Type B Lactic Acidosis in a Patient with Mantle Cell Lymphoma.

Type B lactic acidosis is an uncommon medical emergency in which acid production overwhelms hepatic clearance. This specific etiology of lactic acidosis occurs without organ hypoperfusion and has been most commonly described in patients with hematologic malignancies but also in patients with solid tumors. The mechanism by which cancer cells switch their glucose metabolism toward increasingly anaerobic glycolytic phenotypes has been described as the "Warburg effect." Without treating the underlying malignancy, the prognosis for patients diagnosed with malignancy-related type B lactic acidosis is extremely poor. Here, we present a case of a 66-year-old male who was diagnosed with type B lactic acidosis secondary to mantle cell lymphoma. Bicarbonate drip was started to correct the lactic acidosis. The patient was also immediately treated with rituximab chemotherapy combined with rasburicase to avoid the hyperuricemia associated with tumor lysis syndrome. He responded to the early treatment and was discharged with normal renal function. Type B lactic acidosis secondary to hematologic malignancy is important to recognize. In order to successfully treat this syndrome, early diagnosis and simultaneous treatment of the imbalance of lactic acid levels and the underlying malignancy are necessary.

The Choice between Plasma-Based Common Coagulation Tests and Cell-Based Viscoelastic Tests in Monitoring Hemostatic Competence: Not an either-or Proposition.

There has been a significant interest in the last decade in the use of viscoelastic tests (VETs) to determine the hemostatic competence of bleeding patients. Previously, common coagulation tests (CCTs) such as the prothrombin time (PT) and partial thromboplastin time (PTT) were used to assist in the guidance of blood component and hemostatic adjunctive therapy for these patients. However, the experience of decades of VET use in liver failure with transplantation, cardiac surgery, and trauma has now spread to obstetrical hemorrhage and congenital and acquired coagulopathies. Since CCTs measure only 5 to 10% of the lifespan of a clot, these assays have been found to be of limited use for acute surgical and medical conditions, whereby rapid results are required. However, there are medical indications for the PT/PTT that cannot be supplanted by VETs. Therefore, the choice of whether to use a CCT or a VET to guide blood component therapy or hemostatic adjunctive therapy may often require consideration of both methodologies. In this review, we provide examples of the relative indications for CCTs and VETs in monitoring hemostatic competence of bleeding patients.

COVID-associated non-vasculitic thrombotic retiform purpura of the face and extremities: A case report.

SARS-CoV-2 infection can manifest many rashes. However, thrombotic retiform purpura rarely occurs during COVID-19 illness. Aggressive anti-COVID-19 therapy with a high-dose steroid regimen led to rapid recovery. This immunothrombotic phenomenon likely represents a poor type 1 interferon response and complement activation on the endothelial surface in response to acute infection.

Salicylic acid affects mycorrhizal features, antioxidant enzyme activities and seed yield of linseed under water-deficit stress in open-field conditions.

The research aims were to study salicylic acid (SA) effects on mycorrhiza [hyphal width (HW), vesicle diameter (VD) and mycorrhizal colonization (MC)] and interaction between them on greenness index (GI), drought tolerance index (DTI), antioxidant enzymes activities, and seed yield of linseed under drought. A factorial experiment was conducted in an open-field place with mycorrhiza [non-inoculation, Funneliformis mosseae (FM), and Rhizoglomus intraradices (RI)], SA (250 µM and non-SA), and irrigation levels [100%, 70%, and 40% field capacity (FC)] as treatments. Severe drought increased VD, MC, superoxide dismutase (SOD), ascorbate peroxidase (APX), and peroxidase activities while decreased GI, DTI, and yield. The RI-linseed had higher MC, GI, SOD, and glutathione reductase (GR) activities, but FM-linseed had greater VD and yield under drought. Inoculated linseed with both mycorrhiza showed a reduction in DTI and yield under SA than non-SA. In RI-linseed, SA increased GI, MC, HW, VD, catalase and GR, but decreased in FM-plants. Mycorrhiza (particularly RI) alleviated drought (40% FC)-caused negative effects on linseed via the improvement of SOD, APX, and GI. Regardless of other treatments, SA had negative effects on HW and VD, but SA effects varied depending on mycorrhizal species so that SA increased HW, VD, and MC in RI. Due to the positive correlation between MC and HW, SA reduces FM colonization by reducing the HW of FM. Totally, SA along with RI species can mitigate the harmful effects of drought and improve tolerance via increasing MC, HW, VD, catalase, peroxidase, and GR activities.

Combined effect of putrescine and mycorrhizal fungi in phytoremediation of Lallemantia iberica in Pb-contaminated soils.

As soil contamination with heavy metals is increasing and polyamines have roles in the growth of mycorrhiza and plants, it is important to study phytoremediation, growth, tolerance, and mycorrhization in Lallemantia iberica as a multi-purpose plant, by the application of putrescine along with mycorrhiza in Pb-contaminated soils. For this purpose, the study was performed in a factorial arrangement with Pb (0, 300, 600, and 900 mg Pb/kg soil), mycorrhiza (non-inoculation, Funneliformis mosseae (Fm), and Rhizophagus intraradices (Ri)), and putrescine (0, 0.5, and 1 mM) in a greenhouse. Results showed that antioxidant activities, plant Pb, and mycorrhizal features enhanced, while transfer factor (TF), biomass, and tolerance decreased under Pb levels. Mycorrhiza improved growth, greenness, defense, and tolerance and reduced TF, Pb, and H2O2 content under Pb stress. Putrescine (0.5 mM) increased catalase activity, biomass, and colonization and reduced Pb content and TF under Pb levels. Combination of 0.5 mM putrescine with Fm increased shoot biomass (13%), peroxidase (17.2%), root P (7.5%), shoot tolerance (14.4%), colonization (5.1%), and hyphal width (5.5%) and decreased malondialdehyde (20.5%) and shoot Pb content (28.1%). Putrescine (1 mM) had negative effects on all traits in combination with Ri but not with Fm. Combination of putrescine and Fm showed more efficiency in decreasing Pb content in L. iberica and was effective in phytostabilization. It is generally concluded that 0.5 mM putrescine was the beneficial concentration in combination with mycorrhiza, Pb stress, and single use to improve plant performance, and Fm was a useful species for improving the growth and tolerance of L. iberica under Pb levels.

Short-course administration of a traditional herbal mixture ameliorates asthma symptoms of the common cold in children.

OBJECTIVE: Asthma is an increasing chronic respiratory disease affecting over 300 million people worldwide. Several studies have shown that herbal remedies may improve asthma control and reduce asthma symptoms. In this study, the effects of short-course administration of an herbal mixture (ASMATUSTM) in asthmatic children during viral respiratory tract infection, were evaluated. MATERIALS AND METHODS: Forty-six children (7-12 years old) with intermittent asthma were enrolled in this double-blind randomized clinical trial. At the onset of common cold symptoms, the patients were randomly assigned to daily receive either the herbal mixture (comprised of Matricaria chamomilla, Althaea officinalis, Malva sylvestris, Hyssopus officinalis, Adiantum capillus-veneris, Glycyrrhiza glabra and Ziziphus jujube) or placebo for 5 days. Primary outcomes included day symptoms, night symptoms, and asthma attacks. Secondary outcomes included Peak Expiratory Flow Rate (PEFR), the need for ß-agonist administration, oral prednisolone usage, necessity for re-visit due to uncontrolled or insupportable symptoms, as well as the number of hospital admissions and days absent from school. RESULTS: the herbal mixture significantly decreased the severity of coughs (p=0.049) and nighttime awakenings (p=0.029) in comparison to placebo. There was no significant reduction in wheezing, tachypnea, respiratory distress, PEF rate, absence from school, outpatient visits, asthma exacerbation, oral prednisolone or ß-agonist usage and hospitalization. CONCLUSION: Short-course of herbal mixture this traditional herbal mixture, starting at the onset of signs of a viral respiratory tract infection in children with intermittent asthma, reduced cough and nights awakening. Further studies should be done to determine the most effective herbal admixture, as well as dose and duration of treatment.