Being a confirmed TB patient was directly proportional to e-nose 10-sensor responses. Principal component analysis clusters showed a clear distinction between TB and HC groups, with variances of 93%, 85%, 75% and 95% for blood, breath, sputum and urine samples, respectively. Overall accuracy, sensitivity and specificity of the artificial neural network (ANN) analysis for classifying samples were >99%. The e-nose successfully distinguished TB patients from HC participants for all measured biological samples with great precision. With urine samples gaining broader acceptance for clinical diagnosis, an e-nose-based ANN can be a very useful tool for low-cost mass screening and early detection of TB patients in developing countries.
Background
One year has passed since the announcement of COVID-19 as a pandemic and two waves had already stricken Egypt. The authors witnessed several atypical radiological features through the second pandemic wave, either early at the active infective stage or delayed at the post-infectious convalescent period. They believed every radiologist should be familiar with these features. Therefore, they performed this comparative study on 2000 Egyptian patients using multi-slice computed tomography (MSCT) to highlight the radiological differences between the first and second pandemic waves and correlate them to the clinical status.
Results
This random multi-center comparative study was retrospectively conducted on 2000 COVID-19 Egyptian patients; 1000 patients were registered at the first pandemic wave from April 2020 till September 2020, while the other 1000 patients were registered at the second pandemic wave from October 2020 till March 2020. Follow up CT examinations were performed for 49 and 122 patients through the first and second pandemic waves respectively. MSCT examinations were carefully evaluated by four expert consulting radiologists who came to a consensus. Meanwhile, the correlation with the clinical outcome was performed by two consulting pulmonologists. During the second pandemic wave, the prevalence rate of the “crazy-paving” pattern had significantly increased by 1.3 times (P value = 0.002). Additionally, the prevalence rate of the “air-bubble” sign had significantly increased by 1.9 times (P value = 0.02). Similarly, the presence of enlarged mediastinal lymph nodes (> 1 cm in short-axis diameter) had significantly increased by 1.7 times (P value = 0.036). Furthermore, the prevalence rate of pericardial effusion had significantly increased by 2.5 times (P value = 0.003). The above-mentioned signs were correlated to increased clinical severity and higher rates of hospitalization. Unexpectedly, other atypical radiological signs were only encountered through the second pandemic wave, including bronchiectatic changes (2.5%), “head-cheese” pattern (0.8%), cavitation (0.5%), and “bulls-eye” sign (0.2%). The prevalence rate of post-COVID fibrosis had doubled through the second wave but not in a significant way (P value = 0.234). Secondary fungal infection was only encountered throughout the second pandemic wave in four patients. COVID-19 reinfection was encountered in a single patient only during the second pandemic wave.
Conclusion
After 1 year from the announcement of COVID-19 as a pandemic, the radiological presentation of COVID-19 patients showed some significant differences between its first and second waves.
Objectives: CD4+T cell subtypes are the central orchestrators of airway inflammation in bronchial asthma (BA); however, the mechanisms that regulate their accumulation in asthmatic airways are still a challenging subject. In addition, neutrophils play a significant role in the development of airway remodeling and their presence may influence clinical presentation of BA being linked to the development of severe BA. Neutrophils have also been found to acquire antigen presenting functions, enabling them to directly activate T cells. The study aimed to evaluate the possible association of chemokine receptor 7 (CCR7)+ memory CD4+ T cells and CCR4+ effector T cells with disease severity and immunoglobulin E (IgE) production as well as to explore the relationship between these cells and neutrophil function in both allergic and non-allergic asthmatic patients. Methods: Flow cytometry was used to determine the expression of different T cell subset phenotypes (CCR7 memory CD4+ and CCR4+ T cells using anti-human CD3, CD4, CD45RO, CCR4 and CCR7 monoclonal antibodies) utilizing peripheral blood mononuclear cells (PBMCs) isolated from 78 allergic asthmatic patients, 41 non-allergic asthmatic patients, and 40 healthy individuals. Moreover, neutrophils' phagocytic activity was assessed by ingestion of candida particles. Results: We demonstrated increased percentages of CCR7+ memory CD4+ T cells and CCR4+ CD4+ T cells in patients compared to control, where this upregulation was significantly higher in allergic than non-allergic asthmatic patients. Additionally, these cells were negatively correlated with improved pulmonary tests and significantly associated with disease severity scores and IgE levels. The neutrophil phagocytic activity was markedly increased in patients compared to control, showing a significant positive correlation with disease severity. Conclusion: These findings suggest that increased CCR4+ CD4+ T cells and CCR7+ memory CD4+ T cells (Tcm) may be associated with BA severity, especially in allergic BA patients and can potentially contribute to the rational design of new therapeutic approaches for asthma in the future.
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