Heterogeneity of sensitization profiles and clinical phenotypes among patients with seasonal allergic rhinitis in Southern European countries-The @IT.2020 multicenter study.

BACKGROUND: Pollen allergy poses a significant health and economic burden in Europe. Disease patterns are relatively homogeneous within Central and Northern European countries. However, no study broadly assessed the features of seasonal allergic rhinitis (SAR) across different Southern European countries with a standardized approach. OBJECTIVE: To describe sensitization profiles and clinical phenotypes of pollen allergic patients in nine Southern European cities with a uniform methodological approach. METHODS: Within the @IT.2020 multicenter observational study, pediatric and adult patients suffering from SAR were recruited in nine urban study centers located in seven countries. Clinical questionnaires, skin prick tests (SPT) and specific IgE (sIgE) tests with a customized multiplex assay (Euroimmun Labordiagnostika, Lübeck, Germany) were performed. RESULTS: Three hundred forty-eight children (mean age 13.1 years, SD: 2.4 years) and 467 adults (mean age 35.7 years SD: 10.0 years) with a predominantly moderate to severe, persistent phenotype of SAR were recruited. Grass pollen major allergenic molecules (Phl p 1 and/or Phl p 5) ranged among the top three sensitizers in all study centers. Sensitization profiles were very heterogeneous, considering that patients in Rome were highly poly-sensitized (sIgE to 3.8 major allergenic molecules per patient), while mono-sensitization was prominent and heterogeneous in other cities, such as Marseille (sIgE to Cup a 1: n = 55/80, 68.8%) and Messina (sIgE to Par j 2: n = 47/82, 57.3%). Co-sensitization to perennial allergens, as well as allergic comorbidities also broadly varied between study centers. CONCLUSIONS: In Southern European countries, pollen allergy is heterogeneous in terms of sensitization profiles and clinical manifestations. Despite the complexity, a unique molecular, multiplex, and customized in-vitro IgE test detected relevant sensitization in all study centers. Nevertheless, this geographical diversity in pollen allergic patients imposes localized clinical guidelines and study protocols for clinical trials of SAR in this climatically complex region.

A Novel Phytotherapy Application: Preparation, Characterization, Antioxidant Activities and Determination of Anti-inflammatory Effects by in vivo HET-CAM Assay of Chitosan-based DDSs Containing Endemic Helichrysum pamphylicum P.H. Davis & Kupicha Methanolic Extract.

BACKGROUND: Numerous pharmaceutical applications for chitosan, a polysaccharide made from the shells of crustaceans by deacetylating chitin that occurs naturally, are currently being researched. Chitosan, a natural polymer, is successfully used to prepare many drug-carrier systems, such as gel, film, nanoparticle, and wound dressing. OBJECTIVE: Preparing chitosan gels without external crosslinkers is less toxic and environmentally friendly. METHODS: Chitosan-based gels containing Helichrysum pamphylicum P.H.Davis & Kupicha methanolic extract (HP) were produced successfully. RESULTS: The F9-HP coded gel prepared with high molecular weight chitosan was chosen as the optimum formulation in terms of pH and rheological properties. The amount of HP was found to be 98.83 %± 0.19 in the F9-HP coded formulation. The HP release from the F9-HP coded formula was determined to be slower and 9 hours prolonged release compared to pure HP. It was determined that HP release from F9-HP coded formulation with the DDSolver program was by anomalous (non-fickian) diffusion mechanism. The F9-HP coded formulation significantly showed DPPH free radical scavenger, ABTS•+ cation decolorizing and metal chelating antioxidant activity while weakly reducing antioxidant potential. According to the HET-CAM scores, strong anti-inflammatory activity was obtained by the F9-HP coded gel at a dose of 20 µg.embryo-1 (p<0.05 compared with SDS). CONCLUSION: In conclusion, it can be said that chitosan-based gels containing HP, which can be used in both antioxidant and anti-inflammatory treatment, were successfully formulated and characterized.

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).

Cefaclor Monohydrate-Loaded Colon-Targeted Nanoparticles for Use in COVID-19 Dependent Coinfections and Intestinal Symptoms: Formulation, Characterization, Release Kinetics, and Antimicrobial Activity.

Corona virus disease-2019 (COVID-19) emerged in Wuhan, China in December 2019 and was declared as a pandemic by the World Health Organization in March 2020. Although there is no complete treatment protocol for COVID-19, studies on this topic are ongoing, and it is known that broad-spectrum antibiotics such as cephalosporins are used for coinfections and symptoms in COVID-19 patients. Studies have shown that Staphylococcus aureus and Escherichia coli bacteria can cause symptoms such as diarrhea and coinfections accompanying COVID-19. Therefore, in this study, colon-targeted cefaclor monohydrate (CEF)-loaded poly(lactic-co-glycolic acid) (PLGA)-Eudragit S100 nanoparticles (NPs) were prepared using a nanoprecipitation technique. The particle sizes of the CEF-loaded NPs were between 171.4 and 198.8 nm. The encapsulation efficiency was in the range of 58.4%-81.2%. With dissolution studies, it has been concluded that formulations prepared with Eudragit S100 (E-coded) and Eudragit S100+PLGA (EP-coded) are pH-sensitive formulations and they are targetable to the colon, whereas the formulation prepared only with PLGA (P-coded) can release a higher CEF rate in the colon owing to the slow release properties of PLGA. The release kinetics were fitted to the Korsmeyer-Peppas and Weibull models. The antibacterial activity of E-, EP-, and P-coded formulations was 16-fold, 16-fold, and 2-fold higher than CEF, respectively, for S. aureus and E. coli according to the microdilution results. As a result of the time killing experiment, all formulations prepared were found to be more effective than the antibiotic itself for long periods. Consequently, all formulations prepared in this study hope to guide researchers/clinicians in treating both gram-positive and gram-negative bacteria-induced infections, as well as COVID-19 associated coinfections and symptoms.

Effect of different molecular weight PLGA on flurbiprofen nanoparticles: formulation, characterization, cytotoxicity, and in vivo anti-inflammatory effect by using HET-CAM assay.

Objective: The effect of polymers used in nanoparticle (NP) production on the formulation properties is one of the few studied issues. Therefore, this study aims to formulate flurbiprofen (FLB) loaded NPs with different molecular weight (Mw) poly lactic-co-glycolic acid (PLGA) and investigate the effect of Mw on NP character. One of the most important objectives is to provide a high anti-inflammatory effect with a low dose and the anti-inflammatory efficacy of the selected optimal formulation is to be determined by in vivo hen's egg test on Chorioallantoic Membrane (HET-CAM) analysis that a new, popular and in vivo animal experiment alternative method.Significance: To determine the anti-inflammatory efficacy of the optimum formulation by HET-CAM analysis. To the best of our knowledge, this is the first report on the in vivo anti-inflammatory evaluation of FLB-loaded PLGA NP using the in vivo HET-CAM assay.Methods: Blank and FLB-loaded PLGA NPs were prepared using a nanoprecipitation technique. The cell viability test for all formulation was performed with MTT in the NIH-3T3 mouse embryonic fibroblast cell line. The anti-inflammatory activity of optimum formulation (A6) was examined using the in vivo HET-CAM assay.Results: The particle sizes (PSs) of the FLB-loaded PLGA NPs were between 175 and 198 nm. The encapsulation efficiency (EE%) was a range of 82-93%. In vitro release of NPs showed extended-release up to 144 h. The release kinetics were fitted to the Peppas-Sahlin and Weibull models. The results showed that PS, PDI, EE%, and release rates of NPs were directly related to the Mw of PLGA. There is no statistically significant difference in cell viability study was observed between blank and FLB-loaded PLGA NPs. The in vivo anti-inflammatory activity results indicated that A6 coded formulation was showed significantly good anti-inflammatory potential at low dose.Conclusions: It could be concluded that FLB-loaded NPs seem to be a promising extended-release drug delivery system for oral administration with a low dose and high efficiency.

Surface roughness and morphologic changes of zirconia following different surface treatments.

OBJECTIVE: The aim of this study was to evaluate the roughness and morphology of zirconia after air abrasion and erbium:yttrium-aluminum-garnet (Er:YAG) laser application of different intensities. BACKGROUND DATA: Although surface roughness is important to obtain micromechanical retention, it is unclear which surface treatment is most appropriate for zirconia. METHODS: Fifty sintered zirconia specimens were divided into five groups (n=10). The following treatments were applied: control, Er:YAG laser irradiation with different energy intensities (200, 300, and 400 mJ), and air abrasion with aluminum oxide (Al(2)O(3)) particles (110 µm). Morphologic changes after surface treatments were examined in microscope analyses. Then, the surface roughness (Ra in µm) of the specimens was evaluated using a surface texture measuring instrument. Roughness data were analyzed using one-way analysis of variance (ANOVA) and Tukey's honestly significant difference (HSD) test (p=0.05). RESULTS: Results of microscope analyses revealed changes in surface morphology after surface treatments, including the formation of rare pits in the 400 mJ laser group and the formation of microretentive grooves in the air abrasion group. According to the results of the statistical analysis, the mean surface roughness value for the air abrasion group was significantly higher than that of the other groups (p<0.001). Except for the air abrasion group, there were no statistically significant differences within other groups (p>0.05). CONCLUSIONS: According to the results of the statistical and microscopic analyses, 400 mJ Er:YAG laser energy or air abrasion can be used to obtain micromechanical retention prior to luting; however, air abrasion is the most effective surface treatment method.

Comparison of the effects of surface treatments on roughness of two ceramic systems.

OBJECTIVE: The aim of this study was to evaluate the effects of different surface treatments on the surface roughness of lithium disilicate-based core (IPS Empress 2, shade 210, Ivoclar Vivadent, Schaan, Liechtenstein) and feldspathic ceramics (Vita VM9, VITA Zahnfabrik H. Rauter GmbH & Co. KG, Bad Säckingen, Germany). BACKGROUND DATA: Er:YAG laser irradiation is expected to be an alternative surface treatment, thus enhances surface roughness of procelains and produces morphological changes. METHODS: Fifty lithium disilicate-based core ceramic discs and 50 feldspathic ceramic discs were prepared (diameter, 10 mm; thickness, 1 mm) according to the manufacturers' instructions. All-ceramic discs were polished to standardize, and surface roughness of the discs was evaluated before treatment and serving as controls. Both of two ceramic groups were divided into five groups (n=10), and the following treatments were applied: (1) sandblasting with aluminum oxide (Al(2)O(3); Group SB); (2) Al(2)O(3)+Er:YAG laser (Group SB-L); (3) Er:YAG laser irradiation (distance, 1 mm; 500 mJ; 20 Hz; 10W; manually, contact handpiece [R 14]) (Group L); (4) 5% hydrofluoric acid etching (Group HF); and (5) Er:YAG laser +5% hydrofluoric acid (Group HF-L). Surface roughness was evaluated by profilometry, and specimens were then examined with atomic force microscopy. RESULTS: Data were analyzed by Wilcoxon signed rank, Mann-Whitney U, and Kruskal-Wallis tests (α=0.05). The Wilcoxon signed rank test results indicated that surface roughness after sandblasting was significantly different from the surface roughness after laser irradiation and acid etching (p<0.001). Mann-Whitney U and Kruskal-Wallis test results indicated that groups SB and SB-L had significantly higher mean roughness values (p<0.05) than those in the other groups. CONCLUSIONS: Groups SB and SB-L had rougher surfaces than the groups subjected to the other surface treatment methods. There was no significant difference in surface roughness between the HF acid etching, Er:YAG laser irradiation, and HF and Er:YAG (p<0 .05).

The effects of zoledronic acid and hyperbaric oxygen on posterior lumbar fusion in a rabbit model.

We studied the effects of hyperbaric oxygen (HBO) and zoledronic acid (ZA) on posterior lumbar fusion using a validated animal model. A total of 40 New Zealand white rabbits underwent posterior lumbar fusion at L5-6 with autogenous iliac bone grafting. They were divided randomly into four groups as follows: group 1, control; group 2, HBO (2.4 atm for two hours daily); group 3, local ZA (20 µg of ZA mixed with bone graft); and group 4, combined HBO and local ZA. All the animals were killed six weeks after surgery and the fusion segments were subjected to radiological analysis, manual palpation, biomechanical testing and histological examination. Five rabbits died within two weeks of operation. Thus, 35 rabbits (eight in group 1 and nine in groups 2, 3 and 4) completed the study. The rates of fusion in groups 3 and 4 (p = 0.015) were higher than in group 1 (p < 0.001) in terms of radiological analysis and in group 4 was higher than in group 1 with regard to manual palpation (p = 0.015). We found a statistically significant difference in the biomechanical analysis between groups 1 and 4 (p = 0.024). Histological examination also showed a statistically significant difference between groups 1 and 4 (p = 0.036). Our results suggest that local ZA combined with HBO may improve the success rate in posterior lumbar spinal fusion.

Proton MR spectroscopy correlates of frontal lobe function in healthy children.

BACKGROUND AND PURPOSE: Neuroimaging methods have been used to improve our understanding of the topographic organization of the brain. In our study, proton (1)H-MR spectroscopic imaging was used to evaluate frontal lobe function. The goal was to determine the relationship between neuropsychological measures of frontal lobe function and levels of a surrogate neuronal marker, N-acetylaspartate (NAA), in typically developing healthy children and adolescents. MATERIALS AND METHODS: Fifty-one healthy children (25 girls; 6.2-18.3 years of age; mean age, 12.3 +/- 3.6 years) were examined. All children completed a neuropsychological assessment including measures of attention, executive function, memory, language, and visual and motor skills. (1)H-MR spectroscopic imaging was performed by using a multisection spin-echo sequence at 1.5T. General linear model analysis of covariance was used to examine the relationship between the neuropsychological test scores and NAA/creatine (Cr) ratios, controlling for age and sex. RESULTS: A positive relationship between frontal lobe white matter NAA/Cr ratio and performance on 2 neuropsychological tests associated with frontal lobe function was detected. The Purdue Pegboard right-hand scores were higher with increasing NAA/Cr in the left frontal white matter (P = .047), and Stanford-Binet-IV "Bead Memory" scores improved with increasing NAA/Cr ratio in the right frontal white matter (P = .032). CONCLUSIONS: An association between frontal white matter NAA/Cr ratios and 1) measures of manual speed and dexterity, and 2) visual working memory was detected. Our data may provide a quantitative basis for assessment of frontal lobe impairments in disease states.

What defines the quality of patient care in tinea pedis?

OBJECTIVES: The aim of this study has been to evaluate patients with tinea pedis for their demographic data and attitudes affecting the treatment of disease, and to compare the in vitro activity of 10 antifungal agents and to relate them to their in vivo activity. METHODS: Patients with positive mycological examination were enrolled in the study, and a questionnaire comprised of 22 questions was administered. A mycological culture was carried out for each specimen. The antifungal susceptibility of the subcultured species was determined for griseofulvin, terbinafine, ciclopiroxolamine, fluconazole, ketoconazole, itraconazole, bifonazole, sulconazole, oxiconazole and miconazole with microdilution. RESULTS: Mycological cultures were carried out from 59 patients and there were 35 positive cultures (59.3%). The dermatophytes were Trichophyton rubrum (n = 25) and Trichophyton mentagrophytes (n = 3). The yeasts were Candida albicans (n = 7), Candida glabrata (n = 1) and Trichosporon (n = 2). In the minimum inhibitory concentration (MIC) study, the mean +/- standard error of the mean (SEM) MICs of the antifungals for T. rubrum were as follows: terbinafine 0.01 +/- 0.003, oxiconazole 0.16 +/- 0.05, sulkonazole 0.31 +/- 0.05, miconazole 0.45 +/- 0.15, itraconazole 0.74 +/- 0.01, ketokonazole 1.03 +/- 0.17, ciclopiroxolamine 1.30 +/- 0.12, bifonazole 1.94 +/- 0.51, griseofulvin 4.87 +/- 0.61, and fluconazole 17.91 +/- 3.67 microg/mL. CONCLUSION: Our study supports that azoles could be used as first-line treatment, as oxiconazole is very effective for both dermatophytes and C. albicans. Correlation between in vitro results and clinical outcomes of cases of dermatophytes is still to be established and interpretive breakpoints defined, in order to increase the quality of patient care in tinea pedis.

Hepatoprotective effect of Foeniculum vulgare essential oil.

Hepatoprotective activity of Foeniculum vulgare (fennel) essential oil (FEO) was studied using carbon tetrachloride (CCl(4)) induced liver injury model in rats. The hepatotoxicity produced by acute CCl(4) administration was found to be inhibited by FEO with evidence of decreased levels of serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and bilirubin. The results of this study indicate that FEO has a potent hepatoprotective action against CCl(4)-induced hepatic damage in rats.

Opinions of imams about family planning and their use of methods in Kayseri, Turkey.

OBJECTIVES: Imams are religious leaders who have significant influence on the social attitudes and behavior of a society. This study examined the views of imams on family planning and their personal preference of birth control methods. MATERIALS AND METHODS: Using a pre-prepared questionnaire, an on-site individual interview was conducted face-to-face with each of 164 imams at Kayseri, a city in Central Anatolia. RESULTS: All of the imams included in the study knew of at least one family planning method. Withdrawal was the most widely known method of family planning (84.2%). Among imams, 88.4% approved the use of birth control. While only 61.8% of the imams used at least one method of family planning, 20.1% used none at all. Of the family planning methods used, we considered 43.1% efficient (modem) and 18.7% inefficient (traditional). The most important factor affecting preference of traditional methods was religious suitability. CONCLUSION: Contrary to common belief, imams viewed family planning positively and used family planning methods at a rate similar to that of the general public. If provided with accurate information, we believe that imams may have a positive contribution to make in the development of family planning programs.

Antimicrobial and biological effects of ipemphos and amphos on bacterial and yeast strains.

In this study, the antimicrobial effects of monophosphazenes such as SM ipemphos and amphos were examined on bacterial and yeast strains. In addition, the biological effects of these compounds were tested on the lipid level of Saccharomyces cerevisiae and Candida albicans cells. The SM has an antimicrobial effect on the bacterial and yeast strains within the range of 100 and 1500 microg. When the concentration was increased, the inhibition zone expanded on the growth media ( p < 0.01; p < 0.001). The ipemphos did not affect the bacterial and yeast cells in the 100 and 600 microg range. In addition, the amphos did not show an antimicrobial effect on the bacterial cells between 100 and 300 microg or on yeast cells at any of the administered concentrations. In vitro media, the biological effects of these molecules were compared with vitamin E, melatonin and fish oil on the yeast cells. We have found that monophosphazenes have growth effects on the cells in vitro media. The lipid level of S. cerevisiae cells was decreased by 300 microg doses of vitamin E, fish oil, and ipemphos (respectively; p < 0.05, p < 0.01, and p < 0. 001). In addition, the lipid levels of the same yeast cells were depressed by 1000-microg doses in all supplemented groups. However, it was observed that the highest decrease in lipid level of S. cerevisiae cells occurred in the amphos group ( p < 0.001). The lipid levels of the C. albicans cells were significantly reduced ( p < 0.01) by 300 microg of amphos and melatonin. In contrast, the vitamin E and fish oil significantly raised ( p < 0.01; p < 0.001) the lipid level of the same yeast cell, as compared with the control. In addition, the lipid level of these cells was increased by administration of 1000 microg vitamin E, and melatonin ( p < 0.01). In conclusion, while high concentrations of ipemphos and amphos have an antimicrobial effect on bacterial and yeast cells, amphos did not affect the yeast cells. While ipemphos and amphos increased cell growth in media, they reduced the lipid level of C. albicans and S. cerevisiae. In addition, the antioxidants such as vitamin E, melatonin, and fish oils affected the lipid level of yeast cells.

Effect of vibration massage therapy after extracorporeal shockwave lithotripsy in patients with lower caliceal stones.

PURPOSE: To determine whether vibration massage influences the results of extracorporeal shockwave lithotripsy (SWL) in patients with lower caliceal stones. PATIENTS AND METHODS: One hundred three patients with lower caliceal stones were entered in the study. Patients were divided into two groups that received either SWL alone (Group A, N = 52) or with vibration massage (Group B, N = 51). There was no statistically significant difference between the two groups in stone size, duration of follow-up, or patient age. The complication, stone-free, and stone recurrence rates of the groups were compared. RESULTS: There was no statistically significant difference between the groups in the number of shockwaves, number of SWL sessions, or shockwave energy. The renal colic rate was higher in Group B than in Group A (P = 0.03). The stone-free rates in Group A and Group B were 60% and 80%, respectively (P = 0.003). The stone recurrence rate was higher in Group A than in Group B (P = 0.0006). CONCLUSIONS: This retrospective study demonstrates that SWL with vibration massage appears to have a beneficial effect on the passage of fragments in patients with lower caliceal stones.