Prognostic value of interleukin-6 serum levels in hospitalized COVID-19 patients: A case-control study in Iran.

Introduction: The coronavirus pandemic (COVID-19) is an infectious disease with a high mortality rate that is challenging to treat. Cytokine storm is a crucial factor leading to acute respiratory distress syndrome in COVID-19 patients. Identifying factors that predict the severity of the disease may be primarily prognostic to guide drug therapy. The objective of this study was to investigate the prognostic role of interleukin 6 (IL-6) in the hospitalized patients infected with COVID-19. Methods: This case-control study was conducted from October 2019 to April 2020 at Shahid Faqihi hospital in Iran. Fifty hospitalized COVID-19 patients and 50 healthy individuals were included while controlling demographics and comorbidities. IL-6 serum levels were measured and compared based on demographic characteristics (age, sex) and comorbidities in the case and control groups. Spearman rank correlation coefficient was also used to analyze the correlations between IL-6 levels and lung involvement in COVID-19 patients. Moreover, some laboratory parameters were compared based on the percentage of lung involvement. Results: The level of IL-6 in the case group was significantly higher than the control (p ˂ 0.001). We observed a positive and significant correlation between the level of IL-6 and the severity of lung involvement (r = 0.0.79, p < 0.01). The median level of IL-6 in patients who showed more than 75% lung involvement was 573 (IQR = 320-850). Conclusion: Available evidence suggests that high levels of IL-6 are associated with the severity of COVID-19. According to the results, it could be proposed that inhibition of IL-6 might be a target for therapeutic managements to reduce mortality in the patients with COVID-19.

Experimental study on evaluation and optimization of heavy metals adsorption on a novel amidoximated silane functionalized Luffa cylindrica.

This study aimed to synthesize an amidoximated Luffa cylindrica (AO-LC) bioadsorbent, and evaluate its efficiency in the adsorption of heavy metals from the aqueous solutions. For this purpose, NaOH solution was used to alkaline treatment of Luffa cylindrica (LC) fibers. The silane modification of LC was performed using 3-(trimethoxysilyl)propyl methacrylate (MPS). Polyacrylonitrile (PAN)/LC biocomposite (PAN-LC) was synthesized by PAN grafting onto the MPS-modified LC (MPS-LC). Finally, the AO-LC was obtained by the amidoximation of PAN-LC. The chemical structures, morphology, and thermal properties of biocomposites were characterized by the infrared spectroscopy, X-ray diffraction, thermogravimetric analysis, and field emission scanning electron microscopy. The results showed a successful grafting of MPS and PAN on the surface of LC. The order of heavy metals adsorption on AO-LC was: Pb2+ > Ag+ > Cu2+ > Cd2+ > Co2+ > Ni2+. The effects of operational parameters on the Pb2+ adsorption were studied using Taguchi experimental design method. Statistical analysis of the results showed that the initial Pb2+ concentration and the bioadsorbent dosage significantly affect the adsorption efficiency. The adsorption capacity and removal percentage of Pb2+ ions were obtained as 18.88 mg/g and 99.07%, respectively. The Langmuir isotherm and Pseudo-second order kinetics models were found to be better compatible with experimental data as a consequence of the isotherm and kinetics analysis.

Methodology to determine the extent of anaerobic digestion, composting and CH4 oxidation in a landfill environment.

An examination of the processes contributing to the production of landfill greenhouse gas (GHG) emissions is required, as the actual level to which waste degrades anaerobically and aerobically beneath covers has not been differentiated. This paper presents a methodology to distinguish between the rate of anaerobic digestion (rAD), composting (rCOM) and CH4 oxidation (rOX) in a landfill environment, by means of a system of mass balances developed for molecular species (CH4, CO2) and stable carbon isotopes (δ13C-CO2 and δ13C-CH4). The technique was applied at two sampling locations on a sloped area of landfill. Four sampling rounds were performed over an 18 month period after a 1.0 m layer of fresh waste and 30-50 cm of silty clay loam had been placed over the area. Static chambers were used to measure the flux of the molecular and isotope species at the surface and soil gas probes were used to collect gas samples at depths of approximately 0.5, 1.0 and 1.5 m. Mass balances were based on the surface flux and the concentration of the molecular and isotopic species at the deepest sampling depth. The sensitivity of calculated rates was considered by randomly varying stoichiometric and isotopic parameters by ±5% to generate at least 500 calculations of rOX, rAD and rCOM for each location in each sampling round. The resulting average value of rAD and rCOM indicated anaerobic digestion and composting were equally dominant at both locations. Average values of rCOM: ranged from 9.8 to 44.5 g CO2 m-2 d-1 over the four sampling rounds, declining monotonically at one site and rising then falling at the other. Average values of rAD: ranged from 10.6 to 45.3 g CO2 m-2 d-1. Although the highest average rAD value occurred in the initial sampling round, all subsequent rAD values fell between 10 and 20 g CO2 m-2 d-1. rOX had the smallest activity contribution at both sites, with averages ranging from 1.6 to 8.6 g CO2 m-2 d-1. This study has demonstrated that for an interim cover, composting and anaerobic digestion of shallow landfill waste can occur simultaneously.

Pilot scale evaluation of a model to distinguish the rates of simultaneous anaerobic digestion, composting and methane oxidation in static waste beds.

The aim of this paper was to apply and validate a model for measuring the rate and extent of anaerobic digestion, composting and CH4 oxidation in laboratory scale beds. Degradation studies were performed in four reactors each packed with shredded unsorted municipal solid waste, with one bed covered with a 100 mm layer of soil. The rates of production of CH4, CO2, 13C-CO2 and the rate of consumption of O2 were measured and used as inputs to a mass balance expressions for these components to calculate the rates of anaerobic digestion, composting and CH4 oxidation. The results showed that anaerobic digestion, composting and CH4 oxidation occurred simultaneously in both the covered and uncovered beds. The analysis showed that 50 ±â€¯4% of the solids (COD basis) in the uncovered beds degraded anaerobically, with the generated CH4 subsequently oxidized, and that 32 ±â€¯4% of the solids degraded aerobically in the covered bed.

A mass balance model to estimate the rate of composting, methane oxidation and anaerobic digestion in soil covers and shallow waste layers.

Although CH4 oxidation in landfill soil covers is widely studied, the extent of composting and CH4 oxidation in underlying waste layers has been speculated but not measured. The objective of this study was to develop and validate a mass balance model to estimate the simultaneous rates of anaerobic digestion (rAD), CH4 oxidation (rOX) and composting (rCOM) in environments where O2 penetration is variable and zones of aerobic and anaerobic activity are intermingled. The modelled domain could include, as an example, a soil cover and the underlying shallow waste to a nominated depth. The proposed model was demonstrated on a blend of biogas from three separate known sources of gas representing the three reaction processes: (i) a bottle of laboratory grade 50:50% CH4:CO2 gas representing anaerobic digestion biogas; (ii) an aerated 250mL bottle containing food waste that represented composting activity; and (iii) an aerated 250mL bottle containing non-degradable graphite granules inoculated with methanotrophs and incubated with CH4 and O2 to represent methanotrophic activity. CO2, CH4, O2 and the stable isotope 13C-CO2 were chosen as the components for the mass balance model. The three reaction rates, r (=rAD, rOX, rCOM) were calculated as fitting parameters to the overdetermined set of 4mass balance equations with the net flux of these components from the bottles q (= [Formula: see text] , [Formula: see text] , [Formula: see text] and [Formula: see text] ) as inputs to the model. The coefficient of determination (r2) for observed versus modelled values of r were 1.00, 0.97, 0.98 when the stoichiometry of each reaction was based on gas yields measured in the individual bottles and q was calculated by summing yields from the three bottles. r2 deteriorated to 0.95, 0.96, 0.87 when using an average stoichiometry from 11 incubations of each of the composting and methane oxidation processes. The significant deterioration in the estimation of rCOM showed that this output is highly sensitive to the evaluated stoichiometry coefficients for the reactions. r2 deteriorated further to 0.86, 0.77, 0.74 when using the average stoichiometry and experimental measurement of the composition and volume of the blended biogas to determine q. This was primarily attributed to average errors of 8%, 7%, 11% and 14% in the measurement of [Formula: see text] , [Formula: see text] , [Formula: see text] and [Formula: see text] relative to the measurement of the same quantities from the individual bottles.

Distally based sural artery flap without sural nerve.

The distal third of the tibia, ankle and heel area is difficult to reconstruct. For small to medium size defects, local flaps are often an easier alternative than free flap. In lower limb surgery, the sural flap is based on this principle and this flap is becoming increasingly popular. The distally based superficial sural artery flap, first described as a distally based neuro skin flap by masquelet et al., is a skin island flap supplied by the vascular axis of the sural nerve. The main disadvantage of distally based sural artery flap is sacrifice of the sural nerve because it is described the concept of neurocutaneus island flap. We describe one case of reverse sural flap without sural nerve .The aim of this paper is to establish the reliability of this flap even without sural nerve.

Topography of gastritis and its severity in 864 first degree relatives of gastric cancer patients.

OBJECTIVES: Studies on gastric mucosal histological findings among first degree relatives (FDR) of gastric cancer (GC) patients are scarce. The aim is to evaluate the topography and the severity of gastritis among FDR of GC patients. DESIGN: A total of 989 subjects who were FDR of GC patients, ages 40-65 years underwent gastroscopies. When no gross lesion was found, five specimens were evaluated according to the Sydney Classification and one for urease testing in order to determine the type of gastritis and its severity. RESULTS: Of the 989 subjects, 107 had significant lesions, including two with GC and one with esophageal cancer. The 864 subjects who had complete morphological data taken from five gastric areas (two from the antrum and three from the corpus) comprised 419 males (mean age 48.5±7 years) and 445 females (mean age 47±6.4 years). The H. pylori rate was 76.6%. Normal mucosa was seen in 6.9%, antrum-restricted gastritis in 7.4%, antrum-predominant gastritis in 63.5% and corpus-predominant gastritis in 20% (both had >80% H. pylori infection) and corpus-restricted gastritis in 2%. More atrophy was seen in the antrum and corpus of FDR females than males. The severity did not differ between those with one or more GC patients' relatives. Forty-nine percent of FDR had atrophy and 9.4% intestinal metaplasia (IM) in the corpus. After the age of 40, there was progression of intestinal metaplasia from 12.2 to 27.3% in the antrum and from 6.7% to 26.2% in the corpus during two decades. No high grade dysplasia was found in this mid-age population. CONCLUSION: Only one-fifth of FDR have H. pylori-induced corpus-predominant gastritis who are at risk for cancer and suitable for eradication. Corpus-restricted gastritis is a rare disease in this area.

Serum pepsinogen I, pepsinogen II, and gastrin 17 in relatives of gastric cancer patients: comparative study with type and severity of gastritis.

BACKGROUND & AIMS: First-degree relatives of gastric cancer patients are at risk for developing precancerous conditions. The aim of this study was to investigate the potential of biomarkers pepsinogen I (PGI), pepsinogen II (PGII), their ratio (PG I:II), as well as gastrin 17 for screening of precancerous conditions and corpus predominant gastritis. METHODS: First-degree relatives of gastric cancer patients underwent endoscopy. Three biopsy specimens from the antrum and 3 from the corpus were evaluated according to the Sydney classification. Serum was taken for the measurement of fasting PGI, PGII, and gastrin 17 by enzyme-linked immunosorbent assay kits. RESULTS: A total of 481 patients were examined (age, 47.8 +/- 6.7 y). With the extension of gastritis, PGII was increased up to 2.5 times (6.6 +/- 2.8 microg/mL in normal mucosa, 9.5 +/- 6.7 microg/mL in antral gastritis, and 16.9 +/- 12.4 microg/mL in corpus-predominant gastritis; P < .01), PGI increased slightly (88.3 +/- 29.4 microg/mL in normal mucosa and 111.2 +/- 71.4 microg/mL in corpus-predominant gastritis), and gastrin 17 was increased substantially in corpus-predominant gastritis (15.3 +/- 19.5 pmol/mL vs 3.8 +/- 5.7 pmol/mL in normal mucosa). By using a cut-off value of 7.5 microg/mL for PGII, any type of gastritis from normal mucosa can be diagnosed with a sensitivity and specificity of 80%. The sensitivity and specificity of the PG I:II ratio (< or =3) and gastrin 17 (>17 pmol/mL) together were 9.4% and 99% for screening corpus-predominant gastritis and 14.8% and 97.8%, respectively, for screening intestinal metaplasia in the corpus. CONCLUSIONS: PGII is a suitable marker for screening any gastritis from normal mucosa, but neither PGI, the PG I:II ratio, gastrin 17, nor their combination were able to select those with precancerous conditions and corpus-predominant gastritis among the first-degree relatives of gastric cancer patients.