Hypersensitivity reactions to COVID-19 vaccines: a case of Eosinophilic pneumonia following Sinovac/CoronaVac vaccination.

Summary: Hypersensitivity reactions has been reported with COVID-19 vaccines. Acute eosinophilic pneumonia has not been reported yet after Sinovac/CoronaVac vaccine. A 73-year-old woman presented with maculopapular rash, cough and dyspnea following Sinovac/CoronaVac injection. The complete blood count (CBC) indicated eosinophilia and further evaluation of the eosinophilia with CT and bronchoscopy confirmed a diagnosis of acute eosinophilic pneumonia. After methylprednisolone therapy, her rash resolved with marked improvement of the dyspnea. She is still on treatment and on the follow up period, we plan to continue steroid treatment at least 3 months.

Can Carpobrotus edulis, heal incisional and excisional wounds on the skin?

OBJECTIVES: This study aimed to investigate the wound healing activity of liposomal Carpobrotus edulis powder extract (CEPE) formulation on incisional and excisional wounds in rat. BACKGROUND: In the event of any damage, the damaged tissue undergoes a process of regenerating itself, which is called wound healing. METHODS: Centella asiatica extract (CAE) was used as the reference molecule in the study. The wound healing process was tested by using the excisional and incisional wound model. On the 12th day of the study, maximum stress, stress, % of elongation values were evaluated in the incisional wound. Also; histological parameters and macroscopic photographic analyses were evaluated in the excisional wound. RESULTS: In the photo evaluations, the improvement was more prominent in both CAE and CEPE groups than in the control group. Histological evaluation showed that CEPE group had significant wound healing activity compared to the control and CAE groups. Axial tensile-elongation experiments in incisional wound tissue show that there was no significant difference between CAE and CEPE groups. CONCLUSION: Liposomal formulations of C.edulis extract were found to have positive effects on the healing process, both on excisional and incisional wound tissues (Tab. 2, Fig. 3, Ref. 30).

Can PET-CT predict diagnostic success in ultrasonography-guided transthoracic fine needle aspiration biopsies in lung cancers?

OBJECTIVE: To examine any correlations between tumor maximum standard uptake values (SUVmax) in positron emission tomography-computed tomography (PET-CT) and homogeneous/heterogeneous tumor FDG uptake in PET-CT, and the diagnostic success of the procedure in thoracic ultrasonography (US)-guided transthoracic fine needle aspiration biopsy (TFNAB). METHODS: The files of patients who underwent thoracic US-guided TFNAB between 2013 and 2018 were examined. Patients who underwent thoracic US-guided TFNAB and were diagnosed as having primary lung cancer were considered as the US-TFNAB diagnostic group. Patients whose disease was diagnosed as primary lung cancer using a different diagnostic method (e.g. CT-guided biopsies, fiberoptic bronchoscopy) due to a lack of diagnosis despite undergoing thoracic US-guided TFNAB were allocated to the US-TFNAB non-diagnostic group. The clinical and radiologic characteristics and PET-CT parameters of the two groups were compared. RESULTS: A total of 104 patients were included in the study; 79 (76%) patients whose disease was diagnosed using US-guided TFNAB, and 25 (24%) patients whose primary lung cancer could not be diagnosed with US-guided TFNAB. The mean SUVmax value of the US-TFNAB diagnostic group was 19.5 ±â€¯10.1, whereas it was 15.1 ±â€¯8.9 in the US-TFNAB non-diagnostic group (p = 0.016). Whether a lesion showed homogeneous or heterogeneous FDG uptake did not effect diagnostic success (p = 0.289). SUVmax value was the only effective independent factor in the diagnostic success of the procedure (p = 0.035). CONCLUSIONS: High SUVmax values in PET-CT in lung cancers may increase the diagnostic success of US guided-TFNAB procedures.

HMG-CoA reductase inhibitor rosuvastatin improves abnormal brain electrical activity via mechanisms involving eNOS.

Apart from its repressing effect on plasma lipid levels, 3-hydroxy-3-methyl glutaryl coenzyme A (HMG-CoA) reductase inhibitors exert neuroprotective functions in animal models of neurodegenerative disorders. In view of these promising observations, we were interested in whether HMG-CoA reductase inhibition would affect epileptiform activity in the brain. To elucidate this issue, atorvastatin, simvastatin and rosuvastatin were administered orally at a dose of 20 mg/kg each for 3 days and their anti-epileptic activities were tested and compared in rats. Epileptiform activity in the brain was induced by an intracortical penicillin G injection. Among HMG-CoA reductase inhibitors, simvastatin-treatment was less effective in terms of spike frequency as compared with atorvastatin- and rosuvastatin-treated animals. Atorvastatin treatment reduced spike frequencies and amplitudes significantly throughout the experiment. However, the most pronounced anti-epileptic effect was observed in rosuvastatin-treated animals, which was associated with improved blood-brain barrier (BBB) integrity, increased expression of endothelial nitric oxide synthase (eNOS) mRNA and decreased expressions of pro-apoptotic p53, Bax and caspase-3 mRNAs. Inhibition of eNOS activity with L-NG-Nitroarginine Methyl Ester (L-NAME) reversed the anti-epileptic effect of rosuvastatin significantly. However, L-NAME did not alter the effect of rosuvastatin on the levels of p53, Bax and caspase-3 mRNA expression. Here, we provide evidence that among HMG-CoA reductase inhibitors, rosuvastatin was the most effective statin on the reduction of epileptiform activity, which was associated with improved BBB permeability, increased expression of eNOS and decreased expressions of pro-apoptotic p53, Bax and caspase-3. Our observation also revealed that the anti-epileptic effect of rosuvastatin was dependent on the increased expression level of eNOS. The robust anti-epileptic effect encourages proof-of-concept studies with rosuvastatin in human epilepsy patients with hypercholesterolemia.

Thorax and lung injuries arising from the two earthquakes in Turkey in 1999.

STUDY OBJECTIVE: To make a descriptive analysis of the frequency and the type of thorax and lung injuries among the casualties of the two devastating earthquakes that occurred in Turkey in 1999. DESIGN: Records of the hospitalized patients injured in the earthquakes were examined retrospectively. RESULTS: Among the total of 356 hospitalized patients, 21 (9.7%) in the Izmit earthquake and 6 (7.6%) in the Duzce earthquake had thorax and lung injuries. Pneumothorax and rib fractures were the two most frequent pathologies and accounted for 50% and 33.3% of the injuries, respectively. CONCLUSION: Approximately 10% of the casualties of a great earthquake may be expected to have thorax and lung injuries, and traumatic chest diseases should be considered in planning the medical response strategies.

Cardiac or pulmonary dyspnea in patients admitted to the emergency department.

A simple and quick way of discrimination between cardiac and pulmonary causes of dyspnea is essential in patients admitted to the emergency department. We aimed to assess the utility of easily applicable diagnostic tools in the differential diagnosis of cardiac and pulmonary causes of dyspnea in patients presenting with shortness of breath. Clinical and radiologic evaluation, peak expiratory flow (PEF), PaO2, PaCO2 measurements were performed in 94 patients admitted to the emergency room with dyspnea. All the patients were hospitalized for accurate diagnosis and later were categorized into cardiac and pulmonary dyspnea groups. PEF, %PEF (percent of predicted PEF), dyspnea differentiation index (DDI = PEF x PaO2/1000), %DDI (%PEF x PaO2/1000), PaO2 and PaCO2 measurements were compared between the two groups. When cardiac and pulmonary dyspnea groups were compared, considering 1.6 as the cut-off value for DDI, measurements above this value imply cardiac pathology with 76.7% sensitivity and 67.2% specificity. The sensitivity and specificity for cardiac dyspnea calculated according to the cut-off values were 96.7% and 40.6% for %DDI; 86.7% and 60.9% for PEF; 86.7% and 54.7% for %PEF; 66.7 and 68.7 for PaO2. Also for pulmonary dyspnea, sensitivity and specificity values for PaCO2 were 50% and 93%. We conclude that DDI, %DDI, PEF, %PEF, PaO2 and PaCO2 are simple and easily applicable tools for differential diagnosis of cardiac and pulmonary dyspnea. Adjunctive utility of these tests in the emergency department with clinical and radiologic evaluation contributes to this discrimination.

Hemoptysis: a retrospective analysis of 108 cases.

A retrospective analysis of 108 patients admitted to the hospital for hemoptysis in the year 2000 was performed. The aim of the study was to clarify the etiologic distribution of hemoptysis and the relation of etiology to the severity and recurrence of it. Of the cases, 79 were men and 29 were women, and the mean age was 51.74 +/- 17.51. In 77 of the cases it was the first attack, while in 31 it was recurrent. According to the severity of hemoptysis, it was classified as "mild" (<30 cm3), "moderate" (30-100 cm3), "severe" (100-600 cm3) and "massive" (>600 cm3). Lung cancer was the leading cause of hemoptysis (34.3%) followed by bronchiectasis (25.0%), tuberculosis (17.6%), pneumonia (10.2%) and pulmonary embolism (4.6%). Statistical analysis by chi-square test revealed that most of the lung cancer patients had mild hemoptysis (odds ratio 3.5; P<0.05), and the most frequent etiology in recurrent hemoptysis was bronchiectasis (odds ratio 3.25; P=0.01). Most of the lung cancer patients were male (P=0.002). The two leading causes of hemoptysis in our study are similar to many previous reports. The high rate of tuberculosis in our study is probably due to the high prevalence of tuberculosis in our country.

Evaluation of pulmonary complications of radiotherapy in breast cancer patients.

PURPOSE: To study the early and late pulmonary complications of radiotherapy (RT) in patients with operated breast cancer who received postoperative RT. PATIENTS AND METHODS: Radiation pneumonia (RP) and radiation fibrosis (RF) rates were evaluated after 3 and 18 months from the end of RT, using the Radiation Therapy Oncology Group and the European Organization for the Research and Treatment of Cancer (RTOG/ EORTC) combined toxicity classification scale. Evaluation included physical examination, high resolution computed tomography (HRCT) of the thorax, and pulmonary function tests (PFTs). The incidence of RP and RF, the relationship between RP and RF and possible predisposing factors and the impact of RT on the PFTs were analyzed. RESULTS: Between December 2000 and March 2001 35 patients were included in the study. Due to several reasons 29 patients were evaluable for RP and 25 for RF. On the 3rd month post-RT, 17 (59%) patients developed RP. Three (18%) of the cases were grade 1, 13 (76%) grade 2 and 1 (6%) grade 3. One patient was radiologically diagnosed with early RF. When evaluated for RF, 9 (36%) of 25 patients were found to have RF. Four (45%) of them were grade 1, and 5 (55%) grade 2. FEV1, FEV1/FVC, VC, FVC values showed different degrees of decline on the 3rd month. The most prominent change occurred with DLCO/ VA ratio which decreased by 20%. On the 18th month, all values returned to at least the pretreatment levels. CONCLUSION: RT-induced RP and RF are quite frequent. As clinical findings are generally nonspesific, radiological findings of RP and RF should be known. Early and late effects on PFTs are generally mild and transient.

Sensitization of Cervical Cancer Cells to Cisplatin by Genistein: The Role of NFκB and Akt/mTOR Signaling Pathways.

Cervical cancer is among the top causes of death from cancer in women. Cisplatin-based chemotherapy has been shown to improve survival; however, cisplatin treatment is associated with toxicity to healthy cells. Genistein has been used as an adjunct to chemotherapy to enhance the activity of chemotherapeutic agents without causing increased toxicity. The present study was designed to investigate the effect of genistein (25 µM) on antitumor activity of cisplatin (250 nM) on HeLa cervical cancer cells. We have examined the alterations in expression of NF-κB, p-mTOR, p-p70S6K1, p-4E-BP1, and p-Akt protein levels in response to treatment. The combination of 25 µM genistein with 250 nM cisplatin resulted in significantly greater growth inhibition (P < 0.01). Genistein enhanced the antitumor activity of cisplatin and reduced the expression of NF-κB, p-mTOR, p-p70S6K1, p-4E-BP1, and p-Akt. The results in the present study suggest that genistein could enhance the activity of cisplatin via inhibition of NF-κB and Akt/mTOR pathways. Genistein is a promising nontoxic nutritional agent that may enhance treatment outcome in cervical cancer patients when given concomitantly with cisplatin. Clinical trials of genistein and cisplatin combination are warranted to test this hypothesis.

Anxiolytic and antidepressant properties of methylene blue in animal models.

Methylene blue (MB) has been intermittently used in manic depressive illness over the past century. However, to our knowledge, it has not been studied in the behavioural animal models. The present study was designed to evaluate whether the intravenous (i.v.) administration of MB in a dose range of 1.87-60 mg kg-1 would affect the performance of rats in the elevated plus-maze and the forced swimming (FST) tests. In the plus-maze, MB in doses ranging from 3.25 to 30 mg kg-1 significantly increased the percentage of open arm entries and exhibited an inverted U-shaped dose-response curve. Over a dose range, 7.5-30 mg kg-1, MB also increased time spent in open arms. These data suggest that MB has anxiolytic properties. On the other hand, MB, at doses of 15 and 30 mg kg-1 significantly decreased the immobility time in the FST and behaved as an antidepressant compound in these doses. As known, MB has prominent effects on the nitrergic system; Nitric oxide (NO) produced from L-arginine by the enzyme NO-synthase (NOS) activates soluble guanylyl cyclase (sGC) and exerts its effects on tissues through cGMP. MB acts as a direct inhibitor of NOS as well as of sGC. It also inactivates NO extracellularly through generation of superoxide anions. Thus, it can be speculated that NOS-NO-cGMP pathway may be involved in the antidepressant and anxiolytic actions of MB, and this may lead to search for new antidepressant and anxiolytic compounds.

Effects of nifedipine and Bay K 8644 on the R-PIA and caffeine-induced changes in the locomotor activity of rats.

Possible interaction between adenosine and L type Ca2+ channel in the locomotor activity of rats was investigated. R-PIA (0.05 mg kg-1), an adenosine analogue, and caffeine (20 mg kg-1), an adenosine receptor antagonist, significantly decreased and increased locomotor activity, respectively. Ca2+ channel blocker nifedipine (5 mg kg-1) and the channel activator Bay K 8644 (0.5 mg kg-1) did not alter the locomotor activity. However, both drugs significantly potentiated the inhibitory effect of R-PIA on the locomotor activity. Additionally, caffeine induced increase in the locomotor activity was significantly blocked by nifedipine and Bay K 8644. This interaction might be due to the inhibitory effects of nifedipine and Bay K 8644 on the uptake of adenosine by rat brain.