Can ferritin/lymphocyte percentage ratio, a new indicator, predict the clinical course of COVID-19 cases?

OBJECTIVES: COVID-19 maintains its seriousness as a global emergency with its rapid distribution worldwide. Ferritin/lymphocyte percentage ratio (FLPR) may appear as a prognostic value at the initial evaluation stage and thus can be used as a simple, effective and reliable parameter in identification of patients critically ill with COVID-19. METHODS: In this retrospective cohort study we evaluated patients who were hospitalized after being diagnosed with COVID-19 based on positive PCR results. We calculated FLPRs and classified disease severity due to initial emergency evaluation. The relationship between the severity of the need for hospitalization and intensive care, and 28-day mortality with FLPR were evaluated. RESULTS: The differences between the groups as for COVID-19 severity and FLPR means were statistically significant (x2=148.284; SD=3; p=0.000). FLPR levels were found to be high in groups with critically and seriously ill patients. In the ROC analysis for the FLPR level, the area under the curve (AUC) value was found to be 0.909 (95 % CI 0.857-0.961). When the cut­off value of FLPR was 21.11, the sensitivity and specificity were 82.9 % and 82.8 %, respectively. CONCLUSION: FLPR, a new parameter, can be used as a significant marker to predict the 28-day mortality patients (Tab. 6, Fig. 1, Ref. 25). Text in PDF www.elis.sk Keywords: COVID-19, percentage of lymphocytes, ferritin, FLPR, disease severity, emergency department.

Lymphocyte/mean platelet volume ratio, a new marker; is it effective in predicting the prognosis of COVID-19 cases?

OBJECTIVES: This study aims to determine the prognostic significance of the lymphocyte/mean platelet volume ratio (LMR) in terms of the clinical course of the disease in patients with COVID-19. METHODS: Patients over 18 who were evaluated for COVID-19 during the period from April 1, to April 30, 2020 were retrospectively scanned. Patients with at least 1 positive PCR test result were as assigned to Group 1 while patients with negative test results were assigned to Group 2. The LMR ratio was calculated by dividing the lymphocyte value by that of MPV. The relationship between LMR, severity of patients' CT findings and 28-day mortality was evaluated. RESULTS: A total of 938 patients were included in the study. It was observed that the lymphocyte and LMR levels were significantly different in those who died within 28 days (p < 0.001, p ≤ 0.001). In the ROC analysis for the LMR level, the area under the curve (AUC) was found to be 0.737 (95% CI 0.639‒0.834). When the cut­off value of LMR was 0.045, the sensitivity was found to be 99.0 % and specificity was 15.2 %. CONCLUSION: LMR can be a guide in multiple cases of care provided to critical patients, as is the case in the COVID-19 pandemic and can be used in recognizing critical patients (Tab. 5, Fig. 1, Ref. 21).

Vitamin D may protect against multiple organ damage caused by COVID-19.

The novel coronavirus COVID-19 outbreak quickly spread across many countries and has become a worldwide threat to health, trade and travel. In terms of clinical manifestations, although it starts as an acute respiratory disorder, it could eventually lead to death by causing damage to many organs such as: lung, liver, kidney and heart. It has been shown that COVID-19 pathology is mediated by an excessive inflammation, oxidation and an aggravated immune response. Vitamin D is a an immunomodulator hormone and has receptors in many tissues and organs. In many studies, vitamin D was shown to have antimicrobial and anti-inflammatory properties. In addition, since COVID-19 infection causes a cytokine storm, vitamin D can have a protective effect on many tissues and organs by reducing the production of proinflammatory cytokines. Vitamin D has a high safety profile, and thus could be beneficial against multiple organ damage in COVID-19 patients. This paper aims to highlight the potential benefits of vitamin D against multiple organ damage caused by COVID-19 (Fig. 1, Ref. 109). Keywords: COVID-19, cytokine, inflammation, vitamin D.

Hemopressin increases penicillin-induced epileptiform activity in rats.

OBJECTIVE: Hemopressin (Hp) is the first peptide ligand described for the CB1 cannabinoid receptor. Therefore, we aimed to investigate the effect of hemopressin on pencillin-induced epileptiform activity by using electrophysiological recording (ECoG) technique. METHODS: Male Wistar rats were anesthetized with urethane (1.25 g/kg), and epileptiform activity was induced by intracortical injection of penicillin (500 IU). Animals were randomly divided into eight groups. Subsequently, the rats were administered with saline or hemopressin as follows: saline control group (Group I: 2 µl/i.c.v/saline), hemopressin groups (Group II: 0.025 µg/i.c.v; Group III: 0.075 µg/i.c.v; Group IV: 0.15 µg/i.c.v; Group V: 0.3 µg/i.c.v; Group VI: 0.6 µg/i.c.v; Group VII: 1.2 µg/i.c.v; Group VIII: 2.4 µg/i.c.v). The various doses of hemopressin were injected intracerebroventricularly (i.c.v) 30 minutes after penicillin (2.5µl) injection. After hemopressin injection, ECoGs were recorded for three hours. RESULTS: Hp at doses of 0.075, 0.15, 0.3, 0.6, 1.2 and 2.4 µg/kg significantly increased the frequency of epileptiform ECoG activity compared to penicillin-injected group without changing the amplitude. The 0.6 µg hemopressin was the most effective dose to increase the epileptiform activity (p 0.05). CONCLUSIONS: The results of this study provided electrophysiological evidence for hemopressin to be modulating penicillin-induced epileptiform activity by acting as CB1 receptor antagonist. Further studies are required to elucidate the involved mechanism underlying this effect (Fig. 3, Ref. 40).

Cardioprotective effect of melatonin and agomelatine on doxorubicin-induced cardiotoxicity in a rat model: an electrocardiographic, scintigraphic and biochemical study.

AIM: The present study aimed to determine the protective effect of melatonin and agomelatine on DOX-induced cardiotoxicity in rats by electrocardiographic, scintigraphic and biochemical methods. MATERIALS AND METHODS: Forty-nine male Wistar rats were randomly separated into seven groups; control (CON), doxorubicin (DOX), melatonin (MEL), agomelatine (AGO), melatonin+doxorubicin (MEL+DOX), agomelatine+doxorubicin (AGO+DOX) and melatonin+ agomelatine+ doxorubicin (MEL+AGO+DOX) groups. Cardiotoxicity was induced by intraperitoneal (i.p.) injection of DOX (18 mg/kg daily for three days). Rats receiving MEL and AGO treatment in the DOX-induced cardiotoxicity group received MEL and AGO (40 mg/kg/day, i.p., for seven days). They were injected with doxorubicin (18 mg/kg, i.p.) on days 5, 6, and 7. The rats were given MEL and AGO as substance control (40 mg/kg/day, i.p., for 7 days). On day 8 of the experiment, animals were evaluated by means of electrocardiography (ECG) and 99mtechnetium pyrophosphate (99mTc PYP) scintigraphy and their biochemical parameters [blood urea nitrogen (BUN), creatine kinase (CK), cardiac troponin T (cTnT)] were examined. RESULTS: DOX-induced acute cardiotoxicity in rats is characterized by conduction abnormalities in the ECG pattern (including decreased P wave and QRS complex duration, increased QT and RR intervals, and ST-segment elevation), increased serum BUN, CK, and cTnT parameters and increased 99mTc PYP uptake (p < 0.001). Pretreatment with MEL, AGO, or MEL+AGO effectively alleviated DOX-induced ECG abnormalities close to normal (p < 0.001). Moreover, serum biochemical evidence and 99mTc PYP uptake values demonstrated that pretreatment with MEL, AGO, or MEL+AGO has the same protective effect against the abnormalities produced in the heart by DOX (p < 0.001). CONCLUSIONS: MEL and AGO have a potential protective effect on DOX-induced cardiotoxicity. At the same time, this study suggests that 99mTc PYP is a non-invasive method suitable for early determination of DOX-induced cardiotoxicity (Tab. 3, Fig. 5, Ref. 41).

Protective effect of melatonin and agomelatine on adriamycin-induced nephrotoxicity in rat model: a renal scintigraphy and biochemical study.

OBJECTIVE: We aimed to determine the possible protective effects of melatonin and agomelatine on an animal model of adriamycin nephrotoxicity by 99mTc DMSA renal scintigraphy and biochemical methods. METHODS: Ten weeks old 49 male Wistar rats were randomly separated into seven groups; namely control (CON), adriamycin (ADR), melatonin (MEL), agomelatine (AGO), melatonin + adriamycin (MEL+ADR), agomelatine + adriamycin (AGO+ADR) and melatonin + agomelatine + adriamycin (MEL+AGO+ADR) groups. Nephrotoxicity was induced by a three-dose of 18 mg/kg adriamycin, i.p. at a 24 h interval on the 5th, 6th and 7th days. A dose of melatonin and agomelatine (40 mg/kg/i.p, the same doses) were injected for 7 days before and after the injected of ADR (18 mg/kg, i.p.), respectively. On the 8th day of the experiment, all animals were evaluated and scintigraphic and biochemical parameters were assessed, respectively. RESULTS: ADR significantly increased blood urea nitrogen (1040 %) and plasma creatinine (1020 %), and decreased 99mTc DMSA uptake levels (59 %) compared to the control (p < 0.001). Pretreatment with MEL, AGO, MEL+AGO mitigated these abnormalities produced by ADR in the kidney (p < 0.001). CONCLUSION: 99mTc DMSA for the early determination of ADR-induced nephrotoxicity had an important role. Also, a significant correlation was found between biochemical and scintigraphy parameters. Adriamycin caused significant damages to kidneys that were reduced with MEL and AGO (Tab. 2, Fig. 3, Ref. 39).

Inhibition by Egb761 of the effect of cellphone radiation on the male reproductive system.

OBJECTIVES: To determine the effects of Egb761 on testicular tissues and semen parameters in rats exposed to cellphone waves. BACKGROUND: EGb761 has antioxidant properties as a free-radical scavenger. Cellphone electromagnetic radiation (EMR) induces oxidative stress in cells. METHODS: Twenty-one Wistar albino male adult rats were divided into three groups (control, experimental, treatment), including seven rats in each. The experimental and treatment groups were exposed to cellphone EMR (0.96 W/kg) for six weeks (4 hrs/day). Egb761 (100 mg/kg/day) was also added to the treatment. Testes, epididymal semen and blood plasma were used for analysis. RESULTS: Exposure to cellular phone radiation resulted in a significant impairment in testicular morphometry and histological structure, reduction of total and motile sperm numbers and plasma testosterone level. Egb761 administration improved testicular damage and led to a marked increase in plasma testosterone levels and total and motile sperm numbers. CONCLUSION: Male reproductive system is susceptible to cellphone radiation. Cellphone waves induce toxic effects in testicular tissues, impair spermatogenesis and cause an imbalance in testosterone hormone levels. Egb761 ameliorated these toxic effects by reversing testicular tissue damage, restoring normal spermatogenesis and hormone levels. This suggests that Egb761 is a potential therapeutic agent against EMR-induced male reproductive toxicity (Tab. 3, Fig. 6, Ref. 45).

Effect of pregabalin on post-dural-puncture headache following spinal anesthesia and lumbar puncture.

In this study, we aimed to investigate the effect of pregabalin on post-dural-puncture headache (PDPH). Forty patients who developed PDPH after spinal anesthesia or diagnostic and/or therapeutic lumbar puncture were divided into two groups and followed for 5 days. The first group received 150 mg/day oral pregabalin for the first 3 days, then 300 mg/day for a further 2 days. The second group received a placebo for the same length of time. Patient headaches were scored using the visual analog scale, and diclofenac sodium and pethidine requirements were recorded. Relative to the placebo group, the group administered pregabalin had significantly lower visual analog scale scores after the second day of treatment, and had significantly lower diclofenac sodium requirements. Our results indicate that pregabalin may be useful for the management of PDPH.

Sound absorption by clamped poroelastic plates.

Measurements and predictions have been made of the absorption coefficient and the surface acoustic impedance of poroelastic plates clamped in a large impedance tube and separated from the rigid termination by an air gap. The measured and predicted absorption coefficient and surface impedance spectra exhibit low frequency peaks. The peak frequencies observed in the absorption coefficient are close to those predicted and measured in the deflection spectra of the clamped poroelastic plates. The influences of the rigidity of the clamping conditions and the width of the air gap have been investigated. Both influences are found to be important. Increasing the rigidity of clamping reduces the low frequency absorption peaks compared with those measured for simply supported plates or plates in an intermediate clamping condition. Results for a closed cell foam plate and for two open cell foam plates made from recycled materials are presented. For identical clamping conditions and width of air gap, the results for the different materials differ as a consequence mainly of their different elasticity, thickness, and cell structure.

[Case report: two Leuconostoc bacteremia cases]. / Olgu sunumu:Leuconostoc bakteriyemili iki olgu.

Leuconostoc species, which are the members of Streptococcaceae family, have recently been recognized as potential pathogens. They usually cause infections in patients with underlying disease, with venous catheters or previously treated with vancomycin. In this report, we have presented two cases of Leuconostoc bacteremia. The first case was a 42 years old male patient who was diagnosed to have colon adenocarcinoma. He had undergone colon, stomach and distal pancreas resection operation and had given chemotherapy. Blood and catheter cultures yielded methicillin-resistant Staphylococcus aureus. Blood cultures were repeated since teicoplanin therapy had failed, and Gram positive cocci resistant to vancomycin were isolated. The other case was a 26 years old male patient who had undergone a shunt operation because of pineal lesion and hydrocephaly. He had given ampirical vancomycin therapy since he had post-operative high fever, however the therapy had failed. The catheter culture yielded Gram positive cocci resistant to vancomycin. Both isolates were identified as Leuconostoc spp. with API 20 strep identification kit (Bio Merieux), and both of them were found sensitive to penicillin, ampicillin, clindamycin, gentamicin and chloramphenicol, while they were resistant to teicoplanin and vancomycin. The patients were successfully treated with clindamycin. It is concluded that, Leuconostoc spp. should be considered when vancomycin-resistant organisms resembling streptococci are isolated from blood cultures.

Nonprolyl cis peptide bonds in unfolded proteins cause complex folding kinetics.

Folding of tendamistat, an inhibitor of alpha-amylase, is a fast two-state process accompanied by two minor slow reactions, which were assigned to prolyl isomerization. In a proline-free variant, 5% of the molecules still fold slowly with a rate constant of 2.5 s(-1). This reaction is caused by a slow equilibrium between two populations of unfolded molecules. The time constant for this equilibration process, its sensitivity to LiCl and its temperature dependence identify it as a cis-trans isomerization of nonprolyl peptide bonds. Although nonprolyl peptide bonds have the cis conformation populating only approximately 0.15% in unfolded proteins, their large number generates a significant fraction of slow-folding molecules. This emphasizes that heterogeneous populations in an unfolded protein can induce complex folding kinetics on various time scales.