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To evaluate the effects of modafinil on neuropathic pain induced by sciatic nerve cuffing in mice, and possible contribution of nitrergic/inflammatory and serotonergic systems. Neuropathic pain was induced by applying a polyethylene cuff around the left sciatic nerve. Seven days later, mice received modafinil (50, 100, and 200 mg/kg; intraperitoneal [i.p.]) and morphine (10 mg/kg, i.p.) as control. Mice also received pretreatments of the nonselective nitric oxide (NO) synthase (NOS) inhibitor L-NAME, the selective neuronal NOS inhibitor 7-nitroindazole, the selective inducible NOS inhibitor aminoguanidine, and the selective serotonin reuptake inhibitor citalopram before modafinil (100 mg/kg). von Frey test was used to evaluate mechanical allodynia. Additionally, sciatic nerves were collected for histopathological analysis. Tissue levels of NO metabolites, tumor necrosis factor (TNF)-α, and interleukin (IL)-6 were assessed. Animals whose sciatic nerves were cuffed had a significantly (P<0.001) decreased paw withdrawal threshold (PWT) compared with the sham-operated group. Modafinil (100 mg/kg) and morphine significantly reversed PWT (P<0.001). Pretreatments with L-NAME, 7-nitroindazole, aminoguanidine, and citalopram in different groups markedly reversed analgesic effects of modafinil. Tissue homogenates of Cuffed sciatic nerves showed significantly higher levels of NO metabolites, TNF-α and IL-6 (P<0.001). Modafinil lowered NO metabolites, TNF-α, and IL-6 levels (P<0.001). Histopathology illustrated marked axonal degeneration and shrinkage in the cuffed sciatic nerve, which were improved in the modafinil-treated group. Modafinil exerts analgesic and neuroprotective effects in cuff-induced neuropathic mice via possible involvement of the nitrergic/inflammatory and serotonergic systems. [ABSTRACT FROM AUTHOR]

Purpose: Computed tomography (CT) scan is a commonly used tool for the diagnosis of the novel coronavirus disease 2019 (COVID-19), similarly to reverse transcription-polymerase chain reaction (RT-PCR). Because of the limitations of RT-PCR, there is growing interest in the usability of the CT scan. The present systematic review and meta-analysis aims to summarize the available data on the CT scan features of COVID-19. Material and methods: We conducted a systematic search in electronic databases to find eligible studies published between 1 December 2019 and 4 April 2020, which investigated the computed tomographic features of patients with COVID-19. All preprint and peer-reviewed articles were included. No language limitation was applied. For proportional data, pooled prevalence was calculated using a Freeman-Tukey double arcsine transformation, with a 95% confidence interval (CI). Results: Eighty-six studies were eligible to be included in the meta-analysis. For 7956 patients, the most common CT findings were bilateral pattern of involvement (78%; 95% CI: 0.73-0.82; p < 0.001), involvement of more than 1 lobe (75%; 95% CI: 0.68-0.82; p < 0.001), ground-glass opacities (GGO) (73%; 95% CI: 0.67-0.78; p < 0.001), and peripheral distribution of signs (69%; 95% CI: 0.61-0.76; p < 0.001). Only 5% of patients had a normal CT scan (95% CI: 0.03-0.07; p < 0.001). The proportion of paediatric patients (age < 18 years) with unremarkable CT findings was higher (40%; 95% CI: 0.27-0.55; p < 0.001). Subgroup analysis showed that patients with the severe or critical type of COVID-19 were more likely to have pleural effusion (RR 7.77; 95% CI: 3.97-15.18; p < 0.001) and consolidation (RR 3.13; 95% CI: 1.57-6.23; p < 0.001). CT results in patients with COVID-19 were comparable with those of people having pneumonia from other causes, except for the lower incidence of consolidation (RR 0.81; 95% CI: 0.71-0.91; p < 0.001) and higher risk of showing GGO (RR 1.45; 95% CI: 1.13-1.86; p < 0.001). The mortality rate was slightly higher in patients with bilateral involvement (RR 3.19; 95% CI: 1.07-9.49; p = 0.04). Conclusions: Our study results show that COVID-19 shares some features with other viral types of pneumonia, despite some differences. They commonly present as GGO along with vascular thickening, air bronchogram and consolidations. Normal CT images, lymphadenopathies, and pleural effusions are not common. Consolidations and pleural effusions correlate with more severe disease. CT features are different between COVID-19 and non-COVID-19 pneumonia. Also, they differ by age, disease severity, and outcomes within COVID-19 patients. [ABSTRACT FROM AUTHOR]