The hospitalization rate and clinical characteristics of mucormycosis prior and during COVID-19 pandemic: A single-center study

INTRODUCTION

There have been some reports of the association between SARS-CoV-2 infection and mucormycosis. This study aims to compare the hospitalization rates and clinical characteristics of mucormycosis before and during the COVID-19 pandemic.

METHODOLOGY

In this retrospective study, we compared the hospitalization rate of mucormycosis patients in Namazi hospital in Southern Iran for two periods of 40 months. We defined July 1st, 2018 to February 17th, 2020, as the pre-COVID-19 period and February 18th, 2020, to September 30th, 2021, as the COVID-19 period. In addition, a quadrupled group of hospitalized patients with age and sex-matched SARS-COV-2 infection without any sign of mucormycosis was selected as the control group for COVID-associated mucormycosis.

RESULT

In the total of 72 mucormycosis patients in the COVID period, 54 patients had a clinical history and a positive RT-PCR, which confirms the diagnosis of SARS-COV2 infection. The hospitalization rate of mucormycosis showed an increase of + 306% (95% CI: + 259%, + 353%) from a monthly average value of 0.26 (95% confidence interval (CI): 0.14, 0.38) in the pre-COVID period to 1.06 in the COVID period. The use of corticosteroids prior to the initiation of hospitalization (p ≤ 0.01), diabetes (DM) (p = 0.04), brain involvement (p = 0.03), orbit involvement (p = 0.04), and sphenoid sinus invasion (p ≤ 0.01) were more common in patients with mucormycosis during the COVID period.

CONCLUSIONS

In high-risk patients, especially diabetics, special care to avoid the development of mucormycosis must be taken into account in patients with SARS-COV-2 infection considered for treatment with corticosteroids.

Combined physico-chemical treatment of secondary settled municipal wastewater in a multifunctional reactor

In this paper, the physico-chemical treatment of municipal wastewater for the simultaneous removal of pollutant indicators (chemical oxygen demand (COD) and total coliforms) and organic contaminants (total phenols) was investigated and assessed. A secondary settled effluent was subjected to coagulation, disinfection and absorption in a multifunctional reactor by dosing, simultaneously, aluminum polychloride (dose range: 0-150 μL/L), natural zeolites (dose range: 0-150 mg/L), sodium hypochlorite (dose range: 0-7.5 mg/L) and powder activated carbon (dose range: 0-30 mg/L). The treatment process was optimized using computational fluid dynamics (CFD) and response surface methodology. Specifically, a Latin square technique was employed to generate 16 combinations of treating agent types and concentrations which were pilot tested on an 8 m(3)/h multifunctional reactor fed by a secondary effluent with COD and total coliform concentrations ranging from ≈20 to 120 mg/L and from 10(5) to 10(6) CFU/100 mL, respectively. Results were promising, indicating that removal yields up to 71% in COD and 5.4 log in total coliforms were obtained using an optimal combination of aluminum polychloride (dose range ≈ 84-106 μL/L), powder activated carbon ≈ 5 mg/L, natural zeolite (dose range ≈ 34-70 mg/L) and sodium hypochlorite (dose range ≈ 3.4-5.6 mg/L), with all treating agents playing a statistically significant role in determining the overall treatment performance. Remarkably, the combined process was also able to remove ≈ 50% of total phenols, a micropollutant known to be recalcitrant to conventional wastewater treatments.

CD40 is not detected on human prostate cancer cells by immunohistologic techniques

OBJECTIVES

The CD40 antigen is expressed by antigen-presenting cells, many kinds of epithelium, and carcinomas. As signaling through CD40 modulates the differentiation state of CD40-expressing cells, we wanted to investigate whether benign or malignant prostate epithelium expressed CD40.

METHODS

Twenty-two paraffin-embedded and 10 snap-frozen human prostate tissue samples were analyzed by immunohistologic methods, using the basal cell-specific markers, high molecular weight cytokeratin (HMWCK) and keratin-14 (K14), and the luminal cell marker, low molecular weight cytokeratin (LMWCK), together with CD40. Fresh prostate tissue was cultured in vitro and analyzed by immunocytofluorescence.

RESULTS

The pattern of CD40 expression was continuous on basal epithelial cells of normal and hyperplastic prostate glands but discontinuous in glands that featured prostatic intraepithelial neoplasia. Coexpression of CD40 with the basal cell-specific cytokeratins, HMWCK and K14, was confirmed by double labeling. In contrast, glandular epithelial cells in prostate adenocarcinoma did not express CD40 or these cytokeratins. A luminal cell phenotype defined as CAM5.2-positive and HMWCK-negative K14-negative was identified among primary epithelial cells cultured in vitro. Most of the cultured cells (more than 99%) were also CD40-negative.

CONCLUSIONS

Together, our results support the hypothesis that CD40 expression correlates with the basal cell phenotype, which is lost upon malignant transformation of the prostate. Hence, CD40 may be useful diagnostically to distinguish benign from malignant prostate lesions in biopsy material.

Lymphocyte-filled villi: comparison with other lymphoid aggregations in the mucosa of the human small intestine

BACKGROUND & AIMS

Solitary lymphoid structures that may be sites of primary extrathymic T-cell differentiation have been described recently in murine (cryptopatches) and rat (lymphocyte-filled villi) small intestine. This study tests the hypothesis that similar structures occur in human small intestine.

METHODS

Normal small intestine was obtained during surgery. Fixed tissue was examined histologically, and frozen sections were examined by an indirect immunoperoxidase technique using a panel of mouse monoclonal antibodies.

RESULTS

A new isolated lymphoid structure, with epithelium resembling follicle-associated epithelium of Peyer's patches, is described as a lymphocyte-filled villus. These structures contain major histocompatibility complex (MHC) class II-positive dendritic cells, a majority of memory T cells, a variable B-cell component, and no evidence of immature lymphocytes that express either c-kit or CD1a. Two previously described lymphoid aggregations (isolated lymphoid follicles and submucosal lymphoid aggregations) are components of a single structure. The complete structure contains a B-cell follicle, T cells with mainly memory (CD45RO-positive) phenotype, high endothelial venules, and no detectable population of immature lymphocytes.

CONCLUSIONS

A new solitary lymphoid structure is described in the human small intestine. Neither these structures nor isolated lymphoid follicles appear to be similar to solitary primary lymphoid structures in rodent intestine.