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Objective: There is increasing evidence for the effect of inflammation on the etiology of febrile seizure (FS) patients. We aimed to investigate the role of easily accessible inflammatory markers such as the neutrophil–lymphocyte ratio (NLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), neutrophil–lymphocyte–platelet ratio (NLPR), and pan-immune-inflammation value (PIV) in febrile seizure. Methods: A total of 300 children, including 100 with febrile convulsions (FS), 100 febrile controls (FCs), and 100 healthy controls (HCs), were included in this retrospective study. The FS group was compared with the FC and HC groups in terms of these inflammatory indexes. Results: Between the FS group and the FC group, the neutrophil count was significantly higher in the FS group (p = 0.001) and the lymphocyte count was significantly lower (p < 0.001). The NLR (p < 0.001), SII (p < 0.001), SIRI (p < 0.001), NLPR (p < 0.001), and PIV (p < 0.001) were significantly higher in the FS group than in both the FC and healthy control groups. The optimal cut-off values for predicting FS in febrile conditions were 3.59> for NLR, >870.47 for SII, >1.96 for SIRI, 0.96> for NLPR, and >532.75 for PIV. Conclusions: The inflammatory indices are inexpensive, easily accessible hematological markers that can contribute to the diagnosis of FS. [ABSTRACT FROM AUTHOR]

Respiratory failure is a common perioperative complication. The risk of respiratory failure can be reduced with effective preoperative evaluation, preventative measures, and knowledge of evidence-based management techniques. Effective preoperative screening methods include ARISCAT scoring, OSA screening, and the LAS VEGAS score (including the ASA physical status score). Evaluation by the six-minute walk test and a routine pulmonary physical exam has been shown to be effective at predicting postoperative pulmonary complications, whereas evidence on the predictive power of pulmonary function tests and chest radiography has been inconclusive. Preoperative smoking cessation and lung expansion maneuvers have been shown to decrease the risk of pulmonary complications postoperatively. Intraoperative management techniques that decrease the pulmonary complication risk include neuromuscular blockade reversal with sugammadex, limiting surgical times to less than 3 h when possible, lung-protective ventilation techniques, and multimodal analgesia to decrease opioid usage. In the immediate postoperative period, providers should be prepared to quickly treat bronchospasm, hypoventilation, and upper airway obstruction. For post-surgical patients who remain in the hospital, the risk of pulmonary complications can be decreased with lung expansion techniques, adequate analgesia, automated continuous postoperative ward monitoring, non-invasive ventilatory support, and early mobilization. This article was written to analyze the available literature on this topic in order to learn and practice the prevention of perioperative respiratory failure when caring for patients on a daily basis. [ABSTRACT FROM AUTHOR]

Honokiol, a biphenyl lignan extracted from bark extracts belonging to Magnolia plant species, is a pleiotropic compound which exhibits a widespread range of antioxidant, antibacterial, antidiabetic, anti-inflammatory, antiaggregant, analgesic, antitumor, antiviral and neuroprotective activities. Honokiol, being highly hydrophobic, is soluble in common organic solvents but insoluble in water. Therefore, its biological effects could depend on its bioactive mechanism. Although honokiol has many impressive bioactive properties, its effects are unknown at the level of the biological membrane. Understanding honokiol's bioactive mechanism could unlock innovative perspectives for its therapeutic development or for therapeutic development of molecules similar to it. I have studied the behaviour of the honokiol molecule in the presence of a plasma-like membrane and established the detailed relation of honokiol with membrane components using all-atom molecular dynamics. The results obtained in this work sustain that honokiol has a tendency to insert inside the membrane; locates near and below the cholesterol oxygen atom, amid the hydrocarbon membrane palisade; increases slightly hydrocarbon fluidity; does not interact specifically with any membrane lipid; and, significantly, forms aggregates. Significantly, aggregation does not impede honokiol from going inside the membrane. Some of the biological characteristics of honokiol could be accredited to its aptitude to alter membrane biophysical properties, but the establishment of aggregate forms in solution might hamper its clinical use. [ABSTRACT FROM AUTHOR]

Oxidative stress plays a significant role in the pathogenesis of cardiovascular diseases, such as myocardial ischemia/reperfusion injury, atherosclerosis, heart failure, and hypertension. This systematic review aims to integrate most relevant studies on oxidative stress management in cardiovascular diseases. We searched relevant literatures in the PubMed database using specific keywords. We put emphasis on those manuscripts that were published more recently and in higher impact journals. We reviewed a total of 200 articles. We examined current oxidative stress managements in cardiovascular diseases, including supplements like resveratrol, vitamins C and E, omega-3 fatty acids, flavonoids, and coenzyme-10, which have shown antioxidative properties and potential cardiovascular benefits. In addition, we reviewed the pharmacological treatments including newly discovered antioxidants and nanoparticles that show potential effects in targeting the specific oxidative stress pathways. Lastly, we examined biomarkers, such as soluble transferrin receptor, transthyretin, and cystatin C in evaluating antioxidant status and identifying cardiovascular risk. By addressing oxidative stress management and mechanisms, this paper emphasizes the importance of maintaining the balance between oxidants and antioxidants in the progression of cardiovascular diseases. This review paper is registered with the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY), registration # INPLASY202470064. [ABSTRACT FROM AUTHOR]

Brain arteriovenous malformations (bAVMs) substantially increase the risk for intracerebral hemorrhage (ICH), which is associated with significant morbidity and mortality. However, the treatment options for bAVMs are severely limited, primarily relying on invasive methods that carry their own risks for intraoperative hemorrhage or even death. Currently, there are no pharmaceutical agents shown to treat this condition, primarily due to a poor understanding of bAVM pathophysiology. For the last decade, bAVM research has made significant advances, including the identification of novel genetic mutations and relevant signaling in bAVM development. However, bAVM pathophysiology is still largely unclear. Further investigation is required to understand the detailed cellular and molecular mechanisms involved, which will enable the development of safer and more effective treatment options. Endothelial cells (ECs), the cells that line the vascular lumen, are integral to the pathogenesis of bAVMs. Understanding the fundamental role of ECs in pathological conditions is crucial to unraveling bAVM pathophysiology. This review focuses on the current knowledge of bAVM-relevant signaling pathways and dysfunctions in ECs, particularly the endothelial-to-mesenchymal transition (EndMT). [ABSTRACT FROM AUTHOR]

This work analyzes the production of total lipids and the content of CoQ9 and CoQ10 in the biomass of Thraustochytrium sp. RT2316-16 grown in media containing a single amino acid at a concentration of 1 g L−1 as the sole nitrogen source; glucose (5 g L−1) was used as the carbon source. Biomass concentration and the content of total lipids and CoQ were determined as a function of the incubation time; ten amino acids were evaluated. The final concentration of the total biomass was found to be between 2.2 ± 0.1 (aspartate) and 3.9 ± 0.1 g L−1 (glutamate). The biomass grown in media containing glutamate, serine or phenylalanine reached a content of total lipids higher than 20% of the cell dry weight (DW) after 72, 60 and 72 h of incubation, respectively. The highest contents of CoQ9 (39.0 ± 0.7 µg g−1 DW) and CoQ10 (167.4 ± 3.4 mg g−1 DW) in the biomass of the thraustochytrid were obtained when glutamate and cysteine were used as the nitrogen source, respectively. Fatty acid oxidation, which decreased the total lipid content during the first 12 h of incubation, and the oxidation of hydrogen sulfide when cysteine was the nitrogen source, might be related to the content of CoQ10 in the biomass of the thraustochytrid. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to raise awareness toward early diagnosis, effective treatment, and prevention of respiratory complications in patients with neurological diseases. The goal is to improve patients' overall condition and reduce mortality rates. Materials and Methods: This study is a prospective observational study conducted at Damascus Hospital, Damascus, Syria, from October 2022 to March 2023. It includes (100) patients diagnosed with neurological diseases who developed respiratory complications. Their ages ranged from 18 to 89 years, with an equal gender distribution. Data analysis was performed using SPSS statistics version 19. Results: This study revealed that cerebrovascular accidents cause aspiration pneumonia. The most frequent chest X-ray and thoracic computed tomography findings showed pulmonary densities and infiltrates. Subsequently, arterial blood gas results showed type 2 respiratory failure. Many patients experienced regression of respiratory complications, and the mortality rate was low, indicating the efficacy of treatments. Conclusion: Respiratory complications significantly contribute to mortality in patients with neurological diseases. The study emphasizes the importance of early diagnosis and preventive measures such as elevating the patient's bed and periodic suctioning of secretions. Placing patients in specialized neurological intensive care units for tailored treatment is advised. [ABSTRACT FROM AUTHOR]

Background: In a critically ill patient, when an arterial blood sample is processed on an arterial blood gas (ABG) analyzer, it also measures electrolytes apart from analyzing the blood gases. The turnaround time for ABG analysis is way too less compared to the conventional electrolyte analysis with a serum sample. Objective: This study intends to investigate whether values of electrolytes estimated in arterial blood can substitute the routinely practiced method. Materials and methods: This is a retrospective cross-sectional study. The source of data is patients' reports of serum electrolytes and ABG analysis from the Clinical Biochemistry laboratory, CIMS Teaching Hospital, Chamarajanagar between January and June 2021. The electrolytes report of 200 patients from whom both arterial and venous blood samples were sent to the Clinical Biochemistry laboratory on the same day and at the same time for analysis were selected. The data was compiled, compared, and correlated using a suitable statistical tool. Results: The mean and standard deviation of sodium (135.62 ± 5.20 in venous vs 134.08 ± 8.49 in arterial blood), potassium (4.20 ± 0.64 vs 3.80 ± 0.75), and chloride (102.28 ± 4.99 vs 96.33 ± 8.11) were observed. However, when the concordance correlation coefficient and Bland-Altman plot analysis were made there was no agreement between electrolytes analyzed on serum in an autoanalyzer with that of ABG analyzer. Conclusion: We conclude that the electrolytes measured by a conventional autoanalyzer on a serum sample cannot be replaced by values analyzed on a blood gas analyzer. [ABSTRACT FROM AUTHOR]

Most currently available wearable devices to noninvasively detect hypoxia use the spatially resolved spectroscopy (SRS) method to calculate cerebral tissue oxygen saturation (StO2). This study applies the single source—detector separation (SSDS) algorithm to calculate StO2. Near-infrared spectroscopy (NIRS) data were collected from 26 healthy adult volunteers during a breath-holding task using a wearable NIRS device, which included two source—detector separations (SDSs). These data were used to derive oxyhemoglobin (HbO) change and StO2. In the group analysis, both HbO change and StO2 exhibited significant change during a breath-holding task. Specifically, they initially decreased to minimums at around 10 s and then steadily increased to maximums, which were significantly greater than baseline levels, at 25–30 s (p-HbO < 0.001 and p-StO2 < 0.05). However, at an individual level, the SRS method failed to detect changes in cerebral StO2 in response to a short breath-holding task. Furthermore, the SSDS algorithm is more robust than the SRS method in quantifying change in cerebral StO2 in response to a breath-holding task. In conclusion, these findings have demonstrated the potential use of the SSDS algorithm in developing a miniaturized wearable biosensor to monitor cerebral StO2 and detect cerebral hypoxia. [ABSTRACT FROM AUTHOR]

The aim of this research is to apply the learning using privileged information paradigm to sepsis prognosis. We used signal processing of electrocardiogram and electronic health record data to construct support vector machines with and without privileged information to predict an increase in a given patient's quick-Sequential Organ Failure Assessment score, using a retrospective dataset. We applied this to both a small, critically ill cohort and a broader cohort of patients in the intensive care unit. Within the smaller cohort, privileged information proved helpful in a signal-informed model, and across both cohorts, electrocardiogram data proved to be informative to creating the prediction. Although learning using privileged information did not significantly improve results in this study, it is a paradigm worth studying further in the context of using signal processing for sepsis prognosis. [ABSTRACT FROM AUTHOR]

Background: The risk of aspiration is high in stroke patients due to dysphagia/loss of swallowing. This problem can cause problems affecting the nutrition of patients. Due to the possible risk of aspiration during feeding, patient relatives are hesitant to feed their patients. Because of this fear, malnutrition and hospital readmissions may increase. It is important to evaluate the fear of aspiration risk of relatives of patients hospitalized in the neurology service. The aim of this study is to determine the views of the relatives of patients treated in the neurology service about the risk of aspiration through metaphors. Method: This article analyzed metaphors of patients' relatives' about the risk of aspiration. The analysis uses metaphor identification and analysis. The research sample consisted of 31 patients. First of all, in the study, evaluation of the data was conducted by performing content analysis, as a result of which it was divided into metaphors and conceptual categories, and the relevant field was associated with the text (event, thought, feelings, related in speech or writing). In the reporting of research, the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was used. Results: It was seen that the patients' relatives produced 31 different metaphors in response to the statement 'Aspiration risk is like ..., because it is ...' The patients' relatives mostly compared the concept of 'fear of aspiration' to the concept of 'fear' (n: 24). Conclusions: In this study, relatives mostly described the concept of fear related to the risk of aspiration. According to this result, patients' relatives have a great fear of aspiration increasing the risk of readmission to hospital and of malnutrition. This result shows that informing patients' relatives will increase awareness and will allow them to provide informed care. Patient and Public Contribution: Collaborated with patients and their relatives regarding the risk of aspiration and contributed to the planning of care for the risk of aspiration. [ABSTRACT FROM AUTHOR]

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Objectives: The aim of this study is to determine the factors affecting the duration of hospitalization and causing the initiation of antibiotics in children with acute bronchiolitis. Methods: This study was conducted retrospectively in Konya Training and Research Hospital. Demographic data, clinical features, laboratory and radiological findings, treatment methods and duration of hospitalization of 102 patients followed up in the pediatric service between September 2017 and April 2019 (in autumn, winter and spring seasons) were recorded from patient files. Results: 67 (65.7%) of 102 patients were male, and 35 (34.3%) were female. Median age was 6.5 (11.0) months. According to Wang bronchiolitis clinical scoring, 36 (35.3%) of the patients were mild, 51 (50.0%) were moderate, 15 (14.7%) were severe bronchiolitis The most common agents in polymerase chain reaction (PCR) were respiratory syncytial virus 60 (58.8%), influenza virus 20 (19.6%), rhinovirus 15 (14.7%), bocavirus 15 (14.7%) and parainfluenza virus 12 (11.7%). The median duration of hospitalization was 7.0 (4.0) days. Forty-two (41.2%) of the patients were hospitalized for =5 days, and 60 (58.8%) were hospitalized for >5 days. Duration of hospitalization was significantly and positively correlated with crepitant crackles, leukocytosis, neutrophilia, and coinfection with influenza virus (p=0.036, p=0.034, p=0.028, p=0.036, respectively). Duration of hospitalization was significantly and negatively correlated with pH and increased aeration (p=0.002, p=0.003, respectively) Antibiotic initiation was significantly and positively correlated with wheezing, crepitant crackles, leukocytosis, and neutrophilia (p=0.033, p=0.013, p=0.028, p=0.002, respectively). Conclusion: A significant relationship was found between crepitant crackles in physical examination, respiratory acidosis in laboratory, co-infection with influenza virus detected by PCR and hospitalization for more than 5 days. A significant relationship was determined between wheezing or crepitant crackles in physical examination, leukocytosis or neutrophilia in laboratory and the initiation of antibiotic. [ABSTRACT FROM AUTHOR]

The progression and maintenance of cancer characteristics are associated with cellular components linked to the tumor and non-cellular components with pro-tumoral properties. Pharmacological association with antagonists of the cellular components of the tumor, such as anti- and pro-apoptotic drugs, represents a novel adjuvant strategy. In this study, the antiproliferative, pro-apoptotic, and pharmacological effects of the combination of monophosphoester 2-AEH2P with Simvastatin, Coenzyme Q10, the chemotherapeutic drug paclitaxel, and colony-stimulating factor (GM-CSF) were evaluated. Tests were conducted to determine cytotoxic activity using the MTT method, cell cycle phases, and fragmented DNA by flow cytometry, mitochondrial membrane potential, expression of cell markers Bcl2, TNF-α/DR-4, Cytochrome c, caspase 3, and P53, and analysis of drug combination profiles using Synergy Finder 2.0 Software. The results showed a synergistic effect among the combinations, compared to individual treatments with the monophosphoester and other drugs. In addition, there was modulation of marker expression, indicating a pro-apoptotic and immunomodulatory effect of 2-AEH2P. Pharmacological analysis revealed that tumor cells treated with GM-CSF + 2-AEH2P exhibited a synergistic effect, while groups of tumor cells treated with paclitaxel, Coenzyme Q10, and Simvastatin showed additive effects. Furthermore, treatment with the paclitaxel + 2-AEH2P combination (12 h) resulted in a significant reduction in mitochondrial membrane potential. Pharmacological combinations for normal cells did not exhibit deleterious effects compared to mammary carcinomatosis tumor (EAT) cells. [ABSTRACT FROM AUTHOR]

Decreased total CO2 (tCO2) is significantly associated with all-cause mortality in critically ill patients. Because of a lack of data to evaluate the impact of tCO2 in patients with COVID-19, we assessed the impact of tCO2 on all-cause mortality in this study. We retrospectively reviewed the data of hospitalized patients with COVID-19 in two Korean referral hospitals between February 2020 and September 2021. The primary outcome was in-hospital mortality. We assessed the impact of tCO2 as a continuous variable on mortality using the Cox-proportional hazard model. In addition, we evaluated the relative factors associated with tCO2 ≤ 22 mmol/L using logistic regression analysis. In 4,423 patients included, the mean tCO2 was 24.8 ± 3.0 mmol/L, and 17.9% of patients with tCO2 ≤ 22 mmol/L. An increase in mmol/L of tCO2 decreased the risk of all-cause mortality by 4.8% after adjustment for age, sex, comorbidities, and laboratory values. Based on 22 mmol/L of tCO2, the risk of mortality was 1.7 times higher than that in patients with lower tCO2. This result was maintained in the analysis using a cutoff value of tCO2 24 mmol/L. Higher white blood cell count; lower hemoglobin, serum calcium, and eGFR; and higher uric acid, and aspartate aminotransferase were significantly associated with a tCO2 value ≤ 22 mmol/L. Decreased tCO2 significantly increased the risk of all-cause mortality in patients with COVID-19. Monitoring of tCO2 could be a good indicator to predict prognosis and it needs to be appropriately managed in patients with specific conditions. [ABSTRACT FROM AUTHOR]

Chronic diseases represent one of the major causes of death worldwide. It has been suggested that pregnancy-related conditions, such as gestational diabetes mellitus (GDM), maternal obesity (MO), and intra-uterine growth restriction (IUGR) induce an adverse intrauterine environment, increasing the offspring's predisposition to chronic diseases later in life. Research has suggested that mitochondrial function and oxidative stress may play a role in the developmental programming of chronic diseases. Having this in mind, in this review, we include evidence that mitochondrial dysfunction and oxidative stress are mechanisms by which GDM, MO, and IUGR program the offspring to chronic diseases. In this specific context, we explore the promising advantages of maternal antioxidant supplementation using compounds such as resveratrol, curcumin, N-acetylcysteine (NAC), and Mitoquinone (MitoQ) in addressing the metabolic dysfunction and oxidative stress associated with GDM, MO, and IUGR in fetoplacental and offspring metabolic health. This approach holds potential to mitigate developmental programming-related risk of chronic diseases, serving as a probable intervention for disease prevention. [ABSTRACT FROM AUTHOR]

Mitochondria are subcontractors dedicated to energy production within cells. In human mitochondria, almost all mitochondrial proteins originate from the nucleus, except for 13 subunit proteins that make up the crucial system required to perform 'oxidative phosphorylation (OX PHOS)', which are expressed by the mitochondria's self-contained DNA. Mitochondrial DNA (mtDNA) also encodes 2 rRNA and 22 tRNA species. Mitochondrial DNA replicates almost autonomously, independent of the nucleus, and its heredity follows a non-Mendelian pattern, exclusively passing from mother to children. Numerous studies have identified mtDNA mutation-related genetic diseases. The consequences of various types of mtDNA mutations, including insertions, deletions, and single base-pair mutations, are studied to reveal their relationship to mitochondrial diseases. Most mitochondrial diseases exhibit fatal symptoms, leading to ongoing therapeutic research with diverse approaches such as stimulating the defective OXPHOS system, mitochondrial replacement, and allotropic expression of defective enzymes. This review provides detailed information on two topics: (1) mitochondrial diseases caused by mtDNA mutations, and (2) the mechanisms of current treatments for mitochondrial diseases and clinical trials. [ABSTRACT FROM AUTHOR]

Arterial lines are routinely used for hemodynamic monitoring and blood sampling in the operating room and in cardiac surgery intensive care unit. The complications related to arterial line insertion are very low; the knowledge of the relevant artery anatomy, skills and the experience of the operator and selection of a right size cannula plays a vital role in reducing morbidity related to arterial line insertion. We describe extensive superficial and deep necrosis of lower limb following arterial cannula insertion in a preterm neonate undergoing arterial switch procedure and discuss measures to prevent such a complication. [ABSTRACT FROM AUTHOR]

Acute respiratory distress syndrome (ARDS) is a leading cause of morbidity and mortality in polytrauma patients. Pharmacological treatments of ARDS are lacking, and ARDS patients rely on supportive care. Accurate diagnosis of ARDS is vital for early intervention and improved outcomes but is presently delayed up to days. The use of biomarkers for early identification of ARDS development is a potential solution. Inflammatory mediators high-mobility group box 1 (HMGB1), syndecan-1 (SDC-1), and C3a have been previously proposed as potential biomarkers. For this study, we analyzed these biomarkers in animals undergoing smoke inhalation and 40% total body surface area burns, followed by intensive care for 72 h post-injury (PI) to determine their association with ARDS and mortality. We found that the levels of inflammatory mediators in serum were affected, as well as the degree of HMGB1 and Toll-like receptor 4 (TLR4) signal activation in the lung. The results showed significantly increased HMGB1 expression levels in animals that developed ARDS compared with those that did not. Receiver operating characteristic (ROC) analysis showed that HMGB1 levels at 6 h PI were significantly associated with ARDS development (AUROC=0.77) and mortality (AUROC=0.82). Logistic regression analysis revealed that levels of HMGB1 ≥24.10 ng/ml are associated with a 13-fold higher incidence of ARDS [OR:13.57 (2.76–104.3)], whereas the levels of HMGB1 ≥31.39 ng/ml are associated with a 12-fold increase in mortality [OR: 12.00 (2.36– 93.47)]. In addition, we found that mesenchymal stem cell (MSC) therapeutic treatment led to a significant decrease in systemic HMGB1 elevation but failed to block SDC-1 and C3a increases. Immunohistochemistry analyses showed that smoke inhalation and burn injury induced the expression of HMGB1 and TLR4 and stimulated co-localization of HMGB1 and TLR4 in the lung. Interestingly, MSC treatment reduced the presence of HMGB1, TLR4, and the HMGB1-TLR4 colocalization. These results show that serum HMGB1 is a prognostic biomarker for predicting the incidence of ARDS and mortality in swine with smoke inhalation and burn injury. Therapeutically blocking HMGB1 signal activation might be an effective approach for attenuating ARDS development in combat casualties or civilian patients. [ABSTRACT FROM AUTHOR]

We describe the case of a 13-year-old girl who presented with a new-onset seizure and fever and subsequently developed severe cardiac dysfunction, coronary artery dilation, and shock due to the surprising diagnosis of multisystem inflammatory syndrome in children (MIS-C). Although the clinical entity we now call MIS-C was first mentioned in the medical literature in April 2020, the full picture of this disease process is still evolving. Neurologic involvement has been described in cases with MIS-C; however, seizures are not a typical presenting symptom. Additionally, because children infected with SARS-CoV-2 are often asymptomatic, a documented preceding COVID-19 infection might not be available to raise suspicion of MIS-C early on. Febrile seizures, meningitis, and encephalitis are childhood illnesses that pediatricians are generally familiar with, but associating these clinical pictures with MIS-C is uncommon. Given the possibility of rapid clinical cardiogenic decline, as seen in our patient, a prompt diagnosis and appropriate monitoring and treatment are of utmost importance. This case report aims to raise awareness that new-onset seizures with fevers can be early or the first presenting symptoms in children with MIS-C, and further workup and close monitoring may be required. [ABSTRACT FROM AUTHOR]

In recent years, the discharge of various emerging pollutants, chemicals, and dyes in water and wastewater has represented one of the prominent human problems. Since water pollution is directly related to human health, highly resistant and emerging compounds in aquatic environments will pose many potential risks to the health of all living beings. Therefore, water pollution is a very acute problem that has constantly increased in recent years with the expansion of various industries. Consequently, choosing efficient and innovative wastewater treatment methods to remove contaminants is crucial. Among advanced oxidation processes, electrochemical oxidation (EO) is the most common and effective method for removing persistent pollutants from municipal and industrial wastewater. However, despite the great progress in using EO to treat real wastewater, there are still many gaps. This is due to the lack of comprehensive information on the operating parameters which affect the process and its operating costs. In this paper, among various scientific articles, the impact of operational parameters on the EO performances, a comparison between different electrochemical reactor configurations, and a report on general mechanisms of electrochemical oxidation of organic pollutants have been reported. Moreover, an evaluation of cost analysis and energy consumption requirements have also been discussed. Finally, the combination process between EO and photocatalysis (PC), called photoelectrocatalysis (PEC), has been discussed and reviewed briefly. This article shows that there is a direct relationship between important operating parameters with the amount of costs and the final removal efficiency of emerging pollutants. Optimal operating conditions can be achieved by paying special attention to reactor design, which can lead to higher efficiency and more efficient treatment. The rapid development of EO for removing emerging pollutants from impacted water and its combination with other green methods can result in more efficient approaches to face the pressing water pollution challenge. PEC proved to be a promising pollutants degradation technology, in which renewable energy sources can be adopted as a primer to perform an environmentally friendly water treatment. [ABSTRACT FROM AUTHOR]

Arterial blood oxygen saturation as measured by pulse oximetry (peripheral oxygen saturation (SpO2)) may be differentially less accurate for people with darker skin pigmentation, which could potentially affect the course of coronavirus disease 2019 (COVID-19) treatment. We analyzed pulse oximeter accuracy and its association with COVID-19 treatment outcomes using electronic health record data from Sutter Health, a large, mixed-payer, integrated health-care delivery system in Northern California. We analyzed 2 cohorts: 1) 43,753 non-Hispanic White (NHW) or non-Hispanic Black/African-American (NHB) adults with concurrent arterial blood gas oxygen saturation/SpO2 measurements taken between January 2020 and February 2021; and 2) 8,735 adults who went to a hospital emergency department with COVID-19 between July 2020 and February 2021. Pulse oximetry systematically overestimated blood oxygenation by 1% more in NHB individuals than in NHW individuals. For people with COVID-19, this was associated with lower admission probability (−3.1 percentage points), dexamethasone treatment (−3.1 percentage points), and supplemental oxygen treatment (−4.5 percentage points), as well as increased time to treatment: 37.2 minutes before dexamethasone initiation and 278.5 minutes before initiation of supplemental oxygen. These results call for additional investigation of pulse oximeters and suggest that current guidelines for development, testing, and calibration of these devices should be revisited, investigated, and revised. [ABSTRACT FROM AUTHOR]

Sturge-Weber syndrome (SWS) is a congenital, sporadic, and rare neurocutaneous disorder, characterized by the presence of a facial port-wine birthmark (PWB), glaucoma, and neurological manifestations including leptomeningeal angiomatosis and seizures. It is caused by a postzygotic, somatic, gain-of-function variant of the GNAQ gene, and more recently, the GNA11 gene in association with distinctive clinical features. Neuroimaging can help identify and stratify patients at risk for significant complications allowing closer follow-up; although no presymptomatic treatment has been demonstrated to be effective to date, these patients could benefit from early treatment and/or supportive interventions. Choroid plexus (CP) thickness measurements in brain magnetic resonance imaging (MRI) have a high sensitivity and specificity for early and incipient changes in SWS. In contrast, the absence of pathologic findings makes it possible to rule out associated neurological involvement and leads to periodical observation, with new imaging studies only in cases of new clinical signs/symptoms. Periodic ophthalmological examination is also recommended every 3 months during the first year and yearly afterwards to monitor for glaucoma and choroidal hemangiomas. Treatment for SWS depends on the extent and areas that are affected. These include laser surgery for PWB, anticonvulsants in the case of brain involvement, with either seizures or abnormal EEG, and medical treatment or surgery for glaucoma. Sirolimus has been used in a limited number of patients and appears to be a safe and potentially effective treatment for cutaneous and extra-cutaneous features, however controlled clinical studies have not been carried out. Better knowledge of GNAQ/GNA11 molecular pathways will help to develop future targeted treatments. [ABSTRACT FROM AUTHOR]

Background: The number of aircraft-assisted suicides can only be considered a rough estimate because it is difficult and, at times, impossible to identify all cases of suicide. Methods: Four recent reports of accidents occurring in 1997 in Indonesia, 1999 in Massachusetts in the United States, 2013 in Namibia, and 2015 in France related to commercial aircraft-assisted suicides were analyzed. This analysis relied on data extracted from the accident reports that supported aircraft-assisted suicide from the: (a) cockpit voice recorder (CVR) and flight data recorder (FDR), (b) medical history, (c) psychosocial history, (d) toxicology, (e) autopsy, and (f) any methodology that utilized aviation medicine. There are some limitations in this study. Although all analyzed accident investigations followed ICAO Annex 13 guidelines, there is variability in their accident investigations and reporting. In addition, accident investigation reports represent accidents from 1997 to 2015, and during this time, there has been a change in the way accidents are reported. The nature of this analysis is explorative. The aim was to identify how the various aircraft accident investigators concluded that the accidents were due to suicidal acts. Results: In all four accident reports, FDR data were available. CVR data were also available, except for one accident where CVR data were only partially available. Comprehensive medical and psychosocial histories were available in only one of four of the accident reports. Conclusion: To prevent accidents involving commercial aircraft, it is necessary to identify the causes of these accidents to be able to provide meaningful safety recommendations. A detailed psychological autopsy of pilots can and likely will assist in investigations, as well as generate recommendations that will substantially contribute to mitigating accidents due to pilot suicide. Airborne image recording may be a useful tool to provide additional information about events leading up to a crash and thus assist in accident investigations. [ABSTRACT FROM AUTHOR]

Coronavirus disease (COVID-19) is an emergency pandemic with a high mortality rate worldwide. One of its complications in children is developing multisystemic inflammatory syndrome related to cytokine storm. Anakinra is a recombinant human interleukin-1 (IL-1) receptor antagonist used to suppress the exaggerated inflammatory response in such conditions, and it is potentially lifesaving in a cytokine storm. We present the case of a patient with critical COVID-19 associated with multisystem inflammatory syndrome in children (MIS-C) successfully treated with anakinra intravenous (IV) infusion. [ABSTRACT FROM AUTHOR]

Introduction: Sepsis is a life-threatening complication resulting from a dysregulated host response to a serious infection, of which bacteria are the most common cause. A rapid differentiation of the gram negative (G-)/gram positive (G+) pathogens facilitates antibiotic treatment, which in turn improves patients' survival. Methods: We performed a prospective, observational study of adult patients in intensive care unit (ICU) unit and underwent the analysis of peripheral blood lymphocyte subsets, cytokines and other clinical indexes. The enrolled 94 patients were divided into no infection group (n=28) and bacterial sepsis group (n=66), and the latter group was subdivided into G- (n=46) and G+ (n=20) sepsis subgroups. Results: The best immune biomarker which differentiated the diagnosis of Gsepsis from G+ sepsis, included activation markers of CD69, human leukocyte antigen DR (HLA-DR) on CD3+CD8+T subset. The ratio of CD3+CD4+CD69+T/ CD3+CD8+CD69+T (odds ratio (OR): 0.078(0.012,0.506), P = 0.008), PCT>0.53 ng/ml (OR: 9.31(1.36,63.58), P = 0.023), and CO2CP<26.5 mmol/l (OR: 10.99(1.29, 93.36), P = 0.028) were predictive of G- sepsis (versus G+ sepsis), and the area under the curve (AUC) was 0.947. Additionally, the ratio of CD3+CD4+CD69+T/ CD3+CD8+CD69+T ≤ 0.2697 was an independent risk factor for poor ICU discharge in G- sepsis patients (HR: 0.34 (0.13, 0.88), P=0.026). Conclusion: We conclude that enhanced activation of T cells may regulate the excessive inflammatory response of G- bacterial sepsis, and that T cell activation profiles can rapidly distinguish G- sepsis from G+ sepsis and are associated with ICU discharge. [ABSTRACT FROM AUTHOR]

Background. Although most neonates with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection experience only mild disease, its impact on neurodevelopmental outcomes is unknown. This study aimed to assess the 18-month neurodevelopmental outcomes of infants who had SARS-CoV-2 infection as neonates. Methods. The authors conducted a prospective cohort study of neonates diagnosed with SARS-CoV-2 infection from June 2020 to December 2020 through nasopharyngeal coronavirus disease 2019 (COVID-19). A total of 58 neonates were identified from the Kuwait National COVID-19 Registry and enrolled. Historical controls were selected from the neonatal follow-up registry and matched in a 2 : 1 ratio based on sex and gestational age. When the subjects were 18 months of age, their neurodevelopmental outcomes were assessed by two trained assessors using the Bayley Scales of Infant and Toddler Development-3rd Edition (BSID-III). Results. Forty children diagnosed with SARS-CoV-2 infection were included in the final analysis. The median age at infection was 18 days (range: 10–26 days). Eighteen (45%) patients were asymptomatic, 15 (37.5%) had a sepsis-like presentation, 5 (12.5%) exhibited respiratory distress, and 2 (5%) had a multisystem inflammatory syndrome in children (MIS-C)-like presentation. At the 18 months follow-up, only one child showed a severe developmental delay and one child had a language delay. BSID-III outcomes did not differ significantly between the SARS-CoV-2-infected and control groups. Conclusions There was no difference in neurodevelopmental outcomes at 18 months in children infected with SARS-CoV-2 compared with controls, although longer neurodevelopmental follow-up studies are required. [ABSTRACT FROM AUTHOR]

Background: Work of breathing (WOB) and non-comorbidities factors in the respiratory system are the two probable findings in pediatric COVID-19 patients. However, the association of those factors with level of care was not well reported. Purpose: This study aimed to identify the relation between potential predictors including comorbidity, low nutritional fulfillment, infectious disease, shock, cough, O2 saturation reduction, abnormal blood gas analysis and sore throat with the level of care among pediatric COVID-19 patients. We also analyzed the synergistic correlation of non-comorbidities factors in the respiratory system and work of breathing to predict level of care in pediatric COVID-19 patients. Methods: A cross-sectional study was conducted in the six referral hospitals from July to September 2020 in four provinces in Indonesia. An observation checklist was used to collect data from the medical records of pediatric patients with COVID-19, including medical diagnosis, demographic, and clinical manifestation. This study included 423 participants aged from 0 to 18. The multivariate logistic regression was performed to test the adjusted odds ratios (AORs) with the 95% confidence intervals (CIs) of the association between WOB, non-comorbid respiratory, and level of care. Moreover, dummy variables (2x2) were made to analyze synergistic correlation of non-comorbid respiratory disease and WOB. The AOR with the 95% CIs was applied in the association between the complication of non-comorbid respiratory diseases and high work of breathing with level of care among pediatric patients with COVID-19. Results: Results showed that age, presence of comorbidity, nutritional fulfillment, infectious disease, shock, work of breathing, O2 saturation reduction, abnormal blood gas analysis, sore throat, and convulsive meningeal consciousness were significantly associated with the level of care (p<0.05). Pediatric patients with non-comorbid respiratory and increased work of breathing had a 15.59 times higher risk of requiring PICU care level (p<0.01). Meanwhile, pediatric patients who experienced both non-comorbid respiratory and increased work of breathing had a 5.76 times risk of requiring an intermediate level of care (p<0.05), and 9.32 times higher risk of requiring a PICU level of care (p<.05). Conclusion: It was found that both non-comorbid respiratory and increased WOB had a significant relationship with the level of care for pediatric patients with COVID-19. Nurse should take into account those clinical findings to increase the awareness in monitoring clinical deterioration in pediatric COVID-19 patients. [ABSTRACT FROM AUTHOR]

This paper has reviewed the global research on the pandemic critical care research during the COVID-19 from 2020 to 2022. To this end, a bibliometric and cluster analysis by full counting has been carried out using VOSviewer software and bibliographic data extracted from the Scopus database. The research found and studied 2778 documents. The types of research documents were limited to an article (81.46%), a letter (9.43%), an editorial (3.92%), a note (3.92%), a conference paper (0.90), and a short survey (0.04%). The results show an incessant increase in the number of research documents published and citations received during the COVID-19 pandemic. The U.S., U.K., Italy, and France have been shown to be the most productive countries, and there is a predominance of European institutions supporting and fostering research on pandemic critical care. Cecconi, M. (Italy) and Shankar-Hari, M. (U.K.) produced the highest number of research documents. Mapping of citation, co-citation, co-authorship, and keyword cooccurrence highlighted the hotspot, knowledge structure, and important themes. Citation dynamics for the top-cited research documents revealed static discourse. By reviewing the evolutionary trends of pandemic critical care research investigated factors, such as the influential works, main research topics, and the research frontiers, this paper reveals the scientific literature production's main research objectives and directions that could be addressed and explored in future studies. This paper reveals the scientific literature production's main research objectives and directions that could be addressed and explored in future studies after reviewing the evolutionary trends of pandemic critical care research during the COVID-19 and the investigated factors, such as influential works, main research topics, and research frontiers. [ABSTRACT FROM AUTHOR]

In this case report, we describe a previously healthy eleven-year-old male diagnosed with multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019. The patient presented with shock and neurologic symptoms including altered mental status and dysarthria. Brain magnetic resonance imaging, obtained to rule out thromboembolic injury, demonstrated cytotoxic edema of the corpus callosum, an imaging finding similar in nature to several previous reports of MRI abnormalities in children with MIS-C. Following administration of intravenous immunoglobulin and pulse-dose steroids, the patient convalesced and was discharged home. Medications prescribed upon discharge included a steroid taper, daily aspirin, and proton pump inhibitor. Four days later, he was readmitted with shock and life-threatening gastrointestinal (GI) hemorrhage. After extensive evaluation of potential bleeding sources, angiography revealed active bleeding from two arterial vessels supplying the duodenum. The patient demonstrated no further signs of bleeding following successful coil embolization of the two vessels. We hypothesize that the vasculitic nature of MIS-C combined with anti-inflammatory and antithrombotic therapy placed him at risk of GI hemorrhage. This case highlights unique radiologic features of MIS-C as well as potential complications of treatment. [ABSTRACT FROM AUTHOR]

COVID-19 resulted in a mortality rate of 3–6% caused by SARS-CoV-2 and its variant leading to unprecedented consequences of acute respiratory distress septic shock and multiorgan failure. In such a situation, evaluation, diagnosis, treatment, and care for cancer patients are difficult tasks faced by medical staff. Moreover, patients with gynaecological cancer appear to be more prone to severe infection and mortality from COVID-19 due to immunosuppression by chemotherapy and coexisting medical disorders. To deal with such a circumtances oncologists have been obliged to reconsider the entire diagnostic, treatment, and management approach. This review will provide and discuss the molecular link with gynaecological cancer under COVID-19 infection, providing a novel bilateral relationship between the two infections. Moreover, the authors have provided insights to discuss the pathobiology of COVID-19 in gynaecological cancer and their risks associated with such comorbidity. Furthermore, we have depicted the overall impact of host immunity along with guidelines for the treatment of patients with gynaecological cancer under COVID-19 infection. We have also discussed the feasible scope for the management of COVID-19 and gynaecological cancer. [ABSTRACT FROM AUTHOR]

Objective. Esophageal squamous-cell carcinoma (ESCC) is an aggressive malignant tumor, accounting for more than 90% of esophageal cancers. However, treatments such as surgical resection, radiotherapy, and chemotherapy are unable to achieve ideal clinical outcomes. The purpose of this study was to explore the effects of COQ10B on proliferation, apoptosis, migration, and invasion of esophageal squamous-cell carcinoma (ESCC) cells. Methods. Quantitative real-time PCR (qRT-PCR) was used to detect the expression of COQ10B in ESCC and normal tissues and in ESCC cell lines (KYSE-150 and TE-1). MTT assay and flow cytometry were applied to investigate the effects of COQ10B shRNA lentivirus (LV-shCOQ10B) on ESCC cell proliferation and apoptosis, respectively. The effect of COQ10B silencing on ESCC cell migration and invasion was determined by wound healing assay and transwell invasion assay, respectively. Results. The expression of COQ10B mRNA in ESCC tissues was higher than that in surrounding tissues. The decreased COQ10B level in KYSE-150 and TE-1 cells by LV-shCOQ10B could inhibit cell proliferation, promote cell apoptosis, and reduce the ability of invasion and migration (all P < 0.05). Conclusion. COQ10B was highly expressed in human ESCC tissues. COQ10B silencing contributed to the inhibition of proliferation, invasion, and migration of ESCC cells and the promotion of cell apoptosis, suggesting COQ10B may be a potential molecular target for the diagnosis and treatment of ESCC. [ABSTRACT FROM AUTHOR]

Most reported cases of serotonin syndrome involve either a selective serotonin reuptake inhibitor (SSRI) or monoamine oxidase inhibitors (MAOI) and at least 1 other serotonergic medication or exposure to a single serotonin-augmenting drug. This case report describes serotonin syndrome occurring in association with the concomitant use of the antibiotic linezolid and opioids, specifically methadone, in a pediatric intensive care unit patient. The patient developed hyperpyrexia, muscle rigidity, clonus, and multiorgan dysfunction within 48 hours of receiving linezolid while concurrently on methadone. This drug-drug interaction is a rare cause of serotonin syndrome that has only been described 1 other time in the adult literature. This report raises awareness of this rare but serious and potentially lethal complication of serotonin syndrome associated with concomitant linezolid and opioid use. Timely consideration of the diagnosis in the setting of hyperpyrexia can facilitate prompt initiation of targeted therapies to prevent sequela. [ABSTRACT FROM AUTHOR]

Sturge-Weber syndrome (SWS) type III, a rare neurocutaneous disorder, presents diagnostic challenges due to its variable clinical manifestations. The present study focuses on enhancing the understanding of this syndrome by conducting a detailed analysis of two pediatric cases and providing a comprehensive review of the existing literature. The cases, managed at the Children's Hospital Affiliated to Shandong University (Jinan, China), highlight the diverse clinical presentations and successful management strategies for SWS type III. In the first case, a 4-year-old male patient exhibited paroxysmal hemiplegia, epileptic seizures and cerebral angiographic findings indicative of left pia mater and venous malformation. The second case involved a 2.5-year-old male patient presenting with recurrent seizures and angiographic findings on the right side. Both cases underscore the importance of considering epileptic seizures, acquired and transient hemiplegia and cognitive impairments in the diagnosis of SWS type III. The present study provides insights into the effective use of both pharmacological and surgical interventions, drawing from the positive outcomes observed in these cases. The findings emphasize the need for heightened awareness and a meticulous approach in diagnosing and treating SWS type III, contributing to the better management and prognosis of this condition. [ABSTRACT FROM AUTHOR]

Background. The COVID-19 pandemic marked a health and economic crisis of massive proportions. In its early months, literature was centered on adult medical and critical care. As time progressed, international reports of COVID-19 infection in children steadily grew; however, data on disease features in the United Arab Emirates' pediatric population was noticeably lagging. Method. The presented research was conducted at Latifa Women and Children Hospital Emergency Department to ascertain an association between a child's presenting features and basic investigations to a subsequent positive COVID-19 test result. Data was collected via electronic medical records and statistical analysis performed with SPSS version 22.0. Results. A total of four hundred and five (405) patients were analyzed, with 32 (8%) being COVID-19 positive on initial testing in emergency department. There is a statistically significant correlation (p < 0.05) between testing positive for COVID-19 infection and history of exposure to COVID-19-positive individuals; the presence of runny nose, cough, poor feeding, and abdominal pain with reassuring physical examination findings; and predominantly normal reports of basic blood investigations and chest X-ray images. Conclusion. This research demonstrates that a minority of children tested for COVID-19 in the initial wave of the pandemic tested positive. A significant proportion of COVID-19-positive pediatric patients exhibit history of exposure to COVID-19-positive individuals; the presence of runny nose, cough, poor feeding, and abdominal pain; normal physical examination; normal basic blood investigations and chest X-ray findings. [ABSTRACT FROM AUTHOR]

Major Depressive Disorder (MDD) is a growing disabling condition affecting around 280 million people worldwide. This complex entity is the result of the interplay between biological, psychological, and sociocultural factors, and compelling evidence suggests that MDD can be considered a disease that occurs as a consequence of an evolutionary mismatch and unhealthy lifestyle habits. In this context, diet is one of the core pillars of health, influencing multiple biological processes in the brain and the entire body. It seems that there is a bidirectional relationship between MDD and malnutrition, and depressed individuals often lack certain critical nutrients along with an aberrant dietary pattern. Thus, dietary interventions are one of the most promising tools to explore in the field of MDD, as there are a specific group of nutrients (i.e., omega 3, vitamins, polyphenols, and caffeine), foods (fish, nuts, seeds fruits, vegetables, coffee/tea, and fermented products) or dietary supplements (such as S-adenosylmethionine, acetyl carnitine, creatine, amino acids, etc.), which are being currently studied. Likewise, the entire nutritional context and the dietary pattern seem to be another potential area of study, and some strategies such as the Mediterranean diet have demonstrated some relevant benefits in patients with MDD; although, further efforts are still needed. In the present work, we will explore the state-of-the-art diet in the prevention and clinical support of MDD, focusing on the biological properties of its main nutrients, foods, and dietary patterns and their possible implications for these patients. [ABSTRACT FROM AUTHOR]

Tako-tsubo syndrome is characterized by temporary systolic dysfunction of the left ventricle in the absence of coronary artery disease. Serotonin syndrome is a life-threatening condition associated with increased serotonergic activity in the central nervous system (CNS). We report a case of Tako-tsubo syndrome following seizures secondary to serotonin syndrome. [ABSTRACT FROM AUTHOR]

This paper constructs an algorithm for youth school violence recognition and an occupational therapy education model for victims through the extraction of action speech features. For the characteristics of violent actions and daily actions, action features in time and frequency domains are extracted and action categories are recognized by BP neural network; for complex actions, it is proposed to decompose complex actions into basic actions to improve the recognition rate; then, LDA dimensionality reduction algorithm is introduced for the problem of the high complexity of algorithm due to high dimensionality of features, and the feature dimensionality is reduced to 8 dimensions by LDA dimensionality reduction algorithm, which reduces the system running time by about 51% and improves the accuracy of violent action recognition by 3.3% while ensuring the overall performance of the system. The LDA dimensionality reduction algorithm reduces the number of features to 8 dimensions, which reduces the running time of the system by 51%, increases the accuracy rate of violent action recognition by 3.3%, and increases the recall rate of violent action recognition by 8.86% while ensuring the overall performance of the system. Based on the classical D-S theory, we proposed an improved D-S evidence fusion algorithm by modifying the original evidence model with a new probability distribution function and constructing new fusion rules, which can solve the fusion conflict problem well. The recall rate for violent actions is increased to 90.0%, thus reducing the missed alarm rate of the system. [ABSTRACT FROM AUTHOR]

The article reports that Ms. B, age 44, has posttraumatic stress disorder (PTSD), bipolar disorder, and chronic obstructive pulmonary disease. She presents to the hospital for an outpatient orthopedic appointment. In the hospital cafeteria, she becomes unresponsive, and a code blue is called. Ms. B is admitted to the medicine intensive care unit (MICU), where she is sedated with propofol and intubated.

Introduction: Febrile seizures (FS) are the most common neurological disease in childhood. The etiology of FS is the subject of numerous studies including studies regarding genetic predisposition. Aim: The aim of the study was to analyze the association of TRPV1 rs222747 and KCC2 rs2297201 gene polymorphisms with the occurrence of FS. Materials and Methods: The study included 112 patients diagnosed with FS classified as simple febrile seizures (SFS) or complex febrile seizures (CFS). We analyzed selected polymorphisms of KCC2 and TRPV1 genes using the Real-time PCR method. Results: The CT and TT genotypes of the rs2297201 polymorphism of the KCC2 gene are significantly more common in the group of children with FS than the control group (p =.002) as well as the allele T of this polymorphism (p =.045). Additionally, genotypes CT and TT of the rs2297201 polymorphism of the KCC2 gene were more frequent in the group of children with CFS compared to the control group (p <.001). Different genotypes and alleles of the rs222747 TRPV1 gene polymorphism were not associated with the occurrence of febrile seizures or epilepsy, nor were associated with the occurrence of a particular type of febrile seizure (p =.252). Conclusion: These results indicate that the CT and TT genotypes, as well as the T allele of rs2297201 polymorphism of the KCC2 gene, could be a predisposing factor for the FS, as well as the occurrence of CFS. [ABSTRACT FROM AUTHOR]

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Background. There is limited information available regarding the management of multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2. We performed a systematic review and meta-analysis to evaluate the optimal treatment using IVIG alone versus IVIG plus glucocorticoids. Methods. PubMed, Google Scholar, EMBASE, and Cochrane databases were searched along with other secondary searches. Studies published within the time frame of January 2020 to August 2021 were included. We screened records, extracted data, and assessed the quality of the studies using NOS. Studies that directly compare the two treatment groups were included. Analyses were conducted using the random-effects model (DerSimonian-Laird analysis) if I2 > 50% and fixed-effects model was used if I2 < 50%. Results. We included three studies in the final quantitative analysis. The initial therapy with the IVIG plus glucocorticoids group significantly lowered the risk of treatment failure (OR 0.57, 95% CI (0.42, 0.79), I2 45.36%) and the need for adjunctive immunomodulatory therapy (OR 0.27, 95% CI (0.20, 0.37), I2 0.0%). The combination therapy showed no significant reduction in occurrence of left ventricular dysfunction (OR 0.79, 95% CI (0.34, 1.87), I2 58.44%) and the need for inotropic support (OR 0.83, 95% CI (0.35, 1.99), I2 75.40%). Conclusion. This study supports the use of IVIG with glucocorticoids compared to IVIG alone, as the combination therapy significantly lowered the risk of treatment failure and the need for adjunctive immunomodulatory therapy. [ABSTRACT FROM AUTHOR]

Cytoreg is an ionic therapeutic agent comprising a mixture of hydrochloric, sulfuric, phosphoric, hydrofluoric, oxalic, and citric acids. In diluted form, it has demonstrated efficacy against human cancers in vitro and in vivo. Although Cytoreg is well tolerated in mice, rats, rabbits, and dogs by oral and intravenous administration, its mechanism of action is not documented. The acidic nature of Cytoreg could potentially disrupt the pH and levels of ions and dissolved gases in the blood. Here, we report the effects of the intravenous administration of Cytoreg on the arterial pH, oxygen and carbon dioxide pressures, and bicarbonate, sodium, potassium, and chloride concentrations. Our results demonstrate that Cytoreg does not disturb the normal blood pH, ion levels, or carbon dioxide content, but increases oxygen levels in rats. These data are consistent with the excellent tolerability of intravenous Cytoreg observed in rabbits, and dogs. The study was approved by the Bioethics Committee of the University of the Andes, Venezuela (CEBIOULA) (approval No. 125) on November 3, 2019. [ABSTRACT FROM AUTHOR]