de agonía; en cada una de ellas se incluyeron los posibles diagnósticos, objetivos y acciones. El documento está confeccionado para que pueda ser utilizado por todo el personal de enfermería que atienda a estos pacientes, independientemente de su categoría ocupacional. Conclusiones: el ABC confeccionado pudiera ser de utilidad para facilitar los cuidados de enfermería al enfermo terminal en la atención primaria de salud.

Background: Terminal patients suffer from an acute or chronic process that immerses them in a critical situation leading to death. When providing a cure is no longer possible, the focus is on providing comfort and relief for the dying. Therefore, it is very important to provide an appropriate orientation to the staff nurses taking care of these patients. Objective: To develop an ABC for nursing care to terminally ill patients in Primary Health Care. Methods: A research was conducted in Area VI Polyclinic, in the municipality of Cienfuegos, from January to June 2012, in order to conform the ABC for nursing care to terminally ill patients in Primary Health Care. Theoretical methods of analysis and synthesis and induction-deduction as well as empirical methods were used: document analysis and brainstorming. Results: The ABC for nursing care to terminal patients was conformed for the following stages: initial or stability, symptomatic or state, and decline and final agony. In each of them possible diagnoses, objectives and actions were included. The document was created in such a way that it can be used by all nurses who attend these patients, regardless of their occupational category. Conclusions: This ABC could be useful to facilitate nursing care to terminally ill patients in primary health care.

ABC para los cuidados de enfermería a pacientes con enfermedad terminal en atención primaria de salud / ABC for nursing care to terminal patients in primary health care

Fundamento: el enfermo terminal padece un proceso agudo o crónico que lo sumerge en una situación crítica y lo conduce a la muerte. Cuando curar ya no es posible, el objetivo se centra en proporcionar al moribundo bienestar y alivio, por eso es muy importante la adecuada orientación a las enfermeras encargadas de cuidar a estos enfermos.Objetivo: elaborar un ABC para los cuidados de enfermería a pacientes con enfermedad terminal en Atención Primaria de Salud. Métodos: investigación realizada en el Policlínico Docente Área VI del municipio de Cienfuegos, en el periodo de enero a junio de 2012, para confeccionar el ABC para cuidados de enfermería a pacientes con enfermedad terminal en Atención Primaria de Salud. Se emplearon los métodos teóricos de análisis y síntesis e inducción deducción y empíricos: análisis de documentos y tormenta de ideas. Resultados: el ABC para el cuidado de enfermería al enfermo terminal quedó conformado para las etapas: inicial o de estabilidad, sintomática o de estado, de declive y final de agonía; en cada una de ellas se incluyeron los posibles diagnósticos, objetivos y acciones. El documento está confeccionado para que pueda ser utilizado por todo el personal de enfermería que atienda a estos pacientes, independientemente de su categoría ocupacional. Conclusiones: el ABC confeccionado pudiera ser de utilidad para facilitar los cuidados de enfermería al enfermo terminal en la atención primaria de salud(AU)

Background: Terminal patients suffer from an acute or chronic process that immerses them in a critical situation leading to death. When providing a cure is no longer possible, the focus is on providing comfort and relief for the dying. Therefore, it is very important to provide an appropriate orientation to the staff nurses taking care of these patients. Objective: To develop an ABC for nursing care to terminally ill patients in Primary Health Care. Methods: A research was conducted in Area VI Polyclinic, in the municipality of Cienfuegos, from January to June 2012, in order to conform the ABC for nursing care to terminally ill patients in Primary Health Care. Theoretical methods of analysis and synthesis and induction-deduction as well as empirical methods were used: document analysis and brainstorming. Results: The ABC for nursing care to terminal patients was conformed for the following stages: initial or stability, symptomatic or state, and decline and final agony. In each of them possible diagnoses, objectives and actions were included. The document was created in such a way that it can be used by all nurses who attend these patients, regardless of their occupational category. Conclusions: This ABC could be useful to facilitate nursing care to terminally ill patients in primary health care(AU)

Treatment of anal stenosis: a 5-year review.

BACKGROUND: Benign anal stenosis is an uncommon, disabling and incapacitating disease, occurring mainly after anorectal surgery. Both non-surgical and surgical treatments have been devised in the treatment of anal stenosis with good results. We described the results of the treatment of this disease in the Coloproctology Department of our institution. METHODS: A retrospective clinical study was undertaken over a 5-year period for consecutive patients operated on for anal stenosis. RESULTS: Twenty-three patients with benign anal stenosis were treated in our department. Haemorrhoidectomy was the most common cause of anal stenosis (74%). Nineteen patients with moderate to severe symptoms of anal stenosis underwent surgical treatment. Lateral mucosal advancement flap was the most frequently carried out operation (63.1%). Four patients were treated with anal dilatation (17.3%). All patients had remission of the preoperative symptoms. There was no re-operation and only minor complications were present in four patients: three patients with anal pruritus and one patient with temporary incontinence. CONCLUSION: The easy performance, the absence of major complications and the good results obtained confirm that these methods are effective and safe in the treatment of anal stenosis.

Treatment of rectovaginal fistula: a 5-year review.

This paper presents a chart review of 17 patients who had been treated for rectovaginal fistula (RVF) from 1996 to 2000. In most cases (13; 76.5%), the fistula was the result of post-surgical complications. Following vaginal mucosa advancement flap repair or repair after conversion to a fourth-degree perineal laceration, 16 (94%) of the rectovaginal fistulae (during the first attempted repair or after failed treatment) were successfully treated. In all patients but one, faecal diversion was avoided. In two patients, fistulography was both a diagnostic procedure and the method of treatment.