Efficacy of Hemoperfusion in Severe and Critical Cases of COVID-19.

INTRODUCTION: Uncontrolled overproduction of inflammatory mediators is predominantly observed in patients with severe COVID-19. The excessive immune response gives rise to multiple organ dysfunction. Implementing extracorporeal therapies may be useful in omitting inflammatory mediators and supporting different organ systems. We aimed to investigate the effectiveness of hemoperfusion in combination with standard therapy in critically ill COVID-19 patients. METHOD: We conducted a single-center, matched control retrospective study on patients with confirmed SARS-CoV-2 infection. Patients were treated with hemoperfusion in combination with standard therapy (hemoperfusion group) or standard treatment (matched group). Hemoperfusion or hemoperfusion and continuous renal replacement therapies were initiated in the hemoperfusion group. The patients in the matched group were matched one by one with the hemoperfusion group for age, sex, oxygen saturation (SPO2) at the admission, and the frequency of using invasive mechanical ventilation during hospitalization. Two types of hemoperfusion cartridges used in this study were Jafron© (HA330) and CytoSorb® 300. RESULT: A total of 128 COVID-19-confirmed patients were enrolled in this study; 73 patients were allotted to the matched group and 55 patients received hemoperfusion. The median SPO2 at the admission day in the control and hemoperfusion groups was 80% and 75%, respectively (p value = 0.113). The mortality rate was significantly lower in the hemoperfusion group compared to the matched group (67.3% vs. 89%; p value = 0.002). The median length of ICU stay was statistically different in studied groups (median, 12 days for hemoperfusion group vs. 8 days for the matched group; p < 0.001). The median final SPO2 was statistically higher in the hemoperfusion group than in the matched group, and the median PaCO2 was lower. CONCLUSION: Among critically ill COVID-19 patients, based on our study, the use of hemoperfusion may reduce the mortality rate and improve SPO2 and PaCO2.

Therapeutic effect of curcumin in gastrointestinal cancers: A comprehensive review.

Gastrointestinal (GI) cancers with a high global prevalence are a leading cause of morbidity and mortality. Accordingly, there is a great need to develop efficient therapeutic approaches. Curcumin, a naturally occurring agent, is a promising compound with documented safety and anticancer activities. Recent studies have demonstrated the activity of curcumin in the prevention and treatment of different cancers. According to systematic studies on curcumin use in various diseases, it can be particularly effective in GI cancers because of its high bioavailability in the gastrointestinal tract. Nevertheless, the clinical applications of curcumin are largely limited because of its low solubility and low chemical stability in water. These limitations may be addressed by the use of relevant analogues or novel delivery systems. Herein, we summarize the pharmacological effects of curcumin against GI cancers. Moreover, we highlight the application of curcumin's analogues and novel delivery systems in the treatment of GI cancers.

The activity of encapsulated meglumine antimoniate in stearylamine-bearing liposomes against cutaneous leishmaniasis in BALB/c mice.

Topical treatment of cutaneous leishmaniasis has demonstrated appropriate alternative for reducing toxicity of conventional treatments, improving patients' compliance and reducing treatment costs. Furthermore, outbreak of cutaneous leishmaniasis in war and conflict zones emerges finding an effective, economical and user-friendly treatment. In the context of liposomal topical drug delivery, we developed and characterized meglumine antimoniate (MA) loaded liposomes and investigated their effectiveness in topical treatment of cutaneous leishmaniasis. Previously, we showed the promising use of liposomal formulation of MA in treatment of cutaneous leishmaniasis in BALB/c mice. Here, we included Stearylamine (SA) in liposomes' structure which has antileishmanial activity by itself. . Size and encapsulation efficiency of liposomes were measured and in vitro permeation was performed using mice model. In vitro toxicity of liposomes was measured against leishmania promastigotes and amastigotes. Liposomes were used topically twice a day for 4 weeks to treat leishmania lesions in BALB\c mice model. In vitro permeation study showed liposomal formulations improved the percent of MA permeation compared with MA-cream. Promastigotes and amastigotes assay results showed significant enhanced toxicity in Liposomal-MA containing SA compared to Lip-MA. In BALB\c mice model of cutaneous leishmaniasis, liposomal groups exhibited significantly smaller lesion size compared to control groups (p < 0.01). In addition, the spleen parasite burden was significantly (P < 0.01) lower in mice treated with selected liposomal MA than in mice treated with PBS, control liposomes and MA cream. The results of this study showed that SA-liposomes encapsulated with MA might be useful as a candidate for the topical treatment of CL which merit further investigation.

Integration of suicide prevention program into primary health care network: a field clinical trial in Iran.

BACKGROUND: Suicide prevention is one of the priorities in policies of Iranian Ministry of Health and Medical Education (MHME). The suicide prevention program had two main parts of identifying and treatment of the depressed and suicide high risk individuals by Primary Health Care (PHC) network. The main aim of this study was to evaluate the results of integration of the program into PHC network in two cities with moderate to high rate of suicide with diverse socio-cultural backgrounds. METHODS: This work as a field trial study was conducted in Nahavand and Savojbolagh from April 2010 to March 2011 (12 months). A screening tool was designed. Required capacities such as treatment, referral and registration system were provided six months before the main study. The intervention phase (for one year) including the treatment process and five consultation sessions was conducted to identify depressed people and individuals with high risk of suicide. The data were analyzed by Chi square test. RESULTS: After one year of intervention, the rate of committing suicide became 4.98 and 3.36 per one hundred thousand population in Nahavand and Savojbolagh, respectively (16 and 1.6 per 100,000 in the year of before intervention respectively, 2009-2010). The female: male ratio of committing suicide was 2:1 in Nahavand and 1:1 in Savojbolagh. The most common method of committing suicide was drug intoxication in both cities. The identified cases by health workers at rural setting were 33 to 44 per 1000, in which 1.3 cases per 1000 population had been approved by general physicians. CONCLUSION: This study approved the feasibility and efficacy of integration of suicide prevention program into PHC. The increased rate of suicide in Savojbolagh could be related to low rate of screening and lack of treatment facilities (hospitalization and electroconvulsive therapy (ECT), and part-time psychiatrist. Increasing the PHC capacities could improve the health network efficiency to identify and manage depressed and at risk of suicide individuals. Screening tool/s and method have to be improved to provide better results.

Adherence to HEI-2010 and odds of breast cancer according to the menopause status: Evidence from Middle Eastern Country.

BACKGROUND: Majority of earlier studies have assessed the association between individual healthy eating index-2010 (HEI-2010) and the odds of breast cancer (BC). However, no study has been conducted on the effect of compliance with HEI-2010 and the odds of BC in the Iranian population with a large sample size. Therefore, we aimed to investigate the relationship between the HEI-2010 and the odds of BC in the Iranian population. METHOD: This population-based case-control study included 350 newly diagnosed cases of BC and 700 healthy controls randomly selected from adult women. HEI-2010 was examined using validated questionnaires. The adherence to HEI-2010 among the participants was divided into four categories. The general characteristics of the participants in the quartiles of the HEI score for categorical variables and continuous variables were evaluated using chi-square and one-way analysis of variance, respectively. Also, using logistic regression analysis, dietary intakes were evaluated in HEI score quartiles. Also, confounding variables were adjusted in different models. RESULT: People with the highest HEI score had 60% lower odds of BC (OR: 0.40; 95% CI: 0.27, 0.57) than those with the lowest score among post-menopause women. After controlling for age and energy intake, individuals with the highest HEI score were 78% less likely to have BC compared with those with the lowest score (OR: 0.22; 95% CI: 0.14, 0.33). Adjustments for other potential confounders including demographic factors made the association stronger (OR: 0.21; 95% CI: 0.13, 0.32). This association remained significant even after taking BMI into model (OR: 0.27; 95% CI: 0.17, 0.43). CONCLUSION: Finally, in this study we found an association between HEI-2010 and odds of breast cancer. This association was particularly seen in postmenopausal women. No significant association was found between adherence to HEI-2010 and odds of BC among pre-menopausal.

Probiotics for the Management of Oral Mucositis: An Interpretive Review of Current Evidence.

Mucositis is one of the major side effects of anti-cancer therapies. Mucositis may lead to other abnormalities such as depression, infection, and pain, especially in young patients. Although there is no specific treatment for mucositis, several pharmacological and non-pharmacological options are available to prevent its complications. Probiotics have been recently considered as a preferable protocol to lessen the complications of chemotherapy, including mucositis. Probiotics could affect mucositis by anti-inflammatory and anti-bacterial mechanisms as well as augmenting the overall immune system function. These effects may be mediated through anti microbiota activities, regulating cytokine productions, phagocytosis, stimulating IgA releasement, protection of the epithelial shield, and regulation of immune responses. We have reviewed available literature pertaining to the effects of probiotics on oral mucositis in animal and human studies. While animal studies have reported protective effects of probiotics on oral mucositis, the evidence from human studies is not convincing.

Association of alternative healthy eating index and severity of pemphigus vulgaris: A cross-sectional study.

BACKGROUND: Evidence on the association between following healthy eating and the severity of pemphigus vulgaris (PV) is scarce. Therefore, the aim of this cross-sectional study aimed to investigate the relationship between adherence to the alternative healthy eating index (AHEI) and the severity of Pemphigus vulgaris disease in adults. METHODS: In this hospital-based cross-sectional study, a total of 138 pemphigus vulgaris cases were studied, of which 108 had pemphigus disease area index (PDAI) ≤15, and 30 had PDAI>15. Dietary intakes were assessed using a valid 168-item food frequency questionnaire (FFQ). To calculate the AHEI, the data received from the diet were used. The subjects of this index received a score of 1-10. The final AHEI was calculated by summing the component scores. RESULTS: After adjusting for age and sex, we found that individuals with the highest AHEI score were 72% less likely to have increased PV severity compared with those with the lowest score (OR: 0.28; 95% CI: 0.08-0.92, P trend = 0.020). Further control for another potential confounder, intake energy, made the association stronger (OR: 0.24; 95% CI: 0.06-0.88, P trend = 0.017). Also, after controlling the body mass index (BMI) confounding factor, it maintained its strong relationship (OR: 0.24; 95% CI: 0.06-0.88, P trend = 0.016). CONCLUSION: The evidence of our study shows that following the healthy eating index is associated with a reduction in the severity of pemphigus vulgaris. Prospective cohort studies are needed to confirm these findings.

The effect of vitamin C on oxidative stress indices and skin regimentation of vitiligo patients.

It has been suggested that vitamin C is involved in suppressing stress oxidation signaling in vitiligo disease. However, the effect of vitamin C supplementation on stress oxidative factors has not been investigated in vitiligo subjects. This study was designed to examine the effects on vitamin C supplementation on serum levels of stress oxidative factors and regimentation in vitiligo patients. Forty-four vitiligo patients will be recruited in this study. After block matching for sex and number of phototherapy sessions, they will be randomly assigned to receive 1000 mg/d vitamin C or placebo for 8 weeks. The weight, height, and waist circumference of participants will be measured. Determination of serum stress oxidative indices (CAT, SOD, GPX, MDA, TOS, TAC) will be done at study baseline and at the end of the trial. Also, the regimentation will be determined using the VASI score. This is the first randomized controlled trial that will determine the effect of vitamin C supplementation on serum levels of stress oxidative indices and regimentation in vitiligo patients. The results of this trial will provide clinical evidence on the effectiveness of vitamin C supplementation in controlling oxidative stress in vitiligo patients. Trial registration number: This study is registered in the Iranian Registry of Clinical Trials website (available at http://www.irct.ir , identifier: IRCT20230123057193N1), Registration date: 2023/04/17.

Ion-exchangeable cobalt polysulfide chalcogel.

We present a promising approach in synthetic chalcogel chemistry that is extendable to a broad variety of inorganic spacers. Polychalcogenide aerogels with ion-exchange properties are demonstrated in cobalt polysulfide. The new materials show a broad range of pore sizes and high surface area of 483 m(2)/g.

Therapeutic Potential of Resveratrol in the Treatment of Glioma: Insights into its Regulatory Mechanisms.

Glioma is a prevalent primary tumor of the brain and spinal cord. Several biological pathways play an important role in the pathogenesis of glioma, including apoptosis, autophagy, cell cycle arrest, migration, and invasion. The low efficacy of chemotherapy and radiation therapy has forced researchers to evaluate alternative treatments for glioma. In this regard, flavonoids have been studied. Resveratrol is a flavonoid with distinct pharmacological activities that has been used in the treatment of various diseases. Several recent studies have also focused on its therapeutic efficacy against glioma. Resveratrol exerts its pharmacological attributes by regulating various molecular and cellular pathways. Here, we review contemporary knowledge in support of the use of resveratrol in the treatment of glioma and its effects on various molecular and cellular mechanisms.

Silymarin (milk thistle extract) as a therapeutic agent in gastrointestinal cancer.

Silymarin contains a group of closely-related flavonolignan compounds including silibinin, and is extracted from Silybum marianum species, also called milk thistle. Silymarin has been shown to protect the liver in both experimental models and clinical studies. The chemopreventive activity of silymarin has shown some efficacy against cancer both in vitro and in vivo. Silymarin can modulate apoptosis in vitro and survival in vivo, by interfering with the expression of cell cycle regulators and apoptosis-associated proteins. In addition to its anti-metastatic activity, silymarin has also been reported to exhibit anti-inflammatory activity. The chemoprotective effects of silymarin and silibinin (its major constituent) suggest they could be applied to reduce the side effects and increase the anti-cancer effects of chemotherapy and radiotherapy in various cancer types, especially in gastrointestinal cancers. This review examines the recent studies and summarizes the mechanistic pathways and down-stream targets of silymarin in the therapy of gastrointestinal cancer.

Aluminosilicate relatives: Chalcogenoaluminogermanates Rb(3)(AlQ(2))(3)(GeQ(2))(7) (Q = S, Se).

The new compounds Rb(3)(AlQ(2))(3)(GeQ(2))(7) [Q = S (1), Se (2)] feature the 3D anionic open framework [(AlQ(2))(3)(GeQ(2))(7)](3-) in which aluminum and germanium share tetrahedral coordination sites. Rb ions are located in channels formed by the connection of 8, 10, and 16 (Ge/Al)S(4) tetrahedra. The isostructural sulfur and selenium derivatives crystallize in the space group P2(1)/c. 1: a = 6.7537(3) Å, b = 37.7825(19) Å, c = 6.7515(3) Å, and ß = 90.655(4)°. 2: a = 7.0580(5) Å, b = 39.419(2) Å, c = 7.0412(4) Å, ß = 90.360(5)°, and Z = 2 at 190(2) K. The band gaps of the congruently melting chalcogenogermanates are 3.1 eV (1) and 2.4 eV (2).

The Therapeutic Potential of Quercetin in Parkinson's Disease: Insights into its Molecular and Cellular Regulation.

Parkinson's disease (PD) is a chronic and progressive neurodegenerative disorder characterized by the progressive death of dopaminergic neurons in the substantia nigra pars compacta (SNc). PD is a multifactorial disorder, with several different factors being suggested to play a synergistic pathophysiological role, including oxidative stress, autophagy, underlying pro-inflammatory events and neurotransmitters abnormalities. Overall, PD can be viewed as the product of a complex interaction of environmental factors acting on a given genetic background. The importance of this subject has gained more attention to discover novel therapies to prevent as well as treat PD. According to previous research, drugs used to treat PD have indicated significant limitations. Therefore, the role of flavonoids has been extensively studied in PD treatment. Quercetin, a plant flavonol from the flavonoid group, has been considered as a supplemental therapy for PD. Quercetin has pharmacological functions in PD by controlling different molecular pathways. Although few studies intended to evaluate the basis for the use of quercetin in the context of PD have been conducted so far, at present, there is very little evidence available addressing the underlying mechanisms of action. Various principal aspects of these treatment procedures remain unknown. Here, currently existing knowledge supporting the use of quercetin for the clinical management of PD has been reviewed.

A recipe for new organometallic polymers and oligomers? Synthesis and structure of an oligo- and a polymeric arrangement of P-S anions.

A route to organometallic polymers and oligomers is described using metal complexes with P/S-ligands as examples.

Reactions of P/S-containing proligands with coinage metal salts: a new route to polynuclear complexes with unusual structural types.

The reactions of P/S-precursors with coinage metal alkoxides and carboxylates offer new perspectives for the synthesis of complex metal aggregates.

The anhydride route to Group 15/16 ligands in oligomeric and polymeric environments: from metal complexes to supraionic chemistry.

The aim of this paper is to introduce a synthetic concept suitable for the preparation of a broad variety of compounds. The so-called anhydride route (in this article the term anhydride is used for compounds derived from corresponding acids by formal loss of H2O, H2S and H2Se) has so far led to a range of unusual Group 15/16 ligands in oligomeric and polymeric environments. Commonly, reactions of neutral precursor molecules, for example, [{RP(S)(mu-S)}2] (R=4-anisyl) Lawesson's reagent or [{PhP(Se)(mu-Se)}2] Woollins's reagent and metal salts are performed to result in novel coordination compounds in which ligands and metal atoms form coordination oligomers and polymers. An attempt is made to relate the outcome of the investigations to the type of metal used. By relating the strength of ionic interactions, which correspond to metal-donor distances, to phenomena observed in the solid-state structures, an aspect of supraionic chemistry is described. Chemistry of and beyond novel Group 15/16 anions is further discussed using a novel approach in coordination chemistry where the chemical nature of ligands is unknown prior to the experiment despite the use of a range of similar starting materials.

Novel P-Se anions and their copper complexes.

Three reactions of Cu(i) thiolates and Woollins' reagent (W.R.) give rise to novel copper complexes with unusual P/Se anions.

Polymeric organometallic architectures of novel P-Se anions.

The characterisation of a series of compounds obtained from Woollins' reagent (W.R.) offers a novel approach to organometallic coordination polymers. The syntheses were achieved by nucleophilic ring-opening reactions of W.R. with metal salts and crystallisation using solvent-diffusion techniques. One-dimensional coordination polymers are formed as a result, and we demonstrate that the dimensionality of the polymers can be influenced by using hydrated metal salts or by the construction of heterometallic arrangements.

Metal thiophosphonates and related compounds: an emerging area of supramolecular coordination chemistry.

Nine new compounds containing PS ligands of the types [P(OtBu)S3]2-, [ArP(StBu)S2]- and [ArP(OtBu)S2]- are reported (Ar = 4-anisyl). It is demonstrated that the topology of alkali metal ion and ligand composition influence the structure of supramolecular arrangements.

Polymeric arrangements of P-Se anions and a first insight into their reactivity.

The reactions of the P/Se-precursor Woollins' reagent [PhP(Se)mu-Se]2 with alkali-metal salts offer new perspectives for the synthesis of metal aggregates containing P-Se anions. Depending on the alkali-metal thiolates polymeric arrangements of [PhPSe3]2- or [PhPSe2Se-SeSe2PPh]2- dianions are observed and the mechanisms of their formation described.