Toward the integration of biosimilars into pediatric rheumatology: adalimumab ABP 501 experience of PeRA research group.

Optimization of hydrolysis conditions of lignocellulosic biomass is crucial to able to produce value-added products by fermentation. This study not only determines optimal dilute sulfuric acid (H2SO4) hydrolysis conditions of wheat bran (WB) and rye bran (RB) by using one-factor-at-a-time method and subsequently Box-Behnken design but also elucidates chemical composition of hydrolysates yielded under optimal hydrolysis conditions. Based on the results, optimal hydrolysis conditions of WB and RB were 121 and 130 degrees C of temperature, 1/8 and 1/8 w/v of solid to liquid ratio, 2.66 and 1.58% v/v of dilute H2SO4 ratio, and 30 and 16 min of implementation time, respectively. Hydrolysates obtained from WB and RB at these conditions contained 72.7 (0.58 g sugar/g biomass) and 89.4 g/L (0.72 g sugar/g biomass) of reducing sugar concentration, respectively. Hydrolysis rates of WB and RB were 87.79 and 91.33%, respectively. Main reducing sugar in RB hydrolysate was glucose with 31.17 g/L (0.25 g glucose/g biomass) while glucose and xylose were the main monosaccharides with 20.90 (0.17 g glucose/g biomass) and 18.69 g/L (0.15 g xylose/g biomass) in WB hydrolysate, respectively. With acidic hydrolysis of WB and RB, inhibitors such as phenolics, 5-Hydroxymethylfurfural, 2-Furaldehyde (not for RB), acetic acid, and formic acid (not for WB) formed. Catalytic efficiency values of H2SO4 for WB and RB were 15.2 and 24.4 g /g, respectively, indicating that inhibitor concentration in WB hydrolysate was higher than that of RB. These results indicated that WB and RB have a high potential in production of value-added products by fermentation

Kliniğimizde 1996-2019 yılları arasında takip edilen atopik dermatitli olguların epidemiyolojik yönden değerlendirilmesi: Retrospektif, kesitsel, gözlemsel bir çalışmanın ön bulguları

GİRİŞ VE AMAÇ: Atopik dermatit (AD), özellikle Avrupa ve Amerika’da sıklığı giderek artan, şiddetli kaşıntılı, inflamatuar bir deri hastalığıdır. Ülkemizde görülme sıklığı, şiddeti ve seyrine ait veriler sınırlıdır. Bu çalışmada, AD olgularının epidemiyolojik özelliklerinin geniş bir hasta grubunda belirlenmesi ve ülke verilerine katkıda bulunulması amaçlanmıştır.YÖNTEM: Kliniğimizde 1996-2019 yıllarında, hasta dosyalarında kontrol listesi şeklinde yer alan Hanifin & Rajka (H&R) kriterlerine göre AD tanısı alan olguların epidemiyolojik verileri SPSS programına kaydedilerek retrospektif olarak incelendi.BULGULAR:Devam eden çalışmamızın ön bulguları 362 hastanın (174 erkek, 188 kadın; E:K=1:1.1) verilerini kapsıyordu. Olguların 52’si bebek (<2 yaş), 205’i çocuk/adölesan (2-18 yaş), 105’i erişkindi (>18 yaş). Hastalık süresi 1-480 aydı (ortanca:36 ay). Başlangıç yaşı olguların %43,1’inde <2 yaş, %30,4’ünde 2-10 yaş, %11’inde 10-18 yaş, %15,5’inde >18 yaş idi (erişkin başlangıçlı AD). Başlangıç lezyonu ilk 2 yaşta en sık klasik simetrik yanak ekzeması iken bu yaş grubunun %15,4’ünde fleksural ekzema şeklinde başlangıç dikkat çekiciydi. Fleksural ekzema 2 yaş üzerinde her yaş grubunda en sık görülen başlangıç lezyonuydu (2-10 yaşta %60,5 ve >10 yaşta %54,7). El ekzemasının 10 yaş üzerinde, periorbital ekzemanın ise ilk 10 yaşta daha sık olmak üzere her yaş grubunda başlangıç lezyonu olabildiği görüldü. Olguların çoğunda (n=230, %63,6) klasik morfolojide ekzema izlenirken ilk 10 yaşta numüler, seboreik patern ve friksiyonel likenoid dermatit, 10 yaş üzerinde ise papüler, foliküler patern ve Besnier prurigosu daha sık olmak üzere atipik morfolojide lezyonlar gözlendi. Numüler ve seboreik patern erişkinlerde de nadir değildi.SCORAD değerlerine göre olguların %68’inde (n=246) hafif, %26,8’inde (n=97) orta, %5,2’sinde (n=19) şiddetli AD vardı. Hafif ve orta şiddette AD’de bile gece uykudan uyandıran kaşıntı varlığı (%16,3) ve kısa remisyon süresi (%26,8) dikkat çekiciydi. Şiddetli AD 10 yaş üzerinde anlamlı derecede daha sıktı (p<0,05). İki erişkin hastada eritrodermi gözlendi. Hastalık şiddeti ile cinsiyet arasında anlamlı bir ilişki yoktu. Olguların %31,3’ünde mukozal atopi eşlik ediyordu ve çoğunlukla (%66,2) AD’den sonra başlamıştı. Deri alerji testleri yapılan olgularda yumurta/süt gibi gıda alerjisi (13/123), nikel kontakt duyarlanması (8/36) ve ev tozu akarları ile atopi yama testi pozitifliği (13/29) görüldü. Serum total IgE hastaların %50’sinde yüksekti (>150 kU/L). Sistemik tedavi (kortikosteroid, siklosporin)/fototerapi uygulanması gereken 24 hasta (%6,6) olmuştu. Hastaların %45,3’ünde (n=164) 4 majör H&R kriteri pozitifti. 23 minör kriterden 3-17’si pozitif (ortanca:7) olup en sık kseroz (%85,9), terlemeyle artan kaşıntı (%72,9), yün/tekstil geçimsizliği (%45,6), ön boyun kıvrımı (%44,8) ve Dennie-Morgan çizgisi (%34,3) görüldü. Beyaz dermografizm oranı %10,8 idi. İki yaş üzerinde daha belirgin olmak üzere olguların %22,4’ünde, İngiltere Çalışma Grubu kriterlerinin H&R kriterleriyle uyum göstermediği ve tanı koymada yetersiz kaldığı belirlendi. İki yaş altında ortalama minör kriter sıklığı daha düşüktü ve iki tanı kriteri arasında güçlü bir uyum vardı (%84,6). SONUÇ: Çalışmamızın ön bulguları, erişkin başlangıçlı AD olgularının nadir olmadığını, fleksural ekzemanın bebeklikte de başlayabildiğini, AD’nin numüler/seboreik/foliküler /papüler paternlerle de seyredebildiğini, 2 yaş altında H&R kriterlerinin daha az sayıda olabildiğini, İngiltere Çalışma Grubu kriterlerinin 2 yaş üzerinde tanı için yetersiz kaldığını, şiddetli ve sistemik tedavi gerektiren AD olgularının azlığını, buna rağmen hafif ve orta şiddette AD’de bile uykudan uyandıran kaşıntı ve kısa remisyon süresinin hastaların yaşam kalitesini bozabilecek unsurlar olduğunu göstermektedir

Inflammatory comorbidities ın the largest pediatric Familial Mediterranean fever cohort: a multicenter retrospective study of Pediatric Rheumatology Academy (PeRA)-Research Group (RG)

Aim: The aim of this study was to investigate the frequency and type of FMF-associated inflammatory diseases in a large FMF pediatric patients and to compare them to those FMF patients without concomitant inflammatory diseases. Materials and methods: Familial Mediterranean fever patients enrolled in the Pediatric Rheumatology Academy (PeRA)-Research Group (RG) were included. The patients were divided into two groups according to concomitant inflammatory disease as FMF patients who had a concomitant inflammatory disease (group 1) and FMF patients who did not have a concomitant inflammatory disease (group 1). The clinical findings and treatments were compared between the two groups. Results: The study group comprised 3475 patients with FMF. There were 294 patients (8.5%) in group 1 and 3181 patients (91.5%) in group 2. Juvenile idiopathic arthritis (n = 136) was the most common accompanying inflammatory disease. Arthritis, M694V homozygosity, and the need for biological therapy were more frequently observed in Group 1 (p < 0.05). Fever and abdominal pain were more frequently detected in Group 2 (p < 0.05). FMF patients with concomitant inflammatory diseas more frequently demonstrated colchicine resistance. There were no significant differences in the median attack frequency, chest pain, amyloidosis, erysipelas-like erythema, or family history of FMF between the two patient groups. Conclusion: To the best of our knowledge, this is the largest pediatric cohort reviewed to date. FMF patients may have different clinical profiles and colchicine responses if they have with concomitant inflammatory diseases. Key points • FMF is associated with some inflammatory comorbidities diseases. • To the best of our knowledge, this is the largest cohort evlauated pediatric FMF associated inflammatory comorbidities diseases reviewed to dat

The Impact of CoronaVac Vaccination on 28-day Mortality Rate of Critically Ill Patients with COVID-19 in Türkiye

Background:Vaccines against coronavirus disease-19 (COVID-19) have been effective in preventing symptomatic diseases, hospitalizations, and intensive care unit (ICU) admissions. However, data regarding the effectiveness of COVID-19 vaccines in reducing mortality among critically ill patients with COVID-19 remains unclear.Aims:To determine the vaccination status and investigate the impact of the COVID-19 vaccine on the 28-day mortality in critically ill patients with COVID-19.Study Design:Multicenter prospective observational clinical study.Methods:This study was conducted in 60 hospitals with ICUs managing critically ill patients with COVID-19. Patients aged ≥ 18 years with confirmed COVID-19 who were admitted to the ICU were included. The present study had two phases. The first phase was designed as a one-day point prevalence study, and demographic and clinical findings were evaluated. In the second phase, the 28-day mortality was evaluated.Results:As of August 11, 2021, 921 patients were enrolled in the study. The mean age of the patients was 65.42 ± 16.74 years, and 48.6% (n = 448) were female. Among the critically ill patients with COVID-19, 52.6% (n = 484) were unvaccinated, 7.7% (n = 71) were incompletely vaccinated, and 39.8% (n = 366) were fully vaccinated. A subgroup analysis of 817 patients who were unvaccinated (n = 484) or who had received two doses of the CoronaVac vaccine (n = 333) was performed. The 28-day mortality rate was 56.8% (n = 275) and 57.4% (n = 191) in the unvaccinated and two-dose CoronaVac groups, respectively. The 28-day mortality was associated with age, hypertension, the number of comorbidities, type of respiratory support, and APACHE II and sequential organ failure assessment scores (p < 0.05). The odds ratio for the 28-day mortality among those who had received two doses of CoronaVac was 0.591 (95% confidence interval: 0.413-0.848) (p = 0.004).Conclusion:Vaccination with at least two doses of CoronaVac within six months significantly decreased mortality in vaccinated patients than in unvaccinated patients

Education of healthcare personnel working with pediatric patients during covid-19 pandemic within the framework of infection control Covid-19 pandemisinde enfeksiyon kontrol çalışmaları çerçevesinde çocuk hastalarla çalışan sağlık personeli eğitimi

© 2020, AVES. All rights reserved.Objective: In the early stages of any epidemic caused by new emerging pathogens healthcare personnel is subject to a great risk. Pandemic caused by SARS-CoV-2, proved to be no exception. Many healthcare workers died in the early stages of pandemic due to inadequate precautions and insufficient protection. It is essential to protect and maintain the safety of healthcare personnel for the confinement of pandemic as well as continuity of qualified healthcare services which is already under strain. Educating healthcare personnel on appropiate use of personal protective equipment (PPE) is as essential as procuring them. Material and Methods: A survey is conducted on 4927 healthcare personnel working solely with pediatric patients from 32 different centers. Education given on PPE usage were questioned and analyzed depending on age, sex, occupation and region. Results: Among four thousand nine hundred twelve healthcare personnel from 32 different centers 91% (n= 4457) received education on PPE usage. Of those who received education only 36% was given both theoretical and applied education. Although there was no differences among different occupation groups, receiving education depended on regions. Conclusion: It is essential to educate healthcare personnel appropiately nationwidely for the continuity of qualified healthcare services during the pandemic

SARS-CoV-2 seropositivity among pediatric health care personnel just after the first peak of pandemic: A nationwide surveillance.

BACKGROUND: COVID-19 pandemic affected every single person on earth one way or the other. The healthcare personnel were no exception, their responsibilities as well as their risks being immense. METHODS: 4927 healthcare personnel all working in pediatric units at 32 hospitals from seven different regions of Turkey enrolled to the study to determine the seroprevalence of SARS Co-V-2 after the first peak wave. Point of care serologic lateral flow rapid test kit for IgM/IgG was used (Ecotest CE Assure Tech. Co. Ltd.). Seroprevalence and its association with demographic characteristics and possible risk factors were analyzed. RESULTS: Nearly 6.1% of healthcare personnel were found to be seropositive for SARS Co-V- 2. Seropositivity was more common among those who did not universally wear protective masks (10.6% vs 6.1%). Having a COVID-19 co-worker increased the likelihood of infection. The least and the most experienced personnel affected more. Most of the seropositive healthcare personnel (68%) did not have any suspicion that they had COVID-19 previously. CONCLUSIONS: Health surveillance for healthcare personnel involving routine point-of-care nucleic acid testing as well as monitoring PPE adherence would be important strategies to protect healthcare personnel from COVID-19 and to reduce nosocomial SARS-CoV-2 transmission