Efficacy of fat quantification methods used in MRI to distinguish between normal, benign, and malignant bone marrow pathologies in children.

BACKGROUND: Fat quantification methods in magnetic resonance imaging (MRI) have been studied to differentiate bone marrow pathologies in adult patients; however, scarce literature is available in pediatric patients. PURPOSE: To evaluate the efficacy of the T1 signal intensity value (T1-SIV), out-of-phase/in-phase signal ratio (OP/IP SR), and fat fraction (FF) to differentiate between normal, benign, and malignant pathological processes. MATERIAL AND METHODS: A total of 48 pediatric patients with lumbar and pelvic MRI were classified into three groups according to bone marrow pathology (group 1, normal; group 2, benign pathology/reconversion; group 3, malignant). The efficacy of T1-SIV, OP/IP SR, and FF values in differentiating these pathologies was evaluated using Kruskal-Wallis or analysis of variance and followed by Bonferroni or Dunn-Bonferroni tests. Cutoff values for malignant infiltration were defined using ROC analysis. RESULTS: Although these values were significantly different in all three groups (P = 0.001-0.008), this difference was not sufficient to discriminate between all groups. Subgroup analyses showed significant differences in T1-SIV between groups 1-3, in OP/IP SR between groups 1-3, 2-3, and 1-2, in FF between groups 1-2 and 1-3 in various regions (P = 0.001-0.049). Cutoff values had a sensitivity and specificity of 90%-100% for OP/IP SR and FF. CONCLUSION: T1-SIV, OP/IP SR, and FF may potentially distinguish normal from pathological bone marrow. OP/IP SR and FF values detected malignant infiltration with high sensitivity and specificity in this study. However, only OP/IP SR may significantly differentiate benign and malignant bone marrow pathologies which needs to be confirmed in the future study with a larger patient population.

Influences of calorie restriction and lipopolysaccharide therapy on inflammation, cytokine response, and cell proliferation in pancreatic adenocarcinoma mouse model.

The study aimed to investigate the effects of lipopolysaccharide (LPS) alone and in combination with calorie restriction (CR) on the pancreatic tissues in C57BL/6 mice modeled with pancreatic ductal adenocarcinoma (PDAC). Forty male C57BL/6 mice (10-13 weeks old) were divided into five groups; LPS, LPS + CR, PDAC, PDAC + LPS, and PDAC + LPS + CR. Nuclear factor kappa B (NF-κß), interleukin-6 (IL-6), and c-Jun N-terminal kinases (JNK) mRNA expression levels were measured in pancreatic tissues. NF-κß, IL-6, JNK, and proliferating cell nuclear antigen (PCNA) peptide levels were determined by immunohistochemistry. Oxidative stress markers and antioxidant enzyme activities were determined spectrophotometrically. TH1/TH2 cytokine measurements were determined by a flow cytometer. It was detected that the number of PCNA immune + cells in the PDAC + LPS + CR group was significantly lower than in the PDAC and PDAC + LPS groups (p < 0.01, p < 0.05 respectively). PDAC + LPS + CR group's plasma interferon-gamma (IFN-γ), IL-6, IL-2, tumor necrosis factor-alpha, IL-3, and IL-4 levels were found to be significantly lower than the PDAC group (p < 0.01, p < 0.001, p < 0.01, p < 0.05, p < 0.01, and p < 0.05 respectively). According to our findings, the combination of low-dose LPS and 40% CR was found to be more effective in PDAC model mice.

Successful Treatment of Central Nervous System Involvement in Posttransplant EBV-related Lymphoproliferative Disease With Intrathecal Rituximab Therapy.

The posttransplant lymphoproliferative disease is a severe cause of morbidity and mortality following allogeneic hematopoietic stem cell transplantation. Central Nervous System involvement in EBV-related PTLD is rare, and there is no standard treatment recommendation. We present our patient and discuss other previously reported cases of EBV-associated PTLD with CNS involvement.

Chronic administration of delta9-tetrahydrocannabinol protects hyperinsulinemic gastric tissue in rats.

Hyperinsulinemia (HI) can result from some reasons such as an increase in basal/fasting circulating insulin and/or potentiation of postprandial insulin production. Diabetes mellitus (DM) is indirectly related to HI since it both causes and results from insulin resistance. Understanding the causes of HI and treating this is crucial for preventing DM. Previous research has shown that delta9-tetrahydrocannabinol (THC) has medicinal benefits. In light of this, the relationship between THC and oxidative stress, DNA repair mechanism, apoptosis, and its regulatory impact on appetite hormones in the gastric tissue of hyperinsulinemic rats has been investigated for the first time. Male rats (Spraque-Dawley, total = 32) were used, and they were randomly divided into the following groups (n = 8 in each group): control (CTRL), HI, THC administered control (THC, 1.5 mg/kg/day, during 4 weeks), and THC administered HI (HI + THC) groups. The number of poly (ADP-ribose) polymerase-1 and proliferating cell nuclear antigen (PCNA) and caspase-3 immunopositive cells in the HI group was significantly reduced compared to the CTRL group. The number of PCNA and caspase-9 immunopositive cells was significantly increased in the HI + THC group compared to the HI group. Obestatin immunopositive cell numbers in the HI + THC group were higher than in the HI and CTRL groups. The results show that THC administration may affect the regulation of appetite hormones and regeneration in the fundus of rats with HI. Glutathione (GSH) levels were higher in the HI + THC group than in the HI group. Both immunohistochemical and biochemical analyses revealed that THC promotes regeneration and regulates appetite hormones in hyperinsulinemic gastric tissues.

Radiation Exposure in the Neonatal Intensive Care Unit in Newborns and Staff.

OBJECTIVE: Portable X-rays remain one of the most frequently used diagnostic procedures in neonatal intensive care units (NICU). Premature infants are more sensitive to radiation-induced harmful effects. Dangers from diagnostic radiation can occur with stochastic effects. We aimed to determine the radiation exposure in premature infants and staff and determine the scattering during X-ray examinations in the NICU. STUDY DESIGN: In this prospective study, dosimeters were placed on premature infants who were ≤1,250 g at birth and ≤30 weeks of gestational age who stayed in the NICU for at least 4 weeks. The doses were measured at each X-ray examination during their stay. The measurements of the nurses and the doctors in the NICU were also performed with dosimeters over the 1-month period. Other dosimeters were placed in certain areas outside the incubator and the results were obtained after 1 month. RESULTS: The mean radiation exposure of the 10 premature infants, monitored with dosimeters, was 3.65 ± 2.44 mGy. The mean skin dose of the six staff was 0.087 ± 0.0998 mSV. The mean scattered dose was 67.9 ± 26.5 µGy. CONCLUSION: Relatively high exposures were observed in 90% of the patients and two staff. The radiation exposure levels of premature infants and staff may need to be monitored continuously. KEY POINTS: · The premature infants are exposed to radiation due to the bedside X-rays.. · The radiation exposure levels of premature infants and staff may need to be monitored continuously.. · Measures and alternative methods to reduce radiation exposure should be encouraged..

Effects of gallic acid on expressions of MMP-2 and MMP-9 through the pathway of p38/JNK in C6 glioma cells.

In our study, the effects of gallic acid (GA), a natural therapeutic agent, on oxidative stress biomarkers and MMP-2 and MMP-9 expressions via the p38/JNK pathway in C6 glioma cells were investigated. The toxicity of GA was determined by the WST-1 method. JNK, p38 and MMP-2/-9 mRNA expressions in the cell line were detected by RT-qPCR. JNK/SAPK, Grap-2/p38 and MMP-2/-9 protein levels were analyzed by using ELISA methods. Biochemical markers were analyzed. GA reduced the cell viability of C6 glioma cells after 24, 48 and 72h of treatment. The expression levels of MMP-2 and MMP-9 mRNA decreased in C6 glioma cells treated with 150µg/ml GA for 24 and 48h compared to the control cells. Unlike SOD activity, GA treatment significantly increased PCO and MDA levels in the cells treated with 150µg/ml GA for 24 and 48h compared to the non-treated cells. According to our results, GA inhibited the proliferation of C6 glioma cells. Also, it reduced MMP-2 and MMP-9 expressions and increase oxidative stress. Therefore, GA may have preventive effects on gliomas progression and/or invasion.

Anti-inflammatory potential of delta-9-tetrahydrocannabinol in hyperinsulinemia: an experimental study.

BACKGROUND: Hyperinsulinemia (HI) means that the amount of insulin in the blood is higher than normal and is often associated with type 2 diabetes. It is known that delta-9-tetrahydrocannabinol (THC) obtained from a medicinal plant, Cannabis sativa, has therapeutic effects on many diseases. OBJECTIVE: This study aimed to investigate the effects of THC on inflammatory and oxidant status in rat pancreas with HI. METHODS: Rats were divided into groups; Control, HI, THC and HI + THC. Each group consists of 8 animals. HI and HI + THC groups were given 10% fructose in the drinking water for 12 weeks. In the last four weeks of the experiment, 1.5 mg kg-1 THC was injected intraperitoneally daily into THC and HI + THC groups. The expression of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and nuclear factor-kappa B (NF-κB) were detected. JNK/SAPK and Grap2/p38 levels, total antioxidant and oxidant capacities (TAC and TOC) were analyzed in the pancreas. RESULTS: Levels of IL-6, NF-κß, and TNF-α mRNA expression were higher in the pancreas with HI than in the control (p < 0.001 for all). THC treatment reduced the expression of IL-6, NF-κß, and TNF-α mRNAs in the HI + THC group compared to the HI group (p < 0.001 for all). TOC increased in the HI group compared to the control group (p < 0.001). However, THC treatment reduced TOC levels in the HI + THC group compared to the HI group (p < 0.001). CONCLUSION: According to the results, the THC treatment may regulate inflammation and TOC in rats with hyperinsulinemia. Thus, we can say that THC may have anti-inflammatory and antioxidant potential in metabolic disorders.

Nasolacrimal canal morphology with or without idiopathic obstruction in Caucasian adults: a multidetector CT study.

PURPOSE: To compare the morphological features of the bony nasolacrimal canal (NLC) in Caucasian adults with and without primary acquired nasolacrimal duct obstruction (PANDO). METHODS: The study included one eye each from 38 patients with PANDO and 38 age- and gender-matched controls without PANDO, all of whom underwent multidetector computed tomography. In tomographic images, length, and orientation angles of the NLC, transverse canal diameters at the duct entrance and lower end, and minimum (narrowest) transverse and anterior-posterior canal diameters were measured. RESULTS: The two groups were similar for NLC length and angulations. The transverse entrance diameter was significantly narrower in the PANDO group (mean, 4.6 mm vs. 5.1 mm) (p = 0.09). The narrowest site was most frequently in the middle duct or slightly above the middle in both groups (p > 0.05). The minimum canal diameters were significantly smaller in the PANDO group (p = 0.010 and p = 0.003). When gender subgroups were compared, the significant differences continued for the transverse entrance and minimum diameters in females with PANDO (p = 0.006) and for the minimum anterior-posterior diameter in males with PANDO (p = 0.02). CONCLUSION: Narrowness of the upper and/or middle part of the bony nasolacrimal duct may play a role in the development of PANDO in the adult Caucasian population.

Statistical shape analyses of trigonocephaly patients.

PURPOSE: Surgery is the first treatment option for patients with metopic craniosynostosis. Fronto-orbital advancement is the preferred method for correction of isolated trigonocephaly, but it is hard to understand whether surgery has been successful mainly in an early period. We aim to investigate the shape differences in the head shapes of trigonocephaly patients compared between preoperative and postoperative term. METHODS: Cranial shape data were collected from the two-dimensional digital images. The Generalized Procrustes analysis was used to obtain mean shapes of the preoperative and postoperative term. The shape deformation of the frontal calvarium from preoperative to the postoperative term was evaluated using the thin-plate spline (TPS) method. RESULTS: There was significant cranial shape difference between preoperative and postoperative term. The high-level deformations for preoperative to postoperative term determined seen in TPS graphic. Highest deformation was observed at the bifrontal dimension especially at nasion and posterior edge of the forehead. CONCLUSIONS: In this study, we showed that the shape difference and structural deformation of the calvarium were correlated with the metopic craniosynostosis. The present study also shows that preoperative and postoperative head shapes of patients with trigonocephaly can be compared using the landmark-based geometrical morphometric method by taking into consideration the topographic distribution.

Central nervous system variations and abnormalities in anhidrotic ectodermal dysplasia (AED): neuroimaging findings.

BACKGROUND: Anhidrotic ectodermal dysplasia (AED) is a rare, mostly X-linked recessive genodermatosis, characterized by congenital defects of ectodermal derivative structures as the central nervous system (CNS) is primarily ectodermal in origin. PURPOSE: To evaluate CNS variations and abnormalities in AED. MATERIAL AND METHODS: A retrospective analysis was made of the neurological and neuroimaging findings of 17 children (12 boys, 5 girls; median age = 8 years; age range = 2-14 years) diagnosed with AED in our pediatric clinics during 2008-2016. The pattern of CNS variation and abnormalities were evaluated by comparing of these findings with an age- and gender-matched healthy control group with no family history. RESULTS: Of the 17 AED cases identified on the basis of neuroimaging findings, 6 (35.3%) were seen to be normal. Associated CNS variation and abnormalities including cavum septum pellucidum (35.3%), callosal dysgenesis (11.8%), prominent Virchow-Robin spaces (64.7%), cortical sulcal dilation (41.1%), mega cisterna magna (35.3%), focal cortical dysplasia (11.8%), and delayed myelination (58.8%) were observed in 11 (64.7%) children with AED. CONCLUSION: AED suggests a spectrum of CNS variation and abnormalities, presenting with neurological and neuroimaging findings, demonstrated in the embryonic surface- and neuro-ectoderm derived structures. The results of this study suggest that CNS variation and abnormalities might be associated with AED.

An Atypical Paediatric Optic Nerve Sheath Meningioma.

A 16-year-old male presented with a three year history of right proptosis. All other ocular findings were normal. Imaging demonstrated a large, calcified, contrast-enhancing mass in the apical orbit. The tumour had high gallium-68-DOTATATE uptake and low 18F-2-fluoro-2-deoxy-D-glucose uptake. An incisional biopsy revealed a diagnosis of psammomatous optic nerve sheath meningioma (ONSM). One year later stereotactic radiotherapy was performed due to tumour growth. Tumour size and visual acuity remained stable in the six months after treatment. This case differs from previously reported paediatric ONSMs by its histo-clinical characteristics (exophytic-calcified mass, visual preservation, psammomatous histology).

Clavicle duplication following physeal injury.

Clavicle duplication is a rare entity with limited number of cases reported. Congenital origin and trauma related mechanisms are the main hypotheses to explain this anatomical variation. In skeletally immature patient, trauma may cause physeal-metaphyseal injury in the distal clavicle rather than acromioclavicular strain. The distal epiphysis remains in continuity with acromion and has an intact periosteal sleeve. The periosteal sleeve is extremely osteogenic, and may lead to new bone formation between epiphysis and displaced metaphysis. This remodeling potential and the intact acromioclavicular joint allow the children to be followed by closed reduction. However, there can be new bone formation between epiphysis and displaced metaphysis, resulting in clavicle duplication. Herein, we present the radiographic and computed tomography findings of a post-traumatic duplication of the clavicle in a 5-year-old boy.

Pott Puffy Tumor in Children: A Rare Emergency Clinical Entity.

OBJECTIVES: Pott puffy tumor (PPT) is defined as soft tissue swelling of the forehead due to subperiosteal edema, accumulation of pus, or granulation tissue. It is associated with osteomyelitis of frontal bone secondary to frontal sinusitis. Pott puffy tumor can be complicated by preseptal and orbital cellulitis and intracranial infection. METHODS: Six patients diagnosed with and treated for PPT in Pediatric Clinic of Uludag University Faculty of Medicine from 2010 to 2015 were reviewed retrospectively. Age, sex, presenting symptoms and signs, laboratory and radiological findings, as well as intracranial complications and treatment modalities of all patients were evaluated. RESULTS: The authors present 6 pediatric patients of PPT, 5 males and 1 female with a mean age of 11 years (age range, 7-18 years). All patients presented with headache, fever, and tender frontal swelling. Two of the patients had epidural abscess and 1 had preseptal orbital cellulitis in addition to PPT. All of them had computed tomography scan and/or magnetic resonance imaging. Endoscopic sinus surgery was performed in 4 patients and 2 patients underwent neurosurgical intervention with antibiotherapy. CONCLUSIONS: Pott puffy tumor may be associated with potentially dangerous intracranial complications. Early diagnosis and treatment are essential to reduce morbidity and mortality. Imaging plays an important role in the diagnosis of the disease and the detection of its complications.

Orbital cavitary rhabdomyosarcoma: case report and literature review.

Orbital cavitary rhabdomyosarcoma has been previously reported in 2 cases. The case presented here was a 15-year-old boy who had proptosis, pain, periorbital hyperemia, and visual loss in his OD, which progressed in 6 weeks. Radiologic studies demonstrated a well-demarcated, multilobulated, large mass with cavities, extending from the anterior orbit to the apex, suggesting a diagnosis of venolymphatic malformation with an intrinsic hemorrhage. On surgery, a multilobular, hemorrhagic cystic mass was almost completely excised. Histologic examination revealed a diagnosis of embryonal rhabdomyosarcoma. After postoperative chemotherapy and radiotherapy, the tumor did not recur during a follow-up period of 45 months. This case, together with the previous ones, suggests that cavitary orbital rhabdomyosarcomas may have some distinct clinical, radiologic, and surgical characteristics.

Spectrophotometric Analysis of Color Stability Induced by Various Calcium Silicate Cements in Full Pulpotomy of Permanent Molars: Theracal PT, Biodentine, and ProRoot MTA.

AIM: The objective of this study was to assess the color stability induced by Theracal PT, Biodentine, and ProRoot MTA in teeth subjected to full pulpotomy, over a span of 6 months. MATERIALS AND METHODS: The study employed a total of 48 freshly extracted intact human third molar teeth. Samples were randomly assigned into four groups (n = 12). All teeth, with the exception of the control group, underwent endodontic access. All materials were mixed in accordance with the manufacturer's guidelines and applied at a thickness of 3 mm at the orifice level before they set. The study groups were negative control (was not prepared), positive control (ProRootMTA), Biodentine, and Theracal PT. Glass ionomer and composite resin material was applied to the cavities. The color measurements were performed using the VITA Easy Shade spectrophotometer. All measurements were repeated 3 times in the determined area on the middle buccal surface of the tooth at baseline that (T0); after access preparation and material placement and setting) and then subsequently at 7 (T1), 30 (T2), 90 (T3), and T4 (180) days later. Data were statistically analyzed by using Kruskal-Wallis H at a confidence level of 95% (P < .05). RESULTS: Compared with the negative control group, Biodentine and Theracal PT showed color stability (ΔE ≤ 3.7). The teeth treated with MTA showed clinically observable discoloration (ΔE ≥ 3.7) at T0, T1, T2, T3, and T4 intervals. At all-time intervals, the MTA group induced more discoloration than Biodentine and Theracal PT (P < .05). CONCLUSIONS: Theracal PT and Biodentine caused least discoloration compared to PMTA even 6 months after its application in teeth undergoing pulpotomy, thereby offering clinicians a reliable alternative for use in the esthetic zone.

Δ(9)-tetrahydrocannabinol protects cardiac tissue against endoplasmic reticulum and oxidative stresses, apoptosis, and inflammation in rats with hyperinsulinemia.

OBJECTIVES: In our study, we aimed to examine how δ(9)-tetrahydrocannabinol (THC) administration to hyperinsulinemia (HI) model rats would change endoplasmic reticulum stress (ERS), apoptosis, inflammation, and oxidative stress in cardiac tissue. METHODS: Rats were divided into four groups (n = 32): Control (C), THC, HI, and Treatment (Tre). Fructose (10%) in the drinking water was given to HI and Tre rats for 12 weeks. 1.5 mg/kg/d THC was given intraperitoneally to THC and Tre rats in the last 4 weeks of the experiment. The mRNA expressions of ERS and apoptosis markers in the cardiac tissue were detected. TNF-α concentration and oxidative stress were also analyzed. KEY FINDINGS: THC treatment in rats with HI ameliorated the overexpression of GRP-78, IRE1α, ATF6, ATF4, CHOP, Cas-12, Cas-8, Cas-9, and Cas-3 mRNAs, markers of ERS and apoptosis (P < .0001 for all). In addition, THC has been shown to reduce inflammation in the Tre group by causing a decrease in increased cardiac TNF-α levels (P < .01). Moreover, THC prevented cardiac tissue damage by regulating the degraded oxidative stress marker levels and antioxidant enzyme activities in HI. CONCLUSIONS: Our findings suggest that THC treatment in rats with HI exhibited a significant effect in ameliorating cardiac tissue damage by improving the antioxidant defense system, inflammation, apoptosis, ERS, and oxidative stress.

Plexiform fibrohistiocytic tumor of bone.

Plexiform fibrohistiocytic tumor is an extremely rare soft tissue tumor with a low malignancy potential. The patient is usually a child or a young adolescent and the tumor is usually localized in the upper extremities. We report on a case of a 21-year old male with a plexiform fibrohistiocytic tumor in the left fibula admitted to our hospital due to a swelling and pain in the left lower extremity. Radiologically a lytic lesion in the distal end of left fibula consistent with a non-aggressive lesion with low biological activity was found. Treated with curettage, the specimen revealed plexiform proliferation of mononuclear histiocyte-like cells, multinucleated osteoclast-like cells, and spindle fibroblast-like cells in variable proportions histopathologically. Immunohistochemical stains were positive for CD68 in scattered fashion in histiocytes and giant cells, and spindle like cells showed positivity for smooth muscle actin. Under electron microscopy, rough endoplasmic reticulum and collagen bundles in the spindle cells suggested fibroblastic differentiation. Also multiple large electron-dense lysosomal granules in histiocytoid cells were found. Multinucleated giant cells exhibited osteoclast-like appearance. All these findings suggested plexiform fibrohistiocytic tumor. Interestingly, the tumor was localized in bone. During the follow up for 27 months after the resection, there was no recurrence or metastasis.

Infantile osteopetrosis with superimposed rickets.

BACKGROUND: Rickets is a complication of infantile osteopetrosis and pre-treatment recognition of this complication is important. OBJECTIVE: To describe four children with infantile osteopetrosis complicated by rickets (osteopetrorickets) and review the relevant literature. MATERIALS AND METHODS: Retrospective chart analysis of four infants with osteopetrorickets and a systematic review of the relevant literature. RESULTS: We saw five children with infantile osteopetrosis, of whom four had superimposed rickets, for a period of 12 years. The review of the literature (including the current four children), yielded 20 children with infantile osteopetrorickets. The children ranged in age from 2 months to 12 months. In all children, hepatosplenomegaly was found. Sixteen (80%) children had visual impairments and eight (40%) children had hearing impairments. Serum calcium-phosphorus product was less than 30 in 18 children (90%). Twelve children (60%) were hypocalcemic and 18 (90%) were hypophosphatemic. In all children, the radiological examination demonstrated diffuse bony sclerosis and metaphyseal splaying and fraying of long bones. Five children (25%) had pathological fracture of extremities and 15 (75%) had rachitic rosary. CONCLUSION: Rickets as a complication to infantile osteopetrosis is not uncommon. Skeletal roentgenograms are of critical importance in the diagnosis of both osteopetrosis and superimposed rickets.

Clinical outcomes of COVID-19 in patients with chronic diseases.

OBJECTIVE: This study was carried out to evaluate the clinical outcomes of patients having chronic diseases (CD) and COVID-19 infection. METHODS: The study was carried out retrospectively by including 1.516 patients with CDs who applied to two education and research hospitals between June 01, 2021, and August 01, 2021, and were diagnosed with COVID-19. As CDs; cardiovascular diseases, diabetes mellitus (DM), hyperlipidemia, asthma, chronic obstructive pulmonary diseases, rheumatological diseases, malignancy, cerebrovascular disease, and chronic kidney diseases (CKD) were screened and evaluated statistically. RESULTS: A total of 1.516 patients with a mean age of 58.05±18.51 years were included in the study. It has been observed that 68.9% of COVID-19 patients have at least one CD. Women were more tend to have CDs than men (73.8% vs. 64.8%). Patients with a history of CD were significantly older and had a longer hospital stay than those without. Patients with CDs were 5.49 times more likely to be hospitalized in the intensive care unit (ICU) and their death rate was 2.52 times higher than the other patients. After the regression analysis, while hypertension (HT) (Odds Ratio [OR]: 2.39), DM (OR: 3.64), and any type of cancer (OR: 2.75) were seen as independent risk factors in hospitalizations in the ICU, cardiovascular diseases (OR: 2.27), CKD (OR: 3.69) and psychiatric disorders (OR: 2.18) were seen as independent risk factors associated with mortality. CONCLUSION: The follow-up of COVID-19 patients with CDs should be done more cautiously than others. It should be kept in mind that patients with HT, DM, and cancer may need intensive care at any time of hospitalization, while those with cerebrovascular disease, CKD, and psychiatric problems may have a higher mortality rate than other patients.

The investigation of antidepressant and anxiolytic effects of pregabalin and its mechanisms of action in rats.

OBJECTIVES: Pregabalin (PGB) is used in drug-resistant epilepsy. Also, it has analgesic effects in painful syndromes. Depression and anxiety are commonly seen in epilepsy and neuropathic pain patients. PGB is often combined with anxiolytics and antidepressants. We aimed to investigate the antidepressant and anxiolytic effects of PGB and compare its effects with those of antidepressant and anxiolytic drugs and their combined use. METHODS: Wistar Albino rats were used, and PGB (5, 10, 20, and 40 mg/kg), amitriptylin (AMT), fluoxetine (FLX), ketamine (KET), and diazepam (DZM), as well as combinations of PGB (20 mg/kg) with AMT, FLX, KET, and DZM, were administered. Elevated plus maze, forced swimming, and locomotor activity tests were performed. RESULTS: In the elevated plus maze, PGB10, 20, 40, AMT, FLX, and DZM increased open arm time. The PGB20+FLX combination increased compared to PGB20. In forced swimming, PGB doses increased immobility time. AMT, FLX, DZM, and KET decreased compared to control and PGB doses. Other combinations of PGB20 reversed immobility time, except FLX. In locomotor activity, PGB20, AMT, KET, and DZM decreased distance. CONCLUSION: PGB had a depressant effect in all doses and a dose-dependently anxiolytic effect. In combinations of PGB with AMT, KET, and DZM, it reversed their antidepressant effects. We assumed FLX could be preferred instead of AMT in patients using PGB. When PGB is used in combination, drug interactions should be considered. These results are also very remarkable in terms of pharmacoeconomics.