Convalescent plasma therapy in critically Ill COVID-19 patients: A retrospective cohort study.

Background: Convalescent plasma (CP) therapy can be defined as a passive immunity transfer approach involving the administration of plasma for therapeutic purposes to inpatients hospitalized due to an active virus infection. Passive immunity antibodies can reduce target organ damage and directly neutralize the responsible pathogens. A limited number of studies on the use of CP have reported that critically ill patients can benefit from CP therapy. Aim: We aimed in this study as the outcomes of CP therapy in critically ill coronavirus disease 2019 (COVID-19) patients in intensive care unit (ICU) and determine the differences between the recovery and mortality groups. Patients and Methods: This retrospective design study involved critically ill patients who were diagnosed with COVID-19 pneumonia or who were suspected of having COVID-19 in the ICU between April 1, 2020, and June 1, 2020. Comorbidity of patients, respiratory findings, hemodynamic data, laboratory data, and poor prognostic measures were compared between mortality and recovery group. Results: Convalescent plasma (CP) therapy was supplied for 41 (13.58%) patients in total of 302 COVID-19 patients. Twenty-nine patients were died in total of 41 COVID-19 patients who supplied CP therapy. The mortality rate is 70.73% in CP therapy. There was a significantly higher incidence (P < 0.021) of invasive mechanical ventilation (IMV) and significantly lower mean arterial pressure (MAP) values in mortality group (P < 0.05). There were significantly higher NLR values (P < 0.05), lower platelet count (P < 0.05), lower of glomerular filtration rate (GFR) level (P < 0.05), higher creatinine values (P < 0.05), higher lactate dehydrogenase (LDH) levels (P < 0.05), higher D-dimer levels (P < 0.05), higher level of pro-brain natriuretic peptide (BNP) (P = 0.000), rate of fever (P = 0.031), arrythmia (P = 0.024), and transfusion-associated circulatory overload (TACO) (P = 0.008) were more often in mortality group. Conclusion: Convalescent plasma therapy seems not useful in critically ill COVID-19 patients.

Effects of Different Local Anaesthetics on Oto-acoustic Emission Tests after Spinal Anaesthesia.

PURPOSE: To evaluate whether there is any effect of different local anaesthetic agents on hearing loss after spinal anaesthesia. METHODS: Thirty American Society of Anesthesiologists (ASA) I patients without a hearing problem were included in the study. Transient evoked oto-acoustic emissions (TEOAE) were examined. Patients were randomly separated into two groups: Group L, 15 mg isobaric levobupivacaine application and Group B, 15 mg isobaric bupivacaine application, for spinal anaesthesia. Oto-acoustic emission measurements were repeated on patients at the 24th hour after spinal anaesthesia application. RESULTS: No significant difference was found in the output values of the right and left ears according to the input values in group L at no kHz (p > 0.05). No significant difference was found in the output values of the right and left ears according to the input values in any kHz of Group B (p > 0.05). CONCLUSION: Fifteen milligrammes of isobaric bupivacaine and levobupivacaine had no significant difference on the effect of hearing loss after spinal anaesthesia. Hearing loss after spinal anaesthesia has many unknown issues, and deserves to be explored by performing many studies.

Potential role of some oxidant/antioxidant status parameters in prefrontal cortex of rat brain in an experimental psychosis model and the protective effects of melatonin.

OBJECTIVES: The etiology of schizophrenia is unknown. However, some of the neuropathological changes in schizophrenia may be the result of increased free radical-mediated or reactive oxygen species (ROS) mediated neurotoxicity. Melatonin is a hormone produced especially at night in the pineal gland; additionally is a highly important antioxidant. The aim of this study is to indicate the contribution effect of the neuropathophysiology of schizophrenia and protective effects of melatonin against this oxidative damaged. MK-801 induced selective neurotoxicity has been proposed as an animal model for psychosis. MATERIALS AND METHODS: 21 healthy adult and male Wistar albino rats were divided into three groups. MK-801 was given intraperitoneally for 5 days in experimental psychosis group. Melatonin was given to the treatment group for 6 days by intraperitoneally. In control group, saline was given in the same way. At the 7th day of the experiments, rats were killed by decapitation. Brains were removed and prefrontal part of the brain was divided for biochemical analyses. RESULTS: Some antioxidant enzymes, malondialdehyde and protein carbonyl analyses were made by spectrophotometric methods. SOD, GSH-Px, XO activities and malondialdehyde, protein carbonyl and NO levels were found to be increased significantly in prefrontal cortex of MK-801 group (p < 0.0001) compared to the control group. In melatonin treated rats, prefrontal tissue malondialdehyde and protein carbonyl levels were decreased significantly in comparison with MK-801 group (p < 0.0001). CONCLUSIONS: MK-801 may induce oxidative stress in prefrontal cortex of rats. This experimental study provides some evidences for the protective effects of melatonin on MK-801-induced changes in prefrontal rat cortex.

Transdermal methyl alcohol intoxication cause of pain relief.

A 60-year old female patient was found comatosed at home and taken to the hospital's Emergency Department by her relatives. It was learnt that she wrapped her knees with spirit-impregnated cotton pad for pain for one week. On physical examination, only a colour change of purple violet on her knees was noted. Metabolic acidosis with increased anion gap was detected by arterial blood analysis. The patient underwent haemodialysis. She was discharged from the hospital with no complaints, alert and rational following five days of follow-up treatment, with the diagnosis of methyl alcohol poisoning.

An alternative way for the evaluation of zinc status in the elderly; nail zinc levels and relationship with Alzheimer's disease.

BACKGROUND: Zinc is one of the most important elements for human body. Zinc deficiency can occur in any age, if it is seen in elderly its clinical results can be more harmful due to already diminished functions. Some studies showed zinc deficiency has an important role in the pathogenesis of Alzheimer disease. In this study we measured the nail zinc levels and aimed to show its clinical implications in geriatric patients, especially Alzheimer disease. PATIENTS AND METHODS: 43 patients with Alzheimer disease and 89 patients with normal cognitive function were evaluated. The diagnosis of Alzheimer disease was made according to DSM-IV and NINCDS-ADRDA criteria after cognitive assessment and neuroimaging performed using magnetic resonance. Hand fingernail samples are obtained from the patients. RESULTS: Mean zinc level from fingernail samples was 117.99 ± 73.44 ppm in Alzheimer Disease patients, 123.86 ± 77.98 ppm in control group (p: 0.680). CONCLUSIONS: This is the first study measuring nail zinc levels in elderly patients with and without Alzheimer disease. Our data reveal no significant difference in nail zinc levels between two groups. However, fingernail zinc may be a useful biomarker in elderly population.  

Transdermal methyl alcohol intoxication cause of pain relief / Intoxicación transdérmica con alcohol metílico tratando de aliviar un dolor

A 60-year old female patient was found comatosed at home and taken to the hospital's Emergency Department by her relatives. It was learnt that she wrapped her knees with spirit-impregnated cotton pad for pain for one week. On physical examination, only a colour change of purple violet on her knees was noted. Metabolic acidosis with increased anion gap was detected by arterial blood analysis. The patient underwent haemodialysis. She was discharged from the hospital with no complaints, alert and rational following five days of follow-up treatment, with the diagnosis of methyl alcohol poisoning.

Una paciente de 60 años de edad fue hallada en estado comatoso en su casa, y trasladada por sus familiares al departamento de emergencias del hospital. Se supo que la paciente había sentido dolor en sus rodillas, y las cubrió con almohadillas de algodón impregnadas de metanol por espacio de una semana. Al realizarse el examen físico, sólo se observó un cambio de color violeta púrpura en sus rodillas. El análisis de sangre arterial reveló acidosis metabólica con hiato iónico elevado. A la paciente se le practicó una hemodiálisis. Fue dada de alta del hospital sin dolencias, consciente, y en su sano juicio, luego de cinco días de seguimiento de su tratamiento, tras de haber sido diagnosticada con envenamiento por alcohol metílico.

Comparison of transcutaneous, arterial and end-tidal measurements of carbon dioxide during laparoscopic cholecystectomy in patients with chronic obstructive pulmonary disease.

OBJECTIVE: Transcutaneous, arterial and end-tidal measurements of carbon dioxide were compared in patients (American Society of Anesthesiology physical status classes II and III) with chronic obstructive pulmonary disease (COPD) who underwent laparoscopic cholecystectomy with carbon dioxide insufflation. METHODS: General anaesthesia was performed in all patients. The Sentec(®) system was used for transcutaneous monitoring of the partial pressure of carbon dioxide (TcPCO(2)). TcPCO(2) and arterial partial pressure of carbon dioxide (PaCO(2)) were recorded preoperatively, after induction of anaesthesia, during insufflation and postoperatively; end-tidal carbon dioxide (ETCO(2)) was recorded after induction and during insufflation. RESULTS: PaCO(2) increased during insufflation and reached a maximum at extubation. It declined within 20 min postoperatively but did not return to preoperative levels during this time. TcPCO(2) levels followed a similar pattern. ETCO(2) was significantly lower than PaCO(2) after induction and during insufflation. CONCLUSION: TcPCO(2) was a valid and practical measurement compared with ETCO(2). In patients with COPD undergoing laparoscopic cholecystectomy, TcPCO(2) and ETCO(2) could be used instead of arterial blood gas sampling.

The anticancer mechanism of caffeic acid phenethyl ester (CAPE): review of melanomas, lung and prostate cancers.

BACKGROUND: Caffeic acid phenethyl ester (CAPE), an active component of propolis extract, specifically inhibits NF-κB. It exhibits antioxidant, antiinflammatory, antiproliferative, cytostatic, and most importantly, antineoplastic properties. AIM: The aim of the present mini-review is to summarize and evaluate the anticancer mechanism of CAPE with examples of several cancer types. RESULTS: In view of the mechanisms and findings in our laboratory and those of others in literature, we suggest that CAPE possess anticancer and apoptosis inducing activities. CONCLUSIONS: Further researches are needed regarding the anticancer basis of CAPE in all disciplines of medicine. Also, clinical potential toxicities of CAPE should be revealed if it is going to be used as an anticancer agent.

Occupational health of Turkish Aegean small-scale fishermen.

BACKGROUND: Fishing has always been a dangerous occupation, and numerous factors have a direct or indirect impact on the health of fisherman. AIMS: To examine the health, safety and working conditions of small-scale fishing fleets in the Turkish Aegean Sea coasts. METHODS: Data were obtained from a questionnaire distributed to a random sample of small-scale fishermen along the Aegean Sea coast. Data collection took place between September 2009 and January 2010. RESULTS: Out of 5714 Aegean Sea small-scale fishermen, 1166 from 76 fishing ports participated. Twenty-nine per cent of fishermen did not have any social security cover. The most prevalent health problems (using International Classification of Diseases and Related Health Problems 10th Revision [ICD-10]) found were musculoskeletal problems (e.g. discopathies, muscular strain, rheumatism) and eye, ear-nose, digestive and urinary system problems. Alcohol consumption was high (68%) in fishermen and 72% reported that they smoked more during fishing trips. Health problems appeared to be associated with a number of factors including migrant status, income satisfaction, rank, type of fishing and cumulative work per year. CONCLUSIONS: In Turkey, small-scale fishermen experience a significant number of health problems and have unhealthy lifestyles. Interventions designed to improve working conditions of small-scale fishermen could help to reduce the number of occupational injuries, which in turn may impact positively on their health. Prevention policies to reduce alcohol and tobacco consumption should also be developed.

Intra-erythrocyte magnesium levels and their clinical implications in geriatric outpatients.

OBJECTIVES: Magnesium deficiency has been implicated as a factor in numerous chronic diseases and previous studies suggest a greater prevalence of occult magnesium deficiency among older adults. Serum is the choice for the assessment of most analyses used in clinical medicine, although serum magnesium concentrations have been shown to be poor predictors of intracellular magnesium concentration. The aim of this study was to compare intracellular and extracellular magnesium concentrations in geriatric outpatients. Moreover, we examined whether a significant correlation between magnesium parameters and clinical outcome existed. DESIGN: Cross-sectional study. SETTING: Geriatric medicine outpatient clinic of a university hospital. PARTICIPANTS: A total of 246 patients with a mean age of 71.9 ± 5.7 years were involved. MEASUREMENTS: Intra-erythrocyte magnesium levels were analyzed with atomic absorption spectrophotometry. RESULTS: Serum magnesium levels were within normal range in all patients, whereas intra-erythrocyte magnesium measurements were low in 57% of the patients. Increase in serum levels were together with just only a slightly increase in intra-erythrocyte measurements and the relationship was very weak. Intra-erythrocyte Mg levels were not significantly correlated with many laboratory or clinical parameters. CONCLUSION: Our results confirm that intra-erythrocyte Mg does not correlate with serum levels and clinical parameters in geriatric outpatients, but further studies are needed to define the correlation.

The effect of Nigella sativa oil against experimental allergic encephalomyelitis via nitric oxide and other oxidative stress parameters.

Reactive oxygen species (ROS) including nitric oxide (NO) are thought to be involved in inflammatory processes, exacerbating inflammation and tissue damage in multiple sclerosis (MS). The oil extracts of Nigella sativa (N. sativa) has been known as an antioxidant and antiinflammatory agent. The aim of the present study was to investigate the hypothesis that N. sativa components provide protection against oxidative stress induced by experimental autoimmune encephalomyelitis (EAE) in rats. For this purpose, EAE was induced in rats by using guinea pig myelin basic protein (MBP) in Freud's adjuvant with addition of heat-killed M. Tuberculosis H37Ra to test this hypothesis. In study groups, N. sativa was given by oral gavage to the rats. Treatment of the rats with N. sativa inhibited ROS production induced by EAE showing diminished levels of MDA of both brain and medulla spinalis tissues. Although there was a significant decrease in brain NO level, there was an increase in medulla spinalis NO level after EAE induction in rats. N. sativa regulated tissue NO levels in some extend when applied together with EAE. When N. sativa was given alone to the rats, no changes were shown in brain, medulla spinalis, and serum oxidant/antioxidant parameters. In conclusion, N sativa may protect brain and medulla spinalis tissues against oxidative stress induced by EAE. In addition, N. sativa display its antioxidant and regulatory effects via inflammatory cells rather than the host tissue (brain and medulla spinalis) for EAE in rats.

Erdosteine ameliorates neurological outcome and oxidative stress due to ischemia/reperfusion injury in rabbit spinal cord.

OBJECTIVE: Oxygen-derived free radicals have been suggested as important in degeneration after spinal cord ischemia. The aim of this study was to investigate whether erdosteine has a protective effect against spinal cord ischemia during aortic cross clamping. MATERIALS AND METHODS: New Zealand White rabbits (n=21) were divided into three groups. In the ischemia/reperfusion group (I/R) (n=8), the infrarenal aorta of rabbits was cross clamped for 21 min and then reperfused. In erdosteine group, the administration of erdosteine solution (50 mg/kg) was started two days before aortic cross-clamping and rabbits (n=8) were subjected to ischemia and reperfusion. Animals in control group (n=5) underwent a surgical procedure similar to the other groups but the aorta was not clamped. The animals were sacrificed at 72 h and histopathological, and biochemical analyses were carried out on the lumbar spinal cords. RESULTS: Erdosteine treatment was associated with improved neurological function in the postoperative period. Histopathological examination of spinal cord tissues in erdosteine group revealed changes consistent with mild ischemic injury, but rabbits in I/R group with paraplegia had total destruction of the motor neurons. Biochemical analyses of spinal cord tissues, in the I/R group, revealed a significant increase in the superoxide dismutase, xanthine oxidase, adenosine deaminase and myeloperoxidase activities, and a significant depletion in glutathione peroxidase activity when compared to that of control rabbits. Erdosteine treatment prevented the increase of all these enzymes except adenosine deaminase. Ischemia/reperfusion produced a significant increase in the tissue malondialdehyde levels. Ischemia/reperfusion-induced increments in malondialdehyde content of the spinal cord were significantly prevented by erdosteine treatment. CONCLUSIONS: The present study demonstrated that erdosteine treatment before aortic cross clamping ameliorates neurological outcome, neuronal injury and oxidative stress in the rabbit spinal cord.

Caffeic acid phenethyl ester ameliorated ototoxicity induced by cisplatin in rats.

Caffeic acid phenethyl ester (CAPE), an active component of propolis, exhibits antioxidant properties. This experimental study was designed to determine the effect of CAPE on ototoxicity induced with cisplatin. Twenty-four adult Wistar albino rats were divided into four groups: cisplatin (n=6), saline (n=6), CAPE (n=6), and cisplatin plus CAPE (n=6). Rats were tested before and 5 days after cisplatin treatment with or without chemo protection. The Distortion Product Otoacoustic Emissions (DPOAEs) were elicited from the control and experimental animals utilizing the standard commercial Otoacoustic Emission (OAEs) apparatus. The animals in all groups were sacrificed under general anesthesia on the fifth day following last OAE measurements. For biochemical investigations, the blood samples were drawn from inferior vena cava. On day 0, the initial baseline DPOAEs measurement results presented similar values while comparing the groups in drug free phase (p>0.05). On day 5, intrasubject measurement parameters of DPgrams and I/O functions of cisplatin group were significantly deteriorated (p<0.05). The second measurements of the other groups revealed no significant differences between their DPgrams and I/O functions in all frequencies (p>0.05). Among the biochemical parameters, plasma xanthine oxidase (XO) activity was found to be more elevated in the cisplatin group than the saline group (p<0.05). CAPE led to more decreased XO activity than cisplatin (p<0.05). The results of this study show that prophylactic administration of CAPE for cisplatin ototoxicity ameliorated hearing deterioration in rats.

Plasma malondialdehyde and nitric oxide levels in age related macular degeneration.

AIMS: To evaluate alteration of plasma malondialdehyde (MDA) and nitric oxide (NO) levels in patients with exudative age related macular degeneration (ARMD). METHODS: Plasma nitrite plus nitrate concentrations as an index of plasma NO levels and plasma MDA level as a marker of lipid peroxidation were measured in patients with exudative ARMD and age and sex matched healthy subjects. RESULTS: Significantly higher MDA and lower NO levels were detected in plasma of patients with ARMD compared with their controls (p=0.01, p=0.001, respectively). CONCLUSION: The results may support involvement of oxidative damage and vascular theory in the pathogenesis of ARMD as part of the ageing process.

Caffeic acid phenethyl ester changes the indices of oxidative stress in serum of rats with renal ischaemia-reperfusion injury.

Oxygen-derived free radicals have been implicated in the pathogenesis of renal injury after ischaemia-reperfusion. Caffeic acid phenethyl ester (CAPE), an active component of propolis extract, exhibits antioxidant properties. To investigate whether treatment with either CAPE or alpha-tocopherol modifies the levels of the endogenous indices of oxidant stress, we examined their effects on an in vivo model of renal ischaemia-reperfusion injury in rats. CAPE at 10 micromol kg(-1) or alpha-tocopherol at 10 mg kg(-1) was administered intraperitoneally before reperfusion. Acute administration of both CAPE and alpha-tocopherol altered the indices of oxidative stress differently in renal ischaemia-reperfusion injury.

Effects of caffeic acid phenethyl ester and epidermal growth factor on the development of caustic esophageal stricture in rats.

BACKGROUND/PURPOSE: An experimental study was performed to modify the healing response in caustic esophageal burns to prevent stricture development. Two different agents with different modes of actions, caffeic acid phenethyl ester (CAPE) and epidermal growth factor (EGF), were studied. CAPE has antiinflammatory, immunomodulatory, antioxidant, and antimitotic properties. EGF has known properties in supporting wound healing and in protecting esophagus from injuries. METHODS: The model described by Gehanno and its modification by Liu was used to create standard esophageal burns with 50% NaOH. The study was performed with 76 rats in 4 main groups (sham, CAPE, EGF, and control) and 2 subgroups in each for 5 and 28 days of observation. Efficacy of treatment was assessed in 28-day subgroups by measuring weight gain, contrast esophagograms on day 27, histologic evaluation by measuring stenosis index (wall thickness/lumen diameter), and collagen deposition, and biochemically by determining tissue hydroxy proline (OHP) content. RESULTS: In the end of the study, increase rates of mean body weights of the animals in the 28-day subgroups were as follows: sham, 30%; CAPE, 23%; EGF, 22%; and control, 14%. Although all the animals in subgroups significantly gained weight, the mean weight gain was significantly low in controls when compared with sham, CAPE, and EGF groups (P <.05). Contrast esophagograms on day 27 showed no stenosis in the sham, mild stenosis in CAPE and EGF, and severe stenosis with proximal dilatation in controls. Stenosis indices of the subgroups were as follows: sham, 0.29; CAPE, 0.41; EGF, 0.41; control, 0.84. Index was significantly higher in controls (P <.05). Collagen accumulation scores in the esophageal wall were as follows: Sham, 0.0; CAPE, 0.87; EGF, 0.30; control, 2.70. Scores also were significantly higher in controls (P <.05). Tissue (OHP) levels were as follows (mg/g dry tissue): Sham, 1.48; CAPE, 1.53; EGF, 1.90; control, 4.01. Production of OHP was significantly higher in controls. CONCLUSIONS: The results of the parameters in the study indicate that administration of CAPE and EGF has beneficial effects in the prevention of caustic esophageal strictures. Those effects of CAPE may occur through its antiinflammatory, immunomodulatory, and antioxidant properties, and EGF may occur through its induced proliferative properties on the esophagus.

The effect of caffeic acid phenethyl ester on ischemia-reperfusion injury in comparison with alpha-tocopherol in rat kidneys.

Oxygen-derived free radicals have been implicated in the pathogenesis of renal injury after ischemia-reperfusion. Caffeic acid phenethyl ester (CAPE), an active component of propolis extract, exhibits antioxidant and anti-inflammatory properties. To determine whether CAPE offers any advantage over alpha-tocopherol, we compared their effects on an in vivo model of renal ischemia-reperfusion injury in rats. CAPE at 10 micromol/kg or alpha-tocopherol at 10 mg/kg was administered intraperitoneally before reperfusion. Acute administration of CAPE suppressed ischemia-reperfusion induced renal lipid peroxidation and tissue injury more than alpha-tocopherol. CAPE may therefore offer a therapeutic advantage in acute injury settings.