Interferon Beta-1b Level in Parkinson’s Disease: Before and After SARS-CoV-2 Vaccination

Background: Parkinson’s disease (PD) is a neurodegenerative disease. Immune response varies after vaccination in different patients. We aimed to evaluate interferon beta-1b (IFNβ-1b) level in patients with PD in response to inactivated SARS-CoV-2 (CoronaVac) vaccination.Methods: Eight patients with the diagnosis of idiopathic PD and followed in the outpatient clinic (stages 1-2) were enrolled. Total blood count was performed before vaccination. IFNβ-1b levels were measured by ELISA and motor examination was performed before and two hours after vaccination.Results: IFNβ-1b levels increased in three patients, whereas no change was detected in one patient and the levels decreased in four patients. Divergent responses were found related to the time of diagnosis.Conclusion: The time of PD diagnosis, as well as the age of the patients, may be responsible for the variability of the post-vaccine immune response

Direct Inhibition of Renin

From the beginning of the history of renin angiotensin system (RAS) with the renal extracts in 1898 it still continues to be exciting. After angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARBs), direct renin inhibitors (DRI) recently entered the RAS arena. With the increasing evidence, RAS inhibition is an important treatment strategy in hypertension. Results of ongoing and future clinical trials with specific populations and focusing on protection of end-organ damage will enrich our knowledge and understanding on direct renin inhibition

TWO DIFFERENT PATIENTS WITH SAME GENETIC MAKE-UP: RISPERIDONE INTOXICATION IN MONOZYGOTIC TWINS - CASE REPORT

Intoxication among children is frequently observed among patients visiting pediatric emergency clinics. Inappropriately taken dosages of frequently used drugs which have adverse effects are among remarkably frequent reasons of these visits. In this case report the focus is on 7-year-old monozygotic twins with no previous health problems, who came to the pediatric emergency clinic with a dystonic contraction complaint starting simultaneously in both of them

RENIN INHIBITORS IN DIABETES AND HYPERTENSION: AN UPDATE

The coexistence of hypertension and diabetes increases the incidence of cardiovascular events and long-term morbidity and mortality. Blood pressure should be controlled with the most appropriate drugs as well as tight blood glucose control in patients with diabetes and hypertension. RAAS (Renin Angiotensin Aldosterone System) blockers have an important role in the treatment of these patients, in this sense, ACEi and ARB remained the major treatment option in hypertension guidelines. The most recent RAAS blocker to be approved by the FDA was aliskiren in 2007, a renin inhibitor. Studies showed that aliskiren is as effective as other antihypertensive drugs and has a safety profile similar to placebo. The potent renin inhibitor aliskiren directly inhibits the RAAS system at its rate limiting step and differently from other RAAS blockers; it decreases plasma renin activity (PRA). Although the relationship of increased PRA levels and cardiovascular risk has been shown, it is unclear if the PRA decrease provided by aliskiren has an impact on clinical outcomes and cardiovascular endpoints. On the other hand, large trials like ASPIRE, AVANT-GARDE, ALTITUDE, ASTRONAUT, which investigated the combination of aliskiren with other RAAS blockers, failed to show the expected outcomes or resulted with an increased incidence of adverse effects, which raised more questions. As a result of the ALTITUDE trial, combination of aliskiren with an ACEi or ARB is not recommended in patients with hypertension and diabetes, or at least moderate renal dysfunction. Trials designed to prove aliskiren's efficacy in new indications like diabetes, may face similar problems related to dual RAAS blockade because in the majority of cases, the optimal treatment is achieved with an ACEi or ARB. In this conjuncture, the increase in adverse events seen with aliskiren might be related to dual RAAS blockade rather than aliskiren directly. For instance, it is unclear whether the adverse event incidence would be the same, less, or higher if ALTITUDE was designed to investigate ACEi and ARB combination without aliskiren. In fact, every new molecular entity and mechanism of action faces the same barriers. For the time being, differentiating points like PRA lowering effects as an add-on therapy to calcium channel blockers or hydrochlorothiazide, and the populations that might have additional benefit, should be carefully investigated

Effect of metformin on the human T98G glioblastoma multiforme cell line

Metformin is a guanidine derivative found in Galega officinalis that is commonly used to treat diabetes mellitus. The mechanism of action of metformin involves regulation of the adenosine monophosphate-activated protein kinase/mammalian target of rapamycin signaling pathway, which is implicated in the control of protein synthesis and cell proliferation. This led to the hypothesis that metformin reduces the risk of cancer and slows tumor growth. Thus, in the present study, the effectiveness of metformin as an antiglioma agent was evaluated using the human T98G glioblastoma multiforme cell line. The viability of the T98G cells was assessed using a 3-(4,5-dimethylthiazol-2-yL)-2,5-diphenyltetrazolium bromide assay. Apoptosis was monitored by measuring caspase-3 levels, as well as by terminal deoxynucleotidyl transferase dUTP nick end labeling and staining with acridine orange and ethidium bromide. The results demonstrate that metformin reduced cell viability and caused apoptotic morphological changes in the T98G cells. Furthermore, the caspase-3 levels in the metformin-treated T98G cells were higher than those in the control cells. Metformin induced apoptosis in the T98G cell line in a concentration-dependent manner. Metformin may provide an important contribution to the treatment of glioblastoma multiforme

Rational drug use for acute bronchiolitis in emergency care

Despite the large variety of inhaled treatment options of acute bronchiolitis, there is no generally agreed treatment regime. This study aimed to determine the most appropriate treatment option. This was a double-blind randomized prospective clinical trial and has been performed in emergency department. The mean age of the 378 infants included in the study was 7.63 +/- 4.6 months, and 54.8% (207) were boys. Patients were randomized by using the lottery method for simple random sample into 5 different treatment options; 3% hypertonic saline, nebulized adrenaline, nebulized adrenaline mixed with 3% hypertonic saline, nebulized salbutamol, and as control group; normal saline (0.9% NaCl). From the first treatment time until discharge time; treatment durations, adverse events and readmission rates within the first fifteen days were recorded for each patient. Nebulized adrenaline mixed with 3% hypertonic saline, as compared with other options, were associated with a significantly higher discharge rate at 4th hours (p<0.001) and shorter length of hospital stay (p=0.039). However, there was no significant difference between options with regard to adverse events, discharge rates at 24th hours, and readmission rates within the first fifteen days. The superiority of discharge rates at 4 hours of nebulized adrenaline mixed with 3% hypertonic saline, was evaluated as 'better acute response' and can be helpful to reduce hospitalization needs. Additionally, this option seems to be more effective to reduce length of hospital stay

Rational drug use for acute bronchiolitis in emergency care

Despite the large variety of inhaled treatment options of acute bronchiolitis, there is no generally agreed treatment regime. This study aimed to determine the most appropriate treatment option. This was a double-blind randomized prospective clinical trial and has been performed in emergency department. The mean age of the 378 infants included in the study was 7.63 +/- 4.6 months, and 54.8% (207) were boys. Patients were randomized by using the lottery method for simple random sample into 5 different treatment options; 3% hypertonic saline, nebulized adrenaline, nebulized adrenaline mixed with 3% hypertonic saline, nebulized salbutamol, and as control group; normal saline (0.9% NaCl). From the first treatment time until discharge time; treatment durations, adverse events and readmission rates within the first fifteen days were recorded for each patient. Nebulized adrenaline mixed with 3% hypertonic saline, as compared with other options, were associated with a significantly higher discharge rate at 4th hours (p<0.001) and shorter length of hospital stay (p=0.039). However, there was no significant difference between options with regard to adverse events, discharge rates at 24th hours, and readmission rates within the first fifteen days. The superiority of discharge rates at 4 hours of nebulized adrenaline mixed with 3% hypertonic saline, was evaluated as 'better acute response' and can be helpful to reduce hospitalization needs. Additionally, this option seems to be more effective to reduce length of hospital stay

The expression of CD44, CD90 and CD133 in response to cisplatin in hepatocellular cancer cells

Introduction. Cancer is a leading cause of mortality. Hepatocellular cancer is one of the malignancies associated with poor outcome and resistance to pharmacotherapy. Cancer stem cells (CSCs) contribute to resistance to therapy and hence lead to the treatment failure of tumors. Aim. This study aims to explore the expression of CSCs in response to cisplatin treatment in HepG2 hepatocellular cancer cell line. Material and methods. Cell proliferation test, CCK-8, was used to evaluate the cell proliferation following cisplatin treatment for 72 hours. The expressions of CSC markers CD44, CD90, and CD133 were assessed by flow cytometric analysis. Results. The results showed a dose-dependent decrease in cell proliferation and increased expression of CSC markers CD44 and CD90 in response to cisplatin. Conclusion. Understanding the roles of CSC markers may point to new targets and therapeutic strategies to predict and overcome cisplatin resistance

EVALUATING THE RELATIONSHIP OF BLOOD PRESSURE, PLASMA ANGIOTENSIN PEPTIDES AND ALDOSTERONE WITH COGNITIVE FUNCTIONS IN PATIENTS WITH HYPERTENSION

Renin Angiotensin Aldosterone System (RAAS) plays an important role in the development of hypertension. On the other hand, hypertension is a well-known and independent risk factor for cognitive impairment. The aim of the present study was to evaluate the relationship of blood pressure control, plasma angiotensin peptides and aldosterone with cognitive functions. Forty-one patients who were under treatment with the same antihypertensive medications for at least three months were included in the study. Plasma angiotensin II, angiotensin 1-7, angiotensin IV, and aldosterone concentrations were analyzed using an enzyme-linked immunosorbent assay (ELISA). Standardized Mini Mental State Examination (SMMSE) was used to evaluate cognitive functions. When the participants were grouped according to their SMMSE scores (cut-off value: 26 points), we determined significant differences between systolic blood pressure (SBP) levels, diastolic blood pressure levels, plasma angiotensin II and angiotensin 1-7 concentrations of the groups. When the participants were stratified according to their SBP levels (cut-off value: 140 mm Hg), we found significant differences in SMMSE scores and plasma angiotensin IV concentrations of the groups. A negative correlation between SBP and SMMSE scores and strong linear correlations among angiotensin peptides levels were determined. The relationship found between SBP and SMMSE in the present study was compatible with the literature. Our 33 patients were using at least one angiotensin II receptor blocker (ARB). Regarding AT1 receptor blockage, the significant association between higher SMMSE scores and increased angiotensin peptides may support a finding that ARBs prevent dementia and improve cognitive function. Further larger studies are needed to confirm and prove the relation of RAAS biochemical parameters with cognitive function

Effect of Breast Milk Calcium and Fluidity on Breast Cancer Cells: An In Vitro Cell Culture Study

Aim: The aims of this study were to investigate the effects of calcium at the same concentration as that found in human milk on the viability, proliferation, and adhesion of MCF-7 human breast ductal carcinoma cells by exposing them to calcium at the same frequency as in breastfeeding