Exploring the Potential Medicinal Benefits of Ganoderma lucidum: From Metabolic Disorders to Coronavirus Infections.

Ganoderma lucidum is a medicinal mushroom that has been traditionally used in Chinese medicine for centuries. It has been found to have a wide range of medicinal properties, including antioxidant, anti-inflammatory, and immune-boosting effects. Recent research has focused on the potential benefits of G. lucidum in treating metabolic disorders such as diabetes and obesity, as well as its possible role in preventing and treating infections caused by the coronavirus. Triterpenoids are a major group of bioactive compounds found in G. lucidum, and they have a range of biological activities, including anti-inflammatory and antioxidant properties. These compounds have been found to improve insulin sensitivity and lower blood sugar levels in animal models of diabetes. Additionally, G. lucidum polysaccharides have been found to reduce bodyweight and improve glucose metabolism in animal models of obesity. These polysaccharides can also help to increase the activity of certain white blood cells, which play a critical role in the body's immune response. For coronavirus, some in vitro studies have shown that G. lucidum polysaccharides and triterpenoids have the potential to inhibit coronavirus infection; however, these results have not been validated through clinical trials. Therefore, it would be premature to draw any definitive conclusions about the effectiveness of G. lucidum in preventing or treating coronavirus infections in humans.

Toxicity of Glycyl-l-Prolyl-l-Glutamate Pseudotripeptides: Cytotoxic, Oxidative, Genotoxic, and Embryotoxic Perspectives.

The tripeptide H-Gly-Pro-Glu-OH (GPE) and its analogs began to take much interest from scientists for developing effective novel molecules in the treatment of several disorders including Alzheimer's disease, Parkinson's disease, and stroke. The peptidomimetics of GPEs exerted significant biological properties involving anti-inflammatory, antiapoptotic, and anticancer properties. The assessments of their hematological toxicity potentials are critically required for their possible usage in further preclinical and clinical trials against a wide range of pathological conditions. However, there is so limited information on the safety profiling of GPE and its analogs on human blood tissue from cytotoxic, oxidative, and genotoxic perspectives. And, their embryotoxicity potentials were not investigated yet. Therefore, in this study, measurements of mitochondrial viability (using MTT assay) and lactate dehydrogenase (LDH) release as well as total antioxidant capacity (TAC) assays were performed on cultured human whole blood cells after treatment with GPE and its three novel peptidomimetics for 72 h. Sister chromatid exchange (SCE), micronucleus (MN), and 8-oxo-2-deoxyguanosine (8-OH-dG) assays were performed for determining the genotoxic damage potentials. In addition, the nuclear division index (NDI) was figured out for revealing their cytostatic potentials. Embryotoxicity assessments were performed on cultured human pluripotent NT2 embryonal carcinoma cells by MTT and LDH assays. The present results from cytotoxicity, oxidative, genotoxicity, and embryotoxicity testing clearly propounded that GPEs had good biosafety profiles and were trouble-free from the toxicological point of view. Noncytotoxic, antioxidative, nongenotoxic, noncytostatic, and nonembryotoxic features of GPE analogs are worthwhile exploring further and may exert high potentials for improving the development of novel disease-modifying agents.

Molecular Genetics and Cytotoxic Responses to Titanium Diboride and Zinc Borate Nanoparticles on Cultured Human Primary Alveolar Epithelial Cells.

Titanium diboride (TiB2) and zinc borate (Zn3BO6) have been utilized in wide spectrum industrial areas because of their favorable properties such as a high melting point, good wear resistance, high hardness and thermal conductivity. On the other hand, the biomedical potentials of TiB2 and Zn3BO6 are still unknown because there is no comprehensive analysis that uncovers their biocompatibility features. Thus, the toxicogenomic properties of TiB2 and Zn3BO6 nanoparticles (NPs) were investigated on human primary alveolar epithelial cell cultures (HPAEpiC) by using different cell viability assays and microarray analyses. Protein-Protein Interaction Networks Functional Enrichment Analysis (STRING) was used to associate differentially expressed gene probes. According to the results, up to 10 mg/L concentration of TiB2 and Zn3BO6 NPs application did not stimulate a cytotoxic effect on the HPAEpiC cell cultures. Microarray analysis revealed that TiB2 NPs exposure enhances cellular adhesion molecules, proteases and carrier protein expression. Furthermore, Zn3BO6 NPs caused differential gene expressions in the cell cycle, cell division and extracellular matrix regulators. Finally, STRING analyses put forth that inflammation, cell regeneration and tissue repair-related gene interactions were affected by TiB2 NPs application. Zn3BO6 NPs exposure significantly altered inflammation, lipid metabolism and infection response activator-related gene interactions. These investigations illustrated that TiB2 and Zn3BO6 NPs exposure may affect different aspects of cellular machineries such as immunogenic responses, tissue regeneration and cell survival. Thus, these types of cellular mechanisms should be taken into account before the use of the related NPs in further biomedical applications.

The associations of life quality, depression, and cognitive impairment with mortality in older adults with COVID-19: a prospective, observational study.

AIM: Associations of depression, dementia, and poor life quality with mortality of COVID-19have not been studied yet. We aimed to identify the risk factors for mortality and analyze the associations with patients' physiological and mental well-being, as reflected by comorbidities, life quality, depression, and cognitive impairment. METHODS: : Older patients receiving inpatient hospital care for COVID-19 were included.Demographic data, medical history, symptoms at admission, laboratory findings, and treatment outcomes were recorded. RESULTS: : There were 122 patients with a median age of 73.0 years. The mortality rate was 9.0% (n = 11 patients). Patients with mortality were significantly active smokers, obese, and having comorbidities using polypharmacy. Weight loss ≥of 10% during hospitalization was significantly associated with mortality.Poor life quality and a higher risk of depression, cognitive impairment, and falling were more frequently seen in non-survived patients. (p < 0.05). High ferritin was the only independent risk factor for mortality (OR = 15.61, 95% CI:1.08-226.09, p = 0.044). CONCLUSION: : The presence of comorbidities, depression, cognitive impairment, higher falling risk, and poor life quality were significantly associated with higher mortality rates in older adults with COVID-19. High ferritin level was an independent risk factor for mortality.

Quality of Sleep in Elderly Patients with Diabetes Mellitus from Turkey: A Cross-Sectional Observational Study.

BACKGROUND: Elderly patients frequently experience poor sleep quality. We aimed to determine its prevalence and risk factors in diabetic elderly patients from Turkey. METHODS: An observational cross-sectional study of 220 diabetic elderly patients with a mean age of 70.4 ± 5.9 was conducted between June 2019 and December 2019. Pittsburgh Sleep Quality Index (PSQI) questionnaire was used. Patients were divided based on sleep quality into poor (PSQI> 5) and good (PSQI≤ 5) sleep quality groups. Geriatric Depression Scale, Beck Anxiety Inventory, and Hendrich II Fall Risk Model were adopted. The prevalence of poor sleep quality and risk factors were evaluated. RESULTS: Prevalence of poor sleep quality was 58.6%. Poor sleepers were significantly older, were more likely to be divorced, had more comorbidities, and used more medicines (ps<0.05). Longer duration of diabetes, higher incidence of hypoglycemic events, and diabetic complications were significantly associated with poor sleep quality (ps<0.05). Poor sleepers had higher levels of blood glucose and HbA1c levels (ps<0.05). PSQI was significantly correlated with age, HbA1c, duration of diabetes, higher depression, anxiety, and falling risk (ps<0.05). Severe depression, anxiety, and higher falling risk were independent risk factors. CONCLUSION: Most patients experienced poor sleep quality. It was associated with a longer duration of diabetes, chronic diabetes-related complications, and higher HbA1c levels. Severe depression, anxiety, and higher falling risk were risk factors for poor sleep quality.

Successful pulsed methylprednisolone and convalescent plasma treatment in a case of a renal transplant recipient with COVID-19 positive pneumonia: a case report.

Coronavirus 2019 disease (COVID-19) is a deadly disease that was first seen in Wuhan, China, and primarily affects the respiratory system, but also has different systemic involvements. It has caused 89 million cases and 1.9 million deaths worldwide. COVID-19 positive renal transplant recipients have a higher mortality rate than COVID-19 patients in the normal population. There is no specific treatment and follow-up protocol for COVID-19 infection in transplant recipients. COVID-19 treatment and immunosuppressive therapy choices are controversial. Recently, pulse steroid therapies have been used in cases with severe COVID-19 pneumonia. Convalescent plasma therapy is used limitedly in COVID-19 patients. Our 49-year-old male patient has been a recipient of a renal transplant from a cadaver for 6 years. We aimed to make an additional contribution by presenting our patient to the literature whose COVID-19 PCR-RT test performed in the emergency department due to the complaints of fever, shortness of breath, and cough for five days was positive and had moderate COVID-19 pneumonia in thorax tomography and had serious clinical and radiological improvement after pulsed methylprednisolone and convalescent plasma therapy in the early period.

Glycyl-L-Prolyl-L-Glutamate Pseudotripeptides for Treatment of Alzheimer's Disease.

So far, there is no effective disease-modifying therapies for Alzheimer's Disease (AD) in clinical practice. In this context, glycine-L-proline-L-glutamate (GPE) and its analogs may open the way for developing a novel molecule for treating neurodegenerative disorders, including AD. In turn, this study was aimed to investigate the neuroprotective potentials exerted by three novel GPE peptidomimetics (GPE1, GPE2, and GPE3) using an in vitro AD model. Anti-Alzheimer potentials were determined using a wide array of techniques, such as measurements of mitochondrial viability (MTT) and lactate dehydrogenase (LDH) release assays, determination of acetylcholinesterase (AChE), α-secretase and ß-secretase activities, comparisons of total antioxidant capacity (TAC) and total oxidative status (TOS) levels, flow cytometric and microscopic detection of apoptotic and necrotic neuronal death, and investigating gene expression responses via PCR arrays involving 64 critical genes related to 10 different pathways. Our analysis showed that GPE peptidomimetics modulate oxidative stress, ACh depletion, α-secretase inactivation, apoptotic, and necrotic cell death. In vitro results suggested that treatments with novel GPE analogs might be promising therapeutic agents for treatment and/or or prevention of AD.

The in vitro cytotoxic, genotoxic, and oxidative damage potentials of the oral artificial sweetener aspartame on cultured human blood cells

Background/aim: Aspartame (APM, L-aspartyl-L-phenylalanine methylester) is a low-calorie, nonsaccharide artificial sweetener widely used in foods and beverages. When metabolized by the body, APM is broken down into aspartic acid, phenylalanine amino acids, and a third substance, methanol. Since the amino acid phenylalanine serves as a neurotransmitter building block affecting the brain, and methanol is converted into toxic formaldehyde, APM has deleterious effects on the body and brain. Thus, its safety and, toxicity have been the subjects of concern ever since it was first discovered. Although many studies have been performed on it, due to the presence of conflicting data in the literature, there are still numerous question marks concerning APM.Therefore, the safety of aspartame was tested using in vitro methods. Materials and methods: We aimed to evaluate the in vitro cytotoxic effects by using 3-(4,5-dimetylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and lactate dehydrogenase release tests, genotoxic damage potential by using chromosome aberration (CA) assay, and antioxidant/oxidant activity by using total antioxidant capacity (TAC) and total oxidative stress (TOS) analysis in primary human whole blood cell cultures. Results: The results of the MTT test showed that APM led to significant decreases in cell viability in a clear concentration-dependent manner. Moreover, an increase in CA frequency was found in the cells treated with APM. However, APM treatments did not cause any significant changes in TAC and TOS levels in whole blood cultures. Conclusion: Overall, the obtained results showed that APM had genotoxicity potential and a concentration-dependent cytotoxic activity in human blood cells.

Following Chemotherapy: Serum Cytokine (Tumor Necrosis Factor, Interleukin-2, Interleukin-11), Immunoglobulin, Complement, Vascular Endothelial Growth Factor Levels, and the Systemic Symptoms like Capillary Leak Syndrome.

Several problems such as myalgia, arthralgia, fever, dyspnea, generalized edema, and pleural effusion can occur in cancer patients following the chemotherapy, especially at the first cycle of the first chemotherapy treatment. Although it is assumed that some cytokines are associated with the development of these symptoms and signs, their pathophysiology has not been discovered completely yet. They are usually mild, but they may rarely progress to the severe stage of "Systemic Capillary Leak Syndrome" with a high mortality rate. The objective of this study was to investigate the association between the serum levels of interleukin-2 (IL-2), interleukin-11 (IL-11), tumor necrosis factor alpha (TNF-α), vascular endothelial growth factor (VEGF), and these symptoms and signs. A total of 44 cancer patients who had neither heart, lung, liver, renal, or thyroid disease were recruited into this study. Their symptoms and signs were examined and questioned before the first cycle of the first chemotherapy treatment and the 24 h after this chemotherapy. All participant's serum samples were taken, and the VEGF, TNF, IL-2, and IL-11 levels were studied. There was no association between the chemotherapeutic drugs, and the symptoms and signs such as edema, dyspnea, coughing, and flu-like symptoms. There was a significant decrease in IL-11 levels in the other treatment group compared with the group receiving paclitaxel, docetaxel, gemcitabine, and vinorelbine in the first day following chemotherapy (P = .006). However, no relation was observed between the symptoms and signs, the response to the chemotherapy, and the serum levels of VEGF, TNF, IL-2, and IL-11. These symptoms and life-threatening syndrome have been a current topic between the clinicians. Although some drugs and mediators are accused, its pathophysiology has not been discovered completely yet. In this study, we could not detect any association between the symptoms, signs, and the cytokine levels following the chemotherapy.

Effect of platelet-rich fibrin on epidural fibrosis and comparison to ADCON® Gel and hyaluronic acid.

OBJECTIVE: In this experimental study, PRF (Platelet Rich Fibrin), HA (Hyaluronic Acid) gel and ADCON® Gel were compared in terms of preventing epidural fibrosis. METHODS: Twenty-eight Sprague-Dawley rats (mean weight, 400-450 g) were divided into 4 groups. L3-L4 laminectomy was performed in each group. Following laminectomy, Adcon® Gel, HA gel and PRF were applied onto the surgery site locally in Group 1, 2 and 3, respectively. Group 4 was maintained as control without any local application. After five weeks, L3-L4 vertebrae were removed totally and taken to histopathological evaluation for epidural fibrosis, acute inflammatory cell density, chronic inflammatory cell density, hemorrhage, angiogenesis and new bone formation. RESULTS: Acute inflammation cell density, angiogenesis, and new bone formation levels were comparable among the study groups (p > 0.05). However, new bone formation was higher in the PRF group. Epidural fibrosis and chronic inflammatory cell density were significantly lower in the PRF group (p < 0.05). CONCLUSION: We concluded that PRF contributed to hemostasis and prevented epidural fibrosis.

Unilateral Optic Neuropathy and Acute Angle-Closure Glaucoma following Snake Envenomation.

Purpose. We aimed to describe a unique case in which a patient developed unilateral optic neuritis and angle-closure glaucoma as a result of snake envenomation. Case Report. Approximately 18 hours after envenomation, a 67-year-old female patient described visual impairment and severe pain in her left eye (LE). The patient's best corrected visual acuity was 10/10 in the RE and hand motion in the LE. Cranial magnetic resonance imaging showed signs of neuropathy in the left optic nerve. In the LE, corneal haziness, closure of the iridocorneal angle, and mild mydriasis were observed and pupillary light reflex was absent. Intraocular pressure was 25 mmHg and 57 mmHg in the RE and LE, respectively. The patient was diagnosed with acute angle-closure glaucoma in the LE. Optic neuropathy was treated with intravenous pulse methylprednisolone. Left intraocular pressure was within normal range starting on the fourth day. One month after the incident, there was no sign of optic neuropathy; relative afferent pupillary defect and optic nerve swelling disappeared. Conclusions. Patients with severe headache and visual loss after snake envenomation must be carefully examined for possible optic neuropathy and angle-closure glaucoma. Early diagnosis and treatment of these cases are necessary to prevent permanent damage to optic nerves.

Low-dose cytosine arabinoside-induced syptomatic bradycardia in a patient with acute myeloid leukemia.

Cytosine arabinoside (Ara-C) is one of the critical agents for the treatment of acute myeloid leukemia (AML). The toxicity profile of Ara-C is highly dependent on the dose and schedule of administration. Cardiologic complications associated with Ara-C are rare. These side effects were reported with high doses of cytarabine (1-3 g/m2, 6-12 doses) in the literature. Herein, we report a patient who developed symptomatic sinus bradycardia while receiving low-dose Ara-C therapy for AML. A 45-year-old female patient diagnosed with AML was treated with standard remission induction chemotherapy protocol that includes 3 days of anthracycline and 7 days of low-dose (100-200 mg/m2 2-1) Ara-C. The same chemotherapy regimen was applied again on the 15th day of admission. During the second chemotherapy cycle, the patient developed symptomatic sinus bradycardia. All causes except Ara-C were excluded after required investigational procedures. Ara-C infusion was discontinued for a while and after her symptoms passed chemotherapy was completed with atropine support. Cardiac toxicity is scarce with Ara-C. We want to remind that clinicians should be aware of this potential toxic manifestation even in low doses of the medication, especially as Ara-C is widely used in the treatment of leukemia. .

Bilateral femoral neck fracture-related hyperparathyroidism.

Bilateral femoral neck fracture is not common as unilateral femoral fracture. Femoral neck fracture generally occurs by the high energized traumas. Traffic accidents and fallings are the most common reason for this fracture kind. But suddenly and minor traumatic fractures is not common. Especially, in the hormonal and pathogenic fractures is not common. In this case minor traumatic bilateral femoral fracture is presented. The fracture occurs in the background of critical medical condition by hyperparathyroidism. It can be said chronic hyperparathyroidism conditions must be determined for femoral neck fracture. Because these patients many times fell little disturbed by this fracture, diagnosis can be missed many times.