Acute kidney injury in critically ill children with COVID-19 and MIS-C.

BACKGROUND: This study's objective was to investigate the incidence of acute kidney injury (AKI) in children with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and multisystem inflammatory syndrome (MIS-C) and to report our clinical experience. METHODS: Acute COVID-19 and MIS-C-diagnosed patients observed in two pediatric intensive care units (PICUs) between 2019 and 2021 were examined for AKI and retrospectively compared to children with AKI. RESULTS: The study comprised 163 children, of whom 98 (60.1%) were diagnosed with acute COVID-19 and 65 (39.9%) with MIS-C. AKI was observed in 40 (40.8%) of the acute COVID-19 patients and 18 (27.7%) of the MIS-C patients. Low calcium level and hypotension were linked with AKI at initial presentation (OR: 0.56, 95% CI: 0.369-0.560, p = 0.006 and OR: 3.64, 95% CI: 1.885-7.152, p = 0.001, respectively). A history of nephrotoxic medication usage played an essential role in the development of AKI in patients who acquired AKI after hospitalization (p = 0.001, odds ratio: 9.32, confidence interval: 3.106-27.973). In clinical practice, individuals with respiratory distress and cough had a high chance of having AKI (OR: 4.47, 95% confidence interval: 2.25-8,892 and OR: 3.48, 95% confidence interval: 1.76-6.88). AKI patients had a greater demand for respiratory assistance and a longer period of stay in the PICU. CONCLUSIONS: AKI in the COVID-19 and MIS-C patient groups is related with increased mortality and extended hospitalization, according to the findings. These statistics imply that identifying and preventing risk factors is necessary. A higher resolution version of the Graphical abstract is available as Supplementary information.

Investigation of the effects of Achillea millefolium extract in diabetic rats with second-degree burns.

Our aim was to investigate the effects of Achillea millefolium on wound healing in second-degree burns formed in diabetic rats. This study was conducted at the Kafkas University Experimental Research Center. 20 Sprague Dawley rats were divided into 2 groups. Group I (n=10 rats) was the Control group and contained the diabetic rats with burn injury. Group II (n=10 rats) was the group where burn injury was created and Achillea millefolium was administered to diabetic rats. The backs of the rats were shaved so as to include 30% of the body area. A 10% lanolin extract was administered for 14 days after the burn injury was created. Tissue was obtained from the burn area of the rats sacrificed. No significant difference was found in Group II in terms of the severity of the dermatitis and inflammatory cell reactions when compared to Group I. No significant difference was observed between FGFR1immunoreactivity in the epidermis and dermis in Group I. While FGFR1immunoreactivity in 3 rats in Group II was similar to Group I, strong immunore activity that was more prominent in the epidermis was found in 7 rats in Group II. We believe that Achillea millefolium contributes to wound healing in burn injury due to its antioxidant and anti-inflammatory properties.

Effects of Cinnamomum cassia extract on oxidative stress, immunreactivity of iNOS and impaired thoracic aortic reactivity induced by type II diabetes in rats

Type II diabetes is known to cause neuropathy, nephropathy and retinopathy. However, cardiovascular disorders associated with diabetes have been ignored. In traditional medicine, cinnamon (Cinnamomum cassia) bark has been used for its abilities to relieve fever, inflammation and chronic bronchitis. In the present study, the effect of Cinnamomum cassia extract (CN) on the thoracic aorta in an experimental type II diabetes model was investigated. In rats administered with nicotinamide + streptozotocin, significant endothelial dysfunction and oxidative stress were characterised by increased inducible nitric oxide synthase (iNOS) and decreased insulin/proinsulin levels. This impairment was prevented by administering 1000 mg/kg metformin or 500-1000-1500 mg/kg CN. CN administration attenuated the inflammatory response by decreasing the levels of malondialdehyde (MDA), Nitric oxide (NO) and increasing Glutathione peroxidase (GPx), glutathione (GSH). In addition, CN administration was shown to cause down-regulating effects on iNOS in thoracic aorta. These findings reveal that CN could prevent chronic complications of experimentally induced type II diabetes by attenuating inflammation, oxidant/antioxidant imbalance, and normalised contraction and relaxion responses in the thoracic aorta.

Liver transplantation from a deceased donor with ß-thalassemia intermedia is not contraindicated: A case report.

The use of extended criteria donors who might have previously been deemed unsuitable is an option to increase the organ supply for transplantation. This report presents a pediatric case of a successful liver transplantation from a donor with ß-thalassemia intermedia. A patient, 6-year-old female, with a diagnosis of cryptogenic liver cirrhosis underwent deceased donor liver transplantation from a thalassemic donor. Extreme hyperferritinemia was detected shortly after transplantation. The most probable cause of hyperferritinemia was iron overload secondary to transplantation of a hemosiderotic liver. Hepatocellular injury due to acute graft rejection might have contributed to elevated ferritin levels by causing release of stored iron from the hemosiderotic liver graft. Iron chelation and phlebotomy therapies were started simultaneously in the early postoperative period to avoid iron-related organ toxicity and transplant failure. Follow-up with monthly phlebotomies after discharge yielded a favorable outcome with normal transplant functions. Thalassemia intermedia patients can be candidates of liver donors to decrease pretransplant waitlist mortality. After transplantation of a hemosiderotic liver, it is important to monitor the recipient in terms of iron overload and toxicity. Early attempts to lower iron burden including chelation therapy and/or phlebotomy should be considered to avoid organ toxicity and transplant failure.

Determination of Helicobacter pylori antibiotic resistance patterns in pediatric gastroenterology patients: the Hacettepe experience.

In this study, our aim was to show the antibiotic resistance patterns of Helicobacter pylori (H. pylori) strains isolated from patients who had undergone esophagogastroduodenoscopy at Hacettepe University. Ninety-three culturepositive patients with no history of H. pylori treatment were included in the study. MIC values against clarithromycin, metronidazole, amoxicillin and tetracycline were evaluated by gradient strips. In the 93 strains, no resistance against tetracycline and amoxicillin was observed. Clarithromycin resistance was detected in 28 (30.1%) and metronidazole resistance in 45 (48.4%) patients' strains. Resistance to clarithromycin and metronidazole, respectively, was observed in three age groups as follows: in 3 (17.6%) and 5 (29.4%) strains in the 5-9 age group; in 13 (30.9%) and 16 (38.1%) strains in the 10-14 age group; and in 12 (35.3%) and 24 (70.6%) strains in the 15-19 age group. Antibiotic susceptibility testing prior to treatment would prevent the administration of useless treatments. It is therefore recommended that such testing be performed before planning the treatment.

Serum selenium concentrations in cirrhotic children.

BACKGROUND/AIMS: Selenium is an essential trace element for humans. Plasma selenium concentration is decreased in adults with cirrhosis. We aimed to investigate the serum selenium concentration in cirrhotic children. METHODS: The serum selenium concentration of 38 patients was determined by spectrofluorometric method. The results of the patients were compared with those of 41 age- and gender-matched healthy children. Correlations between the liver function tests, Child classes and serum selenium concentrations in cirrhotic children were also investigated. RESULTS: The mean serum selenium concentration in cirrhotic children was significantly lower than that of controls (42.4 ± 8.2 µg/L vs 64.4 ± 16.9 µg/L, p<0.05). There was no significant difference between the serum selenium concentrations of cirrhotic children who were in Child-Pugh class A versus B+C (p>0.05). Except for serum aspartate aminotransferase level (Pearson coefficient = -0.34), there was no correlation between serum selenium concentration and liver function tests in cirrhotic children. CONCLUSIONS: Serum selenium concentration in cirrhotic children was found to be low; supportive selenium administration may be beneficial in cirrhotic children in appropriate cases.

Effectiveness of melatonin on aflatoxicosis in chicks.

The efficacy of melatonin co-administration on aflatoxicosis in chicks was investigated. Ross PM3 breed chicks were divided into groups of 10 and given conventional feed. One of the groups was kept as a control (C), and the others were given 150ppb aflatoxin (AF1), 300ppb aflatoxin (AF2), 150ppb aflatoxin plus 10mg/kg/bwt melatonin (AF1+M), 300ppb aflatoxin plus 10mg/kg/bwt melatonin (AF2+M), 10mg/kg/bwt melatonin (M), and 1% ethanol (E). After 21 day-treatment period, the chicks were sacrificed, liver and kidney tissues were collected, processed for immuno-histochemical staining, in situ TUNEL method, and biochemical analyses. Vacuolar degeneration, necrosis, bile duct hyperplasia in liver, and mild tubular degeneration in kidney were detected in AF groups. Pathological changes were markedly reduced in AF+M groups, and a microscopic view similar to group C was observed. Increased immunoreactivity against inducible nitric oxide synthase (iNOS) and nitrotyrosine was detected in AF groups compared to weak immunoreactivity in group C. Immunoreactivity in AF+M groups was markedly reduced compared to AF groups and was similar to group C in liver and kidney. Many apoptotic cells were detected in the livers of AF groups, whereas there were no apoptotic cells in AF+M groups. While reduced glutathione (GSH) levels in liver and kidney of AF groups were greatly reduced, malondialdehyde (MDA) levels increased. With melatonin co-administration, the levels of GSH and MDA approached to the values of group C. These results indicated that nitrosative tissue degeneration caused by aflatoxin could be greatly reduced by melatonin supplementation in chicks.

Compositions and antimicrobial activities of the essential oils of two Hypericum species from Turkey.

The chemical compositions of essential oils obtained from Hypericum hyssopifolium var. microcalycinum and Hypericum lysimachioides var. lysimachioides were analysed by using GC and GC-MS. Caryophyllene oxide was found to be the major component. The essential oils of both Hypericum species showed antimicrobial activity against nine microorganism at a concentration of 60 to 80 microg/ml.

The antimicrobial activity of essential oils of Hypericum scabrum, Hypericum scabroides and Hypericum triquetrifolium.

The essential oils of Hypericum scabrum, Hypericum scabroides and Hypericum triquetrifolium were studied for the first time for their antimicrobial activity against nine organisms. All the essential oils exhibited some broad spectrum antibacterial activity, at a concentration of 80 microg/mL. The essential oils of Hypericum species showed antibacterial activity against the tested organisms and a yeast.