A novel fractional order model of SARS-CoV-2 and Cholera disease with real data.

This study presents a novel approach to investigating COVID-19 and Cholera disease. In this situation, a fractional-order model is created to investigate the COVID-19 and Cholera outbreaks in Congo. The existence, uniqueness, positivity, and boundedness of the solution are studied. The equilibrium points and their stability conditions are achieved. Subsequently, the basic reproduction number (the virus transmission coefficient) is calculated that simply refers to the number of people, to whom an infected person can make infected, as R 0 = 6 . 7442389 e - 10 by using the next generation matrix method. Next, the sensitivity analysis of the parameters is performed according to R 0 . To determine the values of the parameters in the model, the least squares curve fitting method is utilized. A total of 22 parameter values in the model are estimated by using real Cholera data from Congo. Finally, to find out the dynamic behavior of the system, numerical simulations are presented. The outcome of the study indicates that the severity of the Cholera epidemic cases will decrease with the decrease in cases of COVID-19, through the implementation and follow-up of safety measures that have been taken to reduce COVID-19 cases.

Folic acid conjugated PAMAM-modified mesoporous silica-coated superparamagnetic iron oxide nanoparticles for potential cancer therapy.

In this study, novel folate-receptor-targeted polyamidoamine (PAMAM) dendrimer functional mesoporous silica-coated magnetic nanoparticles were prepared for drug delivery agents for photodynamic therapy applications. The surface of the magnetic nanoparticles was coated with mesoporous silica (M-MSN). The M-MSN nanoparticles were functionalized with siloxane-cored PAMAM dendrons (generation 1 to 3). The surface of the M-MSN-PAMAM nanocarriers was targeted with folic acid. Indocyanine green (ICG) a near-infrared dye was loaded in the M-MSN-PAMAM nanocarriers and the photodynamic therapy efficiency of the drug-loaded nanocarriers was evaluated on MCF-7 cells. MCF-7 cells were subjected to tissue culture E-Plate that was used to generate dynamic real-time data by measuring electrical impedance across interdigitated microelectrodes on the bottom of the plate. Light source (LEDs) was designed as a system that fit 96 well-plate and cells were irradiated at 785 nm for 20 min. Also, these results were confirmed by WST-1 assay in dark and light conditions for MCF-7 cells. The results showed that in vitro application of ICG loaded M-MSN-PAMAM-FA causes apoptosis in the MCF-7 cell line.

Fractional order modelling of omicron SARS-CoV-2 variant containing heart attack effect using real data from the United Kingdom.

In this study, a new approach to COVID-19 pandemic is presented. In this context, a fractional order pandemic model is developed to examine the spread of COVID-19 with and without Omicron variant and its relationship with heart attack using real data from the United Kingdom. In the model, heart attack is adopted by considering its relationship with the quarantine strategy. Then, the existence, uniqueness, positivity and boundedness of the solution are studied. The equilibrium points and their stability conditions are achieved. Subsequently, we calculate the basic reproduction number (the virus transmission coefficient) that simply refers to the number of people, to whom an infected person can make infected, as R 0 = 3.6456 by using the next generation matrix method. Next, we consider the sensitivity analysis of the parameters according to R 0 . In order to determine the values of the parameters in the model, the least squares curve fitting method, which is one of the leading methods in parameter estimation, is benefited. A total of 21 parameter values in the model are estimated by using real Omicron data from the United Kingdom. Moreover, in order to highlight the advantages of using fractional differential equations, applications related to memory trace and hereditary properties are given. Finally, the numerical simulations are presented to examine the dynamic behavior of the system. As a result of numerical simulations, an increase in the number of people who have heart attacks is observed when Omicron cases were first seen. In the future, it is estimated that the risk of heart attack will decrease as the cases of Omicron decrease.

The prognostic significance of vitamin D deficiency in patients with COVID-19 pneumonia.

BACKGROUND: Vitamin D has anti-inflammatory and immunomodulatory effects via the downregulation of pro-inflammatory cytokines. We aimed to demonstrate the effect of vitamin D levels on survival in COVID-19 patients. MATERIALS AND METHODS: 207 COVID-19 patients were included in the study. Serum vitamin D levels were measured, and patients with levels <20 ng/ml or 21 to 30 ng received a single 300.000 IU dose of vitamin D. RESULTS: Of 207 patients, 37 received vitamin D, while 170 did not. Demographic, radiologic and mean laboratory values were similar between the groups. The mean plasma vitamin D level without vitamin D support (n=170) was 50.82±16.12 ng/ml (30.28-81.35) vs. 16.98±6.2 ng/ml (4.20-28.30) in vitamin D group. The most remarkable finding were the mortality rates; while only 1 patient (2.7 %) died in the vitamin D group, 24 patients (14.1 %) died in no vitamin D supplementation group (p=0.038). CONCLUSION: Although a few retrospective studies put forth a relation between vitamin D deficiency and COVID-19 course severity there is still paucity of data about the efficacy of vitamin supplementations in COVID-19 patients. A single 300.000 IU dose of vitamin D seems to represent a useful, practical, and safe adjunctive approach for the treatment or prevention of COVID-19 (Tab. 1, Fig. 1, Ref. 30).

The use of prone positioning in severe COVID-19 outside the intensive care unit.

OBJECTIVES: It was aimed to demonstrate the applicability of the prone position with high-flow oxygen to COVID-19 patients with severe respiratory failure in the service in September when the number of cases and the need for intensive care were increased. MATERIAL AND METHODS: The prone position was applied for a minimum of 30-minute periods for at least four hours a day. The patients' oxygen saturation levels and respiration rates were monitored before and 30 minutes after prone positioning. RESULTS: Ten patients, nine males (9/1, M/F), were included in the study. Mean oxygen saturation at baseline was 75.8±12.14 (min: 50 %; max: 90 %) and all patients had high oxygen demand. The oxygen saturation of the patients differed significantly before and after (83.4±6.38 %; 90±5.31 %, p <0.001) prone positioning. Similarly, respiration rates differed significantly before and after (23.9±6; 21.4±4.97, p <0.001) prone positioning. Two patients died during treatment. CONCLUSION: This study highlights the promise of prone positioning performed in ward conditions for improving oxygenation in COVID-19. While the study contains a small group, it may provide guidance for the clinical management of COVID-19 patients to prevent the need for intensive care in the challenging course of therapy (Tab. 2, Fig. 2, Ref. 15).

Miller-Fisher syndrome after COVID-19: neurochemical markers as an early sign of nervous system involvement.

Miller-Fisher syndrome (MFS) is classified as a variant of Guillain-Barré syndrome (GBS), accounting for 5%-25% of all GBS cases. Since the coronavirus disease-2019 (COVID-19) outbreak, increasing evidence has been reported of the neurological manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, affecting both the central and peripheral nervous system. Here we report the clinical course, detailed cerebrospinal fluid (CSF) profile including CSF/blood antibody status, and neurochemical characteristics of a patient with a typical clinical presentation of MFS after a positive SARS-CoV-2 infection test.

Tissue characterization by T1 and T2 mapping cardiovascular magnetic resonance imaging to monitor myocardial inflammation in healing myocarditis.

AIMS: Monitoring disease activity in myocarditis is important for tailored therapeutic strategies. This study evaluated the ability of T1 and T2 mapping cardiovascular magnetic resonance (CMR) to monitor the course of myocardial inflammation in healing myocarditis. METHODS AND RESULTS: Forty-eight patients with strictly defined acute myocarditis underwent CMR at 1.5 T in the acute stage, at 3-months (n = 39), and at 12-months follow-up (FU) (n = 21). Normal values were obtained in a control group of 27 healthy subjects. The CMR protocol included standard ('Lake-Louise') sequences as well as T1 (modified Look-Locker inversion recovery sequence, MOLLI) and T2 (gradient- and spin-echo sequence, GraSE) mapping. T1, T2, and extracellular volume (ECV) maps were generated using an OsiriX plug-in. Native myocardial T1, T2, and ECV values were increased in the acute stage, but declined with healing of myocarditis. The performances of global native T1 and T2 to differentiate acute from healed myocarditis stages were significantly better compared with all other global CMR parameters with AUCs of 0.85 (95% CI, 0.76-0.94) and 0.83 (95% CI, 0.73-0.93). Furthermore, regional native T1 and T2 in myocarditis lesions provided AUCs of 0.97 (95% CI, 0.93-1.02) and 0.93 (95% CI, 0.85-1.01), which were significantly superior to any other global or regional CMR parameter. CONCLUSION: Healing of myocarditis can be monitored by native myocardial T1 and T2 measurements without the need for contrast media. Both native myocardial T1 and T2 provide an excellent performance for assessing the stage of myocarditis by CMR.

The chemokine CXCL13 is elevated in the cerebrospinal fluid of patients with neurosyphilis.

BACKGROUND: The chemokine CXCL13 has been discussed as a diagnostic parameter with high specificity for Lyme neuroborreliosis (LNB) and as a marker of disease activity. Neurosyphilis and LNB share similar characteristics. We investigated retrospectively CXCL13 levels in the cerebrospinal fluid (CSF) of patients with neurosyphilis at initial diagnosis and during treatment. RESULTS: Five patients with neurosyphilis were identified retrospectively using an electronic database in a tertiary care hospital from 2005 to 2012. CXCL13 levels were measured using an ELISA. Five patients with definite LNB and 10 patients with multiple sclerosis (MS) served as controls. Median CXCL13 levels at baseline were 972 pg/mL for neurosyphilis patients, 8,000 pg/mL for LNB patients, and 7.8 pg/mL for MS patients. Patients with LNB and neurosyphilis showed significantly higher CXCL13 levels in their CSF compared to MS patients (p < 0.05, p < 0.001, respectively). CXCL13 levels in the CSF declined during treatment. CONCLUSION: CXCL13 levels in the CSF of patients with neurosyphilis can be as high as in patients with LNB, exceeding the proposed threshold of 250 pg/mL for the diagnosis of LNB. Patients with encephalitic/myelitic syndromes appear to have especially high levels of CXCL13. Clinicians should be aware that high levels of CXCL13 are not found exclusively in LNB but also in other infectious diseases of the CNS.

Raman, FT-IR, NMR spectroscopic data and antimicrobial activity of bis[micro2-(benzimidazol-2-yl)-2-ethanethiolato-N,S,S-chloro-palladium(II)] dimer, [(micro2-CH2CH2NHNCC6H4)PdCl]2.C2H5OH complex.

The 1,6-bis(benzimidazol-2-yl)-3,4-dithiahexane (1) ligand and its palladium(II) chloride complex [(micro(2)-SCH(2)CH(2)NHNCC(6)H(4))PdCl](2)xC(2)H(5)OH (2) have been synthesised and characterised by spectroscopical methods. The crystal structure of the triclinic title compound (P-1 (no. 2), a=879.6(1) pm, b=984.4(1) pm, c=1471.8(2) pm; alpha=94.330(6) degrees , beta=98.546(6) degrees , gamma=99.258(7) degrees , Z=2) was solved from X-ray single crystal diffraction data. In the binuclear complex, each palladium atom is coordinated in a slightly distorted square-planar arrangement by one nitrogen, two bridging sulphurs and one terminal chlorine atom. Molar conductivity, FT-Raman, FT-IR (mid-i.r., far-i.r.), (1)H and (13)C NMR spectra of the complex (2) have been recorded and show a good accordance with the square-planar geometry. The antimicrobial and antifungal activities of palladium(II) chloride, free ligand, its hydrochloride salt and the complex were evaluated using the disk diffusion method in dimethyl sulfoxide (DMSO) as well as the minimal inhibitory concentration (MIC) the dilution method, against 10 bacteria and five yeast cultures. The results for the antibacterial from the disk diffusion method were assessed in side-by-side comparison with those for penicillin-g, ampicillin, cefotaxime, vancomycin, ofloxacin and tetracycline. Antifungal activities were referenced with nystatin, ketaconazole, and clotrimazole, commercial antifungal agents. The data from the dilution procedure were compared with gentamycin as antibacterial and nystatin as antifungal agent, respectively. In most cases, the compounds tested showed broad-spectrum (Gram positive and Gram negative) activities that were comparatively more active, or as potent as referenced pharmaceutical agents. The palladium complex has the potential to generate new kind of metabolites by displaying high affinities for most of the receptors compared with palladium chloride, free ligand and its hydrochloride salt.

Impact of early cyclosporin average blood concentration on early kidney transplant failure.

This retrospective study served to examine the correlation between the degree of cyclosporin (CyA) exposure, as estimated by a single pharmacokinetic (PK) profile performed at 1 week post-transplant, and the outcome of 290 consecutive renal transplants performed over a 6-year period. For this retrospective analysis patients were stratified into four historical groups based on 12-versus 24-h PK studies and on the use of radioimmunoassay versus fluorescence polarization immunoassay methods for estimates of CyA concentrations. Four PK measures-trough concentration (C0), average concentration values (Cav; i.e., the dosing interval-corrected area under the concentration-time curve), maximum concentration (Cmax), and time to maximum concentration (tmax)-were examined as predictors of patient, graft, and rejection-free survival rates for each of the four groups individually and for all groups combined. Patients with an initial Cav > or = 550 ng/ml had higher 1-year (88%) and 6-year (66%) graft survival rates than patients with Cav < 550 ng/ml, who had 1- and 6-year graft survival rates of 80% and 59%, respectively (P = NS). Statistically significant differences were observed in graft survival rates between patients with Cav < 550 versus Cav > or = 550 ng/ml at 30 (88% vs 96%; P < 0.02), 60 (85% vs 94%; P < 0.007), 90 (85% vs 94%; P < 0.02), and 180 (83% vs 92%; P < 0.05) days. Moreover, patients with Cav < 550 ng/ml displayed more severe rejection episodes, as judged by Banff classification, than patients who displayed Cav > or = 550 ng/ml (grades II and III; 71% vs 50%; P = 0.036). In contrast, the C0, Cmax and tmax values did not correlate with patient, graft, or rejection-free survival rates. The pharmacokinetic parameter of Cav correlated strongly with early graft survival and may therefore, be a useful predictor of those renal transplant patients who may require more intensive post-transplant monitoring of CyA concentrations by serial PK studies to improve graft survival.

Effects of cyclosporine, azathioprine and prednisone on Kimura's disease and focal segmental glomerulosclerosis in renal transplant patients.

Nephrotic syndrome secondary to focal segmental glomerulosclerosis (FSGS) is a common cause of renal failure leading to transplantation. Various immunosuppressive drugs, including cyclosporine, have been used in the treatment of FSGS with varying degrees of success. The patient described herein was afflicted with end stage renal disease secondary to steroid-resistant nephrotic syndrome due to FSGS with coexistent Kimura's disease. After kidney transplantation, the patient experienced a remission of both the Kimura's disease and the nephrotic syndrome in the native kidneys, leading to the resumption of renal function by the native kidneys in spite of severe transplant glomerulopathy. This case suggests that certain cases of FSGS without extensive interstitial disease may benefit from aggressive treatment with a combination of immunosuppressive drugs.

Sodium ipodate in the treatment of toxic diffuse goiter. Short-term and long-term effects on thyrotoxicosis.

Iodinated radiocontrast medication has been successful in the treatment of thyrotoxicosis when used for short periods up to 21 days, but experience with long-term use is lacking. In the first part of this study, a group of seven patients each taking 1.5 g. sodium ipodate daily was observed for 21 days and compared to a similar group of seven thyrotoxic patients taking 400 mg. propylthiouracil (PTU) daily. Sodium ipodate brought about a more significant decrease in serum total T3 and T4 levels, and more prominent increase in reverse T3 levels in the first ten days of the treatment. In the second part, a group of seven patients with thyrotoxicosis were given sodium ipodate, 1.5 g, daily for 20 days and 0.75 g. thereafter and were compared to a similar group of seven patients who took PTU, 300 mg. daily for the first 20 days and 150 mg. daily afterwards. Serum thyroid hormone levels decreased in both groups at the end of the first month of treatment, but rose again, along with worsening of symptoms, in five patients on ipodate treatment. Therefore, sodium ipodate, an iodinated radiocontrast agent is unable to control thyrotoxicosis for longer than a month.