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Background: Flock-level prevalence and characterization of Mycoplasma ovipneumoniae is determined almost exclusively using nasal swabbing followed by molecular detection with either quantitative PCR or multi-locus sequence typing. However, the diagnostic performance and efficiency of swabbing the nasal passage compared to other anatomical locations has not been determined within sheep populations. The goal of this research was to assess the diagnostic capability of nasopharyngeal swabs in comparison to nasal swabs for the detection of Mycoplasma ovipneumoniae. Results: Nasal and nasopharyngeal swabs were collected during a controlled exposure study of domestic sheep with Mycoplasma ovipneumoniae. Both swab types were then analyzed via conventional and quantitative PCR. This dataset showed that the use of nasopharyngeal swabs in lieu of nasal swabs resulted in higher sensitivity, reduced inhibition during quantitative PCR, and higher bacterial copy numbers per swab. Moreover, it was demonstrated that diagnostic sensitivity could be further increased during quantitative PCR via ten-fold dilution of the extracted DNA. To confirm these observations in naturally infected animals, we conducted a field study employing a production flock of domestic sheep using both nasal and nasopharyngeal swabbing techniques. Extracted DNA was assessed using the same molecular techniques, where detection of Mycoplasma ovipneumoniae was confirmed by sequencing of either the rpoB or 16S rRNA gene. Similar improvements were observed for nasopharyngeal swabs and template treatment methods within the naturally infected flock. Conclusions: Results demonstrate increased diagnostic sensitivity and specificity when sampling with nasopharyngeal swabs as compared to nasal swabs. Therefore, alternate field-testing strategies employing nasopharyngeal swabs should be considered for diagnosis of the presence of M. ovipneumoniae. Importantly, sample treatment following acquisition was found to affect the sensitivity of quantitative PCR, where dilution of eluted DNA template doubled the calculated sensitivity. This demonstrates that, in addition to anatomical location, the presence of inhibitory components in swab extracts also strongly influences diagnostic performance. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the clinical benefit of adding concurrent chemotherapy to intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC) patients with an intermediate risk (stage II and T3N0M0). Methods: A multicenter phase II randomized trial was conducted in intermediate-risk NPC patients. Enrolled patients were previously untreated and aged ranged from 18 to 70 years without severe coexisting diseases. Patients were randomly assigned to receive IMRT alone or IMRT+concurrent chemotherapy (CC; three cycles of 80 mg/m2 cisplatin every 3 weeks). Primary endpoint was defined as 3‑year progression-free survival (PFS). The secondary endpoints were distant metastasis-free survival (DMFS), locoregional relapse-free survival (LRRFS), overall survival (OS), and treatment-associated toxicity. We registered this study with Chinese Clinical Trial Registry (CliCTR1800017132; registered July 13, 2018, study start July 13, 2018). Results: From November 2015 to July 2019, 42 patients with stage II and T3N0M0 NPC were enrolled; 20 patients received IMRT alone while 22 patients received IMRT+CC. After a median of 58 months of follow-up, we estimated the 3‑year PFS rates as 90% (IMRT group) and 86.4% (IMRT+CC group; hazard ratio 1.387, 95% confidence interval 0.240–8.014; P = 0.719). The 3‑year PFS, OS, and cumulative DMFS and LRRFS showed no significant differences between the two groups (P > 0.05). However, the IMRT group displayed a lower incidence of nausea/vomiting, leucopenia, and dry mouth than the IMRT+CC group. Conclusion: Adding CC to IMRT provided no survival benefit but increased treatment-associated toxicities in patients with intermediate-risk NPC. [ABSTRACT FROM AUTHOR]

Before the COVID pandemic, tuberculosis (TB) was the leading cause of death among infectious diseases. As TB can affect different organs, diagnosis sometimes remains difficult. Here, we present a series of three cases where TB was detected in three different systems after a comprehensive workup. The first case was diagnosed as abdominal TB. She had prolonged fever, weight loss, pain abdomen, shortness of breath with mild ascites, jejunal thickening, and bilateral pleural effusion. The initial workup failed to establish a diagnosis. She was put for diagnostic laparoscopy which aided in diagnosis. The second case was confirmed as nasopharyngeal TB. The patient had recurrent upper respiratory symptoms but relevant investigations including imaging studies and nasal endoscopy were normal. Lung parenchyma was not involved. Nucleic acid amplification test confirmed the diagnosis. The third case was diagnosed as pulmonary TB which was detected only after repeated sputum test. The patient had a history of recurrent hemoptysis with weight loss with a cavitary lesion in the left lung. His consecutive three sputum samples were negative even by nucleic acid amplification test before being positive in the 4th time. Extensive workup and repeated test are required in suspected cases of TB to minimize false negative results. [ABSTRACT FROM AUTHOR]

Abstract Background Flock-level prevalence and characterization of Mycoplasma ovipneumoniae is determined almost exclusively using nasal swabbing followed by molecular detection with either quantitative PCR or multi-locus sequence typing. However, the diagnostic performance and efficiency of swabbing the nasal passage compared to other anatomical locations has not been determined within sheep populations. The goal of this research was to assess the diagnostic capability of nasopharyngeal swabs in comparison to nasal swabs for the detection of Mycoplasma ovipneumoniae. Results Nasal and nasopharyngeal swabs were collected during a controlled exposure study of domestic sheep with Mycoplasma ovipneumoniae. Both swab types were then analyzed via conventional and quantitative PCR. This dataset showed that the use of nasopharyngeal swabs in lieu of nasal swabs resulted in higher sensitivity, reduced inhibition during quantitative PCR, and higher bacterial copy numbers per swab. Moreover, it was demonstrated that diagnostic sensitivity could be further increased during quantitative PCR via ten-fold dilution of the extracted DNA. To confirm these observations in naturally infected animals, we conducted a field study employing a production flock of domestic sheep using both nasal and nasopharyngeal swabbing techniques. Extracted DNA was assessed using the same molecular techniques, where detection of Mycoplasma ovipneumoniae was confirmed by sequencing of either the rpoB or 16S rRNA gene. Similar improvements were observed for nasopharyngeal swabs and template treatment methods within the naturally infected flock. Conclusions Results demonstrate increased diagnostic sensitivity and specificity when sampling with nasopharyngeal swabs as compared to nasal swabs. Therefore, alternate field-testing strategies employing nasopharyngeal swabs should be considered for diagnosis of the presence of M. ovipneumoniae. Importantly, sample treatment following acquisition was found to affect the sensitivity of quantitative PCR, where dilution of eluted DNA template doubled the calculated sensitivity. This demonstrates that, in addition to anatomical location, the presence of inhibitory components in swab extracts also strongly influences diagnostic performance.

This review presents the case of a 9-year-old patient who reported headaches and unilateral nasal obstruction, without fever, and with a generally preserved condition. An endoscopic examination revealed a polypoid fleshy mass in the left nasal cavity, along with purulent secretions reaching the inferior turbinate. These findings prompted a facial CT scan to assess the nature of the lesion and the extent of infiltration into surrounding structures. A biopsy and histological analysis confirmed the diagnosis of B-cell lymphoma in the nasal sinuses, a rare occurrence in children. The unusual presentation of this case makes it worthy of sharing.

This study comprehensively evaluated the DNA/RNA Defend Pro (DRDP) sample collection buffer, designed to inactivate and stabilize patient samples. The primary objectives were to assess DRDP's efficacy in ensuring sample stability, facilitating extraction-free polymerase chain reaction (PCR), and ensuring compatibility with rapid antigen testing (RAT). Ninety-five diagnostic nasopharyngeal swab samples tested for influenza virus (influenza A), respiratory syncytial virus (RSV A), and/or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were 10-fold diluted with DRDP and anonymized. Initial characterization and retesting of these samples using cobas Liat confirmed 88 samples as positive, validating the presence of viral targets. Results from rapid antigen testing showed lower sensitivity compared to nucleic acid amplification testing (NAAT) but maintained perfect specificity, with 40 out of 88 positive samples by cobas Liat also testing positive for RAT. Direct RT-qPCR of DRDP-diluted samples demonstrated robust compatibility, with 72 out of 88 samples positive for cobas Liat also testing positive by direct RT-qPCR. Non-concordant results could be explained by the 200-fold lower input of extraction-free NAAT. Stability testing involved incubating 31 positive samples at 4 °C, 20 °C, and 37 °C for 7 days, with extraction-free NAAT. DRDP guaranteed viral RNA stability at all temperatures for influenza A, SARS-CoV-2, and RSV A, showing stability up to 7 days at 4 °C. In conclusion, DRDP is an effective stabilizing medium compatible with direct RT-qPCR and rapid antigen testing and shows great potential for optimizing diagnostic processes, particularly in resource-limited or time-sensitive scenarios. [ABSTRACT FROM AUTHOR]

Juvenile angiofibroma (JA) is a rare, sex-specific, and highly vascularized nasal tumor that almost exclusively affects male adolescents, but its etiology has been controversial. The G protein-coupled hormone receptor LHCGR [luteinizing hormone (LH)/choriogonadotropin (hCG) receptor] represents a promising new candidate for elucidating the underlying mechanisms of sex specificity, pubertal manifestation, and JA progression. We used highly sensitive RNAscope technology, together with immunohistochemistry, to investigate the cellular expression, localization, and distribution of LHCGR in tissue samples from JA patients. Our results provide evidence for LHCGR expression in subsets of cells throughout JA tissue sections, with the majority of LHCGR+ cells located in close vicinity to blood vessels, rendering them susceptible to endocrine LH/hCG signaling, but LHCGR+ cells were also detected in fibrocollagenous stroma. A majority of LHCGR+ cells located near the vascular lumen co-expressed the neural crest stem cell marker CD271. These results are intriguing as both LH and hCG are produced in a time- and sex-dependent manner, and are known to be capable of inducing cell proliferation and angiogenesis. Our results give rise to a new model that suggests endocrine mechanisms involving LHCGR and its ligands, together with autocrine and paracrine signaling, in JA vascularization and cell proliferation. [ABSTRACT FROM AUTHOR]

Background: Nasopharyngeal amyloidoma is a rare, locally aggressive tumor that has been reported in the English literature in only 38 cases to date, most of which were in the form of case reports. The present study was aimed to summarize the characteristics of this rare tumor, with the goal of providing new insights for diagnosis and treatment. Materials and methods: We report three cases of nasopharyngeal amyloidoma diagnosed in our hospital following comprehensive medical examination and review the current literature on all cases of nasopharyngeal amyloidoma from PubMed. The journey of nasopharyngeal amyloidoma, including presentation, diagnostics, surgeries, and follow-up was outlined. Results: None of the three patients had systemic amyloidosis. CT and nasal endoscopy showed irregular masses obstructing the nasopharyngeal cavity. Congo red staining confirmed the deposition of amyloid, and immunohistochemical analysis showed that the amyloid deposition was the AL light chain type. Through literature review, we found that nasopharyngeal amyloidoma most commonly occurred in individuals over the age of 40, patients usually had a good prognosis after complete tumor resection; however, there were still cases of recurrence, and unresected patients were at risk of progression to systemic amyloidosis. The efficacy of radiotherapy and chemotherapy was currently uncertain. Conclusion: Early clinical and pathological diagnosis is crucial, and surgical intervention is the primary treatment option for this disease. Although patients usually have a favorable prognosis, long-term monitoring is necessary to detect potential relapses and initiate timely intervention. [ABSTRACT FROM AUTHOR]

Background and Purpose: Myiasis is an infestation of vertebrates caused by the feeding of fly larvae on the living or necrotic tissue of hosts. Human myiasis is more prevalent among people who live in unsanitary conditions or have close contact with domestic animals. In this report, a case of nasopharyngeal myiasis in a 63-year-old patient admitted to the intensive care unit is presented. Case Presentation: A case of nasopharyngeal myiasis in a 63-year-old man with heart and respiratory failure in a hospital in Tehran City, Iran, is reported. By investigating the morphological characteristics of the isolated larvae and cultivating the pupa, Lucilia sericata was identified. Conclusion: It is recommended that necessary operations be carried out to prevent the entry of insects, including flies, into hospitals and control of them.

Abstract Introduction Worldwide, it has been reported that fully vaccinated people still die of COVID-19-associated symptoms, generating public uncertainty about the safety and effectiveness of the vaccines. Hence, this research is aimed at assessing the incidence of COVID-19 breakthrough infection among vaccinated Health Workers and the possible effect of changes in the practice of post-vaccination safety precautions. Method This was a Health facility-based descriptive cross-sectional study. Data were collected using self-administered questionnaires distributed at the participant’s work unit across the selected health facilities. The nasopharyngeal specimen was also obtained from the participants and analysed using STANDARD Q COVID-19 Ag Test rapid chromatographic immunoassay for the detection of antigens to SARS-CoV-2. All data were input and analyzed using SPSS version 20. Results There was a statistically significant relationship between the vaccination status of respondents and the post-vaccination test result (χ2 = 6.816, df = 1, p = 0.009). The incidence of COVID-19 infection among the vaccinated and unvaccinated HCWs was 2% and 8% respectively. 5 of the 15 respondents who tested positive for COVID-19 had been fully vaccinated. However, all 5 of them did not practice safety measures after vaccination. None of the respondents who practised safety measures after vaccination tested positive for COVID-19. The remaining 10 respondents that tested positive for COVID-19 had not been vaccinated though they practised safety precautions. Conclusion Vaccination and the practice of safety precautions will go a long way to preventing future COVID-19 breakthrough infections.

Introduction: Worldwide, it has been reported that fully vaccinated people still die of COVID-19-associated symptoms, generating public uncertainty about the safety and effectiveness of the vaccines. Hence, this research is aimed at assessing the incidence of COVID-19 breakthrough infection among vaccinated Health Workers and the possible effect of changes in the practice of post-vaccination safety precautions. Method: This was a Health facility-based descriptive cross-sectional study. Data were collected using self-administered questionnaires distributed at the participant's work unit across the selected health facilities. The nasopharyngeal specimen was also obtained from the participants and analysed using STANDARD Q COVID-19 Ag Test rapid chromatographic immunoassay for the detection of antigens to SARS-CoV-2. All data were input and analyzed using SPSS version 20. Results: There was a statistically significant relationship between the vaccination status of respondents and the post-vaccination test result (χ2 = 6.816, df = 1, p = 0.009). The incidence of COVID-19 infection among the vaccinated and unvaccinated HCWs was 2% and 8% respectively. 5 of the 15 respondents who tested positive for COVID-19 had been fully vaccinated. However, all 5 of them did not practice safety measures after vaccination. None of the respondents who practised safety measures after vaccination tested positive for COVID-19. The remaining 10 respondents that tested positive for COVID-19 had not been vaccinated though they practised safety precautions. Conclusion: Vaccination and the practice of safety precautions will go a long way to preventing future COVID-19 breakthrough infections. [ABSTRACT FROM AUTHOR]

Aims: This study analyzed the post-infection viral dynamics of the Alpha, Delta and Omicron variants of severe acute respiratory syndrome coronavirus 2. Patients & methods: Nasopharyngeal samples and anterior nasal samples from patients hospitalized with severe acute respiratory syndrome coronavirus 2 infection were collected and analyzed. Results: Omicron variant specimens from the two sites showed lower threshold cycle (Ct) values, smaller difference in Ct values between the nasopharyngeal samples and anterior nasal samples (ANS) and significantly lower Ct values in the ANS taken within 6 days of disease onset than those of the Alpha and Delta variants. Conclusion: Compared with other variants, the Omicron variant showed more active viral replication in the nasal cavity, which significantly increased in the ANS in early stages of the disease. This study looked at whether the amount of the severe acute respiratory syndrome coronavirus 2 virus in an infected person's blood differed if the person was infected with a different variant of the virus – Alpha, Delta or Omicron. Samples were collected from the back and front of the nose in order to work out how much of the virus was present. Larger amounts of the Omicron variant were found in the front of the nose, particularly in the early stages of illness. This may be because the Omicron variant is more infective. Background This study aimed to clarify the differences in viral dynamics of each severe acute respiratory syndrome coronavirus 2 variant (Alpha, Delta and Omicron variant). Methods Ct values were assayed for samples collected simultaneously from the nasopharyngeal and anterior nasal sites. Results Viral load was higher in the nasopharyngeal site than that in the anterior nasal site for each variant and the difference in viral load between the nasopharyngeal and anterior nasal sites was small in the Omicron variant. Discussion The Omicron variant had a low Ct value in the anterior nasal site during onset, justifying the high infectivity of the Omicron variant. [ABSTRACT FROM AUTHOR]

Nasopharyngeal carcinomas (NPC) are endemic in southeast Asia and rare in Europe with an incidence of 0.07/100.000 persons. Five-year survival is about 50%. Diagnosis is provided by histological findings and staging classification is done according to AJCC. EBV DNA serum levels should be determined before and after local treatment, carry prognostic significance and can be used in the active surveillance of cancer survivors. The best method for serum determination of EBV DNA is still under discussion. Advanced locoregional disease carries a greater risk of distant spread, highlighting the need of treatment intensification in higher risk patients. The best treatment plan is still under discussion: concurrent chemoradiation followed by adjuvant chemotherapy (ACT) or induction chemotherapy (ICT) followed by chemoradiation. ACT/ICT regimens should consist of two-/three-drug regimens, including a platinum agent and the best drug regimen is still under investigation. ACT carries great toxicity (50% require dose reductions, 60% complete treatment) and has a relatively low PFS and OS benefit. ICT is better tolerated, but may compromise cisplatin cumulative dose in concomitant chemoradiation and delay radiation start, possibly compromising the effectiveness of local treatment. Nonetheless, ICT improves PFS and OS when compared to chemoradiation alone, mostly because of better metastasis free survival (MFS), making this a promising strategy in properly selected high risk patients. Most NPC trials were conducted in countries where NPC is endemic, primarily non-queratinizing and EBV-related. Data in non-endemic countries are lacking. Our study aims to compare ACT and ICT in locally advanced and oligometastatic NPC patients treated in a European reference centre. Retrospective, observational study of patients with NPC diagnosis between January 2017 and September 2023 and disease stage III-IVb. Data were collected from patient records and included patient characteristics (gender, age, smoking history, ECOG performance status), tumor characteristics (T, N, staging, histology, EBV-status) and treatment characteristics (ACT, ICT, toxicities). PFS and OS were analyzed. Toxicity grading is according to CTCAE 5.0 and statistical analysis is descriptive. A total of 69 patients were included. Most patients were male (56.5%, n=39) with a median age of 53.0 years (18-75). Most patients had a good performance status (0 or 1 in 98.5%, n=68). Stage IVa was the most frequent initial staging (50.7%, n=35), with a majority of patients having T4 (33.3%, n=23) and N3 (39.1%, n=27) tumours. All tumours were undifferentiated queratinizing carcinomas and 86.9% (n=60) were EBV-positive. EBV DNA was rarely determined. [Display omitted] Until 2019 the most frequent treatment strategy was ACT with cisplatin-5FU (57.9%, n=40), after which ICT became more frequently used (15.9%, n=11), mostly with cisplatin-gemcitabin (45.4%, n=5). ICT had less acute toxicities that lead to treatment discontinuation (0.9% (n=1) versus 39.7% (n=23)). All patients completed radiotherapy after ICT, but in 4 patients optimal concomitant cisplatin dose (≥200mg/m2) was compromised. Both ICT and ACT showed good response rates, with a complete response in 63.6% versus 79.3%, respectively. Median follow up was 45 months in the ACT group (4-125) and 27 months (1-55) in the ICT group. PFS with ACT was 45.0 months (95%CI 34.8-55.2) and OS was 46.0 months (95%CI 38.5-53.4). The ICT group is small and has a short follow-up time; PFS and OS data will be determined in the future. [Display omitted] The best course of treatment of advanced NPC is still unclear - which patients and histologies benefit most from treatment intensification? What is the role of EBV DNA and what is the best method for its determination? Should ACT or ICT be preferred? Which chemotherapy regimen is better? Treatment center expertise and the ability to provide timely treatment may also play a role in treatment decisions. Our study presents the experience of a European reference centre where ACT was the preferred treatment for a longer period of time and therefore has a significantly larger patient population with longer follow-up time. ACT seems to provide good patient outcomes, despite a worse toxicity profile and more related treatment discontinuations, but group comparison is not yet possible since our centre only recently changed strategies in managing advanced NPC patients, preferring ICT over ACT. ICT patients are still underrepresented in this analysis, with fewer patients and shorter follow-up time. Moreover, the ICT patient group has more advanced disease, including IVb oligometastatic disease (that was not included in the intensification ACT and ICT studies), making head-to-head comparisons difficult. The management of advanced NPC is a clinical challenge and more data are needed to better select both patients and treatment strategies for treatment intensification, while taking into consideration the differences between endemic and non-endemic NPC. [ABSTRACT FROM AUTHOR]

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Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is the cause of the on‐going global pandemic of coronavirus disease 2019 (COVID‐19) that continues to pose a significant threat to public health worldwide. SARS‐CoV‐2 encodes four structural proteins namely membrane, nucleocapsid, spike, and envelope proteins that play essential roles in viral entry, fusion, and attachment to the host cell. Extensively glycosylated spike protein efficiently binds to the host angiotensin‐converting enzyme 2 initiating viral entry and pathogenesis. Reverse transcriptase polymerase chain reaction on nasopharyngeal swab is the preferred method of sample collection and viral detection because it is a rapid, specific, and high‐throughput technique. Alternate strategies such as proteomics and glycoproteomics‐based mass spectrometry enable a more detailed and holistic view of the viral proteins and host–pathogen interactions and help in detection of potential disease markers. In this review, we highlight the use of mass spectrometry methods to profile the SARS‐CoV‐2 proteome from clinical nasopharyngeal swab samples. We also highlight the necessity for a comprehensive glycoproteomics mapping of SARS‐CoV‐2 from biological complex matrices to identify potential COVID‐19 markers. [ABSTRACT FROM AUTHOR]

Objectives: Rapid antigen test (RAT) and polymerase chain reaction (PCR) using nasopharyngeal (NP) or oropharyngeal (OP) swab specimens are the two main testing techniques used for laboratory diagnosis of influenza in clinical practice. However, performance variations have been observed not only between techniques, but also between different specimens. This study evaluated the differences in performance between specimens and testing techniques to identify the best combination in clinical practice. Methods: Both NP and OP samples from suspected influenza patients collected in the 2023/4–2023/5 Flu-season in Xiamen, China, were tested for RAT and quantitative PCR. The testing performance of the different specimens and testing techniques were recorded and evaluated. Results: Compared to PCR, RAT showed 58.9 % and 10.3 % sensitivity for NP and OP swabs, respectively. The Limit of Detection (LoD) was 28.71 the Median Tissue Culture Infectious Dose (TCID50)/mL. Compared with PCR using NP swabs, PCR with OP swabs showed 89.5 % sensitivity and 95.4 % specificity. Conclusions: There were no significant differences in performance between the specimens when PCR was used to test for influenza. However, a decrease in sensitivity was observed when the RAT was used, regardless of the specimen type. Therefore, to avoid false-negative results, PCR may be a better choice when OP swabs are used as specimens. In contrast, NP swabs should be the recommended specimens for RAT.

ObjectivesThe COVID-19 pandemic caused a global shortage of nasopharyngeal (NP) swabs, required for RT-PCR testing. Canadian manufacturers were contacted to share NP swab innovations. The primary objective was to determine whether novel NP test swabs were comparable to commercially available swabs regarding user characteristics, ability to collect a specimen, and diagnostic performance using RT-PCR testing.MethodsParticipants were randomized by swab (test/control) and nostril (left/right). A calculated positive percent agreement ≥90% was considered successful. Mean Ct values of viral genes and housekeeping gene (RNase P) were considered similar if a Ct difference ≤ 2 between control and test group was obtained. There also was a qualitative assessment of swabs usability.Results647 participants were enrolled from Huaycan Hospital in Lima, Peru, distributed over 8 NP swabs brands. Seven brands agreed to share their results. There were no statistically significant differences between the test swabs of these 7 brands and control swabs.ConclusionAll the seven brands are comparable to the commercially available flocked swabs used for SARS-CoV-2 regarding test results agreement, ability to collect a specimen, and user characteristics.

We describe the presentation and treatment of the first reported case of a nasopharyngeal pleomorphic lipoma. The mass was successfully treated with a combined endoscopic trans‐oral surgical excision approach by using low temperature‐controlled plasma technology, resulting in optimal patient outcomes. Laryngoscope, 134:2710–2712, 2024 [ABSTRACT FROM AUTHOR]

Juvenile angiofibroma (JA) is a rare, sex-specific, and highly vascularized nasal tumor that almost exclusively affects male adolescents, but its etiology has been controversial. The G protein-coupled hormone receptor LHCGR [luteinizing hormone (LH)/choriogonadotropin (hCG) receptor] represents a promising new candidate for elucidating the underlying mechanisms of sex specificity, pubertal manifestation, and JA progression. We used highly sensitive RNAscope technology, together with immunohistochemistry, to investigate the cellular expression, localization, and distribution of LHCGR in tissue samples from JA patients. Our results provide evidence for LHCGR expression in subsets of cells throughout JA tissue sections, with the majority of LHCGR+ cells located in close vicinity to blood vessels, rendering them susceptible to endocrine LH/hCG signaling, but LHCGR+ cells were also detected in fibrocollagenous stroma. A majority of LHCGR+ cells located near the vascular lumen co-expressed the neural crest stem cell marker CD271. These results are intriguing as both LH and hCG are produced in a time- and sex-dependent manner, and are known to be capable of inducing cell proliferation and angiogenesis. Our results give rise to a new model that suggests endocrine mechanisms involving LHCGR and its ligands, together with autocrine and paracrine signaling, in JA vascularization and cell proliferation.

Abstract Objective The objective of this study was to describe a case of epiglottic entrapment in a cat. Case Summary A 5‐month‐old male neutered Russian Blue cat was evaluated for progressive stertorous upper airway sounds, acute onset vestibulopathy and abnormal laryngeal anatomy. Endotracheal intubation was only able to be achieved using videoscopic guidance and identified concern for severe nasopharyngeal stenosis. A computerized tomography scan revealed otitis interna, narrowed nasopharynx and no definitive cause for the stertorous breathing. The cat recovered very slowly from anaesthesia due to concern for airway obstruction following extubation. It was discharged the following day and then passed away at home 2 weeks later. Necropsy revealed that the epiglottis was obscured by 2 cm of redundant mucosal tissue extending from the base of the tongue to the larynx resulting in epiglottic entrapment. Also noted was chronic, severe otitis interna and externa. Upper airway obstruction is suspected to be the cause of sudden death. New or Unique Information To the authors’ knowledge, this is the first report of these oropharyngeal anatomic abnormalities in a cat.

Objective: Streptococcus pneumoniae (S. pneumoniae) nasopharyngeal carriage has significantly decreased after the generalization of pneumococcal vaccination worldwide. This study sought to investigate changes in S. pneumoniae carriage rates, serotype distribution and penicillin non-susceptibility following the generalization of 10-valent pneumococcal conjugate vaccine. Methods: A prospective study was conducted in Marrakesh, Morocco, between 2017 and 2018, among healthy children attending vaccination centers. We collected nasopharyngeal swabs and questionnaire data for each child. Using univariate logistic regression, we analyzed the association between S. pneumoniae carriage and various risk factors. Comparisons of serotype diversity and penicillin resistance between 2017 and 2018 and the period before introduction of vaccination (2008–2009, n = 660) were performed using Simpson index and the chi-squared test, respectively. Results: During 2017–2018, 515 children aged between 6 and 36 months participated. The S. pneumoniae carriage rate was 43.3%. Looking at the distribution serotypes, the rate of PCV10 serotypes rate was only 9.6%. Among non-vaccine serotypes, an increase in serotypes 6C/6D (22; 14%), 19B/19C (17; 10.8%), and 15B/15C (11; 7%) was observed. A particular increase in serotype diversity was also observed after the generalization of PCV10 (p

COVID-19, caused by the SARS-CoV-2 virus, manifests with a wide range of clinical symptoms that vary from mild respiratory issues to severe respiratory distress. To effectively manage and predict the outcomes of the disease, it is important to understand the molecular mechanisms underlying its severity. This study focuses on analyzing and comparing the expression patterns of microRNAs (miRNAs) in serum, urine, and nasopharyngeal samples from patients with mild, moderate, and severe COVID-19. The aim is to identify potential associations with disease progression and discover suitable markers for diagnosis and prognosis. Our findings indicate the consistent upregulation of miR-21, miR-146a, and miR-155 in urine, serum, and nasopharyngeal samples from patients with mild COVID-19. In moderate cases, there were more significant changes in miRNA expression compared to mild cases. Specifically, miR-let-7 demonstrated upregulation, while miR-146b exhibited downregulation. The most notable alterations in miRNA expression profiles were observed in severe COVID-19 cases, with a significant upregulation of miR-223. Moreover, our analysis using Receiver-operating characteristic (ROC) curves demonstrated that miR-155, miR-let-7, and miR-223 exhibited high sensitivity and specificity, suggesting their potential as biomarkers for distinguishing COVID-19 patients from healthy individuals. Overall, this comparative analysis revealed distinct patterns in miRNA expression. The overlapping expression patterns of miRNAs in urine, serum, and nasopharyngeal samples suggest their potential utility in discriminating disease status. [ABSTRACT FROM AUTHOR]

Streptococcus pneumoniae is leading bacterial cause of community acquired pneumonia and according to World Health Organization, responsible for 14 % death in children. There is effective vaccine available against Streptococcus pneumoniae. Hence the primary objective was to isolate Streptococcus pneumoniae from nasopharyngeal swabs in children aged 2–59 months with and without community acquired pneumonia and to assess their serotypes. This case-control study was conducted in tertiary teaching institutes in northern India. Hospitalized children, aged 2–59 months, with World Health Organization-defined community acquired pneumonia were included as cases. Age matched healthy controls were recruited from immunization clinic. All enrolments were done after written informed parental consent. Nasopharyngeal swabs were taken from both cases and controls, and were cultured on 5 % sheep blood agar with gentamycin plate for growth of Streptococcus pneumoniae and incubated in a jar at 370 for 18–24 hrs. Quellung reaction test was used for serotyping. From March 2017 to December 2022, 2693 children (1910 cases and 783 controls), were recruited. The median age of cases was 7 months and controls 10 months. Almost all the cases had received antibiotics prior to hospitalization. Streptococcus pneumoniae positivity in nasopharyngeal swab was 8.1 % in cases, of which 56.8 % were vaccine serotypes and 23.6 % in controls, of which 37.8 % were vaccine serotypes. Adjusted odds ratio of isolating vaccine serotypes among cases as compared to controls was 1.77 (95 % CI, 1.09–2.88). Streptococcus pneumoniae isolation from nasopharyngeal was found to be in lower proportion in cases as compared to control, though colonization with vaccine serotypes was higher in cases as compared to control. Therefore, pneumococcal vaccine coverage must be increased to prevent community acquired pneumonia. [ABSTRACT FROM AUTHOR]

Background: There are limited studies and no surveillance protocols on pituitary dysfunction for adults who underwent anterior skull base radiation. Methods: Cross‐sectional study of 50 consecutive patients with sinonasal or nasopharyngeal cancer who underwent definitive radiotherapy. The mean radiation doses, prevalence of pituitary dysfunction, and associated factors were calculated. Results: Pituitary hormone levels were abnormal in 23 (46%) patients, including 6 (12%) with symptomatic abnormalities requiring treatment. The most common hormonal abnormality was hyperprolactinemia (30%), central hypothyroidism (8%) and central hypogonadism (6%). Patients with abnormal pituitary hormone values received higher mean radiation doses to the pituitary gland (1143 cGy, P = 0.04), pituitary stalk (1129 cGy, P = 0.02), optic chiasm (1094 cGy, P = 0.01), and hypothalamus (900 cGy, P = 0.01). Conclusions: Nearly half of the patients had abnormal pituitary function, including over a tenth requiring treatment. There may be a dose‐dependent association between hormonal dysfunction and radiation. [ABSTRACT FROM AUTHOR]

Background:Streptococcus pneumoniae(S. pneumoniae)is an important pathogen responsible for numerous infections in humans particularly children under 5 years causing unparalleled fatality.Aim:This study set out to determine the prevalence and circulating serotypes of Streptococcus pneumoniaein under 5 years old children attending Toro General Hospital, Bauchi State, Nigeria.Methods:The study was cross-sectional, and hospital based. A total of 114 nasopharyngeal swabs were collected from children < 5 years old.Streptococcus pneumoniae was isolated, biochemically identified, and molecularly confirmed using PCR via the gene marker CpsA. Latex agglutination was used to serotype the confirmed isolates.Results: a prevalence of 22.6% was established in this study for S. pneumoniae. The age group 0 – 11 months had the highest prevalence of 28.1% while 36 – 47 months had the least prevalence (11.8%). Males had relatively higher prevalence of 29.0% compared to females (20.0%). There was no significant association between the carriage of S. pneumoniae, age, and sex (p < /em>> 0.05). Though there was no significant association between vaccination status and prevalence of S. pneumoniae (p < /em> = 0.937), non-vaccinated group had lower prevalence of 22.4% as opposed to 23.1% in the vaccinated subjects. Six circulating serotypes [1 (23.1%), 6 (34.6%), 9 (3.8%), 11 (11.5%), 19 (3.8%), and 23 (3.8%)] were detected. Serotypes 1 and 6 were found in both vaccinated and non-vaccinated children but serotypes 9, 11, 19, and 23 were detected in vaccinated children only.Conclusion:PCV vaccine and non-vaccine S. pneumoniae serotypes were found to be prevalent and circulating among under 5 children in the current study.

Treatment of nasopharyngeal cancer is based on radiotherapy associated to chemotherapy. The standard for patients with locoregionally advanced carcinoma is induction chemotherapy associated to concurrent chemoradiotherapy. The aim of our study is to determine the recurrence free survival and overall survival. Our study focused on non metastatic patients with locoregionally advanced nasopharyngeal carcinoma: T3-T4 with positive nodes. Treated by induction chemotherapy and concurrent chemoradiotherapy between 2018 and 2021. For the induction chemotherapy, patients received cisplatin associated to gemcitabine for three cycles. In concurrent chemoradiotherapy, total dose was 69,96-70 Gray in 33-35 fractions 5 days a week using Volumetric Modulated Arc Therapy (VMAT) plus cisplatin weekly at a dose of 40 mg per square meter of body surface. Treatment, side effects, loco-regional and distant control and overall survival were collected. A total of 153 patients were included in the study, patients with metastatic disease were excluded. We had 61,4% of men vs 38,6% of women with a median age of 49 years old. 13,7% of patients had arterial hypertension or diabetes. A total of 83,1% of the patients received three cycles of induction chemotherapy. 81,6% received the full dose of radiotherapy, the others interrupted the treatment for side effects. 52,3% of the patients received seven cycles of concurrent chemotherapy. Side effects were reported in 41,8% of the patients with a higher incidence of neutropenia, anemia, nausea-vomiting, renal toxicity and mucositis. Grade 3 or 4 toxic side effects were reported in 19,6% of the patients. At a median follow-up of 44 months, the 2-year recurrence-free survival was 73,2%. Overall survival at 2 years was 89.4%. The results of our study are similar to literature's results; the induction chemotherapy followed by concurrent chemoradiotherapy in the locoregionally advanced nasopharyngeal carcinoma promotes distant control and increases overall survival. Sides effects are unavoidable so they must be recognized and treated early to avoid grade 3 and 4. [ABSTRACT FROM AUTHOR]

OM-85 is a bacterial lysate from common respiratory tract pathogens, with an excellent safety profile, widely used to prevent recurrent respiratory tract infections. Several studies have been reporting the immunomodulating properties and antiviral roles of OM-85. The COVID-19 pandemic, originating in 2019, has presented a significant global public health crisis. While effective vaccines have been developed, vaccination rates vary considerably, and numerous concerning viral variants continue to emerge. The challenge persists in creating early interventions to halt the progression of the disease to its severe stages. To examine the therapeutic effect of OM-85 after SARS-CoV-2 infection and compared to recombinant human (rhINF-β) we collected nasopharyngeal cells from COVID-19 patients. The cells were treated ex-vivo with OM-85 or hrINF-β and the response was analyzed after 24h for gene expression by real-time PCR. We found that OM-85 decreased the SARS-CoV-2 N1 gene expression and increased RIG-I (DDX58) in these cells. The expression of ACE2 was undetected in these samples. These data support the antiviral effect of OM-85 against SARS-CoV-2.

Objective: The objective of this study was to describe a case of epiglottic entrapment in a cat. Case Summary: A 5‐month‐old male neutered Russian Blue cat was evaluated for progressive stertorous upper airway sounds, acute onset vestibulopathy and abnormal laryngeal anatomy. Endotracheal intubation was only able to be achieved using videoscopic guidance and identified concern for severe nasopharyngeal stenosis. A computerized tomography scan revealed otitis interna, narrowed nasopharynx and no definitive cause for the stertorous breathing. The cat recovered very slowly from anaesthesia due to concern for airway obstruction following extubation. It was discharged the following day and then passed away at home 2 weeks later. Necropsy revealed that the epiglottis was obscured by 2 cm of redundant mucosal tissue extending from the base of the tongue to the larynx resulting in epiglottic entrapment. Also noted was chronic, severe otitis interna and externa. Upper airway obstruction is suspected to be the cause of sudden death. New or Unique Information: To the authors' knowledge, this is the first report of these oropharyngeal anatomic abnormalities in a cat. [ABSTRACT FROM AUTHOR]

Purpose of Review: Despite the available pneumococcal conjugate vaccination (PCV), children in developing countries suffer significant morbidity and mortality from pneumococcal illness. This review outlines the pneumococcal carriage rate, common serotypes, antibiotic resistance, and PCV coverage among western Asian children. Recent Findings: The carriage rate and prevalence of PCV serotypes remain high among children in Western Asia. In recent times, the national immunization rates have increased, but there was a considerable rate of invasive pneumococcal diseases (IPD) strains and non-invasive pneumococcal diseases (NIPD) serotypes with high antimicrobial resistance rates and many communities in western Asian countries are experiencing the phenomenon of pneumococcal vaccine serotype replacement (PVSR). Summary: An accurate and updated disease surveillance in Western Asia is urgently needed to guide immunization efforts and protect children effectively. Increasing the PCV covering rate and antimicrobial stewardship is crucial for countries to implement strict systems and effectively minimize the high rate of resistance. [ABSTRACT FROM AUTHOR]

Open in new tab Download slide OBJECTIVES Core temperature monitoring is critical during cardiopulmonary bypass (CPB). In this prospective observational study, we investigated the performance of the transoesophageal echocardiography (TOE) probe for core (oesophageal) temperature monitoring during CPB. METHODS Thirty adult patients, 18–70 years of either gender, undergoing cardiac surgery with CPB were enrolled. All patients received a reusable nasopharyngeal probe for monitoring core temperatures. In addition, the oesophageal temperatures were monitored with the TOE probe. The arterial outlet temperatures at the membrane oxygenator were also monitored and taken as the reference standard. Monitoring was performed every 5 min until 20 min, and then at 30 min during both the cooling and rewarming periods. RESULTS During cooling, the oesophageal and nasopharyngeal temperatures lagged behind the arterial outlet temperatures. However, the intra-class correlation of the oesophageal temperatures with the arterial outlet temperatures was better (range 0.58–0.74) than the correlation of the nasopharyngeal temperatures with the arterial outlet temperatures (range 0.46–0.62). During rewarming, the performance of the TOE probe was significantly superior to the nasopharyngeal probe. After 15 and 20 min of rewarming, there was a difference of ∼1°C between the oesophageal and nasopharyngeal temperatures. At 30 min of rewarming, the oesophageal and the arterial outlet temperatures were similar, while the nasopharyngeal temperatures still lagged by 0.5°C. Bias was significantly less both during cooling and warming between the oesophageal temperatures and arterial outlet temperatures. CONCLUSIONS Performance of the TOE probe as an oesophageal temperature probe is superior to the nasopharyngeal probe during CPB. Clinical trial registration number CTRI no 2020/10/028228; ctri.nic.in. [ABSTRACT FROM AUTHOR]

The nasopharynx is an important, understudied, reservoir for emergence and spread of antibiotic-resistant bacteria that cause invasive disease, including pneumonia, meningitis, and sepsis, a leading cause of mortality in children under 5 years of age worldwide. Metagenomic sequencing techniques provide a culture-unbiased, high-resolution tool for characterising nasopharyngeal resistome composition, with the ability to capture microbial taxonomy, function, and resistance from a single specimen. Challenges in nasopharyngeal resistome characterisation include low sample biomass, high burden of human host DNA, the need to functionally validate novel ARGs, varying bioinformatic approaches, and limited computational resources. The nasopharynx is an important microbial reservoir for the emergence and spread of antibiotic-resistant organisms. The nasopharyngeal resistome is an extensive, adaptable reservoir of antibiotic-resistance genes (ARGs) within this niche. Metagenomic sequencing decodes the genetic material of all organisms within a sample using next-generation technologies, permitting unbiased discovery of novel ARGs and associated mobile genetic elements (MGEs). The challenges of sequencing a low-biomass bacterial sample have limited exploration of the nasopharyngeal resistome. Here, we explore the current understanding of the nasopharyngeal resistome, particularly the role of MGEs in propagating antimicrobial resistance (AMR), explore the advantages and limitations of metagenomic sequencing technologies and bioinformatic pipelines for nasopharyngeal resistome analysis, and highlight the key outstanding questions for future research. [ABSTRACT FROM AUTHOR]

The study aimed to investigate the antitumor efficacy of anti-LMP1 antibodies in EBV-positive nasopharyngeal and stomach cell lines and xenograft models. The study also examined the NF-κB expression and cell cycle activation of NPC-serum-exosome-associated LMP1. Anti-LMP1 antibody treatment before or during cell implantation prevented tumor growth in nude mice. A small dose of antibodies resulted in complete tumor regression for at least three months after the tumors had grown in size. The consumption of antigen–antibody complexes by tumor cells limited tumor growth. In vitro experiments showed that anti-LMP1 antibodies killed EBV-positive NPC- or GC-derived epithelial cell lines and EBV-positive human B-cell lines but not EBV-negative cell lines. Treatment with anti-LMP1 reduced NF-κB expression in cells. The animal model experiments showed that anti-LMP1 inhibited and prevented NPC- or GC-derived tumor growth. The results suggest that LMP1 antibody immunotherapy could cure nasopharyngeal cancer, EBV-positive gastric carcinoma, and EBV-associated lymphomas. However, further validation of these findings is required through human clinical trials. [ABSTRACT FROM AUTHOR]

Introduction: The novel coronavirus (SARS-CoV-2) is the cause of COVID-19, which has had a devastating international impact. Prior reports of testing have reported low sensitivities of nasopharyngeal polymerase chain reaction (PCR), and reports of viral co-infections have varied from 0-20%. Therefore, we sought to determine the accuracy of nasopharyngeal PCR for COVID-19 and rates of viral co-infection.Methods: We conducted a retrospective chart review of all patients who received viral testing between March 1, 2020–April 28, 2020. Test results of a complete viral pathogen panel and COVID-19 testing were abstracted. We compared patients with more than one COVID-19 test for diagnostic accuracy against the gold standard of chart review.Results: We identified 1950 patients, of whom 1024 were tested for COVID-19. There were 221 repeat tests for COVID-19. Among patients with a repeat test, COVID-19 swabs had a sensitivity of 84.6% (95% confidence interval (CI), 69.5-94.4%) and a specificity of 99.5% (95%CI, 97-100%) compared to a clinical and radiographic criterion reference by chart review. We found viral co-infection rates of 2.3% in patients without COVID-19 and 6.1% in patients with COVID-19. Rates of co-infection appeared to be related to base rates of infection in the community and not a specific property of COVID-19.Conclusion: COVID-19 nasopharyngeal PCR specimens are accurate but have imperfect sensitivity. Repeat testing for high-risk patients should be considered, and presence of an alternative virus should not be used to limit testing for COVID-19 for patients where it would affect treatment or isolation.

Background: Bacteria colonizing the nasopharynx play a key role as gatekeepers of respiratory health. Yet, dynamics of early life nasopharyngeal (NP) bacterial profiles remain understudied in low- and middle-income countries (LMICs), where children have a high prevalence of risk factors for lower respiratory tract infection. We investigated longitudinal changes in NP bacterial profiles, and associated exposures, among healthy infants from low-income households in South Africa. Methods: We used short fragment (V4 region) 16S rRNA gene amplicon sequencing to characterize NP bacterial profiles from 103 infants in a South African birth cohort, at monthly intervals from birth through the first 12 months of life and six monthly thereafter until 30 months. Results: Corynebacterium and Staphylococcus were dominant colonizers at 1 month of life; however, these were rapidly replaced by Moraxella- or Haemophilus-dominated profiles by 4 months. This succession was almost universal and largely independent of a broad range of exposures. Warm weather (summer), lower gestational age, maternal smoking, no day-care attendance, antibiotic exposure, or low height-for-age z score at 12 months were associated with higher alpha and beta diversity. Summer was also associated with higher relative abundances of Staphylococcus, Streptococcus, Neisseria, or anaerobic gram-negative bacteria, whilst spring and winter were associated with higher relative abundances of Haemophilus or Corynebacterium, respectively. Maternal smoking was associated with higher relative abundances of Porphyromonas. Antibiotic therapy (or isoniazid prophylaxis for tuberculosis) was associated with higher relative abundance of anerobic taxa (Porphyromonas, Fusobacterium, and Prevotella) and with lower relative abundances of health associated-taxa Corynebacterium and Dolosigranulum. HIV-exposure was associated with higher relative abundances of Klebsiella or Veillonella and lower relative abundances of an unclassified genus within the family Lachnospiraceae. Conclusions: In this intensively sampled cohort, there was rapid and predictable replacement of early profiles dominated by health-associated Corynebacterium and Dolosigranulum with those dominated by Moraxella and Haemophilus, independent of exposures. Season and antibiotic exposure were key determinants of NP bacterial profiles. Understudied but highly prevalent exposures prevalent in LMICs, including maternal smoking and HIV-exposure, were associated with NP bacterial profiles. 9NqP-bpPho7pt36-yeLZTt Video Abstract [ABSTRACT FROM AUTHOR]

Radiation therapy with chemotherapy (CCR) is currently the gold standard treatment for nasopharyngeal carcinoma (NPC). Anatomical changes are mainly due to weight loss. Our prospective study aimed to evaluate the nutritional status and the quality of weight loss in our patients to adapt the subsequent nutritional management of patients during treatment for NPC. A prospective, single-center study of 27 patients with non-metastatic NPC treated in our oncology radiotherapy department between August 2020 and March 2021. Data from interrogation, physical examination, and bioelectrical impedancemetry (weight [W], body mass index [BMI], fat index [GI], fat mass [FM], and fat-free mass (FFM]) were collected at the beginning, the mid, and the end of treatment. Weight loss from mid to end of treatment (median = −4 kg [−9.4; −0.9]) was greater than that from baseline to mid-treatment (median = −2.9 kg [−8.8; 1.8]) (P = 0.016). Weight loss during the entire treatment was −6.2 kg [−15.6; −2.5] (8.4%). The losses of FM were identical between the beginning-mid treatment and the mid-end treatment; they were respectively −1.4 kg [−8.5; 4.2] and −1.4 kg [−8.2; 7.8] (P = 0.4). FFM losses between the mid- and the end of treatment (−2.5 kg [−27.8; 0.5]) were greater than those between baseline and mid-treatment (−1.1 kg [−7.1; 4.7]) (P = 0.014). Median FFM loss during treatment was −3.6 kg [−28.1; 2.6]). The results of our study show that weight loss during CCR for NPC is complex and is not just about loss but about a disruption of body composition. Regular follow-ups by nutritionists are required to prevent denutrition during treatment. [ABSTRACT FROM AUTHOR]

Purpose: During the COVID-19 pandemic, the use of salivary swabs (SS) to detect the SARS-CoV-2 virus has been implemented and widely studied in adults and children. However, the role of SS in detecting other common respiratory viruses in children is poorly investigated. Methods: Children younger than 18 years of age admitted with respiratory signs and symptoms underwent both nasopharyngeal and SS procedures. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of SS were calculated, considering the nasopharyngeal swab result as the gold standard. Results: A total of 83 patients (44 females, 53%) underwent both nasopharyngeal and SS procedures. Overall, the sensitivity of SS was 49.4%. Sensitivity according to different respiratory viruses ranged from 0% to 71.43%, while the specificity ranged from 96% to 100%. Negative predictive value ranged from 68.06% to 98.8%, while positive predictive value ranged from 0 to 100%. SS sensitivity in patients younger than 12 months of age was 39.47%, while in patients older than or equal to 12 months of age it was 57.78%. Patients with negative SS had a significantly lower median age (8.5 months (15.25) vs. 23 months (34), p = 0.001) and a significantly lower quantity of median saliva collected for salivary analysis (0 μL (213) vs. 300 μL (100), p < 0.001). Conclusions: SS has a relatively low sensitivity in detecting common respiratory viruses in children with LRTI, with a lower probability in younger children (and in particular those younger than 6 months of age) or those from whom we have collected lesser amounts of saliva. New strategies to improve saliva collection are needed for testing on a larger study population. [ABSTRACT FROM AUTHOR]

Background:Streptococcus pneumoniae(S. pneumoniae)is an important pathogen responsible for numerous infections in humans particularly children under 5 years causing unparalleled fatality.Aim:This study set out to determine the prevalence and circulating serotypes of Streptococcus pneumoniaein under 5 years old children attending Toro General Hospital, Bauchi State, Nigeria.Methods:The study was cross-sectional, and hospital based. A total of 114 nasopharyngeal swabs were collected from children < 5 years old.Streptococcus pneumoniae was isolated, biochemically identified, and molecularly confirmed using PCR via the gene marker CpsA. Latex agglutination was used to serotype the confirmed isolates.Results: a prevalence of 22.6% was established in this study for S. pneumoniae. The age group 0 - 11 months had the highest prevalence of 28.1% while 36 - 47 months had the least prevalence (11.8%). Males had relatively higher prevalence of 29.0% compared to females (20.0%). There was no significant association between the carriage of S. pneumoniae, age, and sex (p> 0.05). Though there was no significant association between vaccination status and prevalence of S. pneumoniae (p = 0.937), non-vaccinated group had lower prevalence of 22.4% as opposed to 23.1% in the vaccinated subjects. Six circulating serotypes [1 (23.1%), 6 (34.6%), 9 (3.8%), 11 (11.5%), 19 (3.8%), and 23 (3.8%)] were detected. Serotypes 1 and 6 were found in both vaccinated and non-vaccinated children but serotypes 9, 11, 19, and 23 were detected in vaccinated children only.Conclusion:PCV vaccine and non-vaccine S. pneumoniae serotypes were found to be prevalent and circulating among under 5 children in the current study. [ABSTRACT FROM AUTHOR]

Background and Objectives: Airway management is crucial for emergency care in critically ill patients outside the hospital setting. An Airway Registry is useful in providing essential information for quality improvement purposes. Therefore, this study aimed to develop an out-of-hospital airway registry and describe airway management practices in Aotearoa New Zealand (AoNZ). Methods: Data from the Aotearoa New Zealand Paramedic Care Collection (ANZPaCC) database were used in a retrospective cohort study covering July 2020 to June 2021. All patients receiving airway interventions were included. An airway intervention was defined as one or more of the following: non-drug assisted endotracheal intubation (NDA-ETI), drug-assisted endotracheal intubation (DA-ETI; where a combination of paralytic agent and sedative were used to aid in intubation), laryngeal mask airway (LMA), oropharyngeal airway (OPA), nasopharyngeal airway (NPA), surgical airway (cricothyroidotomy), suction, jaw thrust. Descriptive statistics were analysed using Chi-Square and logistic regression modelling investigated the relationship between advanced airway success and patient characteristics. Results: The study included 4,529 patients who underwent 7,779 airway interventions. Basic airway interventions were used most frequently: OPA (45.1%), NPA (29.3%), LMA (28.9%), suction (19.9%) and jaw thrust (17.6%). Advanced airway interventions were used less frequently: NDA-ETI (19.8%), DA-ETI (8.7%), and surgical airways (0.2%). The success rate for ETI (including both NDA-ETI and DA-ETI) was 89.4%, with NDA-ETI success at 85.8% and DA-ETI success at 97.7%. ETI first-pass success rates were significantly lower for males (aOR 0.65, 95%CI 0.48–0.87, p

Rapid antigen testing for coronavirus disease 2019 (COVID-19) available at present provides immediate results at low cost with less expertise and without any need of sophisticated infrastructure. Most of these test kits available are for nasopharyngeal samples. This is a novel study to detect the presence of COVID antigen in samples other than throat and oropharyngeal. Various samples received from patients admitted in the COVID-19 dedicated center were tested for the presence of antigen. Same procedure was followed as done for the nasopharyngeal sample. A total of 150 samples were tested, which included ascitic fluid, pleural fluid, drain fluid, bile, bronchoalveolar lavage, cerebrospinal fluid, endotracheal tube aspirate, sputum, tissue, and urine. Out of 150, 11 (7.33%) were positive and 138 (92.66%) were negative for the antigen test. The COVID-19 antigen test kit, though designed for nasopharyngeal samples, was able to detect the presence of antigen in other clinical samples.

Background Monitoring changes in pharyngeal carriage of pneumococcus in children following 13-valent pneumococcal conjugate vaccine (PCV13) introduction in the United Kingdom in 2010 informs understanding of patterns of invasive pneumococcal disease (IPD) incidence. Methods Nasopharyngeal swabs from healthy children vaccinated with PCV13 according to schedule (2, 4, and 12 months) were cultured and serotyped. Results for children aged 13–48 months were compared between 2014–2015 and 2017–2019 and with children aged 6–12 months (2017–2020). Blood was obtained from a subset of children for pneumococcal serotype-specific immunoglobulin G (IgG). Results Total pneumococcal carriage at 13–48 months was 47.9% (473/988) in 2014–2015 and 51.8% (412/795) in 2017–2019 (P =.10); at age 6–12 months this value was 44.6% (274/615). In 2017–2019, 2.9% (95% confidence interval, 1.8%–4.3%) of children aged 13–48 months carried PCV13 serotypes (mainly 3 [1.5%] and 19A [0.8%]) and >20% carried the additional 20-valent PCV (PCV20) serotypes. Similar proportions of children had IgG ≥0.35 IU/mL for each serotype in 2014–2015 and 2017–2019. Serotype 7C carriage increased significantly (P <.01) between 2014–2015 and 2017–2019. Carriage of PCV20 serotypes 8 and 12F, both major causes of IPD, was rare. Conclusions Introduction of PCV20, if licensed for children, could significantly change the composition of pneumococcal serotypes carried in the pharynx of UK children. Clinical Trials Registration NCT03102840. [ABSTRACT FROM AUTHOR]

In symptomatic children tested for COVID-19 by PCR during both Delta and Omicron surges, Cycle threshold value medians and distributions in anterior nares (AN) and nasopharyngeal (NP) samples were very similar, suggesting similar yield of NP and AN sampling for SARS-CoV-2 PCR testing in symptomatic children. [ABSTRACT FROM AUTHOR]

COVID-19, caused by the SARS-CoV-2 virus, manifests with a wide range of clinical symptoms that vary from mild respiratory issues to severe respiratory distress. To effectively manage and predict the outcomes of the disease, it is important to understand the molecular mechanisms underlying its severity. This study focuses on analyzing and comparing the expression patterns of microRNAs (miRNAs) in serum, urine, and nasopharyngeal samples from patients with mild, moderate, and severe COVID-19. The aim is to identify potential associations with disease progression and discover suitable markers for diagnosis and prognosis. Our findings indicate the consistent upregulation of miR-21, miR-146a, and miR-155 in urine, serum, and nasopharyngeal samples from patients with mild COVID-19. In moderate cases, there were more significant changes in miRNA expression compared to mild cases. Specifically, miR-let-7 demonstrated upregulation, while miR-146b exhibited downregulation. The most notable alterations in miRNA expression profiles were observed in severe COVID-19 cases, with a significant upregulation of miR-223. Moreover, our analysis using Receiver-operating characteristic (ROC) curves demonstrated that miR-155, miR-let-7, and miR-223 exhibited high sensitivity and specificity, suggesting their potential as biomarkers for distinguishing COVID-19 patients from healthy individuals. Overall, this comparative analysis revealed distinct patterns in miRNA expression. The overlapping expression patterns of miRNAs in urine, serum, and nasopharyngeal samples suggest their potential utility in discriminating disease status.

Nosocomial myiasis is a rare event that has a higher incidence in the hospitals of poor and developing countries. The presence of nosocomial myiasis reflects the need for improved medical facilities and increased awareness among healthcare personnel. Severely ill patients are more susceptible, such as those with impaired consciousness, paralysis, and underlying diseases. The two cases here in described represent the first report of nosocomial myiasis in the Kurdistan Province, in Western Iran and one of them is the first report of myiasis involving a COVID-19-infected patient. The causal agent was Lucilia sericata. The taxonomical identification of the larvae of the second and third instar was based on the morphology of the cephaloskeleton, anterior spiracles, and peritreme plaques.