Search Results (190)

Objective: Early-signet-ring cell carcinoma has a low malignancy and good prognosis, while advanced signet-ring cell carcinoma has high malignancy and high mortality. So, we need to understand the risk factors of early-signet-ring cell carcinoma, analyze the relationship between early gastric signet-ring cell carcinoma and non-Signet-ring cell carcinoma, and between pure signet-ring cell carcinoma and mixed signet-ring cell carcinoma, in order to provide the basis for the early diagnosis and treatment of signet-ring cell carcinoma. Methods: In this study, a retrospective analysis of 424 cases of early gastric cancer that underwent endoscopic submucosal dissection and surgical treatment between March 2019 and March 2023 in Shanghai Oriental Hospital was carried out. Among the cases, the two groups, namely, the signet-ring cell carcinoma and non-signet-ring cell carcinoma group, and the pure signet-ring cell carcinoma and mixed signet-ring cell carcinoma group, were compared and analyzed. With the help of logistic regression analysis, gender, age, smoking history, alcohol consumption history, tumor site, pathological characteristics, disease progression, tumor size, infiltration depth, and H. pylori infection were investigated between the two groups. Result: The results of the univariate regression analyses in the signet-ring cell carcinoma and non-signet-ring cell carcinoma groups showed that being female (p = 0.001), age < 60 years (p = 0.001), with cancer foci in the middle part of the stomach (p = 0.001), and with a mixed type of cancer foci (p = 0.007) were the risk factors for signet-ring cell carcinoma. In the multifactorial regression analysis, age < 60 years (OR = 1.037, CL = 1.008–1.067, p = 0.012), cancer foci in the middle part of the stomach (OR = 2.094, CL = 1.488–2.948, p = 0.001), mixed-type patients (OR = 0.702, CL = 0.519–0.951, p = 0.022), and women (OR = 0.421, CL = 0.254–0.698, p = 0.001) were the risk factors for signet-ring cell cancer. These are independent risk factors for signet-ring cell carcinoids. Univariate regression analysis on the pure and mixed signet-ring cell carcinoma groups showed that Helicobacter pylori infection (p = 0.001), Kimura–Takemoto classification O1–O3 (p = 0.013), flat and concave types (p = 0.004), and age < 60 years (p = 0.013) were risk factors affecting the development of pure signet-ring cell carcinoma. In the multifactorial regression analysis, age (OR = 0.233, CL = 0.059–0.930, p = 0.039) was the main independent risk factor for pure signet-ring cell carcinoma. Conclusions: Age < 60 years, cancer foci located in the middle of the stomach, mixed type, and female are associated with the development of early gastric signet-ring cell carcinoma; age < 60 years is related to the development of pure signet-ring cell carcinoma, so we need to pay attention to these clinical and pathological factors to prevent the growth of ring cell carcinoma. Full article

Ixodid ticks are blood-sucking ectoparasites of vertebrates. They constitute an integral part of natural foci and are responsible for the worldwide transmission of infections to humans, which can result in severe symptoms. For instance, the Tomsk region, where three abundant tick species (Dermacentor reticulatus, Ixodes pavlovskyi, I. persulcatus) occur, is an endemic area for tick-borne encephalitis virus (TBEV). An increasing number of novel infectious agents carried by ticks have been identified using metagenomic sequencing. A notable example is the Yezo virus (Orthonairovirus yezoense, YEZV), which was discovered in patients with fever after tick bites in Japan and China between 2014 and 2025. For the first time, we have performed metagenomic sequencing of the virome of ticks collected in the Tomsk region. In a sample obtained from a pool of I. pavlovskyi ticks, all three segments of the YEZV genome were detected. The phylogenetic analysis showed that the newly identified isolate formed a sister group to previously described virus isolates, indicating the presence of a new genetic variant. This study presents the first report of YEZV detection in I. pavlovskyi ticks in the Tomsk region, thereby expanding the geographical range and number of vector species for YEZV and highlighting the importance of monitoring viral agents circulating among ticks in Western Siberia. Full article

Background/Objectives: Acute-on-chronic liver failure (ACLF) is a life-threatening complication of cirrhosis, characterized by organ failures and high short-term mortality. Alcohol-related cirrhosis is one of the most frequent underlying etiologies of ACLF in Europe. Infections, particularly those leading to sepsis are recognized triggers; however, their relative contribution, clinical features, and prognostic impact in critically ill patients with alcohol-related cirrhosis remain incompletely defined. This study aimed to systematically identify and characterize precipitating events of ACLF in this population and to compare outcomes between sepsis- and non-sepsis-related cases. Methods: We conducted a retrospective cohort study including 188 ICU patients with alcohol-related cirrhosis who were treated for ACLF at a tertiary university medical center. ACLF was defined and graded according to the European Association for the Study of the Liver—Chronic Liver Failure Consortium (EASL-CLIF) criteria, and sepsis was diagnosed according to Sepsis-3 definitions. Clinical data, precipitating events, microbiological evidence, organ support requirements, and in-hospital outcomes were systematically analyzed. Results: Sepsis was the most frequent precipitating event, identified in 118 patients (62.8%), while 70 patients (37.2%) developed ACLF due to non-septic triggers such as gastrointestinal bleeding. Patients with sepsis-associated ACLF presented with more advanced disease (ACLF grade 2–3 in 80.5% vs. 57.1%, p = 0.004), higher Chronic Liver Failure Consortium—Acute-on-Chronic Liver Failure Score (CLIF-C ACLF) scores (median 55 vs. 50, p = 0.04), longer ICU stays (median 11 vs. 4.5 days, p < 0.001), and markedly higher in-hospital mortality (60.2% vs. 20.0%, p < 0.001) compared to patients without sepsis. Pneumonia (48.3%), urinary infections (17.8%) and spontaneous bacterial peritonitis (16.1%) were the leading infectious foci triggering sepsis. Microbiological evidence was obtained in 82.2% of sepsis cases, with frequent polymicrobial infections and opportunistic pathogens including Enterococcus faecium and Candida albicans. Conclusions: In critically ill patients with alcohol-related cirrhosis, infections leading to sepsis are the predominant precipitating event of ACLF and the strongest determinant of short-term prognosis. Compared with non-sepsis triggers, sepsis-associated ACLF is characterized by more severe disease, greater need for organ support, longer ICU stays, and substantially higher mortality. These findings highlight the urgent need for early recognition, rapid diagnostic strategies, and optimized infection management to improve outcomes in this high-risk population. Full article

Introduction: Brain abscess is defined as a suppurative collection resulting from hematogenous dissemination as an extension from otorhinolaryngologic infectious foci, or secondary to cranial trauma and neurosurgical procedures. Its evolution follows four histopathological stages, the most severe complication being intraventricular rupture, which is associated with extremely high mortality. Central nervous system infections caused by multidrug-resistant (MDR/XDR) Acinetobacter baumannii are rare but severe, significantly limiting therapeutic options due to the reduced penetration of the blood-brain barrier by active antimicrobial agents. Case report: We report the case of a 48-year-old patient with a history of hemorrhagic stroke treated surgically, who was admitted for fever, severe headache, and vomiting. On admission, lumbar puncture confirmed bacterial meningitis, with isolation of A. baumannii susceptible only to colistin. Brain magnetic resonance imaging revealed a postoperative cerebellar abscess. Initial empirical therapy consisted of meropenem and vancomycin, subsequently adjusted according to the susceptibility profile to cefiderocol, intravenous and intrathecal colistin, combined with ampicillin/sulbactam and minocycline. The clinical course was favorable with regard to meningitis, with partial regression of the cerebellar abscess. Follow-up lumbar punctures were sterile, and the patient’s neurological condition stabilized, allowing avoidance of neurosurgical drainage. Conclusions: Meningitis and brain abscess caused by MDRA. baumannii represent rare clinical entities with potentially severe outcomes. Intrathecal administration of colistin, in combination with systemic multidrug therapy, proved decisive in controlling the infection. An interdisciplinary approach and individualized antimicrobial regimens are essential to achieving a favorable prognosis in such complex cases. Full article

Eikenella corrodens is a facultative anaerobic Gram-negative bacillus, part of the normal oropharyngeal flora, with opportunistic pathogenic potential particularly in immunocompromised hosts. The progression from localized intracranial infections such as cerebritis and subdural empyema to secondary bloodstream infection represents a rare but clinically significant pathway, especially in immuno-compromised patients. Here, we report a case of secondary E. corrodens bacteremia following left temporal cerebritis and ipsilateral subdural empyema in a 50-year-old man with advanced nasopharyngeal carcinoma treated with nivolumab. The patient presented neurological deficits and systemic inflammatory response, suggesting for a bacterial infection. Neuroimaging confirmed the intracranial infectious foci and blood cultures identified E. corrodens via MALDI-TOF MS and 16S rRNA gene sequencing. We discuss how cancer-associated immune dysregulation and immune checkpoint inhibition could modulate host susceptibility and clinical presentation of infection, potentially facilitating microbial dissemination across compromised blood–brain barriers. Additionally, we examine the cases of E. corrodens bacteremia secondary to CNS and head and neck infections. This case underscores the importance of heightened clinical vigilance for secondary bacteremia in oncologic patients with CNS infections and highlights the need for integrated microbiological and radiological assessment to optimize outcomes. Full article

Bacterial diseases are widespread in pet birds, posing a severe threat in nestlings and birds with weakened immune systems, often resulting in high mortality during the first days after hatching. This study aimed to describe the pathological findings of a natural bacterial co-infection with Klebsiella pneumoniae and Pseudomonas aeruginosa in nestling European goldfinches (Carduelis carduelis), as a cause of mortality after hatching. Eight nestlings kept in a breeding facility showed an inability to move, anorexia, and respiratory distress, and were found dead between 1 and 4 days of life. Gross pathological findings included diffuse pneumonia with edema and multifocal hemorrhages and occasionally hepatic necrosis. On histopathology, the main findings in all examined birds included severe, subacute bronchopneumonia and severe necrotizing hepatitis. Gram-negative bacilli were observed in parabronchial walls, within pulmonary arteries and surrounding hepatocellular necrotic foci. Lungs, livers and kidneys were sampled for bacteriological examination, resulting in two Gram-negative bacterial isolates. Four housekeeping genes (i.e., 16S rRNA; rpoB; khe; ecfX) were amplified and sequenced for bacterial identification at species level. Although K. pneumoniae and P. aeruginosa are common Gram-negative pathogens and are often co-isolated in human bacterial pneumonia, co-infection with these bacteria has not been documented in nestling goldfinches to date. Pathogen identification is essential for formulating a correct etiological diagnosis and further selecting the most appropriate therapeutic strategy. Full article

Novel waterfowl reoviruses (nWRVs) have been reported in several countries, but their circulation and genetic characteristics in Vietnam remain poorly understood. In this study, we investigated nWRVs in northern Vietnam through molecular detection, virus isolation, experimental infection in ducklings, and molecular analysis of the sigma C-encoding (sC) gene. We also applied immunoinformatic tools to explore the antigenic and structural features of the sC protein. nWRVs were detected in 15.6% of tested samples across ten provinces. Three isolates were successfully recovered, all showing a characteristic cytopathic effect—syncytium formation—in Vero cells. When tested in ducklings (n = 72), the isolates caused disease of varying severity, but all induced characteristic gross and microscopic lesions, particularly ecchymotic hemorrhages and large necrotic foci in the liver and spleen. Phylogenetic analysis based on sC sequences placed the Vietnamese isolates (n = 14) within the nWRV clade, with evidence of two genetically distinct groups. Our immunoinformatic analysis identified four predicted B-cell epitopes located in the head and body domains of the sC protein, with little variation. Full article

The metastrongyloid nematodes Angiostrongylus vasorum, Aelurostrongylus abstrusus, and Crenosoma vulpis can cause severe cardiopulmonary and respiratory symptoms in domestic dogs and cats and free-ranging canids and felids (e.g., foxes, wolves, wild cats, lynxes). Recent data on the prevalence of A. vasorum infections in dogs and foxes and on the prevalence of Ae. abstrusus and Troglostrongylus brevior infections in free-ranging lynxes and wild cats revealed several endemic and hyperendemic foci in Germany. Nonetheless, long-term investigations on the prevalence of metastrongyloid larvae infecting gastropod intermediate hosts are still scarce for Germany. To fill this gap, we conducted an epidemiological survey on native slugs and snails in a selected meadow close to Obrigheim, previously identified as a hyperendemic focus for canine angiostrongylosis. To re-evaluate this location as a ‘hotspot’ of canine angiostrongylosis, terrestrial slugs and snails (n = 533) were collected in all seasons, artificially digested, and microscopically and molecularly analyzed for the presence of metastrongyloid lungworm larvae. Here, the prevalence ranged greatly between seasons. In summer, 27.46% (59/215) of gastropods were infected with metastrongyloid larvae. In fall, the prevalence dropped to 10.00% (16/160) and lowest infection rates were observed in both winter (5.65%) and spring (1.47%). In total, A. vasorum was detected in 12.01% (64/533), Crenosoma sp. in 0.94% (5/533), and Ae. abstrusus in 0.38% (2/533) of gastropod samples. Even though total A. vasorum infection levels were revealed to be considerably lower than in the prior study, this epidemiological survey in principle reconfirms Obrigheim as a stable hyperendemic focus and thereby as a location with high metastrongyloid infection risk for domestic dogs, cats, and wildlife throughout the year. These results call for continuous epidemiological studies on gastropod populations to better understand metastrongyloid lungworm spread and infection dynamics over the years. Full article

We present a case with unusual findings on nuclear imaging after mild SARS-CoV-2 infection. During evaluation for an incidentaloma, 18F-Fluorodeoxyglucose Positron Emission Tomography–Computed Tomography imaging showed activity in the thyroid gland, in the lower thoracic spinal column, in portal lymph nodes, and in the terminal ileum and surrounding lymph nodes, all suspicious for metastatic cancer. The patient underwent extensive invasive and non-invasive diagnostic procedures, including biopsies of all the suspicious foci, only showing a small low-grade thyroid cancer that would often be followed and not immediately operated on. Three months later, the findings had either disappeared or were considered reactive. The patient later recalled having had mild COVID-19 seven days prior to the PET/CT. Full article

We aim to investigate the role of the Herpesviridae family (HHV) in the onset and progression of prostate cancer (PCa) and to profile the local PCa immunological status. A total of 116 “tru-cut” biopsies (58 PCa and 58 benign prostatic hyperplasia [BPH]) and 49 formalin-fixed paraffin-embedded (FFPE) instances of PCa were analysed using real-time qPCR and histological examination. Infection with CMV, EBV, HHV6, and HHV7 was detected in 11.5% of the “tru-cut” biopsies (25.9% in BPH and 6.9% in the PCa group). In the formalin-fixed paraffin-embedded (FFPE) samples, infection was detected in 69.4% of the patients, with individual rates of EBV (47%), HHV6 (38%), HHV7 (41%), CMV (2.9%), HSV2 (2.9%), and VZV (5.8%). In the HHV-infected PCa cases, the histopathological landscape included intratumor lymphocyte infiltration with fibrosis and necrosis, periductal chronic inflammatory reaction and granulomatous lesions with foci of abscesses and necrosis, as well as inflammatory infiltration, chronic lymphadenitis, prostatic intraepithelial atrophy (PIA), and high-grade prostatic intraepithelial neoplasia (HGPIN). The majority of HHV-infected PCa patients were predominantly classified as grade G3/G4/G5 tumours, exhibiting perineural, perivascular, and lymphovascular invasion, seminal vesicle invasion, senile vesicle amyloidosis, and lymph node metastasis. Statistical analysis demonstrated a significant association between HHV infection and PCa (χ² ≈ 20.3, df = 1, p < 0.0001; Fisher’s exact test, p < 0.0001) with an odds ratio of 6.50 (95% CI: 2.80–15.12). These findings suggest that long-term HHV infection could contribute to a complicated and potentially altered immune PCa tumour environment due to inflammation. This may serve as a predictor of aggressive disease progression. Full article

Congregate animal settings can serve as foci for the increased transmission of pathogens, including zoonoses. Domestic cats have been shown to be reservoirs for SARS-CoV-2 but the public health importance of infected cats has not yet been determined. A population of indoor-only residential cats at a cat café in central Texas with a high level of human interaction was evaluated for infection with SARS-CoV-2 in a longitudinal study in 2021–2022. Among 25 cats, none were qRT-PCR-positive, while 50% harbored SARS-CoV-2-neutralizing antibodies, including 1 that remained seropositive for >8 months. The high level of human exposure in this unique congregate cat setting—in which dozens of new visitors interact with the cats every day—likely facilitated the human-to-cat transmission of SARS-CoV-2 that led to a 50% infection prevalence in cats. This work was conducted when the Delta and Omicron variants predominated. Given that feline susceptibility to infection and shedding of a virus may vary across different viral variants, veterinary surveillance may be an important component of veterinary and human health risk assessments. Full article

Hemorrhagic fever with renal syndrome (HFRS) is the result of acute, zoonotic, natural foci hantavirus infections. It has serious social and medical importance due to its widespread distribution and the disease’s severity. There is a lack of effective etiotropic therapy and specific prophylaxis available. The aim of this review is to observe the etiological, clinical, and epidemiological features of nosologic HFRS forms in Russia, as well as differences and similarities with hantavirus pulmonary syndrome (HPS). The various clinical HFRS manifestations characterized diseases associated with Puumala, Kurkino, and Sochi hantaviruses in the Russian European part, and with Hantaan, Amur, and Seoul hantaviruses in the Russian Far East. Differences were observed for HFRS foci types based on biological characteristics and natural host population dynamics. As a result of clinical and epidemiological analysis six nosological forms were established, all of which were classified as “hemorrhagic fever with renal syndrome” according to the WHO’s expert recommendation from 1983 year. The study showed comparable taxonomic characteristics and determined the mechanism of human infection course for HFRS and HPS. The accumulated knowledge of this study allows for the combination of HFRS and HPS names into a common logical disease name “Hantavirus fever”. Full article

Melioidosis is an endemic tropical disease caused by Burkholderia pseudomallei. It typically causes pulmonary disease and bacteraemia but can disseminate to cause multi-organ disease. 18-F FDG PET/CT has an evolving role in diagnosing other infectious diseases, especially where the pathogen or extent of infection is challenging to elucidate clinically and with conventional imaging (CT, US and MRI). We present a case series of patients diagnosed with melioidosis who also underwent 18-F FDG PET/CT from December 18th 2018 to September 30th 2022. Indications for imaging were categorised and analysed as to whether 18-F FDG PET/CT changed management over conventional imaging. Twenty-one 18-F FDG PET/CT scans were performed for sixteen patients. Two scans (9.5%) performed for pyrexia of unknown origin changed management in both cases. Twelve scans (57.1%) performed to ascertain the extent of dissemination of melioidosis changed management in only three (25%) cases. Five scans (23.8%) performed to monitor the response to treatment of known foci changed management in all five cases. Five scans (23.8%) performed for suspected or known malignancy changed management in three (60%) cases. 18-F FDG PET/CT is an emerging tool which improves diagnosis and changes the management of melioidosis when applied judiciously and for well-selected indications. Full article

Severe fever with thrombocytopenia syndrome (SFTS), caused by infection with the SFTS virus, is an emerging fatal tick-borne zoonosis endemic to East Asia. Although SFTS is a tick-borne disease, the virus can be transmitted from animals with SFTS without a tick bite. Direct transmission of the SFTS virus from animals to humans has been reported; however, the transmission route is unclear in some cases. Therefore, this study focused on the possibility of SFTS virus transmission through urine and attempted to isolate the infectious virus from the urine of animals with SFTS. Since more efficient cell isolation is needed to determine whether the SFTS virus is present, we first expressed dendritic cell-specific ICAM-3-grabbing nonintegrin (DC-SIGN), the major receptor for the virus, in Vero cells (Vero-DC-SIGN cells) using a retroviral vector. When inoculated with equal amounts of the SFTS virus strain and SFTS-virus-infected animal serum, Vero-DC-SIGN cells had 42–136% and 20–85% more foci, respectively, than their parent Vero cells. After confirming that Vero-DC-SIGN cells were more suitable for the isolation of the SFTS virus, we investigated whether it could be isolated from the urine of eight cats and two dogs with SFTS. The virus was isolated from 25 μL of urine from two cats with SFTS. Considering that cats excrete 50–100 mL of urine per day, the transmission of the SFTS virus via the urine of cats with SFTS cannot be ruled out. Individuals examining or caring for cats suspected of having SFTS should be aware of the possibility of viral transmission via urine. Full article

The population density of susceptible animals, including domestic pigs and wild boar, is a major risk factor for the emergence of African Swine Fever outbreaks. The ASF foci in wild boar in Russia is sustained by the presence of the virus in the environment, which is primarily determined by the number of infected carcasses found. This study investigates the risk factors related to the occurrence of ASF virus among wild boar, identified through passive monitoring and depopulation control measures, by employing generalized logistic regression models and random forest analysis. The random forest regression outperformed logistic regression coefficient of determination (R² = 0.98 and R² = 0.88) according to the statistical modeling of ASF using different regression types. When comparing regression models, the results showed that wild boar population density, the number of hunting farms, the presence of infected carcasses, and ASF outbreaks among domestic pigs were the main predictors of epidemic in wild boar. The application of a multiple logistic regression model confirmed the significance of the identified risk factors, determining of the probability of ASF outbreaks among wild boar. Given the prolonged affected area across most regions of Russia, the random forest model proved to be the most effective and interpretable based on quality indicator assessments. By highlighting the important role of geographical conditions, identifying these risk factors enhances our understanding of ASF dynamics in specific regions and offers valuable information for decision-makers in developing targeted control strategies against this disease. Full article