Impaired SARS-CoV-2 specific T-cell response in patients with severe COVID-19.

Cellular immune responses are of pivotal importance to understand SARS-CoV-2 pathogenicity. Using an enzyme-linked immunosorbent spot (ELISpot) interferon-γ release assay with wild-type spike, membrane and nucleocapsid peptide pools, we longitudinally characterized functional SARS-CoV-2 specific T-cell responses in a cohort of patients with mild, moderate and severe COVID-19. All patients were included before emergence of the Omicron (B.

Differential abundance of IgG antibodies against the spike protein of SARS-CoV-2 and seasonal coronaviruses in patients with fatal COVID-19.

Infection with the novel pandemic SARS-CoV-2 virus has been shown to elicit a cross-reactive immune response that could lead to a back-boost of memory recall to previously encountered seasonal (endemic) coronaviruses (eCoVs). Whether this response is associated with a fatal clinical outcome in patients with severe COVID-19 remains unclear. In a cohort of hospitalized patients, we have previously shown that heterologous immune responses to eCoVs can be detected in severe COVID-19.

Differential vaccine-induced kinetics of humoral and cellular immune responses in SARS-CoV-2 naive and convalescent health care workers.

Effective vaccination is a key element in the exit strategy from the current severe acute respiratory syndrome-CoV coronavirus-2 (SARS-CoV-2) pandemic, and may also offer protection against severe disease from future variants of concern. Here, we prospectively monitored T-cell responses over time, using ELISpot interferon-γ (INF-y) release assays, and B-cell responses, using serological tests, after vaccination and booster with BioNTech/Pfizer mRNA (Pfizer) and Janssen vector (Janssen/Johnson & Johnson) vaccines in hospital health care workers. Vaccine recipients were divided into seropositive and seronegative individuals at baseline, in order to determine the effect of natural immunity on vaccine-induced immune kinetics.

Heterologous Immune Responses of Serum IgG and Secretory IgA Against the Spike Protein of Endemic Coronaviruses During Severe COVID-19.

Defining immune correlates of disease severity is important to better understand the immunopathogenesis in COVID-19. Here we made use of a protein microarray platform to detect IgG- and IgA-reactive antibodies in sera and saliva respectively, and assess cross-reactivity between SARS-CoV-2 and endemic coronaviruses (eCoVs). IgG responses against the full protein of spike, but not the S1 subunit, were significantly higher in convalescent sera of patients with severe disease compared to mild disease and healthy controls.

[A 30-year-old man with a puddle of pleural effusion].

Background: The pleural effusion found in urinothorax is traditionally classified as transudate. In some cases, however, the Light-criteria can show an exudate.

Case Description: We describe the case of a 30-year-old man who attended the emergency department with shortness of breath and severe, diffuse, chest pain; this occurred two days after he had undergone a left-sided percutaneous nephrolithotomy by a urologist.

Addison's Disease Caused by Tuberculosis: Diagnostic and Therapeutic Difficulties.

Objectives: To demonstrate difficulties in diagnosing and treating Addison's disease caused by tuberculosis.

Materials And Methods: We present a clinical case and review of the literature.

Results: A 62-year-old man presented with gastrointestinal symptoms, weight loss and enlarged adrenal glands.

Clinical relevance of Corynebacterium pseudodiphtheriticum in lower respiratory tract specimens.

Background: Corynebacterium pseudodiphtheriticum may be present as commensal flora of the respiratory tract and therefore it may be difficult to assess clinical relevance when it is cultured from lower respiratory tract specimens. Our objective was to determine the clinical relevance of C. pseudodiphtheriticum as a lower respiratory tract pathogen and to define patients at risk of developing lower respiratory tract infections caused by C.

Diagnosis of Coxiella burnetii infection: comparison of a whole blood interferon-gamma production assay and a Coxiella ELISPOT.

Diagnosis of ongoing or past infection with Coxiella burnetii, the causative agent of Q fever, relies heavily on serology: the measurement of C. burnetii-specific antibodies, reflecting the host's humoral immune response. However, cell-mediated immune responses play an important, probably even more relevant, role in infections caused by the intracellular C.

[Recurrent miscarriage turns out to be lung cancer].

Background: If a positive pregnancy test is followed by profuse vaginal bleeding, the diagnosis of miscarriage can generally be made. Sometimes, however, elevated hCG levels may be associated with a phantom pregnancy, which may be a paraneoplastic symptom.

Case Description: A 27-year-old woman was referred for a diagnosis after having experienced 3 consecutive miscarriages.

Diagnosis and management of Q fever--United States, 2013: recommendations from CDC and the Q Fever Working Group.

Q fever, a zoonotic disease caused by the bacterium Coxiella burnetii, can cause acute or chronic illness in humans. Transmission occurs primarily through inhalation of aerosols from contaminated soil or animal waste. No licensed vaccine is available in the United States.

Developing a new clinical tool for diagnosing chronic Q fever: the Coxiella ELISPOT.

Definitively establishing a clinical diagnosis of chronic Q fever remains challenging, as the diagnostic performance of both conventional serological tests and PCR is limited. Given the importance of an early diagnosis of chronic Q fever, there is a need for a reliable diagnostic test. We developed an enzyme-linked immunospot assay to measure Coxiella burnetii (C.

Diagnostic value of histology compared with cytology in transbronchial aspiration samples obtained by histology needle.

Objective: Results from endoscopic needle aspiration [transbronchial needle aspiration (TBNA), esophageal ultrasound-guided fine needle aspiration, real-time endobronchial ultrasound] mainly rely on cytology. We performed a retrospective study to evaluate the possible advantage of obtaining histologic samples during TBNA in the diagnostic assessment of mediastinal lymph node enlargement.

Materials And Methods: In a retrospective study 2 pathologists evaluated all TBNAs from patients with mediastinal lymph node enlargement in whom representative histologic and cytologic material was obtained, using only a histology needle.

Pleural FDG Uptake More Than a Decade after Talc Pleurodesis.

Talc pleurodesis induces a strong local inflammatory reaction which can be detected by PET scan for years after the procedure. When patients undergo PET scanning in the workup of a suspected malignancy later in life, pleural FDG uptake may unnecessarily lead to an additional invasive diagnostic workup. We present two cases of positive pleural PET findings more than 10 years after talc pleurodesis, where we adopted a watchful waiting approach.

Learning curve of conventional transbronchial needle aspiration in pulmonologists experienced in bronchoscopy.

Background: Despite its proven efficacy, transbronchial needle aspiration (TBNA) remains an underutilized technique for sampling enlarged mediastinal lymph nodes in the staging of lung cancer. Previous investigators have reported on TBNA experience, but without mentioning individual learning curves related to lymph node size in pulmonologists experienced in bronchoscopy.

Objectives: The aim of this study was to evaluate the TBNA learning curve in a group of pulmonologists already experienced in bronchoscopy, and to relate their yields to lymph node size and location.